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Increase regulation of online sale of weight-loss jabs, pharmacists say

Pharmacies are demanding tougher regulation of the online sale of weight-loss jabs amid a predicted new year’s boom in demand.

The National Pharmacy Association (NPA), who represent independent community pharmacies, urged the regulator to require greater consultation with patients before dispensing weight-loss jabs and other high-risk medication online.

Current rules, the NPA said, “leaves the door open for medicines to be supplied without appropriate patient consultation and access to patient records”.

Nick Kaye, chair of the NPA, said: “Obesity is one of the biggest challenges facing our country and pharmacies want to play their part in helping patients lose and maintain a healthy weight. Weight-loss injections can play an important role in efforts to tackle obesity when prescribed as part of a carefully managed treatment programme for patients who are most in need of support.

“However, we are concerned that the current regulations allow some patients to inappropriately access weight-loss injections without proper consultation or examination of historical medical records.”

The NPA urged regulators to require that pharmacies conduct a full two-way consultation with patients before dispensing “higher-risk” medication such as weight-loss jabs.

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Source: The Guardian, 27 January 2025

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Increase in number of patients accidentally exposed to ionising radiation in Irish hospitals last year

76 people were unintentionally exposed to ionising radiation in Irish hospitals in 2020, according to the Health and Information Quality Authority (HIQA). This figure represents an 11% increase on the total reported in 2019.

HIQA today published an overview report on the 'increase in accidental and unintended exposure to ionising radiation events notified to HIQA in 2020.

Under the European Union (Basic Safety Standards for Protection against dangers arising from Medical Exposure to Ionising Radiation) Regulations 2018 and 2019, HIQA is the competent authority for patient protection in relation to medical exposure to ionising radiation in Ireland.

In its 2019 report — its first such publication — HIQA expressed hope that the areas of improvement it identified "would help reduce the likelihood of such events and drive quality improvements in safety mechanisms for medical exposures in Ireland."

Despite this, eight more accidental exposure incidents were recorded in 2020 than in the previous year.

Human error was identified as the main cause of accidental exposure in 58% of the incidents, however, HIQA determined that other factors likely contributed to these.

Some 34% of the incidents involved the wrong patient being exposed to ionising radiation. HIQA said these exposures occurred at varying points along the medical exposure pathway.

It stressed that the number of unintended exposure to ionising radiation incidents last year was small compared with the total number of procedures carried out, estimated to be in the region of three million.

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Source: Irish Examiner, 15 September 2021

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Increase in learning disability deaths during the coronavirus outbreak

The Care Quality Commission (CQC) have looked at how the number of people who have died during the coronavirus outbreak this year compares to the number of people who died at the same time last year.

They looked at information about services that support people with a learning disability or autism in the 5 weeks between 10 April to 15 May in 2019 and 2020. These services can support around 30,000 people. They found that in that 5 weeks this year, 386 people with a learning disability, who may also be autistic, died. Data for the same 5 weeks last year found that 165 people with a learning disability, who may also be autistic, died. This information shows that well over twice as many people in these services died this year compared to last year. This is a 134% increase in the number of death notifications this year.

This new data should be considered when decisions are being made about the prioritisation of testing at a national and local level.

Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission (CQC) said: "Every death in today's figures represents an individual tragedy for those who have lost a loved one."

"While we know this data has its limitations what it does show is a significant increase in deaths of people with a learning disability as a result of COVID-19. We already know that people with a learning disability are at an increased risk of respiratory illnesses, meaning that access to testing could be key to reducing infection and saving lives."

"These figures also show that the impact on this group of people is being felt at a younger age range than in the wider population – something that should be considered in decisions on testing of people of working age with a learning disability."

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Source: Care Quality Commission, 2 June 2020

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Increase in hepatitis (liver inflammation) cases in children under investigation

The UK Health Security Agency (UKHSA) has recently detected higher than usual rates of liver inflammation (hepatitis) in children. Similar cases are being assessed in Scotland.

Hepatitis is a condition that affects the liver and may occur for a number of reasons, including several viral infections common in children. However, in the cases under investigation the common viruses that cause hepatitis have not been detected.

