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Assaults, neglect and a Taser revealed in ‘deeply shocking’ BBC care home investigation

A company which ran children's homes where residents were systemically abused also failed to prevent adults being harmed, BBC News has learned.

An investigation found 99 cases of abuse at a Doncaster home for vulnerable adults in 2010. One worker even ordered a Taser to use there.

The care home company - Hesley - said improvements were made at the time. But children at other Hesley homes were later reported to have been punched, kicked and fed chillies.

The BBC reported in January how more than 100 reports of appalling abuse and neglect - dating from 2018 to 2021 - were uncovered at sites run by the Hesley Group. They included children being locked outside in freezing temperatures while naked, and having vinegar poured on wounds.

Now the BBC has obtained confidential reports from within Hesley and the local authority which reveal wider safeguarding failings spanning more than a decade at both children's homes and placements for vulnerable young adults.

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Source: BBC News, 14 April 2023

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‘Buckling’ NHS fails to treat 250,000 children with mental health problems

A quarter of a million children in the UK with mental health problems have been denied help by the NHS as it struggles to manage surging case loads against a backdrop of a crisis in child mental health.

Some NHS trusts are failing to offer treatment to 60% of those referred by GPs, the research based on freedom of information request responses has found.

The research carried out by the House magazine and shared with the Guardian also revealed a postcode lottery, with spending per child four times higher in some parts of the country than others, while average waits for a first appointment vary by trust from 10 days to three years.

Olly Parker, head of external affairs at YoungMinds, said the freedom of information findings showed a “system is in total shutdown” with “no clear government plan to rescue it”, after the 10-year mental health plan was scrapped.

“In the meantime, young people are self-harming and attempting suicide as they wait months and even years for help after being referred by doctors,” he said. “This is not children saying ‘I’m unhappy.’ They are ill, they are desperate and they need urgent help.”

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Source: The Guardian, 16 April 2023

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Deaths rise as junior doctors go on strike

Junior doctors have been accused of putting “politics above patient safety” as figures showed excess deaths almost tripled after their strikes.

Office of National Statistics (ONS) figures showed the number of deaths above average increased significantly in the two weeks during and after the first round of industrial action by the British Medical Association (BMA).

Junior doctors walked out for 72 hours between March 13 and 15, with more than 175,000 appointments and operations cancelled. Health experts said the walkout around that time could be linked to the rise.

A government source said: “The militant leaders of the BMA junior doctors committee seem willing to put politics above patient safety. They have adopted increasingly hardline tactics whilst demanding a completely unrealistic 35 per cent pay rise. 

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Source: The Telegraph, 13 April 2023

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I was in so much pain I’d faint — yet doctors ignored me for decades

“You’re just unlucky,” the doctor told me. Whichever GP I saw, wherever I was, male or female, I would be asked the same questions. Do you drink alcohol? Are you sexually active? Is your underwear too tight? If I heard another woman being relentlessly quizzed like that today, I’d probably call it victim blaming."

"... when you’re told, over and over, that it’s just bad luck and that some women suffer more than others, you believe it. You put your trust in the professionals. You don’t advocate for yourself because you don’t understand that there’s anything that needs fighting for."

Claire Cohen, 39, had spent much of her life since her mid-teens in acute pain, begging for help. Now she’s finally been diagnosed with endometriosis, she looks at how medicine is still failing to treat a condition that can have a devastating effect on one in ten women

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Source: The Times, 13 April 2023

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Thousands receive diagnosis after 60 new diseases found

Thousands of children with severe developmental disorders have finally been given a diagnosis, in a study that found 60 new diseases.

Children, and their parents, had their genetic code - or DNA - analysed in the search for answers to their condition.

There are thousands of different genetic disorders. Having a diagnosis can lead to better care, help parents to decide whether to have more children, or simply provide an explanation for what is happening.

The Deciphering Developmental Disorders study, conducted over 10 years in the UK and Ireland, was a collaboration between the NHS, universities and the Sanger Institute, which specialises in analysing DNA.

Among the findings, researchers discovered Turnpenny-Fry syndrome.

Jessica Fisher's son, Mungo - who took part in the study - was diagnosed with the syndrome.

