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Immensa Covid test lab concerns ignored by Test and Trace

Concerns raised about dangerous discrepancies at a Covid testing lab which has since been blamed for causing an estimated 23 deaths were ignored by health officials for months.

Documents show Public Health Wales flagged "significant concerns" about results from Immensa, in Wolverhampton, in letters to colleagues in England.

They were told nothing was wrong and testing continued for six months.

Letters were released after a Freedom of Information request by the Times.

The UK Health Security Agency (UKHSA) has said as many as 39,000 positive results were wrongly reported as negative in September and October 2021, mostly originating from south-west England.

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Source: BBC News, 26 January 2023

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Illegal teeth-whitening industry exposed by BBC

Illegal teeth-whitening treatments that can burn gums and destroy teeth are being handed over in car parks and on doorsteps, a BBC investigation has found.

Some gels, containing more than 500 times the legal limit of bleaching agent for over-the-counter products, are sold blatantly on social media.

As part of the investigation, a BBC North West reporter was able to obtain a fraudulent teeth-whitening qualification, as well as being given "extreme" bleach and advised to "practise on friends and family".

The British Dental Association (BDA) said it was "appalled" by the BBC's findings.

In one case, a seller boasted that there are "insane" profits to be made from providing the treatments.

In the UK, treatments using teeth-whitening products containing more than 0.1% hydrogen peroxide can only be carried out by dentists and other professionals registered with the General Dental Council (GDC).

And products used in treatments offered by dentists cannot contain more than 6% hydrogen peroxide.

However, products sold to undercover BBC reporters were sent to a laboratory for tests where results showed they contained hydrogen peroxide levels of up to 53%.

Kellie Howson, 54, who lost four teeth after she paid £65 for a whitening treatment at a beauty salon in Lancaster, urged the public to be aware of the dangers.

She said: "I just remember not long into the treatment my gums starting to really hurt, and afterwards it just got worse and worse.

"I was in agony."

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Source: BBC News, 29 October 2025

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Ill health in ‘left behind’ areas costs England £30bn a year, says report

Endemic ill-health in England’s “left behind” neighbourhoods costs the country almost £30bn a year because people are often too ill to work and die earlier, a report claims.

The cost of lost productivity results directly from those very deprived areas having much worse health than the rest of the country, according to parliamentarians and academics.

Experts from the Northern Health Science Alliance (NHSA) have calculated that the economy would grow by that amount if health in those areas was improved to such an extent that local people began to enjoy the same health as those in better-off places.

The report, by the NHSA and all-party parliamentary group for left behind neighbourhoods (LBNs), highlights the scale of the challenge Boris Johnson faces in meeting his pledge to level up England’s poorest and richest areas.

“The health of people living in left behind neighbourhoods is considerably worse than the health of people living in the rest of the country,” said Dr Luke Munford, the report’s lead author and a lecturer in health economics at the University of Manchester. “This is true across all measures of health.”

The report shows rates of obesity, lung conditions, high blood pressure, mental health problems and other diseases are much higher than the national average in the 225 LBNs. This means people there have less “healthy life expectancy” and also shorter lives and thus are less productive over their lifespan than those elsewhere.

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Source: The Guardian, 13 January 2022

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IHPN launch “refresh” of medical governance framework for independent providers

The Independent Healthcare Providers Network (IHPN) have today launched a “refresh” of its Medical Practitioners Assurance Framework (MPAF), designed to further improve the safety and quality of care independent providers deliver to patients.

Initially launched in October 2019, the MPAF – led by former National NHS Medical Director Sir Bruce Keogh – contains key principles to strengthen and build upon the medical governance systems already in place in the sector and sets out expected practice in a number of key areas.

Care Quality Commission (CQC) now uses the framework’s principles in assessing how well-led an independent service is, with the framework a requirement of the NHS’ 2022/23 Standard Contract which all independent sector providers of NHS-funded care must adhere to.

