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Unvaccinated health and care workers in England could be redeployed

Health and care sector workers in England who decline to be fully vaccinated could be moved to back-office roles, a UK government minister has suggested, as a consultation on plans to mandate COVID-19 and flu vaccinations was launched.

The six-week consultation process will take views on whether vaccine requirements should apply for health and wider social care workers – those in contact with patients and people receiving care.

It would mean only those who are fully vaccinated, unless medically exempt, could be deployed to deliver health and care services.

Speaking on Times Radio, Helen Whately, the minister for care, said the government was working with care homes and other settings to see if workers who refused the vaccine could be redeployed.

She said: “You can look at whether there are alternative ways somebody could be deployed, for instance, in a role that doesn’t involve frontline work, or doesn’t involve being physically in the same setting as the patient – whether it’s, for instance, working on 111, something like that."

But she suggested that people who refused to get vaccinated against coronavirus should not work in social care.

Speaking on Sky News, Whately said care homes had been hit particularly hard by Covid, and added: “The reality is that one of the best ways we can protect people living in care homes is through making sure that staff are vaccinated.”

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Source: The Guardian, 9 September 2021

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Unvaccinated children to face isolation for 21 days during measles surge

Children who have not been vaccinated against measles may have to enter isolation for 21 days if a classmate becomes infected.

The UK Health Security Agency (UKHSA) predict the capital alone could see 160,000 cases occur as measles, mumps and rubella (MMR) vaccination rates are at the lowest in a decade.

Both Haringey and Barnet Council wrote to parents to tell them any unvaccinated child who comes into close contact with a measles case could be asked to self-isolate for up to 21 days.

This week statistics from NHS England show that across the country more than 102,000 children aged four and five starting in reception are not protected against catching measles, mumps and rubella.

32,000 children in London alone aren’t vaccinated, reveal NHS England, and just three-quarters of children in the capital have received the two required doses of the MMR jab, which protects against measles. This is 10% lower than the national average.

Measles is highly infectious and if left unvaccinated nine out of ten children in a classroom will catch the disease if just one child is infectious.

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Source: The Independent, 15 September 2023

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Untested AI-based tools could harm patients, WHO warns

As excitement builds throughout health and information systems worldwide over the rich potential benefits of new tools generated by artificial intelligence (AI), the World Health Organization (WHO) has called for action to ensure that patients are properly protected.

Cautionary measures normally applied to any new technology are not being exercised consistently with regard to large language model (LLM) tools, which use AI for crunching data, creating content, and answering questions, WHO warned.

“Precipitous adoption of untested systems could lead to errors by healthcare workers, cause harm to patients, erode trust in AI, and thereby undermine or delay the potential long-term benefits and uses of such technologies around the world,” the agency said.

As such, WHO proposed that these concerns are addressed and clear evidence of benefits are measured before their widespread use in routine health care and medicine.

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Source: United Nations News, 16 May 2023

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Unsupportive Government ‘indirectly puts GP patient lives at risk’

A lack of support for general practice is indirectly putting patient lives at risk, amid escalating abuse in GP practices, the England LMCs conference has heard.

A debate around abuse saw 99% of conference delegates agree that ‘the abuse of primary care staff directly affects patient care and puts patient safety at risk’.

And 98% agreed that ‘when Government and [NHS England] choose not to support NHS staff, they directly affect patient safety and knowingly put lives at risk’.

The conference also voted to ‘demand that healthcare policy is decided based on high-quality evidence on population health, and not the whims of a handful of vitriolic media’, with the vote unanimous on the topic.

Speaking in the debate, which focussed on GP abuse and wellbeing, Dr Abel Adegoke of Wirral LMC told delegates that the NHS "runs on the blood of GPs"

He said: "About four weeks ago, my younger sister was being buried and I had to watch via Zoom because that was taking place in Nigeria – yet I was still seeing patients. That was the day I felt so sad about being a GP because despite that sacrifice, I was still abused by a patient who wanted to be seen urgently for an absolutely non-urgent condition."

"We are being taken for granted."

