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Leading clinicians ‘horrified’ as NHSE slashes community funding without warning

Senior medics have reacted in horror to NHS England’s decision to ‘dramatically’ cut the funding of a key long-term plan commitment designed to improve older people’s community services and deliver more care at home.

British Geriatrics Society president Jennifer Burns told HSJ the professional body was “horrified” that the budget for the Ageing Well programme for 2022-23 would be £70m instead of the £204m originally promised in the long-term plan for the NHS.

“We are dismayed that the promised funding for the Ageing Well programme as set out in the NHS long-term plan is being so dramatically cut at this time,” Dr Burns said.

NHSE said: “The NHS is also investing an additional £200m in funding for virtual wards across the country by March 2023, delivering more care to patients safely in the comfort of their own home which will directly benefit older patients.”

But Dr Burns said that although virtual wards would go “some way to helping with hospital admissions”, they were “no substitute” for the original commitments.

“Older people suffered a devastating toll during the pandemic. Now is the time for systems to ensure the right services are in place and there is sustainable planning for the healthcare needs of an ageing population.”

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Source: HSJ, 7 April 2022

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Leadership review launched at ‘outstanding’ trust

The Care Quality Commission has launched a review of leadership at an “outstanding”-rated specialist trust, after receiving multiple concerns from whistleblowers.

The regulator is understood to have made an unannounced visit to The Christie Foundation Trust within the last week to inspect its medical services. The review will also cover the trust’s overall leadership.

HSJ understands the review is, at least, partly in response to the regulator receiving a number of concerns from whistleblowers about the trust’s leadership culture and behaviour of senior staff.

It comes after the trust came under scrutiny from NHS England last year, with independent reviews finding there had been multiple failings around the handling of a major research project.

The reviews also criticised the trust’s reaction to staff who had raised concerns, but failed to answer a key accusation that was made about the detriment suffered by whistleblowers.

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Source: HSJ, 19 October 2022

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Leadership improves at ‘toxic’ trust

One of England’s largest trusts previously criticised for its “toxic” environment has made significant improvements to its culture, inspectors have said.

The Care Quality Commission updated its well-led rating for University Hospitals Birmingham Foundation Trust from “inadequate” to “good” following an inspection in April and May.

The trust’s leadership was rated “inadequate” last year and staff reported a “toxic” culture, including bullying, racism and inappropriate behaviour. It has been subject to a string of leadership, cultural and care quality concerns in recent years, and undergone a major overhaul of its senior leadership. 

Charlotte Rudge, CQC deputy director of operations in the Midlands, said UHB should be “proud” of its leadership, culture and governance improvements.

“At the previous inspection, we told the trust leadership they needed to do more work to significantly improve culture and staff wellbeing,” she said.

“In response, they introduced a comprehensive plan and took action to make significant improvements in this area.

“Leaders now provided a clear shared direction for the organisation which didn’t just align plans and objectives but translated them into real action to improve people’s care.” 

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Source: HSJ, 29 August 2025

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Leaders urge review of single-word CQC ratings after headteacher death

Trust chiefs have collectively called for the Care Quality Commission (CQC) to review its use of single-word inspection ratings, following MPs’ calls for an overhaul of Ofsted ratings for schools.

In a report containing a series of recommendations for CQC reform, shared with HSJ, NHS Providers urges the regulator to re-evaluate the success of its single-word ratings, asking it to consider adding a narrative verdict as part of its new provider assessment reports.

The recommendation is made “in the context of the Ofsted inquiry findings” following the death of headteacher Ruth Perry by suicide, which a coroner ruled was contributed to by an Ofsted inspection. It prompted MPs on the Commons’ education committee to call for a ban on single-word Ofsted ratings.

The NHSP report said the inquiry’s concerns around inspectors’ behaviour, the complaints process, and single ratings can also be applied to CQC.

The report adds: “While we recognise the differences between the two regulators’ approaches, we believe now is the right time to take stock… for example, CQC may need to consider the value of its single-word ratings, modelled upon Ofsted’s rating system.

“As suggested by the Nuffield Trust and many trust leaders, a single-word rating will inevitably oversimplify what happens in a very complex organisation".

