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NHS yet to see ‘a single penny’ of promised £500m emergency fund

Hospitals and care homes have not received a single penny of a £500m emergency fund promised by the government to prevent the NHS becoming overwhelmed this winter, the Guardian has learned.

Ministers announced they were injecting the cash into the health and social care system last month, to help get thousands of medically fit patients out of hospital into either their own home or a care home as soon as possible in an effort to better prepare the NHS for the coming months.

“At the moment, one of the key challenges is discharging patients from hospital into more appropriate care settings to free up beds and help improve ambulance response times,” Thérèse Coffey, the then health and social care secretary, said on 22 September. “To tackle that, I can announce today that we are launching a £500m adult social care discharge fund for this winter.”

However, the Guardian has been told that none of the funding has materialised. Senior health and social care sources described the government’s failure to release the promised cash as “inexplicable” and “outrageous”.

More than 13,000 of the 100,000 NHS hospital beds in England currently contain “delayed discharge” patients, which has led to A&E units becoming heavily congested and long delays in ambulance handovers. As a direct result, thousands of 999 patients are suffering potential “severe harm” every month because ambulances are stuck outside hospitals.

“Leaders across the NHS and local authorities are yet to see a single penny of this investment or any official detail on how it will be allocated,” said Matthew Taylor, the chief executive of the NHS Confederation.

“Currently, only two-fifths of patients in hospital are able to leave when they are ready to do so, including due to problems accessing social care, yet health leaders still do not know how and when the £500m will be released to the system. So close to winter, this is unbelievable.

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Source: The Guardian, 31 October 2022

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Ministers urged to launch inquiry into inpatient mental health services after ‘systemic abuse’ allegations

Ministers have been urged to launch a public inquiry into the care of mental health patients after The Independent revealed allegations that patients had suffered “systemic abuse” in inpatient units.

A joint investigation with Sky News found that teenagers at facilities run by The Huntercombe Group had been left with post-traumatic stress disorder by their treatment despite hundreds of warnings to regulators and the NHS.

Now the government is facing calls to review all mental health care services over fears that these cases are “the tip of the iceberg”.

Labour’s shadow mental health minister Dr Rosena Allin-Khan has called for a “rapid review” by the government into inpatient mental health services, while Deborah Coles, the chief executive of charity Inquest, has called on the new health secretary Steve Barclay to launch a statutory public inquiry.

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Source: The Independent, 28 October 2022

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Plea to vaccinate children against flu as hospitalisations rise in England

Parents are being urged to get their young children vaccinated against flu as data suggests hospitalisation rates among under-fives have almost doubled in England in the space of two weeks.

Data suggests the UK could face a triple whammy of respiratory illness this winter. While experts are concerned there could be another Covid wave, levels of both flu and respiratory syncytial virus (RSV) are increasing. The latter is a common winter virus that typically affects young children and can cause bronchiolitis.

Dr Conall Watson, consultant epidemiologist for the UK Health Security Agency (UKHSA), said hospital admission rates for flu had risen in recent weeks and were highest in children under five.

“Already this year a small number of young children have needed intensive care. Please book your preschooler in for flu vaccine at your GP surgery as soon as you can,” he said. “Flu nasal spray vaccine is also currently being offered to all primary school children and will be available for some secondary school years later this season.”

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Source: The Guardian, 28 October 2022

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New rules will discourage trusts from consuming more than their ‘fair share of NHS resources’

NHS England has launched the first substantive consultation on changes to the NHS provider licence since 2013. 

Licences set out the requirements providers must meet and are the legal mechanism NHS England can use to take enforcement action. Having a licence has long been mandatory for foundation trusts and independent providers, and will become so for trusts. The intention is for the proposals to take effect from next year.  

Most of the changes to the licence regime have been made to bring it into line with this year’s Health and Care Act and accompanying policy changes. For example, trusts will be required to collaborate with other providers and work effectively as part of their integrated care system. 

This extends to trusts delivering agreed financial plans decided at a system level. The aim is to provide “mutual accountability” and ensure each provider does not use “more than their fair share of NHS resources”.'

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Source: HSJ, 28 October 2022

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'I wouldn't bring a member of my family to this hospital,' says medic

Steve Barclay is back as England's health secretary, just as the NHS prepares for what its chief executive Amanda Pritchard says could be a "very, very challenging winter".

The government has said "intensive work" is under way in the 15 most under-pressure hospital trusts in England, to speed up ambulance delays, free up beds and reduce waiting times in A&E.

