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Silent crisis of soaring excess deaths gripping Britain is only tip of the iceberg

Britain is in the grip of a new silent health crisis. For 14 of the past 15 weeks, England and Wales have averaged around 1,000 extra deaths each week, none of which are due to Covid. 

If the current trajectory continues, the number of non-Covid excess deaths will soon outstrip deaths from the virus this year.

Experts believe decisions taken by the Government in the earliest stages of the pandemic – policies that kept people indoors, scared them away from hospitals and deprived them of treatment and primary care – are finally taking their toll.  

Prof Robert Dingwall, of Nottingham Trent University, a former government adviser during the pandemic, said: “The picture seems very consistent with what some of us were suggesting from the beginning.

“We are beginning to see the deaths that result from delay and deferment of treatment for other conditions, like cancer and heart disease, and from those associated with poverty and deprivation. 

“These come through more slowly – if cancer is not treated promptly, patients don't die immediately but do die in greater numbers more quickly than would otherwise be the case.”

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Source: The Telegraph, 18 August 2022

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UK dentists should give antibiotics to patients at risk of heart infection

Dentists in the UK should be encouraged to give antibiotics to patients at high risk of life-threatening heart infection before invasive procedures, a study has found.

Research suggests bacteria from the mouth entering the bloodstream during dental treatment could explain 30% to 40% of infective endocarditis cases. The rare but life-threatening condition occurs when the inner lining of the heart chambers and valves become infected.

Antibiotics could limit the number of cases and reduce the risk of heart failure, stroke and premature death in high-risk patients, the study says.

Current guidelines from the National Institute for Health and Care Excellence (Nice) advise against the routine use of antibiotics before invasive dental procedures for those at risk of infective endocarditis.

“Ours is the largest study to show a significant association between invasive dental procedures and infective endocarditis, particularly for extraction and surgical procedures,” said Prof Martin Thornhill from the University of Sheffield, who led the study.

Nice should review its guidelines advising against antibiotic prophylaxis, the researchers said.

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Source: The Guardian, 19 August 2022

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Safety fears prompt NHS trusts to support troubled independent provider

Five East Midlands trusts are working with the country’s largest independent mental health provider in a bid to improve service quality, amid concerns patient safety would have been put at risk if they had not stepped in.

This move follows the Care Quality Commission (CQC) placing conditions on the registration of St Andrew’s Healthcare in Northampton in July and August last year after inspectors found patients were not given appropriate care in a safe environment.

The service could not admit any new patients into forensic, long-stay rehabilitation wards and the wards for people with a learning disability at the women’s service and to the wards for people with a learning difficulty at the men’s service, without consent from CQC following the inspection report. This restriction was lifted in May this year. 

Following the inspection, five local community and mental health trusts have “buddied up” to provide “targeted support” to improve the care quality provided by the charity provider. The programme is being co-ordinated by Northamptonshire Healthcare Foundation Trust.

Angela Hillery, chief executive of NHFT and Leicestershire Partnership Trust, told HSJ there was an “overwhelming” agreement amongst the pre-existing East Midlands alliance of trusts that they should work with St Andrew’s, which “clearly had an improvement journey to make”.

Ms Hillery said: “If we were not going to help, the risk was to our patients. [The initiative] was driven from us to say, ‘these are our patients and why wouldn’t we want to support each other as I know St Andrew’s would support us in the same situation.”

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Source: HSJ, 18 August 2022

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Government defends medical student number cap

Questions are being asked why the government is sticking to its cap on medical and dentistry places.

A shortage of doctors and other medical staff has been described as the biggest challenge facing the NHS. But the number of places at UK medical schools are capped - in England this year there are 7,500 places.

England's Education Secretary James Cleverly told the BBC that you can't just "flick a switch" to increase the capacity to train more doctors.

Medicine is one of a handful of courses where numbers are limited by the government, because the cost is heavily subsidised.

In 2020 and 2021 the government lifted the cap on numbers, which last year led to more than 10,000 places being accepted. But this year the cap in England is being reintroduced.

Mr Cleverly told the BBC that the nature of highly technical, vocational courses like medicine meant increasing the number of places was far from straightforward.

"To increase those numbers you would also need to increase the capacity in training institutions, both in universities and in hospitals.

