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Epilepsy drug that harms babies may damage their children too

An epilepsy drug that caused disabilities in thousands of babies after being prescribed to pregnant women could be more dangerous than previously thought.

Sodium valproate could be triggering genetic changes that mean disabilities are being passed on to second and even third generations, according to the UK’s medicines regulator.

The Medicines and Healthcare Products Regulatory Agency (MHRA) has also raised concerns that the drug can affect male sperm and fertility, and may be linked to miscarriages and stillbirths.

Ministers are already under pressure after it emerged in April that valproate was still being prescribed to women without the legally required warnings. Six babies a month are being born after having been exposed to the drug, the MHRA has said. It can cause deformities, autism and learning disabilities.

Cat Smith, the Labour chairwoman of the all-party parliamentary group on sodium valproate, said: “This transgenerational risk is very concerning. There have been rumours that this was a possibility, but I had never heard it was accepted until last week by the MHRA."

“The harm from sodium valproate was caused by successive failures of regulators and governments, and this news means it could be an order of magnitude worse than we first thought. It underlines the need for the Treasury to step up to their responsibilities around financial redress to those families.”

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Source: Sunday Times, 19 June 2022

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MHRA joins international partnerships to set global standards for medicines and medical devices regulation

The UK is set to play a greater international role in making sure medicines and medical devices are regulated safely and efficiently worldwide, the Medicines and Healthcare products Regulatory Agency (MHRA) announced after being accepted as a full member of three international work-sharing partnerships.

Two of these, the International Medical Device Regulatory Forum (IMDRF) and the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) are focused on improving the harmonisation and convergence of medicines and medical devices regulation globally.

Through these partnerships, the MHRA will share expertise with other leading organisations, support the development of regulatory guidelines and drive greater harmonisation of regulation around the world. This will help deliver timely access to innovative medical products not just in the UK but globally.

The MHRA has also been accepted as a member of the US-based Medical Devices Innovation Consortium (MDIC). This public-private partnership brings together representatives of regulatory bodies, industry, non-profits, and patient organisations from different countries to improve the processes for development, assessment, and review of new medical technologies. This enables transformational medical technology to get to the people who need it sooner, by shortening the path from innovation to safety to access.

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Source: Gov.uk, 16 June 2022

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Man paralysed from neck down ‘not eligible’ for night-time care

A quadriplegic man was told his care funding would be revoked, after NHS officials deemed him not disabled enough to qualify for support.

Simon Shaw, 54, has received 24-hour care since he was left paralysed from the neck down after a car accident in 1984.

He relies on carers at night to help him with everything from turning in bed to having a drink of water. They also intervene with medical aid if he develops life-threatening complications related to his paralysis, which could happen at any time, without warning.

But a recent NHS assessment controversially ruled Shaw’s health needs were not severe enough to warrant full-time medical care. Local health authority officials told him he did not meet eligibility criteria and his NHS funding would be stopped from 20 June.

Shaw, from Clapham, south London, said that meant there was no money for his night-time care and he would be left unsupported from 8pm to 8am for the first time in nearly four decades.

“It’s frightening, to be honest,” Shaw said. “I don’t know what I’m going to do when they take my care away.

“I don’t cease to exist after 8pm. I still need to get into bed, have a drink of water and use the toilet – and I can’t do any of it on my own.

“There are a lot of things that can go wrong with my health and when they do, they usually need urgent attention. If there’s no one there, to be frank… it could mean death.”

Mandy Jamieson, a caseworker for the Spinal Injuries Association, said: “We have noticed an increase in patients with severe disabilities being turned down for funding in recent years, particularly since the introduction of assessments via video call since the pandemic.

“But I feel particularly in Simon’s case the decision that has been made is wrong. He has so many health needs that I find it incredible that they turned him down.”

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Source: The Guardian, 19 June 2022

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Coeliac patient died after being fed Weetabix in hospital, inquiry hears

An 80-year-old woman with coeliac disease died within days of being fed Weetabix in hospital, an inquest has heard.

