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Digital training ‘should be embedded in clinical curricula’

Digital training should be “embedded” into clinical curricula rather than being “bolted on”, the Chief Executive of ORCHA has said. Liz Ashall-Payne said more needed to be done to ensure appropriate digital training for clinicians or risk a “knowledge gap” forming between current and future staff.

Dr Sandeep Bansal, Chief Executive of Medic Creations and mentor on the Royal College of GPs innovation mentorship programme, echoed calls for digital training to be incorporated in the medical school curriculum. 

“Your organisation is only as strong as lowest digitally mature staff member. It is all very well educating our tech-savvy junior doctors, but we must make sure those less au fait with digital advancements are not left behind. That is where patient safety could be put at risk. After all the main purpose of digital innovation is to enhance our ability to care for patients, by enabling more effective, efficient and precise clinical practice.”

Clive Flashman, Patient Safety Learning's Chief Digital Officer, agreed with the need for clinicians to receive digital training but with a focus on how to quickly evaluate an apps. “What is essential is that all clinicians, not just GPs, have access to advice, tools and support to enable them to prescribe and monitor the effectiveness of apps and digital therapies,” he told Digital Health News.

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Source: Digital Health, 29 October 2019

 

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End-of-life care will become a legal right

Dying people will be given an explicit legal right to healthcare for the first time in NHS history, requiring every part of England to provide specialist palliative care.

New analysis from the charity Marie Curie shows that about 215,000 people a year miss out on end-of-life care and that without intervention this could rise to 300,000 within 20 years.

The government will back an amendment to the Health and Care Bill in the House of Lords.

Baroness Finlay of Llandaff, a professor of palliative care medicine and supporter of the amendment, said: “This change is incredibly important. For the first time the NHS will be required to make sure that there are services to meet the palliative care needs of everyone for whom they have responsibility in an area. People need help early, when they need it, seven days a week — disease does not respect the clock or the calendar.”

She told the Lords that although “general basic palliative care should be a skill of every clinician”, specialist palliative care was a “relatively new specialty, which is why it was not included in the early NHS legislation”.

The government amendment will introduce a specific requirement for “services or facilities for palliative care” to be commissioned by integrated care boards, responsible for local services under the government’s NHS reforms, in every part of England.

Matthew Reed, chief executive of Marie Curie, said: “If you need palliative and end-of-life care today, the chances of you getting the pain relief, symptom control and support for your family that you need depend largely on where you live, your ethnicity, gender and on what condition you have. This is wrong.

“We welcome the news coming out of the Department of Health and Social Care. The impact of this legal requirement to provide appropriate care to dying people could be transformative — it is one of the biggest developments in end-of-life care since the inception of the NHS. This change has the potential to end the current postcode lottery and make end-of-life care fair for all."

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Source: The Times, 25 February 2022

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Woman stored baby’s remains in fridge after London hospital refused them

A London hospital has launched an investigation after a woman whose baby died in the womb had to deliver her son at home due to lack of beds and keep his remains in her fridge when A&E staff said they could not store them safely.

Laura Brody and her partner, Lawrence, said they were “tipped into hell” after being sent home by university hospital Lewisham to await a bed when told their baby no longer had a heartbeat but no beds were immediately available to give birth, the BBC reported.

Two days later, after waking up in severe pain, Brody, who was four months into her pregnancy, gave birth in agony on the toilet in their bathroom. “And it was then,” she told the broadcaster, “I saw it was a boy”.

The couple, who wanted investigative tests to be carried out at a later time, dialled 999 but were told it was not an emergency. They wrapped their baby’s remains in a wet cloth, placed him in a Tupperware box, and went to A&E where they were told to wait in the general waiting room, they said.

She was eventually taken into a bay and told she would require surgery to remove the placenta. But, with the waiting room hot and stuffy and staff refusing to store the remains or even look inside the Tupperware box, they decided as it got to midnight they had no option but for her partner to take their baby’s remains home.

Brody said the whole experience “felt so grotesque”.

“When things go wrong with pregnancy there are not the systems in place to help you, even with all the staff and their experts – and they are working really hard – the process is so flawed that it just felt like we had been tipped into hell,” she told Radio 4’s Today programme.

