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Number of patients hurt by rogue surgeon unknown

Former patients of a surgeon who has been struck off say their lives have been ruined by his misconduct.

The number of people harmed by Jeremy Parker is unknown but at least 123 are taking legal action.

Their lawyer said the scale of harm caused by his malpractice "could be huge".

A total of 53 allegations against him were found "proved" including dishonestly adding to the case notes of 14 patients, botching operations, not diagnosing infections, failing to consult colleagues and not obtaining patient consent.

The General Medical Council also confirmed a patient had a leg amputated below the right knee after a procedure carried out by Mr Parker went awry.

Christian Beadell from Fletchers Solicitors, which is representing former patients in a class action, said East Suffolk and North Essex NHS Trust (ESNEFT) had not answered questions over whether it had initiated a recall process to determine the number patients harmed.

"It's difficult to say how many patients have been injured by him," Mr Beadell said.

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Source: BBC News, 8 March 2023

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Ministers blasted by scandal inquiry chair

The government’s response to the East Kent maternity scandal inquiry has been condemned as ‘very disappointing’ by its chair. 

More than four months on from the inquiry report, ministers this morning issued what they called an “initial response” to it, as a brief written statement to Parliament. It contained few specific proposals, instead saying government was kicking off a series of other reviews, and “working” with various other agencies.

Inquiry chair Bill Kirkup, the well-regarded former medic and expert in care failures, told HSJ the response was poor and should have been “wider and deeper”.

Dr Kirkup said the response showed government had “not grasped how fundamental” some of the issues outlined in his report were, and “what sort of initiative” was needed to address them.

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Source: HSJ, 7 March 2023

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‘We are struggling’: US doctors faced with vacuum of information on Long Covid

More than three years into the Covid pandemic, there are a host of important unanswered questions about Long Covid, which significantly limit healthcare providers’ ability to treat patients with the condition, according to US physicians and scientists.

That vacuum of information remains as much of the US has moved on from the pandemic, while Covid long-haulers continue to face stigma and questions over whether their symptoms are real, providers say.

“We don’t quite have our finger on the pulse of what’s wrong, what biologically is causing it, and that’s a big problem,” said Dr Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center. “It’s hard to direct drugs or treatments without having the biological underpinnings for why someone is feeling so fatigued with exercise.”

In addition to the ambiguity around the root causes of Long Covid, there are also challenges in research because of how Covid can produce so many different symptoms. The Centers for Disease Control and Prevention list includes fatigue, respiratory issues and difficulty thinking or concentrating but also states that “post-Covid conditions may not affect everyone the same way”.

“Everyone has a different constellation of symptoms,” said Dr Steven Deeks, an infectious disease specialist at the University of California, San Francisco. “Some people get better over time, some people wax and wane, some people get worse,” and so it is difficult for researchers to determine when a study should end and compare a drug versus a placebo.

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Source: The Guardian, 6 March 2023

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Rheumatic patients 'left behind' after lockdown

Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research.

The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them.

Researchers interviewed 15 rheumatology patients from the Bristol area. Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives.

"I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards.

"How do I get food? I cannot leave the house. How can I see friends? I was not allowed to."

Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield.

"It is a new normal, which is about being on high alert and managing risk every day," she said.

Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment".

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Source: BBC News, 6 March 2023

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Nursing shortages are delaying spinal operations

Nursing shortages are contributing to children waiting up to three times longer for spinal surgery than pre-pandemic, a top surgeon has claimed.

Chris Adams says up to one in four operations are cancelled at NHS Lothian, with staffing the main reason.

Mr Adams also claims that some children are not being put on waiting lists as early as they should be.

NHS Lothian disputes some of Mr Adams' statements but says "significant pressures" are affecting waiting times.

