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Black Country doctors back vote of no confidence in management

Doctors at a Black Country mental health trust have backed a vote of no confidence in their management team.

Sources say that the Black Country Healthcare NHS Trust is not acting in the best interests of patients and they believe it wants to cut beds.

They also have no confidence in the way that the trust has removed its chief medical officer, Mark Weaver.

The NHS Trust said it was aware of concerns and had agreed to work on them going forward.

The doctors wrote to the trust board following a meeting of the Medical Advisory Committee claiming that over the past two years the relationship with the board had become fractured.

In the letter they claimed the voice of doctors was not being taken seriously by the board and that clinical priorities were secondary to financial performance.

They also said they were seriously disturbed with the way in which Mr Weaver had been asked to step down and that the deputy chief medical officer Dr Sharada Abilash had not been asked to take over while due process occurred.

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Source: BBC News, 9 December 2023

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CQC sorry for failing to act on ‘note tampering’ concerns

The Care Quality Commission (CQC) has apologised after admitting it failed to act on whistleblowing concerns “in a timely manner”.

Allegations had been made to the CQC about staff at Cambridgeshire and Peterborough Foundation Trust tampering with a patient’s record after they had died by suicide.

As previously reported, the accusations by whistleblower Des McVey have sparked a review of the trust’s conduct in more than 60 suicide cases.

Mr McVey says the trust only took action following media coverage and that the CQC had ignored his concerns.

The regulator has now upheld a complaint from him, with operations manager James DeCothi writing to Mr McVey: “I have established that [the relevant CQC inspector] did not share your concerns with the provider in a timely manner and that our contact with you from July 2022 to June 2023 was inconsistent. I apologise on behalf of CQC for this. [The CQC inspector] has reflected on this and has asked me to offer her apologies to you also.

“I can confirm that CQC have followed up the areas of concern that you have shared, and we will continue to use the information you have shared to inform future regulatory activity. I would like to thank you again for sharing this information with us.”

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Source: HSJ, 11 December 2023

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Top doctors warn A&E crisis is making patients sicker as corridor care becomes routine

Patients needing emergency treatment are becoming sicker in A&E as hospitals struggle to free up enough beds, top doctors have warned.

Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told The Independent that elderly patients are waiting so long for treatment in A&E that they’re developing bed sores and delirium.

Another senior NHS doctor, Dr Vicky Price, who is president-elect of the Society for Acute Medicine, warned that corridor care is now “routine practice” with the situation only set to worsen as A&E departments come under increasing pressure.

Their comments highlight the ongoing chaos in emergency medicine, as strikes take place during the most difficult time of the year. The chief executive of the NHS, Amanda Pritchard, said on Thursday that last winter was the worst she’d ever seen for the health service, warning that strikes by junior doctors will only make the situation harder for hospitals this year

The warnings come as the latest NHS data shows that the prime minister, Rishi Sunak, could fail in his promise to deliver 5,000 more acute hospital beds to the NHS this month. Current data shows that the NHS is falling short of the target by just under 1,200 beds, with 97,818 against a target of 99,000.

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Source: The Independent, 10 November 2023

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Warning lack of line flushing leading to ‘under delivery’ of IV antibiotics

The under delivery of intravenous antibiotics in some NHS hospitals due to lack of polices and compliance may be contributing to antimicrobial resistance (AMR), according to a parliamentary report.

Findings in the report indicated that many health service organisations do not have policies in place to reduce the risk of under delivery and those that do can struggle to comply fully with them.

The report’s authors warned that the residual volume of antibiotic remaining in the line of the IV administration set can result in under delivery of up to 30% of the prescribed dose.

They said that, as a result, this could be leading to possible resistance within patients, owing to the accumulative effect. Nurses involved with compiling the document have called for action.

Based on the findings, the report recommended that all NHS organisations implement line flushing policies by late 2024, with support from the Department for Health and Social Care.

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Source: Nursing Times, 9 December 2023

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London hospital cuts waiting lists with innovative system

Surgeons at one London hospital are performing an entire week’s operations in a single day as part of a ground-breaking initiative that could help tackle the record waiting lists in the NHS.

