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Leaked review warns CDCs a ‘burden’ on trusts

Community diagnostic centres could become a financial “burden” on providers without extra funding and changes to how tests are paid for, the programme’s architect has warned in an internal review obtained by HSJ.

The NHS England review, led by Sir Mike Richards, follows ministers making community diagnostic centres a central plank of their elective recovery plan and mission to shift care into the community.

The review concluded prices for some imaging tests are making significant amounts of CDC work loss-making – and says additional central funding over “multiple years” is required.

It also called for CDCs to be rebranded and a major publicity campaign to address “low level[s] of awareness and understanding” among clinicians and the public about what they do. It also highlighted substantial digital challenges.

The report declared the programme has “successfully” established 170 operational CDCs “delivering more than 20 million tests, primarily in new community settings”. But it also warned more funding and national directives are needed to “fully utilise” the centres.

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Source: HSJ, 5 May 2026

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Leaked report shows ‘long-standing’ bullying and discrimination within national agency

Internal documents show significant evidence of bullying and discrimination within NHS Blood and Transplant (NHSBT) which dates back at least eight years, when the organisation was led by the current chief executive of the Care Quality Commission.

HSJ has seen a report which detailed major tensions and dysfunction at NHSBT’s Colindale site in north London in 2016, four years before another report found similar problems.

Given the damning findings of the second report, in 2020 – which found a “toxic environment”, multiple accounts of bullying, and “systemic racism” at the same site – it raises questions around the actions taken by NHSBT’s former leaders, including current CQC boss Ian Trenholm, to address the issues raised in the 2016 report.

The 2016 report was commissioned by the manufacturing directorate and concluded the hospital services department at the Colindale site was “dysfunctional” after a highly contentious reorganisation of some services and teams.

It noted “a series of bullying and harassment incidents” were being reported, but which staff felt were not investigated appropriately, and claims of “discriminatory practice” by managers.

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Source: HSJ, 26 August 2022

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Leaked report reveals culture of bullying and harassment at scandal-hit NHS hospital

A culture of systemic bullying and harassment has been allowed to flourish among staff at one England’s most scandal-hit hospitals, a damning leaked report reveals.

The safety of patients at Blackpool Victoria hospital was affected as a result of the failings, the report by the Royal College of Physicians (RCP) found.

The report was provided to leaders at the Blackpool teaching hospitals NHS trust in January but its findings were not shared widely with staff until 10 months later, prompting concerns that employees’ ability to take urgent action on its 19 recommendations was compromised.

Staff who spoke to the RCP inquiry team said that excessive workloads were handed to inexperienced doctors, leaving them fatigued and stressed while treating patients. They described a “keeping your head down culture” where their concerns were inadequately addressed. Consultants said that there was “systemic bullying, harassment and racial discrimination among staff”.

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Source: The Guardian, 3 December 2025

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Leaked report reveals almost half of Victorian isolation wards failed to meet all ventilation guidelines

A new leaked report has found almost half of hospital isolation rooms did not meet ventilation guidelines after an audit was commissioned after healthcare staff and patients were found to be infected with COVID-19. 

The audit revealed nearly 40 per cent of hospital wards failed air filtration guidelines and though 99 percent of wards had enough outside air, problems begin to occur when it gets into the hospitals. 

The ABC has contacted the Victorian Health Department for comment.

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Source: The ABC News, 1 July 2021

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Leaked NHS report warns GPs face ‘shocking levels’ of racism

GPs face “appalling and systemic” racism from patients and colleagues, a leaked NHS report has revealed.

The first Health Education England report for London of its kind says racism and discrimination are widespread within primary care across the capital, and GPs in other parts of the country have raised similar concerns.

Doctors speaking with The Independent have told stories of being called derogatory and racist names, of staff leaving due to the bigotry they’ve faced, and of patients asking to see a “white” or “English” GP.

Senior GPs have warned patients will ultimately suffer as a result, as experienced doctors leave practices to avoid such abuse.

