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Late diagnosis of ectopic pregnancy 'putting women at risk'

Women are at risk of serious harm and death because hospitals are not always diagnosing ectopic pregnancies quickly enough, an investigation reveals.

About 12,000 women a year in the UK suffer an ectopic pregnancy – when a fertilised egg grows outside the womb – putting them at risk if a fallopian tube containing the foetus ruptures and causes potentially fatal heavy bleeding.

An investigation by the Healthcare Safety Investigation Branch (HSIB)  has found flaws in the treatment women receive. It has highlighted late diagnosis and consequent delay in treatment as a major concern, especially as a result of the condition being mistaken for a urinary tract infection.

NHS patient safety data shows that 30 ectopic pregnancies were missed and led to “serious harm” between April 2017 and August 2018.

As well as the risk to life, an ectopic pregnancy can also damage a woman’s chances of conceiving again and have serious psychological effects.

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Source: The Guardian, 5 March 2020

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Late diagnosis of breast cancer rises as NHS struggles in Covid crisis

Soaring numbers of women are being diagnosed with advanced breast cancer, undermining their chances of survival, because of Covid’s disruption of NHS care, a charity has warned.

The number of women being diagnosed with the disease at stage 4 is as much as 48% higher in some months than expected, with the pandemic to blame, says Macmillan Cancer Support.

At the same time, fewer women are being confirmed as having breast cancer at stage 1, when their chances of responding well to treatment and living longer are much higher.

Macmillan estimates that there is now a backlog of 47,300 people across the UK who have not yet been diagnosed with some form of cancer, as a direct result of Covid. They include people who could not access care in the usual way because many NHS services were scaled back, and also those who were too scared to seek help or did not want to add to the pressure the health service was already under. None have had a confirmed diagnosis of cancer, though some may be undergoing tests or screening.

Steven McIntosh, Executive Director of Advocacy and Communications at Macmillan Cancer Support, says:

“Nearly two years into the pandemic, there is still a mountain of almost 50,000 people who are missing a cancer diagnosis. Thousands more are already facing delays and disruption as they go through treatment. While hard-working healthcare professionals continue to do all they can to diagnose and treat patients on time, they are fighting an uphill battle. Cancer patients are stuck, waiting in a system that doesn’t have the capacity to treat them fast enough, let alone deal with the backlog of thousands who have yet to come forward.”

“The Government has promised an NHS Elective Recovery Plan. This must show how it will tackle spiralling pressures on cancer services. It has never been more crucial to boost NHS capacity to treat and support everybody with cancer, so people receive the critical care they need now and in the years to come.”

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Source: The Guardian, 26 November 2021

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Late delivery of equipment linked to patient’s death

The late supply of defective equipment used by care staff to reduce harm from a pressure ulcer contributed to the death of a vulnerable patient, a coroner has concluded.

Private provider NRS Healthcare supplies dozens of local authorities with equipment for patients in the community and contracts directly with NHS trusts providing community services.

A prevention of future deaths notice issued by a coroner in north London last week said the court had heard evidence of “numerous and ongoing delays and ‘problems’ in the service provided by NRS Healthcare. While I heard that there had been some improvement, I was told that the service provided was still ‘not great’.”

The inquest was into the death of Sheila Wexler, whom coroner Ian Potter found died of “natural causes, contributed to by increased immobility as a result of delayed and defective turning equipment being supplied for the treatment of a pressure ulcer”.

Trust board papers presented to directors in January said: “There are known issues with NRS (pressure ulcer-relieving equipment company) for a number of equipment types since the contract implementation. Concerns were escalated to the integrated care board and the commissioners of this service. Although there [have] been some improvements it remains inconsistent.”

The Whittington would not release its incident report or confirm how many people came to harm. It said: “Disclosing this incident report into the public domain could seek to damage our relations with the supplier in question, and possibly that with our other suppliers, which would not be in the public good.”

