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Medical body NICE backs online mental health treatments

The National Institute for Health and Care Excellence (NICE) has recommended eight online therapies for anxiety and depression.

NICE says the therapies have the potential to help more than 40,000 people in the UK.

Each therapy must come with a formal assessment from an NHS therapist in order for it to be recommended.

According to NHS Digital, there is a six-week waiting list for patients who need mental health support in England. There are hopes that introducing online digital therapies could ease pressure on the NHS.

The treatments can help those with depression, anxiety, PTSD and body dysmorphia and are centred on the use of cognitive behavioural therapy (CBT) - a talking therapy which can help a patient manage their problems by suggesting alterations to their thought process and behaviour.

The therapies have been conditionally recommended by NICE - meaning early assessments have taken place to identify promising medical technology but more evidence needs to be gathered.

However, Professor Dame Til Wykes, of the School of Mental Health and Psychological Sciences at London's King's College, cautioned "we don't know enough" about the effectiveness of online therapies and whether the therapies will offer sufficient support for mental health patients.

Her view was echoed by mental health charity Mind, with content manager Jessica D'Cruz asserting "the majority" of people needing support "will struggle to benefit from this".

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Source: BBC News, 1 March 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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Measles, once eliminated in the USA, rises in Texas and New Mexico

Nearly 100 people across Texas and New Mexico have caught measles, state officials said, escalating anxiety over the spread of a potentially life-threatening illness that was declared eliminated in the United States more than two decades ago.

Ninety cases of measles — the majority affecting children under age 17 — were detected in Texas’s South Plains, a sprawling region in the state’s northwest, the Texas Department of State Health Services said Friday. The spread marks a significant jump from the 24 cases reported earlier this month. The DSHS warned that “additional cases are likely to occur in the outbreak area and the surrounding communities.”

The United States had declared measles eliminated in 2000, meaning the disease had not spread domestically for more than 12 months. It credited the achievement to widespread inoculation campaigns after the vaccine became available in 1963.

However, the national vaccination rate for measles has dropped in recent years, particularly during and after the coronavirus pandemic. 

Most cases recorded this year have occurred in people who were unvaccinated or whose vaccination status was unknown, the CDC said.

The disease’s comeback has occurred in tandem with the rise of anti-vaccine rhetoric propagated on social media and among some public officials.

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Source: The Washington Post, 24 February 2025

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Measles warning for young children as MMR jab rate drops in England

More than 1 in 10 school entry-age children in England are at risk of measles because they have not had their vaccine jabs, data reveals.

Coverage for the two doses of MMR that helps protect five-year-olds against measles, mumps and rubella is currently at 85.5%.

That is the lowest for a decade, and well below the 95% target recommended to stop a resurgence of measles.

Measles is highly contagious, more than Covid, and can cause serious illness. Nine in every 10 people can catch it if they are unjabbed and exposed.

As well as a distinctive rash, measles can lead to severe complications, such as pneumonia and brain inflammation, and sometimes can be fatal.

Vaccination can remove almost all of these risks.

Two doses of the MMR vaccine give 99% protection against measles and rubella and about 88% protection against mumps.

When a high percentage of the population is protected through vaccination, it becomes harder for the disease to pass between people.

But since the start of the Covid pandemic, there has been a concerning drop in the number of children receiving these vaccines on time.

Experts say some parents may not have realised doctors were still offering appointments, or did not want to burden the NHS.

Coverage of the first dose of the MMR vaccine in two-year-olds has now fallen below 90%. This means that more than one in 10 children under the age of five are not fully protected from measles and are at risk of catching it.

Among all five-year-olds in England, 93.7% have had one dose and 85.5% have had the recommended two doses.

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Source: BBC News, 1 February 2022

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Measles now an 'imminent' global threat due to pandemic, say WHO and CDC

There is now an "imminent threat" of measles spreading in every region of the world, the World Health Organisation and the US public health agency has said.

In a joint report, the health organisations said there had been a fall in vaccines against measles and less surveillance of the disease during the COVID pandemic.

Measles is one of the most contagious human viruses but is almost entirely preventable through vaccination, though it requires 95% vaccine coverage to prevent outbreaks.

A record high of nearly 40 million children missed a dose last year because of hurdles created by the pandemic, according to the report by the WHO and the US Centers for Disease Control and Prevention.

This has left millions of children susceptible to the disease.

"We are at a crossroads," Patrick O'Connor, the WHO's measles lead, said.

"It is going to be a very challenging 12-24 months trying to mitigate this."

