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Hospital trust accused of risking lives after raising patient-to-nurse ratio to dangerously high levels

A hospital trust in Bristol has been accused of risking lives after raising its patient-to-nurse ward ratio to dangerously high levels, having allegedly dismissed staff concerns and national guidance on safe staffing.

University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) has introduced a blanket policy across its hospitals that assigns one nurse to 10 patients (1:10) for all general adult wards. This ratio, which previously stood at 1:6 or 1:8 depending on the ward, rises to 1:12 for nights shifts.

The new policy, which is applicable to Bristol Royal Infirmary (BRI) and Weston General Hospital, also extends to all specialist high-care wards, which treat patients with life-threatening conditions such as epilepsy and anaphylaxis.

Nurses at the trust have expressed their anger over the decision, saying they were never fully consulted by senior officials. Many are fearful that patient safety will be compromised as the second coronavirus wave intensifies, culminating in the unnecessary loss of life.

“Patients who would have extra nursing staff because they are very acutely unwell and need close observation I think are going to unnecessarily die,” one nurse at BRI told The Independent. 

“Or if they survive, they’ll suffer long-term conditions because things were missed as they don’t have the staff at their bed side to watch the deterioration.”

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Source: The Independent, 18 November 2020

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Hospital trust ‘missed earlier opportunity’ to raise alarm on Kent meningitis case

A hospital trust did not immediately alert health officials about a case of meningitis in Kent.

A patient first presented to East Kent Hospitals University NHS Foundation Trust on the evening of Wednesday 11 March, a spokesperson said.

But the trust waited until Friday 13 March, once a diagnosis had been confirmed, to notify the UK Health Security Agency (UKHSA), which manages an outbreak of such an illness.

Dr Des Holden, acting chief executive of East Kent Hospitals University NHS Foundation Trust, said: “Our first patient presented on the evening of Wednesday 11 March.

“We recognise there was an opportunity prior to diagnosis being confirmed on Friday 13 March to notify UKHSA".

Health secretary Wes Streeting said that there was a 24-hour window in which hospitals were meant to raise a suspected case with the agency, and that staff had instead done so in 26 hours.

He told LBC: “The patient came in on the Wednesday unwell. By mid-morning on Thursday, the staff suspected meningitis. Now at that stage, they had 24 hours within which they should have notified the UKHSA. They did so in 26 hours.

“While I can reassure people that it appears in this case that that delay did not have a material impact – we have not found evidence of onward transmission to other people through that delay that we would otherwise have traced faster – nonetheless, we have that 24-hour standard for a reason, and I am taking this seriously.”

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Source: The Independent, 25 March 2026

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Hospital trust ‘deeply sorry’ for harm to dozens of children

At least 40 children suffered harm – with over 20 cases classed as “moderate or severe” – due to delays while receiving care from a hospital’s audiology department, HSJ  can reveal.

Bedfordshire Hospitals Foundation Trust has identified 109 children who may be at risk of harm due to problems with their hearing aid management, and harm has been identified in at least 40 of them, including developmental delay.

The findings were included in an interim “patient safety incident review” being carried out by the trust and supported by NHS England.

The preliminary findings were published in papers for Luton’s health overview and scrutiny committee last month.

The review follows a major national investigation into harm caused by audiology failings, culminating in the Kingdon review, published in November 2025, which found the NHS ignored warnings on testing failures for a decade.

Bedford’s review is understood to form part of the national improvement programme for paediatric audiology services.

It comes as the sector awaits the Department of Health and Social Care’s response to the Kingdon review, which British Association of Audiology President Claire Benton said she hoped would bring “additional support desperately needed for the system”.

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Source: HSJ, 12 May 2026

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Hospital told to improve safety probes a decade after baby deaths

A hospital in East Ayrshire has been ordered to improve the way it handles patient safety incidents in its maternity unit, almost 10 years after it was the centre of an investigation into baby deaths.

The report from Healthcare Improvement Scotland (HIS) made 16 requirements for improvement at the unit in Crosshouse University Hospital, near Kilmarnock, including for delays women faced when they contacted the triage unit.

It said some staff were reluctant to report patient safety events, and reviews into incidents took too long to the detriment of families.