"It is not something you can just flick a switch and significantly increase the capacity to train.

"The increases have got to be funded, they are technical and expensive courses and we need to understand the balance of requirements between these courses and other courses that the government is supporting financially."

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Source: BBC News, 18 August 2022

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Family welcomes new guidance to prevent breathing tube deaths

A grieving family has welcomed new guidance to try to prevent a common surgical procedure from going wrong and causing deaths.

Oesophageal intubation occurs when a breathing tube is placed into the oesophagus, the tube leading to the stomach, instead of the trachea, the tube leading to the windpipe.

It can lead to brain damage or death if not spotted promptly.

Glenda Logsdail died at Milton Keynes University Hospital in 2020 after a breathing tube was accidentally inserted into her oesophagus. The 60-year-old radiographer was being prepared for an appendicitis operation when the error occurred.

Her family welcomed the guidance, saying in a statement: “We miss her terribly but we know that she’d be happy that something good will come from her tragic death and that nobody else will go through what we’ve had to go through as a family."

Oesophageal intubation can occur for a number of reasons including technical difficulties, clinician inexperience, movement of the tube or “distorted anatomy”.

The mistake is relatively common but usually detected quickly with no resulting harm.

The new guidance, published in the journal Anaesthesia, recommends that exhaled carbon dioxide monitoring and pulse oximetry – which measures oxygen levels in the blood – should be available and used for all procedures that require a breathing tube.

Experts from the UK and Australia also recommended the use of a video-laryngoscope – an intubation device fitted with a video camera to improve the view – when a breathing tube is being inserted.

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Source: The Independent,18 August 2022

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Joint Commission Resources appoints two leading international healthcare experts to board of directors

The Joint Commission Resources (JCR) has announced the appointment of two world-class and leading healthcare experts to serve as international outside directors on its board of directors: Abdulelah M. Alhawsawi and Sangita Reddy.

As international outside directors, Dr. Alhawsawi and Ms. Reddy will provide their global expertise and direction to improve safety and quality of healthcare in the United States and abroad. They will be full voting members of the 13-person board of directors, which serves as JCR’s governing body. The board includes healthcare professionals, business executives and quality experts from around the world. 

“Dr. Alhawsawi and Ms. Reddy have dedicated their lives to transforming healthcare globally, and we are thrilled to welcome them to Joint Commission Resources’ Board of Directors,” says Jonathan B. Perlin, president and chief executive officer, The Joint Commission. “These board appointments bring unique international expertise and perspective on healthcare policy and the challenges and opportunities to advance quality and safety worldwide.” 

“We are so pleased that Dr. Alhawsawi and Ms. Reddy are joining Joint Commission Resources’ Board of Directors,” says Jean Courtney, interim president and chief executive officer, and chief operating officer, JCR. “They each bring in-depth and unparalleled international healthcare expertise. This will be invaluable as JCR continues to expand its mission to improve patient safety and quality of care around the globe.”

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Source: Joint Commission Resources, 16 August 2022

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‘This tiny piece of tape is ruining my life’: Women left in agony by vaginal mesh still struggling to get help

At 34 years old, Dawn Jaxson had two young daughters. Since going through childbirth she had been experiencing a prolapsed bladder and urinary incontinence. Her doctors recommended she have a vaginal mesh fitted to treat the problem, and she didn’t question their advice.

But more than 15 years later, she wishes she had. “As soon as I’d actually had it fitted, I felt discomfort,” says Jaxson, now 50. “Then the pain just didn’t go.” After years of almost constant pelvic pain and “countless” medical appointments, Jaxson says: “This little tiny piece of tape is still ruining my life.”

“I can literally be sat down and then out of nowhere, it will be like somebody is shoving a red-hot poker through my bladder,” she tells iNews. “Being intimate with somebody is just impossible. Sex is no joy. Imagine your worst period pain you could possibly have, and that’s what it’s like on a daily basis.”

NHS Digital records show that between April 2008 and March 2017, 100,516 patients had a tape insertion procedure for stress urinary incontinence. A further 27,016 patients had a mesh procedure for pelvic organ prolapse. But the surgery was suspended in Scotland in 2014 and across the rest of the UK by 2018 following complaints about complications – and a review ordered.