UKHSA is working swiftly with the NHS and public health colleagues across the UK to investigate the potential cause. In England, there are approximately 60 cases under investigation in children under 10.

Dr Meera Chand, Director of Clinical and Emerging Infections, said:

"Investigations for a wide range of potential causes are underway, including any possible links to infectious diseases. We are working with partners to raise awareness among healthcare professionals, so that any further children who may be affected can be identified early and the appropriate tests carried out. This will also help us to build a better picture of what may be causing the cases."

"We are also reminding parents to be aware of the symptoms of jaundice – including skin with a yellow tinge which is most easily seen in the whites of the eyes – and to contact a healthcare professional if they have concerns."

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Source: UK Health Security Agency, 6 April 2022

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Increase in corridor care ‘haemorrhaging morale’, trust told

Governors at one of the largest trusts in the country have warned that moving patients from beds to chairs to free up space is a risk to staff and public morale.

University Hospitals Birmingham Foundation Trust has been moving patients from beds on wards to trolleys and chairs in corridors for at least the past two months, to make way for patients who need beds after arriving in an ambulance or attending A&E.

However, staff raised concerns during a governors’ meeting last month that it had also begun moving patients from beds in the middle of the night, and in a way that undermined their privacy.

Staff governor Lee Williams said this was “sitting very uneasily with the staff” and “badly affecting morale”.

Mr Williams said: “My big fear is the advances the trust has made in terms of its morale in the clinical areas is going to haemorrhage away.”

He added: “Sometimes the [location] of these temporary escalation spaces is preventing other healthcare professionals providing the care that they would like to in cramped spaces in bays… and relatives are very unhappy with the situation too.”

Another governor, Gerry Moynihan, described the situation as “shocking”. He questioned if patients are being displaced “so that we can have statistics that say we’ve offloaded ambulances quickly”. He said that at Heartlands Hospital, patients were being offloaded “very quickly”.

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Source: HSJ, 14 May 2026

Further reading on the hub:

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Incorrect covid tests spark harm review for staff and patients

Trusts are carrying out harm reviews after a ‘contamination issue’ affecting hundreds of samples resulted in some staff and patients being wrongly told they had coronavirus, HSJ can reveal.

The error happened in mid-October and involved swabs from five trusts in the South East region, which were being processed by the NHS-run Berkshire and Surrey Pathology Services.

HSJ understands it is thought that around 100 people across several trusts were given false positive results, and subsequently tested negative.

The trusts involved are the Royal Surrey Foundation Trust, Frimley Health Foundation Trust, Royal Berkshire Foundation Trust, Ashford and St Peter’s Hospitals Foundation Trust and Berkshire Healthcare Foundation Trust.

Frimley has completed a clinical review and found no harm had been caused, while Royal Berkshire, Ashford and St Peter’s and the Royal Surrey have reviews ongoing. The position for Berkshire Healthcare, a mental health trust, is not known.

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Source: HSJ, 2 December 2020

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Incessant noise of tinnitus can feel like torture

Tinnitus Week 2022 is taking place from 7-13 February and the British Tinnitus Association are calling for the establishment of a Tinnitus Biobank

The UK urgently needs a biobank library of human tissue samples so experts can study and find better treatments, or a cure, for "ringing in the ears", says the BTA.

More than seven million adults in the UK are thought to have tinnitus. This stressful and upsetting condition of hearing whooshing, buzzing or other intensely annoying sounds with no external source is poorly understood. For some, it becomes difficult or impossible to lead a normal life.

A survey by the charity, carried out in November with 2,600 people with tinnitus, suggests almost one in 10 living with the condition has experienced thoughts about suicide or self-harm in the past two years. One in three thought about their condition every hour - causing them anxiety and sadness. The BTA says other people with tinnitus share similar experiences of feeling isolated, debilitated and stressed.

Malcolm Hilton, an ear, nose and throat expert at University of Exeter's Medical School, says a national biobank for tinnitus would be massively beneficial, and might reveal better ways for managing the condition.

"There are many treatments available for tinnitus and it is disappointing that people still come away with the message that they have to 'learn to live with it' without support."