Guy’s and St Thomas’ NHS Foundation Trust has already slashed its own elective backlog in certain specialities by running monthly HIT (High Intensity Theatre) lists at weekends.

Under the innovative model, two operating theatres run side by side and as soon as one procedure is finished the next patient is already under anaesthetic and ready to be wheeled in.

Nurses are on standby to sterilise the operating theatre and instead of taking 40 minutes between cases it takes less than two, the only delay is the 30 second it takes for the anti-bacterial cleaning fluid to work.

Kariem El-Boghdadly, the consultant anaesthetist who designed the programme with his colleague Imran Ahmad, compares it to a Formula One pit stop. “They’ve got one person doing the rear right wheel, one person doing the front left wheel. It’s the same thing. The operating theatre is effectively like that.”

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Source: The Times, 10 December 2023

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Climate crisis will amplify the UK’s existing health inequalities

The health inequalities between different ethnicities, neighbourhoods and social classes are already stark, with millions of women in the most deprived areas in England dying almost eight years earlier than those from wealthier areas.

But according to the UK Health Security Agency’s (UKHSA) report, these disparities will worsen as the impact the climate crisis has on health is disproportionately negative to the most disadvantaged groups.

These particular groups include people with disabilities, homeless people and people living in local authorities with high levels of deprivation.

Sir Michael Marmot, the director of the Institute of Health Equity and the author of the landmark Marmot review into health inequalities in 2010, said that climate breakdown can make health inequalities worse.

Prof Lea Berrang Ford, the head of the Centre for Climate and Health Security at the UKHSA, made it clear that the negative health effects of climate breakdown will not be distributed equally across the UK, social determinants or generations.

The report said that children and young people will experience increasingly severe weather into their retirement, with effects persisting or increasing for their children.

Ford said: “The distribution of the impacts of climate change do not just differ across geographic regions, but also across different socio-demographic groups.

“Climate change is well recognised as likely to exacerbate existing health inequalities, and across a range of health impacts the most vulnerable groups are adults over 65 years old, children and those with pre-existing medical conditions.”

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Source: The Guardian, 11 December 2023

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New menopause therapy guidance will harm women’s health, say campaigners

New official guidance on treating menopause will harm women’s health, experts, MPs and campaigners have warned.

Last month, new draft guidelines to GPs from the National Institute for Health and Care Excellence (NICE) said that women experiencing hot flushes, night sweats, depression and sleep problems could be offered cognitive behavioural therapy (CBT) “alongside or as an alternative to” hormone replacement therapy (HRT) to help reduce their menopause symptoms.

But critics have castigated the guidance, saying it belittled symptoms through misogynistic language, and women’s health would suffer as a result of failing to emphasise the benefits of HRT on bone and cardiovascular health as opposed to CBT.

In its response to the guidance, Mumsnet said NICE's recommendations used “patronising” and “offensive” language and would be “detrimental” to women’s health.

Justine Roberts, the founder and chief executive of Mumsnet, said: “Women already struggle to access the HRT they are entitled to. We hear daily from women in perimenopause and menopause who are battling against a toxic combination of entrenched misogyny, misinformation and lack of knowledge among GPs.

“Too often they are fobbed off or told they simply need to put up with severe physical and mental symptoms – often with life-changing effects.

“By emphasising the negative over the positive, failing to include information about the safest forms of HRT and placing CBT on a par with hormone replacement therapy, this guidance will worsen that struggle. It will make doctors more reluctant to prescribe HRT and women more fearful about asking for or accepting it.”

Carolyn Harris, the MP for Swansea East and the chair of the all-party parliamentary group on menopause, said the new guidance was “antiquated”, “naive” and “ill thought-out”.

”Talking can make you feel better, but it’s not going to take away the aches in your joints and it’s not going to change how you live your life,” she said. “Whatever a woman feels is what she needs to support her through the menopause should be readily and immediately available, and that’s not true currently [of HRT or CBT]."

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Source: The Guardian, 11 December 2023

 

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NHSE warns widely used EPR could pose ‘serious risks to patient safety’

NHS England has issued a national alert to all trusts providing maternity services after faults were discovered in IT software that could pose “potential serious risks to patient safety”.