Professor Simon Gregory, deputy medical director for Health Education England, said: “There is considerable evidence that the UK is systemically racist, and that the NHS is a systemically racist workplace.

“This report is shocking evidence of terrible, indeed appalling, levels of discrimination across protected characteristics and with much intersectionality, but especially shocking levels of racial discrimination.”

“The awful and painful narratives of so many colleagues over so many years cannot be ignored but thanks to London’s primary care educational leaders we now have firm evidence. Evidence that cannot be ignored.”

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Source: The Independent, 4 May 2022

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Leaked NHS figures reveal 15,000 died in care of mental health trusts in one year

The shocking number of patients who are dying while under the care of stretched community mental health services can be revealed for the first time after a major NHS report was leaked to The Independent.

More than 15,000 people are estimated to have died in a single year while being cared for by community mental health teams – as trusts scramble for staff and funding while the demand for care is at an all-time high.

The figures, which relate to deaths between March 2022 and March 2023, can be revealed after a concerned insider handed the secret report to this publication. Health officials admitted the statistics had been collated for the first time last year in a bid to reduce deaths – but have not made them public.

The leaked report reveals that:

  • At least 137 women died between 2022 and 2023 while under the care of services for pregnant women at one unnamed trust.
  • Nearly one in 10 of the patients treated by a crisis service – designed to help those with the most severe mental health conditions – died while under that care.
  • One unnamed mental health trust recorded more than 500 deaths in that year-long period.

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Source: The Independent, 22 April 2024

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Leaked national survey reveals steep fall in support for staff wellbeing

Leaked results from a national survey of NHS staff has revealed a sharp drop in those who believe their health and wellbeing is being supported by their employer.

The People Pulse is a national, monthly survey launched in 2020. It enables provider and commissioner organisations to monitor the NHS workforce’s health and wellbeing.

According to a snapshot of the results recorded between May and August seen by HSJ, there was a drop of 9.6 percentage points in “perceptions of wellbeing support”, with “positivity” sitting at 57.3%.

Almost a quarter of the survey respondents reported a “negative” experience of health and wellbeing support.

The survey results also revealed almost a third of respondents said they wanted to speak up about a specific issue during the pandemic, especially on issues of staff safety, health and wellbeing, but they did not because they feared repercussions or believed nothing would happen.

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Source: HSJ, 21 September 2021

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Leaked government review plans new law to push data sharing

An official review carried out for the health secretary, leaked to HSJ,  reveals plans to bolster the law to require greater sharing of patient data, saying it would help improve safety for those wrongly prescribed drugs.

A draft of the report on overprescribing, carried out for Matt Hancock by NHS England, says a major problem is that clinicians in different parts of the system can’t see what’s been prescribed and dispensed elsewhere. It says “wider access” should be given, which would also ensure “many eyes” are looking at the data to detect patterns or problems.

This should include making it a requirement that prescribing apps make their data openly available, according to the report by chief pharmaceutical officer Keith Ridge.

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Source: HSJ, 16 November 2020

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Leaked emails reveal child gender service concerns

Senior bosses have shared concerns about the closure of the NHS gender identity clinic for young people, leaked emails seen by BBC News reveal.

Hospital executives voiced worry about the cancellation of appointments, patients lacking information and poor communication with the new services.

In one email, the service's director, Dr Polly Carmichael, said cancellations could potentially put patients at risk.

The controversial Gender Identity Development Service (Gids), which is run by the Tavistock and Portman NHS Foundation Trust, is due to close later this week.

Its closure was announced in July 2022, after an independent review said a "fundamentally different" model of care for young people with gender-related distress was needed.

It will initially be replaced by two new regional hubs; a London-based southern hub and a north of England hub. Additional hubs are expected to open in the coming years.

However, BBC News has spoken to staff at the existing service who say, just days before the 31 March closure, they have been unable to answer basic questions from patients about the future of their care.

They say they still do not have enough details about how the new services will operate or when some provisions will be fully operational in the new clinics.