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Source: HSJ, 21 March 2024

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Leaders ‘quick to blame’ at ‘inadequate’ hospital department

Staff have accused leaders of being “quick to find someone to blame” in an inspection that has rated a hospital department “inadequate”.

The Care Quality Commission said it had found systemic cultural issues in the children and young people’s service at Broomfield Hospital, run by Mid and South Essex Foundation Trust, where employees “did not always feel listened to or feel safe to speak up in fear of being targeted or bullied”.

The CQC inspection report said: “Staff at all levels were concerned senior leaders within the trust did not fully understand the demand and pressure on staff and told us drastic change was needed.

“Staff said there was a blame culture when it came to incidents and safety. They told us leaders were quick to find someone to blame without looking at the bigger issues with staffing, capacity and leadership.”

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Source: HSJ, 17 September 2025 

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Leaders ‘pay lip service’ to public engagement, NHSE director says

Health leaders ‘pay lip service’ to engaging with patients and "do not look like or live the lives of the people they are making decisions about", an NHS England director has said.

Olivia Butterworth, NHSE’s deputy director of people and communities, told a public event hosted by the New Local think tank there is a “whole load of work” going on around reforming patient-reported outcome measures.

But she said that “none” of this work “starts with conversations with people about what do they value and what they want to measure.”

Asked whether NHS England’s top leadership is “paying lip service” to patient engagement, Ms Butterworth said: “I think often everybody pays lip service to it. We all use the right words. But whether it’s local government, whether it’s the NHS we know the words to use, but do we really live that in our actions in the way that we really like to change things?

“Or do we just blame the system for being too complex and it is the system that won’t let us, without recognising that we are the system, we make the system, we run the system, the system is people.”

Elsewhere in the session, Ms Butterworth said that “our decision makers do not look like or live the lives of the people they are making decisions about.”

She added that health services need to “join up around people” and that integrated care systems and partnerships offer the opportunity to “cut the crap of the organisational boundaries that stopped us doing things”.

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Source: HSJ, 8 April 2022

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Layla Moran secures first Commons debate on Long Covid

Layla Moran, Lib Dem MP for Oxford West and Abingdon and Chair of the APPG on Coronavirus, has secured the first Commons debate on Long Covid on Thursday 7 January following cross-party support.

The Backbench Business Committee granted the application by Layla Moran, co-sponsored by Dr Dan Poulter MP (Con) and Andrew Gwynne MP (Lab) and supported by many others.  Layla said that the debate “is long overdue” and called on “those with lived experience and clinical experience to tell us your stories” in advance of the debate.

Layla Moran said: “I’m pleased that we’ve been able to secure this important debate on Long Covid, which is long overdue. The APPG on Coronavirus, which I chair, has submitted recommendations to the Government on this, and the debate will give us the opportunity to hold them to account and represent our constituents suffering from it."

“What’s really important now is that as many MPs as possible take part in the debate, so we can give this the profile it deserves and give the Government the opportunity to listen and respond to our concerns. Thank you to my cross-party colleagues for supporting this. I’m calling on those with lived experience and clinical experience to tell us your stories between now and the 7 January. This is a crucial opportunity.”

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Source: Liberal Democrats, 19 December 2020

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Lax oversight of semaglutide advertising could harm patients, warn critics

UK organisations responsible for protecting the public from advertisements of prescription-only drugs are putting patients at risk from the harms of weight loss drugs by not enforcing the law, critics have told The BMJ.

The UK’s Human Medicines Regulations 2012 prohibit the advertising of prescription drugs to the general public, and companies that break the rules can be sanctioned with fines, orders to issue a corrective statement, or prosecution.

Legal responsibility for regulating advertisements for medicines in the UK rests with the Medicines and Healthcare Products Regulatory Agency (MHRA) on behalf of health ministers. But there is also a system of self-regulation with a number of organisations operating their own codes of practice, including the Advertising Standards Authority.

But The BMJ has found that the MHRA has not issued a single sanction for prescription drugs in the past five years. And among 16 cases where the MHRA took action by requesting changes to advertisements for weight loss drugs from June 2022 to July 2023, all were triggered by external complaints, not internal mechanisms, and none resulted in sanctions.

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Source: The BMJ, 13 December 2023

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Lawyers warned trust that staff could ‘pick and choose’ documents for coroners

An ambulance trust accused of withholding key evidence from coroners was previously warned its staff needed training to ‘understand the real risk of committing criminal offences’ in relation to inquests into patient deaths.