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Source: Pulse, 30 November 2021

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Unsafe maternity care has cost the NHS £8.2bn in 15 years

Negligent maternity care in the NHS has cost taxpayers an “eye-watering” £8.2bn over the past 15 years, The Independent reveals.

Ministers face calls to urgently increase spending to ensure maternity units are safe for women and babies by providing adequate staffing levels, training and equipment.

New data, obtained by The Independent from NHS Resolution, which handles clinical negligence costs for the service, reveals that total payments made following settled cases and legal costs rose from £271m in 2006-07 to an estimated £920m in 2020-21.

The number of maternity claims being made by families has almost doubled in the past decade, rising from 391 in 2009-10 to 765 in 2019-20.

Recent maternity scandals at the Shrewsbury and Telford Hospital Trust, East Kent Hospitals University Trust and at hospitals in Nottingham have all had common themes around poor culture, a lack of honesty and not enough staff or equipment.

The Department of Health and Social Care is exploring how it can make changes to the UK clinical negligence system to reduce the costs to the taxpayer. Health minister Nadine Dorries told MPs on the Commons health committee in February that the reforms would look “across the NHS… not just maternity, at how issues of no-blame, no-fault compensation and clinical negligence are treated”.

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Source: The Independent, 20 September 2021

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Unregulated online clinic gave teen dangerous hormone dose

A 15-year-old child was prescribed dangerous levels of hormones by an unregulated online clinic without speaking to a doctor, a court ruling has revealed.

Now 16, the teenager, known as J, was born female but identifies as a boy and has an autism diagnosis.

J got a prescription for testosterone and puberty blockers from Singapore-registered GenderGP in late 2022. He had previously been unable to get the treatment through the NHS.

Judge Sir Andrew McFarlane said: "There must be very significant concern about the prospect of a young person such as J accessing cross-hormone treatment from any off-shore, online, unregulated private clinic."

The judgement highlights the lack of NHS gender services for children and young people in England and Wales, after the closure of the Tavistock Gender Identity and Development Service (Gids) in April. Gids, rated as "inadequate" by inspectors in 2021, was the only specialist gender clinic for children and young people in the two countries. The judgement says that, as a result: "There is no relevant NHS service available for J."

Although the prescription was from a private doctor, J was given injections of testosterone by his local NHS GP every six weeks between January and August 2023. 

An expert witness in the case, Australia-based consultant paediatric endocrinologist Dr Jacqueline Hewitt, was critical of the lack of physical and psychological checks carried out by GenderGP on J. Dr Hewitt also raised concerns about the size of the doses of testosterone given to J, describing the level of the hormone in his blood during his treatment as "dangerously high".

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Source: BBC News, 2 May 2024

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Unregulated ‘eating disorder coaches’ putting people at risk, say experts

Vulnerable mental health patients are being put at risk by unregulated “eating disorder coaches” who do not have the necessary qualifications, experts have said.

As demand for eating disorder support soars – hospital admissions for eating disorders increased by 84% in the last five years – more people are filling gaps in NHS care.

So-called eating disorder coaches, who tend to be personal trainers or dietitians recovering from the illness themselves, are charging as much as £1,000 a month for sessions to offer support to others despite having little or no training and expertise.

The Guardian has found that many coaches cite short courses, which are intended as professional development for psychologists, as a qualification to practise.

The National Centre for Eating Disorders (NCED) offers a number of professional training courses, accredited by the British Psychological Society (BPS). The Guardian found a number of coaches were using these courses to claim they were qualified to offer professional services to people with eating disorders.

Agnes Ayton, chair of the Royal College of Psychiatrists’ eating disorders faculty, said she was “amazed” to see people “advertising themselves as experts after going on one course”.

“Eating disorders sit between physical and mental health so the risks associated with eating disorders can be physically debilitating and potentially fatal,” Ayton said. “I don’t know why there is not better regulation on that because there is lots of regulation for a medical professional – but therapy is the first line of treatment for eating disorders, and if it is not delivered properly, it can be harmful or misleading.”

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Source: The Guardian, 21 March 2023

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Unpublished hospital patient safety reports exposed

Serious patient safety issues are being buried in confidential hospital reports, BBC Panorama has found.