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Source: HSJ, 21 January 2025

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Late attendance 'driving trust’s high stillbirth rate'

Delays in seeking help among women from deprived communities or with poor English are a major contributor to high stillbirth rates, according to a review by a trust trying to reduce deaths.

A report by the Calderdale care partnership quality group, part of West Yorkshire Integrated Care Board, said that in Calderdale and Huddersfield Foundation Trust’s two maternity units “reduced foetal movements is a significant cross cutting theme… [and] delay in attendance to the hospital to seek midwifery support and advice”.

It said delays were more common among women who lived in areas of higher deprivation or where English was not their preferred language. They were less likely to contact a hospital midwife and more likely to reach out to their GP or family when they were concerned during pregnancy.

Benash Nazmeen, an assistant professor of midwifery at Bradford University and a co-founder of the Association of South Asian Midwives, warned trusts against “making assumptions” about communities without understanding “the realities of their lives”.

She said: “For example, worse outcomes for Black and Asian mothers and babies have previously been attributed to higher levels of deprivation and complex care needs.

“Recent MBRRACE reports and the 2022 Confidential Inquiry into Maternal deaths show that these disparities persist even in affluent areas and that complex care needs are not exclusive to any one ethnic group.

”We cannot continue to rely on outdated assumptions. Instead, we must work collaboratively with communities to build trust, relationships and locally informed solutions to address the barriers which remain poorly understood.”

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Source: HSJ, 14 July 2025

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Last minute offer may avert strike by resident doctors

Next week's strike by resident doctors in England may be averted after ministers offered the British Medical Association a fresh deal.

The doctors' union has agreed to put the offer to members over the coming days - if they support it, the five-day walkout starting on Wednesday 17 December could be called off.

The offer includes a rapid expansion of specialist training posts as well as covering out-of-pocket expenses such as exam fees.

But it does not include any promises of extra pay. Health Secretary Wes Streeting has been adamant he will not negotiate on that, given resident doctors - the new name for junior doctors - have had pay rises of nearly 30% over the past three years.

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Source: BBC News, 10 December 2025

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Lassa fever: Patient who died in UK ‘was newborn baby’

A patient who died from Lassa fever last week was a newborn baby, according to reports.

The UK Health Security Agency (UKHSA) confirmed on Friday that an individual with the Ebola-like disease had died in Bedfordshire, and that two other people  were infected.

All three cases were linked to recent travel in West Africa.

The BBC said the fatality had been an infant at Luton and Dunstable Hospital, quoting an email sent to staff by Cambridge University Hospitals NHS Trust.

Hundreds of frontline workers at the hospital, as well as at Addenbrooke’s Hospital in Cambridge, were reportedly told to isolate after being identified as potential contacts.

Lassa fever is an acute viral infection endemic in parts of Africa, and the UKHSA has assured the public that the risk of further infections in the UK remains “very low”.

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Source: The Independent, 15 February 2022

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Largest private-sector nurses strike in U.S. history begins in Minnesota

About 15,000 nurses in Minnesota walked off the job Monday to protest understaffing and overwork — marking the largest strike of private-sector nurses in U.S. history.

Slated to last three days, the strike spotlights nationwide nursing shortages exacerbated by the coronavirus pandemic that often result in patients not receiving adequate care. 

Minnesota nurses charge that some units go without a lead nurse on duty and that nurses fresh out of school are delegated assignments typically held by more experienced nurses, across some 16 hospitals where strikes are expected.

The nurses are demanding a role in staffing plans, changes to shift scheduling practices and higher wages.

“I can’t give my patients the care they deserve,” said Chris Rubesch, the vice president of the Minnesota Nurses Association and a nurse at Essentia Health in Duluth. “Call lights go unanswered. Patients should only be waiting for a few seconds or minutes if they’ve soiled themselves or their oxygen came unplugged or they need to go to the bathroom, but that can take 10 minutes or more. Those are things that can’t wait.”