The senior clinician, one of Scotland's three paediatric spinal surgeons, said he was speaking out of behalf of spinal patients and their families

The surgeon's claims appear in a new BBC Disclosure investigation into Scotland's NHS, which reveals that some children are waiting up to three times longer than pre-pandemic for spinal surgery, with some waiting more than a year. At least 51 out of a possible 190 planned spinal surgeries at RHCYP were cancelled at short notice in 2022, with nursing shortages understood to be the main cause

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Source: BBC News, 7 March 2023

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Surge in patients paying for GP appointments as pressure on NHS grows

Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice.

Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021.

The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022.

It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”.

On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.”

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Source: The Independent, 4 March 2023

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Elon Musk's bid to implant microchips in human brains rejected over safety concerns

Elon Musk's attempt to implant microchips into human brains has been rejected by US medical regulators over concerns about the safety of the technology.

Mr Musk's Neuralink business, which is hoping to insert tiny chips into people's skulls to treat conditions such as paralysis and blindness, was denied initial permission for clinical trials last year.

US medical regulators were said to have "dozens" of concerns over the risks posed by the device, Reuters reported. Concerns include fears that tiny electrodes could get lodged in other parts of the brain, which could impair cognitive function or rupture blood vessels.

Neuralink's chips are designed to be threaded into the brain using tiny filaments and harness artificial intelligence technology to pick up brain activity using a so-called "brain computer interface".

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Source: The Times, 3 March 2023

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Medical records changed as hospitals cover up mistakes, watchdog warns

Hospitals are still covering up serious mistakes in patient care and fobbing off families that raise concerns, the head of the watchdog that investigates complaints against the NHS has warned.

Rob Behrens told The Times he had seen cases of medical records being changed after a death and spoken to doctors who were too scared to speak out about failings in their hospitals.

He called on ministers to change the law to introduce a “duty of candour” on health and other public service staff to “transform” the system and make it more accountable to patients.

He warned: “There is a deep reluctance to explain and give an account of what you do in the health service or the public service for fear of retribution. The things that really get to me are the avoidable deaths of babies in the health service — dying because there’s been poor coordination or they’d been wrongly diagnosed or the parents hadn’t been listened to. That is shocking.”

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Source: The Times. 6 March 2023

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‘It’s not just about dying’: Uganda’s pioneers of palliative care undaunted by huge challenges

 

Morphine was first introduced in Uganda 30 years ago, but as the burden of cancer increases, thousands of people still lack access to even basic treatment or pain relief.

About 70% of the 2,000 patients on Hospice Africa Uganda (HAU)’s programme have cancer, and some are HIV positive, too. Few can afford tests or treatment for their conditions and, even when they can, it is not uncommon for doctors to misdiagnose or fail to prescribe adequate pain relief. Often, by the time a patient is referred to HAU, their condition is incurable, much to the frustration of the team, whose goal is to offer palliative care from the moment a person is diagnosed with a life-limiting condition.

“One of our biggest challenges is to remove the stigma [around palliative care]. Some people think it is about dying, but it is for anyone with a chronic illness that is not going away,” says Antonia Kamate Tukundane, programmes manager at HAU’s Mbarara site in south-west Uganda. “Palliative care focuses on holistic care: How are you? How is your family? What other things are affecting your illness? We provide something the doctors and nurses have no time for.

Dr Anne Merriman at home in Kampala. She founded Hospice Africa Uganda in 1993, with a vision to introduce “palliative care for all in need in Africa”

“Sometimes the patient comes to us very ill and passes on, but if we had known the patient earlier we could have explained what was happening to their body; agreed on realistic goals; all this is so helpful for the patient. Those who find us are glad they did.”

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Source: The Guardian, 6 March 2023

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Maternity units must only remove gas and air as a ‘last resort’

Hospital trusts must only remove gas and air on maternity wards as a “last resort”, NHS England has said.

Several hospitals temporarily suspended the use of gas and air following concerns that midwives and staff are being exposed to too-high levels of gas over prolonged periods of time.

Some pregnant women have posted on social media, saying the decisions have left them feeling anxious and worried about their pain relief options.

Some NHS trusts have also come under fire for the way they communicated the message that gas and air would be suspended.