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Source: BBC News, 27 March 2024

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Leaked emails raise flag on ‘extremely concerning’ bed shortage

‘Systemic’ problems within mental health services in Birmingham have caused the number of people waiting for an inpatient bed to reach ‘extremely concerning’ levels, according to documents leaked to HSJ.

There are currently 41 people waiting to be admitted to a bed by Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) , according to internal documents, while 36 people have already had to be sent to private sector facilities up to 150 miles away.

The NHS in the area has indicated to HSJ  that it is due to need for “intensive levels of care” now growing because of the impact of the COVID-19 pandemic.

In an email thread, sent to 60 people in the trust including senior executives, one senior clinician wrote in response to the bed figures: “The number of patients with Mental Health Act assessments completed is extremely concerning. This needs to be escalated to commissioners. The problem is systemic.”

It comes after an HSJ investigation earlier this year into the deaths of 12 patients under BSMHFT’s services. It revealed senior medics had repeatedly warned the trust about severe bed shortages and a lack of capacity within home treatment services.

The trust said it was addressing the issues raised, but senior clinicians told HSJ this week the trust is still short of at least 80 adult mental health beds.

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Source: HSJ, 15 October 2020

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Leaked data reveals nearly quarter of a million year-plus waiters

Nearly a quarter of a million people have been waiting more than a year for operations and other hospital procedures, HSJ has learned. 

Official NHS England data for November, released on Thursday, showed 192,000 patients had been waiting for treatment for more than a year.

However, figures leaked to HSJ of weekly data up to 3 January showed a steep increase to 223,000 patients — the highest reported so far throughout the COVID-19 pandemic and before.

According to the leak, just under 4.2 million people are waiting for treatment, of which year-long waiters comprise 5.4%. The data also showed 175 patients across England had waited more than two years for treatment.

In February, before the pandemic, 1,613 patients were waiting more than a year — meaning there has been a 138-fold increase.

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Source: HSJ, 15 January 2021

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Leaked data reveals ‘distressing’ scale of ‘unacceptable’ A&E waits

One in five cases in which patients attend A&E needing mental healthcare are spending more than 12 hours in the department – at least double the rate of patients with physical health problems.

Unpublished internal NHS data seen by HSJ also suggests the proportion of mental health patients suffering long waits in accident and emergency has almost tripled when compared to the situation before the pandemic. 

According to the data, the proportion of attendances by patients with a mental health problem who waited more than 12 hours in A&E before being admitted or discharged increased from 7% (34,945 breaches) in 2019-20 to 20% (88,250 breaches) in 2022-23.

The situation has become so difficult, that some acute trusts are spot purchasing private sector mental health in order to discharge patients. 

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Source: HSJ, 5 June 2023

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Leaked data gives first view of growing cancer waiting list post covid peak

Official data from mid-September shows that nearly 6,400 people had waited more than 100 days following a referral to cancer services.

The leaked data reveals for the first time the length of the cancer waiting list in the wake of the first pandemic peak, during which much diagnostic and elective cancer care was paused.

The list consists of those waiting for a test, the outcome of a test, or for treatment. NHS England and Improvement only publish waiting times for patients who have been treated – not the number still waiting – so this information has been secret.

The data, obtained from official emails seen by HSJ, showed the total number of people on the cancer waiting list grew substantially, from 50,000 to around 58,000, between the start of August and the middle of September. 

Of the 6,400 people recorded to be waiting more than 104 days on 13 September, 472 had a “decision to treat classification”, meaning they have cancer and are awaiting treatment. 

NHS England has said reducing the cancer waiting list would be overseen by a national “taskforce”, which is being chaired by national director for cancer Peter Johnson.

Experts have warned the delays already stored up in the system could cost tens of thousands of lives as patients go undiagnosed or have their diagnosis and treatment later than they otherwise would.

HSJ asked NHS England if harm reviews had been carried out for those on the waiting list and whether it had discovered if those waiting longer than104 days had been harmed, but did not receive an answer.