The case is said to have raised wider concerns among campaigners who argue that miscarriage care needs to be properly prioritised within hospitals including A&E.

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Source: The Guardian, 30 May 2022

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‘Long covid’ – The under-the-radar coronavirus cases exhausting thousands

We’re swiftly learning the symptoms of Covid-19 may last longer than previously thought. One in 10 people are reporting a longer tail of symptoms, which exceeds the suggested two-week recovery time.

It’s thought around 30,000 people in the UK could be impacted by a prolonged version of the illness – what some are calling ‘long covid’. These people are months into their recovery from the virus and still fighting a range of persistent symptoms. In some cases, the symptoms disappear for a while before coming back. In others, they’re gradually improving over time.

Research from the Covid-19 Symptom Study in the UK, led by Professor Tim Spector of King’s College London, shows after three weeks of first reporting symptoms, a group of people continue to experience fatigue, headaches, coughs, loss of smell, sore throats, delirium and chest pain.

People with mild cases of the disease are more likely to have a wide range of symptoms that come and go over an extended period, Prof Spector found. And these people are often flying under the radar because they’re not in hospital.

Those who believe they’ve had ‘long covid’ are now calling on the government to recognise their plight, invest in research and put support in place.

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Source: Huffpost, 2 July 2020

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Essure: Women in England take legal action against sterilising-device maker

Lawyers have begun legal action on behalf of 200 UK women against the makers of a sterilisation device, after claims of illness and pain.

The device, a small coil called Essure, was implanted to prevent pregnancies.

Manufacturer Bayer has already set aside more than $1.6bn (£1.2bn) to settle claims from almost 40,000 women in the US. It has withdrawn the device from the market for commercial reasons but says it stands by its safety and efficacy.

The metal coil was inserted into the fallopian tube to cause scarring, blocking the tube and preventing pregnancy. 

Introduced in 2002, it was promoted as an easy, non-surgical procedure - a new era in sterilisation. But many women who had the device fitted have now either had hysterectomies or are waiting for procedures to remove the device.

Tracey Pitcher, who lives in Hampshire, felt she had completed her family and did not want any more children.

Her doctor strongly encouraged her to have an Essure device fitted, she says. But after it had been, she began to feel very unwell.

"I just started to have heavy periods, migraines, which I had only ever had when I was pregnant so they were hormonal," she says. "My back was so painful I'd wake up crying in the middle of the night with pains in my hips and my back."

Tracey says she battled to persuade doctors to take her symptoms seriously. But the only information she received was from a Facebook group.

"... there's nobody there, there's no support apart from people that we've found ourselves, no-one will listen, because it's just 'women's things'."

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Source: BBC News, 15 November 2020

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Investigation begins into woman's childbirth death

An investigation has been launched after a woman died during childbirth at a hospital's maternity unit.

It was the third death of a mother in just over three years at Basildon University Hospital in Essex, in addition to a newborn baby's death.

The trust that runs the hospital said it could not comment on the case while it was under investigation.

Basildon University Hospital is part of Mid and South Essex NHS Foundation Trust, which also runs Southend and Broomfield hospitals.

The latest fatality follows the death of 36-year-old Gabriela Pintilie in February 2019. Ms Pintilie died after losing six litres of blood giving birth to her second child at the unit.

In separate incidents, a mother died and another woman had a stillborn baby at the unit in March 2019, while the trust was being inspected by the Care Quality Commission (CQC) following Ms Pintilie's death.

The unit at Basildon had its rating upgraded from "inadequate" to "requires improvement" in December by the CQC.

The hospital also apologised for the death of newborn Frederick Terry after he suffered a brain haemorrhage during a failed forceps delivery in November 2019.

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Source: BBC News, 27 March 2022

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Woman died after being given the wrong medication

An 87-year-old woman died after her carers gave her the wrong medication, a coroner was told.

Heather Planner, from Butler's Cross in Buckinghamshire, died at Wycombe Hospital on 1 April from a stroke. Senior coroner Crispin Butler heard three staff from Carewatch Mid Bucks had failed to spot tablets handed over by the pharmacy were for a male patient.