The MPAF was always designed to be a “live document” and today’s refresh strengthens the framework to ensure it remains in-keeping with current best practice in the health system. This includes taking into account recommendations from the Bishop of Norwich’s inquiry into Ian Paterson, as well as Baroness Cumberlege’s Independent Medicines and Medical Devices Safety Review (IMMDS). Key areas strengthened in the refresh include giving more prominence to expectations around patient consent, and the need to have greater transparency around conflict of interest declarations.

New initiatives such as the Learn from Patient Safety Events (LFPSE) service are also reflected in the refreshed framework, as well as an IHPN Development Plan which sets how the network will support providers to continue to implement the MPAF.

 David Hare, Chief Executive of the Independent Healthcare Providers Network (IHPN) said:

 “IHPN are delighted to be launching today a new refresh of our Medical Practitioners Assurance Framework (MPAF), reflecting the independent health sector’s commitment to continuously improving the safety and quality of care they deliver to millions of patients every year.

“Since the MPAF was launched in 2019, independent healthcare providers – with the support of CQC and NHS England –  have really embraced the framework, using it to review and update their practices to further raise the bar in medical leadership in the sector.

“With a continued focus amongst the entire healthcare system around improving patient safety and quality, this framework ensures providers adhere to the latest medical governance practices.

“This will not only ensure greater consistency around how clinicians work across the independent sector and NHS, but also give confidence to patients that independent healthcare providers are committed to delivering the safest possible care”.

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Source: Independent Healthcare Providers Network, 26 September 2022

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IHI's Patient Safety Awareness Week

This week is Patient Safety Awareness Week (13-19 March) and is an annual recognition event intended to encourage everyone to learn more about healthcare safety. During this week, the US Institute for Healthcare Improvement (IHI) seeks to advance important discussions locally and globally, and inspire action to improve the safety of the health care system — for patients and the workforce.

Patient Safety Awareness Week serves as a dedicated time and platform for growing awareness about patient safety and recognising the work already being done.

Find out more here.

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IHI marks World Patient Safety Day with patient safety certification milestone and commitment to diagnostic excellence

For World Patient Safety Day, the Institute for Healthcare Improvement (IHI) is celebrating the milestone of 7,000 healthcare professionals who have earned the Certified Professional in Patient SafetyTM (CPPS) credential. Certification requires a combination of education, experience, and successful completion of the evidence-based certification exam. This includes more than 1,000 students, staff, and faculty from the University of North Texas Health Science Center’s Texas College of Osteopathic Medicine, which is the first medical education program in the world to incorporate the CPPS review course and exam as a required part of the curriculum.

“These are 7,000 health care professionals across the world who are changemakers in safety, and their expertise and commitment to safer care for all is saving lives each and every day,” said Patricia McGaffigan, RN, MS, CPPS, IHI Senior Advisor, Safety, and President of the Certification Board of Professionals in Patient Safety (CBPPS). “The impressive growth of the CPPS program in recent years has resulted in a larger, more diverse health care workforce with competencies in safety. This is concurrent with the call to action for health care leaders to use the National Action Plan to Advance Patient Safety Organizational Assessment Tool to identify opportunities to improve foundational areas for safety across many elements that are aligned with the new CMS Patient Safety Structure Measure that will take effect next year.”

The 7,000 certificants span clinical settings and include safety, quality, and risk managers and leaders, nurses, physicians, pharmacists, health care executives, medical students and residents, academic faculty, and many more clinical and non-clinical professionals. IHI offers scholarships that cover the full cost of the CPPS review course, practice exam, and CPPS exam. A full day CPPS review course will be held December 8 at the 2024 IHI Forum. Learn more about the full Forum agenda and how to register here.

In addition to the CPPS review course, the Forum’s Patient and Workforce Safety track offers nearly 20 unique sessions for onsite learners, including multiple workshops that align with the theme for this year’s World Patient Safety Day: “Improving diagnosis for patient safety.” IHI is steadfastly committed to diagnostic excellence and continues to advance this critical component of safe and effective care through educational offerings, fellowships, projects, and tools, including the Safer Dx Checklist: 10 High-Priority Practices for Diagnostic Excellence. 