Hazel Pearson, from Connah’s Quay in Flintshire, was being treated at Wrexham Maelor hospital and died four days later on 30 November from aspiration pneumonia. Although her condition was recorded on her admission documents, there was no sign beside her bed to alert healthcare assistants to her dietary requirements.

Coeliac disease is a condition where the immune system attacks the body’s own tissues after consuming gluten, a type of protein found in wheat, rye and barley, causing damage to the small intestine.

The hospital’s action plan to avoid similar fatal incidents lacked detail and had “narrow vision”, the coroner said.

The hospital’s matron, Jackie Evans, told the inquest that changes, including placing signs above the beds of patients with special dietary requirements, had been implemented since Pearson’s death. But Sutherland raised concerns that the hospital had yet to carry out a formal investigation into what went wrong.

She said: “The action plan lacks detail. What has happened locally is commendable, but it lacks detail and it has narrow vision.” She added that the plan that had been put in place was “amateurish with no strategic vision”.

The assistant coroner said she would be unable to make a decision on a prevention of future deaths report until the Betsi Cadwaladr University Health Board (BCUHB) provided a witness to answer further questions about changes.

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Source: The Guardian, 17 June 2022

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'Urgent' changes needed for child disability care

The mothers of two teenage boys who died after failures in their care have called on the government to make "urgent improvements" to how children with disabilities are assessed.

Sammy Alban-Stanley, 13, and 14-year-old Oskar Nash both died in 2020. Inquests for both boys recorded they had received inadequate care from local authorities and mental health services.

The calls were made in an open letter to the secretaries of state for health and social care, and education.

Patricia Alban and Natalia Nash asked Sajid Javid and Nadim Zahawi to make fundamental changes to several care areas to prevent future deaths.

The pair said they both experienced problems with support for disabled children and families.

Services lacked understanding of neurological conditions like autism, they said.

The pair also pointed to a lack of access to children and adolescent mental health services (CAMHS), and failure to assess or review the severity of a child's developing needs.

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Source: BBC News, 16 June 2022

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Sweden: surgeon convicted of bodily harm over synthetic trachea transplant

A Swedish court has found an Italian surgeon, once hailed for pioneering windpipe surgery, guilty of causing bodily harm to a patient, but cleared him of assault charges.

Paolo Macchiarini won praise in 2011 after claiming to have performed the world’s first synthetic trachea transplants using stem cells while he was a surgeon at Stockholm’s Karolinska University hospital. The experimental procedure was hailed as a breakthrough in regenerative medicine.

But allegations soon emerged that the procedure had been carried out on at least one person who had not been critically ill at the time of the surgery.

During the May trial, held in the Solna district court, prosecutors argued that the surgeries on three patients in Sweden constituted assault, or alternatively bodily harm due to negligence, as Macchiarini disregarded “science and proven experience”.

The district court agreed with the prosecutors, but cleared Macchiarini on two counts as the patients’ health was in such a dire state. “Given the patients’ condition, the district court finds that the procedures on the first two patients were justifiable,” it said in a statement.

However, in the third patient, the court found him guilty of "causing bodily harm". 

"At the time of the third procedure, the experience from the first procedures was such that the surgeon should have refrained from letting yet another patient go through the operation", the court said.

Macchiarini was handed a suspended sentence.

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Source: The Guardian, 16 June 2022

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Almost 100,000 facing excessive wait for serious cardiac care in England

Almost 100,000 people with serious heart problems, including some “living on borrowed time”, are enduring long waits for potentially life-saving NHS care because hospitals are so busy.

Some of them are in such poor health they will have a heart attack and die as a consequence of facing such “dangerous” long delays, the British Heart Foundation has warned.

The number of patients in England being forced to wait more than the supposed maximum 18 weeks for cardiac treatment has trebled since Covid-19 struck, from 32,186 in February 2020 to an unprecedented 96,321, a BHF analysis of published NHS England data shows.