The review panel, overseen by Baroness Julia Cumberlege, spoke to more than 700 affected individuals and concluded that pelvic mesh procedures had caused “anguish, suffering, and many ruined lives”.

In 2020, the panel set out nine recommendations to help the thousands of women affected, including the creation of specialist centres, so patients could have their mesh removed or receive further treatment. But two years on from that landmark report, women say they are still suffering debilitating symptoms and struggling to access the help they so desperately need.

Kath Sansom, the founder of the campaigning group Sling the Mesh, has heard many similar stories from among the group’s 9,700 members. 

“The lack of action on financial redress is the biggest disappointment for women,” she says. “Pelvic mesh caused lifelong damage, and worse, the majority of us were not given any information on the risks. It’s not our fault this happened to us."

“Some women have been left disabled in wheelchairs or walking with sticks. Others have had organs removed where mesh has turned brittle and sliced into them. Seven in 10 have lost their sex life. Everyone suffers chronic pain in varying degrees. Women have lost jobs, marriages, homes, and their quality of life.”

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Source: iNews, 18 August 2022

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Covid: Brain fog more common two years on, study suggests

Two years after having Covid-19, diagnoses of brain fog, dementia and epilepsy are more common than after other respiratory infections, a study by the University of Oxford suggests.

But anxiety and depression are no more likely in adults or children two years on, the research found.

More research is needed to understand how and why Covid could lead to other conditions.

This study looked at the risks of 14 different disorders in 1.25 million patients two years on from Covid, mostly in the US. It then compared them with a closely-matched group of 1.25 million people who had a different respiratory infection.

In the group who had Covid, after two years, there were more new cases of:

  • dementia, stroke and brain fog in adults aged over 65
  • brain fog in adults aged 18-64
  • epilepsy and psychotic disorders in children, although the overall risks were small.

Some disorders became less common two years after Covid, including:

  • anxiety and depression in children and adults
  • psychotic disorders in adults.

The increased risk of depression and anxiety in adults lasts less than two months before returning to normal levels, the research found.

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Source BBC News, 18 August 2022

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Poor quality monkeypox guidelines 'impeding patient care'

There is an urgent need to develop evidence based clinical guidelines for managing cases of monkeypox, scientists said, after finding that existing guidance frequently lacked detail and was based on poor research.

They urged establishing a 'living guideline' for infectious disease to ensure that up-to-date information, based on robust research, was available globally and in any setting.

The study, published in BMJ Global Health, also called for investment to back research into optimal treatments and prophylaxis strategies.

The study authors wrote: "The lack of clarity between guidelines creates uncertainty for clinicians treating patients with MPX [monkeypox] which may impact patient care."

They concluded: "Our study highlights a need for a rigorous framework for producing guidelines ahead of epidemics and a recognised platform for rapidly reviewing and updating guidance during outbreaks, as new evidence emerges."

Current global concern over the spread of monkeypox was an opportune time to act, they argued.

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Source: Medscape, 17 August 2022

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Covid-19 'unmasked' existing problems in Irish healthcare

The Irish health services did “relatively well” during Covid-19 but, as in other countries, the pandemic unmasked existing problems, a renowned patient safety expert has said.

Peter Lachman of the Royal College of Physicians of Ireland (RCPI), was one of nine international experts who consulted on a new World Health Organization (WHO) report on the implications of the Covid-19 pandemic for patient safety.

Dr Lachman said the impact is only starting to be understood.

“Ireland did very well early on [in the pandemic], then opened up over Christmas [2020] which led to our numbers going sky-high, then we clamped down again,” he said.

"We did well on some things and not so well on others. We have done relatively well when compared with other countries." 

“Covid-19 was an event which around the world unmasked problems which were there already rather than creating them necessarily,” he said.

“The findings start with safety problems — we’ve had safety problems in Ireland but things are getting better.  There is a good strategy coming on. I’ve worked with hospitals around the country on this. It’s no worse than other countries.”

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Source: The Irish Examiner, 12 August 2022

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'Sticking plaster' NHS winter plan criticised for lacking workforce strategy

Doctors and health service providers welcomed publication of an NHS strategy for managing demand ahead of another busy winter for health and social care, but said it failed to address underlying problems with the system.

