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Priory Group whistleblowers 'concerned for patient safety'

Two former senior managers at a large mental healthcare provider have told the BBC they had concerns about the safety of patients and staff.

The whistleblowers claim they felt pressure to cut costs and fill beds.

The Priory Group, which receives more than £600m of public money each year, is the biggest single private provider of mental health services to the NHS.

The company denies the claims and says it successfully treats tens of thousands of patients each year.

It adds its services "remain amongst the safest in the UK".

The former members of the Priory Group's senior management said that, when they were working for the company, they found it difficult to recruit or retain staff, due to poor pay and conditions.

They believe this resulted in patients being placed on wards that did not have staff equipped with the right skills to handle their conditions.

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Source: BBC News, 26 April 2023

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What the US government should be doing – but isn’t – to guard against unsafe prescription drugs

Documents released in an Ohio court case last month, in a landmark, multi-district opioid lawsuit, gave new insight into an unparalleled opioid epidemic in the United States. It revealed that between 2006 and 2012, some 76 billion opioid pills were distributed in the United States — more than 200 pills for every man, woman and child.

It paints a damning picture of the tension between drug company profits and patient safety during the time opioid sales were climbing dramatically. In one 2009 exchange, a pharmaceutical company representative emailed a colleague at another company to alert him to a pill shipment. “Keep ’em comin’!” was the response. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are.”

According to Charles L. Bennett et al. in an editorial published in the Los Angeles Times, the failings are at every point in the system, starting with drug approvals. But the authors believe there is a particularly serious problem with the mechanisms for identifying, monitoring and disseminating information about issues with a drug after its release.

They suggest a good starting point for reforming the system would be increased transparency about drugs already recognised as particularly dangerous. These drugs, currently numbering about 70 (including opioids), carry the FDA’s so-called 'black box warning,' intended to alert patients and their doctors to the high risks associated with the drugs. But that is not enough. The authors propose a 'black box' database or 'registry,' publicly available and simple to use, that would contain extensive information about where, by whom and for what purpose black box drugs are prescribed, as well as where and in what quantities such drugs are being distributed and sold. Information about adverse side effects, culled from the myriad of government databases that now collect them, would also be consolidated in an open form and format.

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Source: Los Angeles Times, 8 August 2019

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‘Devastated’ doctors warn trust CEO of ‘extremely unsafe situation’

Consultants at a major tertiary centre have written to their chief executive, warning services are in ‘an extremely unsafe situation’ and calling for elective work to be diverted elsewhere.

Surgeons and anaesthetists at the former Brighton and Sussex University Hospitals Trust — now part of University Hospitals Sussex Foundation Trust — said: “We are devastated to report that the care we aspire to is not being provided at UHS… we are forced to contemplate that it is not safe to be open as a trauma tertiary centre and we feel elective activity must be proactively diverted elsewhere.”

The letter from BSUH’s anaesthetist and surgical consultant body is dated yesterday and was sent to UHSussex chief executive Dame Marianne Griffiths. The Royal Sussex County Hospital in Brighton — part of the trust — is the major trauma centre for the South East coast, from Chichester to parts of Kent.

In the letter, seen by HSJ, the consultants claimed a shortage of theatre staff is leading to “clinical safety issues, gross operational inefficiencies and burnout within our remaining depleted staff groups”. 

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Source: HSJ, 21 September 2021

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Review reveals trust’s ‘deep-seated’ cultural and governance issues

One of the NHS’ most high-profile mental health trusts has ‘multiple’ corporate governance problems and ‘deep-seated’ cultural issues, according to an external review.

Tavistock and Portman NHS Foundation Trust, which provides mental health, educational and training services in London, commissioned an external firm to look into its leadership amid a period of intense public scrutiny in the latter half of 2021.

Among cultural issues identified at the trust, which reviewers described as “deep seated”, was a reluctance of staff to speak up about concerns.

Assessors said a recent employment tribunal, which ruled the trust’s treatment of a whistleblower had damaged her professional reputation and “prevented her from proper work on safeguarding”, had impacted the ability of staff to raise concerns.

They urged leaders to review their Freedom to Speak Up and whistleblowing procedures. 

And while reviewers commended board members for commissioning an external review of race equality, they said it had “yielded an outpouring of emotion” which suggested many staff from minority ethnic groups do not feel consistently supported, respected or valued.

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Source: HSJ, 25 January 2022

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Staff warn of ‘worsening’ culture at beleaguered trust

The culture at a long-troubled ambulance trust is ‘worsening, not improving’, its staff have told a health watchdog.

Concerns about culture and patient safety at East of England Ambulance Service Trust (EEAST) were raised to inspectors at the Care Quality Commission (CQC) during an inspection of the trust last month, according to public documents.