Jessica subsequently started an online support group for the syndrome, which is now made up of 36 families from around the world, including America, Brazil, Croatia and Indonesia.

"It's devastating to learn that your child has a rare genetic disorder, but getting the diagnosis has been key to bringing us together," said Jessica.

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Source: BBC News, 13 April 2023

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One in 10 A&E patients waits 12hrs, long-hidden data reveals

Around 10 per cent of the 1.2 million accident and emergency attendees in February waited 12 hours or more, newly published NHS England data has revealed, laying bare the true extent of the NHS’s emergency care crisis.

The data – which NHSE has collected for years but has only now started to publish – shows 125,505 patients waited 12 hours or more from their arrival at A&E to be admitted, transferred or discharged.

This is more than double the highest figure under the existing metric of around 55,000, which only starts the clock from when the patient has received a decision to admit.

NHSE’s decision to publish the data for 12-hour breaches from time of arrival follows a concerted campaign by the Royal College of Emergency Medicine, which has long raised concerns the measure from decision to admit has significantly masked the true extent of long waits in A&E.

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Source: HSJ, 13 April 2023

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UK in ‘rapidly escalating’ diabetes crisis as cases top 5m, report says

The UK is experiencing a “rapidly escalating” diabetes crisis, with cases topping five million for the first time and under-40s increasingly affected, a report has revealed.

About 90% of diabetes patients have type 2, a condition much more likely to develop if people are overweight. About two-thirds of adults in the UK are overweight or obese.

Statistics published by Diabetes UK reveals an all-time high for type 2 and type 1 combined of 4.3m officially diagnosed cases and another 850,000 people living with one or other of the conditions but still to be diagnosed. Another 2.4 million people are at high risk of developing the type 2 form in the UK.

“These latest figures show we’re in the grip of a rapidly escalating diabetes crisis, with spiralling numbers of people now living with type 2 diabetes and millions at high risk of developing the condition,” said Chris Askew, the chief executive of Diabetes UK.

“These latest figures show we’re in the grip of a rapidly escalating diabetes crisis, with spiralling numbers of people now living with type 2 diabetes and millions at high risk of developing the condition,” said Chris Askew, the chief executive of Diabetes UK.

The stark figures mean millions of Britons are at increased risk of complications including heart attacks, kidney failure, stroke, amputation and blindness.

As a result, the UK faces a public health emergency unless action is taken, Askew said. “Diabetes is serious, and every diagnosis is life-changing. It’s a relentless condition, and the fear of serious complications is a lifelong reality for millions of people across the UK.

“But it doesn’t have to be this way. With the right care and support, cases of type 2 diabetes can be prevented or put into remission. What we need to see is the will, grit and determination from government and local health leaders to halt this crisis in its tracks and improve the future health of our nation for generations to come.”

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Source: The Guardian, 13 April 2023

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Ghana first to approve 'world-changer' malaria vaccine

Ghana is the first country to approve a new malaria vaccine that has been described as a "world-changer" by the scientists who developed it.

The vaccine - called R21 - appears to be hugely effective, in stark contrast to previous ventures in the same field.

Ghana's drug regulators have assessed the final trial data on the vaccine's safety and effectiveness, which is not yet public, and have decided to use it.

The World Health Organization is also considering approving the vaccine.

Malaria kills about 620,000 people each year, most of them young children.

It has been a massive, century-long, scientific undertaking to develop a vaccine that protects the body from the malaria parasite.

But widespread use of the vaccine hinges on the results of a larger trial involving nearly 5,000 children.

These had been expected to take place at the end of last year, but have still not been formally published. However, they have been shared with some government bodies in Africa, and scientists.

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Source: BBC News, 13 April 2023

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Pharmacies on ‘brink of collapse’ in England

England’s pharmacies are on the brink of collapse – struggling with a shortage of staff and medical supplies – combined with increased patient demand and soaring costs, according to an industry survey shared exclusively with this programme.

Staff say that some patients are so frustrated by the supply problems, they’re getting aggressive.

The Pharmaceutical Services Negotiating Committee, the industry body which carried out the survey, says the Government and NHS need to step in now, before it’s too late.