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Source: Sky News, 24 November 2022

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Measles highest in 25 years in Europe, WHO says

The number of measles cases in the European region doubled last year to reach the highest level in 25 years, health officials say.

A joint report by the World Health Organization (WHO) and the UN children's fund, Unicef, said children under the age of five accounted for more than 40% of the cases reported in Europe and central Asia.

"Measles is back, and it's a wake-up call," Hans Henri Kluge, WHO regional director for Europe, said. "Without high vaccination rates, there is no health security."

The MMR vaccine - which immunises people against measles, mumps and rubella - is 97% effective in fighting off the dangerous virus.

Measles is a highly contagious disease which is spread by coughs and sneezes.

The measles virus can lead to pneumonia, brain swelling and death.

The WHO/Unicef joint analysis covering 53 countries said there had been 127,350 measles cases reported in the European region in 2024 - the highest since 1997.

A total of 38 deaths had been reported up to 6 March 2025.

Measles cases, they added, had been declining since 1997, but the trend reversed in 2018-19 and cases rose significantly in 2023-24 "following a backsliding in immunisation coverage during the Covid-19 pandemic".

"Vaccination rates in many countries are yet to return to pre-pandemic levels, increasing the risk of outbreaks," they warned.

The WHO/Unicef statement concluded that measles remained "a significant global threat" and urged governments where cases were occurring to take quick action - and those where the virus had not arrived to be prepared to act.

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Source: BBC News, 13 March 2025

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Measles could see a deadly comeback after pandemic saw millions of children miss vaccines

A global threat in the form of a measles outbreak is mounting as more than 22 million infants missed their first vaccine dose for the disease in 2020, warned the world’s top health agencies.

The World Health Organization (WHO) and the US Centres for Disease Control (CDC), in a joint statement on Wednesday, said the number represents the largest increase in missed vaccinations in two decades.

The 22-million figure is three million more than in 2019, “creating dangerous conditions for outbreaks to occur,” according to the agencies.

The surveillance of measles cases deteriorated because of the coronavirus pandemic, which resulted in a reported dip in cases by more than 80%t in 2020, the statement said.

Measles is one of the most contagious viruses to date. It kills more than 60,000 people a year, mostly young children. But at the same time, the disease is entirely preventable through vaccinations, which have averted more than 30 million deaths from the disease globally.

“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support Covid-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, the CDC’s global immunisation director.

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Source: The Independent, 11 November 2021

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ME care reforms promised after woman’s tragic death

The government has pledged to overhaul care for hundreds of thousands of people living with chronic fatigue syndrome, acknowledging that many "struggle" to access appropriate support.

The Department of Health and Social Care (DHSC) stated its intention to publish a new plan, asserting it is "committed to changing attitudes and transforming care" for individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

The pledge comes in the wake of Maeve Boothby-O’Neill’s death at just 27.

She had suffered with ME for a decade before dying at her home in Exeter in October 2021 from severe malnutrition.

Her inquest revealed she had been admitted to the Royal Devon and Exeter Hospital three times in the year of her death for malnutrition treatment.

Deborah Archer, now an area coroner for Devon, Plymouth and Torbay, concluded Miss Boothby-O’Neill had died from natural causes “because of severe myalgic encephalomyelitis (ME)”.

Last year she wrote to the Government to highlight a lack of specialist beds, “extremely limited” training for doctors and lack of available funding for research and treatment of the condition.

On Tuesday, the Government said that it has created a plan which “outlines clear steps to improve care for patients, by investing in research and offering access to care in the community”.

But Action for ME said that the plan “does not go far enough”.

Sonya Chowdhury, chief executive of the charity, said: “We appreciate the time DHSC has put into the delivery plan and their engagement with us and the ME community throughout.

“However, the plan simply does not go far enough. We are at the stage now where we need more than rhetoric, we need to take a strategic approach if we want a different outcome. What is proposed in the plan will not offer this.

“We must have a funded, dedicated research hub to leverage our world-leading life sciences sector to unlock treatments and ultimately cures for ME.

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Source: The Independent, 22 July 2025

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Mayor intervenes in NHSE reconfiguration row

The mayor of London is independently reviewing NHS England plans to reconfigure children’s cancer services in the capital, which were triggered when the commissioner finally accepted the current arrangements are unsafe.

In a letter to NHSE London director Caroline Clarke, Sadiq Khan’s health adviser said the mayor would apply his six tests for major reconfigurations to both the options proposed for the “principal treatment centre” for paediatric cancer in south London.