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If you don’t like it, go private: what my maternity clinic said over scans delay

After a raft of prenatal check-ups were cancelled because of Covid staff shortages, one mother asked how other mums fared. The replies shocked her.

Alison, 38, gave birth to her son in June 2021 at a busy London hospital.

“We had exemplary care during delivery, and the midwives looking after me during my antenatal care were likewise fantastic,” she recalls.

“However, I didn’t see a midwife face-to-face between my nine-week intake appointment and my 30th week of pregnancy. Then I saw nobody again until I was 34 weeks pregnant, and the next time I was seen was at 38 weeks, even though you’re supposed to be seen weekly at that stage.”

At Alison’s two-week postpartum check-up, she had to have her stitches examined in a chair as no other facilities were free.

“The ward was so full they’d had to close the birth centre; labour and delivery was full, and I met two women labouring in the early stages of their induction in the hallway. The midwives that came to do home visits were rushed and left me in tears every time,” she says.

When another mother found she was suffering from early pregnancy malaise, she reluctantly decided to go back to the London hospital where she had given birth eight years before.

Her high-risk twin pregnancy had ended in premature birth at 24 weeks and tragedy – with one baby dying after a three-month battle in intensive care. Throughout her antenatal journey, crucial appointments had been cancelled due to staffing issues, with the result that nobody picked up on early signs of premature labour, until it was too late for intervention.

Her hopes of receiving better care this time, assuming the trust would be aware of my history, evaporated quickly. By nearly 15 weeks of pregnancy, I had still not been seen by anyone, with text messages supposed to inform me of appointments failing to arrive.

When she queried why I had been given a date for a scan two weeks after the latest possible date such a screening could give a diagnosis of chromosomal abnormality, a clinic receptionist told me I should go private if I didn’t like my appointments. A complaint triggered an apology from the trust’s chief executive months later for protracted problems in the booking process, as well as an apology from the deputy head of midwifery for the receptionist’s “inappropriate” advice.

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Source: The Guardian, 30 January 2022

 

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If we only ever sanctify the NHS, its harrowing failures will NEVER be cured, says Ian Birrell

Daniel Mason was born half a century ago without hands, with missing toes, a malformed mouth and impaired vision.

From an early age, he and his family had to deal with people asking about his disabilities. The impact on his life has been considerable.

Daniel’s mother Daphne long suspected the cause of his problems was a powerful hormone tablet called Primodos that was given to women to determine whether they were pregnant. But when she raised her concerns with doctors, they were dismissed.

Now, at last, Daphne has been vindicated with official confirmation this week that her fears were right, in the landmark review by Baroness Cumberlege into three separate health scandals that has exposed a litany of shameful failings by the NHS, regulatory authorities and private hospitals.

This damning report shows again the danger of placing a public service on a pedestal, with politicians happy to spout platitudes but scared to tackle systemic problems or confront the medical establishment.

But how many more of these inquiries must be held? How many more disturbing reports and reviews must be written?

How many more times must we listen to ministerial apologies to betrayed patients? How much more must we hear of ‘lessons being learned’ when clearly they are largely ignored?

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Source: Mail Online, 9 July 2020

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If we can’t learn from errors, families relive tragedy for nothing

It was in a coroner’s court last year, at the inquest into the death of his 27-year-old daughter Maeve, that Sean O’Neill heard the most dispiriting words. The coroner, Deborah Archer, said she was going to write a prevention of future deaths (PFD) report, highlighting to the NHS and other agencies areas of concern. Then she added: “I write a lot of these reports, and often nothing happens.”

Maeve died after suffering for half her life with myalgic encephalomyelitis (ME), a post-viral condition that is not well understood, inadequately researched and which doctors often refuses to recognise or treat.