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Source: Channel 4 News, 12 April 2023

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Medic blames NHS Highland 'dysfunction' for doctor exodus

A top doctor has blamed a "dysfunctional" culture at NHS Highland for a crisis in medical recruitment and retention engulfing its rural hospitals.

Dr Gordon Caldwell, a consultant physician who was the clinical lead at Lorn and Islands hospital in Oban until he resigned last summer, said there "still seems to be a lot of fear" among staff more than four years on from a bullying scandal that cost the health board nearly £3 million in settlements.

Dr Caldwell - who joined NHS Highland in 2018 - said an exodus of senior consultants from Oban and Fort William over the past 18 months is down to management "undermining us, bullying us, and blaming us for problems that were due to a lack of leadership".

The 66-year-old, who is internationally regarded for his expertise in medical education, became so concerned about the impact on junior doctor training in Oban that he whistleblew to NHS Education for Scotland (NES) while on sick leave for stress after finding his own internal complaints rebuffed.

A resulting inspection report, published in May last year, said NES had "serious concerns about the training environment" at Lorn and Islands hospital, including around the "safety of care".

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Source: The Herald, 1 April 2023

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A&E staff in England struggling to spot abuse cases in infants, says watchdog

Staff in hospital emergency departments in England are struggling to spot when infants are being physically abused by their parents, raising the risk of further harm, an investigation has found.

Clinicians often do not know what to do if they are concerned that a child’s injuries are not accidental because there is no guidance, according to a report from the Healthcare Safety Investigation Branch (HSIB) that identifies several barriers to child safeguarding in emergency departments.

Matt Mansbridge, a national investigator, said the report drew on case studies of three children who were abused by their parents, which he said were a “hard read” and a “stark reminder” of the importance of diagnosing non-accidental injuries quickly, since these are the warning sign in nearly a third of child protection cases for infants under the age of one.

“For staff, these situations are fraught with complexity and exacerbated by the extreme pressure currently felt in emergency departments across the country,” Mansbridge said. He said the clinicians interviewed wanted to “see improvement and feel empowered” to ask difficult questions.

“The evidence from our investigation echoes what staff and national leads told us – that emergency department staff should have access to all the relevant information about the child, their history and their level of risk, and that safeguarding support needs to be consistent and timely/ Gaps in information and long waits for advice will only create further barriers to care,” he said.

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Source: The Guardian, 13 April 2023

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Covid: Staff propped up care homes without extra pay, says report

Many care home staff worked extra hours without extra pay to prop up the system during the pandemic, a study suggests.

Public money helped stabilise UK care homes during the first wave of Covid-19 but it was withdrawn too soon and not focused on staff, says the research, led by Warwick Business School.

The researchers studied the accounts of more than 4,000 UK care home companies, from just before the pandemic and during the first year of the health crisis.

They found nearly two thirds (60%) of care homes were already financially fragile as the pandemic took hold.

The report concludes: "The decision by government to end financial support for care home companies after the peak of the pandemic had passed has likely contributed to the current financial and operational difficulties experienced by the sector."

It states the financial plight of many staff and the immense pressure they were under "means it is not surprising the care home sector has struggled to both recruit and retain staff once lockdown restrictions were removed and the wider economy re-opened".

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Source: BBC News, 12 April 2023

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Over two million patients have to visit GP four times for referral

More than two million patients each year have to make four or more repeat visits to their GP before they get a referral, a patient watchdog has warned.

Patient safety campaigners said people faced waits of “weeks, months or even years” before officially joining NHS waiting lists, and that their health and wellbeing was suffering as a result. They warned it would also add to pressure on other services such as A&E departments.

Research by Healthwatch England revealed what the patient watchdog called a “hidden waiting list”.

“People wait for a GP appointment; they wait for their GP to tell them they will be referred; they wait for the hospital to confirm that referral; and then they join a hospital waiting list,” it said.

“NHS statistics monitor only the hospital waiting list, leaving the steps between getting a GP referral and a letter confirming a hospital appointment as a dangerous ‘blind spot’ for the NHS and patients.”