NHSE London is currently running a process to decide the principal treatment centre's location. An earlier assessment put the bid from the Evelina Hospital, part of Guy’s and St Thomas’ Foundation Trust, ahead of the other bidder, St George’s University Hospitals FT.

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Source: HSJ, 5 June 2023

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Matt Morgan and Peter Brindley: Why it’s time we all woke up to the importance of sleep

For too long, medicine has been a cult that deifies workaholism and mocks those who “fuss” about sleep, say Matt Morgan, Honorary Senior Research Fellow at Cardiff University, Consultant in Intensive Care Medicine and Head of Research and Development at University Hospital of Wales, and Peter Brindley, Professor of Critical Care Medicine, Medical Ethics, Anesthesiology at the University of Alberta, Canada.  But we know that lack of sleep kills. Data have consistently shown how it kills slowly and silently by increasing the likelihood of cancer, heart disease, immunosuppression and weight gain. Poor sleep also kills suddenly and loudly through motor vehicle crashes and workplace trauma. More and better sleep is needed for all but the question is do we care enough to do the right thing? 

Regardless of whether insomnia is limited to medicine or is, instead, a society wide issue, we can likely all agree that we need a cultural shift. This starts by senior folks speaking up and standing side by side with junior colleagues. We should not, cannot, and need not stand by as doctors work hours that we would never condone for pilots or bus drivers. Lessons must be heeded. Fortunately, these are lessons that we have known for decades. Patient safety matters, and so does practitioner safety. 

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Source: BMJ Opinion, 28 July 2019

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Matt Hancock says UK's pandemic strategy was completely wrong

Ex-health secretary Matt Hancock has criticised the UK's pandemic planning before Covid hit, saying it was "completely wrong".

He told the Covid Inquiry that planning was focused on the provision of body bags and how to bury the dead, rather than stopping the virus taking hold.

He said he was "profoundly sorry" for each death.

After giving evidence he approached some of the bereaved families, but they turned their backs on him as he left.

The former health secretary, who answered questions from the inquiry on Tuesday, said he understood his apology might be difficult for families to accept, even though it was "honest and heartfelt".

Under questioning from Hugo Keith KC, lead counsel to the Covid Inquiry, Mr Hancock stressed that the "attitude, the doctrine of the UK was to plan for the consequences of a disaster".

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Source: BBC News, 27 June 2023

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Matt Hancock orders urgent review into how coronavirus daily deaths are calculated

Matt Hancock has ordered an urgent review into how Public Health England (PHE) calculates daily COVID-19 death figures.

It comes after scientists said they believed PHE was “over-exaggerating” the daily coronavirus death toll, by counting people if they die of any cause at any time after testing positive for the disease.

Professor Yoon K Loke, of the University of East Anglia, and Carl Heneghan, professor of evidence-based medicine at the Nuffield Department of Primary Care, said on Thursday night that a “statistical flaw” in the way PHE compiles data on deaths created a disparity in figures published by the different UK nations.

“It seems that PHE regularly looks for people on the NHS database who have ever tested positive, and simply checks to see if they are still alive or not,” they wrote. “PHE does not appear to consider how long ago the Covid test result was, nor whether the person has been successfully treated in hospital and discharged to the community. Anyone who has tested Covid-positive but subsequently died at a later date of any cause will be included on the PHE Covid death figures.”

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Source: The Independent, 17 July 2020

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Matt Hancock faces judicial review threat over 'do not resuscitate' orders

The health secretary Matt Hancock has been threatened with a judicial review amid fears patients’ human rights are at risk from the incorrect use of controversial do not resuscitate orders during the coronavirus pandemic.

Ministers have been told they should use emergency powers to issue a direction to doctors and nurses in the NHS requiring them to comply with the law on do not attempt resuscitation orders (DNARS) and to ensure patients are properly consulted.

In recent weeks there have been a number of reports of patients having DNARs put in place without their knowledge or in GPs imposing blanket decisions, prompting a warning letter from NHS England’s chief nurse last month.

The legal action is being brought by Kate Masters, the daughter of Janet Tracey, who died at Addenbrooke's hospital in 2011 after a DNAR was put in place without her knowledge.

In 2014, Tracey's husband David won a landmark victory at the Court of Appeal which gave patients a new legal right to be consulted by doctors when DNARS were being considered. Not consulting a patient was a breach of their human rights, the court ruled.

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Source: The Independent, 6 May 2020

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Matt Hancock - the future of healthcare

Health and social care secretary Matt Hancock delivered a ‘future of healthcare’ speech to the Royal College of Physicians on Thursday and laid out seven lessons from the health and care response to Covid-19 that he wants to see retained. If followed through, some of his points would mark significant shifts in policy and Conservative thinking. However, Hancock said it was important to “build better” in the way that London was built better after the Great Fire in 1666.