NHS Ayrshire and Arran said it is committed to ensuring patients receive safe and dignified care at all times.

In 2016, a review was ordered into failures of care at the hospital after BBC Scotland News revealed there had been six "unnecessary" baby deaths at the hospital. NHS Ayrshire and Arran was told to improve the way it investigated adverse events.

Last year, the Scottish government said it would carry out a national review of maternity care after another BBC investigation revealed ongoing safety concerns across several maternity units.

In total, the latest report made two recommendations and 16 requirements.

Other areas for improvement include flushing of infrequently used water outlets and improvements in the cleanliness of patient equipment.

The HIS report also highlighted 10 areas of good practice including "positive and respectful" interactions between staff and women, families and babies and that staff felt well supported in an under-pressure environment.

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Source: BBC News, 4 February 2026

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Hospital told it’s ‘undoubtedly causing harm’

A major emergency department described by a national team as “undoubtedly causing patient harm and distress to staff” told HSJ it believes it has started to crack some of its problems.

The review of the Royal Sussex County Hospital in Brighton — a major trauma centre for much of the South East — found it had the lowest score in England for patient flow.

It was carried out by Getting It Right First Time, which is part of NHS England.

Only half of patients waited less than 12 hours from arrival — much worse than elsewhere in Sussex — and on average they spend more than 26 hours in the department before admission, the review said. It used data from May last year, and said there had been deterioration over the previous two years.

The review, dated July 2024 and obtained by HSJ under the Freedom of Information Act, paints a grim picture based on a visit by the GIRFT team. They saw the hospital ”stacking” patients in the ED, making “infection prevention control almost impossible”, and creating a potential fire risk.

It highlighted problems with mental health patients, who often are left in its care in short stay beds because of a shortage of mental health beds.

However, since the review was conducted last year, University Hospitals Sussex Foundation Trust says it has taken strides to improve flow. 

“We felt we needed to invest time and effort, paradoxically, outside the four walls of the hospital,” said Mae Sullivan, operational flow manager for the trust’s eastern medicines division.

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Source: HSJ, 17 March 2025

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Hospital to send hundreds of births elsewhere

The trust at the centre of a maternity scandal is trying to reduce the number of births at its main maternity units by 650 a year following a highly critical Care Quality Commission (CQC) visit.

East Kent Hospitals University Foundation Trust is looking at ways to reduce pressure on staff at the William Harvey Hospital in Ashford, including stopping bookings from women who are “out of area”. The unit currently has around 3,600 births a year, of which 200 are out-of-area bookings. The trust is also seeking to send more births to its other site, in Thanet.

It comes after the CQC used enforcement powers to order immediate improvements at the unit, following a visit in January, when it had “significant concerns about the ongoing wider risk of harm to patients”. 

Earlier this year, the trust’s new chief executive, Tracey Fletcher, held what board papers describe as an “emotional” meeting with 135 midwives, other staff and senior Royal College of Midwives representatives. She was told by staff that the service at the WHH was not felt to be safe due to a lack of substantive staff, high acuity of patients and the level of activity.

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Source: HSJ, 28 April 2023

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Hospital threatened with loss of junior doctors over safety concerns

A struggling trust has been warned by regulators that it could see its junior doctors removed, after concerns about clinical supervision and safety at a hospital whose A&E closes at night.

NHS England inspectors who visited Cheltenham General Hospital found emergency patients – including potential surgical patients – became the responsibility of the overnight medical team when its accident and emergency closed in the evening.

One night, 26 patients had been handed across, the inspectors were told, and some patients were felt to be inappropriate for medical referral. A surgical registrar could be telephoned at Gloucester Royal Hospital about surgical patients.

They were told that although there were no incidents of serious harm, there had been many “near misses” and juniors felt “unsafe and unsupported in terms of consultant clinical supervision, overall clinical/nursing staffing support or logistically in managing patients in this setting or arranging transfers”.

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Source: HSJ, 7 July 2023

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Hospital takes tough stance against patient violence

Death threats, physical abuse and racist slurs aimed at NHS workers has prompted one hospital to make it easier for staff to “red card” violent and abusive patients.

Aggressive patients or visitors could be banned from Barking, Havering and Redbridge University Hospitals NHS Trust for up to 12 months.