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Source: The Times, 11 April 2023

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Covid no longer the leading cause of death in England and Wales

Covid-19 has dropped out of the top five leading causes of death in England and Wales for the first time since the start of the pandemic, figures show.

Coronavirus was recorded as the main cause of death for 22,454 people in 2022, or 3.9% of all deaths registered, making it the sixth leading cause overall.

In both 2020 and 2021 Covid-19 was the leading cause of death, with 73,766 deaths (12.1% of the total) and 67,350 (11.5%) respectively.

By contrast, dementia and Alzheimer’s disease was the leading cause in England and Wales in 2022, with 65,967 deaths registered (11.4% of the total), up from 61,250 (10.4%) in 2021.

The other causes in the top five were ischaemic heart diseases (59,356 deaths and 10.3% of the total); chronic lower respiratory diseases (29,815 deaths, 5.2%); cerebrovascular diseases such as strokes and aneurysms (29,274 deaths, 5.1%); and trachea, bronchus and lung cancer (28,571 deaths, 5.0%).

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Source: The Independent, 11 April 2023

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Junior doctors’ strike: hospitals ‘worried about overnight patient safety’

Hospital bosses are worried about keeping patients safe overnight this week because of a shortage of consultants available to cover for striking junior doctors.

When junior doctors in England staged their first strike in mid-March in their pay dispute with the government, their consultant colleagues covered for them for the three days involved.

However, fewer consultants are available to do the same during this week’s four-day stoppage because it coincides with Easter, Passover and Ramadan and many are off.

NHS Providers, which represents health service trusts, highlighted the difficulty hospital bosses are facing in trying to ensure nightshift medical rotas are fully staffed this week. T

“Getting through today is just the start. Trust leaders are worried about securing adequate cover for the night shifts ahead. This is going to be a very long, difficult week for the NHS,” said Miriam Deakin, the head of policy at NHS Providers. “Keeping patients as safe as possible, trusts’ No 1 priority, will be even harder than in previous strikes so it’s all hands on deck.”

Other health professionals, including GPs, paramedics and pharmacists, were helping hospitals ensure patients received good care, Deakin added.

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Source: The Guardian, 11 April 2023

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NHS drop-out rate an accident waiting to happen, says surgeon

A leading surgeon says a major drop-out rate of trainee doctors is "an accident waiting to happen" for the NHS.

Nigel Mercer was tasked with prioritising surgery across the NHS during the pandemic when services were under intense pressure.

His biggest fear with what he sees as an up to 40% drop-out rate is whether there will be enough doctors to replace his generation of medics.

The government said the majority of trainees go on to work in the NHS.

"[But] at the moment everyone is so fed up with the system," Mr Mercer said

Concerns over pay and conditions are leading many trainees to consider moving to other countries, he said.

"You can get much more pay over in Australia and New Zealand and we reckon it's now 40% of medical graduates who are going to leave after their training and that's criminal," he continued.

"That's an accident waiting to happen, but if we don't produce high-quality paramedical staff there won't be the ability to train anybody.

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Source: BBC News, 12 April 2023

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Tory ‘neglect’ blamed for 3.6m abandoned calls to NHS 111 in England

Patients contacting NHS 111 in England are having to wait so long for medical help that they are abandoning millions of calls, with 3.6m ditched in the past 12 months, official figures reveal.

The national helpline service is supposed to make it quicker and easier for patients to get the right advice or treatment they need, either for their physical or mental health. It is billed as being open 24 hours a day, seven days a week.

However, analysis by the House of Commons Library, commissioned by the Liberal Democrats, shows callers are waiting so long to speak to someone that nearly one in five give up. In 2022, 3,682,516 calls to NHS 111 were abandoned.

MPs said the “dire” figures exposed how the NHS had reached “breaking point” after years of “neglect and underfunding” by the government.

The data suggests that, on average, more than 10,000 callers hang up every day without receiving medical advice or treatment.

As well as being distressing for those who are unwell, abandoned NHS 111 calls pose a risk to patient safety. The problem also increases pressure on other urgent care services as people seek care elsewhere.

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Source: The Guardian, 10 April 2023

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USA: For uninsured people with cancer, access to care can be "very random"

Eighteen months after April Adcox learned she had skin cancer, she finally returned to Charleston's Medical University of South Carolina last May to seek treatment.

