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Number unable to get a hospital appointment after GP referral up 50% in two years

The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show.

NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020.

Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. 

The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital.

Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments.

Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.”

She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.”

Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.”

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Source: The Telegraph, 7 August 2022

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Cyber attack triggers 111 ‘total system outage’

Many NHS 111 services are without a crucial IT system for several days, after a cyber attack on a software supplier.

Providers had to move to pen-and-paper yesterday, and have been unable to access patient records.

Adastra – which is used by 85% of NHS 111 providers  – went offline at 7am on Thursday. It was still affected as of Sunday, and staff were told it may not be online for several days.

Advanced, which supplies Adastra, confirmed on Friday evening the incident was caused by a cyberattck, but says it managed to limit the damage to a small number of its servers. It was reported on Saturday that the attack is thought to have been by a criminal group trying to extort money — so-called ransomware — rather than an attack by a group linked to a state/government.

As well as NHS 111, the system is used by some GP out-of-hours services and has also been marketed to urgent care providers. 

NHS 111 services have had to use lists of protocols when answering calls and write details down, rather than the software automatically implementing the protocols.

One briefing note from commissioners in London, seen by HSJ, described the issue as a “total system outage” for NHS 111, and said “likely delays for patients… will continue throughout the weekend and potentially over next week”.

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Source: HSJ, 8 August 2022

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‘Difficult discussions’ as NHS faces shortage of childbirth pain relief

The NHS has been hit by a shortage of epidural kits to give mothers-to-be, a key form of pain relief during childbirth, as well as the drug that women are offered as an alternative.

Supplies of epidural kits and the painkiller Remifentanil are now under such pressure that some hospitals cannot offer pregnant women their usual right to choose which one they want to reduce labour pains.

Anaesthetists have told the Guardian that the simultaneous shortage of both forms of pain management has led to “difficult discussions” with women who had been told during their antenatal care that they would have that choice but were upset to learn that it was not available.

The disruption to supplies of epidural kits is so acute that NHS Supply Chain (NHSSC), the health service body that ensures hospitals in England and Wales receive regular supplies of drugs and equipment, to ration deliveries to just one week’s worth of stock.

Childbirth organisations voiced their concern and warned that the disruption to supplies meant some women in labour were already facing long delays before they received pain relief.

“Offering a choice of options during birth is an integral element of good maternity care, and this includes pain relief. It is concerning that the shortage of epidural kits and Remifentanil could be denying many that right”, said Jo Corfield, the NCT’s head of communications and campaigns.

“We don’t yet fully understand the impact this shortage is having but we have heard of long waiting times to receive pain relief and epidurals.”

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Source: The Guardian, 7 August 2022

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‘A historic wrong’: Government set to announce compensation for victims of contaminated blood scandal

A scheme handing payments to those affected by the contaminated blood scandal will be announced this week, as ministers scramble to help those harmed by the “historic wrong”.

Whitehall sources confirmed that a programme handing interim payments will be confirmed in the coming days, once officials have ironed out issues to ensure that victims are not taxed on the payments or have their benefits affected by them. It is thought that ministers accept recent recommendations that infected people and bereaved partners should get “payments of no less than £100,000”.

More than 4,000 people are in line for the payment. Kit Malthouse, the cabinet office minister, has been prioritising the scheme in the last week to ensure payments are made as soon as possible.

“The infected blood scandal was a tragedy for everyone involved, and the prime minister strongly believes that all those who suffered so terribly as a result of this injustice should receive compensation as quickly as possible,” said a No 10 source. “He has tasked ministers with resolving this issue so that interim payments can be made to all those infected as soon as possible, and we will set out the full details later this week.”

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Source: The Guardian, 6 August 2022

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Full extent of NHS dentistry shortage revealed

Nine in 10 NHS dental practices across the UK are not accepting new adult patients for treatment under the health service, a BBC investigation has found.

BBC's research shows no dentists taking on adult NHS patients could be found in a third of the UK's top-tier councils. And eight in 10 NHS practices are not taking on children.