North East Ambulance Service, which has been accused by whistleblowers of withholding details from coroners in more than 90 deaths, was told by its lawyers in 2019 about serious shortcomings in its processes for disclosing information, according to internal documents obtained by a campaigner.

According to the documents, the lawyers said trust staff could “pick and choose” documents to release to coroners “regardless of relevance.”

The following year, an audit report said the issues had not been addressed.

Whistleblowers’ concerns about the trust were first reported by The Sunday Times in the spring, with a review highlighting several cases between 2018 and 2019 where key facts were omitted in disclosures to coroners.

But campaigner Minh Alexander has since obtained new details of warnings that were being made to internally, from lawyers and auditors who were advising the trust.

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Source: HSJ, 20 September 2022

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Law protecting women seeking emergency abortions is target in US supreme court case

Mylissa Farmer’s pregnancy was doomed. But no one would help her end it.

Over the course of a few days in August 2022, Farmer visited two hospitals in Missouri and Kansas, where doctors agreed that because the 41-year-old’s water had broken just 18 weeks into her pregnancy, there was no chance that she would give birth to a healthy baby. Continuing the pregnancy could risk Farmer’s health and life – yet the doctors could not act.

Weeks earlier, the US supreme court had overturned Roe v Wade and abolished the national right to abortion. It was, legal counsel at one hospital determined, “too risky in this heated political environment to intervene”, according to legal filings.

In immense pain and anguish, Farmer ultimately traveled several hours to Illinois, where abortion is legal. There, doctors were able to end her pregnancy.

Farmer’s account is detailed in a legal complaint she filed against the hospitals, arguing that they broke a federal law that requires hospitals to treat patients in medical emergencies. In a first-of-its-kind investigation, the US government sided with Farmer and declared that the two hospitals had broken the law.

The future of the government’s ability to invoke that law to protect women seeking emergency abortions is now in question. The law, the Emergency Medical Treatment and Labor Act (Emtala), is at the heart of the US supreme court’s latest blockbuster abortion case, which comes out of Idaho.

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Source: The Guardian, 9 January 2024

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Law change to let pharmacists sign people off sick

Pharmacists and some other healthcare professionals, rather than just GPs, will soon be able to sign people off sick from work, under new rules.

The law change will take effect in July and apply across England, Wales and Scotland. The aim is to free up family doctors' time.

People off work for more than seven consecutive days because of illness may need to show a note from a healthcare professional to their employer.

When the new legislation is passed, nurses, occupational therapists, pharmacists (working in hospitals and GP practices) and physiotherapists will be able to provide the notes, in addition to GPs.

Health and Social Care Secretary Sajid Javid said: "I know how important it is for people to be able to see their GP speedily and in the way they want.

"That's why we are slashing bureaucracy to reduce GPs workloads, so they can focus on seeing patients and giving people the care they urgently need.

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Source: BBC News, 9 June 2022

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Launch of PPE delivery system for care home staff hit by delays

A planned Amazon-style delivery system for personal protective equipment to care workers will not be nationally available for at least another fortnight, the housing and communities secretary has told MPs, before weekly figures for deaths in care and nursing homes which are on course to rise by more than 2,000.

Robert Jenrick told the housing, communities and local government select committee on Monday that the logistics system for PPE could take three more weeks to launch.

Clipper Logistics was contracted by the government at the end of March and care home operators have been increasingly outspoken in their warnings that a lack of masks, aprons, gloves, gowns and face shields is causing the spread of the virus in their facilities and putting workers’ lives at risk. About 340 people a day have been dying in care homes of COVID-19, according to official figures.

The largest private care home provider, HC-One, said on Monday that 703 of its residents had died across the UK while last week, Sam Monaghan, the chief executive of MHA, the largest charitable provider, warned: “Our residents and staff have not received the enhanced level of protection they need. The government will be held to account for this.”