Adcox had first met with physicians at the academic medical center in late 2020, after a biopsy diagnosed basal cell carcinoma. The operation to remove the cancer would require several physicians, she was told, including a neurosurgeon, because of how close it was to her brain.

But Adcox was uninsured. She had lost her automotive plant job in the early days of the pandemic, and at the time of her diagnosis was equally panicked about the complex surgery and the prospect of a hefty bill. Instead of proceeding with treatment, she attempted to camouflage the expanding cancerous area for more than a year with hats and long bangs.

If Adcox had developed breast or cervical cancer, she likely would have qualified for insurance coverage under a federal law that extends Medicaid eligibility to lower-income patients diagnosed with those two malignancies. For female patients with other types of cancer, as well as pretty much all male patients, the options are scant, especially in South Carolina and the 11 other states that haven't yet implemented Medicaid expansion, according to cancer physicians and health policy experts who study access to care.

In the face of potentially daunting bills, uninsured adults sometimes delay care, which can result in worse survival outcomes, research shows. The odds of patients getting insurance to help cover the cost of treatment play out a bit like a game of roulette, depending upon where they live and what type of cancer they have.

"It is very random — that's, I think, the heartbreaking part about it," said Dr. Evan Graboyes, a head and neck surgeon and one of Adcox's physicians. "Whether you live or die from cancer shouldn't really be related to what state you live in."

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Source: CBS News, 7 April 2023

 

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Third scan could greatly reduce UK breech birth numbers, study suggests

Giving women a third scan at the end of their pregnancy could dramatically reduce the number of unexpected breech births and the risk of babies being born with severe health problems, research suggests.

Pregnant women in the UK have routine scans at 12 and 20 weeks only, with no further scan offered in the third trimester unless they are considered at risk of a complicated pregnancy. The researchers hope their findings could lead to a change in guidance for clinicians that will improve maternity care.

Prof Asma Khalil, who led the study at St George’s, University of London, said: “For the first time we’ve shown that just one extra scan could save mothers-to-be from trauma, an emergency C-section, and their babies from having severe health complications which could otherwise have been prevented.”

She said the two routine scans were “far too early” to establish how the baby would be positioned during labour. “That’s why a third scan at 36-37 weeks could be a gamechanger to pregnancy and birth care.”

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Source: The Guardian, 7 April 2023

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Trust CEOs’ strike warning: ‘If anyone gets sick, we’re stuffed’

The leaders of acute trusts across England have told HSJ the second junior doctor’s strike ‘feels very different’ from the first stoppage, and services are much more vulnerable because of ‘thinner’ consultant coverage.

They also reported that the instruction from NHS England not to proactively cancel elective procedures and apppointments has been largely ignored by trusts.

The chief executive of a large trust in the east of England said they were “more concerned about clinical safety than at any time during covid surges”.

A trust CEO in the North West told HSJ this week’s stoppage “feels much more risky than the previous strike. We have managed to cover rotas but we are very stretched and concerned about short notice cancellation from agencies and short term sickness after bank holiday.”

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Source: HSJ, 11 April 2023

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Sexual assault, crude banter — what it’s like to be a female surgeon

Mehdian-Staffell, 37, is part of a new generation of female surgeons who are challenging the male-dominated culture in the profession.

It is clear that she loves her job. “My aim is not just to be a surgeon – it is to be a damn good one. I didn’t go into it to be average,” she says. But she is also exhausted and demoralised. “The sexism comes from patients as well as other members of staff. People will assume you’re a nurse. I’ve previously worked in departments where the guys all went off to golf and men were prioritised for opportunities over women. Sometimes, as female surgeons, we feel as if we have to work twice as hard.”

She says many of her more recent male colleagues have been supportive, but there is a systemic problem. Even the surgical instruments are made for male hands. Traditionally, surgeons are known as “Mr” rather than “Dr”, but women often get called by their first name.

There have been darker moments. “I’ve been sexually harassed lots of times,” she says.