In a feedback letter to the trust following the inspection, the CQC said staffing at EEAST’s control room was below planned levels, and the inspectors were “not assured that staffing levels met the demands within the service and this may impact on patient safety when managing the high volume of calls”.

The trust, which is in the equivalent of special measures and currently rated “requires improvement” by the CQC, has had long-standing cultural problems and last year signed a legal agreement with the Equality and Human Rights Commission on how it would protect staff from sexual harassment.

According to the feedback letter, staff described a “worsening, not improving, culture” and said the workforce was “tired” and not receiving mandatory training, one-to-ones with managers or appraisals.

The letter, published in the trust’s latest board papers, also reported inspectors raising concerns about potential risks to patients over the management of the trust’s call stack and a lack of consistency over “standard operating procedures”.

Additionally, some staff in the control room on an accelerated training programme were unable to undertake full patient assessments and had to call for assistance from others.

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Source: HSJ, 11 May 2022

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Suboptimal care contributed to deaths of 10 cancer patients treated in “dysfunctional” urology department, coroner finds

A coroner has criticised an NHS trust for “suboptimal care” and “missed opportunities” in the treatment of 10 patients with cancer at a urology department where relationships were “dysfunctional.”

Coroner Penelope Schofield said that all 10 had died of natural causes but that missed opportunities, suboptimal care, and in three cases “neglect” had contributed to the deaths.

The patients, who died from prostate or bladder cancer from 2006 to 2015, were under the care of Paul Miller, a consultant urologist at East Surrey Hospital in Redhill. 

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Source: BMJ, 25 October 2019

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Trust criticised for ‘extreme positivity’ and drops two ratings to ‘inadequate’

Senior leaders of an ambulance trust have been told their ‘extreme positivity’ has made them appear ‘out of touch’ as the Care Quality Commission downgraded the organisation’s rating to ‘inadequate’.

The health watchdog has dropped the overall rating of South Central Ambulance Service Foundation Trust, as well as the provider’s ratings for safety, leadership and for its urgent and emergency care services, from “good” to “inadequate”.

The CQC has served SCAS with a warning notice and has criticised the trust’s board for its “extreme positivity about its performance”, which “could feel dismissive of the reality to frontline staff.” The regulator also said it saw evidence “of executive leaders attempting to discredit people raising valid concerns” and was told that serious concerns including sexual harassment had been “brushed under the carpet”.

The CQC, which published the report today, also said there was “no evidence” of action being considered by SCAS to manage risk for patients suffering long handover delays outside A&E departments, and that serious issues “had not been addressed internally”.

Will Hancock, chief executive of SCAS, said the trust had an “extensive improvement plan” and is “committed to making things better”.

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Source: HSJ (25 August 2022)

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Nearly 900 children test positive for HIV in Pakistan after doctor ‘reuses syringes’

Nearly 900 children in a Pakistani city have tested positive for HIV after a rogue paediatrician allegedly reused infected syringes.

About 200 adults have also tested positive for the virus since the epidemic in Ratodero was confirmed in April. But health officials fear the true number affected could be far higher, with less a quarter of city’s 200,000 residents tested so far.

The outbreak was initially blamed on Dr Muzaffar Ghanghro, a paediatrician who at 16p a visit was one of the cheapest in the small central city. He was arrested and charged with negligence and manslaughter after his patients accused him of frequently reusing syringes on their children.

Despite an initial investigation by police and health officials concluding Dr Ganghro’s “negligence and carelessness” as the “prime” reason for the outbreak, officials believe he is unlikely to be the sole cause. Visiting health workers often see doctors in Ratodero reusing syringes, while dentists use unsterilised tools in roadside surgeries and barbers use the same razor on various customers, The New York Times reported.

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Source: The Independent, 27 October  2019

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Trusts criticise ‘completely chaotic’ covid-19 supply response

Several trust procurement leads have expressed frustration with the government’s response to covid-19, with HSJ being told of shortages of crucial personal protective equipment, unpredictable deliveries and a lack of clarity from the centre

NHS Supply Chain, which procures common consumables and medical devices for trusts, has been “managing demand” for an increasing number of PPE and infection control products for since the end of February to ensure “continuity of supply”. Some products, like certain polymer aprons, are unavailable altogether because of the increased demand and disrupted supply caused by the covid-19 outbreak. 

One procurement lead told HSJ: “They aren’t supplying enough, they aren’t fulfilling orders. It’s completely chaotic.” Another said his trust had “just enough to manage for the time being.”

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Source: HSJ, 20 March 2020

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Has the government broken the law by putting NHS staff in harm's way?