Emergency departments across the UK are struggling to quickly treat patients.

Only 57% of people who turned up at major A&E departments in England last month were seen, admitted or discharged within four hours, well below the 95% national target.

The latest figures from Gloucestershire Royal show it performs slightly worse than average, with 55% dealt with in four hours.

One medic, speaking anonymously to the BBC, said: "I wouldn't bring a member of my family to this hospital. And winter is going to be worse unless something changes fast."

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Source: BBC News, 28 October 2022

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NICE recommends NHS collects real-world evidence on devices that monitor people with Parkinson’s disease

Five promising technologies that could help improve symptoms and quality of life for people with Parkinson’s disease have been conditionally recommended by NICE.

The wearable devices have sensors that monitor the symptoms of people with Parkinson’s disease while they go about their day-to-day life. This information may more accurately record a person’s symptoms than a clinical assessment during in-person appointments and help inform medication decisions and follow up treatment such as physiotherapy.

Parkinson's disease is an incurable condition that affects the brain, resulting in progressive loss of coordination and movement problems. It is caused by loss of the cells in the brain that are responsible for producing dopamine, which helps to control and coordinate body movements.

Mark Chapman, interim director of Medical Technology at NICE, said: “Providing wearable technology to people with Parkinson’s disease could have a transformative effect on their care and lead to changes in their treatment taking place more quickly.

“However there is uncertainty in the evidence at present on these five promising technologies which is why the committee has conditionally recommended their use by the NHS while data is collected to eliminate these evidence gaps.

“We are committed to balancing the best care with value for money, delivering both for individuals and society as a whole, while at the same time driving innovation into the hands of health and care professionals to enable best practice.”

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Source: NICE, 27 October 2022

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Pinned down, force-fed and drugged into ‘zombie-like’ state: ‘Systemic abuse’ at children’s hospitals revealed

Children say they were "treated like animals" and left traumatised as part of a decade of “systemic abuse” by a group of mental health hospitals, an investigation by The Independent and Sky News has found.

The Department of Health and Social Care has now launched a probe into the allegations of 22 young women who were patients in units run by The Huntercombe Group, which has run at least six children’s mental health hospitals, between 2012 and this year.

They say they suffered treatment including the use of “painful” restraints and being held down for hours by male nurses, being stopped from going outside for months and living in wards with blood-stained walls. They also allege they were given so much medication they had become “zombies” and were force-fed.

But despite reports to police and regulators dating back seven years, and findings by the Care Quality Commission (CQC) that the units were inadequate, the NHS has still handed Huntercombe nearly £190m since 2015-16 to admit children to its mental health beds.

Through witness testimony, documents obtained by Freedom of Information request and leaked reports, the investigation has uncovered:

  • The CQC has received more than 700 whistleblowing and safeguarding reports, including “incidents of concern” and several “sexual safety” concerns.
  • NHS England was notified of 195 safeguarding reports between 2020 and 2021.
  • A 2018 internal report at Meadow Lodge hospital in Newton Abbot (now closed) found staff members using sexually inappropriate language in front of patients.
  • 160 reports investigated by Staffordshire police about Huntercombe Staffordshire between 2015 and 2022.
  • Between March 2021 and 2022, the CQC gave permission for 29 patients to be admitted to Maidenhead hospital after it was placed in special measures.

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Source: The Independent, 27 October 2022

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CQC inspection approach helping fuel emergency care crisis, says trust chief

A trust chief executive says the Care Quality Commission’s (CQC) inspection regime is still overly focussed on individual organisations, rather than systems, and this is driving the “risk aversion” which is partly responsible for the emergency care crisis.

Mid Yorkshire Hospitals Trust CEO Len Richards acknowledged the CQC has started to scrutinise system-wide issues but suggested the “heat” of its regulation is still on individual providers.

Mr Richards told the House of Lords’ public services committee on Wednesday that care homes and nursing homes in his area have declined to take patients ready to be discharged from hospital, due to concerns it would put their CQC accreditation at risk.

He said: “[Last winter] we asked nursing homes and care homes to take patients and they couldn’t take them beyond a certain limit because it would put their accreditation at risk.

“We went to the CQC to try and create some flexibility. Their perspective was very much of an independent regulatory body that would look at the organisation and not look at the system. I think we’ve got an awful long way to go there.

“I think regulation does drive risk aversion… [and] the heat of regulation right at the moment is on individual organisations.

“Therefore, when the CQC come and look at my organisation, they will talk about congestion in the A&E department. They won’t talk about the assessment that we made around there being a greater risk in the community if we didn’t offload ambulances.”