The trust has also started using a series of body cameras in a bid to curb violence and aggression towards health workers after cases at the East London/Essex trust have doubled in the last three years.

Trust workers have been punched, subject to racist slurs – including being told to “go back to the jungle” – and had their teeth broken by violent patients.

As a result, hospital bosses have launched a new campaign – ‘No Abuse, No Excuse’ – to reduce violence and aggression towards staff, which includes:

  • The introduction of 60 body cameras for staff in areas such as A&E and frailty units.
  • Easier policies to ban patients or visitors, with bans which can last for up to a year.
  • An increased visibility of security staff.
  • A “de-escalation” training course for trust employees.

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Source: Medscape, 26 February 2024

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Hospital surgical teams with more women improve patient recovery, study finds

Hospital surgical teams that include more female doctors improve patient outcomes, lower the risk of serious complications and could in turn reduce healthcare costs, according to the world’s largest study of its kind.

Studies show diversity is important in business, finance, tech, education and the law not only for equity but for output. However, evidence supporting the value of sex diversity in healthcare teams has been limited.

Now researchers who examined more than 700,000 operations spanning a decade report that hospitals with more women in their surgical teams provide better outcomes for patients. The findings were published in the British Journal of Surgery.

“Care in hospitals with greater anaesthesia-surgery team sex diversity was associated with better postoperative outcomes,” the researchers concluded. “The main takeaway for clinical practice and health policy is that increasing operating room teams’ sex diversity is not a question of representation or social justice, but an important part of optimising performance."

Dr Julie Hallet, the lead author of the study at the University of Toronto, said, “These results are the start of an important shift in understanding the way in which diversity contributes to quality in perioperative care.”

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Source: Guardian, 15 May 2024

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Hospital stops admitting patients following covid spike

Weston General Hospital has stopped admitting new patients – including to the accident and emergency department – following a spike in coronavirus cases. The hospital announced yesterday it was taking this “precautionary measure”  due to the “high number of coronavirus patients” on site.

MP for Weston-super-Mare John Penrose tweeted that he had spoken to local health chiefs and a deep clean is being carried out at the hospital “following a spike in infections”. He added that a temporary A&E has been set up outside the hospital, while inpatients will be re-directed to hospitals in Taunton or Bristol.

Out of hours GP practices, pharmacies and walk-in services at the minor treatment unit in Clevedon and Yate have also been given as alternative options for patients seeking medical treatment.

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Source: HSJ, 25 May 2020

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Hospital stayed silence as surgeon 'harvested body parts'

For more than two decades, Derek McMinn harvested the bones of his patients, according to a leaked report – but it was not until last year that anyone challenged the renowned surgeon.

The full scale of his alleged collection was apparently kept from the care regulator until just days ago, and thousands of those who went under his knife for hip and knee treatment still have no idea that their joints may have been collected in a pot in the operating theatre, and stored in the 67-year-old’s office or home.

Clinicians and managers at the BMI Edgbaston Hospital, where McMinn carried out the majority of his operations, actively took part in the collection of bones and – even after alarms were raised – the hospital did not immediately act to stop the tissue being taken away, according to a leaked internal report seen by The Independent.

An investigation found operating theatre staff at the private hospital left dozens of pots containing joints removed from patients femurs during hip surgery in a storage area, in some cases for months. According to the report, there had been warnings about their responsibilities under the Human Tissue Act when an earlier audit between 2010 and 2015 identified the storage of femoral heads, the joints removed in the procedure.  

The internal report said there was no evidence McMinn had carried out any research or had been approved for any research work – required by the Human Tissue Authority to legally store samples. It said one member of staff told investigators the samples were being collected for research on McMinn’s retirement.

Although the Care Quality Commission knew about claims that a small number of bones being kept by McMinn, it is understood that the regulator received a copy of the BMI Healthcare investigation report only last Friday, after The Independent had made initial inquiries about the case. That report suggests a minimum of 5,224 samples had been taken by McMinn.

The regulator confirmed to The Independent it had not been aware of the extent of McMinn’s supposed actions.

An insider at BMI Healthcare accused the company of “covering up”, adding: “Quite senior staff at the hospital went along with it and just handed the pots over to his staff when they came to collect them.”