They are waiting for procedures such as having a stent or balloon inserted to reopen a blocked artery, a pacemaker or implantable defibrillator fitted, or open heart surgery, including bypasses or valve replacement operations. Others urgently need to have an echocardiogram, CT or MRI scan to help doctors decide on treatment.

Dr Sonya Babu-Narayan, a consultant cardiologist who is also the BHF’s associate medical director, said: “Cardiac care can’t wait. Without timely treatment, heart patients may be living on borrowed time.”

“Tens of thousands of people feel in limbo, waiting many months or even years for cardiac surgery, invasive heart procedures or important diagnostic tests. During this time they could quite quickly become much sicker, and tragically some could even die before they can receive the heart care they so desperately need,” she added.

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Source: The Guardian, 16 June 2022

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England appoints ambassador to shake up women's health

England's first women's health ambassador is calling for "one-stop shops" where women can sort out their health needs.

Dame Lesley Regan, also a practising doctor, wants to make it easier for women and girls to access care such as contraception and smear tests in the community.

Her new role aims to close the "gender health gap". She will also support the upcoming government-led women's-health strategy.

"At the moment, we waste a lot of resource in telling girls and women that they cannot have things," she told BBC News.

"So you might go off to your doctor or gynaecologist or heart specialist and get told, well, you cannot have a smear here, even if it is due, or you need to go somewhere else for this, that and the other.

"We should make it very, very easy for people to access this out in the community - why do you need to go to a secondary or tertiary facility for things that are very easy to provide?"

Instead, she wants health hubs where women could "go for half a day and get all these things sorted out" and then get on with their lives.

"A one-stop shop is what I want for myself and what I want for my daughters and I'm sure it is what every other girl and woman wants and what every man and boy wants for the women in their lives, to be looked after that way," Dame Lesley said.

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Source: BBC News, 17 June 2022

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Over half of ethnic minority NHS leaders consider quitting due to racism

Just over half of senior ethnic minority leaders have considered leaving the NHS due to experiencing workplace racism a survey suggests.

The survey was carried out by the NHS Confederation’s BME Leadership Network and its 123 respondents included chief executives, directors and senior managers.

Responses were collected from network members online before three roundtables were held with senior ethnic minority leaders to understand their experiences and the challenges they have faced in relation to discrimination.

The survey found:

  • 51% of respondents said they had considered leaving the NHS in the past three years because of their experience of racist treatment while working.
  • More than 20% said they had experienced verbal abuse or abusive behaviour targeting racial, national or cultural heritage five times or more in the last three years.
  • 69% had experienced this behaviour from other leaders or managers within their organisation at least once in the same timeframe.
  • 57% had experienced it from leaders or managers in another organisation at least once over the same period.

Joan Saddler, NHS Confederation’s director of equality and partnerships, said the NHS was at risk of losing “committed, highly skilled and motivated talent to institutional racism and discrimination”.

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Source: HSJ, 17 June 2022

You may also be interested in reading: BMA: Racism in medicine

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Rail strikes ‘will kill people’, warns NHS leader

Next week’s rail strikes will ’probably end up killing people’ as they will prevent staff working for already struggling ambulance trusts from getting to work, a senior NHS leader has told HSJ.

Both London Ambulance Service Trust and South Central Ambulance Service Foundation Trust have moved to ”Reap 4”, This is the highest level of alert, meaning they are under extreme pressure. 

Ambulance trusts are already experiencing high demand amid soaring temperatures and continuing problems with lengthy handovers at the accident and emergency departments. Fears are now growing that next week’s rail strikes will push services to breaking point as many ambulance staff travel to work by public transport.

The three days of rail strikes – on Tuesday, Thursday and Saturday next week – will see many lines with very limited services. Tube services in London will also be hit by a strike on Tuesday and the London Overground and some tube lines will be affected on rail strike days. 

A senior leader closely involved in southern England’s emergency and urgent care services told HSJ: “Next week’s rail strikes will probably end up killing people because they’ll prevent ambulance trust staff getting to work.”