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Source: HSJ, 28 October 2022

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Nurses are working the equivalent of one day a week for nothing, research says

Nurses are working the equivalent of one day a week for nothing, according to a study.

Researchers from London Economics were commissioned by the Royal College of Nursing (RCN) to look at pay in England, Wales, Scotland and Northern Ireland since 2010.

They found that the salary of an experienced nurse had fallen by 20% in real terms, based on a five-day week.

Experienced nurses in England, Wales, and Northern Ireland would need a nominal pay rise of 45% by 2024-25 just to return their salaries to levels seen in 2010-11 in real terms, the research said.

And such a pay rise would actually help the NHS save money in the long term, as it would be cheaper than hiring staff from overseas, according to the study.

Dr Gavan Conlon, who oversaw the research, said that bringing staff in from overseas costs approximately £16,900 more annually than retaining a nurse, while using agency workers costs around £21,300 more per year.

He said that about 32,000 nurses leave the NHS every year, many due to the failure of their pay to keep up with the rising cost of living.

The RCN is balloting its 300,000 members for strike action, calling for higher pay and an effort by government to fill the hundreds of thousands of nursing vacancies across the country.

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Source: Sky News, 28 October 2022

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NHS AI Lab and Health Education England call for healthcare staff to be trained in AI

A new report published by the NHS AI Lab and Health Education England (HEE) has advocated for training and education for providers in how they deliver and develop AI guidance for staff.

The report, entitled ‘Developing healthcare workers’ confidence in AI (Part 2)’, is the second of two reports in relation to this research and follows the 2019 Topol Review recommendation to develop a healthcare workforce “able and willing” to use AI and robotics. It is also part of HEE’s Digital, AI and Robotics Technologies in Education (DART-ED) programme, which aims to understand the impact of advances of these technologies on the workforce’s education and training requirements.

In the previous report, the AI Lab and HEE found that many clinicians and staff were unaccustomed to the use of AI technologies, and without the suitable training patients would not be able to experience and share the advantages.

The new report has set out recommendations for education and training providers in England to support them in planning, resourcing, developing and delivering new training packages in this area. It notes that specialist training will also be required depending on roles and responsibilities such as involvement in implementation, procurement or using AI in clinical practice.

Brhmie Balaram, Head of AI Research and Ethics at the NHS AI Lab, added: “This important new research will support those organisations that train our health and care workers to develop their curriculums to ensure staff of the future receive the training in AI they will need. This project is only one in a series at the NHS AI Lab to help ensure the workforce and local NHS organisations are ready for the further spread of AI technologies that have been found to be safe, ethical and effective.”

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Source: Health Tech Newspaper, 25 October 2022

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Halt patient access to medical records if there are safety concerns, BMA tells GPs

General practices should delay rolling out the accelerated citizens’ access programme, due to go live on 1 November, if they have concerns over safety, the BMA has said.

In guidance published on 25 October the BMA’s General Practitioners Committee said that while many practices would be able to implement the scheme before the deadline some would need more time to prepare, to ensure that they can roll it out in line with the Data Protection Act and safeguarding measures.

The access scheme, led by NHS England, will automatically give patients the ability to see any new entries to their GP medical record through the NHS App.

As part of safeguarding practices it will require GPs to review each record to identify any safety concerns related to providing patient access, such as in cases of domestic violence or coercive relationships. Where there are safeguarding concerns, practices can prevent patients from having automatic access by adding a specific SNOMED code to the patient’s record before 1 November 2022.

David Wrigley, deputy chair of the BMA’s GP Committee for England, said, “We have a duty of care to speak up when patient safety is at risk, which is why we encourage practices even slightly unsure about whether they can deliver this programme before the start of November, to refer to our guidance. Our patients are at the heart of what we do, and we will always act in their best interests.”

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Source: BMJ, 26 October 2022

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USA: Patients from minority groups face longer wait times for vital lung cancer treatment

Patients from minority groups are facing longer wait times for potentially life-saving lung cancer treatment compared to their white counterparts, according to a study.

Experts warn that disparities can have real consequences – the earlier treatment is initiated, the better the health outcomes for patients.

Researchers at the University of Virginia (UVA) Cancer Centre reviewed data from more than 222,700 patients with non-small cell lung cancer across the US.

The findings, published in the scientific journal Health Equity, showed that the mean time for radiation initiation was 61.7 days. Broken down by ethnicity, white patients had to wait only 60.9 days, while Black patients had a wait time of 65.9 days, meanwhile for Asian patients, it was 71.9 days.