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Source: Washington Post, 12 September 2022

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Largest nursing strike in NHS history starts

Nurses in England, Wales and Northern Ireland have started a nationwide strike in the largest action of its kind in NHS history.

Staff will continue to provide "life-preserving" and some urgent care but routine surgery and other planned treatment is likely to be disrupted.

The Royal College of Nursing said staff had been given no choice after ministers refused to reopen pay talks.

RCN general secretary Pat Cullen has called on the government to "do the decent thing" and resolve the dispute before the year ends.

Ms Cullen told BBC Breakfast the strike marked "a tragic day in nursing".

"We need to stand up for our health service, we need to find a way of addressing those over seven million people that are sitting on waiting lists, and how are we going to do that? By making sure we have got the nurses to look after our patients, not with 50,000 vacant posts, and with it increasing day by day," she said.

Health Minister Maria Caulfield, a former nurse, accepted "it is difficult" living on a nurse's wage, but said that a 19% pay rise "is an unrealistic ask".

Under trade union laws, the RCN has to ensure life-preserving care continues during the 12-hour strike.

Chemotherapy and kidney dialysis should run as normal, along with intensive and critical care, children's accident and emergency and hospital neonatal units, which look after newborn babies.

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Source: BBC News, 15 December 2022

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Largest Independent Randomized Controlled Trial of a Digital Therapy against Chronic Pain

In the largest independent randomized controlled trial (RCT) of its type, a multimodal digital therapy program for patients with non-specific chronic low back pain has outperformed standard-of-care treatment across all medical outcomes.

Results of the study, published in the Journal of Pain Research, show that patients using Kaia, the back pain management app developed by leading digital therapeutics company Kaia Health, reduced pain levels, anxiety, depression, stress, and improved wellbeing and body functionality significantly more compared to standard-of-care treatments, e.g. pain killers, surgeries, physical therapy.

“This large-scale study demonstrates the significant benefits for people managing low back pain when using Kaia to deliver a multimodal treatment through a digital device, such as a smartphone,” says Thomas R. Toelle, M.D., Ph.D., Head of the Pain Center of the Technical University Munich, Germany. “These results add to the growing body of medical evidence that supports the use of digital multimodal treatments for chronic conditions, such as back pain.”

Low back pain is one of the leading causes of global disability, with an enormous cost for healthcare systems worldwide. 1,2 According to a 2018 report on the impact of musculoskeletal pain on employers, chronic pain, including back pain, accounts for 188.7 million lost work days, and $62,4 billion in lost productivity cost.3

Kaia is an app-based, multimodal digital therapy program for chronic back pain, which focuses on Physical therapy, Relaxation exercises, and Medical education.

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Largest hospital building programme in a generation confirmed

The Prime Minister has confirmed a £3.7bn funding package to facilitate the construction of 40 new hospitals around the England by 2030, with a further eight schemes invited to bid for future funding.

Talked about over the coming months, the funding announcement comes as the first official confirmation to deliver on the Government’s manifesto commitment.

New standards are set to be developed over the coming months to help standardise the design of new hospitals and make use of modular construction methods to speed up the build process.

Originally launched last September with a £2.8bn investment which provided six new hospitals with the funding to go ahead, alongside seed funding for trusts to work up business cases, the health infrastructure plan (HIP) represents the largest hospital building programme in the UK for a generation.

The trusts which received seed funding will now all be fully funded to deliver 25 new hospitals. An additional site – a new hospital in Shotley Bridge – has also been added to the programme.

The new Shotley Bridge hospital represents a commitment from the Government to ensure much of the funding also goes to rebuilding across the North of England, as part of its levelling up agenda.

As part of welcoming new schemes to bid for funding for the eight further new hospitals down the line, the Government also committed that a proportion of these would be new mental health hospitals.