Other ambulance trusts are understood to be monitoring the situation closely. Trusts in REAP 4 (REAP stands for resource escalation action plan) normally take a series of measures including diverting more staff to frontline duties, asking some patients to make their own way to hospital and concentrating on reaching the most serious patients.

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Source: HSJ, 16 June 2022

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Doctors warn against over-medicalising menopause after UK criticism

Doctors have hit back at critics saying they are failing menopausal women, and said that treating menopause as a hormone deficiency that requires medical treatment could fuel negative expectations and make matters worse.

Writing in the British Medical Journal they said there was an urgent need for a more realistic and balanced narrative which actively challenges the idea that menopause is synonymous with an inevitable decline in women’s health and wellbeing, and called for continued efforts to improve awareness about the symptoms and how to deal with them.

“Menopause is a natural event for half of humankind. While media attention in the UK may give the impression that growing numbers of women are struggling to cope with menopausal symptoms and are seeking hormonal treatment, there is no universal experience and most women prefer not to take medication unless their symptoms are severe,” wrote Martha Hickey, a professor of obstetrics and gynaecology at the University of Melbourne, Australia, and colleagues.

They added that over-medicalisation of the menopause risked collapsing this wide range of experiences into a narrowly defined disease requiring treatment.

“It tends to emphasise the negative aspects of menopause and, while effective treatments are important for those with troublesome symptoms, medicalisation may increase women’s anxiety and apprehension about this natural life stage.”

Women’s experiences of menopause were strongly influenced by personal, family and social factors, they said. For instance, a recent review found that negative attitudes and expectations before menopause predicted the likelihood of women experiencing distressing symptoms.

“Changing the narrative by normalising menopause and emphasising positive or neutral aspects such as freedom from menstruation, pregnancy and contraception, together with information about managing troublesome symptoms might empower women to manage menopause with greater confidence,” Hickey said.

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Source: The Guardian, 15 June 2022

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Time for change: The College of Medicine launches its Beyond Pills campaign

On Thursday 16 June, The College of Medicine launched its Beyond Pills campaign – calling for Government intervention on over-prescribing – at the Integrated and Personalised Medicine Congress 2022.

Around 1.1 billion medicines are currently prescribed unnecessarily. Supported by eminent voices in both the Government and our healthcare system, the Beyond Pills campaign calls for the Government to immediately address the nation’s unsustainable prescription service through re-prescribing and social prescribing.

Speaking at the Integrative and Personalised Medicine Congress 2022, The College of Medicine Chair Dr Michael Dixon said: “Medicine, as we know it, is no longer affordable or sustainable. Nor is it able to curb the increase in obesity, mental health problems and most long-term diseases.

“A new medical mindset is needed, which goes to the heart of true health care. The advantages and possibilities of social prescription are limitless.

“An adjustment to the system now will provide a long-term, sustainable solution for the NHS to meet the ever-increasing demand for funding and healthcare professionals.”

The Campaign was established in the wake of the Chief Pharmaceutical Officer’s National Overprescribing Review published in September 2021.

The Beyond Pills Campaign aims to reduce drug prescription, expand the number of social prescribing link workers, save crucial funds, and provide support to individuals and local communities hampered by health inequalities. To achieve these goals, it has today launched a campaign that includes six specific actions that need to be taken:

  • Improving medical and healthcare training. Social prescribing and a psychosocial approach to treatment needs to be embedded throughout the curriculum
  • Addressing financial incentives within the NHS. Financial incentives in the system should centre around community health. For those patients already on a cocktail of pills, medication reviews and appropriate deprescribing need to be emphasised
  • Increasing the number of social prescribing link workers. Primary Care
  • Networks need to employ more link workers to enable access to social prescribing for everyone who could benefit
  • Increasing support for the voluntary sector. Government departments need to fund and support voluntary initiatives that encourage healthy communities
  • Empowering individuals and communities. Informing individuals about social prescribing and collaborating with volunteers involved in social prescription and local health creation and showcasing benefits
  • Further systematic research. Mobilising the research community to develop a fully-fledged programme review into topics including the therapeutic efficacy of social prescribing

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Source: College of Medicine, 16 June 2022

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Hospitals have become less safe during the pandemic. So why does the US government want to suppress hospital safety data?