In new guidance to trusts, NHS England said it had looked at the health impacts for staff of levels of nitrous oxide exceeding prescribed levels, “drawing upon relevant legislation and existing guidance on the safe management of gas and air in healthcare settings”.

It said trusts must ensure they are compliant with legislation and national guidance on the use of gas, but must only remove it for women as a last resort and must tell them about other pain relief.

“Where, following the meeting of the (medical gas) committee, there is concern that the trust is not compliant, then this should be formally reported by the trust to the NHS England regional operations centre for the attention of the regional chief midwife,” the guidance said.

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Source: The Independent, 3 March 2023

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Less than 3% of NHS England trusts hit key cancer waiting-time target

Patients are being warned of a “shocking gap in cancer care” as new figures reveal that fewer than 3% of England’s NHS trusts met a key waiting-times target last year for cancer patients to be treated within two months of an urgent GP referral.

Of 125 hospital trusts in England analysed, only three (2.4%) hit the standard of treating 85% of patients within 62 days after an urgent referral in 2022. Some trusts have not hit the standard for at least eight years.

More than 66,000 patients were forced to wait more than two months for their first treatment last year after a referral, the figures reveal. One leading cancer charity said this weekend the cancer care system was not fit for purpose, with “lives left hanging in the balance”.

Daisy Cooper, the Lib Dems health spokesperson, said the figures showed that even before the pandemic struck, the number of hospital trusts meeting targets was falling rapidly. “Now the situation is so bad that barely any hospitals are able to provide patients with the treatment they need on time. Ministers have consistently failed to plan ahead or provide adequate funding, while taking patients and NHS staff for granted. There is a shocking gap in cancer care from one area to another,” she said.

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Source: The Guardian, 5 March 2023

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More than half of ambulance workers have seen patient die because of delay

More than half of ambulance workers have seen a patient die because of a delay in reaching them after a 999 call or overcrowding in A&E, a new survey has found.

The findings, from a survey of frontline paramedics and other ambulance staff, are another stark illustration of the patient safety risks created by the crisis in NHS urgent and emergency care.

“These findings are utterly terrifying,” said Rachel Harrison, the national secretary of the GMB union, which sought the views of more than 1,200 members working in NHS ambulance services in England and Wales.

It asked them if they had ever witnessed a death that had occurred because of a delay involving an ambulance or other part of the care system. Just over half (53%) said they had done so and another 30% were aware of it happening with a colleague.

The findings are disclosed in a Channel 4 Dispatches documentary being shown this Thursday about how long delays in ambulance crews handing over patients to A&E staff, and thus being unable to respond quickly to 999 calls, are affecting both patients and staff.

“The delay and dilation of care that we see is just unconscionable,” Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, told the programme.

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Source: The Guardian, 6 March 2023

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The patients who gave up waiting on the NHS

There are 625,000 people on a hospital waiting list in Scotland. That figure is the highest on record and equivalent to one in nine of the population.

Backlogs have soared since the Covid pandemic and more people faced with long waits are seeking private treatment.

An opinion poll commissioned by BBC Scotland suggests one in five of those who replied said they - or one of their family - had paid for private medical care in the past 12 months.

Most (73%) said they would have preferred to use the NHS.

Linda Fyfe, from South Ayrshire, was among those not prepared to wait for NHS treatment when she needed a hip replacement.

Within months Linda went from living with the "bearable" pain in her right hip to being unable to comfortably move more than 100 yards.

The 75-year-old said the pain changed her whole lifestyle and she could not wait between 12 and 18 months for an operation on the NHS.

The retired social work administrator was quoted £14,000 to go private in the UK but this was more than she could afford. She opted to have the same procedure done in Lithuania for about half the price. 

The Kaunas clinic that treated Linda said it sees about 10 people a month from Scotland and more from across the UK."I made the right decision. I couldn't have gone another year or 18 months and it might even have taken longer.

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Source: BBC News, 6 March 2023

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Inside the A&E crisis: ‘We were lined up so patients wouldn’t see the bodies’

An NHS whistleblower has sacrificed his career to capture on hidden camera the brutal reality of working in an ambulance service.