Mr Butler said action should be taken to prevent similar deaths.

A hearing in Beaconsfield on Thursday, where he issued a Prevention of Future Deaths report, followed an inquest in November. In the report he said he was told at the inquest that the carers from Carewatch Mid Bucks gave widow Mrs Planner the wrong medication four times a day for two and a half days. She suffered a fatal stroke because she did not receive her proper apixaban anticoagulation medication.

Mr Butler said he would send his concerns to the chief coroner and the Care Quality Commission. He said there was no procedure in place to ensure individual carers read and specifically acknowledged any medication changes.

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Source: BBC News, 27 February 2020

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Quarter of women say their decisions weren’t respected during childbirth, new study reveals

A new study shows a quarter of mothers say their choices were not respected during childbirth, with some left with life-changing injuries as a result, despite Britain’s highest judges establishing women should be the primary decision makers during labour five years ago.

A poll of 1,145 women, carried out by leading pregnancy charity Birthrights and shared exclusively with The Independent, also found that a third said healthcare professionals did not even seek their own opinions on the childbirth process, while 14& said their choices were overruled.

One woman told The Independent she had been forced to give up her career as a lawyer following what she described as a “violent delivery”, while her baby daughter also sustained serious injuries to her face which can still be seen now – 12 years after she gave birth.

Birthrights, which campaigns for respectful pregnancy care for women, pointed to the fact half a decade has passed since Nadine Montgomery’s Supreme Court case proved mothers-to-be are the primary decision-makers in their own care yet this is still not the reality for the majority of women.

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Source: The Independent, 3 September 2020

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‘Bullying, intimidation and reprisals’ undermined patient care at trust, review concludes

A ‘culture of distrust’ between consultants and the use of incident reporting as a tool of ‘reprisal’ impacted patient care at a trust’s cardiology department, a review has concluded.

An external review undertaken for Hull University Teaching Hospitals Trust has made a series of recommendations after looking into allegations of bullying and several examples of poor care within its cardiology services.

In a report published in the trust’s board papers, the Royal College of Physicians reported a “perceived tendency to downplay clinical incidents, and, to undermine those who wanted to raise patient safety issues”.

It added: “We met a group of individual consultants who did not work well as a team. There is a culture of distrust, a lack of departmental cohesion and allegations of bullying in the department. All of which reinforce a clear divide between the interventional and non-interventional consultant cardiologists."

“There have been a number of allegations of belittling, intimidation and undermining…The review team heard accounts of a culture where datix has been used as a tool for possible personal reprisal along with ignoring/downplaying incidents that have been raised.”

The review concludes: “This behaviour is impacting on patient care and therefore, all medical staff should be reminded of good medical practice as the [General Medical Council] code of conduct of how doctors must work collaboratively with colleagues.”

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Source: HSJ, 16 November 2021

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NHS given its 10 priorities for 2022

NHS England has set out 10 priorities for 2022-23 in its annual planning guidance.

NHSE chief executive Amanda Pritchard makes clear in an introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.”

The 10 priorities are:

  • Workforce investment, including “strengthening the compassionate and inclusive culture needed to deliver outstanding care”.
  • Responding to COVID-19.
  • Delivering “significantly more elective care to tackle the elective backlog”.
  • Improving “the responsiveness of urgent and emergency care and community care capacity.”
  • Increasing timely access to primary care, “maximising the impact of the investment in primary medical care and primary care networks”.
  • Maintaining “continued growth in mental health investment to transform and expand community health services and improve access”.
  • Using data and analytics to “redesign care pathways and measure outcomes with a focus on improving access and health equity for underserved communities”.
  • Achieving “a core level of digitisation in every service across systems”.
  • Returning to and better “prepandemic levels of productivity”.
  • Establishing integrated care boards and collaborative system working, and “working together with local authorities and other partners across their ICS to develop a five-year strategic plan for their system and places”.

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Source: HSJ, 24 December 2021

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AI advancements in healthcare – two sides to the story

If ever there were an industry that could reap the benefits of artificial intelligence (AI), it is healthcare. The adoption of this technology to actually make medicine better is obvious. However, with this adoption comes a slew of ethical issues. With AI, there is always a human consequence beyond the tech storyline.