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Source: The Independent, 30 September 2020

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Hospital staff told to ‘only change linen if essential’ amid supply shortages

The NHS is facing a shortage of laundry supplies that could have a “knock-on effect” on bed numbers, an industry leader has warned, with staff at one trust recently told to “only change linen if essential”.

The Textile Services Association (TSA), which represents multiple laundry businesses that provide supplies to the NHS, said Brexit and the pandemic had caused large labour shortages which were making it difficult to meet demand across the healthcare and hospitality sectors.

David Stevens, chief executive of TSA, told The Independent that “shortages of linen and laundry will have a knock-on effect on the provision of beds in trusts”, adding that the “bounce back post-Covid created a high demand for product and the supply chain was not able to deliver”.

In an internal email circulated to staff last month at Oxford University Hospitals NHS Trust, one senior official said both the trust and the NHS were “currently experiencing severe issues with the supply chain for linen deliveries,” adding that the situation is “currently very serious”.

The email reads: “Please follow good Infection Prevention and Control practices, but only change linen if essential. For example, always change bed linen between patients, but do not change inpatients’ bed linen daily if at all possible.”

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Source: The Independent, 30 June 2022

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Hospital staff likely to get covid vaccine first

Hospital trusts have been put on notice that the challenging storage requirements of the first covid vaccines are likely to mean the vaccination of their staff will have to form the vanguard of the planned roll-out next month due.

HSJ reported last week that healthcare staff would share priority with “care home residents and staff” in the vaccine roll-out. 

However, a letter sent to trust chief executives by NHS England seeks to clarify the situation by stressing that “different vaccines are likely to be better suited to different settings because the vaccines are likely to have different storage, reconstitution and administration requirements”. 

“Given what we currently know about the first expected vaccine, the imperative is that NHS trusts are ready to start vaccinating from the beginning of December.” 

Trusts are one of several components of the vaccination programme that includes primary care-run sites, mass vaccination centres, and “roving” visits to those who need them. Local systems and regional teams will decide “the most appropriate combination of models required to deliver the vaccine to their local populations based on local needs” the letter says. However, during the early stages of the roll-out this is likely to be dictated by the vaccine types that become available.

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Source: HSJ, 25 November 2020

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Hospital staff failed man living with HIV by unnecessarily delaying surgery

A hospital that unnecessarily delayed a man’s surgery at the last minute because he had HIV failed in their care, according to England’s Health Ombudsman.

The 48-year-old from Walsall, who does not want to be named, had been due to have prostate surgery at Walsall Manor Hospital on 10 March 2020.

His surgery was scheduled to be the first of the morning. As he was about to enter the operating room, he was told that due to his HIV status his surgery would now be moved to last on the operating list that afternoon.

The hospital claimed that this was due to the level of cleaning and infection control that would need to take place following his surgery to reduce the risk to others.

However, the Parliamentary and Health Service Ombudsman (PHSO), found that Walsall Healthcare NHS Trust acted inappropriately and failed the man.

This is because the universal precautions that apply to all patients having surgery are enough to protect and prevent infections from spreading among patients and staff. Therefore, no additional cleaning should have been necessary.  

The policy of placing a patient at the end of an operating list usually relates to patients with a high-risk bacterial infection. It should not be applied to a person who has HIV and is receiving treatment.

The Ombudsman also found that although the Trust had made some changes since this happened, they had not done enough to make sure the same mistake did not reoccur.

PHSO recommended the Trust apologise to the man and create an action plan to stop this happening again. The Trust has complied with these recommendations.

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Source: Parliamentary and Health Service Ombudsman, 1 December 2023

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Hospital staff complain to regulator about bullying, harassment and racism

Hospital staff at the Royal London Hospital have complained about bullying, harassment, racism and sexism during an inspection by the care watchdog.

After conducting a review of the imagining department at the Royal London Hospital and Whipps Cross Hospital, there are now concerns over the culture of the service and conflict between staff.

With both hospitals being overseen by Barts Health NHS Trust, chief executive Dame Alwen Williams has said “We will be ensuring staff have the resources to sustain improvements we need to make and there is appropriate oversight and processes in place for escalating wellbeing issues. We have a responsibility to listen to what our hard working team are saying, and respond appropriately and sensitively." 