According to the alert, the Euroking electronic patient record provided by Magentus Software could be displaying incorrect patient information to clinicians.

The Euroking EPR is used in the maternity departments of at least 15 trusts according to information held by HSJ.

These organisations have been asked to “consider if Euroking meets their maternity service’s needs” and to “ensure their local configuration is safe”. Trusts with different maternity EPR providers have also been asked to reassess the clinical safety of their solutions.

The potential “serious risks” relate to a fault in the Euroking EPR which allows new patient information to overwrite previously recorded information, which could lead to “incorrect management of the pregnancy and subsequent harm”.

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Source: HSJ,  8 December 2023

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Nearly nine in ten GPs have faced verbal abuse in the last year

GPs have warned that the extent of verbal abuse directed at them and their practice staff ‘is increasing’, with the majority reporting that things are worse now than during the height of the Covid pandemic.

A UK-wide survey of more than 2,000 doctors – of which 617 were GPs – found that 85% of GPs have reported receiving verbal abuse from patients within the last 12 months.

The research conducted by Medical and Dental Defence Union of Scotland (MDDUS) also found that 15% of GPs reporting verbal abuse said they ‘had to resort to involving the police’ to deal with abusive patient situations over the past year.

In the survey, GPs identified key triggers such as ‘lack of access to a face-to-face consultation’ and ‘complaints about their quality of care’ as the factors that could escalate to verbal abuse.

One GP who responded to the survey said: "During a consultation with a young adult, they got very irate and demanded I just give them what they came for.

"I explained they had to calm down and we would only proceed then at which they called me an ugly, fat, c**t and threatened to smash my face in. That consultation stayed with me for quite a while after that."

Another said: ‘A patient smashed the surgery front door (it needed replacing) because he didn’t get what he wanted when he wanted it.

"This was very scary for staff and other patients and the police didn’t even come until the next day. I felt alone, defensive and wondered why we bother to try to provide a service when some patients have already decided it isn’t good enough for them."

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Source: Pulse, 7 December 2023

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Hospital leads way in using AI to help patients

A hospital has introduced a new artificial intelligence system to help doctors treat stroke patients.

The RapidAI software was recently used for the first time at Hereford County Hospital.

It analyses patients' brain images to help decide whether they need an operation or drugs to remove a blood clot.

Wye Valley NHS Trust, which runs the hospital, is the first in the West Midlands to roll out the software.

Jenny Vernel, senior radiographer at the trust, said: “AI will never replace the clinical expertise that our doctors and consultants have.

"But harnessing this latest technology is allowing us to make very quick decisions based on the experiences of thousands of other stroke patients.”

Radiographer Thomas Blackman told BBC Hereford and Worcester that it usually takes half an hour for the information to be communicated.

He said the new AI-powered system now means it is "pinged" to the relevant teams' phones via an app in a matter of minutes.

"It's improved the patient pathway a lot," he added.

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Source: BBC News, 7 December 2023

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Danger warning for hospitals as flu cases soar by 50%

NHS leaders have issued a warning over surging flu cases as the number of patients in hospital with the bug soared by more than 50% in a week.

An average of 234 people were in hospital with flu each day last week – up 53% on the previous seven days. Figures from NHS England also showed a rise in norovirus cases in hospitals last week with an average of 406 cases per day, up from 351 the previous week and a 28% rise from last year.

The latest data comes after public health officials sent a warning over whooping cough levels, with 719 suspected cases reported between July and November, up from 217 last year.

This week several NHS hospitals have sent out alerts to the public warning of “extremely busy” A&Es.

Dr Tim Cooksley, former president of the Society for Acute Medicine, warned: “Pressures are being exacerbated by increasing rates of sickness among colleagues, as well as pressures on precious resources such as isolation areas and side rooms, adding to the strain on already overstretched services...

“Undoubtedly we will see more older patients enduring prolonged degrading periods of corridor care and many people experiencing difficult symptoms whilst they sit on elective waiting lists.

“Most hospitals are already experiencing chaotic and dangerous scenarios.”