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Source: HSJ, 29 September 2020

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Leak shows surge in staff absence as trusts consider letting covid positive clinicians return to wards

NHS staff absences due to covid have risen by a further 11,000 staff in a week in England, figures seen by HSJ reveal. 

At a national level, the number of absences for covid-related reasons - including isolation - rose to about 44,200 on 29 December, up from 32,800 on 22 December.

The 29 December figure has pushed up overall absence for all reasons to 103,727 - 7.8% of the total reported workforce - the leaked data shows.

Numerous senior NHS managers have said their main concern at present is about the level of staff absences, which in some cases is undermining services, with staff having to be redeployed to support others. There is concern about it rising further in the new year.

One trust is looking at whether staff who test positive could opt to work on wards dedicated to covid patients. Louise Ashley, the chief executive of Dartford and Gravesham Trust in Kent, tweeted yesterday that some nurses had asked if they could come into work while positive but asymptomatic.

Ms Ashley later confirmed to HSJ that the trust had assessed the request and “unfortunately” had to refuse it.

The two main reasons for the decision were that staff may have the more dangerous Delta strain and that it be too difficult to keep them isolated from other staff.

She added: ”I am amazed at their commitment to their patients and colleagues – very humbling after the two years they have been through. We are seeing high levels of staff absenteeism but we are hurrying through PCR tests to get staff back to work and are managing safe staffing levels currently.”

 There is also growing concern over NHS staff access to testing, which is required to enable contacts to come to work if they are negative.

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Source: HSJ, 31 December 2021

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Leak shows NHSE ‘sorry’ for endorsing service which ‘hurt patients’

NHS England is ‘sorry’ for backing a mental healthcare model which it now admits has caused hurt to patients, according to a leaked draft policy document.

The serenity integrated mentoring model was launched in 2013 in the Isle of Wight and Hampshire. It quickly became viewed by mental health trusts as an “innovative approach” to helping support frequent users of the emergency services.

A core element of the scheme involves placing a local community police officer within the healthcare team charged with supporting those patients. 

In 2021, the pressure group StopSIM raised concerns about the model, which included a belief that police involvement was potentially coercive, criminalised mental health crises, and could result in withholding healthcare from people, which would breach human rights legislation. The group also argued the SIM programme had not been robustly and clinically evaluated.

As a result, NHSE committed to co-producing policy guidance on SIM with StopSIM. 

The draft document states: “NHS England did not apply sufficient scrutiny to the decision [to endorse SIM] and involve the voice of lived experience sufficiently. This compromised the safety and quality of care for service users and has caused hurt to patients. For this, NHS England is sorry.”

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Source: HSJ, 19 May 2023

Further reading on the hub:

The High Intensity Network (HIN) approach and SIM model for mental health care and 'high intensity users' – what are your views?

 

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Leak reveals urgent care patients face 30-hour waits because of covid pressures

Patients calling NHS 111 in London could face a 30-hour wait before being admitted to a hospital bed, the capital’s ambulance service has warned.

Slides presented by London Ambulance Service Trust at a webinar with NHS London this week showed “category three” patients faced long delays at all stages of the process.

The length of each stage was said to be as follows: having calls answered at 111 centres (20 mins); the “revalidation” of the call before it is passed to 999 (two hours); 10 to 12 hour waits for an ambulance; and similar waits in emergency departments before being admitted to a bed.

Category three calls are considered urgent, but not immediately life-threatening. The calls could involve abdominal pain, uncomplicated diabetic issues and some falls. Category three patients are among those the NHS is encouraging to call first, rather than going straight to accident and emergency, as part of the flagship “111 first” drive designed to produce pressure on emergency care. 

Normally, the pathway from a 111 call being made to a patient being admitted to a bed would take nine hours with a faster response at all stages, the slides suggest. But the pressure across the NHS from covid cases is leading to much longer waits.  