A single-week delay in treatment could lead to a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non-small cell lung cancer, respectively.

“Our results suggest that non-white lung cancer patients have delayed time to cancer treatment compared with white patients, and this is not limited to a particular type of treatment facility,” said senior researcher Rajesh Balkrishnan, PhD, of UVA Cancer Center and the University of Virginia School of Medicine’s Department of Public Health Sciences.

“Collaboration among providers and community stakeholders and organisations is much needed to increase accessibility and patient knowledge of cancer and to overcome existing disparities in timely care for lung cancer patients.”

Scientists cite multiple reasons for the racial disparities, including health insurance – non-white patients are more likely to be uninsured, face greater socioeconomic barriers to care and may be perceived by doctors as being at risk for not following through with treatment plans.

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Source: The Independent, 26 October 2022

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WHO publishes first ever list of fungal infections that pose ‘major threat’

The World Health Organization has published its first ever list of lethal fungal infections that represent a threat to public health.

Experts have noticed an increase in deadly fungal disease, with drug-resistant bacterial infections now responsible for roughly 1.27 million deaths every year.

“Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment,” WHO said.

The types of fungal infections listed often affect severely ill patients and those with significant underlying problems with their immune system, including people with cancer, HIV or AIDs, organ transplants, chronic respiratory disease or tuberculosis.

“Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide,” said Dr Hanan Balkhy, WHO assistant director-general, antimicrobial resistance, said.

In its new report, the WHO warns that there is only limited access to quality diagnostics and treatment for these developing fungal diseases. Medicines are often unavailable in low and middle income countries, leading to increased deaths among these populations.

One deadly fungal pathogen, Candida auris, which is resistant to multiple drugs, is particularly difficult to eradicate from hospitals - even with intensive infection prevention measures, the WHO said.

This means hospital wards often have to be shut down for prolonged periods of time when Candida auris is detected.

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Source: The Independent, 26 October 2022

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Home blood test kits ‘piling work on NHS’

Private companies are offering “misleading” home blood-testing kits that fuel health anxieties and pile pressure on the NHS, a report has suggested.

There has been a boom in sales of the kits, which promise to reveal everything from cancer risk to how long patients can expect to live.

But an investigation by the BMJ found these “unnecessary and potentially invasive tests” can be misleading and generate false alarms. The NHS is then left to “clear up the mess” as worried patients see GPs for reassurance or extra tests, piling more pressure on the overstretched service.

One GP described patients coming in “clutching the results of private screening tests”, with doctors asked to review the results.

The companies have been criticised for not providing sufficient follow-ups after the “poor quality and overhyped” tests, and for misleading results such as wrongly telling people their test levels are outside the “normal” range.

Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, said: “Most of the online [tests] will send the results to the patient with at best a sort of asterisk next to the ones that are abnormal, with advice to either pay some more money to get some sort of health professional to speak about it or go and see your own GP.”

Doctors are calling for the tests to be more tightly regulated by the health watchdog, the Care Quality Commission.

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Source: The Times, 27 October 2022

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Rotherham NHS Foundation Trust fined for exposing babies to 'serious harm'

A hospital trust has been fined £200,000 for putting four babies at "serious risk"of harm.

Staff at Rotherham Hospital failed to spot non-accidental injuries during admissions, Sheffield Magistrates' Court heard.

District Judge Naomi Redhouse criticised failures in the hospital's systems and processes.

Health watchdog, the Care Quality Commission (CQC), had earlier highlighted problems with safeguarding training at the trust prior to the babies' admissions between January 2019 and February 2020.

The court was told how one eight-day-old baby was brought into the hospital on 23 December 2019 suffering from breathing difficulties and bleeding from the nose and mouth.

It was only on the child's fifth visit to hospital - after a GP raised concerns - that a child safety examination took place, revealing rib and leg fractures that were deemed non-accidental.

Ms Redhouse also heard how a month-old baby brought in with a mouth injury on 20 January 2019 was on a child protection plan but this was not spotted by the paediatric nurse who examined the baby.

This child was twice released from hospital, with no safeguarding concerns, before a scan and other examinations revealed multiple fractures, the court heard.

Prosecutor Ryan Donohue said failings had been identified in areas including policy implementation, training, reporting, auditing and governance.

Eleanor Sanderson, mitigating for the trust, said: "The trust wishes to express to the court its deep regret for the circumstances which gave rise to these offences and the risk posed to those who required safeguarding."

