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‘Smart bandages’ could improve outcomes for patients with non-healing wounds

Pioneering new technology could help patients with non-healing wounds avoid infections and the need for antibiotics, scientists say.

Wirelessly powered, environmentally friendly “smart bandages” have been developed by a team of scientists from the UK and France, with the University of Glasgow and the University of Southampton leading the research.

The bandage could help improve the quality of life for people with chronic non-healing wounds as a result of conditions such as cancer, diabetes or damaged blood vessels, they said.

Currently, wounds require painful cleaning and treatment.

Researchers believe the technology could help to slow the rise of dangerous new strains of antibiotic resistant bacteria known as superbugs.

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Source: The Independent, 30 May 2023

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Inadequate maternity unit handed safety warning

An NHS maternity department has been handed a warning notice by the health regulator because of safety failings.

The Care Quality Commission (CQC) said it was taking the action over the James Paget Hospital in Norfolk to prevent patients coming to harm.

Inspectors found the unit did not have enough staff to care for women and babies and keep them safe.

The maternity department has been deemed "inadequate" by the CQC, which meant the overall rating for the hospital has now dropped from "good" to "requires improvement".

Between June and November 2022 there were 30 maternity "red flags" that the inspectors found, of which more than half related to delays or cancellations to time-critical activity.

In one instance, there was a delay in recognising a serious health problem and taking the appropriate action.

The report also highlighted the service did not have enough maternity staff with the right qualifications, skills, training and experience "to keep women safe from avoidable harm and to provide the right care and treatment".

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Source: BBC News, 31 May 2023

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Complaints to Australian medical regulator about telehealth rise by 413% over three years

Complaints to the national medical practitioner regulator arising from telehealth appointments have increased by 413% in three years, a significant number of these relating to prescriptions.

The data provided to Guardian Australia by the Medical Board of Australia comes as the body prepares to release new guidelines for health practitioners and companies that provide telehealth consultations with patients.

Guardian Australia understands the guidelines, to be made public by Friday, will state that real-time video or phone consults are “preferred” over real-time text-based consults such as online chat because identification is harder to establish without video.

The guidelines will not ban real-time text-based consults but they will mean online quizzes, for example, can not be used to diagnose and prescribe medications to patients.

“Prescribing or providing healthcare for a patient with whom you have never consulted, whether face-to-face, via video or telephone is not good practice and is not supported by the board,” the draft guidelines state.

“This includes requests for medication communicated by text, email or online that do not take place in real-time and are based on the patient completing a health questionnaire but where the practitioner has never spoken with the patient.”

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Source: The Guardian, 20 May 2023

 

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'Appalling' gynaecology waiting times in NI under rapid review

Waiting times for gynaecology services in Northern Ireland are so bad that an independent and rapid review is taking place, BBC News NI has learned.

It is being conducted by the Getting it Right First Time (GIRFT) programme which helps improve the quality of care within the NHS.

A GIRFT team spent a week this month visiting all five health and social care trusts.

In October 2022, 36,900 women in NI were on a gynaecology waiting list. A report from the Royal College of Obstetricians and Gynaecologists said that figure was a 42% increase since the start of the Covid-19 pandemic and that Northern Ireland had the longest gynaecological waiting lists in the UK.

While waiting lists show that some women are waiting about 110 weeks to see a consultant gynaecologist for the first time, consultants have told BBC News NI that the reality is women depending on their medical issue are waiting much longer.

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Source: 31 May 2023

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NHSE expands overseas recruitment drive

NHS England has expanded its drive to increase overseas recruitment, introducing funding for trusts to hire more types of health professionals from abroad.

Employers are now able to use national NHS England funding to recruit physiotherapists, therapeutic radiographers and operating department practitioners from overseas.

Until now, within allied health professionals, the scheme has only covered diagnostic radiographers, occupational therapists and podiatrists. None of the professions are on the government’s shortage occupation list.