In a letter to the heads of NHS trusts and integrated care boards, NHS England chiefs said they had begun planning for capacity and operational resilience in urgent and emergency care ahead of "significant challenges" during the coming months.

The British Medical Association (BMA) said the strategy was a "step in the right direction", but "lacks detail", while the Royal College of Emergency Medicine (RCEM) said it amounted to little more than "a crisis mitigation plan".

The package of measures included creating the equivalent of 7000 extra general and acute beds through a mix of new physical beds, scaling up 'virtual' beds, and "improvements in discharge and flow". The letter acknowledged that there was "a significant number of patients spending longer in hospital than they need to" and that whilst "the provision of social care falls outside of the NHS’s remit, the health service must ensure patients not requiring onwards care are discharged as soon as they are ready and can access services they may need following a hospital stay."

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Source: Medscape, 15 August 2022

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Government examines surge in ‘potentially preventable’ deaths

Department of Health and Social Care (DHSC) officials are concerned that many more people are dying than expected in recent months – particularly older working-age people – with NHS care delays and interruptions a likely cause.

HSJ understands there is concern and analysis under way across the chief medical officer’s team and in the Office for Health Improvement and Disparities.

The DHSC told HSJ initial work showed the biggest causes of the “excess deaths” were cardiovascular disease (heart attacks and strokes) and diabetes.

This supports the case they are being caused by a combination of the current very long delays for ambulances and other emergency care, and by people with heart disease and diabetes missing out on routine checks due to Covid and its knock-on effects, HSJ was told.

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Source: HSJ, 17 August 2022

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Dozens of referrals for vulnerable mothers refused due to ‘lack of beds’

Dozens of referrals to specialist care for women with serious mental health problems during or after pregnancy are being turned down because no bed was available, data collected by HSJ reveals.

HSJ submitted freedom of information requests to 19 trusts running mother and baby units (MBUs) – which are inpatient services where women who experience serious mental health problems during or after pregnancy can stay with their child – asking for the “total number of referrals… which could not be admitted because no bed was available”. 

Although all of the 19 trusts HSJ sent freedom of information requests to responded, many said they did not hold this information. However, five – Cumbria, Northumberland, Tyne and Wear Foundation Trust, Essex Partnership University FT, Greater Manchester Mental Health FT, Hertfordshire Partnership University FT, and Nottinghamshire Healthcare FT – together identified 197 referrals which were rejected. Greater Manchester identified a further three which were turned down in the calendar year 2022, although it did not specify which financial year this was.

Several experts told HSJ the figures reflected a lack of capacity for mothers with serious mental health problems.

Maternal Mental Health Alliance campaign manager Karen Middleton said MBUs offered “the best outcomes” for new mothers who needed inpatient treatment".

Ms Middleton continued: “When a much-needed MBU bed isn’t available, women instead face admission to general adult psychiatric wards, separating them from their newborn babies at a crucially important time for relationship development. These wards lack appropriate facilities and expertise to support postnatal mothers with their specific physical and emotional needs.”

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Source: HSJ, 16 August 2022

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Internal memo warns of ‘increasingly common’ deaths in A&E

Senior doctors have raised concerns about the numbers of patients now dying in their A&E department due to extreme operational pressures.

HSJ has seen an internal memo sent to staff at Royal Albert Edward Infirmary in Wigan, which warns it is becoming “increasingly common” for patients to die in the accident and emergency department.

The memo suggests the department has reported five deaths in the latest weekly audit, when it would normally report one or two fatalities.

The memo said: “Of the 72 patients in A&E as I write this, 16 have been there over 24 hours and 34 over 12 hours. The longest stay is almost 48 hours…

“It’s becoming increasingly common to die in A&E. We have included A&E deaths [in weekly audits] for the last 4 years. They used to be 1 or 2. This week there were 5. They used to die at or just after arrival, but that’s changing too…

“There is every reason to think winter will be worse.”

The memo echoes warnings made by numerous NHS leaders in recent months around the intense service pressures and an increased risk of incidents and mistakes. 

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Source: HSJ, 17 August 2022

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Midwife numbers fall in every English region, figures show

The number of midwives has fallen in every English region in the past year, figures show.