He added that there was “a lack of understanding of the gravity of the situation” from new health secretary Victoria Atkins.

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Source: The Independent, 7 December 2023

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A third of new mothers worldwide ‘have lasting health issues after childbirth’

More than 40 million women a year experience lasting health issues after childbirth, a global review has found, prompting calls for greater recognition of common postnatal problems.

The sweeping analysis of maternal health worldwide shows a very high burden of long-term conditions that last for months and even years after giving birth. One in three new mothers worldwide are affected.

The findings emerged from a series published in the Lancet Global Health and eClinicalMedicine, backed by the UN’s Special Programme on Human Reproduction, the World Health Organization and the US Agency for International Development.

Prof Pascale Allotey, the director of sexual and reproductive health and research at the WHO, said: “Many postpartum conditions cause considerable suffering in women’s daily life long after birth, both emotionally and physically, and yet they are largely underappreciated, underrecognised, and underreported.

“Throughout their lives, and beyond motherhood, women need access to a range of services from healthcare providers who listen to their concerns and meet their needs – so they not only survive childbirth but can enjoy good health and quality of life.”

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Source: The Guardian, 6 December 2023

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Pregnant women told to get vaccinated amid spike in suspected whooping cough cases

Pregnant women have been urged to get vaccinated following a spike in suspected whooping cough cases in England and Wales.

Official figures show doctors reported some 716 suspected cases between July and November - up from 217 in the previous period last year.

Whooping cough, or pertussis, is a bacterial infection of the lungs and breathing tubes that spreads easily and infected tens of thousands of people before vaccines were introduced.

It is easily preventable, experts say, but can sometimes cause serious problems for babies and children.

Dr Gayatri Amirthalingam, consultant epidemiologist at the UKHSA, said the rise in suspected cases of whooping cough was “expected” due to low immunity as a result of the Covid pandemic.

Despite vaccinations being available in the UK the infection hasn’t gone away “completely” but immunisation can provide “life-long protection”.

“Social distancing and lockdown measures imposed across the UK during the COVID-19 pandemic had a significant impact on the spread of infections, including whooping cough,” Dr Amirthalingam added.

“As expected, we are now seeing cases of whooping cough increase again so it’s vital pregnant women ensure they get vaccinated to protect their baby.”

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Source: The Independent, 7 December 2023

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Duty of candour review announced

Patient Safety Learning sets out its response to the announcement by the Department of Health and Social Care that it will be reviewing the statutory duty of candour for health and social care providers in England.

"We welcome today's announcement by the Government that they will hold a review into the statutory duty of candour for health and social care providers.

The statutory duty of candour is intended to ensure that healthcare providers are open and transparent with the public. It sets specific requirements for organisations to follow when things go wrong with care and treatment.

Earlier this year the Parliamentary and Health Service Ombudsman highlighted concerns around the implementation of duty of candour and called for a review to assess its effectiveness in their report Broken trust: making patient safety more than just a promise. In our response to this report, we supported this recommendation.

As part of reviewing problems with compliance, we believe that there are also broader questions that also need to be addressed concerning how the implementation of this is monitored and what remediation and redress is available to patients and the families when these obligations are not met.

We also believe that this review should look at how the duty of candour is being implemented in light of the introduction of the new Patient Safety Incident Response Framework (PSIRF), given that this represents a significant change to the NHS’s approach to incident investigation."

Source: Patient Safety Learning, 6 December 2023

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Private hospital admissions soar to record high as hundreds of thousands rely on insurance

Private hospitals saw record admissions this year after hundreds of thousands of people sought care through their insurance amid rocketing NHS waiting lists, new figures show.

Between January and June 443,000 private treatments took place – a 7% rise from 2022, the vast majority of which were claimed through medical insurance policies.

According to the Private Hospital Information Network (PHIN), which collects data from hospitals in the sector, there was a 12% increase in the number of people paying for care via insurance with 157,000 people using this route from January to March and 148,000 from April to June this year.

The news comes as the NHS’s waiting list continues to grow with almost 7.8 million appointments recorded. Recently published data shows that there is a total of 6.5 million individual people on the waiting list.