There’s little question that US hospitals—up against COVID, patient surges, and labor and supply shortages—have become less safe for patients during the pandemic, as preventable events and complications have become more common.

Leaders with the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) said as much, earlier this year, in an article for the New England Journal of Medicine: “Many indicators make it clear that health care safety has declined,” they wrote, noting, “the fact that the pandemic degraded patient safety so quickly and severely suggests that our health care system lacks a sufficiently resilient safety culture and infrastructure.”

Despite such frank assessments, CMS is now at odds with public safety advocates about whether to make some of the hospital-specific data behind those trends publicly available. 

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Source: Fortune, 14 June 2022

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Bristol NHS 'causing harm' to patients by withholding thyroid drug

Bristol's NHS commissioning group is one of many across the country which is "causing harm" to people with thyroid problems by limiting the provision of a drug, a new report says.

Analysis from the Thyroid Trust says that 58 per cent of NHS Clinical Commissioning Groups in England are withdrawing, refusing or reducing prescriptions of T3 for people with underactive thyroids - against national guidance. People who have thyroid problems can suffer from depression, crippling fatigue, weight gain and muscle weakness, which can be alleviated by the drug.

But the Bristol, North Somerset and South Gloucestershire CCG does not permit prescribing the drug for new patients, according to the report. One Westcountry woman told the Express that she had her T3 prescription withdrawn, which caused her significant problems.

Former police officer Carole Morgan-Anstee, 62, told the website she went through "hell" after her T3 was stopped. The Somerset woman was prescribed the drug after suffering symptoms including chronic fatigue and hair loss for 15 years.

But after being treated with T3 for five years, her endocrinologist told her he had been ordered to stop prescribing it for her. He reportedly said the problem was that her local Bristol North Somerset and South Gloucestershire CCG had began cutting back on T3 supplies.

Carole said: "I was really upset. It was hell. My treatment was completely within the guidelines and he knew how ill I would get if they took it away.

The Thyroid Trust report says: "Around the country most Clinical Commissioning Groups have policies in place which are causing harm to patients by denying treatment. In those cases where this has occurred, patients have resorted to the private sector or to informal means, such as buying the medication online, or even travelling abroad where it is sometimes available to buy over the counter, to source the medicine they need which the NHS should be providing.

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Source: Bristol Post, 15 June 2022

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Covid care home restrictions in Scotland caused harm, says report

Severe restrictions imposed on care home residents in Scotland during the Covid pandemic caused "harm and distress" and may have contributed to some deaths, academics have said.

A 143-page report has been produced by Edinburgh Napier University. It had been commissioned by the independent inquiry into the country's handling of the pandemic.

The report says that the legal basis for confining residents to their rooms and banning visitors was "unclear".

And it said care home residents were arguably discriminated against compared to other citizens.

The report is 1 of 14 that have been published by the Scottish Covid-19 Inquiry, which is chaired by Lady Poole.

It found that in the early months of the pandemic there was "little evidence" that the human rights of residents and their families had been considered.

It said: "There is substantial evidence of the harm and distress caused to residents and their families by the restrictions imposed in care homes.

"This includes concerns that, particularly for people with dementia, being unable to maintain contact with their family exacerbated cognitive and emotional decline, potentially hastening their death."

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Source: BBC News, 16 June 2022

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Sickle cell: Just half of nurses and doctors feel confident about treating illness, report finds

Only half of healthcare professionals feel they have sufficient tools to manage the long-term damage that sickle cell disease brings, new research has revealed.

The in-depth study by Global Blood Therapeutics - carried out across 10 countries including the UK, US and Canada - shows that patients living with the illness remain dramatically underserved by healthcare systems, while healthcare professionals don’t feel like they have the knowledge of the disease or their patients, to properly treat them.