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Source: HSJ, 8 January 2021

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Leak reveals trust omitting two-year waits from reported figures

A hospital trust has been breaching national guidance by excluding some long waiters from its reported waiting list figures, in a move experts warned could put patient safety at serious risk.

The practice appears to have helped Sandwell and West Birmingham Hospitals report zero patients waiting more than two years for treatment during most of last year.

Its policy means cases that unexpectedly “pop up” as two-year waits in its datasets are temporarily removed. The trust will then review whether the cases are data errors or genuine two-year waits, and if genuine, aim to provide treatment within a month.

If not treated within a month, the cases would be added back to the reported waiting list the following month.

Rob Findlay, an expert on RTT waiting lists, said the implications of the SWBH policy are far more serious than simply reporting incomplete numbers for a month.

He said allowing a month to deal with the pop-up without declaring it “relieves them of pressure to solve the problems that are causing patients to be lost in the first place”.

He added: “Some patients – the hospital would never know – might never pop up and be lost from the waiting list forever.

“[This is] a serious patient safety issue which could potentially have a significant impact on how long patients are waiting for treatment.”

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Source: HSJ, 19 January 2024

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Leak reveals priorities of NHS long-term plan refresh

A drive to ‘transform’ access to urgent, emergency and planned care will be added to the goals of the NHS long-term plan, a document leaked to HSJ has revealed

The  long-term plan for the NHS was originally published in January 2019. Last September, NHS England said it was reviewing the commitments made within the plan, with senior officials warning that many of them could not be met after the damage of the pandemic.

HSJ has seen a document prepared for the most recent meeting of the NHS Assembly which sets out NHSE’s approach to the refresh.

Strategic developments expected include better joined-up community based and preventive care, transform access to urgent, emergency and planned care, improve care quality and operations, and tackle health inequalities, improve population health and develop a sustainable health service through greater collaboration.

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Source: HSJ, 24 June 2022

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Leak reveals national plans to tackle A&E crisis

A raft of reforms NHS England and the government are proposing to address the crisis in urgent and emergency care can be revealed after a draft of the recovery plan was obtained by HSJ.

HSJ has seen an early “confidential working draft” of the national UEC improvement plan, which national officials are still working on, for publication in the coming weeks.

It is likely to develop, and HSJ understands officials are considering taking on board recommendations from cross-sector proposals published earlier this week. 

The draft seen by HSJ confirms a target for 2025-26 to increase four-hour A&E performance to 78% – the same target as in 2024-25 – despite health secretary Wes Streeting having originally pledged to return the NHS to meeting the 95 per cent standard by 2029. 

The new proposals are instead centred on 10 ‘action’ points for trusts and systems. They include aims to reduce 111 calls put through to 999 or A&E, and “avoidable” ambulance conveyances and handover delays; implement rapid triage at the ‘front door’ of A&Es; improve patient flow and access to mental health services; and deliver more care closer to home.

It also goes on also say that NHSE should separately “performance manage” A&Es on the length of waits for patients who attend with less serious conditions and therefore are not admitted.

As part of a “refreshed improvement offer,” an NHSE UEC improvement team will identify around 25 per cent of A&E sites which are “most in need” and work with them on “a clinical commitment to change whilst deploying multi-disciplinary improvement support” for a time limited period.

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Source: HSJ, 23 January 2025

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Leak reveals management consultants’ role in recovery plans

Consultants will set strategy, provide analytics and help lead the creation of integrated care systems’ elective recovery plans, a leaked document reveals.

HSJ reported that seven management consultancy firms would be paid up to £21m to “support” every ICS design its elective recovery plans by April. According to internal NHS documents, leaked to HSJ, the firms will provide “tailored skills and expertise” to help ICS teams develop their plans.

The document, shared with ICS and regional chiefs in a presentation by NHS elective care chief Sir Jim Mackey, states the consultancies will work alongside ICS teams to “ensure” the ICS plans achieve many objectives.