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Source: The Guardian, 4 May 2020

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Launch of Patient Safety Learning’s 'the hub'

After many months of development and several user workshops, we are delighted and proud to present the hub at Patient Safety Congress 2019.

the hub is one of the actions proposed by Patient Safety Learning's A Blueprint for Action. The report identifies six foundations of safe care: shared learning, leadership, professionalising patient safety, patient engagement, data and insight, and culture, and proposes a range of actions to address these foundations. the hub is Patient Safety Learning's share online learning platform, which encourages and facilitates knowledge sharing, collaboration and conversation in patient safety across the whole of health and social care. It is a platform for health and social professionals, patients and their families to share and learn from one another.

the hub is free for everyone to use. Have a browse and you will find the latest news, research, resources and events in patient safety, and lively conversations and debates. Members can share content, comment on posts and start conversations in our communities. Please use the hub, share content and let us know what you think and how we can continue to develop it.

We would like to take the opportunity to thank everyone who has contributed this far in the development of the hub. Your thoughts, ideas and critique have been invaluable. the hub is still in development and we continue to seek out user testing and feedback. Please contact us at [email protected] with your ideas or if you would like to be a part of our user testing group.  

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Launch of NHS People Plan (2020-21)

"We are the NHS: People Plan 2020/21 – action for us all, along with Our People Promise, sets out what our NHS people can expect from their leaders and from each other.  It builds on the creativity and drive shown by our NHS people in their response, to date, to the COVID-19 pandemic and the interim NHS People Plan. It focuses on how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as take action to grow our workforce, train our people, and work together differently to deliver patient care.

This plan sets out practical actions for employers and systems, as well as the actions that NHS England and NHS Improvement and Health Education England will take, over the remainder of 2020/21. It includes specific commitments around:

  • Looking after our people – with quality health and wellbeing support for everyone
  • Belonging in the NHS – with a particular focus on tackling the discrimination that some staff face
  • New ways of working and delivering care – making effective use of the full range of our people’s skills and experience
  • Growing for the future – how we recruit and keep our people, and welcome back colleagues who want to return

The arrival of COVID-19 acted as a springboard, bringing about an incredible scale and pace of transformation, and highlighting the enormous contribution of all our NHS people. The NHS must build on this momentum and continue to transform – keeping people at the heart of all we do."

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Launch of new centre to promote patient safety in NI

A new regional centre which promotes the reporting of suspected safety concerns associated with healthcare products has been launched in Northern Ireland.

The Yellow Card centre for Northern Ireland will bring together a dedicated team to increase awareness, educate, and promote reporting of suspected adverse events to the Medicines and Healthcare products Regulatory Agency (MHRA) Yellow Card scheme.

The Yellow Card scheme provides a mechanism for patients, care givers and healthcare staff to report suspected safety concerns associated with healthcare products.

Speaking at the launch of the new service, Northern Ireland Chief Pharmaceutical Officer Professor Cathy Harrison said: “Collecting and monitoring information on possible adverse effects of medications and healthcare products is vital to ensuring patient safety.

"It is fitting that the launch of the Yellow Card centre for Northern Ireland coincides with World Patient Safety Day on 17 September, with this year’s theme of "Engaging patients for patient safety".

"The Yellow Card scheme puts the patient voice at its heart. By voluntarily reporting issues, patients, families and care givers can play a crucial role in their own care, and the safety of healthcare as a whole. I welcome the launch of the new regional centre and would encourage anyone who has suspected safety concerns to report them.”

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Source: Department of Health (Northern Ireland), 13 September 2023

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Launch of a new Patient Entrepreneur Programme

Are you a patient whose experience has led you to develop a healthcare innovation? Do you want to develop your skills to help scale this innovation?  

The NHS Clinical Entrepreneur Programme (CEP) is offering a 12-month pilot programme for people who have experience of a long-term health condition and are working on healthcare innovations.  

The NHS CEP Patient Entrepreneur Programme, ran by Anglia Ruskin University and in collaboration with NHS England’s Patient and Public Involvement (PPI) team, is free, part-time, and open to all patients, or carers with an innovation in healthcare. The programme aims to give individuals the skills and knowledge to develop their innovation, while giving them access to a network of mentors, healthcare experts, and patient support. 

Applications for this programme will open on the 1 November 2023, with the programme starting March 2024.  

So, if you are a patient with lived experience of an illness or condition who has developed an innovation to improve patient care, this is your chance to scale your idea with the help of the NHS Clinical Entrepreneur Programme.  