Sean's aim was to use the media to highlight what happened to Maeve and raise awareness of the plight of the hundreds of thousands of people whose lives are limited by ME and similar conditions. His second aim was to convince the coroner to write a PFD report and point out areas in healthcare, medical research, education and training where action could be taken that might prevent further such deaths.

The written responses to Archer’s PFD report have been underwhelming. The public health minister, (the recently resigned) Andrew Gwynne, promised an NHS delivery plan. NHS England said it would do a “stocktake” of ME services, even though there had been evidence at the inquest that such services are scarce, and in the cases of severely ill patients, “non-existent”. The Medical Research Council said it “recognises the unmet clinical need for better diagnosis and treatments for people living with ME” but defended its record to date.

In 2023 there were more than 1,600 inquests that had been open for more than two years; often these are the most difficult cases, yet bereaved families face being repeatedly traumatised by every preliminary hearing and legal letter.

As in Maeve’s case, the best hope for a family is that a PFD report points the way to reform. A coroner is not allowed to recommend, only suggest. Yet only rarely are these reports written. 

Those coroners who do write reports often find their suggestions ignored. Just under 40% of the 5,532 PFD reports published since 2013 have received no responses. There is no other section of the legal system in greater need of reform. There should be a national coronial service, more PFD reports should be written and lessons should be disseminated. What is the point of investigating avoidable deaths — of making bereaved families relive their trauma, of spending millions of public pounds — unless we are prepared to learn how to avoid similar fatal errors?

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Source: The Times, 23 February 2025

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If a female doctor gets treated like this, is there hope for any women?

The agonising pains came midway through Dr Rageshri Dhairyawan’s third cycle of IVF, ten years ago. “I felt as if a heavy metal shovel was scraping away at the lining of my abdomen,” she recalls. 
“It was like nothing I’d ever felt before,” she says. Her fear was ovarian torsion — “when the ovaries become so big from all the follicle stimulation that they twist on their stalk, which is excruciating and needs to be repaired surgically because the ovary becomes starved of oxygen.”

Her husband rushed her to A&E where she was given morphine, then admitted to a gynaecology ward. As a scan revealed no ovarian torsion, “It was thought the hormones had flared up my endometriosis.” 

Dhairyawan was in so much pain she couldn’t move, and yet she recalls being treated as though she was an attention-seeker “trying to get strong opioids through dishonest means” and “as a nuisance for pressing my buzzer”. It was as if, she says, “I didn’t have something they thought was very serious so why was I still there? I just remember not wanting to feel like more of a nuisance because I knew what being a nuisance on a ward can look like — I’d been a doctor for ten years.”

Dhairyawan’s husband demanded pain relief for her. She left hospital shaken. “It massively changed me,” she says. “The experience of not being listened to as a patient, not being taken seriously — it really shocked me. Because I thought, I’m a senior doctor, I know exactly how the NHS works, I know my medical condition, I now what to ask for. And I still can’t speak up and advocate for myself.”

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Source: The Times, 2 July 2024

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Ida Lock: Baby's inquest delayed amid 'whistleblower' claims

An inquest into the death of a baby has been adjourned after a whistleblower claimed hospital inspectors ignored safety concerns about a NHS trust.

Ian Kemp has raised concerns the University Hospitals of Morecambe Bay NHS Trust was "covering up" the death.

The former health watchdog inspector said he had been asked to investigate maternity care at the trust in December 2019 after the death of Ida Lock.

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Source: BBC News, 19 February 2024

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ICUs advised how to improve staffing ratios as covid pressure eases

Intensive care units (ICU) will be advised how to improve their staffing-to-patient ratios shortly as the number of patients admitted to hospital with COVID-19 falls across the country.

In expectation that the pandemic would put intense pressures on ICUs, staff ratios were relaxed. NHS England told trusts to base their staffing models on one critical care nurse for every six ICU patients, supported by two non-specialist nurses, and one senior ICU clinician for every 30 patients, supported by two middle-grade doctors.