NHSE said it decided to expand the AHP scheme to more staff groups where it had decided there were NHS shortages, and others where it had identified there was global availability of staff. For example, it said other groups such as prosthetics professionals still could not be recruited from abroad as there is limited international supply. 

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Source: HSJ, 30 May 2023

 

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Royal College of Midwives warns maternity strategy is urgently needed in Northern Ireland

The Royal College of Midwives says the need for a maternity strategy in Northern Ireland has gone beyond urgent and is now critical.

The warning comes as the RCM is publishing a report on Northern Ireland's maternity services at Stormont on Tuesday.

The report will highlight growing challenges as more women across the country with additional health needs are being cared for by maternity services.

The RCM report will outline three steps to deliver high quality and safe services for women and families.

  • Develop, publish and fund the implementation of a new maternity and neonatal strategy for Northern Ireland.
  • Sustain the number of places for new student midwives at their recent, higher level.
  • Focus on retaining the midwives in the HSC.

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Source: ITV News, 30 May 2023

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NI patients suing GPs over hospital waiting time targets

Northern Ireland GPs are being hit with bills of thousands of pounds as they are sued by patients coming to harm on hospital waiting lists.

Family doctors are being taken to court by their patients as a result of spiralling hospital waiting lists — even though GPs are not responsible for the crisis.

It comes as official figures show 14% of the population — around one in seven — had been waiting longer than a year for an outpatient or inpatient appointment at the end of March.

The growing risk to patient safety, as the health service struggles to cope with demand, and the potential for primary care doctors to be held accountable have been blamed as reasons for the rising number of GPs who are handing back their contracts.

Sixteen GP surgeries in Northern Ireland have handed back contracts in recent months, bringing the key NHS service closer to collapse.

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Source: Belfast Telegraph, 30 May 2023

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CQC case reveals ‘degrading’ conditions in England care home as Covid hit

The depth of suffering in care homes in England as Covid hit has been laid bare in a court case exposing “degrading” treatment with residents being “catastrophically let down”.

Care levels at the Temple Court care home in Kettering collapsed so badly in April 2020, when ministers rushed to free up NHS capacity by discharging thousands of people, that residents were left lying in their own faeces, dehydrated, malnourished and suffering necrotic, infected wounds, the Care Quality Commission found. Fifteen of its residents died with Covid in the first weeks of the pandemic.

The case foreshadows the UK Covid-19 public inquiry module on the care sector, which next year will test Matt Hancock’s claim to have thrown “a protective ring around social care”.

The prosecution resulted in a £120,000 fine handed down at Northampton magistrates court last week. The operator, Amicura, apologised but said it had been “acting in the national interest and supporting the NHS by accepting patients discharged from hospitals into care homes under government policy”.

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Source: The Guardian, 29 May 2023

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Primodos: Pregnancy test damages claims thrown out by judge

Claims for damages by more than 170 people who say they were affected by hormone-based pregnancy test drugs have been thrown out by a High Court judge.

The drugs, including Primodos, were given to women to test if they were pregnant from the 1950s to 1970s and alleged to have caused birth defects.

But the judge ruled there was no new evidence linking the tests with foetal harm and "no real prospect of success".

Campaigners say they are "profoundly disappointed" with the judgement.

Legal action had been brought against three drug companies - Bayer Pharma, Schering Health Care, Aventis Pharma - as well as the government in a bid for compensation. However, they argued there was no evidence of a "causal association" between the hormone pregnancy tests and the harm suffered by the claimants.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said she was "profoundly disappointed" with the judgement.

"We do not accept the defendants' claim that our evidence did not provide sufficient scientific evidence and look forward to the additional scientific evidence, to support our original argument, which is due to be published shortly," she added.

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Source: BBC News, 28 May 2023

Further reading on the hub:

Patient Safety Spotlight interview with Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests

 

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East Kent: A decade of failure in maternity care

After health inspectors considered closing a maternity unit over safety fears, the BBC's Michael Buchanan looks at a near-decade of poor care at East Kent Hospitals NHS Trust.