 In 2021 the Royal College commissioned the human rights lawyer Helena Kennedy to do a review of diversity and inclusion in surgery. “The evidence I had from women was that the culture was very male and the chat in and around the operating theatre for surgeons was often inappropriate. It’s really not a very conducive environment for women.” She made a raft of recommendations to improve the situation but says she is “disappointed” at how slowly they are being implemented.

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Source: The Times, 8 April 2023

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‘He tarnished my reputation’: whistleblower demands action against CQC accuser

A former adviser for the Care Quality Commission (CQC) has called on the regulator to explain what action it has taken against the officials responsible for wrongly dismissing him after he raised whistleblowing concerns.

Shyam Kumar, a surgeon who was part of inspection teams in the North West, told HSJ that he had to live with question marks over his reputation for several years. He is furious that a senior CQC official sought to question his honesty and integrity in evidence submitted to the employment tribunal examing his dismisal.

The tribunal heard Mr Kumar had raised a number of whistleblowing disclosures to the CQC, including concerns about the lack of appropriate expertise on inspection teams.

After a wide-ranging review around its handling of whistleblowing concerns, CQC chief executive Ian Trenholm last week apologised to Mr Kumar for “unacceptably poor treatment” by his organisation, and thanked him for contributing to the review.

However, Mr Kumar told HSJ: “I’m glad the CQC has looked at this and finally acknowledged what they did to me was wrong. But I want to know what has happened to the individuals that were responsible.”

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Source: HSJ, 6 April 2023

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1,643 ‘sexual safety incidents’ in a single 59-bed children’s unit

A single children’s mental health hospital with just 59 beds reported more than 1,600 “sexual safety incidents” in four years, shocking NHS figures reveal.

Huntercombe Hospital in Maidenhead was responsible for more than half of the sex investigations reported in the 209 children’s mental health units across the country.

Despite warnings at a rate of more than one a day to the health service since 2019, no action was taken to stop vulnerable NHS patients being sent to the scandal-hit unit as a result of the 1,643 sexual incident reports.

The private unit is now finally due to be closed after an investigation by The Independent revealed allegations of verbal and physical abuse, prompting the NHS to withdraw patients. The hospital since said it plans to reopen as an adult unit.

Figures obtained from the NHS show Huntercombe’s Maidenhead unit, Taplow Manor, was behind 57% of the 2,875 reported sexual incidents and assaults reported at England’s child and adolescent mental health services (CAMHS) over the past four years. Reported incidents can range from sexually inappropriate language to serious sexual assault and rape.

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Source: The Independent, 11 April 2023

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NHS patient 'stuck in hospital with months to live'

A woman who may only have months to live has told the BBC she is "angry and frustrated" at being in hospital five months after being cleared to go home.

Charlotte Mills-Murray, 34, said attempts to organise care at her family home had been repeatedly delayed.

Charlotte lives with intestinal failure caused by a severe form of Ehlers-Danlos syndrome, which weakens her body's connective tissue.

She was admitted to St James's Hospital in Leeds in June 2022 following an infection, and a new Hickman line - a tube that allows feeding and the administering of pain relief - was inserted.

By November, Charlotte was told she was well enough to be cared for at home, but she remains in hospital following delays in the hiring and training of staff able to support her.

With limited access to a hoist which would enable her to use her wheelchair, Charlotte said she had spent 10 months "stuck in bed".

Because of the complexity of her condition, Charlotte only has months to live. She believes her situation merits greater urgency because of the increased risk of infection in hospital.

Charlotte qualifies for 24-hour home care support through the NHS Continuing Healthcare scheme, but she said decisions over how this would be put in place had been slow and unclear.

The BBC has found a 16% rise over the past year in the number of patients in England who are in hospital despite being well enough to leave.

The Department of Health and Social Care said it was "fully committed to speeding up the safe discharge of patients who no longer need to be in hospital" and was making £1.6bn available in England over the next two years to support this, on top of £700m of extra funding in 2022 to ease NHS pressures over the winter.

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Source: BBC News, 9 April 2023

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Junior doctors’ strike will have ‘catastrophic impact’ on waiting lists

The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said.

Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”.

“These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid."

He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.”

He called on the public to use NHS services responsibly.

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Source; The Guardian, 10 April 2023

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