Numbers dropped by around 600 on top of a longstanding shortage of more than 2000 midwives, according to analysis of NHS Digital data by the Royal College of Midwives (RCM).

The RCM said more investment is needed in maternity services to ensure the safety and quality of care, as "even the smallest falls are putting increasing pressures on services already struggling with shortages, worsened by the pandemic".

Dr Suzanne Tyler of the RCM said midwife numbers had "fallen significantly over the past year on top of already serious shortages" in England.

Dr Tyler said: "The falls across the regions are compounding the difficulties employers are facing to recruit and keep their midwives.

"We are raising these issues because we want women to get the best possible care and midwives to not only stay in the profession, but to encourage others to become one.

"These figures must shock this moribund Government into action for the sake of women, babies, their families and staff."

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Source: Medscape, 16 August 2022

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Survivors of contaminated blood scandal awarded interim payments

Survivors of the contaminated blood scandal have been awarded interim government payments after a 40-year battle, but thousands of parents and children of the victims have still received nothing.

Ministers have accepted the urgency of the need to make the £100,000 payments to about 3,000 surviving victims, after being warned that those mistakenly infected with HIV and hepatitis C were dying at the rate of one every four days.

But parents and children of the victims accused the government of perpetuating the scandal by failing to recognise their own trauma and loss in today’s announcement.

Contaminated blood products administered in the 1970s and 1980s to up to 6,000 people have already led to the deaths of more than 2,400 people in the biggest treatment scandal in NHS history.

The government said it intends to make payments to those who have been infected and bereaved partners in England by the end of October. The same payments will be made in Scotland, Wales and Northern Ireland.

Announcing the plan, the prime minister, Boris Johnson, said: “While nothing can make up for the pain and suffering endured by those affected by this tragic injustice, we are taking action to do right by victims and those who have tragically lost their partners by making sure they receive these interim payments as quickly as possible.

“We will continue to stand by all those impacted by this horrific tragedy, and I want to personally pay tribute to all those who have so determinedly fought for justice.”

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Source: The Guardian, 17 August 2022

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Poorest women in England have same ill health at 60 as richest at 76

A 60-year-old woman in England’s poorest areas typically has the same level of illness as a woman 16 years older in the richest areas, a study into health inequalities has found.

The Health Foundation found a similarly stark, though less wide, gap in men’s health. At 60 a man living in the most deprived 10% of the country typically has the burden of ill-health experienced by a counterpart in the wealthiest 10% at the age of 70.

The thinktank’s analysis of NHS data also shows that women in England’s poorest places are diagnosed with a long-term illness at the age of 40 on average, whereas that does not happen to those in the most prosperous places until 48.

The findings underline Britain’s wide and entrenched socio-economic inequalities in health, which the Covid-19 pandemic highlighted. Ministers have promised to make tackling them a priority as part of the commitment to levelling up, but a promised white paper on that has been delayed.

Researchers led by Toby Watt said their findings were likely to be the most accurate published so far because they were based on data detailing patients’ interactions with primary care and hospital services, and unlike previous studies did not rely on people’s self-reported health.

“In human terms, these stark disparities show that at the age of 40, the average woman living in the poorest areas in England is already being treated for her first long-term illness. This condition means discomfort, a worse quality of life and additional visits to the GP, medication or hospital, depending on what it is. At the other end of the spectrum, the average 40-year-old woman will live a further eight years – about 10% of her life – without diminished quality of life through illness,” Watt said.

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Source: The Guardian, 17 August 2022

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Safety requirements for use of valproate ‘still not being fully met’, finds NHS audit

Only a quarter of patients on valproate, who do not have appropriate contraception, are being referred by their pharmacist to their GP or a specialist about the issue, an audit carried out by NHS England has found.

A report on the 2019/2020 Pharmacy Quality Scheme Valproate Audit — which was carried out in community pharmacies across England — published on 11 August 2022, has indicated that the Medicines and Healthcare products Regulatory Agency’s (MHRA’s) safety requirements for use of valproate in women and girls of childbearing age, and trans men who are biologically able to be pregnant, are “still not being fully met”.

Since 2018, the MHRA has advised that valproate, a treatment for epilepsy and bipolar disorder, must not be used in anyone of childbearing potential, unless a Pregnancy Prevention Plan (PPP) is in place.

