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Maternity delays spark thousands of safety alerts each year

Maternity departments are raising thousands of safety reports every year about delayed inductions of labour, HSJ can reveal.

Induction of labour may be used when women are overdue, because their waters have broken, or for other medical reasons to speed up the birth, such as poor growth of the baby.

Delaying induction therefore may increase risks for both mothers and babies and the National Institute for Health and Care Excellence says trusts should raise a “red flag event” if it is delayed for more than two hours after admission.

Information collected by HSJ from 50 trusts show 4,945 red flags related to delays in induction of labour in 2022-23. HSJ also found 3,109 reports in 2021-22 and 1,807 in 2020-21 across 47 trusts. 

Meanwhile, there were 1,997 Datix reports mentioning induction of labour in 2022-23 across 59 trusts able to give HSJ figures, in response to Freedom of Information Act requests, compared with 1,690 in 2021-22 and 1,368 in 2020-21. 

The Care Quality Commission has also raised concerns in inspections that incidents which should have been treated as “red flags” have not always been reported as such. The watchdog has also raised concerns about a lack of board-level oversight of maternity safety incidents and a need for clearer guidance for staff on reporting processes. 

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Source: HSJ, 2 April 2024

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Maternity deaths at 20-year high as NHS ‘ignores warnings’

Women’s deaths during pregnancy, labour or soon after giving birth are at the highest level for two decades despite the NHS receiving dozens of recommendations to act on life-threatening symptoms.

An investigation by The Times shows the NHS was issued with 67 separate warnings between 2013 and 2023 to take signs of potentially fatal complications in mothers — known as red flags — seriously.

Over the same decade, there was a 50% rise in the UK’s maternal death rate — defined as deaths in pregnancy, childbirth, or the six weeks after giving birth — from 8.54 deaths per 100,000 pregnancies in 2013 to 12.80 in 2023. The last time the rate was this high was in 2005.

The most recent available data shows 257 women died in the two years to 2023. The biggest killer was blood clots, followed by heart issues, suicide, stroke, sepsis and severe bleeding.

Over the past decade, a string of reviews have issued 748 recommendations for improving NHS maternity services across 59 official reports, yet death rates have soared.

Wes Streeting, the health secretary, has commissioned a national maternity inquiry led by Baroness Amos, a Labour peer, which is due to deliver its recommendations in the summer. Campaigners are sceptical about whether another report will result in real change.

Theo Clarke, a former Conservative MP who led a parliamentary inquiry into birth trauma in 2024, said it was a “national scandal” that maternal deaths were rising while “recommendations are ignored”.

She said: “NHS maternity services are swamped with recommendations from scores of reports, and still women and their babies are being harmed by a lack of focus and leadership necessary to implement them.”

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Source: The Times, 5 April 2026

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Maternity care failings 'much worse' than anticipated, says head of national review

Hungry mothers, dirty wards and poor care are blighting England's maternity services while staff receive death threats for working in some units, according to a new report.

Baroness Amos, who is chairing a review into maternity care, said that what she has seen so far "has been much worse" than she'd anticipated.

Some women had felt blamed for their baby's death, while others suffered from a lack of empathy, care or apology when things had gone wrong, with poor and black mothers often at the end of discriminatory services.

Health Secretary Wes Streeting, who set up the review, external, said "the systemic failures causing preventable tragedies cannot be ignored".

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Source: BBC News, 9 December 2025

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Maternity care ‘in crisis’ as pregnant women are forced to delay induced deliveries

Pregnant women are being forced to wait days longer than expected for “urgent” inductions of labour as NHS staff shortages and a lack of beds lead to severe delays.

New mothers told i the delays, which the health watchdog has found can last up to five days, increased the anxiety they felt during labour.

One first-time mother, who wanted to remain anonymous, said that her ordeal has put her off having any more children. The woman, who gave birth to a son in August, said she was “pushed” to book an induction when her waters broke and her baby was almost two weeks overdue. Despite being told by multiple healthcare professionals she needed to “give birth within 24 hours” due to a risk of infection, she did not end up delivering her baby for another 49 hours – without being induced.

A birthing expert told i she has “never seen a crisis in maternity” like it during her almost 10 years working in the sector.

It comes after it was revealed that the Care Quality Commission (CQC) watchdog has issued warnings to seven hospitals due to delays to the induction of labour since last year.