Prime Minister Boris Johnson said: “The dedication and tireless efforts of our nurses, doctors and all healthcare workers have kept the NHS open throughout this pandemic. But no matter what this virus throws at us, we are determined to build back better and deliver the biggest hospital building programme in a generation."

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Source: NHE, 5 October 2020

40hospitals.pdf

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Largest ever daily fall in covid hospital patients

The number of covid positive patients in English hospitals fell by 1,491 yesterday, by far the biggest decline recorded since the start of the pandemic.

The previous record was set during the decline of the first wave, when numbers fell 1,055 on 17 April. The largest drop in the third wave before yesterday’s record was the 798 seen last Saturday.

The national total of covid positive hospital patients now stands at 30,846, a drop of 9 per cent on the peak set on 18 January, but still 163 per cent of the mid-April peak.

All seven English regions are now seeing a week-on-week decline in the number of their covid hospital patients for the first time.

All have well established trends in falling admissions, with London and the south east seeing the running seven-day total fall by almost a third since a peak on 9 January. The east and south west have seen their admissions total decline by a fifth, while the midlands total has dropped 16 per cent in just five days and north east and Yorkshire nine in only four.

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Source: HSJ, 28 January 2021

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Largest Covid vaccine study ever finds shots are linked to small increased risk of neurological, blood and heart disorders - but they are still extremely rare

Covid vaccines have been linked to small increases in heart, blood, and neurological disorders, according to the largest global study of its kind.

An international coalition of vaccine experts looked for 13 medical conditions among 99 million vaccine recipients across eight countries in order to identify higher rates of those conditions after receiving the shots.

They confirmed that the shots made by Pfizer, Moderna, and AstraZeneca are linked to significantly higher risk of five medical conditions - including a nerve-wasting condition that leaves people struggling to walk or think.

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Source: Daily Mail, 19 February 2024

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

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

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

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

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Source: HSJ, 31 August 2021

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Large UK-wide pandemic preparedness tests planned this year

Emergency service teams, local councils and government officials will take part in a full, multi-day pandemic preparedness exercise, to help the UK prepare for potential future threats.

The test, which is likely to take place in the autumn, will involve thousands of people across different parts of the UK, minister Pat McFadden has announced.

The plans come in response to the first set of recommendations made by the Covid-19 Inquiry - the ongoing public inquiry into the handling of the pandemic.

The chair of the inquiry, Baroness Hallett, found the UK was "ill-prepared" for the coronavirus pandemic, and "failed" its citizens.

The national pandemic response exercise will be the first of its kind in nearly a decade, designed to test capabilities, plans and procedures in the face of new threats, the government says.

The government has also committed to training 4,000 people a year to be better prepared for crises such as pandemics, through a UK resilience academy, planned to open in April.

The Covid-19 inquiry report found the pandemic had a disproportionate impact on vulnerable groups.

A new national "vulnerability map" will be produced, Mr McFadden says, to highlight populations who may be vulnerable in a crisis, using data on age, disability, ethnicity and whether someone is receiving care.

It is designed to help people get more targeted local support.

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Source: The Guardian, 16 January 2025

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Large trial of new covid treatment begins in UK

A large-scale trial of a new treatment it is hoped will help stop COVID-19 patients from developing severe illness has begun in the UK.

The first patient received the treatment at Hull Royal Infirmary on Tuesday afternoon. It involves inhaling a protein called interferon beta which the body produces when it gets a viral infection.

The hope is it will stimulate the immune system, priming cells to be ready to fight off viruses.

Early findings suggested the treatment cut the odds of a COVID-19 patient in hospital developing severe disease - such as requiring ventilation - by almost 80%.

It was developed at Southampton University Hospital and is being produced by the Southampton-based biotech company, Synairgen.

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Source: BBC News, 13 January 2021

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Large numbers of medical trainees uncomfortable raising concerns with senior colleagues

More than a quarter of medical trainees in some specialties reported feeling apprehensive or hesitant about escalating a patient to the supervising clinician, a “deeply troubling” finding that the General Medical Council says could put patient safety at risk.