As part of a PPP, pharmacists are required to remind patients of the risks of taking sodium valproate in pregnancy and the need for highly effective contraception; ensure patients have been given the patient guide; and remind patients of the need for an annual specialist review.

However, the audit, which was conducted by 10,293 community pharmacies in England, including responses from 12,068 patients and patient representatives, found that pharmacists were not referring or signposting “a sizeable minority”, who appeared to be without appropriate contraception, back to the prescriber.

The report said that community pharmacists should refer “all people aged 12–55 who are biologically able to be pregnant and have not had their valproate medication reviewed within the last 12 months to their GP or specialist, as well as to local contraception services as appropriate”.

For patients not referred to their GP or specialist, the report said that the pharmacist should be able to confirm that the patient is fully informed, understands the risks of not using highly effective contraception and knows who to contact if their circumstances change.

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Source: The Pharmaceutical Journal, 12 August 2022

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New approach to safety incidents will see fewer investigations

Major reforms have been set out on how NHS organisations should respond to patient safety incidents, which are aimed at ensuring better engagement with patients and families.

The Patient Safety Incident Response Framework (PSIRF), published today, replaces the serious incident framework and provides guidance to trusts on how and when they should conduct investigations.

According to NHSE, a key aim is to allow trusts to focus resources on where investigations will have the greatest impact, rather than investigating all incidents as they did under the old framework.

NHSE said the more flexible approach should make it easier to address concerns specific to health inequalities, as incidents can be learnt from that would not have met the serious incident definition.

However, it does not affect the need for a patient safety incident investigation following a never event’ or maternity incident; this is still required.

Helen Hughes, chief executive of charity Patient Safety Learning, said the new framework “places an emphasis on individual organisations assessing their patient safety risks”, and provided a “welcome acknowledgement of the importance of engaging patients and families as part of the investigation process”.

However, she said there would need to be a “significant training programme for staff in a range of human factors informed approaches”, to ensure reviews lead to safety improvements.

She added: “What is being proposed is a complex innovation in the NHS’s approach to incident investigation. Its success to a large part will depend on having the right organisational leadership and resources to support this transition. [NHSE has] now provided a set of tools and a timetable for this. However, ultimately this initiative should be judged on its implementation and effectiveness in reducing avoidable harm.”

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Source: HSJ, 16 August 202

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‘Underfunded’ FDA falls short in ensuring medical devices protect against cyberattacks, experts say

As the risk of cyberattacks on medical devices continues to mount, the Food and Drug Administration isn’t doing enough to ensure device makers include adequate security in their products, experts say. 

They charge that part of the problem is that the agency lacks the funds and the trained personnel to evaluate the cyber risk the devices carry and enforce the rules it does have on the books for approving devices.

“I’ve spoken to device manufacturers, specifically product security people at device manufacturers, saying that they’ve been telling their organizations for the last year or two that they need to include cybersecurity as part of their submissions or else they’re going to get rejected,” said Mike Kijewski, CEO of medical device cybersecurity firm MedCrypt. “Yet for some of their recent submissions, they didn’t have a lot of cybersecurity documentation and they still got accepted by the FDA.”

Cyberattacks remain a significant risk for healthcare companies. US patient safety group ECRI reported 173 medical device cybersecurity alerts in the past five years. The organisation warned that cybersecurity incidents don’t just disrupt business operations, but can “pose a real threat of physical harm.” For instance, ransomware attacks on hospitals can cause device outages that disrupt patient care, and at worst, put lives at risk. 

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Source: MedTech Dive, 11 August 2022

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Covid redeployment ‘wrong’ and ‘will never be repeated’

Redeployment of community staff to other services – meaning visits for babies and parents were missed – was the “wrong decision” and would “never be repeated”, a provider has stated.

Nikki Lawrence, the head of public health nursing at Sirona Care and Health, which provides community services for Bristol and the surrounding area, appeared to blame the government for about 70% of its health visiting staff being redeployed to adult services, leaving around 30% to care for new families at the height of the pandemic.

Health visitors take over from midwives to monitor the health of children and parents for a period after the baby is born, including to guard against safeguarding threats.