After watching yet another patient die needlessly in the back of his ambulance, Daniel Waterhouse became a whistleblower. That decision would end his career with the NHS at the age of only 30.

Waterhouse, from Finchley, north London, said his decision to go undercover for a Channel 4 Dispatches programme to be broadcast on Thursday was not easy.

“I thought about it for quite a while,” said Waterhouse, an emergency medical technician who wore hidden cameras and microphones while on shift for the East of England Ambulance Service. “It was a moral choice, and there’s a caveat to that as well, because going undercover in those situations could be considered immoral and will draw criticism I’m sure.

“But I think patient safety outweighs that, and those occasions were so strong in my head that I thought, ‘If only some change can happen, where some people don’t have to go through that and die or suffer permanent disability, then it would be worth it’.”

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Source: The Times, 3 March 2023

 

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Scotland first country in the world to ban environmentally harmful anaesthetic

Scotland has become the first country in the world to stop its hospitals using the anaesthetic desflurane because of the threat it poses to the environment.

NHS data suggests the gas, used to keep people unconscious during surgery, has a global warming potential 2,500 times greater than carbon dioxide.

Banning it in Scotland - from its peak use in 2017 - would cut emissions equal to powering 1,700 homes a year.

In the last few years, more than 40 hospital trusts in England and a number of hospitals in Wales have stopped using it.

Dr Kenneth Barker, anaesthetist and clinical lead for Scotland's national green theatres programme, said he was shocked to find the anaesthetic drug he had used for more than a decade for many major and routine operations was so harmful to the environment.

"I realised in 2017 that the amount of desflurane we used in a typical day's work as an anaesthetist resulted in emissions equivalent to me driving 670 miles that day," he said.

"I decided to stop using it straight away and many fellow anaesthetists have got on board.

"When you are faced with something as obvious as this and with the significance it has to the environment - I am very glad we have got to this stage."

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Source: BBC News, 3 March 2023

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Los Angeles hospital under investigation accused of ignoring Black woman’s pain

April Valentine planned to have a complication-free delivery and to enjoy her life as a first-time parent to a healthy baby girl. Instead, California’s department of health and human services is investigating the circumstances of the April's death during childbirth.

April, a 31-year-old Black woman, went to Centinela hospital in Inglewood on 9 January and died the next day. Her daughter Aniya was born via an emergency caesarean section. Her family and friends say that staff at the hospital ignored the pregnant woman’s complaints of pain, refused to let her doula be in the hospital room during the birth and neglected Valentine as her child’s father performed CPR on her.

“It’s hard to even sleep, to even look at my child after seeing what I saw in that hospital that night,” said Nigha Robertson, Valentine’s boyfriend and Aniya’s father, to the Los Angeles county board of supervisors during its 31 January meeting. “I’m the only one who touched her, I’m the one who did CPR. Nobody touched her, we screamed and begged for help … they just let her lay there and die.”

During the 31 January board of supervisors meeting, people who spoke in support of Valentine said that Centinela hospital is known around the community for being one of the “worst hospitals in the county” for Black and Latina mothers and their infants. 

Since 2000, the maternal mortality rate in the US has risen nearly 60%, with about 700 people dying during pregnancy or within a year of giving birth each year. More than 80% of the deaths are preventable, according to the US Centers for Disease Control and Prevention. The US has the highest maternal mortality rate among industrialized countries and Black women are three times more likely to die during childbirth than white women.

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Source: The Guardian, 3 March 2023

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Covid inquiry: what stage is it at and what will it look at?

The Covid-19 Inquiry is a public inquiry to examine the UK’s response to the pandemic, as well as its wide-sweeping impact.

In the UK, at least 216,726 people have had Covid-19 mentioned on their death certificate since the start of the pandemic.

Multiple lockdowns, school closures and furloughs later, a public inquiry aims to gauge what lessons can be learned for the future.