The Department of Health said it had made an extra £50m available "to help bust the Covid backlogs" and that improving NHS access was a priority.

BBC News contacted nearly 7,000 NHS practices - believed to be almost all those offering general treatment to the public.

The British Dental Association (BDA) called it "the most comprehensive and granular assessment of patient access in the history of the service".

While NHS dental treatment is not free for most adults, it is subsidised.

The BBC heard from people across the UK who could not afford private fees and said the subsidised rates were crucial to getting care.

The lack of NHS appointments has led people to drive hundreds of miles in search of treatment, pull out their own teeth without anaesthesia, resort to making their own improvised dentures and restrict their long-term diets to little more than soup.

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Source: BBC News, 8 August 2022

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‘We should be offered compensation’ - Mesh campaigner's plea to Steve Barclay

Pelvic mesh campaigner Kath Sansom has met with the health secretary Steve Barclay to discuss financial redress for those suffering complications from the procedure.

The UK government decided last year not to provide compensation to women whose lives had been affected by vaginal mesh implants.

But Kath Sansom, a Cambridgeshire mum and former journalist for this news outlet, has continued campaigning and says she will put pressure on the health secretary to revisit the issue.

It also comes as the government revealed victims of the 1970s and 1980s blood scandal will receive compensation for the impact it has had on their lives.

Ahead of her meeting with the Secretary of State for Health, she said: “We [mesh injured] deserve to be compensated based on the fact we are suffering lifelong damage from a health treatment that caused avoidable harm.

“It is not our fault this happened to us and the State should take responsibility.”

Former Health Secretary Matt Hancock issued a public apology when a public inquiry in 2020 revealed a shocking extent of patient failings and lack of regulation for mesh victims.

“The State has apologised for the suffering of the mesh community, which is an acknowledgement of responsibility,” Kath added.

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Source: Cambs Times, 5 August 2022

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Economically inactive Britons with Long Covid have ‘doubled’ in a year

One in twenty people in the UK who are neither employed nor seeking paid work are suffering from Long Covid, with the figure more than doubling in the past year, official data has revealed.

The proportion is far higher than for the 1 in 29 people who are unemployed but seeking work who have long Covid symptoms, or the one in 30 employed people who are sufferers, data released by the Office for National Statistics (ONS) shows.

Individuals who are not employed and are not looking for paid work are classified as being economically inactive.

The data suggests the long-term impacts of the virus could be driving people into this category, or into retirement.

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Source: The Guardian, 4 August 2022

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Private provider says its ‘robust nursing pipeline’ can benefit NHS

A large private provider says it is finding it harder than ever to fill its staffing vacancies, but is optimistic that its investment in nursing apprenticeships and overseas recruitment can help expand NHS-commissioned capacity.

In an interview with HSJ, Shelley Thomas, group HR director for Spire Healthcare, said the company is facing the same staffing difficulties as NHS providers.

She said: “We’re all feeling the same things at the moment… high sickness absence, high holidays, teams that are worn out. We’re all… experiencing the same from a workforce perspective.”

However, she said Spire is “working harder than ever” to fill vacancies, and now has a “really robust pipeline” of apprentices and oversees recruits.

Despite the waiting list backlogs which have ballooned since the pandemic began, and a £10bn framework in place for the NHS to utilise private sector capacity, analysis suggests NHS activity undertaken by private hospitals has been below pre-covid levels in almost all specialities.

Ms Thomas suggested the staffing difficulties had been a factor in that, but acknowledged there were more conversations to be had locally about how the private sector could undertake more activity.

She said the pandemic was a “huge catalyst for stronger working partnerships” between the NHS and the private sector and that relationships are “stronger than they’ve ever been”.

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Source: HSJ, 4 August 2022

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'Bolder government action' needed to address inequalities in dementia risk

"Bolder government action" is needed to address inequalities in dementia risk, the charity Alzheimer's Research UK has warned this week. The comments come in response to findings from four new studies presented at the Alzheimer's Association International Conference (AAIC) which link socio-economic deprivation with increased risk of dementia and cognitive decline.