More than two in five (43%) doctors and nurses cited difficulties due to having different ethnic backgrounds from their patients, it was revealed, while almost three quarters (73%) stated patients of lower economic status can be more difficult to treat. Almost a third of healthcare professionals (31%) found it challenging to understand their patients’ needs.

Sebastian Stachowiak, Head of Europe and GCC at Global Blood Therapeutics, told The Independent that the survey “confirms the lack of options for physicians” and expressed hope that, with recent advances in available treatment, patients can be better served in the future.

The study also found that almost half (46%) of patients say that emergency room healthcare providers did not believe them about their symptoms, while 48% said that they have been treated like a drug seeker in the emergency room.

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Source: The Independent, 14 June 2022

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Diabetes: Warning that missing eye test appointments risks sight loss

Diabetes patients have been warned that non-attendance at eye-test appointments puts them at greater risk of developing unnecessary sight loss.

The Royal National Institute for the Blind (RNIB) has described the attendance rates at clinics in Northern Ireland as "alarmingly low" .

It said 20% to 40% of patients were not showing up for their appointments on any given day.

Prof Tunde Peto, clinical lead for the NI Diabetic Eye Screening Programme, said the most common of many complications caused by diabetes was diabetic eye disease.

Diabetes can cause cataracts early on but it can also affect the retina at the back of the eye, "which will eventually lead to sight loss if not treated on time," Prof Peto explained.

"Diabetic retinopathy causes no symptoms until it can be just about too late to treat," she said.

Ian Catlin from Ballymoney has experienced sight loss due to diabetic retinopathy.

He has had Type 1 diabetes since childhood and became aware of problems with his eyesight in his mid-30s.

Mr Catlin said he put off asking for medical help because of the fear of what he would be told."I did eventually go, but you're scared and you put your head in the sand," he said.Read full story

Source: BBC News, 15 June 2022

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New drugs to fight superbugs will save 1,700 lives a year

Two drugs that combat superbugs are being introduced on the NHS, offering a lifeline to thousands of patients with deadly infections such as sepsis which fail to respond to antibiotics.

About 65,000 people a year in the UK develop drug-resistant infections and 12,000 die, many after routine operations or from infections such as pneumonia or urinary tract infections.

These superbugs such as MRSA have mutated to develop resistance to many different types of antibiotics as a result of overuse of the drugs. It means patients end up dying from common infections that would previously have been easily treatable with antibiotics.

In a attempt to “turn the tide” on antibiotic resistance, the NHS has announced a deal for two drugs, cefiderocol and ceftazidime–avibactam, which can kill bacteria that is resistant to many other types of drugs.

The drugs, manufactured by Shionogi and Pfizer respectively, will save the lives of about 1,700 patients a year. They will be offered to patients with conditions such as drug-resistant pneumonia, sepsis or tuberculosis who have run out of other treatment options.

Amanda Pritchard, NHS chief executive, said this would make the UK a world leader in tackling “the global challenge of antimicrobial resistance”.

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Source: The Times, 15 June 2022

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Ambulance waits: 'Can you please tell them to hurry up or I shall be dead'

Delays unloading ambulances at busy hospitals are causing serious harm to patients, a safety watchdog is warning.

The Healthcare Safety Investigation Branch has been investigating how the long waits are delaying 999 emergency response times across England.

Kenneth Shadbolt, 94, waited more than five hours for an ambulance after a bad fall - an accident that proved fatal.

Logs show that in his final 999 call he asked: "Can you please tell them to hurry up or I shall be dead."

Ken Shadbolt had been in good shape for his age. On the night of Wednesday, 23 March 2022, just before 03:00, he got out of bed to go the bathroom and fell, hitting a wardrobe before collapsing on the floor.

He had hurt his hip - how badly he didn't know - and couldn't get up. He could reach his mobile on his bedside, though, and dialled 999 for help.

The BBC has seen transcripts of the three separate phone calls he made to South Western Ambulance Service that night.

The first was short and factual, covering the basic details of his injury. 

He seemed calm and lucid but made clear he was in pain and needed an ambulance. Internal call logs seen by the BBC show that at this point Ken was triaged as a category two emergency, meaning paramedics should arrive in 18 minutes, on average.