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Source: The Independent, 30 July 2021

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Hospital staff charged over patient mistreatment

Five healthcare staff have been charged with criminal offences as part of a major investigation into the ill-treatment of hospital patients.

Concerns had been raised over the welfare of some patients on the stroke unit at Blackpool Victoria Hospital.

Three nurses and two healthcare assistants will appear at court for offences including unlawful sedation of patients and theft, police said.

The charges relate to a period between August 2014 and November 2018.

Those charged are Catherine Hudson, 52, of Coriander Close, Blackpool; Charlotte Wilmot, 47, of Bowland Crescent, Blackpool; Matthew Pover, 39, of Bearwood Road in Smethwick; Victoria Holehouse, 31, of Riverside Drive, Hambleton, and Marek Grabianowski, 45, of Montpelier Avenue, Bispham.

They face charges including ill-treatment or wilful neglect, encouraging a nurse to sedate a patient, theft, supplying drugs and perverting the course of justice.

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Source: BBC News, 6 May 2022

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Hospital staff broke man’s arm while restraining him and then left him ‘untreated for 24 hours’

A private healthcare provider has agreed to pay damages to a patient with learning disabilities after staff broke his arm, The Independent can reveal.

Cygnet Health Care, one of the largest providers of mental health inpatient care in the UK, has settled a claim with the former patient of a hospital it now owns.

Jamie Newcombe, a 29-year-old young autistic man with learning disabilities, took action against the healthcare giant after he allegedly suffered “significant physical and psychological harm” at Bostall House assessment and treatment unit in London.

He claimed he had been “violently restrained by staff and pushed out into the hospital garden” in 2014, at the age of 19. At the time, the hospital was owned by another private company The Danshell Group.

As a result of this restraint, he says he sustained a fracture in his right arm and staff allegedly left his injuries untreated for 24 hours.

He said he suffered further physical assaults in December 2014 and January 2015, that he was subjected to “degrading treatment” such as personal care being ignored, and was denied access to hot running water for three weeks.

Following his experience, his mother Julie Newcombe launched an autism and learning disability rights campaign group, called Rightful Lives, which now has hundreds of members.

She told The Independent: “What happened to Jamie was horrific and is still happening to so many others 10 years later. I co-founded Rightful Lives 6 years ago to shine a light on the human rights of autistic people and people with learning disabilities. Yet the fact remains that if Jamie were to go into one of these units again, the same things could happen. That is our fear.”

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Source: The Independent, 2 October 2024

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Hospital seclusion: ‘I’ve been treated like an animal’

Evidence of abusive and inappropriate treatment of vulnerable patients at a secure mental health hospital has been uncovered by BBC Panorama. One young woman was locked in a seclusion room for 17 days, was then allowed out for a day, only to be hauled back in for another 10 days.

Harley was sitting on the floor wearing pink pyjamas, with her hair tied up in neat braids, when hospital staff piled through the door one after another.

Two male nurses grabbed her by the arms.

"You're not giving me a chance to work with you," she screamed.

"Let me get up."

But it was no use. Managers at the secure mental health hospital had decided there would be - in their words - "no negotiation".

As she struggled, other nurses and support staff joined in. With her arms, legs and head restrained, she was pinned to the floor, face down.

Secret filming by BBC Panorama captured the moment the 23-year-old was forced into a seclusion room at the Edenfield Centre in Prestwich, near Manchester. The hidden camera had already recorded staff justifying their actions and agreeing they would not try to reason with her this time.

Panorama's undercover reporter was told that Harley had previously been aggressive towards staff - but, this time they said she was being isolated for screaming and being verbally abusive.

Seclusion should only be used when it is of "immediate necessity" to contain behaviour that is likely to harm others, with patients locked away for the shortest time necessary, guidelines say.

England's independent healthcare regulator, the Care Quality Commission, says it should only be used in extreme cases - while the government has said the use of restrictive methods in hospitals should be reduced. But research by BBC News has found the numbers are steadily increasing.

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Source: BBC News, 28 September 2022

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Hospital robots are helping combat a wave of nurse burnout in the US

Since February, the nurses at Mary Washington Hospital in Fredericksburg, Virginia, USA, have had an extra assistant on their shifts: Moxi, a 4-foot-tall robot that ferries medication, supplies, lab samples, and personal items through the halls, from floor to floor. After two years of battling Covid-19 and related burnout, nurses say it’s been a welcome relief.