"I've been telling you for months. The place is getting worse."

The message in February, which Michael received from a member of the maternity team, was stark but unsurprising. In a series of texts over the previous few months, the person had been getting increasingly concerned about what was happening at the East Kent trust.

The leadership is "totally ineffective" read one message. "How long do we have to keep hearing this narrative - we accept bad things happened, we have learned and are putting it right. Nothing changes."

Friday's report from the Care Quality Commission (CQC) is unfortunately just the latest marker in a near-decade of failure to improve maternity care at the trust. The revelation that inspectors considered closing the unit at the William Harvey Hospital in Ashford comes nine years after the trust's head of midwifery made a similar recommendation for the same reasons - that it was a danger to women and babies. The failure to act decisively then allowed many poor practices to continue.

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Source: BBC News, 28 May 2023

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NHS England workforce plan delayed amid rumours of cost issues

NHS leaders have raised concerns about the delay to the long-awaited workforce plan, after the health secretary, Steve Barclay, refused to give a deadline for its publication and with rumours suggesting it is considered too costly.

The plan, which was expected to be published on Tuesday, appears to have been delayed, according to the deputy chief executive of NHS Providers, Saffron Cordery.

Barclay blamed the pandemic and “various things that have been happening in recent years” for the delay during broadcast interviews over the weekend. He had previously promised that the plan to increase the number of doctors and nurses would be published before the next general election.

Cordery said the plan, which aims to fix the UK’s crumbling healthcare system by plugging chronic staff shortages but which has already been postponed from last year, was needed “as quickly as possible”.

Until this weekend NHS Providers – which represents all England’s hospital, ambulance, community and mental health trusts – had believed publication of the plan was “imminent”. Cordery suggested that the failure to release it could be linked to the need for funding.

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Source: The Guardian, 29 May 2023

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Metropolitan Police: Move to attend fewer mental health calls sparks alarm

The Met Police's plan to stop attending emergency mental health incidents is "potentially alarming", a former inspector of constabulary has said.

From September, officers will only attend mental health 999 calls where there is an "immediate threat to life".

The Met argues the move will free up officers after a significant rise in the number of mental health incidents being dealt with by the force in the past five years.

Metropolitan Police Commissioner Sir Mark Rowley wrote to health and social care services in Greater London to inform them of the plan last week.

In the letter, which has been seen by the BBC, Sir Mark said it takes almost 23 hours on average from the point at which someone is detained under the Mental Health Act until they are handed into medical care.

He writes that his officers are spending more than 10,000 hours a month on "what is principally a health matter", adding that police and other social services are "collectively failing patients" by not ensuring they receive appropriate help, as well as failing Londoners more generally because of the effect on police resources.

However Zoe Billingham, who is now chair of the Norfolk and Suffolk NHS mental health trust after 12 years as Her Majesty's Inspector of Constabulary and Fire and Rescue, warned mental health services are "creaking" and "in some places are so subdued with demand they are not able to meet the requirements of people who need it most".

Speaking to BBC Radio 4's Today programme, she warned there is "simply no other agency to call" other than the police for people in crisis, adding: "There isn't another agency to step in and fill the vacuum."

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Source: BBC News, 29 May 2023

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Evidence supports health guidelines for Down Syndrome

One of the first studies to examine the full lifespan of people living with Down syndrome (DS) has provided evidence in support of health guidelines specifically for people with the condition.

Life expectancy for people with DS had increased dramatically over the last 80 years or so, yet people with the condition still died at an earlier age than people in the general population or those with other intellectual disabilities, said the authors of a new study, published in The Lancet. This meant that there was an "opportunity to improve health outcomes for this minority", they said.

There continued to be disparities in surveillance, diagnosis, and treatment of common health conditions in people with intellectual disabilities, including those with DS, highlighted the authors, with ongoing premature mortality and excess morbidity identified in these groups.