Neil Raden suggests there are two storylines to consider: the usefulness of the application, and the ultimate effect, often unintended, on people.

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Source: Diginomica, 19 September 2019

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Nearly 70,000 patients injured in Ontario’s hospitals each year, auditor says

Nearly 70,000 patients are injured while receiving care in Ontario's hospitals each year, the province's auditor general said Wednesday, calling for immediate government action to help reduce that number.

In her 2019 annual report, Bonnie Lysyk said her team's audits of acute-care centres found that six in every 100 patients treated and discharged from provincial hospitals were harmed during care.

"Each year, Ontario hospitals discharge one million people," Lysyk said. "Of those, about 67,000 people were harmed during their hospital stay."

The audit found that hospitals are currently not required to report to the Ministry of Health so-called "never-events" — a medical error that should never happen, such as leaving a foreign object inside a patient.

Lysyk said her team visited six of the 13 hospitals that track "never-events," and found that 214 such incidents had occurred since 2015.

Ontario's rates of patient harm are the second-highest in Canada, after Nova Scotia.

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Source: Niagara Falls Review, 5 December 2019

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FDA approves first bedside COVID-19 test by Danaher’s Cepheid

A Covid-19 test can deliver results in less than an hour has been approved under an FDA emergency authorization, marking the first test that clinicians can use at the bedside.

Cepheid, a Silicon Valley molecular diagnostics company that’s a unit of Danaher Corp., announced Saturday it received an emergency authorisation from the U.S. Food and Drug Administration to use the test, making it the 13th Covid-19 test the agency has allowed on the market as long as the public health emergency exists.

But it’s the first one that can be used at the point of care, meaning providers don’t have to send patient samples to a separate lab to be processed and then come back to the hospital or provider’s office. Cepheid said it expects to start shipping tests next week.

“An accurate test delivered close to the patient can be transformative — and help alleviate the pressure that the emergence of the 2019-nCoV outbreak has put on healthcare facilities that need to properly allocate their respiratory isolation resources,” said David Persing, Cepheid Chief Medical and Technology Officer.

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Source: Bloomberg, 21 March 2020

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USA: Rising focus on patient safety and regulatory compliance driving growth in medical device complaint management market

The medical device complaint management market is experiencing significant growth due to the increasing focus on patient safety and regulatory compliance. As medical devices become more complex and the regulations governing them become more stringent, it has become essential for manufacturers to have effective complaint management systems in place to ensure the safety and satisfaction of their customers.

The global medical device complaint management market is expected to grow at a CAGR of 6.3% from 2021 to 2026. 

One of the key factors driving the growth of the medical device complaint management market is the increasing emphasis on patient safety. In recent years, there has been a growing awareness of the potential risks associated with medical devices, and patients are increasingly demanding higher levels of safety and quality. This has led to a greater focus on complaint management among medical device manufacturers, who are now investing in advanced complaint handling systems to ensure that they are able to identify and address issues before they become major problems.

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Source: Digital Journal, 20 April 2023

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Large-scale GP group says its doctors routinely have ‘unsafe’ workload

The Modality Partnership, one of England's biggest general practice groups told HSJ that its GPs are regularly seeing more patients each day than is safe, after the number of people going to see their GP surged in the wake of Covid-19.

Data has shown the provider’s GPs had an average of 20 patient contacts per day during April 2020, which has now risen to to an average of nearly 50 patient contacts per day. Modality, which had drawn up a report on the situation were quoted as saying, "There is just so much to cover – I am worried about missing something.” 

One partner at Modality who is also quoted in the report said: “An increasing number of patients I see are broken, often in tears, and seeking help to cope with the new stresses of life.”

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Source: HSJ, 31 August 2021

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Gosport War Memorial Hospital patient deaths inquiry ‘buried evidence’

Whitehall investigators have launched an inquiry into allegations of serious misconduct during the official review of the Gosport hospital scandal. They are examining claims that civil servants working on the £13m inquiry bullied staff, buried evidence and went on taxpayer-funded “working retreats” to Spain.

An independent panel last year linked Dr Jane Barton to the premature deaths of up to 656 elderly people given opiate overdoses at Gosport War Memorial Hospital between 1989 and 2000.