Ms Lawrence said: “The national learning about redeployment – we have reflected on it, the government has reflected on it and they have agreed it was the wrong decision to make.

“We basically abandoned families at a time of need, and that decision will never, ever be taken again, from what I’ve been told. In hindsight it was the wrong decision to make, and… it did have a detrimental impact on families and we really regret that, but it was out of our hands.”

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Source: HSJ, 16 August 2022

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Lamborghinis, ski trips used to market controversial mesh implant to surgeons, documents show

Lamborghinis and ski trips to the Swiss Alps were among the incentives a pharmaceutical giant developed to market a surgical device that has ruined the lives of hundreds of Australian women.

Documents obtained by the ABC show the extent to which Johnson and Johnson oversold its surgical mesh products, which are used to treat incontinence and prolapse after childbirth.

They paint a picture of a company that tried to sell surgeons a jet-setting lifestyle where they could insert four devices "before lunch" and notch up $10,000 in surgeries in a single morning.

The mesh devices have left at least 3,000 Australian women with serious side effects including chronic pain, infections and inability to have sex, and are the subject of both a Senate inquiry and a class action.

New court documents released in the class action against Johnson and Johnson show that as early as 2009, concerns were raised inside the company that it was making "a huge mistake" by commercialising its latest brand of mesh, was "rushing to market", and opening up the use of the product to "unqualified surgeons".

Lawyers from Shine, who are representing the women in the class action, claim the pharmaceutical giant did not investigate proper clinical trials on the possible complications of the mesh.

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Source: ABC News, 13 August 2022

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Ministers admit 34 hospital buildings in England have roofs that could collapse

Thirty-four hospital buildings in England have roofs made of concrete that is so unstable they could fall down at any time, ministers have admitted.

The revelation has prompted renewed fears that ceilings at the hospitals affected might suddenly collapse, injuring staff and patients, and calls for urgent action to tackle the problem.

Maria Caulfield, a health minister, made the disclosure in a written answer to a parliamentary question asked by the Liberal Democrats’ health spokesperson, Daisy Cooper.

Caulfield said surveys carried out by the NHS found that 34 buildings at 16 different health trusts contained reinforced autoclaved aerated concrete (RAAC), which one hospital boss has likened to a “chocolate Aero bar”. RAAC was widely used in building hospitals and schools in the 1960s, 70s and 80s but has a 30-year lifespan and is now causing serious problems.

In 2020 Simon Corben, NHS England’s director of estates, declared that RAAC planks posed a “significant safety risk” because their age meant they could fall down without warning.

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Source: The Guardian, 14 August 2022

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ICSs will be first to intervene in failing trusts, says NHS England

NHS England has said integrated care systems (ICSs) will be responsible for ‘initial problem solving and intervention’ if trusts fail to deliver against key targets to prepare for winter.

NHSE’s letter on winter planning and response, published on Friday, said system working “means a new approach to accountability” and that ICBs – the NHS executive of ICSs – would be accountable for ensuring that providers and others “deliver their agreed role in their local plans and work together effectively”.

The document, signed by NHSE’s leadership, says: “ICBs are responsible for initial problem solving and intervention should providers fail, or be unable, to deliver their agreed role.

“Intervention support can be provided from NHS England regional teams as required, drawing on the expertise of our national level urgent and emergency care team as needed.”

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Source: HSJ, 15 August 2022

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Covid: UK first country to approve dual-strain vaccine

The UK has become the first country to approve a dual vaccine which tackles both the original Covid virus and the newer Omicron variant.

Ministers say the vaccine will now form part of the autumn booster campaign.

Moderna thinks 13 million doses of its new vaccine will be available this year, but 26 million people are eligible for some form of booster.

Health officials say people should take whichever booster they are offered as all jabs provide protection.

Moderna's latest vaccine - called Spikevax - targets both the original strain and the first Omicron variant (BA.1), which emerged last winter. It is known as a bivalent vaccine as it takes aim at two forms of Covid.

The UK's Medicines and Healthcare Products Regulatory Agency has considered the evidence and given the vaccine approval for use in adults.

Dr June Raine, the regulator's chief executive, said: "What this bivalent vaccine gives us is a sharpened tool in our armoury to help protect us against this disease as the virus continues to evolve."

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Source: BBC News, 16 August 2022

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