Dr Susan Mitchell, head of policy at Alzheimer’s Research UK, said: "These findings are a stark reminder of the health gap between the most and least deprived in society, with the most deprived at a higher risk of developing dementia.

"Ultimately, these inequalities are profoundly unfair, but they are also avoidable. The Government has a key role in addressing inequalities through a range of measures to improve poverty, employment, housing and education."

She added: "We urge Government to make dementia prevention a key priority in its aim to level up healthcare across the country, and hope the forthcoming health disparities white paper lays the foundation for a fairer, healthier nation."

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Source: Medscape, 5 August 2022

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Covid-19: One in eight adults develops long covid symptoms, study suggests

One in eight Covid-19 patients (12.7%) is likely to experience long term symptoms, a study from the Netherlands has reported.

Using digital questionnaires, researchers collected data on the frequency of 23 symptoms commonly associated with Covid in an uninfected population and in people who had had a Covid diagnosis.

The findings, published in the Lancet, found that 21.4% of adults who had had Covid experienced at least one new or severely increased symptom three to five months after infection when compared with before. This compared with only 8.7% of uninfected people followed over the same period.

The core Long Covid symptoms highlighted by the researchers include chest pain, difficulties breathing, pain when breathing, painful muscles, loss of taste and smell, tingling extremities, lump in throat, feeling hot and cold, heavy arms or legs, and general tiredness.

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Source: BMJ, 4 August 2022

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Use of antipsychotic drugs among dementia patients increasing, study suggests

Prescribing potentially harmful antipsychotic drugs to people with dementia has increased by more than 50% on average in care homes during the pandemic, new research suggests.

It found that the number of people with dementia receiving these prescriptions had soared from 18% to 28% since 2018 – with prescription rates of over 50% in a third of care homes.

Professor Clive Ballard, who was part of a national campaign in 2009 to reduce antipsychotic prescribing by half, said: “Covid-19 put tremendous pressure on care homes, and the majority of them must be applauded for maintaining relatively low antipsychotic prescribing levels amid incredibly difficult circumstances."

“However, there were very significant rises in antipsychotic prescribing in one third of care homes and we urgently need to find ways to prioritise support to prevent people with dementia being exposed to significant harms.”

Antipsychotic drugs are used to treat some of the more distressing behavioural and psychological symptoms of dementia, such as agitation and psychotic episodes. They have only very limited, short-term benefits in treating psychiatric symptoms in people with dementia – but significantly increase the risk of serious side effects, including stroke, accelerated decline and death.

Dr Richard Oakley, from the Alzheimer’s Society, added: “This study shows the shocking and dangerous scale of the use of antipsychotic drugs to treat people with dementia in care homes.

“Alzheimer’s Society has been campaigning for a move away from the model of ‘medicate first’ and funded research into alternatives to antipsychotic prescriptions, focused on putting people living with dementia at the centre of their own care.

“This drug-free, tailored care can help avoid the loss of lives associated with the harmful side effects of antipsychotic medications.”

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Source: The Independent, 4 August 2022

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LGBT groups demand more action on monkeypox

Sexual health charities and LGBT groups are calling for the government to step up efforts to control the monkeypox outbreak in the UK.

In an open letter to Health Secretary Steven Barclay, they say that without a quicker and wider vaccine rollout, the virus could become "endemic".

There have been more than 2,600 cases of monkeypox in the UK so far, mostly among men who have sex with men.

The Department of Health & Social Care (DHSC) says it is working "rapidly" to vaccinate those at risk.

The Terrence Higgins Trust, which co-wrote the letter, says the rollout needs to be speeded up across the UK to help combat "fear and anxiety" within the LGBT community.

Trust head of policy Ceri Smith told BBC News: "We need to see far better co-ordination, increased vaccine procurement, improved delivery and a cash injection to sexual health services to treat monkeypox."