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Source: BBC News, 7 February 2022

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Inappropriate anticoagulation of patients with a mechanical heart valve

NHS England have issued a safety alert on the risk of inappropriate anticoagulation of patients with a mechanical heart valve.

Published guidance supported clinical teams in reviewing patients being treated with a vitamin K antagonist (VKA) early on in the pandemic and change their medication to an alternative anticoagulant where needed. 

However, there have been reports that those with a mechanical heart valve have been prescribed a molecular weight heparin (LMWH) or a direct oral anticoagulant (DOAC) which the guidance lists as an exception to its use in such patients.  

The alert asks GPs and other NHS providers to urgently identify patients with a mechanical heart valve and ensure they are on the most appropriate anticoagulant. 

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Source: NHS England, 14 July 2021

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Inadequate Reading surgery had 'backlogs of test results', CQC says

A GP surgery that provides treatment to about 5,600 patients has been placed in special measures by a regulator.

London Street Surgery, in Reading, Berkshire, was found to have "significant backlogs of test results and care-related tasks".

The Care Quality Commission (CQC) found there was "poor identification of risks to patients" during an inspection in April.

The surgery has been approached for comment.

The regulator rated the surgery's safety and leadership as inadequate, and said it had insufficient processes to ensure services' safety and effectiveness.

Repeat prescriptions and medicines were "not managed safely", which could have posed risks to patients, and there were "risks associated" with the storage of blank prescriptions, it found.

Staff training was "not monitored appropriately" and inspectors found patients with learning disabilities were not provided with health checks to make sure their wellbeing was properly monitored.

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Source: BBC News, 7 June 2022

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Inadequate maternity unit handed safety warning

An NHS maternity department has been handed a warning notice by the health regulator because of safety failings.

The Care Quality Commission (CQC) said it was taking the action over the James Paget Hospital in Norfolk to prevent patients coming to harm.

Inspectors found the unit did not have enough staff to care for women and babies and keep them safe.

The maternity department has been deemed "inadequate" by the CQC, which meant the overall rating for the hospital has now dropped from "good" to "requires improvement".

Between June and November 2022 there were 30 maternity "red flags" that the inspectors found, of which more than half related to delays or cancellations to time-critical activity.

In one instance, there was a delay in recognising a serious health problem and taking the appropriate action.

The report also highlighted the service did not have enough maternity staff with the right qualifications, skills, training and experience "to keep women safe from avoidable harm and to provide the right care and treatment".

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Source: BBC News, 31 May 2023

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In-person GP appointments save lives and must return

Last week a receptionist saved a patient’s life. She put him straight into a face-to-face appointment early in the day. The doctor saw him and sent him to A&E urgently. He was operated on the same day.

Receptionists are are given an impossible task, to fit a large number of patients into a small number of slots, and they have to stay calm. When the slots run out – which sometimes happens by 9am – they then have to persuade one of the doctors, already at the end of their tether, to add any patient they are especially worried about to their list.

So it’s not surprising that when during the early part of the pandemic demand for appointments dropped by 30%, some very stressed and overworked GPs found their lives were a lot nicer without patients. And now that appointment levels have finally (as of May 2021) gone back to normal levels, some are finding the demand very difficult to cope with.

This could explain GPs’ persistence at keeping patients at arms length. Telephone consultations are less intense somehow, less tiring. Some GPs feel they can control the day better by using telephone consultations and only bringing in some patients. But patients are experiencing this persistent distancing as rejection. And these rejections are hurtful. Some people have held on to problems for six months or more and then finally felt free to book an appointment when the restrictions ended in August.

Except the restrictions haven’t ended, not in general practice. GPs seem unable to let the remote triage go. GPs say: “We are seeing patients face-to-face. We’ve been seeing them throughout the pandemic,” which is true. But only some patients. Plenty of patients who would have benefitted from a face-to-face appointment or an examination have not been seen. Patients are not idiots. They know telephone consultations are not as good. They know, especially older patients, that proper doctoring involves an examination. They know that the rapport and connection with a doctor can only come from a face-to-face appointments. And they wish to book an appointment with their GP themselves, without facing multiple barriers.