Whistleblowers have alleged that the panel ignored concerns about the hospital’s culture and use of faulty medical equipment to deliver a “clean hit” and “draw a line under it all”.

The Department of Health said last night: “We take all and any allegations of wrongdoing very seriously. An investigation is being undertaken and it would be inappropriate to comment further until it is concluded.”

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Source: The Sunday Times, 11 August 2019

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NHS is ‘losing its memory’ warns new report on patient safety alerts

In a report published today, AvMA, the charity Action Against Medical Accidents, reveals serious delays in NHS trusts implementing patient safety alerts, which are one of the main ways in which the NHS seeks to prevent known patient safety risks harming or killing patients.

The report, authored by Dr David Cousins, former head of safe medication practice at the National Patient Safety Agency, NHS England and NHS Improvement, identifies serious problems with the system of issuing patient safety alerts and monitoring compliance with them. Compliance with alerts issued under the now abolished National Patient Safety Agency and NHS England are no longer monitored – even though patient safety incidents continue to be reported to the NHS National Reporting and Learning System.

David said: “The NHS is losing it memory concerning preventable harms to patients. Important known risks to patient safety are being ignored by the NHS. The National Reporting and Learning System, the NHS Strategy and new format patient safety alerts, all managed by NHS Improvement, now ignore the majority of ‘known/wicked harms’ which have been the subject of patient safety alerts in the past and have now been archived."

“Implementation of guidance in new Patient Safety Alerts can be delayed, for years in some cases. The Care Quality Commission that inspects NHS provider organisations also no longer appear to check that safeguards to major risks, recommended in patient safety alerts, have been implemented, or continue to be implemented, as part of their NHS inspections.

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Source: AvMA, 28 January 2020

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Accidents on maternity wards cost NHS £1bn a year

Accidents on maternity wards cost the NHS nearly £1 billion last year, Jeremy Hunt, the chairman of the Commons health committee, has revealed.

The former health secretary said the bill for maternity legal action was nearly twice the amount spent on maternity doctors in England. It was part of the NHS’s £2.4 billion total legal fees and compensation bill, up £137 million on the previous year.

Mr Hunt has also told the Daily Mail there is evidence that hospitals are failing to provide details of avoidable deaths despite being ordered to do so three years ago as he highlighted “appalling high” figures which showed that up to 150 lives are being lost needlessly every week in public hospitals.

Responding to the figures, Mr Hunt said: "Something has gone badly wrong."

In 2017, he told trusts to publish data on the number of avoidable deaths among patients in their care. But freedom of information responses from 59 hospital trusts, about half the total, found less than a quarter gave meaningful data on avoidable deaths.

Mr Hunt cited “major cultural challenges” which he blamed for preventing doctors and nurses from accepting any blame. He blamed lawyers who get involved “almost immediately” once something goes wrong with a patient’s care.

“Doctors, nurses and midwives worry they could lose their licence if they are found to have made a mistake. Hospital managers worry about the reputation of their organisation,” he added.

Mr Hunt said: “We have appallingly high levels of avoidable harm and death in our healthcare system. We seem to just accept it as inevitable.”

An NHS spokesman said: “Delivering the safest possible health service for patients is a priority, and the national policy on learning from deaths is clear that hospitals must publish this information every three months, as well as an annual summary, so that they are clear about any problems that have been identified and how they are being addressed.

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Source: The Telegraph, 18 September 2020

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‘A bit of a nightmare’: fuel shortages starting to affect vulnerable patients

Patients are starting to suffer because health and care workers are unable to purchase fuel.

The fuel crisis is starting to have an effect on the care of vulnerable patients, community and mental health service providers have warned. Many petrol stations are running short of fuel as a result of panic buying, after the oil firm BP warned that it would have to close some of its petrol stations because of the lack of lorry drivers. Currently there is a shortage of about 100,000 HGV drivers.

Crystal Oldman, chief executive for the Queen’s Nursing Institute, which represents community nurses, told the journal HSJ that the fuel shortage was already affecting them: “This potentially means nurses cannot get to the patients they need to if they are unable to access fuel. At the very least, it will mean more time searching for petrol stations that have a supply, taking valuable time from their working day and more unpaid overtime will be undertaken as nurses will always prioritise their patient care.”