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Source: The Independent, 7 December 2023

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New tests may finally diagnose Long Covid

One of the biggest challenges facing clinicians who treat Long Covid is a lack of consensus when it comes to recognising and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify Long Covid with accuracy approaching 80%. 

Effective diagnostic testing would be a game-changer in the Long Covid fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with Long Covid also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of Long Covid patients are unemployed because of the severity of their illness and their employers may be sceptical of their condition.

Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with Long Covid and 87 who had not. All participants had recovered from a severe bout of acute Covid-19.

In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular—Ba, iC3b, C5a, and TCC—predicted the presence of Long Covid with 78.5% accuracy.

"I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of Long Covid.." 

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Source: Medscape, 29 November 2023

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Trust reviewing bed capacity after three patient deaths

A coroner has warned a trust in the West Midlands for the third time about bed shortages, after three patient deaths which he believes are linked.

In his report on the death in July of Philip Malone, area coroner for Birmingham and Solihull James Bennett told Birmingham and Solihull Mental Health Foundation Trust that its psychiatric bed capacity “remains inadequate”.

Mr Malone – who was diagnosed with treatment-resistant schizophrenia in the 1980s and adult autism in May this year – died by suicide while awaiting an inpatient psychiatric bed at BSMHFT after a deterioration in his symptoms of anxiety, thought disorder, and hallucinations.

Clinicians decided on 28 June that Mr Malone should be detained under the Mental Health Act, but as no inpatient psychiatric bed was available, he remained in the supported accommodation. Mr Malone died on 3 July.

In a public report warning of the risks which may cause future deaths, issued last week, Mr Bennett said he had issued two previous “prevention of future death” reports which focused on a “chronic lack” of mental health resources in Birmingham and Solihull.

Mr Bennett said: “The issue of adequately funding psychiatric beds is local and national. Locally, BSMHFT requires its commissioners to provide the necessary funding.

“Whilst some action may have been taken it is insufficient to resolve the problem. It follows there is a genuine risk of future deaths directly connected to a shortage of psychiatric bed spaces in Birmingham and Solihull unless further action is taken.”

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Source: HSJ, 5 November 2023

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Urgent investment for Long Covid: Call to action for Prime Minister Rishi Sunak

Former Prime Minister Boris Johnson is scheduled to provide evidence at the Covid Inquiry on the 6 and 7 of December. Long Covid is one of the most catastrophic consequences of the pandemic and it deserves a prominent place in the discussions during this critical phase of the inquiry.

The Long Covid Groups will be delivering a letter to No.10 Downing Street today, urging attention to the unique challenges faced by those with Long Covid. 

Read the letter and sign the petition

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Doctor suspended for sterilising woman without permission

A consultant gynaecologist who admitted sterilising a woman without her permission has been suspended from practising for 12 months.

The woman - known as Patient A - was sterilised by Dr David Sim following an emergency caesarean section.

Dr Sim previously admitted that the sterilisation was not necessary to save the woman's life or prevent harm to her health.

The procedure took place at Daisy Hill Hospital in Newry in September 2021.

On 1 December, the Medical Practitioners Tribunal Service (MPTS) found his fitness to practice was impaired.

The tribunal previously heard Dr Sim and the patient had discussed sterilisation twice over a period of years, but the patient had never consented or expressed any wish to undergo sterilisation.

When she required the emergency caesarean section, Dr Sim delivered the baby and blocked the patient's fallopian tubes to permanently impair their normal function.

Dr Sim previously admitted to the tribunal that this was in violation of the woman's reproductive rights.

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Source: BBC News, 5 December 2023

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"I'm begging for help for endometriosis"

Living with seizures and crippling pain, Zara Corbett says she's "begging for help" as she copes with endometriosis.

The 21-year-old told BBC News NI that if she had any other condition she would be receiving help.

"With gynae problems, particularly endometriosis, you are left waiting for years."

"Women should not be left suffering this pain, it's not good enough," the beautician said.

Zara has been put into early menopause - which is one potential treatment for endometriosis.

The County Down woman said Northern Ireland needed a dedicated centre to provide specialist support.