The letter reads: "Without urgent action, we risk monkeypox becoming endemic in the UK. This poses a serious risk to health and will exacerbate the health inequalities already experienced by gay and bisexual men and other men who have sex with men.

"Vaccinating those most at risk of monkeypox must be a priority if we are to stand a chance of preventing the virus from becoming endemic in the UK."

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Source: BBC News, 5 August 2022

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NHS too reliant on overseas recruits, says union

The NHS in England is increasingly reliant on doctors and nurses recruited from outside the UK and EU, analysis has found.

Some 34% of doctors joining the health service last year came from overseas, a rise from 18% in 2014.

The government said overseas recruitment had always been part of its strategy, but unions have warned it is an unsustainable way of recruiting in the long-term.

Patricia Marquis, Royal College of Nursing (RCN) director for England, said ministers must do more to reduce the "disproportionate reliance" on international recruits.

The government is funding an additional 1,500 undergraduate medical school places each year for domestic students in England - a 25% increase over three years.

However, last week a report by MPs concluded the large number of unfilled NHS job vacancies, about 110,000 in total, was posing a serious risk to patient safety.

Danny Mortimer, chief executive of NHS Employers, said it was "high time for the government to commit to a fully-funded, long-term workforce plan for the NHS" to tackle "chronic workforce shortages".

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Source: BBC News, 5 August 2022

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Hospitals test evacuations due to roof collapse fears

NHS England has called for a “deep dive” into local evacuation and shelter arrangements, amid ongoing concerns about outdated and unsafe estate.

NHS England’s director of emergency preparedness, resilience and response Stephen Groves wrote to trusts: “Following the publication of the updated evacuation and shelter guidance for the NHS in England, and recent work driven by the heightened risk associated with reinforced autoclaved aerated concrete (RAAC), the 2022-23 EPRR annual deep dive will focus on local evacuation and shelter arrangements.”

The letter, sent at the end of last week, comes amid growing concerns about NHS estate, including RAAC planks which were used in constructing public sector buildings in the 1960s, 70s and 80s. 

Areas to be examined in the deep dive vary by type of organisation. However, according to a self-assessment tool referenced in the letter, questions for providers include: whether they have “a process in place to triage patients in the event of an incident requiring evacuation and/or shelter of patients”; whether there are “effective arrangements in place to support partners in a community evacuation, where the population of a large area may need to be displaced”; and whether “evacuation and shelter arrangements include resilient mechanisms to communicate with staff, patients, their families and the public, pre, peri and post evacuation”. 

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Source: HSJ, 5 August 2022

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Man died after doctors missed opportunities to identify abnormalities on his X-ray

A 65-year-old man died after doctors failed to notice serious abnormalities on his X-ray, an investigation by the Parliamentary and Health Service Ombudsman (PHSO) has revealed.  

The investigation comes a year after a landmark report by the Ombudsman highlighted failings in how X-rays and scans are reported and followed up in the NHS.  

Mr B, who was admitted to University Hospitals Birmingham NHS Foundation Trust in May 2019, had been unwell for several days. He was admitted to hospital suffering from abdominal pain and vomiting. An X-ray of his abdomen was taken, which two doctors said did not show any apparent abnormalities.

The following day the man’s condition deteriorated. He suffered a heart attack and died. A PHSO investigation found the Trust failed to notice a blockage in his intestine on the X-ray. Because of this failure, Mr B did not receive treatment that could have saved his life. 

Speaking on this case Ombudsman Rob Behrens said:  

“The case of Mr B highlights the devastating impact mistakes like this can have. If the Trust had picked up the abnormalities on his X-ray sooner, Mr B could still be with his family today. 

“As the NHS faces the challenge of rebuilding after the pandemic, it must not lose momentum in improving the way X-rays and scans are handled during a patient’s care.”  

Progress has been made by the NHS in implementing recommendations made by the Ombudsman in the report; however, Rob Behrens has said more needs to be done to protect patients from serious harm. 