Patient transport has also been affected. A source at a patient transport provider in the West Midlands told HSJ that it had been “a bit of a nightmare”. The provider had had to turn down a request for a patient going to London because of the fuel shortage and because of climate protesters disrupting motorway transport: “Ultimately those patients are either at home and distressed carrying a big risk in the community or [accident and emergency] departments which [are not] the right settings.”

Read the full article here
Source: Future Care Capital

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Loss of 25,000 NHS beds caused ‘serious patient safety crisis’, finds report

The NHS has lost almost 25,000 beds across the UK in the last decade, according to a damning report  says the fall has led to a sharp rise in waiting times for A&E, ambulances and operations.

The Royal College of Emergency Medicine said the huge loss of beds since 2010-11 was causing “real patient harm” and a “serious patient safety crisis”. At least 13,000 more beds are urgently needed, it added, in order to tackle “unsafe” bed occupancy levels and “grim” waiting times for emergency care and handover delays outside hospitals.

Patients are increasingly “distressed” by long waiting times, the college said, as are NHS staff who face mounting levels of burnout, exhaustion and moral injury. The UK has the second lowest number of beds per 1,000 people in Europe at 2.42 and has lost the third largest number of beds per 1,000 population between 2000 and 2021 (40.7%), the report said.

There are currently 162,000 beds in the NHS across the UK, according to the college.

“The situation is dire and demands meaningful action,” said Dr Adrian Boyle, the college’s vice-president. “Since 2010-11 the NHS has lost 25,000 beds across the UK, as a result bed occupancy has risen, ambulance response times have risen, A&E waiting times have increased, cancelled elective care operations have increased.

“These numbers are grim,” Boyle added. “They should shock all health and political leaders. These numbers translate to real patient harm and a serious patient safety crisis. The health service is not functioning as it should and the UK government must take the steps to prevent further deterioration in performance and drive meaningful improvement, especially ahead of next winter.”

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Source: The Guardian, 31 May 2022

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Surgeon suspended over treatment concerns

A doctor who worked at the same private healthcare firm as rogue breast surgeon Ian Paterson has been suspended, it has emerged.

Spire Healthcare said Mike Walsh – a specialist in trauma and orthopaedic surgery – was suspended in April 2018 over concerns about patient treatment. Almost 50 of his patients from its Leeds hospital had been recalled.

The details emerged following an independent inquiry into Paterson, who is serving a 20-year jail sentence.

Earlier this month, an inquiry into the breast surgeon found that a culture of "avoidance and denial" had allowed him to perform botched and unnecessary operations on hundreds of women.

Spire said in a statement that it acted after concerns were raised about Mr Walsh's work at its hospital in Leeds in 2018. The company, which contacted the Royal College of Surgeons to assist with its investigation, said it had reviewed the notes of fewer than 200 patients, of which "fewer than 50" had been invited back for a follow-up appointment.

"Where we have identified concerns about the care a patient received, we have invited the patient to an appointment with an independent surgeon to review their treatment," a spokesman for Spire Healthcare said. "This is a complex case and the review is ongoing."

It said that Mr Walsh, who was immediately suspended after the concerns were raised, was no longer working with Spire Healthcare. The company said any patients at its Spire Leeds Hospital who had concerns about their treatment under Mr Walsh should contact the hospital. It said its findings had also been shared with the Care Quality Commission and the General Medical Council (GMC).

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Source: BBC News, 17 February 2020

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‘White leaders under pressure’ to prove black lives matter

Incoming Health Education England chief executive Navina Evans said the momentum created by the death of George Floyd and the Black Lives Matter movement meant there was now increased “pressure on white leaders” to act on racism and discrimination in the service.

Dr Evans praised a letter written by Birmingham and Solihull Mental Health Foundation Trust chief executive Roisin Fallon-Williams, in which she admitted to being “culpable” and “complicit” in failing to fully understand the inequality and discrimination faced by people with black, Asian or other minority ethnic backgrounds.

“That was great to see, and as you can see from the reactions to her letter people were really, really pleased to have it acknowledged,” she said.