These objectives include:

  • Delivering or exceeding the expected performance ambitions… and are “triangulated across activity, finance and workforce capacity”;
  • Making “full use of transformational opportunities” to manage demand, increase capacity or improve productivity; 
  • Having a clear link to the health inequalities agenda; and
  • Maximising elective activity through all available options including making use of the available independent sector capacity. 

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Source: HSJ, 10 February 2022

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Leak reveals hour-long ambulance delays have quadrupled in 12 months

Ambulance handover delays lasting more than 60 minutes have increased four-fold compared to this time last year, according to internal NHS data.

NHS data seen by HSJ suggests there were around 28,900 ambulance handovers lasting longer than an hour during a four-week period in October. This was almost four times higher than the 7,772 hour-long handovers recorded in October 2020.

It is also significantly higher than the 17,137 seen in January 2021, which was the peak of the coronavirus pandemic.

Last week NHS England wrote to trusts and integrated care systems telling them to take urgent action to “immediately stop all delays” to ambulance handovers, and that “corridor care” is “unacceptable as a solution”.

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Source: HSJ, 3 November 2021

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Leak reveals details of mortuary sex assaults inquiry

The inquiry into sex offences carried out in a hospital mortuary will consider whether the trust board ‘received sufficient assurance’ about the issues raised by the assaults, documents shared with HSJ show.

The draft terms of reference for the independent inquiry have been shared with the families of women and girls abused by maintenance supervisor David Fuller for comment.

The inquiry will take place in two phases. The first phase – which will concentrate on Mr Fuller’s actions in Maidstone and Tunbridge Wells Trust – will look at his initial employment and access to the mortuary and other areas, and whether processes were appropriate.

It will also in this phase “consider whether the trust’s board received sufficient assurance on the issues raised by the case”.

But it will also seek to identify any evidence of “other inappropriate or unlawful activities” by Mr Fuller elsewhere on trust premises. It will review any evidence of concerns around his behaviour, and how the trust and the private contractors who later employed him addressed them.

In a letter to the families, inquiry chair Sir Jonathan Michael says it is intended that the evidence sessions will be held in private “primarily to protect and safeguard the dignity and anonymity of those people that Fuller abused” but also to encourage people to be “candid”. It is unclear whether families or their legal representatives will be able to attend these private sessions – other than when they are giving evidence – and to raise questions.

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Source: HSJ, 28 January 2022

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Leading oncologist faces GMC allegations of inappropriate treatment of dying patients

A UK oncologist with a world reputation is facing allegations by the General Medical Council that he provided medication inappropriately in an attempt to keep terminally ill patients alive.

Justin Stebbing, professor of cancer medicine and oncology at Imperial College London, who has a private practice in Harley Street, faces allegations at a medical practitioners tribunal of failing to provide good clinical care to 11 patients between March 2014 and March 2017.

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Source: BMJ, 15 September 2020

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Leading doctors launch legal action over physician associates

Leading doctors are to launch legal action against the medical regulator amid rising concerns about the use of physician associates.

The British Medical Association said it needed to take action before the “uncontrolled experiment” of the use of medical associate professions (MAPs) “before it leads to more unintended patient harm”.

The union said it is launching legal action against the General Medical Council (GMC) over the way it plans to regulate MAPs.

"We have had enough of the Government and the NHS leadership eroding our profession. We are standing up for both doctors and patients to block this ill thought through project before it leads to more unintended patient harm," said Professor Philip Banfield, BMA council chairman.

It said that there is a “dangerous blurring of lines” for patients between doctors and assistant roles.

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Source: The Independent, 24 June 2024

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Leading doctors issue warning amid ‘bad’ flu season

Leading children’s doctors are urging parents to get their children the flu nasal spray, amid fears of a particularly severe flu season.

The Royal College of Paediatrics and Child Health (RCPCH) stressed that even healthy children can become seriously ill.

This advice comes as the UK Health Security Agency (UKHSA) confirms this year’s flu vaccine provides "strong protection".

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Source: Independent, 12 November 2025

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