“Attention and buy-in from the NHS’s senior leaders is crucial if we want to see sustained and meaningful change in how X-rays and scans are managed during a patient’s care. We need more collaboration across clinical specialties, looking at the whole patient journey once a scan has been carried out.

"I want to see the NHS treating complaints as a source of insight to drive improvements in patient care. Not learning from mistakes will mean missed opportunities to diagnose patients earlier. In the most serious cases, like that of Mr B, it will mean a death which should never have happened.”

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Source: PHSO, 20 July 2022

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NHS Wales: App helping keep heart patients out of hospital

Mobile apps to track patients' health are keeping them out of hospital and could cut waiting times, experts have said.

It follows a trial of a new app which heart patients are using through their mobile phones. The trial allows clinicians to change treatments quickly and uses video consultations, avoiding unnecessary hospital visits.

Rhodri Griffiths is the innovation adoption director at Life Sciences Hub Wales, and is looking for more ways to introduce similar technology. He believes the pandemic accelerated the use and acceptance of digital solutions in healthcare, by patients and clinicians.

"We really are looking at a big digital revolution within healthcare and there are an amazing myriad of things coming through," he said.

He explained data collected by smartphones and watches can help predict who is likely to have a heart attack.

"We can avoid that happening. So prevention is key but it's also looking at how some of this can impact on waiting lists," he said.

"So, looking at how theatres are used, which patients can be prioritised?

"In social care it's looking at how pain is managed by face recognition."

Mr Griffiths said he believed the data collected could also identify wider problems: "It's combining these digital solutions with our genetic information - bringing big data together on a population level we can start spotting trends".

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Source: BBC News, 4 August 2022

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Record number of midwives have quit due to stress of the job amid fears for safety of pregnant women

Midwife numbers are reaching a dangerous level which could put lives at risk, as records show more staff leaving than joining the profession for the first time in a decade.

As a record number suffer burnout and leave, the figures from NHS Digital for 2021/22 show almost 300 more staff abandoned midwifery than joined the service, with 3,440 leaving and only 3,144 coming in.

Analysis of the data showed a record 551 resigned in 2021 because of a lack of work-life balance.

Midwives working in NHS trust maternity units typically work 12-hour shifts, but many work longer for no additional pay to cover staff shortages and to keep services running.

The Royal College of Midwives (RCM) says members are "at the end of their tether' and 'physically and emotionally burnt out"

Joeli Brearley, chief executive of campaign group Pregnant Then Screwed, said: "We don't have enough midwives, and those we do have are underpaid, undervalued and overworked."

"This is a problem that has been communicated to the Government repeatedly for years. It is putting the lives of women and their babies in danger and causing untold damage to their mental and physical health. The Government needs to get a grip of the situation urgently before there are more tragedies."

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Source: Daily Mail, 1 August 2022

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Restraint and sexual safety among transport service failings

Private and NHS ambulance services are reviewing safety procedures after the Care Quality Commission identified a series of risks to mental health patients being transported by non-emergency providers.

The care watchdog wrote to all providers of non-emergency patient transport earlier in the summer, warning of concerns identified at recent inspections about use of restraints, sexual safety, physical health needs, vehicle and equipment safety standards, and unsafe recruitment practices.

The letter, seen by HSJ, stated: “We know there are many independent ambulance providers providing a good standard of care. Unfortunately, our recent inspections suggest that this is not always the case."

“We expect providers to deliver on their commitment to provide safe, high-quality care and we will do everything within our powers to ensure this happens.”

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Source: HSJ, 4 August 2022

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Trust chief calls for six-hour A&E target

The chief executive of a trust trialling the new emergency care standards being considered by the government has called for a new six-hour target to either move patients out of accident and emergency, or for them to receive treatment.

North Tees and Hartlepool Foundation Trust chief executive Julie Gillon told HSJ  a new target should be set as a “body of evidence” indicates patients are at risk of deterioration following A&E waits of six hours or more.

The proposal is likely to be broadly welcomed by many clinicians, but could prove controversial in some quarters. NHS England did not include a six-hour target in the bundle of new A&E metrics being piloted, and the proposal could be interpreted by some as a watered-down version of the existing four-hour standard.