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Source: inews, 5 November 2023

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Maternity Advisor to champion safer care for mothers and babies

Women and families failed by maternity services will be better heard and their experiences will drive lasting improvements to care, as Michelle Welsh MP has been appointed as the government’s first Maternity Advisor.

Welsh will work directly with families, the government, the NHS and key maternity organisations to push for better, safer care for mothers, babies and families.

She will meet regularly with ministers to share evidence and advice, and work with families and communities to bring a wide range of voices into the heart of the government’s action to improve maternity services. There will be a special focus on those from communities that face the greatest health inequalities.

Health and Social Care Secretary James Murray said:

"Far too many women and families have been let down by maternity services, and that must change.

"Michelle Welsh brings exactly the commitment and expertise this role demands, and I know she will be a powerful champion for the women and families.

"Today marks a significant step forward in our determination to make maternity care safer for every mother and baby in England."

Michelle Welsh, MP and Maternity Advisor said:

"I am honoured to have been appointed as the National Maternity Advisor to the Government.

"This role is deeply personal to me. Like far too many women across this country, I know what it feels like to come through childbirth carrying both physical and emotional scars. That experience has strengthened my determination to fight for safer, more compassionate maternity care for every family.

"As National Maternity Advisor, I will work tirelessly to drive forward meaningful reform focused on safer staffing, stronger accountability, listening to women, tackling inequalities and ensuring lessons are learned when failures happen.

"This is about rebuilding trust and creating a maternity system that is not only safer, but kinder too."

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Source: Department of Health and Care, 19 May 2026

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Matching drugs to DNA is 'new era of medicine'

We have the technology to start a new era in medicine by precisely matching drugs to people's genetic code, a major report says.

Some drugs are completely ineffective or become deadly because of subtle differences in how our bodies function. The British Pharmacological Society and the Royal College of Physicians say a genetic test can predict how well drugs work in your body.

The tests could be available on the NHS next year.

It would have helped Jane Burns, from Liverpool, who lost two-thirds of her skin when she reacted badly to a new epilepsy drug.

She was put on to carbamazepine when she was 19. Two weeks later, she developed a rash and her parents took her to A&E when she had a raging fever and began hallucinating.

The skin damage started the next morning. Jane told the BBC: "I remember waking up and I was just covered in blisters, it was like something out of a horror film, it was like I'd been on fire."

Jane's experience may sound rare, but Prof Mark Caulfield, the president-elect of the British Pharmacological Society, said "99.5% of us have at least one change in our genome that, if we come across the wrong medicine, it will either not work or it will actually cause harm."

"We need to move away from 'one drug and one dose fits all' to a more personalised approach, where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines," said Prof Sir Munir Pirmohamed, from the University of Liverpool.

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Source: BBC News, 29 March 2022

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Mass rapid tests in Liverpool cut hospital stays by a third

Mass lateral flow testing cut the number of people needing hospital treatment for Covid by 32% and relieved significant pressure on the NHS when the measures were piloted last year, a study has shown.

Liverpool conducted the first city-wide testing scheme using rapid antigen tests in November last year, amid debate about whether or not lateral flow tests (LFTs) were accurate enough to detect the virus in asymptomatic carriers.

It expanded the project to cover the whole of the Liverpool region, offering people LFTs whether or not they had symptoms. Key workers did daily tests before going to work to show they were not infectious.

Now an analysis has shown that it was more successful than Liverpool’s scientists and public health teams had anticipated, after they compared Covid cases and outcomes in the region with other parts of England.

Professor Iain Buchan, dean of the Institute of Population Health, who led the evaluation, said: “This time last year, as the Alpha variant was surging, we found that Liverpool city region’s early rollout of community rapid testing was associated with a 32% fall in Covid-19 hospital admissions after careful matching to other parts of the country in a similar position to Liverpool but without rapid testing.

“We also found that daily lateral flow testing as an alternative to quarantine for people who had been in close contact with a known infected person enabled emergency services to keep key teams such as fire crews in work, underpinning public safety.”

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Source: The Guardian, 19 December 2021

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Mass cancellations of NHS operations inevitable this winter, say doctors

Mass cancellations of routine operations in England are inevitable this autumn and winter despite an NHS edict that hospitals must not again disrupt normal care, doctors’ leaders have said.