This year’s GMC national training survey was completed by around 50 637 doctors in training and 21 289 trainers. For the first time the survey asked about escalation of care.

Among doctors in training, 21% reported feeling uncomfortable raising concerns with their senior colleagues. The figure was even higher among trainees in certain specialties—with 26% of trainees in emergency medicine, 27% in obstetrics and gynaecology, and 29% in surgery.

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Source: BMJ, 15 July 2025

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Large Language Models hallucinate when removing patient info from EPR, finds study

Artificial intelligence (AI) tools sometimes produce hallucinations when asked to remove personal patient information from electronic patient records (EPRs), a study has found.

Researchers from the University of Oxford evaluated the ability of large language models (LLMs) and purpose-built software tools to detect and remove patient names, dates, medical record numbers, and other identifiers from real-world records, without altering clinical content.

The study, published by iScience on 9 December 2025, found that smaller LLMs frequently over-redacted or produced hallucinatory content, in which erroneous text not present in the original record was shown, or occasionally introducing fabricated medical details.

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Source: Digital Health, 18 December 2025.

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Large hospital trusts still missing key crisis support in A&E

Some of the country’s leading acute hospitals are not meeting a key NHS standard for mental health support in emergency departments, HSJ research suggests, with some regions faring better than others.

Latest official estimates indicate that more than a third of EDs (36 per cent) are not yet meeting ‘core 24’ standards for psychiatric liaison – which requires a minimum of 1.5 full-time equivalent consultants and 11 mental health practitioners.

The long-term plan target is for 70 per cent of acute trust emergency departments to have the optimum ‘core 24’ standard service by 2023-24. The NHS appears to be on track to hit this, with significant progress made, despite the pandemic.

Annabel Price, chair of the Royal College of Psychiatrists’ liaison faculty, said tackling the workforce crisis with a fully funded plan would “prove instrumental in boosting recruitment across all acute trusts”.

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Source: HSJ, 23 August 2022

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Language around birth should be less judgemental, midwives' report says

The language used around childbirth should be less judgemental and more personal, a report led by midwives has found.

Most women consulted said terms such as "normal birth" should not be used, it says.

The report recommends asking pregnant women what language feels right for them.

Maternity care has been under the spotlight after a recent review found failures had led to baby deaths.

The new guidance "puts women's choices at its heart, so that they are in the driving seat when it comes to how their labour and birth are described", Royal College of Midwives chief executive Gill Walton said.

About 1,500 women who had given birth in the past five years gave their views. Most preferred the term "spontaneous vaginal birth" to "normal birth", "natural birth" or "unassisted birth". Words suggesting "failure", "incompetence" or "lack of maternal effort" should also be avoided, they said.

They wanted labour and birth to be a positive experience and for the language used to be non-judgemental, accurate and clear.

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Source: BBC News, 15 June 2022

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Landmark study compares risks of water births to births out of water

A landmark study has compared the risk of complications of water births.

The results could have implications for thousands of women each year who use birthing pools as a form of pain relief during labour, researchers said.

It concluded having a water birth does not increase the risk of complications for mother or baby.

The Pool study analysed 73,229 records from low-risk pregnant women who used a pool during labour across 26 NHS organisations in England and Wales between 2015 and 2022.

The team explored the rate of severe tears suffered by women during childbirth, as well as the number of babies who needed antibiotics or help with breathing on a neonatal unit after birth.

They also looked at the number of babies that died.

According to researchers, risks “were no higher among waterbirths compared with births out of water”.

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Source: The Independent, 11 June 2024

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Landmark sickle cell disease inquiry finds evidence of racism in patient care

A groundbreaking inquiry into sickle cell disease has found “serious care failings” in acute services and evidence of attitudes underpinned by racism.