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Source: The Independent, 6 November 2021

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In trenches of New York's coronavirus crisis, nurses beg, borrow and steal precious masks

Amid growing shortages of vital protective equipment in New York hospitals, healthcare workers are desperately scrounging to find facemasks, hiding supplies from colleagues in other departments, and sometimes even pilfering for themselves.

The novel coronavirus has infected nearly 45,000 across New York, and more than 550,000 globally. Nurses in New York City were shaken on Tuesday, when Kious Kelly, a nurse manager at a Mount Sinai Health System hospital, died after being infected.

Nurses who would normally use masks and other protective gear only once are keeping them for entire shifts or longer to conserve supplies.

"Masks disappear," said Diana Torres, a Mount Sinai nurse. "We hide it all in drawers in front of the nurses' station. We hide masks, we have to hide chucks for beds," she said, referring to incontinence pads.

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Source: MedScape Nurses, 30 March 2020

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In Louisiana, pregnant women struggle to get maternal health care, and the situation is getting worse

The United States is in the middle of a maternal health crisis. Today, a woman in the US is twice as likely to die from pregnancy than her mother was a generation ago.

Statistics from the World Health Organization show the United States has one of the highest rates of maternal death in the developed world. Women in the US are 10 or more times likely to die from pregnancy-related causes than mothers in Poland, Spain or Norway.    

Some of the worst statistics come out of the South - in places like Louisiana, where deep pockets of poverty, health care deserts and racial biases have long put mothers at risk.

Dr Rebekah Gee: The state of maternal health in the United States is abysmal. And Louisiana is the highest maternal mortality in the US. So, in the developed world, Louisiana has the worst outcomes for women having babies."

A third of Louisiana's parishes are maternal health deserts – meaning they don't have a single OB-GYN, leaving more than 51 thousand women in the state without easy access to care and three times more likely to die of pregnancy related causes.

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Source: CBS News, 20 August 2023

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Improving safety in care homes

A new report from the AHSN Network is shining a light on ways we can do more to improve safety for residents of care homes.

The publication showcases over 30 examples of projects delivered by England’s 15 Patient Safety Collaboratives (PSCs) and the Academic Health Science Networks (AHSNs) which host them. They include case studies in medicines safety, dementia, monitoring and screening, and workforce development.

AHSN Network Patient Safety Director Dr Cheryl Crocker, said:

“Many residents have complex healthcare needs, reflecting multiple long-term conditions, significant disability and advanced frailty. All these factors make caring for residents an incredibly difficult job for care homes and their staff.

“Given this operating landscape, there are some fantastic examples of care, safety and quality improvement in care homes. The aim of this summary is to share good practice supported by the AHSN Network, and we are actively encouraging readers to get in touch with those who have shared their work for this report and discuss how we can have even greater impact on patient safety and improvement in care homes.”

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Improving patient safety in the NHS with point-of-care scanning

A new report has highlighted how point-of-care scanning in the NHS can help to improve patient safety, saving the NHS millions of pounds.

Six NHS hospital trusts which implemented regular point-of-care scanning have ensured complete traceability of healthcare items to help improve patient safety while securing millions of pounds of savings and releasing thousands of hours of clinical time, a new report reveals.

‘A scan of the benefits: the Scan4Safety evidence report’ details the results at hospital trusts that took part in a national two-year programme, known as Scan4Safety, to investigate the benefits of point-of-care barcode scanning in the NHS.

Full article here

We wonder if @Richard Price might like to post more about what the impact of Scan4safety has been at University Hospitals Plymouth. Perhaps here:
https://www.pslhub.org/learn/commissioning-service-provision-and-innovation-in-health-and-care/digital-health-and-care-service-provision/other-health-and-care-software/ 

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Improving patient safety in conflict-affected areas

On the first-ever World Patient Safety Day on 17 September 2019, WHO recognised the efforts of healthcare workers in the north-western Syrian Arab Republic, which has been affected by intense conflict for over 8 years.

In support of improving the quality of healthcare delivery, WHO launched a pilot infection prevention and control project in 30 Syrian health facilities in 2019. Initial assessment highlighted that 28 out of the 30 facilities were inadequately implementing the core components of infection prevention and control programmes according to WHO guidelines for acute health facilities. This emphasised the need to improve patient safety.