"I am begging for help from medical professionals including support from a multi-agency network because we are at our wits end - life cannot go on like this," she said.

Endometriosis UK, an organisation that helps women with the condition, said it was shocked and saddened that it does not see "good, prompt care" in Northern Ireland.

Its chief executive, Emma Cox, who visited Belfast in May, said services in Northern Ireland were "lagging behind" the rest of the UK.

"We hear of the very long waiting lists to access gynaecologists to get a diagnosis but also waiting lists to access surgeons, it's about the disease being taken seriously," Ms Cox said.

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Source: BBC News, 6 December 2023

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Experts call for fewer antidepressants to be prescribed in UK

Open letter to government from experts and politicians says rising usage ‘is a clear example of over-medicalisation’.

Medical experts and politicians have called for the amount of antidepressants being prescribed to people across the UK to be reduced in an open letter to the government.

The letter coincides with the launch of the all-party parliamentary group Beyond Pills, which aims to reduce what it calls the UK healthcare system’s over-reliance on prescription medication.

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Source: Guardian, 5 December 2023

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Huge delays to access maternal mental health care in England called a scandal

NHS figures obtained by Labour reveal 11,507 women sought care but did not get any last year.

Almost 20,000 women a year living with mental health problems triggered by being pregnant or giving birth are being denied support by the NHS, the Guardian can reveal.

Furthermore, those who do receive mental health help for their trauma are having to wait up to 19 months to start treatment in some parts of England because specialist services are so overstretched.

The situation has been described as “an absolute scandal” and sparked warnings that “rationing” of such vital care could leave women who do not get it in a very vulnerable state and risk their children facing lifelong health problems and stop mothers bonding with their baby.

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Source: Guardian, 5 December 2023

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Ministers lose infected blood vote after Tory MPs revolt

MPs have backed a move to speed up compensation for victims of the NHS infected blood scandal, delivering the prime minister his first Commons defeat.

Ministers will now have to set up a body to run the scheme within three months of a new bill becoming law.

The vote was passed by 246 votes to 242 after 22 Conservatives rebelled.

The Haemophilia Society said Rishi Sunak "should be ashamed" he had been forced "to do the right thing".

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Source: BBC News, 5 December 2023

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Humiliated Covid whistleblower says boss tried to 'break' her

A senior doctor who won a record £3.2m payout says her boss tried to "break" her after she raised concerns about how Covid was being handled.

Rosalind Ranson, medical director on the Isle of Man during the pandemic, experienced months of humiliation, an employment tribunal found.

Dr Ranson has given BBC News her first interview since the hearing.

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Source: BBC News, 5 December 2023

 

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GPs will not be nationally mandated to use advice and guidance, NHSE confirms

There will be no national mandate for GPs to use advice and guidance in a certain number of cases, NHS England has told Pulse. 

National medical directors for primary and secondary care said that formalised pathways should be developed ‘locally’, and decisions should be based on an area’s population.

In September, it was reported that NHS England’s upcoming outpatients strategy would further increase the use of advice and guidance (A&G) before GP referrals are accepted, with the RCGP then "voicing concerns" about this proposal. 

However, when asked about the reports that this would be mandated, Dr Stella Vig, national medical director for secondary care and clinical director for elective care, said she ‘doesn’t know’ where that came from, and ‘doesn’t recognise’ those comments.

NHS England also released guidance clarifying the medico-legal risks and clinical responsibility for clinicians using A&G or referral assessment services (RAS), which is now available on the NHS Futures website.

The guidance said that these forms of specialist advice are "expanding rapidly" as a result of improvements to digital services.

On legal issues, it said liability ‘will be determined on a case by case basis’ but that GPs could be liable if "all relevant clinical information is not provided" when sending an A&G request. 

But specialists at hospitals would be accountable if they send back advice to the GP which is ‘not clinically appropriate’ or if they ‘refuse to accept a patient’. 

On turnaround times, NHS England has said that ‘local variables will ultimately dictate the agreed response times’ for hospital teams dealing with A&G – but the guidance recommends that the response time "should not exceed 10 working days for routine requests". 

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Source: Pulse, 30 November 2023

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