Freedom of Information requests revealed 111 reports, written by medical royal colleges, which NHS trusts have a duty to share. Eighty reports were given to the BBC but only 26 had been shared in full with regulators, and 16 published.

The Department of Health would not comment on whether it might change the law to ensure publication.

Since the 2015 Morecambe Bay maternity scandal in which 11 babies and a mother died, NHS Trusts are supposed to publish summaries of external reviews, and share them with the regulator.

An earlier review into the hospital had previously identified concerns but had not been made public.

Dr Bill Kirkup, who led a 2015 investigation into the Morecambe Bay scandal, said Panorama's findings were a "great disappointment".

"People should know that there is something that is important enough to be looked at and they should know what the results of that scrutiny are. I can't understand what the rationale would be for withholding the existence of a report or the findings of the report. These are important matters of accountability in the public service."

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Source: BBC News, 19 May 2021

 
 
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Unplanned ‘Ozempic babies’ may be harmed by weight-loss drugs

Women have been told to avoid using weight-loss drugs to help them get pregnant, as doctors report a rise in surprise “Ozempic babies”.

Some women struggling with infertility have unexpectedly become pregnant after being prescribed semaglutide, which is used to treat obesity and type 2 diabetes under the brand names Wegovy and Ozempic.

However, scientists have now issued a warning that the weight-loss injections may cause birth defects and should not be used by anyone hoping to become pregnant.

Professor Tricia Tan, from the department of metabolism, digestion and reproduction at Imperial College London, said: “Women need to know that these drugs should not be used during pregnancy. You can also see that most of the clinical trials have not included women who are intending to become pregnant. Animal studies did show that the animal babies born to animals who were given these medications had problems.”

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Source: The Times, 23 April 2024

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Unlocking risk for pregnant women

The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) has warned there may be a risk to pregnant women when next weeks restrictions relax. 

Experts are warning that infection rates among pregnant women may increase once the restrictions are lifted and encourage them to protect themselves and their families as women who are pregnant are more likely to become severely ill with Covid-19.

RCN chief executive Gill Walton, has said: "Along with mask wearing, hand washing and social distancing, vaccination is a vital tool in the fight to protect yourself against this virus.

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Source: BBC News, 15 July 2021

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Unlicensed implants made with non-medical parts used in Temple Street spinal operations – surgery suspended

Certain spina bifida-related surgeries remain suspended at Children's Health Ireland at Temple Street (CHI) for almost a year amid serious allegations that unlicensed devices made with non-medical parts have been implanted in child patients. In two cases where these devices were used, the implants had to be removed from patients after causing significant harm, while the efficacy of a third is yet to be determined.

One senior member at the hospital has raised concerns about the number of repeat operations required on young spina bifida patients and associated rates of reinfection, with disquiet in the hospital eventually leading to first an internal review of operations in October 2022 and later an external probe by US clinicians.

In June this year there were 287 children on waiting lists in Ireland for life-changing spinal surgery. Despite a commitment first given by then health minister Simon Harris in 2017 that no child would be on the waiting list for more than four months, there are still more than 120 children waiting more than a year for scoliosis surgery, according to the Ombudsman for Children.

CHI has declined to comment on allegations that one of its surgeons has used the unlicensed, failed implants, as well as its decision to cease operations on spina bifida patients.

Patient advocate Amanda Santry, who took part in the external review on behalf of Spina Bifida & Hydrocephalus Paediatric Advocacy, has said she has been denied access to the review findings and has also called for a “full investigation” into the allegations of the use of non-medical parts.

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Source: The Ditch, 15 September 2023

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Unlawful do not resuscitate orders imposed on people with learning disabilities

Unlawful 'do not resuscitate' orders are being placed on patients with a learning disability during the coronavirus pandemic without families being consulted.

National charities have successfully challenged more than a dozen unlawful do not resuscitate orders (DNRs) that were put in place because of the patient’s disability rather than due to any serious underlying health risk.

Turning Point said it had learned of 19 inappropriate DNRs from families while Learning Disability England said almost one-fifth of its members had reported DNRs placed in people’s medical records without consultation during March and April.

In one example, a man in his fifties with sight loss was admitted to hospital after a choking episode and was incorrectly diagnosed with coronavirus. He was discharged the next day with a DNR form giving the reason as his “blindness and severe learning disabilities”.