Hancock’s seven points were: the NHS must value people and ‘bust bureaucracy’ that gets in their way; the future is “collaboration not competition”; “better technology means better healthcare”; the NHS must be open to other sectors; planning and funding will be “system first”; and social care and public health need more attention. On tech, Hancock said consultations will be digital first, and there will be a new focus on interoperability and data sharing.

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Maternity warning system hit by IT fault

A maternity unit criticised by the Care Quality Commission is battling a high-risk fault in its new electronic patient record system which causes women’s deterioration scores to display incorrectly.

The issue – affecting St George’s University Hospitals Foundation Trust’s implementation of Oracle Health’s iClip Pro – was first identified in June and remains unresolved.

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Source: HSJ, 26 November 2025

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Maternity units told to meet target staffing levels by next April

NHS maternity units have been told they have until next April to increase the numbers of midwives on wards to expected levels after a near £100 million investment.

NHS England has told hospitals they must bring staffing levels for midwives up the levels needed to meet their planned demand from mothers and to ensure women get safe care.

In a letter to NHS trusts, England’s chief nurse Ruth May said she expected hospitals to use their share of a recent £96 million investment by NHS England to boost staffing levels along with extra spending from local budgets.

NHS England has carried out an analysis of demand and supply with Health Education England as part of a four year plan to boost the number of midwives.

Hospitals are expected to set the level of midwives needed to deliver more one-to-one care and to try and ensure more than half of women see the same midwife throughout their pregnancy.

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Source: The Independent, 13 April 2021

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Maternity units told to allow partners and visitors so mothers are not left to give birth alone

Hospitals have been ordered to allow partners and visitors onto maternity wards so pregnant women are not forced to give birth on their own.

NHS England and NHS Improvement have written to all of the directors of nursing and heads of midwifery to ask them to urgently change the rules around visiting.

The letter, which is dated 19 September and seen by The Independent, says NHS guidance was released on 8 September so partners and visitors can attend maternity units now “the peak of the first wave has passed”.

“We thank you and are grateful the majority of services have quickly implemented this guidance and relaxed visiting restrictions,” it reads. “To those that are still working through the guidance, this must happen now so that partners are able to attend maternity units for appointments and births.”

The letter adds: “Pregnancy can be a stressful time for women and their families, and all the more so during a pandemic, so it is vital that everything possible is done to support them through this time.”

Make Birth Better, a campaign group which polled 458 pregnant women for a new study they shared exclusively, said mothers-to-be have been forced to give birth without partners and have had less access to pain relief in the wake of the public health crisis.

Half of those polled were forced to alter their own childbirth plans as a result of the COVID-19 outbreak – while almost half of those who were dependant on support from a specialist mental health midwife said help had stopped.

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Source: The Independent, 23 September 2020

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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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Maternity units disrupted for nine months by IT fault

An IT fault has prevented several major maternity units in South London from properly storing foetal heart monitoring records for more than nine months, HSJ has learned.

St George’s, Epsom and St Helier Hospital Group (GESH) and Kingston and Richmond Foundation Trust have confirmed they are affected by a problem which prevents cardiotocography (CTG) traces from being automatically downloaded and stored.

A manual workaround has been put in place, which the trusts said ensured CTG traces were captured and safely stored, but the fault is not yet fixed.

CTGs can track a baby’s heart rate and a mother’s contractions during labour and are often critical evidence in clinical negligence investigations.

Board papers from GESH, published in September, said CTG traces from Neoventa STAN machines were not being downloaded or stored as expected.

It warned that the absence of CTG traces “presents a clinical and legal risk”, given their frequent role in determining breach of duty in clinical negligence claims.

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Source: HSJ, 3 October 2025

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Maternity unit under investigation for baby deaths was often operating without senior doctor

A hospital trust under the spotlight over avoidable baby deaths provided inadequate antenatal care, with inexperienced junior midwives working alone and doctors not always available to assess high risk women, the Care Quality Commission (CQC) has found.

The latest CQC report on maternity services at East Kent Hospitals University Foundation Trust follows a report last month by the NHS Healthcare Services Investigation Branch on 24 maternity care investigations at the trust.

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Source: BMJ, 28 May 2020

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Maternity unit to be closed despite safety fears

An integrated care board has decided which of the five maternity units on its patch should close despite concerns from clinical leaders the move could increase deaths.