However, Dr Evans added: “As well as that [acknowledgement] there needs to be action”.

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Source: HSJ, 22 June 2020

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NHS whistleblowers still face consequences

Criticism of NHS managers over the treatment of whistleblowers has been reignited by Donna Ockenden’s damning review of maternity services at Shrewsbury and Telford Hospital Trust.

Her findings come seven years after the “Freedom to speak up?” report from Sir Robert Francis QC, which found that NHS staff feared repercussions if they blew the whistle on poor practice. He recommended reforms to change the culture and support whistleblowers.

The Public Interest Disclosure Act 1998 makes it unlawful to subject workers to negative treatment or dismiss them because they have raised a whistleblowing concern, known as a “protected disclosure”. But critics say little has changed since the Francis review.

According to Protect, a whistleblowing charity, 64% of those contacting it for advice said that they had been victimised, dismissed or forced to resign. Shazia Khan, founding partner at Cole Khan Solicitors, says that instead of being afforded protection, whistleblowers are “targeted as a form of retaliation by trust senior management and disciplined on trumped up charges to shut them down”.

Those seeking to vindicate their rights before an employment tribunal, Khan adds, will often be “priced out of justice” by well-resourced NHS trust lawyers who at public expense “deploy a menu of tactics” to defend cases. 

When Peter Duffy, a consultant urologist at University Hospitals of Morecambe Bay Foundation NHS Trust, reported on allegedly unsafe practices by colleagues in 2016, he was demoted, falsely accused of financial irregularities, and threatened with a six-figure adverse costs order by Capsticks, the hospital’s law firm.

“All my witnesses dropped out after the medical hierarchy told them that the department might be dissolved if the case went badly,” Duffy says, which meant there was no one to rebut the trust’s evidence.

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Source: The Times, 7 April 2022

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Coronavirus: Home secretary urged to do more to relax drug rules to help ease end-of-life suffering

The government is under pressure to go further on measures to relax rules on powerful painkillers such as morphine to prevent patients suffering “unnecessary pain and distress in the last days of their lives”.

On Tuesday the health secretary, Matt Hancock, announced staff in care homes and hospices would be allowed to “re-use” controlled drugs such as morphine and midazolam, with medication prescribed for one patient used for another where there is an immediate need.

But the Home Office today confirmed to The Independent that it had no plans to extend the rules to the care of patients in their own homes – a restriction experts and charities have warned could leave people suffering at the end of their lives.

The government announced the changes following concerns over the supply of drugs. 

The Royal College of GPs (RCGP) welcomed the changes announced by Mr Hancock, calling them “a significant step forward”, but added: “This only applies to patients living in care home and hospice settings, so there is still work to be done to ensure patients living in their own homes have appropriate access to necessary medication in a timely way.”

Last week the RCGP wrote to home secretary Priti Patel warning that people were suffering unnecessarily due to problems accessing drugs.

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Source: The Independent, 30 April 2020

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Bullying and harassment ‘normalised’ at trust put back in special measures

An ambulance trust has been placed in special measures after the Care Quality Commission (CQC) rated its leadership ‘inadequate’ and said staff felt unable to raise concerns without fear of reprisal

The CQC inspected South East Coast Ambulance Service Foundation Trust after being contacted by staff with concerns about bullying and harassment, inappropriate sexualised behaviour and a leadership team which failed to address concerns.

Many of the concerns echo those raised in 2017 in an independent review into a “culture of fear” at the trust, shortly after it was first placed in regulatory special measures. It was taken out in 2019 but has now been placed back in the equivalent “recovery support programme” on the CQC’s recommendation.

CQC director of integrated care Amanda Williams praised staff who had contacted the regulator. She said: “While staff were doing their very best to provide safe care to patients, leaders often appeared out of touch with what was happening on the front line and weren’t always aware of the challenges staff faced. Staff described feeling unable to raise concerns without fear of reprisal – and when concerns were raised, these were not acted on.

“This meant that some negative aspects of the organisational culture, including bullying and harassment and inappropriate sexualised behaviour, were not addressed and became normalised behaviours."

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Source: HSJ, 22 June 2022

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