Marie-Anne Peters, whose brother Alistair has epilepsy but no other health conditions, overturned a DNR on her brother which included instructions for him not to be taken to hospital.

Both charities fear other people with learning disabilities who are vulnerable could be wrongly denied life-saving treatment. They have now launched a new checklist for families and care workers to challenge illegal DNRs.

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Source: The Independent, 13 June 2020

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University of Leicester team finds more stillbirths in deprived areas

Research suggests there are higher rates of stillbirth and neonatal death for those living in deprived areas and minority ethnic groups.

A report from a team at the University of Leicester shows that while overall stillbirth and neonatal mortality rates have reduced, inequalities persist.

MBRRACE-UK, the team that carried out the research, said it had looked at outcomes for specific ethnic groups. The report showed the stillbirth rate in the UK had reduced by 21% over the period 2013 to 2020 to 3.33 per 1,000 total births. Over the same period the neonatal mortality rate has reduced by 17% to 1.53 per 1,000 births.

However despite these improvements, the authors found inequalities persisted, with those living in the most deprived areas, minority ethnic groups and twin pregnancies all experiencing higher rates of stillbirth.

Elizabeth Draper, professor of perinatal and paediatric epidemiology at the university, said: "In this report we have carried out a deeper dive into the impact of deprivation and ethnicity on stillbirth and neonatal death rates.

"For the first time, we report on outcomes for babies of Indian, Pakistani, Bangladeshi, Black Caribbean and Black African, rather than reporting on broader Asian and black ethnic groups, who have diverse backgrounds, culture and experiences.

"This additional information will help in the targeting of intervention and support programmes to try to reduce stillbirth and neonatal death."

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Source: BBC News, 14 October 2022

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University Hospitals Sussex urged to release review findings

An NHS trust has been urged to publish the full findings of an independent review of its services after it released a heavily redacted report.

University Hospitals Sussex has refused to reveal the recommendations made after a review by the Royal College of Surgeons in 2019.

A patients' group said the findings should be "in the public domain".

The trust said the review of its neurosurgery department "did not highlight any safety concerns".

The review was discovered as part of a BBC Panorama investigation into unpublished patient safety reports. A heavily edited report was released under freedom of information laws.

It showed the trust asked the Royal College of Surgeons to look at "concerns raised in respect of clinical outcomes, allocation of sub-specialties and governance arrangements".

All issues and recommendations were obscured, with only positive feedback disclosed.

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Source: BBC News, 20 May 2021

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University Hospitals Birmingham: Whistleblowers fear no change at 'toxic' NHS trust

Whistleblowers who first revealed a toxic environment at one of England's largest NHS trusts say they do not believe crucial changes will be made.

In a letter, they said families who suffered due to management failings at University Hospitals Birmingham (UHB) "have every reason to feel let down".

Investigations have been examining UHB after staff told the BBC a climate of fear put patients at risk.

The letter was written by three doctors to the Labour MP For Birmingham Edgbaston, Preet Gill, who is heading a cross-party reference group on the trust.

In their letter, the consultants raise concerns about the appointment from within the trust of new chief executive Jonathan Brotherton and feel the management team remains largely unchanged.

"More than six months have elapsed since we spoke to you of the need to repay the debt owed to those UHB staff, patients and their families who have suffered as a result of the board's serious failings," they wrote.

"They now have every reason to feel let down."

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Source: BBC News, 29 August 2023

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University Hospitals Birmingham: Half of staff felt bullied

More than half of staff at a hospital trust that has been under fire for its "toxic culture" have said they felt bullied or harassed.

The findings come from an independent review commissioned by University Hospitals Birmingham (UHB) NHS Trust.

It has been at the centre of NHS scrutiny after a culture of fear was uncovered in a BBC Newsnight investigation.

UHB has apologised for "unacceptable behaviours". It added it was committed to changing the working environment.

Of 2,884 respondents to a staff survey, 53% said they had felt bullied or harassed at work, while only 16% believed their concerns would be taken up by their employer.

Many said they were fearful to complain "as they believed it could worsen the situation," the review team found.