In April 2022, the Down Syndrome Act was introduced in England, which stipulated that the Government must provide information to the NHS and local councils on how to provide the most appropriate care and support for people with DS.

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Source: Medscape, 26 May 2023

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GPs urged to trial experimental drugs on patients

Lord O’Shaughnessy has carried out a widespread review of clinical trials in Britain and found it is falling behind in medical research.

He has suggested a raft of reforms, which include financial incentives for GPs who carry out community drugs and treatments trials on their patients at local surgeries or in their own homes.

Patients who receive genomic testing on the NHS should also be automatically asked to consent to their genetic data being used for research, the report recommends.

The Medicines and Healthcare products Regulatory Agency (MHRA) has been told to cut red tape and speed up approvals for medicines. It has also been asked to approve clinical trials within 60 days of submission.

Writing in The Telegraph, Will Quince, Minister of State for Health and Secondary Care, said: “Cutting the time it takes for new medicines to reach patients is vital and has a direct impact on how patients recover faster or better manage conditions.

“We want to make it easier for more people to be a part of life-changing research and giving the option to take part in trials virtually will improve the scope of who wants to, or can take part.

“From cancer to obesity, these research studies can lead to billions of pounds in savings for the NHS and cut waiting lists through faster diagnosis and enhanced treatment.”

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Source: The Telegraph, 26 May 2023

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Child died at mental health hospital ‘while staff were meant to be watching her’

A 14-year-old girl who should have been under constant supervision at a mental health hospital died after a member of staff on his first shift left her unattended, an inquest has heard.

Ruth Szymankiewicz died at Taplow Manor Hospital in Maidenhead on 12 February 2022 after a care worker responsible for her one-to-one supervision “sporadically” left his post, the hearing was told.

It also emerged at the hearing that the care worker, who is now abroad, was allegedly using a fake name. Detectives are investigating him as part of a fraud investigation although he has not yet been interviewed by police.

After Ruth’s death, the Care Quality Commission launched a criminal investigation. In an update to the coroner, it said that the investigation was looking at whether the provider had “brought about avoidable harm or exposure to risk” in relation to the young girl’s death.

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Source: The Independent, 26 May 2023

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Trust top team was ‘least cohesive I’ve ever joined’, says new CEO

A review into how a reporting error came about has uncovered tension among an ambulance trust’s previous senior leaders, including that its new CEO felt it was ‘the least cohesive team I have ever joined’.

Management consultancy Verita was commissioned by London Ambulance Service Trust to carry out a review of how it came to be misreporting category 1 (the most serious) response times.

The report, published in board papers on Thursday, said it was caused by a contractor’s programming error going unnoticed and concluded it was “impossible to typify the events of August 2020 as other than an avoidable failure of governance and process”. 

Daniel Elkeles, who joined the trust as CEO in August 2021, told the review that when he joined the senior team it was “the least cohesive team I have ever joined” and said the organisation was not “psychologically safe” for those who wanted to speak up.

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Source: HSJ, 26 May 2023

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Closing baby unit considered over safety concerns

Health inspectors considered shutting down a maternity unit earlier this year over safety concerns.

The Care Quality Commission (CQC) instead called for "immediate improvements" following a visit to the William Harvey hospital in Ashford, Kent.

Helen Gittos, whose newborn daughter died in the care of the East Kent Hospitals Trust, said there were "fundamental" problems at the trust.

The inspection of East Kent's William Harvey hospital laid bare multiple instances of inadequate practices at the unit, including staff failing to wash their hands after each patient, and life-saving equipment not being in the right place.

Days after the visit, the watchdog raised safety concerns and threatened the trust with enforcement action to ensure patients are protected.

Ms Gittos, whose baby Harriet was born at the East Kent trust's Queen Elizabeth the Queen Mother Hospital (QEQM) in 2014 and died eight days later, said: "When my daughter Harriet was born, the then head of midwifery was so concerned about safety that she thought that the William Harvey in particular should be closed down."