Organisations representing frontline doctors, including the British Medical Association (BMA), also criticised NHS England for ordering hospitals to provide “near normal” levels of non-Covid care in the second wave of the pandemic, and demanded that fines for failing to meet targets be scrapped.

"Things are very, very difficult at the moment, very challenging at the moment. It feels like a juggling act every day,” said one official in the South Yorkshire NHS. “The problem is both the growing numbers of patients coming into hospital with Covid and the numbers of staff we have off sick due to Covid, either because they are ill themselves or because someone in their household has symptoms, so they are isolating.”

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Source: The Guardian, 23 October 2020

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Masks for public 'could put NHS supplies at risk'

NHS supplies of face masks could be put at risk if the government starts advising the public to wear them, hospital bosses have warned.

The government's scientific advisers are to meet later to discuss whether the public should be urged to wear masks in a bid to combat coronavirus, but Chris Hopson, chief executive of NHS Providers, warned there should be "clear evidence" to justify their use.

He said securing supplies for NHS staff amid huge global demand was "crucial".

The World Health Organization (WHO) has said there is no evidence to support the use of face masks by the general population. It says people who are not in health and care facilities should only wear masks if they are sick or caring for those who are ill.

But the debate around their use in the UK has been gaining momentum in recent weeks, with proponents arguing they can help reduce the risk of people with the virus passing it on to others.

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Source: BBC News, 21 April 2020

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Masks 'aggravated' fatal dosage miscommunication at Watford Hospital

Masks worn by doctors "aggravated" a miscommunication over the dose of an anti-epileptic drug that resulted in a man's death, a coroner has warned.

John Skinner died at Watford General Hospital in May 2020.

A coroner has written a Prevention of Future Deaths Report (PFDR) saying he feared the same could happen at other hospitals if action was not taken.

Assistant Coroner for Hertfordshire, Graham Danbury, said in the report: "As a result of failure in verbal communication between the doctors, aggravated as both were masked, a dose of 15mg/kg was heard as 50mg/kg and an overdose was administered."

Mr Danbury, writing to NHS England, said: "This is a readily foreseeable confusion which could apply in any hospital and could be avoided by use of clearer and less confusable means of communication and expression of number."

A spokesperson for West Hertfordshire Hospitals NHS Trust said: "A comprehensive action plan is in place to ensure that lessons are learned from this incident."

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Source: 15 February 2022

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Mask rules to return for Jersey

Mandatory mask wearing rules are set to return to Jersey from Wednesday 21 July amid concerns for rising case numbers. 

The rules stipulate that anyone over the age of 12, must wear a mask when inside indoor public places such as transport, shops and health care settings.

Minister for Health and Social Services, Deputy Richard Renouf has said: "While we have seen a rise in cases over the past two weeks, it is important to remember the effect our vaccination programme has had on the island".

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Source: BBC News, 20 July 2021

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Mask guidance downgraded amid reports of failing stock

Public Health England PHE) has made new changes to its guidance on the use of face masks as “a pragmatic approach for times of severe shortage”.

The update came as trust procurement leads reported receiving substandard face masks from national stocks over the weekend, although a PHE spokesman told HSJ that this had not caused the change to guidance.

PHE on Sunday updated its guidance on the use of certain facemasks facing “acute shortages”. The new advice states that FFP2 respirators can be worn without fit testing in lieu of surgical masks in non-surgical settings.

The new guidance says: “This is a pragmatic approach for times of severe shortage of respiratory protective equipment, FFP2 respirators being used in this way will not be carrying out the function they were designed to perform.”

However, FFP2 respirators must still be properly fit-tested in situations where this level of protection is required, the new PHE advice states.

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Source: 4 May 2020

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Martha’s rule now in operation at every acute hospital in England

Martha’s rule, which lets NHS patients request a review of their care, is now in operation in every acute hospital in England, health service bosses disclosed on Thursday.

The system has helped hundreds of people receive potentially life-saving improvements to their treatment since its rollout began last year. It has led directly to patients being moved to intensive care or receiving drugs they needed, such as antibiotics, or benefiting from other vital interventions.