“There's two levels of burnout: There's ‘we’re short this weekend’ burnout, and then there's pandemic burnout, which our care teams are experiencing right now,” says Abigail Hamilton, a former ICU and emergency room nurse that manages nursing staff support programmes at the hospital.

Moxi is one of several specialised delivery robots that has been developed in recent years to ease the strain on healthcare workers. Even before the pandemic, nearly half of US nurses felt that their workplace lacked adequate work–life balance. The emotional toll of seeing patients die and colleagues infected at such a large scale—and fear of bringing Covid-19 home to family—has made feelings of burnout worse. Studies also found that burnout can have long-term consequences for nurses, including cognitive impacts and insomnia years after the exhaustion of their early careers. The world already had a nurse shortage going into the pandemic; now, roughly two out of three nurses in the US say they have considered leaving the profession, according to a survey from the National Nurses United union.

Moxi has spent the pandemic rolling down the halls of some of the largest hospitals in the country, carrying objects like a smartphone or beloved teddy bear to patients in emergency rooms when Covid-19 protocol kept family members from bedsides.

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Source: Wired, 19 April 2022

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Hospital reports rise in pregnant Covid patients

A hospital has reported a "significant" increase in the number of pregnant women being treated for coronavirus.

New Cross Hospital, in Wolverhampton, said part of its maternity ward had been sectioned off for Covid patients. 

Nationally, the proportion of pregnant women in intensive care has almost doubled since the first wave.

The Royal College of Obstetricians and Gynaecologists said pregnant women were at no greater risk of being infected with Covid than the general public.

The Royal Wolverhampton NHS Trust's chief executive said the cause of the increase in the city was unclear.

"We're seeing a lot more pregnant women now suffering with Covid and some of them have been very, very ill," Prof David Loughton said at a regional coronavirus briefing on Friday."We have had some deaths," he continued, "so that is really sad".

An intensive care audit has shown the percentage of pregnant women aged 16-49 has almost doubled in the second wave compared to the first wave of the pandemic. Up until the end of August, 29 women in that age bracket who had been admitted with coronavirus were pregnant, compared to 103 from September to the end of January.

Recently, the intensive care unit treated two Covid-positive pregnant patients and almost 200 expectant mothers tested positive in the city during the past quarter.

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Source: BBC News, 2 February 2021

 

 
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Hospital removed 1,000 patients from waiting list 'retrospectively'

A hospital trust has removed more than 1,000 patients from its waiting list by retrospectively applying referral criteria, which local GPs have said is disruptive and unsafe.

In June, University Hospitals of North Midlands Trust switched its criteria for non-obstetric ultrasound back to a method it had previously used until it was widened in September last year.

The trust, which runs Royal Stoke University Hospital and Stafford County Hospital, recently announced its ultrasound list had dropped from more than 15,500 in June to 10,563 in October, gaining local media coverage for a “significant” performance improvement.

North Staffordshire local medical committee (LMC) told HSJ the trust was “misleading” the public as a significant amount of the cut was due to the retrospective change to criteria, which it also said was disruptive for patients and compromised their safety. GPs say some of the patients had already been waiting six months.

One local GP who spoke to HSJ anonymously said some of those delisted would need to be re-referred for an ultrasound or alternative test. They cited a referral for abdominal pain with suspected gallstones which was made in January 2025, then rejected in August. For many people, suspected gallstones are not a serious problem. However, complications can be serious and sometimes life-threatening, if it leads to a blocked bile duct.

The GP said: “It’s all good for the trust to say that there is no risk, but if we don’t know [who has been removed], how would we mitigate that?” The GP also questioned: “If we miss something, who is actually responsible?”

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Source: HSJ, 17 October 2025

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Hospital recorded 50 times birth gas legal limit

Nitrous oxide levels on Watford General Hospital's maternity suite far exceeded legal limits during peak periods, a BBC investigation has found.

In February 2022, air monitoring showed levels of almost 5,000 parts per million (ppm) - 50 times what is safe.

The hospital's trust said it had since installed machines to remove the gas.