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Source: BBC News, 27 September 2023

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University Hospitals Birmingham NHS Foundation Trust pays fixed penalties of £8,000 for failures around consent

The Care Quality Commission (CQC) has issued two fixed penalty notices to University Hospitals Birmingham NHS Foundation Trust totalling £8,000 for failing to seek consent to care and treatment of someone in their care.

A 55-year-old gentleman who had diagnoses of epilepsy and autism was admitted to Good Hope Hospital in Birmingham on six occasions between 12 May 2019 and 6 October 2019. He had also been deaf since birth and communicated via British Sign Language (BSL) and lip reading.

These fixed penalty notices relate to the trust’s care and treatment of the patient at Good Hope Hospital in relation to three medical procedures, which occurred in September, October and November 2019.

CQC found that on these three occasions, the trust did not comply with Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, requiring registered persons to obtain the consent of the relevant person when providing care and treatment to them. Regulation 11 also states if someone is 16 or over and is unable to give consent because they lack capacity, the registered person must act in accordance with the Mental Capacity Act 2005.

The three procedures where CQC found consent failures, were feeding tubes, aimed at providing nutritional support to the patient, who was struggling with food.   

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Source: CQC, 7 October 2022

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Unit put into special measures after ‘inadequate’ rating

A low secure unit for people with learning disabilities and autism has been put into special measures after inspectors found the use of restraint and segregation affected the quality of life for some patients.

Cedar House, in Barham near Canterbury, houses up to 39 people and had been rated “good” by the Care Quality Commission early last year.

But at an inspection in February this year inspectors rated the service – run by the Huntercombe Group — “inadequate,” saying it was not able to meet the needs of many of the patients at the unit. It was issued with three requirement notices.

One patient had been subject to prolonged restraint 65 times between September and February. Each time he was restrained by between two and 19 staff, for an average of nearly two hours. On one occasion, this restraint lasted for eight hours.

But the inspectors were told that in the six months before the inspection 29 staff had been injured during these restraints, and the hospital had been trying to refer the patients to a more secure environment.

“The impact of this inappropriately placed patient was considerable for both the patients and the hospital,” the report said. “The staff who were regularly involved in restraining the patient were tired and concerned about the welfare and dignity of the patient.”

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Source: HSJ, 21 July 2020

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Unfilled consultant posts pose key risk to patient safety - Irish Medical Council

Unfilled specialised medical consultant roles and an over-reliance on overworked, internationally trained graduates for non-consultant hospital doctors are among key risks to patient safety identified by the Irish Medical Council.

The council, which is the regulatory body for the medical profession, sets out the risks to healthcare for the first time in its workforce intelligence report that breaks down the make-up of the medical register and explains why doctors are leaving the health system.

More than a third of all clinically active doctors are on the general register, which is a key risk to patient safety because consultant and specialist roles are not being filled and “a considerable proportion” of non-consultant hospital doctors are required to perform the duties of consultants.

The report found that the majority of non-consultant hospital doctors are trained overseas and that the health system overly relied on these doctors who reported being “overworked, undervalued, experiencing discrimination and unable to access specialist training.”

“Aside from the individual impact on the doctors, the treatment of international medical graduates has serious implications for patient safety,” the council said.

In another risk identified by the regulatory body, more than a quarter of doctors reported working more than 48 hours a week, in breach of the European Working Time Directive.

This has further serious implications for patient safety,” the council said.

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Source: Irish Times, 1 September 2022

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Under-18s being denied urgent mental health treatment, say GPs

Troubled teenagers seeking urgent help from NHS mental health services are being denied treatment or facing months of delays, GPs have said. Three in four family doctors do not believe under-18s they refer to child and adolescent mental health services will end up being treated, research shows.

In a survey of 1,008 GPs across the UK, 76% said they did not usually feel confident a young person they referred to Child and Adolescent Mental Health Services (CAMHS) would receive treatment for their illness. Only 10% were confident that treatment would follow.

Emma Thomas, Chief Executive of YoungMinds, said: “As these worrying results show, GPs are on the frontline when it comes to mental health. But too often they don’t believe that there is good enough early support in their community".  She added, "This means many young people either receive support from GPs who have the best of intentions but may not feel equipped to provide the right help, or face long waiting times for specialist services, which may then turn them away because of high thresholds for treatment.”