It is named after Martha Mills, who died in 2021 at the age of 13 from sepsis after a bicycle accident. A coroner found she would probably have survived if she had been moved to the intensive care unit at King’s College hospital in London when she began deteriorating. Martha would have been 18 on Thursday if she had lived.

Martha’s rule became available in 143 acute hospitals in England last year. But it has also been implemented in the other 67 such sites, which means all 210 acute facilities are covered.

It gives patients, their loved ones and NHS staff the right to ask for a different medical team to examine the care being provided and recommend changes.

NHS England’s national medical director, Prof Meghana Pandit, said it is having “a transformative impact” on how hospitals work with patients and their families when their condition is worsening.

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Source: The Guardian, 4 September 2025

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Martha’s rule must be available 24/7, England’s patient safety commissioner says

Patients and their relatives will be able to request a second opinion from senior medics around the clock when the “Martha’s rule” system starts in hospitals in England.

The government’s patient safety commissioner, asked by the health secretary, Steve Barclay, to advise on how to implement the change, has said access to a medic’s opinion must operate 24/7.

Dr Henrietta Hughes made clear to Barclay in a letter that inpatients and families worried that their loved one’s health is deteriorating should be able to seek a second opinion at any time of day or night.

In her letter, which she published on Wednesday, Hughes also said the availability of that service must be widely advertised in hospitals, so patients know they can use it.

She told Barclay that all staff in acute and specialist medical NHS trusts in England “must have 24/7 access to a rapid review from a critical care outreach team who they can contact should they have concerns about a patient”.

Hughes added: “All patients, their families, carers and advocates must also have access to the same 24/7 rapid review from a critical care outreach team which they can contact via mechanisms advertised around the hospital and more widely if they are worried about the patient’s condition. This is Martha’s rule.”

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Source: The Guardian, 3 November 2023

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Martha’s rule may have saved more than 500 lives in England since 2024

More than 500 people have received potentially life-saving care thanks to Martha’s rule, which gives hospital patients the right to seek a second opinion about their health.

They were moved to intensive care or a specialist unit after they, a loved one or a member of NHS staff triggered the patient safety mechanism, which the NHS in England began using in 2024.

Martha’s rule lets patients, relatives and staff call a helpline run by the hospital if they are worried about the person’s condition or treatment and ask for a “rapid review” of their care.

In the 18 months between September 2024 and February 2026, a total of 524 adults and children about whom concerns had been raised were moved to an intensive care or high-dependency unit, a specialist hospital or a specialist ward at the hospital where they were already an inpatient.

Wes Streeting, the health secretary, said the figures proved that Martha’s rule is “already having a life-saving impact”. It has been widely hailed as a major advance in patient safety.

Martha’s rule is named after Martha Mills, who died aged 13 in 2021 after her family’s concerns that she was deteriorating went unheeded by staff at King’s College hospital in London.

NHS England’s latest data on how Martha’s rule is operating shows that 12,301 calls were made to Martha’s rule helplines during those 18 months. About one in three – 4,047 – helped to identify a patient whose health was getting worse. Three-quarters of them (2,967) were made either by a patient and their carer or by the patient themselves. Hospital staff made the other 1,080.

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Source: The Guardian, 1 May 2026

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Martha’s rule may have saved 400 lives so far in England, figures show

More than 400 lives may have been saved as a result of Martha’s rule, which lets NHS patients request a review of their care, official figures reveal.

Helplines received more than 10,000 calls in the first 16 months of the scheme after its introduction in England in 2024, according to data seen by the Guardian. Thousands of patients were either moved to intensive care, received drugs they needed or benefited from other changes as a direct result of the calls.

The system is named after Martha Mills, 13, who died in 2021 from sepsis after a bicycle accident. A coroner found she would probably have survived if she had been moved to the intensive care unit at King’s College hospital in London when she began deteriorating.

Martha’s rule helplines received 10,119 calls between September 2024 and December 2025 from patients, relatives or staff who were worried about care, the figures show. That led to 446 people receiving improvements to their care that may have saved their life.

One in three calls (3,457) identified a rapid worsening of a patient’s condition, helping raise the alarm more quickly and enable crucial interventions to be made. The NHS England data shows 1,885 patients had their treatment changed as a result.

In addition, about 6,000 calls had addressed clinical, communication or coordination concerns, which led to “meaningful improvements” in care or navigating the healthcare system for patients and their families, health officials said.