The report by the all-party parliamentary group (APPG) on Sickle Cell and Thalassaemia, led by Pat McFadden MP, found evidence of sub-standard care for sickle cell patients admitted to general wards or attending A&E departments.

The inquiry also found widespread lack of adherence to national care standards, low awareness of sickle cell among healthcare professionals and clear examples of inadequate training and insufficient investment in sickle cell care.

The report notes frequent disclosures of negative attitudes towards sickle cell patients, who are more likely to be people with an African or Caribbean background, and evidence to suggest that such attitudes are often underpinned by racism.

The inquiry also found that these concerns have led to a fear and avoidance of hospitals for many people living with sickle cell.

Care failings have led to patient deaths and “near misses” are not uncommon, leading to a cross-party call for urgent changes into care for sickle cell patients.

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Source: The Independent, 15 November 2021

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Landmark rule change to allow more gay and bisexual men to donate blood

More gay and bisexual men will now be allowed to donate blood after rule change. 

The new rules which came into effect on World Blood Day mean that men who have sex with other men will now be able to donate blood without being asked about their sexual behaviours. 

Under the new rules, anyone who has had the same sexual partner for the past three months will be eligible to donate blood, but it will also be based on an individual case by case basis.

However, the rules state that anyone who has had anal sex or multiple partners, been exposed to an STI, used pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) within the last three months will not be eligible to donate. 

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Source: Evening Standard, 14 June 2021

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Landmark legal agreement sees Equality Rights Commission monitor trust’s record on sexual harassment

The Equality and Human Rights Commission has required an ambulance trust to sign a legally-binding agreement stating how it will protect its staff from sexual harassment.

This is thought to be the first time the EHRC has taken such action against an English NHS organisation and follows repeated concerns about the culture at East of England Ambulance Service Trust.

As a result, EHRC will now monitor the trust’s action plan for protecting staff from sexual harassment.

The Care Quality Commission asked the EHRC to consider taking enforcement action against the trust last summer, after a CQC investigation found evidence of “bullying and predatory behaviour” and warned the trust’s leaders were not adequately promoting patients’ and staff’s wellbeing.

The CQC also found at least 10 incidents in 2019-20 involving allegations of sexual assault, harassment or inappropriate behaviours, and 13 instances of staff, including those working for subcontractors, being referred to the police for sexual misconduct and predatory behaviour. The trust was subsequently placed in special measures for quality.

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Source: HSJ, 28 April 2021

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Landlord was warned of mould that killed toddler in Rochdale flat

A health visitor wrote to housing officials expressing concern about conditions in a rented flat months before a two-year-old died after his exposure to mould.

An inquest in Rochdale is investigating the death of toddler Awaab Ishak who lived with his mother and father in a one-bedroom housing estate flat managed by Rochdale Boroughwide Housing (RBH).

Awaab’s father, Faisal Abdullah, first reported the damp and mould in autumn 2017, a year before the birth of his son. He made numerous complaints – phoning and emailing – and requested re-housing.

In December 2020 Awaab developed flu-like symptoms and had difficulty breathing. He was given hospital treatment and then discharged.

Two days later his condition at home worsened and he was seen at Rochdale urgent care centre where he was found to be in respiratory failure. He was transferred to Royal Oldham hospital where, upon arrival, he was in cardiac arrest and died. It was just a week after his second birthday.

A pathologist told the inquest that the child’s throat was swollen to an extent it would compromise breathing. Exposure to fungi was the most plausible explanation for the inflammation.

Lawyers for the family say the inquest will consider a number of matters including concerns about mould and damp and how they were dealt with. It will also look at the sharing of information between agencies and how the family’s cultural and language requirements were taken into account.

Officials from RBH have yet to give evidence at the inquest but a statement was provided to the coroner on Tuesday in which RBH admits it “should have taken responsibility for the mould issues and undertaken a more proactive response”.

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Source: The Guardian, 8 November 2022

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