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Source: BBC News, 26 October 2022

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Struggling trusts’ CEOs must ‘self certify’ to NHS England

Bosses at struggling trusts must sign new commitments to national leaders about how they are approaching the task of clearing their elective and cancer backlogs, under a new protocol drawn up by NHS England.

National leaders have written to CEOs and chairs of trusts in NHSE’s bottom two “tiers” for elective and cancer performance, telling them they must fill out a new “board self certification” by 11 November.

It requires them to sign that they have carried out a list of 12 separate actions to try to improve.

In addition to some fundamental administrative requests, these include increased scrutiny around issues such as theatre productivity, list validation, especially for non-admitted lists, and cancer pathway redesign.

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Source: HSJ, 28 October 2022

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Long Covid: ‘fraction’ of patients getting NHS help in England

Just a “fraction” of people with Long Covid is getting the help they need, with a third of them waiting more than three and a half months to be assessed after a GP referral, rising to almost half in some areas.

More than 60,000 people in England had a first assessment for post-Covid syndrome in an NHS specialist service between July 2021 and August 2022.

But the latest estimates released by the Office for National Statistics (ONS) show that about 277,000 people with Long Covid in England report that the disease has limited their day-to-day activities “a lot”. These are the people that experts would expect to be referred for an assessment; however, the numbers who have been seen are far lower.

Dr Helen Salisbury, a GP and columnist for the BMJ, said: “A fraction of the people who have got this problem are actually being seen” within the existing services.

She said reasons could include patients not realising that the help is available to them; GPs not recognising Long Covid in those who do not self-label as having the condition; and a lack of knowledge of, and local access to, specialised clinics.

While Salisbury conceded that there was no current cure for long Covid, she added that patients require treatment that involves symptom management, psychology and knowing they are not alone in their diagnosis.

Ondine Sherwood, a co-founder of the advocacy charity Long Covid SOS, said many people with long Covid “are struggling to get any healthcare. Many are not getting any treatment at all.”

She said public misconceptions around long Covid made it harder for sufferers to ask for and get help. “There was a lack of preparedness for the potential long-term morbidity which was not conveyed to healthcare professionals and this has contributed to the lack of care for long Covid.”

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Source: The Guardian, 27 October 2022

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Board to get anti-racism training as CQC orders cultural improvements

Regulators have told the agency that supplies blood to the NHS to develop a more inclusive culture, after hearing multiple reports of ethnic minority staff being ‘disrespected’ and discriminated against.

“Many staff” at NHS Blood and Transplant also expressed fear of reprisal for raising issues and concerns, the Care Quality Commission (CQC) said.

The CQC carried out a “well-led” inspection of the agency over the summer, after receiving concerns about its culture and the behaviour of some senior leaders.

Chief executive Betsy Bassis resigned after the inspection, although the CQC report does not refer to any specific allegations made against her.

NHSBT has acknowledged it needs to improve its culture, particularly around diversity and inclusion issues. An internal memo sent to staff last week, seen by HSJ, said executives and board members would receive one-to-one training in “inclusive leadership and understanding racism”.

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Source: HSJ, 27 October 2022

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NHS staff struggling with menopause choosing to leave

The NHS faces an “exodus” of female doctors who are struggling to work due to a lack of menopause support, a report has warned.

The Medical Protection Society, which helps doctors in legal and ethical disputes, said that many quit or reduce their hours over fears that their menopause symptoms, such as brain fog, insomnia and hot flushes, will cause them to accidentally harm patients. A survey found that 36 per cent of female doctors have considered reducing their hours because of menopause symptoms, while one in five have considered early retirement.

“With females making up most of the healthcare workforce, it is crucial that they can access the support they need to avoid an exodus from the profession,” the report said.

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Source: The Times, 26 October 2022

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RSV, other viruses making it hard to find a bed in children’s hospitals

Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses.

Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV.

Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics, said, "It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full.”

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Source: The Washington Post, 21 October 2022

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Harm to patients ‘normalised’ as ‘burned-out’ paramedics work without breaks, care watchdog warns

Harm to patients has become “normalised” as burned-out paramedics are working without breaks, the national care watchdog has warned.

Concerns over the pressures on staff at South East Coast Ambulance Service have been raised by the Care Quality Commission (CQC).

Senior staff told the CQC that patients were being adversely affected by ambulance delays but it was now being seen as “part of the culture”.