Two preliminary hearings have already taken place on 28 February and 1 March. The next one will be on 21 March and will cover Scotland, including strategic issues, political governance, lockdowns and restrictions. The inquiry is chaired by Baroness Heather Hallett, a former Court of Appeal judge.

The inquiry has been split into three modules: resilience and preparedness, core UK-decision making; political governance, and the impact of Covid-19 on healthcare systems across the UK.

In Spring 2022, the inquiry held a public consultation on its draft terms of reference which allowed people to give their opinions on the topics the inquiry would cover.

The public inquiry has come under heavy criticism after it was announced that structural racism will not be explicitly considered.

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Source: The Independent, 2 March 2023

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Misplaced tube contributed to first UK child Covid death, coroner rules

A misplaced medical tube contributed to the death of the first child in the UK to die after contracting Covid, a coroner has found.

Ismail Mohamed Abdulwahab, 13, of Brixton, south London, died of acute respiratory distress syndrome, caused by Covid-19 pneumonia, on 30 March 2020, three days after testing positive for coronavirus. He had a cardiac arrest before he died.

Ismail’s death prompted widespread alarm about the potentially lethal impact of Covid on children.

Hours before Ismail died, an endotracheal tube (ET) used to help patients breathe was found to be in the wrong position. A consultant in paediatric intensive care decided to leave it and monitor him.

Giving his judgment on Thursday, senior coroner Andrew Harris said: “I am satisfied that he [Ismail] would not have died when he did were it not for the tube misplacement.”

On Wednesday, the inquest at London Inner South London coroner’s court heard evidence from Dr Tushar Vince, a consultant in paediatric intensive care at King’s College hospital who treated Ismail on 29 March after he had been intubated.

Asked by Harris if it would be reasonable to put the positioning of the ET on the death certificate as one of the causes, Dr Vince said: “I think it would be reasonable to consider it, yes.”

She said: “I was so focused on the lungs I just didn’t see how high this tube was and I’m so sorry that I didn’t see it.”

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Source: The Guardian, 2 March 2023

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‘Significant escalation’ in strike action, warns ambulance chief

Ambulance chiefs have warned of a ‘significant escalation’ in the strike action being planned by unions next week – saying the flexibilities that helped deal with previous walk-outs will no longer be available.

In a letter to local NHS leaders, seen by HSJ, North West Ambulance Service said unions are “becoming more stringent in their approach”, and the trust’s ability to respond to incidents will be severely weakened.

For the last day of strike action in February, the GMB union told NWAS it was abandoning exemptions (derogations) for category 2 calls, which include heart attacks and strokes.

The NWAS letter, sent yesterday, said the Unite union also now intends to take this approach on 6 March.

Last month the head of the London Ambulance Service said the reduced level of service in the capital “causes harm to our patients”

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Source: HSJ, 2 March 2023

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More than half of humans on track to be overweight or obese by 2035

More than half of the world’s population will be overweight or obese by 2035 unless governments take decisive action to curb the growing epidemic of excess weight, a report has warned.

About 2.6 billion people globally – 38% of the world population – are already overweight or obese. But on current trends that is expected to rise to more than 4 billion people (51%) in 12 years’ time, according to research by the World Obesity Federation.

Without widespread use of tactics such as taxes and limits on the promotion of unhealthy food, the number of people who are clinically obese will increase from one in seven today to one in four by 2035. If that happens, almost 2 billion people worldwide would be living with obesity. Evidence shows that obesity increases someone’s risk of cancer, heart disease and other diseases.

Prof Louise Baur, the federation’s president, said the stark findings were “a clear warning that by failing to address obesity today, we risk serious repercussions in the future.

“It is particularly worrying to see obesity rates rising fastest among children and adolescents.”

Countries need to take “ambitious and coordinated action” as part of a “robust international response” to tackle the growing health and economic crisis that obesity involves, the federation believes.

“Governments and policymakers around the world need to do all they can to avoid passing health, social and economic costs on to the younger generation,” Baur added.