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Source: Guardian, 7 November 2019

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Under fives betrayed as health declines

Worsening health among the under fives in the UK needs to be urgently addressed, experts say.

The Academy of Medical Sciences highlights what it says are "major health issues" like infant deaths, obesity and tooth decay.

It says society is betraying children and the problems are limiting their future and damaging economic prosperity.

The report says:

  • The UK is 30th out of 49 rich countries for infant mortality.
  • One in five children falls short of the expected level of development aged two.
  • One in five is overweight or obese by five.
  • Vaccination targets are being missed for diseases such as measles.
  • One in four is affected by tooth decay by five.
  • One in five women struggles with their mental health during or just after pregnancy.
  • Air pollution is linked to worsening asthma.
  • Rising demand for child mental health services.

The report calls for a cross-government vision to be developed to tackle the problems and investment in the child health workforce, including health visitors.

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Source: BBC News, 5 February 2024

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Unclear UK advice on PPE cited in home care COVID-19 death inquiry

A home care worker who did not wear protective equipment may have infected a client with a fatal case of coronavirus during weeks of contradictory government guidance on whether the kit was needed or not, an official investigation has found.

The government’s confusion about how much protection care workers visiting homes needed is detailed in a report into the death of an unnamed person by the Healthcare Safety Investigation Branch (HSIB), which conducts independent investigations of patient safety concerns in NHS-funded care in England. It was responding to a complaint raised by a member of the public in April.

The report shows that Public Health England published two contradictory documents that month. One advised care workers making home visits to wear PPE and the other did not mention the need. The contradiction was not cleared up for six weeks.

The government’s guidance had been a shambles that had placed workers and their vulnerable clients at risk, the policy director at the United Kingdom Homecare Association, Colin Angel, said on Wednesday. The association also accused the government of sidelining its expertise and publishing new guidance with little notice, sometimes late on Friday nights, meaning that it was not always noticed by the people it was intended for.

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Umbilical cord stem cells implanted into Covid patients improve survival chances, study suggests

An experimental treatment involving stem cells from umbilical cords could significantly reduce deaths and quicken recovery time for patients suffering the most severe form of COVID-19, a study suggests.

US researchers reported a 91% survival rate in seriously ill patients given the stem cell infusion, compared to 42% in a second group who did not receive the treatment.

Researchers said the treatment also appeared to be safe, with no serious adverse reactions reported.

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Source: The Independent, 5 January 2021

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Ukraine’s hospitals ‘desperate’ for medical supplies as oxygen runs out

Hospitals across Ukraine are “desperate” for medical supplies, doctors have warned, as oxygen stores are hit and other vital health supplies run low amid bombardment from Russian forces.

UK-based Ukrainian doctors have issued an urgent appeal for donations of supplies as they travel to eastern Europe in response to reports of shortages of medical equipment and medicines.

The World Health Organisation warned on Sunday evening that oxygen supplies in Ukraine were “dangerously low” as trucks were unable to transport oxygen supplies from plants to hospitals across the country.

Dr Volodymyr Suskyi, an intensive care doctor at Feofaniya Clinical Hospital in Kyiv, told The Independent he had been forced to use an emergency back-up system to supply oxygen to a patient on life support after the area near plant which supplies his hospital was bombed.

Dr Dennis Olugun, a UK-based doctor who is leading the group of medics from the Ukrainian Medical Association of the United Kingdom (UMAUK) to deliver medical supplies, said the situation was “desperate” in some areas. He said some hospitals did not have basic necessities such as rubber gloves.

He told The Independent: “What they need in the hospitals is portable ultrasound machines, portable x-ray machines because they have so many patients they much rather walk around the wards and do whatever diagnostic work rather than transporting patients."

The Association of the British Pharmaceutical Industry and European Federation of Pharmaceutical Industries and Associations have called for medicines, pharmaceutical ingredients and raw materials to be excluded from the scope of sanctions being levied against Russian trade.

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Source: The Independent, 1 March 2022

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