However, Ms Gillon cited analysis by the Royal College of Emergency Medicine last year which revealed thousands of excess deaths resulting from overcrowding and long stays in A&Es.

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Source: HSJ, 4 August 2022

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Russell-Cooke secures victory and £970k payout for Karen Preater in vaginal mesh negligence case

Russell-Cooke personal injury and clinical negligence partner Grant Incles recently represented Mrs Karen Preater in a clinical negligence case over vaginal mesh surgery performed on her at a hospital in north Wales in 2014. 

Wrexham County Court found in favour of Mrs Preater, and roundly dismissed allegations made by the defendant in this case, the Betsi Cadwaladr University Health Board, that the claimant had lied in the presentation of her case, as part of a Fundamental Dishonesty defence. 

Mrs Preater underwent vaginal mesh surgery in January 2014 - to which she had not been properly consented. The surgery itself was performed negligently and as a result she suffered a life-changing chronic pain condition. In late 2020, the defendant carried out intrusive video surveillance of Mrs Preater and trawled through her life on social media, proceeding to launch a defence of Fundamental Dishonesty pursuant to S.57 of the Criminal Justice and Courts Act 2015.

The defendant alleged that the claimant was seeking to lie to the Court about her ability to work and need for care and assistance which, if found to be correct by the Court, would have meant that Mrs Preater would have lost all of her claimed compensation, and which may well have led to an application by the defendant to have her committed to prison for her alleged dishonesty.

The case was fought to trial over seven days in July 2022. HHJ Howells found that Mrs Preater had not sought to deceive any party at any time and should be fully compensated for her grave suffering since being injured over eight years ago. 

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Source: Russell-Cooke, 4 August 2022

Court judgement:

22081101.Preater v BCUHB approved judgment dated 4 August 2022.pdf

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NHS to roll out life-changing glucose monitors to all Type 1 diabetes patients

NHS England patients with Type 1 diabetes will now be eligible for life-changing continuous glucose monitors after the health service secured a new cut-price deal.

The wearable arm gadget sends information to a mobile app and allows diabetes patients to keep track of their glucose levels at all times without having to scan or take a finger prick test.

Traditionally, continuous glucose monitors are more expensive than their flash monitor counterparts – which record glucose levels by scanning a sensor – but thanks to the NHS agreeing on a new cost-effective deal with manufacturers DEXCOM, they will now be available for NHS patients on prescription at a similar price.

The monitor, called Dexcom ONE Real Time-Continuous Glucose Monitoring, uses a sensor no bigger than a bottle cap that attaches to the arm for up to 10 days and measures glucose levels from just under the skin.

Patients will receive their starter pack – which will include information on the product and usage, a sensor and transmitter – from the hospital or GP surgery once prescribed, after which they can go to the pharmacy for their repeat prescription.

Dr Partha Kar, national speciality advisor for diabetes and obesity said: “This is a huge step forward for Type 1 diabetes care and these monitors will be life-changing for anyone with the illness – giving them more choice to manage their condition in the most convenient way possible – as well as the best chance at living healthier lives, reducing their risk of hospitalisation and illnesses associated with diabetes, which in turn reduces pressure on wider NHS services.

“The new deal also delivers on our commitment to get patients the latest cutting-edge medical technology at the best value for taxpayer money – saving the NHS millions over the coming years”.

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Source: NHS England, 2 August 2022

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Fresh allegations of whistleblower mismanagement at ‘witch hunt’ trust

Fresh concerns have been raised about the treatment of whistleblowers by managers at a trust recently embroiled in a high-profile bullying scandal, the hospital’s workforce director has disclosed.

A series of further accusations have been made against managers at West Suffolk Foundation Trust, where executives were recently judged to have led an “intimidating, flawed” hunt for a whistleblower, prompting a series of high-profile departures.

The trust’s executive director for workforce detailed in a paper for the hospital’s July board meeting how managers had been hunting to identify staff who had raised concerns through supposedly confidential channels.