About 15 minutes later, Ken called 999 for a second time.

An internal ambulance service log seen by the BBC shows that South Western Ambulance Service was indeed busy that night.

It talks about "high demand" in the Gloucester area, with more than 60 patients waiting for help, some for more than eight hours.

Another hour passed before Ken made his third and final call to 999.

It was clear now that he was in serious pain. He felt "terrible sick" and said his "breathing is going too".

"I need an ambulance because I'm going to fade away quite quickly," he said.

The same reply came back: "The ambulance service is just under a lot of pressure at the moment... we are doing our best."

An ambulance finally got to Kenneth Shadbolt's house at 08:10 that morning, four hours after that final call.

Ken died at 14:21 that afternoon, with the cause of death given as a "very large subdural haematoma" or bleed on the brain.

His son Jerry Shadbolt said: "The doctors were saying his injuries were non-survivable but would they have been non-survivable if he'd arrived at hospital four hours earlier? I'd like an answer to that question.

"He was on his own and he knew he was on his own. He must have felt abandoned and alone on his bedroom floor. That's the most troubling part of it for me."

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Source: BBC News, 16 June 2022

 

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NHS risks losing one third of Black and Asian doctors over racism, finds landmark survey

The NHS is facing a major exodus of doctors of ethnic minority backgrounds due to persistent levels of racism faced at a personal and institutional level, a ground breaking study has revealed.

Nearly one third of doctors surveyed have considered leaving the NHS or have already left within the past two years due to race discrimination, with 42 per cent of Black and 41 per cent Asian doctors in particular having considered leaving or having left.

The survey paints a picture of institutional barriers to career progression, dangerously low levels of reporting of racist incidents and a growing mental health burden on ethnic minority doctors.

With more than 2,000 responses from doctors and medical students across the UK, the BMA – a professional association representing all doctors in the UK – believes that this survey is one of the largest of its kind to document the experience of racism in the medical profession and workplace.

Dr Chaand Nagpaul, BMA chair of council, said: “The NHS was built on the principle of equality of care for patients whoever they are, but this report shows that the NHS is shamefully failing in this principle for its own doctors, with those from ethnic minorities reporting alarming levels of unfair treatment and racial inequality at work.

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Source: The Independent, 15 June 2022

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NHS England reviewing bed capacity

The NHS has a low bed base, and NHS England is reviewing ‘how we right-size our capacity’ across hospital, community and ‘virtual’ services, Amanda Pritchard has said.

The NHSE chief executive addressed the annual NHS Confederation this week and said: “The NHS has long had one of the lowest bed bases among comparable health systems. And in many respects this reflects on our efficiency and our drives to deliver better care in the community.

“But it was true before the pandemic, and it remains true now that we have passed the point at which that efficiency actually becomes inefficient.

“So the point has come where we need to review how we right-size our capacity across the NHS. That will of course look at the whole picture of hospital, community and virtual capacity.”

Ms Pritchard also highlighted the current pressures on the emergency care system, which has widely been linked to slow discharges from hospital and insufficient social care provision.

She cited the “unacceptable rise in 12-hour waits for admission from [accident and emergency]” which “underlines that the issue is flow”, and said “we know we will need to make more progress before winter”. 

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Source: HSJ, 15 June 2022

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Language around birth should be less judgemental, midwives' report says

The language used around childbirth should be less judgemental and more personal, a report led by midwives has found.

Most women consulted said terms such as "normal birth" should not be used, it says.

The report recommends asking pregnant women what language feels right for them.

Maternity care has been under the spotlight after a recent review found failures had led to baby deaths.

The new guidance "puts women's choices at its heart, so that they are in the driving seat when it comes to how their labour and birth are described", Royal College of Midwives chief executive Gill Walton said.

About 1,500 women who had given birth in the past five years gave their views. Most preferred the term "spontaneous vaginal birth" to "normal birth", "natural birth" or "unassisted birth". Words suggesting "failure", "incompetence" or "lack of maternal effort" should also be avoided, they said.