She told BBC Radio 4's Today programme: "Here we are, almost nine years later, in a similar kind of situation. What has been happening has not worked.

"I keep being surprised at how possible it is to keep being shocked about all of this, but I am shocked, that under so much scrutiny, and with so much external help, it's still the case that so much is not right.

"The problems that are revealed are so fundamental that we have to do things differently."

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Source: BBC News, 26 May 2023

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MHRA and Genomics England to launch pioneering resource to better understand how genetic makeup influences the safety of medicines

A brand-new genetic research resource, known as a ‘biobank’, will be piloted by the Medicines and Healthcare products Regulatory Agency (MHRA) in a joint venture with Genomics England to better understand how a patient’s genetic makeup can impact the safety of their medicines.

The Yellow Card biobank, which will contain genetic data and patient samples, will operate alongside the MHRA’s Yellow Card reporting site for suspected side effects and adverse incidents involving medicines and medical devices. It forms part of a long-term vision for more personalised medicine approaches, as scientists will use the repository of genetic information in the biobank to determine whether a side effect from a medicine was caused by a specific genetic trait. This will in turn enable doctors to target prescriptions using rapid screening tests, so patients across the UK will receive the safest medication for them, based on their genetic makeup.

Adverse Drug Reactions (ADRs), or side effects, continue to be a significant burden on the NHS and account for one in 16 hospital admissions. Understanding the underlying mechanism of an adverse reaction would support the development of pharmacogenetic testing strategies, such as the screening tests enabled through the information provided by the Yellow Card biobank. These strategies would in turn provide the opportunity to prevent rather than react to adverse drug reactions.

The biobank pilot will officially begin on 1 June 2023 with participant recruitment commencing later this year, on 1 September.

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Source: MHRA, 25 May 2023

 

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Shop around on NHS app to shorten wait for treatment

Patients are being urged to shop around on the NHS app and website to cut their waiting time for treatment in England.

IT systems have been updated to allow patients to more easily exercise their right to choose where they go for planned care, such as knee operations.

They will now be able to view up to five providers - filtered by distance, waiting times and quality of care.

But hospitals warned staffing shortages still needed to be tackled to make the biggest impact on waits.

The idea of choosing where to go for treatment has been in place since the early 2000s, but few use it.

Currently only1 in 10 exercises their right to choose, with patients reporting they are not always offered a choice of where to go or that it is hard to select different venues.

Ministers believe that by searching the list of different hospitals, patients will be able to reduce their waits - potentially by up to three months, research suggests.

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Source: BBC News, 25 May 2023

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Government pledge to build 40 ‘new’ England hospitals likely to be delayed until after 2030

The health secretary is set to signal a major delay to one of the headline promises in the last Conservative manifesto by suggesting the delivery of 40 new hospitals in England is likely to be pushed back until after 2030.

In a move that will spark anger among MPs who wanted “spades in the ground” before the next election, government sources said Steve Barclay would make the announcement today.

The pledge to build and fund “40 new hospitals over the next 10 years” was one of the major headlines of Boris Johnson’s pitch to the electorate in 2019.

Sources indicated the government had been ready to make the announcement about the probable delay for some time, but it was repeatedly pushed back because of fears about a backlash from Tory MPs.

Rundown NHS hospitals have become a danger to patients, warn health chiefs

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Source: The Guardian, 25 May 2023

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More hospital beds ‘squeezing out rehab and keeping people out of work’

Extra beds squeezed into hospitals as part of winter planning are crowding out space for rehab, pushing up length of stay and knock-on costs, and increasing the chance of readmission, NHS leaders have been warned. 

Systems and trusts were encouraged to staff thousands of additional ward beds in the run-up to last winter to try to ease emergency care pressures, and government and NHS England have since asked for many of them to be kept open through the year.