Find out more

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Laughing gas users risk spine damage, say doctors

Doctors at an east London hospital say they are seeing so many risky cases of laughing gas misuse that they have drawn up treatment guidelines for colleagues in the UK.

Nitrous oxide, sold in metal canisters, is one of the most commonly used drugs by 16 to 24-year-olds.

Heavy use can lead to a vitamin deficiency that damages nerves in the spinal cord.

The Royal London Hospital team say medics need to be on alert.

They have been seeing a new case almost every week.

The guidelines, endorsed by the Association of British Neurologists and written with experts from Manchester, Birmingham, Nottingham and the Queen Mary University of London, warn doctors what to look for and how to treat.

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Source: BBC News, 23 February 2023

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Latest NHS maternity scandal is product of toxic 'can't happen here' mentality

Shrewsbury and Telford hospital NHS trust has uncovered dozens of avoidable deaths and more than 50 babies suffering permanent brain damage over the past 40 years. But how many more babies must die before NHS leaders finally tackle unsafe, disrespectful, life-wrecking services? The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service.

Too many hospital boards complacently believe “it couldn’t happen here”. Instead of constantly testing the quality and reliability of their services, they look for evidence of success while explaining away signs of danger.

Across the NHS there are passionate clinicians and managers dedicated to building a culture that delivers consistently high quality care. But they are undermined by a pervasive willingness to tolerate and excuse poor care and silence dissent. Until that changes, the scandals will keep coming.

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Source: The Guardian, 2 November 2019

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Latest HSIB report highlights ‘devastating’ impact of delays and pressure on national glaucoma services

Delays to follow-up appointments for glaucoma patients leaves them at risk of sight loss, the Healthcare Investigation Safety Branch (HSIB) warns in their new report.

The report highlights the case of a 34-year old woman who lost her sight as a result of 13 months of delays to follow-up appointments.

Lack of timely follow-up for glaucoma patients is a recognised national issue across the NHS. Research suggests that around 22 patients a month will suffer severe or permanent sight loss as a result of the delays. In HSIB’s reference case, the patient saw seven different ophthalmologists and the time between her initial referral to hospital eye services (HES) and laser eye surgery was 11 months. By this time her sight had deteriorated so badly, she was registered as severely sight impaired.

The investigation identified that there is inadequate HES capacity to meet demand for glaucoma services, and that better, smarter ways of working should be implemented to maximise the current capacity. The report makes several safety recommendations focused on the management and prioritisation of appointments. 

Helen Lee, RNIB Policy and Campaigns Manager, said: “This report has brought vital attention to a serious and dangerous lack of specialist staff and space in NHS ophthalmology services across the country. We know that thousands of patients in England are experiencing delays in time-critical eye care appointments, which is leading to irreversible sight loss for some."

“Without immediate action, the situation will only continue to deteriorate as the demand for appointments increases. RNIB urges full and immediate implementation of the recommendations set out in this report to improve the capacity, efficiency and effectiveness of ophthalmology services.”

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Source: HSIB, 9 January 2020

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Latest data shows true scale of the number of patients waiting longer than 12 hours in A&E

The first publication of data from the Royal College of Emergency Medicine’s 2019-20 Winter Flow Project shows that existing data does not reflect the true scale of the problem of 12 hour stays in A&E.

RCEM data shows that in the first week of December over 5,000 patients waited for longer than 12 hours in the Emergency Departments of 50 Trusts and Boards across the UK. The sample of trusts and boards from across the UK is the equivalent to a third of the acute bed base in England. 

From the beginning of October 2019 over 38,000 patients have waited longer than 12 hours for a bed at the sampled sites across the UK – yet data from NHS England reports that in England alone a total of only 13,025 patients experienced waits over 12 hours since 2011-12. 

President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “In a nine-week period, at only a third of trusts across the UK, we’ve seen nearly three times the number of 12 hour waits than has been officially reported in eight years in England. This must be fixed."

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Source: Royal College of Emergency Medicine, 9 December 2019

 

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Latest Covid surge a ‘heavy straw on camel’s back’ for every hospital in UK

Every hospital in the UK is under significant pressure and a new Covid surge is “a very heavy straw on the camel’s back”, health leaders have warned.