Before the pandemic, guidance from the Faculty of Intensive Care Medicine recommended a ratio of one non-specialist nurse per patient. For senior clinicians the ratio was 1:10

New guidance, expected as early as next week, will encourage trusts to reduce the number of patients per ICU specialist nurses and senior clinicians on a localised basis as part of “transitional arrangements” aimed at moving staffing models back towards normal standards of care, HSJ has been told.

The new guidance, drawn up by NHS England, the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses, will give trusts recommended staffing ratios based on the occupancy rates of their ICUs. It will tell trusts the existing ratios should be applied if their ICUs are running at four times their normal capacity. For ICUs running at double capacity, this ratio would be reduced to 1:2 for ICU nurses, and 1:15 for senior clinicians.

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Source: HSJ, 8 May 2020

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ICU hospital staff: 'Scared, sad, petrified, worried'

For the first since April the UK has recorded more than 1,000 daily Covid-related deaths – one of the highest figures of the pandemic.

Right now, London is at the epicentre of this crisis. Hospitals now have more Covid patients being admitted every day than they did at the peak in April. Many doctors and nurses say they're reaching breaking point.

The BBC's medical editor Fergus Walsh filmed inside the intensive care unit at London's University College Hospital, which is one of the busiest in the capital.

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Source: BBC News, 6 January 2021

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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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ICSs told to prepare ‘nuclear’ service cuts as NHSE plays ‘hardball’

Health systems are still struggling to meet their financial plans, despite hundreds of millions being raided from investment budgets to help balance the books.

Senior leaders in most regions said the cash falls short of their existing financial gaps.

Earlier this month, NHS England announced that £800m would be made available to integrated care systems (ICSs) to offset the additional cost of strikes. 

HSJ understands ICSs reported a combined deficit that was £1.5bn worse than planned in the six months to October, which implies a gap of several hundred million pounds unless systems can report substantial surpluses for the second half of the year.

HSJ spoke to senior sources in all seven regions, with more than half saying their systems would still fail to deliver breakeven, despite the funding transfers.

A source in the South East said their system’s share of the funding “won’t touch the sides”, adding that NHSE was playing “hardball”.

Another local source said they had identified a set of “nuclear options” to balance the books, but these would be “catastrophic for quality of care and/or nigh-on impossible to deliver”.

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Source: HSJ, 22 November 2023

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ICSs most ‘off target’ on recovery named by NHS England

Seven integrated care systems and one ambulance trust have been placed in ‘intensive support’ because of their performance against urgent and emergency care metrics.

NHS England launched the new intervention regime for emergency care earlier this year to measure progress against the urgent and emergency care recovery plan.

The most troubled systems and organisations are now placed in a first “tier” and will receive central support from NHSE. Other systems requiring support from NHSE regional teams are placed in a secondary tier. This tiered approach is already in place for cancer and elective performance.

Support will include help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”.

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Source: HSJ, 7 June 2023

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ICSs may be breaching patient confidentiality, watchdog warns

The health service’s independent data watchdog has issued a warning to local NHS bodies over concerns confidential patient information is being shared unlawfully with third parties, including for ‘population health’ analysis.

In a letter to integrated care systems (ICSs), National Data Guardian Nicola Byrne and UK Caldicott Guardian Council chair Arjun Dhillon said they had both “been made aware that within some local record sharing programmes, organisations could be processing confidential patient information without ensuring that the processing does not breach confidentiality”.

They added among the four areas of concern health and care staff had raised with them was that confidential patient information may be being transferred from local record sharing programmes to third party hosted secure data environments. Secure Data Environments are data storage and access platforms where organisations can apply to access data for planning and research purposes.

It is not clear what kind of patient data may have been unlawfully shared.

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Source: HSJ, 17 November 2022

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ICS told to increase help for trust that treated patients on the floor

A troubled integrated care system has been told it must provide more help to a severely under-pressure acute trust where patients were treated on the floor and in a storeroom.