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Source: The Guardian, 8 March 2026

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Martha’s rule having ‘transformative effect’, NHS England data shows

Patients have been moved to intensive care or received potentially life-saving treatment such as oxygen as a direct result of hospitals adopting Martha’s rule, NHS data shows.

Doctors and nurses have changed how they care for dozens of very sick patients since its introduction in many parts of the NHS in England during the course of 2024.

Martha’s rule, named after Martha Mills, who died in 2021 aged 13, gives patients and their loved ones the right to request an urgent review of the person in hospital’s treatment. That triggers their care being looked at urgently by a team of specialists, who offer a second opinion.

Prof Sir Stephen Powis, NHS England’s national medical director, said: “The introduction of Martha’s rule represents one of the most important changes to patient care in recent years, and we are really encouraged to see the impact it is already having for patients in this first phase.”

The new patient safety procedure has led to 573 calls, across the 143 hospitals using it, in which someone has sought an urgent review. About half (286) have prompted an urgent review by critical care staff. And about one in five of those reviews – 57 cases – has led to the person’s care being escalated, for example by being given potentially life-saving antibiotics or other drugs.

Martha's mother, Merope Mills, told the Today programme: “It’s clear to me that if we implement Martha’s rule nationally, we can confidently say that it would greatly improve care, change the culture, and save lives.”

She continued: “Any doctors who still have doubts about the value of Martha’s rule, I’d love them to realise a bit of humility and being open to the opinions of the family and patients makes for the best and safest medicine.

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Source: The Guardian, 17 December 2024

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Martha's rule: Mother to press health secretary on patient rights

The mother of Martha Mills, whose preventable death in hospital has led to calls for extra patients' rights, has said she is to meet the health secretary to discuss "Martha's Rule".

If introduced, it would give families a statutory right to get a second opinion if they have concerns about care.

Merope Mills said patients needed more clarity and to feel empowered.

Her daughter, Martha, died two years ago after failures in treating her sepsis at King's College Hospital.

She had entered hospital with an injury to her pancreas after falling off her bike. The injury was serious but should never have been fatal. Within days she had died of sepsis.

In an interview on Radio 4's Today programme, Mrs Mills said she had raised concerns but doctors told her the extensive bleeding was "a normal side-effect of the infection, that her clotting abilities were slightly off".

The King's College Hospital Trust said it remained "deeply sorry that we failed Martha when she needed us most" and her parents should have been listened to.

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Source: BBC News, 12 September 2023

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Martha's rule: Call for right to second opinion after tragic teen death

The parents of a teenager who died in hospital two years ago are calling for patients to be given the right to an urgent second opinion, if they feel their concerns are not being taken seriously by medical staff.

Martha Mills, who would have been 16 on Monday, died after failures in treating her sepsis at King's College Hospital. An inquest said she could have survived had her care been better.

Martha's mother, Merope, has helped the think tank Demos write a report which is calling on NHS England to urgently put in place Martha's rule.

This would "effectively formalise the idea of asking for a second opinion, from a different team outside the team currently looking after you if you feel you are not being listened to", she said.

She added that asking for a second opinion when there is a deterioration "shouldn't be a problem and it shouldn't involve confrontation".

It might be that a patient or family could escalate to another team over the phone to get an urgent critical care review.

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Source: BBC News, 4 September 2023

 

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Mapped: The stark north-south divide in UK life expectancy

Men across the country are, on average, living four fewer years than women – but there are stark disparities across the UK, new analysis shows.

Research from the Centre for Ageing Better found from 2021-2023, the average life expectancy at birth is 79 years for men and 83 years for women.

The charity’s 2025 State of Ageing report found men living in the bottom fifth of areas of the country in terms of wealth can expect to live 4.4 fewer years on average than those living in the wealthiest areas of England.

There is a clear north-south divide in average life expectancy at birth across England, the report found. The lowest life expectancy at birth for men and women is in the North East (77.4 and 81.4 years respectively), according to the Centre for Ageing Better.

Dr Carole Easton OBE, Chief Executive at the Centre for Ageing Better, said: “The substantial regional inequalities highlighted in our new State of Ageing report are truly a matter of life and death. Living in a part of the country where good quality jobs and opportunity is scarce, and where financial insecurity and poverty is rife, is robbing people of their health in later life and depriving them of years spent with loved ones. This is the true human cost of our very unequal society.