North Central London Integrated Care Board yesterday announced plans to close the maternity unit at Royal Free Hospital in north London.

The move will have to be approved at the ICB’s board meeting next week and by NHS England. The ICB has said it wants to close the service in the face of stretched staffing and reduced demand.

But the plans have proved controversial among some clinicians. Last year, the clinical leaders of the Royal Free’s maternity services wrote to their chief executive saying the closure could increase maternal mortality.

NCL ICB medical director Jo Sauvage said: “We have a declining birth rate in our area, and the need for more complex support for mothers, pregnant people and their babies is growing.

“Our services are not currently set up to meet the needs of everyone that uses them. Doing nothing is not an option and we have carried out extensive work to make sure we are able to make the right decision for local families.”

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Source: HSJ, 19 March 2025

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Maternity unit shut for four days after generator fails

Shrewsbury and Telford Hospital Trust temporarily suspended admissions to the women’s and children’s centre at Princess Royal Hospital – which houses the provider’s consultant-led maternity services – earlier this week due to an issue with a generator.

HSJ understands a power cut occurred and estates chiefs were concerned about running solely on battery power, hence suspending admissions while the problem was fixed.

Five inductions of labour were diverted to neighbouring trusts, while fewer than five caesarean sections were rescheduled during the outage.

Meanwhile, 56 patients accessing the trust’s telephone triage service were advised by medical chiefs to attend nearby hospitals.

Following the incident, a learning review is taking place, and HSJ understands this will investigate whether any women came to harm. HSJ has also been told the generator has been fixed “as good as permanently”.

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Source: HSJ, 23 June 2023

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Maternity unit refutes suggestion it breached safety standards

The trust at the centre of a maternity scandal insists it has been providing immediate anaesthetic cover for obstetric emergencies, contrary to an NHS England report suggesting it had not and had been potentially breaching safety standards.

Health Education England – now part of NHSE – visited William Harvey Hospital in March and was told senior doctors in training who were covering obstetrics could also be covering the cath lab – which deals with patients who have had a heart attack, and could receive trauma, paediatric emergency and cardiac arrest calls. This suggested the trust was in conflict with Royal College guidelines which state an anaesthetist should always be “immediately available” for obstetrics. 

East Kent Hospitals University Foundation Trust, which runs the hospital, originally told HSJ its rota had very recently been changed and that an anaesthetist with primary responsibility for maternity could leave any other work to attend to a maternity emergency immediately. However, it has since said it has been the case for a long time that an anaesthetist is available to return to maternity in case of an emergency. 

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Source: HSJ, 17 June 2023

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Maternity unit rated ‘inadequate’ as trust faces scrutiny over horrific stillbirth

An Essex maternity department has been served with further warnings by the Care Quality Commission (CQC) and again rated “inadequate”.

Serious concerns were raised about the services at Basildon University Hospital in the summer, after several babies were found to have been starved of oxygen and put at risk of permanent brain damage.

Despite the CQC issuing warning notices to Mid and South Essex Foundation Trust in June 2020, a subsequent visit on 18 September found multiple problems had persisted.

The CQC’s findings at Basildon included:

  • the service was short-staffed and concerns were not escalated appropriately
  • multidisciplinary team working was “dysfunctional”, which sometimes led to safety incidents
  • doctors, midwives and other professionals did not support each other to provide good care.

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Source: HSJ, 19 November 2020

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Maternity unit rated ‘inadequate’ after delayed Caesarean warning

A trust’s main maternity unit has been rated “inadequate” and given a warning notice amid concerns delayed Caesarean sections are causing harm to babies.

The Care Quality Commission (CQC) told Maidstone and Tunbridge Wells Trust to make significant improvements in how quickly it carries out emergency C-sections, the regulator said in a report today.

The trust was also told to improve risk management, governance and oversight of services at its Tunbridge Wells Hospital.

Inspectors found between April and July last year, 42% of “category 1” emergency Caesareans – defined as those posing an immediate threat to the life of the woman or foetus — at the Tunbridge Wells Hospital were delayed. The National Institute for Health and Care Excellence says these should be carried out “as soon as possible and in most situations within 30 minutes of making the decision”.

The report identified “ongoing recurrent delays” to emergency Caesareans overnight, as the trusts did not have a second theatre available.

This “meant an increased risk of harm, including cases reported by the service such as babies with ‘acute foetal hypoxia’ had emerged due to delayed births”, the inspection report said.

It also criticised the trust for not responding to a high level of post-partum haemorrhages, some of which had caused “moderate” harm.

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Source: HSJ, 16 February 2024

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