The report, by executive director of workforce and communications, Jeremy Over, said: “Feedback has been given indicating that some people have had a poor experience when speaking up.

“In two separate cases, where people spoke up in confidence, it was reported that the managers were then asking and wishing to find out who had spoken up making the individuals very uncomfortable.

“Another case reported that the individual was ‘told off’ by their manager for ‘going about their heads’ [sic] and another where staff felt discouraged from raising any points or suggestions as these were taken [as] a personal offence [by] the senior staff. In a further case, the person speaking up was criticised [for] doing so.”

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Source: HSJ, 3 August 2022

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Over 100,000 monkeypox vaccines procured, government says

More than 100,000 doses of the monkeypox vaccine have been acquired in order to combat the spread of the virus, the government has said.

Last month the NHS stepped up its monkeypox vaccination programme in England as infections rose.

Vaccines minister Maggie Throup said the majority of vaccines were being made available in London, with about 75% of confirmed cases in the capital.

But she urged people to wait to be invited to receive their jabs.

While anyone can get monkeypox, the majority of those with the virus are gay, bisexual and other men who have sex with men.

The latest figures show that nationally there have been 2,436 confirmed cases, with 1,778 of those in London.

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Source: BBC News, 3 August 2022

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Ministers admit they will break NHS pledge on hospital waiting times

Ministers have admitted a key NHS pledge to ensure that everyone who has been waiting at least two years for hospital care would be treated by last month has not been met.

The then health secretary Sajid Javid made the promise in February when launching the NHS’s “elective recovery plan”. It was intended to tackle what is now a record 6.6 million-patient backlog in England for those awaiting a procedure such as a joint replacement or cataract removal and included a series of treatment milestones the health service had to hit.

“No one will wait longer than two years by July,” Javid said. However, the Department of Health and Social Care has now admitted that it will miss that target and that “a small number of patients” will have remained untreated by that deadline.

The health minister Maria Caulfield told Wes Streeting, the shadow health secretary, in a written parliamentary answer on 18 July that while “no formal estimate has been made … engagement with the National Health Service suggests a small number of patients with complex cases will have waited longer than two years for NHS treatment by the end of July 2022”.

Streeting said the admission was a further example of the government not backing up rhetoric on the NHS with concrete action. “It is unacceptable for anyone to be left waiting more than one year for healthcare, let alone two,” he said. “Once again the Conservatives have overpromised, [and] undelivered, and patients are paying the price.”

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Source: The Guardian, 3 August 2022

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After Roe v Wade: US doctors are harassed, confused, and fearful, and maternal morbidity is increasing

On 24 June the US Supreme Court overturned Roe v Wade, the 1973 decision that legalised abortion and left the regulation of abortion to the states.4 At present, about half of the 50 states ban or severely limit abortions, but the picture is changing daily as century old bans go into place in some states, bans are challenged in courts, and state legislatures debate changes to their laws.

The American College of Obstetricians and Gynecologists (ACOG) said, “Each piece of legislation is different, using different language and rationales. State legislators are taking it upon themselves to define complex medical concepts without reference to medical evidence. Some of the penalties for violating these vague, unscientific laws include criminal sentences.”

Doctors report being confused and fearful about how they can continue to practise in states where abortion laws are changing day by day and sometimes hour by hour.

Katie McHugh, an obstetrician and gynaecologist in Indianapolis, where abortion until 20 weeks is legal for the moment, told The BMJ about a patient who arrived from another state (around 200 miles away) with a miscarriage.

“A fetal heartbeat could still be detected. The local hospital sent her home and told her to come back if she became very sick.” Instead she travelled two and a half hours by car to McHugh.

“I don’t blame the physicians in [the other state]. I don’t know if abortion is legal now a trigger law is in effect. They could face lawsuits. As a physician, it’s unacceptable to have to watch the news to know what’s legal and how to practise,” said McHugh.

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Source: BMJ, 1 August 2022

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