The CQC found pressures on staff within the South East Coast Ambulance Service, such as long waits outside of the emergency department, had led to low morale and staff feeling they were not valued.

It said: “Staff described feeling frustrated and burnout and that senior leaders did not understand or respond to the challenges or concerns they raised. Some local senior managers described that harm to patients, caused by delays in reaching them, had become normalised as a culture.”

“At times there were many outstanding category 3 [urgent] patients awaiting an ambulance or assessment by a paramedic practitioner. At busy times, these patients waited for extended lengths of time for crews and callbacks. Therefore, this group of patients were at risk of deterioration whilst they were waiting for a response.”

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Source: The Independent, 26 October 2022

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Seven in 10 NHS trusts in England failing to hit cancer referrals target

People with suspected cancer in England are facing a higher risk of “worrying” outcomes owing to unacceptable delays in being referred to hospital, experts have said, as figures show seven in 10 NHS trusts are failing to hit a key target.

The number of NHS trusts missing the national target for urgent cancer referrals is the highest it has been for at least three years, according to analysis of NHS data.

In England, the maximum waiting time for a hospital appointment for suspected cancer is two weeks from the day the hospital receives a referral letter from a GP. At least 93% of patients should be seen within 14 days, according to the NHS. But analysis by the PA news agency, using data from August 2019 to August 2022, shows this target is routinely being missed, putting patients at greater risk of poor outcomes.

Minesh Patel, head of policy at Macmillan Cancer Support, said: “There are huge pressures even at that early stage of the cancer pathway, let alone when you get to treatment, and it is really worrying for somebody’s prognosis. If somebody starts treatment later, the more worrying the outcome could be in terms of their ability to survive their cancer, to have minimal after-effects after a treatment. This is about survival and giving people the best chance and improving their quality of life, ultimately.”

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Source: The Guardian, 26 October 2022

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Public health cuts must be avoided, new PM told

Cuts to public health budgets will hit poorest communities the hardest, the new government is being warned.

Directors of public health say local authorities - which pay for initiatives such as smoking cessation services - are on a financial cliff edge.

Rising inflation means ventures will cost more to run. Any reduction in funding in next week's spending announcement will have a direct impact on the lives of the most vulnerable, they said.

David Finch, assistant director of healthy lives at The Health Foundation, said: "Public health interventions have been shown to be really cost effective. Investing in these preventative measures that help to keep people in good health in the first place means you're protecting against future costs to the economy and society by keeping people healthy and reducing poor health in the future."

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Source: BBC News, 26 October 2022

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Trust criticised over handling of 60-hour A&E waits

Senior staff have questioned why a major hospital did not seek support from neighbours when emergency patients were left waiting more than 60 hours to be admitted to a bed.

Cambridge University Hospitals Foundation Trust’s emergency department came under severe pressure last week, with patients being bedded down in corridors and facing very long waits to be admitted to a ward.

Senior sources told HSJ there were two cases where patients were waiting more than 60 hours last Monday, and the trust declared an internal incident.

But the sources felt the trust should have escalated its alert level to “Opel 4”, which prompts calls for external support when trusts are under the most severe levels of operational pressure. This can include diverting ambulances to other hospitals.

The trust apologised to patients who had been kept “waiting for a long time” but that the required threshold for Opel 4 had not been reached.

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Source: HSJ, 25 October 2022

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Aggressive breast cancer hits black women harder

Researchers in the US have found a genetic link between people with African ancestry and the aggressive type of breast cancer. They hope their findings will encourage more black people to get involved in clinical trials in a bid to improve survival rates for people with the disease.

Triple negative breast cancer (TNBC) is more common in women under 40 and disproportionately affects black women.

A study published in the journal JAMA Oncology found that black women diagnosed with TNBC are 28% more likely to die from it than white women with the same diagnosis.

Now a new study has confirmed a definitive genetic link between African ancestry and TNBC. Lisa Newman, of Weill Cornell Medicine, has been part of an international project studying breast cancer in women in different regions of Africa for 20 years.

She says representation of women with diverse backgrounds on clinical trials is absolutely critical.

"Unfortunately, African-American women are disproportionately under-represented in cancer clinical trials and we see this in the breast cancer clinical trials as well," says Dr Newman.

"If you don't have diverse representation, you don't understand how to apply these advances in treatment.

"Part of it is because there is some historic mistrust of the healthcare system.

"We do continue to see systemic racism in the healthcare delivery system where it has been documented, tragically, that many cancer care providers are less likely to offer clinical trials to their black patients compared with their white patients."

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