Globally, it is estimated that as many as 4 out of 10 patients are harmed in primary and ambulatory care settings; up to 80% of harm in these settings can be avoided. By investing in patient safety in health facilities, no matter how challenging the environment, WHO can save lives and improve the quality of care.

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Source: WHO, 16 October 2019

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Improving cancer care a huge challenge post-pandemic

Improving cancer care will be a huge challenge, ministers are being warned as they promise a new 10-year strategy for England.

Figures suggest there have been 34,000 fewer diagnoses since Covid hit - 50,000 if you include the whole UK. It risks an increasing number of late diagnoses which reduces the chances of survival, cancer charities said.

It comes as the government is promising to invest in new technologies and equipment to spot cancer quicker.

Health Secretary Sajid Javid said the new "war on cancer" strategy will be published later this year.

"It will take a far-reaching look at how we want cancer care to be in 2032. Looking at all stages from prevention, to diagnosis, treatment and vaccines," he said.

Mr Javid pointed out the NHS was already taking steps, including evaluating new blood tests to spot cancers early and opening a network of testing centres.

Lynda Thomas, of Macmillan Cancer Support, said given the impact of the pandemic people with cancer needed "support more than ever".

"We have been sounding the alarm for a long time," she added.

But she said while improving diagnosis and treatment was crucial, it was like "building sandcastles while the tide comes" without extra staff to tackle the backlogs and demand for care.

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Source: BBC News, 4 February 2022

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Improved patient care and safety: Scotland, Republic of Ireland and Northern Ireland joint pharmacy project

A cross-border trial has improved care for patients prescribed multiple medicines.

The iSIMPATHY project, funded by the European Union's INTERREG VA Programme, worked with professionals in Scotland, the Republic of Ireland and Northern Ireland to comprehensively review patient medication.

Taking multiple medicines can be problematic if the increased risk of harm from interactions between drugs, or between drugs and diseases, outweighs the intended benefits.

Interim findings showed these interventions potentially prevented major organ failure, adverse drug reactions, avoided hospital admissions and saw patients moved to more appropriate medication.

Scotland’s Public Health Minister Maree Todd said: “This project looked at some of our most vulnerable patients taking more than five medications. The reviews have avoided adverse combinations of drugs and hospitalisations while also reducing prescriptions and drugs costs.

“We will know more when the full evaluation is published in June, we will work with partners to see how we can these improvements can be applied more widely, potentially saving lives and money.”  

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Source: Scottish Government, 10 March 2023

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Improve NHS mental health funding or more children will die by suicide, says coroner

A London coroner has warned the health secretary that preventable child suicides are likely to increase unless the government provides more funding for mental health services.

Nadia Persaud, the east London area coroner, told Steve Barclay that the suicide of Allison Aules, 12, in July 2022 highlighted the risk of similar deaths “unless action is taken”.

In a damning prevention of future deaths report addressed to Barclay, NHS England and two royal colleges, Persaud said the “under-resourcing of CAMHS [child and adolescent mental health services] contributed to delays in Allison being assessed by the mental health team”.

An inquest into Allison’s death last month found that a series of failures by North East London NHS foundation trust (NELFT) contributed to her death.

In her report, Persaud said delays and errors that emerged in the inquest exposed wider concerns about funding and recruitment problems in mental health services.

“The failings occurred with a children and adolescent mental health service which was significantly under-resourced. Under-resourcing of CAMHS services is not confined to this local trust but is a matter of national concern,” she said.

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Source: The Guardian, 14 September 2023

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Improve brand and batch number recording, urge drug safety professionals

New research from the UK’s Drug Safety Research Unit (DSRU) has found that hospital pharmacists, doctors and nurses only recorded batch numbers for biologic medicines between 38% and 58% of the time during routine hospital practice.

Further, an analysis of spontaneous adverse drug reaction (ADR) reports showed that brand names were only included 38% of the time, while batch number traceability was only 15%.