They wanted labour and birth to be a positive experience and for the language used to be non-judgemental, accurate and clear.

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Source: BBC News, 15 June 2022

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USA: Four-year-old accidentally given vasectomy

A family in Texas is suing a Houston-based doctor after their 4-year-old on son underwent an "unintended vasectomy" during a surgery.

The child was reportedly in the hospital for a hernia surgery at the time of the incident, according to Randy Sorrels, the family's personal injury attorney. He told Fox4 that part of the procedure involved work near the child's groin.

The attorney claimed the surgeon "cut the wrong piece of anatomy."

“The surgeon, we think, cut accidentally the vas deferens, one of the tubes that carries reproductive semen in it. It could affect this young man for the rest of his life,” Mr Sorrels told the broadcaster.

The surgeon who operated on the boy has no history of malpractice and has otherwise never received any negative reports on their work.

Mistakes like the one made on the toddler are generally very rare due to safety precautions built into the surgery process.

“It’s not a common mistake at all,” Mr Sorrels said. “Before a doctor transects or cuts any part of the anatomy, they are supposed to positively identify what that anatomy is and then cut. Here, the doctor failed to accurately identify the anatomy that needed to be cut. Unfortunately, cut his vas deferens. That wasn’t found out until it was sent in for pathology.”

The attorney said his and the family’s top concern is for the boy’s health. They are considering options for reversing the procedure, but the attorney noted that doing so would require the boy to undergo more surgery.

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Source: The Independent, 15 June 2022

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Trust branded ‘inadequate’ for leadership and maternity

One of the trusts worst affected by coronavirus has been issued with two warning notices and rated ‘inadequate’ for leadership, following a Care Quality Commission inspection.

The regulator raised serious concerns about the safety of Countess of Chester Hospital Foundation Trust’s maternity services, as well as the oversight and learning from incidents.

It also found staff were experiencing multiple problems with a newly installed electronic patient record, while systems for managing the elective waiting list were said to be unsuitable.

In maternity services, the inspectors flagged severe staff shortages and a failure to properly investigate safety incidents.

They said there were three occasions during the inspections when the antenatal and post-natal ward was served by only one midwife, despite the interim head of midwifery saying this would never happen. 

Inspectors also highlighted five incidents last year where women had suffered a major post-partum haemorrhage, involving the loss of more than two litres of blood and which resulted in an unplanned hysterectomy. The CQC said two were not reported as serious incidents, and where learning had been identified from the others, action plans were not being completed on time.

The CQC said it was only made aware of the incidents by a whistleblower, while internal actions agreed in December 2021 had still not been implemented two months later.

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Source: HSJ, 15 June 2022

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Review intended to drive change at NUH accused of ‘traumatising’ families – what went so wrong?

A review intended to drive ‘rapid improvements’ to maternity services in Nottingham has been scrapped after just eight months – with some bereaved families saying instead it did ‘irreparable’ damage to their mental health and trust in the system. 

It was hoped the process would lead to rapid change, restore families’ faith in maternity in Nottingham, and provide a voice for parents who wanted to share both positive and negative experiences.

Instead, some families said they found the review process slow, unprepared for the number of people who came forward and lacking the impact needed to improve a maternity service rated ‘inadequate’ by health inspectors.

The growing frustration that followed would turn to anger for some families, leading to the direct involvement of a Government minister, the arrival and rapid departure of a new chair, and the eventual disbanding of the review altogether in favour of a fresh start with one of the country’s top advisers on midwifery, Donna Ockenden – who led an in-depth review into Shrewsbury and Telford NHS Trust’s maternity services.

The U-turn came after pressure from a group of more than 100 people named ‘Families Harmed by Nottingham Maternity’ – which includes parents whose babies have died or been injured while being cared for at Nottingham’s two main hospitals.

Local Democracy Reporter Anna Whittaker looks at what led to so many families turning on a system which the NHS said was set up to bring about major changes.

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Source: Notts, 14 June 2022

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