It was one of a number of nitrous oxide incidents reported by NHS trusts to the Health and Safety Executive (HSE), Freedom of Information data has shown.

The HSE disclosed the details following a request for its notifications under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

There were 11 notifications to the HSE between August 2018 and December 2022 from seven NHS trusts and one private hospital in relation to nitrous oxide - almost all relating to maternity units.

Monitoring has led to a string of NHS trusts suspending the use of Entonox - a mixture of nitrous oxide and air used to assist women in labour with pain relief.

NHS bosses acknowledge there is "limited research on the occupational exposure to Entonox, and the long-term health risks this may pose", though at least one expert has played down the risk.

But staff working in maternity units face uncertainty due to prolonged periods of time spent in affected areas, with particular concerns over Vitamin B deficiency due to exposure.

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Source: BBC News, 13 February 2023

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Hospital reconfigurations ‘negatively impacting’ patients, warn government advisers

Clinical service reconfigurations are mostly driven by the “poor condition of [the] NHS estate” and a lack of staff rather than a desire to “improve clinical outcomes”, advisers to the Department of Health and Social Care have said.

The Independent Reconfiguration Panel, which advises ministers on large-scale changes to clinical services, today published its evidence to the Darzi review of NHS performance.

IRP chair Sir Norman Williams said the panel had “seen a shift to centralisation within the NHS justified as a clinical necessity and a means of resolving staffing issues, even when it presents a risk to access for patients and may negatively impact the patient experience, often with regards to travel, transport, and ambulance conveyance times.”

The former Royal College of Surgeons president said the NHS had got better at involving patients and use “clinical senates”, but warned: “In recent times, the IRP has observed that rather than service change being driven by an ambition to improve clinical outcomes, the trend has often been for reconfigurations to emerge from operational necessity such as a lack of NHS staffing to sustain services, as well as the poor condition of NHS estates, an issue particularly seen with community hospitals.”

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Source: HSJ, 3 September 2024

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Hospital ratings often depend more on nice rooms than on health care

A study of 50,000 patients throughout the United States showed that those who were the most satisfied with their care (the top quartile) were 26% more likely to be dead six months later than patients who gave lower ratings to their care.

The study, “The Cost of Satisfaction,” appeared in JAMA Internal Medicine.

The researchers looked at Centers for Medicare and Medicaid Services (CMS) hospital data and patient surveys at more than 3,000 US hospitals over three years. The hospitals where fewer patients died had only a 2% point edge in patient satisfaction over the others.

Cristobal Young, associate professor of sociology at Cornell University and lead author of the study, calls it “the halo effect of hospitality.” Young found that what mattered most to patients in ratings were the compassion of nurses and amenities like good food and quiet rooms. It’s why hospital managers are being recruited from the service industry and we’re seeing greeters in the lobby and premium TV channels in rooms, he says.

Patients tend to value what they see and understand, but that can be limited, Young continues. They give hospitals good cleanliness ratings when they observe waste baskets are emptied and sheets are changed. “They can’t see a virus or tell you how clean the room is in ways that matter,” he says.

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Source: 4 July 2020, Washington Post

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Hospital rated ‘inadequate’ over leadership and infection failures

A hospital run by the largest trust in the East of England has been downgraded to “inadequate” by the care regulator, which found ”disconnected” leaders and “bowls of bodily fluids left for multiple hours”.

The Care Quality Commission is also taking enforcement action against Basildon Hospital, run by Mid and South Essex Foundation Trust, due to problems found in its emergency department.

It said conditions had been placed on its registration – a step up from a warning notice served to the service earlier this year.

The CQC rated urgent and emergency care services as “inadequate”, in what was the first inspection of the department since MSEFT was created in a merger five years ago. Medical care services, including older people’s care, were also inspected, and were again rated “requires improvement”.

The overall hospital rating dropped to the lowest score from “requires improvement” following the visits between December last year and March this year,.

The CQC said emergency department, hospital and trust leaders were “disconnected from each other”, which created a “culture of distrust and low morale” among staff. 

Hazel Roberts, its deputy director of operations in the East of England, said inspectors also found “serious overcrowding” in the emergency department, which was risking patient safety. 

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Source: HSJ, 15 October 2025

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