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Source: The Guardian, 2 March 2023

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Race and deprivation set back medical trainees, GMC analysis finds

New research shared with HSJ  has ‘laid bare’ the inequalities experienced by medical trainees, with black doctors more likely to perform worse in exams than any other ethnic group.

The report published by the General Medical Council (GMC) highlights that UK medical graduates of black or black British heritage have the lowest specialty exam pass rate of all ethnic groups at 62%, which is almost 20 percentage points lower than that of white doctors (79%). It is the first time the medical regulator has split this data by ethnicity, it said. 

The GMC has pledged to “eliminate discrimination, disadvantage and unfairness” in undergraduate and postgraduate medical education by 2031 and the disproportionate number of fitness to practise complaints received about ethnic minority doctors and doctors who gained their medical qualification outside of the UK by 2026.

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Source: HSJ, 2 March 2023

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Older and overweight patients ‘hampering efforts to clear NHS backlogs’

Older and overweight patients are making it harder to clear NHS surgery backlogs, anaesthetists have warned.

New data reveal an “extremely worrying picture” of increasing age, rates of obesity and complexity of surgical patients across the UK, the Royal College of Anaesthetists said.

The average age of patients requiring anaesthesia increased by 2.3 years, from 50.5 to 52.8, over the last decade, while their BMI also jumped from 24.9 (borderline normal/overweight) to 26.7 (overweight).

The proportion of patients who are complex or have other comorbidities has also significantly increased, the study found.

When patients are older, overweight and have other problems, this makes anaesthetic and surgical care more complicated and higher risk, the authors said. Managing these patients safely takes longer during surgery and can lead to slower recovery times, requiring more time in hospital.

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Source: The Telegraph, 2 March 2023

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Pharmacy leaders hit out at NHS England ads redirecting patients from GPs

Pharmacies do not have the capacity to absorb pressure from GPs unless it comes with additional funding, pharmacy leaders have warned.

A new NHS England ad campaign, announced earlier this week, aims to redirect patients from GP practices to local pharmacies for minor conditions such as coughs, aches, cystitis and colds.

But community pharmacy negotiating body PSNC has spoken out against the campaign calling it ‘deeply concerning’, ‘irresponsible, ‘extremely unhelpful’ and ‘irritating’.

Malcom Harrison, chief executive of the Company Chemists’ Association (CCA) said: ‘Community pharmacies are often the best place for patient to go for help with minor health concerns. 

‘However the current situation that many pharmacies find themselves, with a 30% cut in real term funding, the NHS recruiting their pharmacists and technicians to work in general practice and with the continuing increase in the number of medicines prescribed, will mean that there is now a very real risk that when patients visit a pharmacy, they will be faced by exhausted teams and longer than expected waiting times.

‘The NHS policy of moving asking patients to visit their local pharmacy does not address the problem of delays to access in primary care, it simply moves it from one pressurized location to another.  The NHS must address the chronic underfunding of primary care, and of pharmacy in particular, if patients are to be able to access the care they need and should rightly expect.’

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Source: Pulse, 28 February 2023

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Age discrimination leading to avoidable eating disorder deaths, government warned

The government must end “age discrimination” against eating disorder patients that is causing avoidable deaths, experts have warned.

A cross-party parliamentary group and the Royal College of Psychiatrists are calling for access targets to make sure adults with eating disorders get treated within a set time. The demands come after the healthcare watchdog said patients were dying while waiting to be seen.

Wera Hobhouse, chair of the All Party Parliamentary Group, and Agnes Ayton, chair of the Royal College of Psychiatrists’ eating disorder committee, said the targets must be equal to those for children, which were set in 2016.

According to the Health Service Journal, 19 patients under the care of inpatient and community eating disorder services have died since 2017.

A senior coroner in Norfolk also highlighted failings in 2019 and sent a warning to both NHS England and the Department for Health and Social Care, over the deaths of five young women.

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Source: The Independent, 1 March 2023

To support Eating Disorders Awareness Week, we have pulled together eight useful resources to help healthcare professionals, friends and family support people with eating disorders:

 

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