Because of the study results, the DSRU is encouraging health professionals to improve the recording in order to aid patient safety, suggesting that it has “some way to go to encourage health professionals to record this information.”

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Source: PharmaTimes Online, 7 January 2020

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Implementation of safety improvements for the placement of nasogastric tubes

The Healthcare Safety Investigation Branch (HSIB) has launched an investigation looking at nasogastric tubes and how previously identified safety improvements for the placement of these tubes are put into practice.

Nasogastric (NG) tubes are used to deliver fluid, food and medication to patients via a tube that passes through the nose and down into the stomach. There is a risk of serious harm and risk to life if NG tubes are incorrectly placed into the lungs, rather than the stomach, and feed is passed through them.

HSIB has started this investigation after they were notified of a patient who inadvertently had a nasogastric tube inserted into his lung.

Further information

Source: HSIB, 7 January 2020

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Impaired consciousness: new guidelines aim to ensure people aren’t “lost in system”

Doctors who look after patients in a vegetative or minimally conscious state must ensure they initiate regular conversations with relatives about what is in the best interests of the person so that they do not get “lost in the system,” says new guidance.

The Royal College of Physicians has published new and revised guidelines on prolonged disorders of consciousness (PDOC) to take into account changes in the law and developments in assessment and management.

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Source: BMJ, 6 March 2020

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Impact of long NHS waits on patients revealed, plus who waits longest

People who wait longer for NHS treatment are significantly more likely to seek emergency care in the months after eventually receiving it, compared with those who are seen quickly.

People treated within 18 weeks of being on the waiting list made 18% fewer A&E visits per week in the three months following their treatment, compared to how often they visited A&E while waiting for treatment.

In contrast, people who waited over a year ended up making 31% more A&E visits in the three months following their care.

The Health Foundation, which carried out the research and shared the findings with the Sky News Data and Forensics Unit, say that the fact people need more emergency care after long waits for treatment "may indicate additional aftercare needs or decreased effectiveness of treatment following a longer wait".

They analysed detailed patient-level data that had previously not been available for research use.

It complements new NHS data published last week which revealed the make-up of the waiting list for the first time, in terms of the gender, age, ethnicity and deprivation status of the patients on it.

The Health Foundation explained that, as well as patients having to live with the "consequences of debilitating conditions for longer", long waits can also lead to "more complex, difficult and expensive treatment" being required.

They also "significantly increase consumption of pain relief medication". In some cases, while waiting, conditions for the patient become permanent and untreatable.

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Source: Sky News, 25 July 2025

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Immigration changes a huge risk for social and healthcare provision, say sector leaders

Sweeping changes to immigration rules could cut the “lifeline” of international recruitment for the UK care sector and negatively impact the NHS, leaders have warned.

The government unveiled its Restoring Control over the Immigration System white paper on 12 May in which it said it would close social care visas to new applications from abroad because of “significant concerns over abuse and exploitation of individual workers.”

“The agreements will move the UK away from dependence on overseas workers to fulfil our care needs,” said the paper, which aimed to tackle longstanding levels of low pay and poor working conditions in the sector in other ways, such as through establishing fair pay agreements.

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Source: BMJ, 13 May 2025

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Immensa lab closed one month after ‘unusual’ Covid results first detected

Authorities were aware of discrepancies in Covid test results across England one month before the lab responsible was ordered to shut down its operations, legal papers show.

An estimated 43,000 incorrect false negative tests were processed for the NHS by the Immensa laboratory in Wolverhampton between 8 September and 12 October.

UK Health Security Agency became aware of an “unusual spike” in suspicious test results on 14 September, with large numbers of people testing positive on lateral flow devices but negative via PCR.

It took a month before the UKHSA determined that the “likely cause was a technical issue at the Immensa laboratory”, according to court papers filed by the government in response to a lawsuit.

The Independent also revealed in October how machines at the Wolverhampton lab were poorly maintained, concerns over quality control dismissed and untrained staff regularly “left to their own devices”.

Samples at the site were wrongly processed or cross-contaminated, leading to incorrect test results, while faulty air conditioning and fluctuating humidity levels within the lab also led to spoiled tests, whistleblowers said.

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Source: The Independent, 22 December 2021

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