The Care Quality Commission said Devon ICS must give more “input” to University Hospitals Plymouth Trust, where inspectors warned staff could “not ensure the safety of all patients” arriving at the emergency department.

During a visit to the trust’s Derriford Hospital in September, inspectors saw staff treating six patients who “lay on the floor” of the ambulatory assessment unit, while another patient who had been in the department overnight was being “treated/assessed in the ‘storeroom’” – according to the CQC’s report.

Inspectors reported: “The department was overcrowded, there was no seating available… Social distancing was not possible.”

While the CQC praised senior leaders in the ED and executive chiefs for being “open to challenge” and “understanding the problems” faced by the urgent and emergency care service, inspectors said there was only so much the trust could do alone.

Catherine Campbell, head of hospital inspection at CQC, said: “The impact of a high number of patients attending to receive care, combined with reduced staffing levels in the ED, created issues that the trust couldn’t solve alone and further support was needed from the local health and social care system."

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Source: HSJ, 19 January 2022

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ICS stops referrals to largest private provider

A health system has stopped sending mental health patients to the country’s largest single provider of out-of-area placements.

Southern Hill Hospital in Norfolk provided more than 18,000 bed days classed as OAPs for NHS patients last year, with Greater Manchester Integrated Care System (GM) being the main contributor to that total.

However, HSJ has learned that GM’s integrated care board and mental health providers have decided not to send any more patients to the provider.

The move comes after a recent visit to and review of the service at Southern Hill by GM commissioners. This, in turn, followed concerns about the “co-ordination” of patient care at Southern Hill received by GM. The exact nature of the concerns is unclear, and the ICB said in a statement “no significant safety or quality concerns were found and feedback from patients was positive,” when it carried out its review.

The ICB said the decision to cease placements at Southern Hill shortly after the concerns were raised was a coincidence, and that the move was part of its strategy to reduce OAPs.

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Source: HSJ, 2 May 2024

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ICS set to miss July two-year waiters target by 860 patients

One of England’s most challenged integrated care systems (ICS) is set to miss by more than 800 patients the government’s target of eliminating two-year elective waits by July. 

Devon ICS currently estimates 860 patients will have waited longer than two years for planned care by July 2022, when all patients waiting longer than two years should have been treated – according to the NHS’s elective recovery plan.

It is the first reported example of an ICS forecasting to miss the high-profile target which government has agreed with NHS England.

The ICS, which is among the health systems with the lowest rating from NHSE, is a national outlier against the target, with around 1,500 patients currently waiting two years or more for care.

The backlog has occurred despite the ICS previously being one of 12 systems given extra money for planned care through the elective accelerator programme and retaining the use of its Nightingale Hospital.

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Source: 6 May 2022

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ICS leaders must have courage to put quality first, says CQC chief inspector

The Care Quality Commission’s (CQC) outgoing chief inspector of hospitals has called on integrated care system leaders to be ‘courageous’ in putting quality first.

Speaking at the HSJ’s Patient Safety Congress, Ted Baker implored ICS leaders to not focus solely on financial and operational targets, although he also acknowledged “there is a lot of pressure to meet [those] targets”.

In his speech yesterday, he said: “It’s often taken really courageous leaders to put quality first ahead of financial targets and operational targets… You have to be courageous to do that and I think some of the leaders of the ICSs, they need to be that courageous.

“They need to focus on quality and safety within an [ICS] and not, if you like, go down the kind of NHS path of focusing on financial and operational targets.

“If we can do that, we can have a really transformative effect on integrated care across [the] system. I suppose that’s what I’m asking for: courage from all of us to tackle some of the cultural issues in the NHS."

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Source: HSJ, 22 September 2021

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ICS cancels four urgent treatment centre contracts after performance concerns

An integrated care system has terminated a private provider’s contract to run four urgent treatment centres following performance concerns.