“The really worrying trend is that inequality in life expectancy is increasing almost everywhere. The bombardment of shocks from austerity, Covid and the cost-of-living crisis have compounded longer-term health and inequality issues to ensure we truly are the sick man of Europe.”

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Mapped: RTT waiting times

HSJ has published an interactive map of local NHS waits around England in June 2023, showing the pressures, with links to all the details by organisation and specialty.

It shows the local picture on 18-week referral to treatment taken from the latest Referral to Treatment (RTT) waiting times data released by NHS England.

View the map

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Source: HSJ, 14 August 2023

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Mapped: Areas of England with the highest risk of dying from cancer

Large regional variations in the risk of death from cancer by the age of 80 have been revealed in research by Imperial College London based on NHS data for England.

Analysis of the figures by The Independent shows the risk of dying is highest in northern England cities, while men and women living in the London boroughs had the lowest chance.

Although the risk of dying from cancer has decreased across all areas of England in the last two decades, it is now the leading cause of death in England, having overtaken cardiovascular diseases.

The Less Survivable Cancers Taskforce has that warned Britain has some of the worst cancer survival rates among the world’s wealthiest countries. It ranked the UK 28th out of 33 countries for five-year survival rate for stomach and lung cancer; for pancreatic cancer the UK was 26th, and it was 25th for brain cancer.

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Source: The Guardian, 13 January 2024

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Many patients leave GP appointment without discussing all worries, survey shows

Two-fifths of patients leave their GP appointment without discussing everything that is worrying them about their health, a survey has revealed.

The finding has prompted claims that older people often feel family doctors “want them out the door as soon as possible” rather than listening to all their concerns.

The polling firm Ipsos found that while 51% of patients were able to talk about “everything” or “most things” they wanted to raise the last time they saw a GP, 40% were only able to discuss “some things”, “hardly anything” or “nothing at all”.

Dennis Reed, the director of Silver Voices, a membership organisation for older people, said that while “there are many wonderful GPs who take all the time that is necessary … an increasing number appear irritated and impatient if an older patient feels the need to explain their medical history to give context”.

He warned that patients not having enough time to talk through all their concerns with a GP meant there was a “great danger that only the immediate and obvious symptoms are dealt with” and that “underlying, more serious concerns can easily be missed”.

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Source: The Guardian, 2 September 2024

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Many overseas doctors feel ill-prepared to join NHS, survey finds

Many doctors from overseas are left feeling lost, anxious and not ready to care for patients after joining the NHS because they are not properly looked after, research has found.

Many international medical graduates (IMGs) feel the NHS does not help them prepare for life as a doctor in the UK and the practicalities of moving to a new country, according to a survey.

Almost six in 10 (58%) of those questioned thought their induction was inadequate, and almost half (48%) felt anxious about starting to perform clinical duties in the UK.

The Medical Protection Society (MPS), which surveyed 737 IMGs working in England, said the results showed that too many foreign-trained doctors were “still being let down” professionally and personally by the NHS.

One doctor said: “I was very anxious and worried as working clinically without induction and [a] very brief period of shadowing … I was just lost.”

Another said: “I asked several times about induction, to be told that I will just learn on the job and ‘it will be fine’.”

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Source: The Guardian, 28 June 2024

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Many more women now beating early breast cancer

Most women with early breast cancer now beat the disease thanks to huge improvements in treatments in recent years, a BMJ analysis has found.

Their risk of dying within five years of diagnosis is estimated to be around 5% - down from 14% in the 1990s.

The BMJ analysis tracked more than half a million women with early, invasive breast cancer - mostly stage one and two - diagnosed in the 1990s, 2000s and between 2010 and 2015.

It found the prognosis for nearly all women "has improved substantially since the 1990s", with most becoming long-term cancer survivors.

And based on those trends, the researchers behind the Oxford University-led study say women diagnosed today also have a much lower risk.

"That's good news - and reassuring for clinicians and patients," oncologist and lead researcher Prof Carolyn Taylor says.

Cancer Research UK says this offers "reassurance" to many women but warns more highly-trained staff are needed to meet rising demand.

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Source: BMJ, 14 June 2023

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