However, many of the additional beds are not in proper ward spaces, instead being located in gyms and other areas used for physiotherapy and other rehab. This followed on from some rehab areas already being lost during the pandemic, to be used for beds or storage.

NHSE has sent out a warning about the issue, following a commitment by ministers earlier this year. However, senior figures in physio and older people’s care remain concerned the spaces will not be restored without checks and enforcement, especially as acute trusts remain under pressure to increase general bed space.

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‘Over a year behind’ on key maternity target, NHSE admits

Pregnant women and new mothers are facing wide variation in access to mental health support, new figures suggest, as NHS England admits national performance on a key long-term plan goal to expand services is ‘over a year behind trajectory’.

Analysis of access rates for perinatal mental health services from NHS Digital shows the rates of women accessing support within the past 12 months range from 3.7 per cent in Humber and North Yorkshire to 15 per cent in Shropshire, Telford and Wrekin ICS.

The long-term plan target is for 66,000 women per year to be accessing specialist perinatal services, which can help with conditions such as post-partum psychosis, by March 2024. NHSE admitted in its papers that “although access is increasing, performance remains over a year behind trajectory”.

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Source: HSJ, 25 May 2023

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Young mental health patients 'at risk' in child wards

A safety investigation has warned that young people with complex mental health needs are being put at significant risk, by being placed on general children's wards in England.

The findings come from the Healthcare Safety Investigation Branch (HSIB).

BBC News recently highlighted the plight of a 16-year-old autistic girl, who spent several months in a children's ward.

Other families have since contacted the BBC describing similar situations.

The majority had faced similar difficulties getting appropriate support.

HSIB says that paediatric wards are designed to care for patients who only have physical health needs and not for those with mental health needs.

It describes the situation in 18 hospitals it visited as "challenging", and 13 were described as "not safe" for children who were suicidal or at risk of harming themselves to be on their paediatric wards.

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Source: BBC News, 25 May 2023

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Top doctor questions need for change at gender clinic

A doctor with a key role in reforming a controversial gender identity clinic for children has been recorded questioning the need for change.

Prof Gary Butler, clinical lead for the children's gender clinic in England and Wales, also appeared to accuse the author of a report, which will underpin the new service, of "nepotism".

He was recorded making the comments in a keynote speech at a major conference.

The Gender Identity Development Service (Gids), based at London's Tavistock and Portman NHS Foundation Trust, was rated as "inadequate" by inspectors, who visited in late 2020. It was earmarked for closure in July 2022.

An independent review, led by Dr Hilary Cass, also called for a "fundamentally different" model of care for children with gender dysphoria.

Prof Butler has been awarded a key role in shaping the new service, as one of several people tasked with implementing a new training programme, underpinned by Dr Cass's recommendations.

However, BBC Newsnight has learned Prof Butler has publicly questioned the need for change and described Dr Cass's recommendations as "slightly unusual".

In the 14-minute speech at the conference, he talked about current services across the UK, the legal challenges to the situation in England, and how he felt Gids has been the subject of "lies" in the media.

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Source: BBC News, 24 May 2023

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Northern Ireland: No shows to health appointments costing thousands

Patients who fail to turn up for surgical day case procedures are costing the health service thousands of pounds.

It is a problem across Northern Ireland's five health trusts.

Over a 10-month period in the South Eastern area 14,000 patients did not attend or cancelled review appointments on the day they were due to turn up.

Assistant Director of Elective Surgery at the South Eastern Trust Christine Allam said it was "frustrating".

The South Eastern trust review showed between April 2022 and January 2023, 7,755 people did not attend or cancelled new outpatient appointments on the day.

During the same period, 14,003 or 10% of patients didn't show for review appointments.

Ms Allam said the situation was "frustrating for those patients who are waiting to be seen".

"Those slots where people don't turn up are lost capacity because we haven't been given notice - and this only lengthens the waiting lists," she added.

It is a problem that all health trusts are experiencing.

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Source: BBC News, 24 May 2023

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