Two local acute trusts were expected to take over from provider Greenbrook Healthcare this week, following the decision by North West London ICS.

The impacted sites include Hillingdon UTC, which is co-located with the Hillingdon Hospitals Foundation Trust, as well as the Ealing, Central Middlesex and Northwick Park sites that are near to the respective hospitals run by London North West University Healthcare Trust.

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Source: HSJ, 24 January 2023

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ICBs told to get tighter grip on GP referrals

Integrated care boards have been told to significantly strengthen the drive to ensure that potential GP referrals are first scrutinised by hospital consultants.

The approach, known as “advice and guidance”, involves GPs discussing cases with specialist consultants. The discussions can lead to the patient being triaged to alternative services or the GP continuing to be responsible for their management, rather than being placed on a waiting list to see a consultant.

The use of A&G to reduce referrals is a key plank of NHS England’s plan to deal with the elective care backlog.

NHSE’s elective reform plan pledged to drive up A&G requests by GPs to 4 million in 2025-26, nearly double the amount seen in 2023-24. NHSE forecasts this would deliver 2 million “diversions” – cases where a referral is avoided. 

For the first time, GPs will be paid £20 each time they use the model, and the government has announced that an £80m pot has been allocated to fund the policy.  

But new guidance published by NHS England warns local systems must deliver a “higher degree of rigour and standardisation” in their A&G services. It also sounds the alarm about the “considerable variation” in A&G models operating in different areas. 

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Source: HSJ, 17 April 2025

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ICBs told to fix ‘substantial gaps’ in whistleblowing support

Integrated care boards have been told to rectify the “substantial gaps” in reporting through Freedom to Speak Up in primary care.

While numbers of “freedom to speak up” whistleblowing reports from staff in primary care are “improving”, they remain “relatively low”, NHS England said.

This is largely because “routes to escalate concerns are more limited than in secondary care, with risks to individual confidentiality due to the size of some providers,” Sir Andrew Morris, deputy chair of NHSE, said in a letter to ICBs this week.

He asked ICBs to ensure primary care workers are aware of and have access to “speaking up routes”, in order to support the primary care patient safety strategy published last week.

Primary care staff should be able to reach an FTSU guardian, the letter said. NHSE said there are “relatively very few trained and registered Freedom to Speak Up guardians that support primary care workers” and that even where guardians are in place, levels of speaking up “remain extremely low”.

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Source: HSJ, 3 October 2024

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ICBs told to ‘urgently review unacceptable waiting times’

NHS England has warned integrated care boards it is “not acceptable” to set “minimum waiting times” of more than 18 weeks for elective care.

The warning follows proposals by several ICBs to set minimum waiting times above the 18-week statutory target. One system proposed a 28.5-week minimum wait for some procedures.

In an official briefing for NHS leaders, NHSE elective chief Mark Cubbon said: “I’m aware that some ICBs have set minimum waiting times above 18 weeks. This is not acceptable, given our commitment to the constitutional standard.

“These ICBs have been asked to urgently review their approach and work with providers to ensure patients can be treated sooner.”

The introduction of minimum waiting times prompted concerns from patient and clinical groups, who warned patients were facing “unnecessary pain”. The Nuffield Trust said the proposals gave “no clear process” to ICBs on how to ration funding and that this “will lead to inequity and undermine public trust in the NHS”.

Royal College of Surgeons vice president Frank Smith said: “It is deeply concerning that some ICBs have set minimum waits above 18 weeks. It is right NHS England intervenes, but this is another symptom of the NHS under severe strain.”

The Independent Healthcare Providers Network CEO David Hare said: “It is hard to see how minimum waits set even below [18 weeks] will support the government’s elective recovery targets and clear commitments to supporting and promoting patient choice.

“We know that many patients value the option of choosing a provider with a short waiting time and that a degree of contestability in the system drives up efficiency and productivity.”

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Source: HSJ, 3 September 2025

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