At least eight hospitals declared a critical incident, cancelled operations or asked people not to come to A&E unless they were seriously ill last week. One of Britain’s most senior emergency doctor said there were links between incidents like these and the rapid rise in hospitalisations for Covid, up nearly 37% in a week to 7,024. While the Office for National Statistics said it was too early to say if an autumn Covid wave had begun, health leaders said ministers need to urgently address staffing shortages.

Dr Adrian Boyle, the incoming president of the Royal College of Emergency Medicine told the Observer: “Our system is under-resourced. We don’t have enough beds, and we don’t have the workforce for the demand that we’re being asked to deal with.

“Covid just makes everything that much harder and it’s entirely valid to link this with critical incidents being called around the country. All hospitals are feeling significant levels of pressure at the moment. Covid is a very heavy straw on the camel’s back.”

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Source: The Guardian, 1 October 2022

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Lateral flow tests to be ‘constrained’ over next two weeks, warns Sajid Javid

The health secretary, Sajid Javid, has warned MPs he may need to “constrain” the Covid testing system over the next fortnight, as demand for lateral flow kits surges.

Ministers have repeatedly encouraged members of the public to test themselves using a lateral flow device (LFD) before attending gatherings or meeting vulnerable relatives.

However, test kits have repeatedly been unavailable online in recent days, and many pharmacies have complained of being unable to secure them.

Labour has accused the government of presiding over a “shambles”, with many members of the public struggling to obtain tests despite ministers putting testing at the centre of efforts to control the spread of Omicron.

Demand for the tests has also been boosted by a change in quarantine rules that allows people to emerge from self-isolation after seven days instead of 10, as long as they carry out two negative lateral flow tests.

In a letter sent to MPs on Wednesday evening, Javid acknowledged the intense strain being put on the system as cases of the Omicron variant continue to increase, with 183,037 new infections recorded on Wednesday.

“In light of the huge demand for LFDs seen over the last three weeks, we expect to need to constrain the system at certain points over the next two weeks to manage supply over the course of each day, with new tranches of supply released regularly throughout each day,” he wrote.

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Source: The Guardian, 30 November 2021

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Lateral flow tests could cost care home visitors £73 a month

Lateral flow tests could cost care home visitors £73 a month, a leading UK charity has said, as it renewed calls to keep the devices free in such settings.

The government has previously announced that free testing for the general public will end from 1 April, and that this will include care home visitors.

However, charities have warned the shift away from free tests could place a heavy financial burden on those visiting care homes, where testing is still advised.

James White, the head of public affairs and campaigns at the Alzheimer’s Society, said the proposed charge on lateral flow tests for visitors to care homes was a cruel tax on care.

“Over the past two years, we’ve consistently heard many tragic stories from families struggling to visit their loved ones in care homes. For many people with dementia, this isolation has led to a significant deterioration in their condition and mental health,” he said.

“With infection rates rising once again, the government must provide free lateral flow tests for all visitors to care homes so that families are not put in an agonising position where they are forced to ration visits, leaving people with dementia once again isolated and alone.”

Caroline Abrahams, Age UK’s charity director, said: “No one should have to pay out of their own pocket for tests in circumstances where the expert advice is clear that testing remains an important safeguard against Covid,” she said.

“If care home visitors are going to continue to be asked to keep testing to protect their loved ones, it would be completely unacceptable to expect them to pay.”

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Source: The Guardian, 15 March 2022

Further reading

Visiting restrictions and the impact on patients and their families: a relative's perspective

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Lateral flow tests being prepared for UK outbreaks of avian flu

British health officials are preparing plans to deploy lateral flow tests if signs emerge that avian flu has begun to spread from one person to another.

The programme would provide rapid information about the dangers posed by the disease.

The UK Health Security Agency (UKHSA) is also working on blood tests to detect antibodies against the virus and officials will analyse the disease’s genetic mutations to reveal data about the increased risk to human health from avian flu.

The moves follow last week’s news that an 11-year-old girl in Cambodia has died from H5N1, the flu strain that is being spread around the globe by migrating birds and is infecting poultry farms.

At present, evidence suggests the H5N1 virus does not pass easily to people although scientists have urged care and caution. “The risk to humans is still very low, but it’s important that we continue to monitor circulation of flu in both bird and mammal populations", said Prof Jonathan Ball, of Nottingham University.

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Source: The Guardian, 26 February 2023

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