We don’t yet know the number of NHS staff who have lost their lives in the battle against COVID-19. On Wednesday, Dominic Raab put the figure at 69, but the true figure is considered to be far greater. 

These deaths are not “natural” casualties of the coronavirus pandemic. In fact, they may be the result of a failure in the government’s duty to care for NHS staff, which is why it is vital it is properly investigated under the law.

Since the pandemic reached the UK, we have heard countless reports of doctors and nurses raising the alarm over the lack of personal protective equipment (PPE) when treating COVID-19 patients.

How many of these deaths could have been prevented had sufficient PPE been provided to NHS workers? And if there is a lack of PPE, how did this happen? The health secretary, Matt Hancock, says the biggest challenge is “one of distribution rather than one of supply”. Should more have been done to meet this challenge, and if so what? Does the government have a legal duty to do more to protect the lives of healthcare workers?

There must be investigations into the individual deaths of NHS workers, out of respect to them, and also so that future deaths can be prevented. The evidence appears to be that the government has failed to protect them from risk to their lives, and if that is the case then an investigation will be required by law.

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Source: The Guardian, 25 April 2020

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Warning over warring Great Ormond Street surgeons

Warring between two surgeons at Great Ormond Street Hospital could put patients at risk, a review suggests.

A board paper released by the leading children's hospital said a "fractured" relationship between two consultants in the paediatric surgical urology team was affecting the service last year.

The London hospital said steps were being taken to resolve the problems. This has included mediation, mentoring and away days.

The board paper from a meeting in November set out the findings of a two-day inspection by the Royal College of Surgeons last May. The college was invited in by the trust itself after reports of problems. The summary of the report said there were "significant difficulties" between two surgeons in the team. It described a "lack of trust and respect" which meant they did not work collaboratively and led to significant competition for work.

If this continued it would have the "potential to affect patient care and safety" as well as longer waits for surgery, it said. The "dysfunction" between the two senior doctors caused problems for the wider team with evidence support staff had also been treated inappropriately.

Great Ormond Street said it took the issue "extremely seriously" and good progress was being made.

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Source: BBC News, 15 January 2020

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Prime Minister urged to give NHS 100 new hospitals plus an extra £7bn a year

NHS leaders have urged Boris Johnson’s government to build 100 new hospitals and give the service an extra £7bn a year for new facilities and equipment. They want the Prime Minister to commit to far more than the 40 new hospitals over the next decade that the Conservatives pledged during the general election.

So many hospitals, clinics and mental health units are dilapidated after years of underinvestment in the NHS’s capital budget that a spending splurge on new buildings is needed, bosses say. Too many facilities are cramped and growing numbers are unsafe for patients and staff, they claim.

Johnson has promised £2.7bn to rebuild six existing hospitals and pledged to build 40 in total and upgrade 20 others, although has been criticised for a lack of detail on the latter two pledges.

The call has come from NHS Providers, which represents the bosses of the 240 NHS trusts in England that provide acute, mental health, ambulance and community-based services.

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Source: The Guardian, 3 February 2020

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Archie Batten: Inquest hears baby's mother was turned away from maternity unit

The parents of a baby boy who lived for just 27 minutes have told an inquest they were "completely dismissed" throughout labour.

Archie Batten died on 1 September 2019 at the Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate, Kent.

His inquest began on Monday at Maidstone Coroner's Court. The East Kent Hospitals University NHS Foundation Trust has already admitted liability and apologised for Archie's death.

The coroner heard Archie's mother Rachel Higgs was frustrated at being turned away from the maternity unit in the morning, when she had gone to complain of vomiting and extreme pain.

She was told she was not far enough into labour to be admitted. 

She returned home to Broadstairs with her partner Andrew Batten, but continued to feel unwell so phoned the hospital. She was told the unit was now closed.

Instead, two community midwives were sent to their home, where they attempted to deliver the baby but could not find a heartbeat.

Andrew Batten told the inquest the midwives looked "terrified," and that there was "an air of panic", with the midwives whispering in the hallway instead of telling him and Ms Higgs what was happening.

Under examination from the family's barrister Richard Baker, Victoria Jackson, the midwife who had originally seen Ms Higgs, admitted the high number of patients she was having to deal with had affected her ability to spend time with her.

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Source: BBC News, 14 March 2022

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Woman died after taking medicine from husband’s ‘identical’ dosette box

A Berkshire woman with cognitive impairment died after taking medicines from her husband’s dosette box rather than her own “for several days,” a coroner has found. 

A report by assistant coroner for Berkshire Katy Thorne found that Sewa Kaur Chaddha died on May 10 2023, five days after she was found collapsed at home in Slough. 

Both she and her husbands were taking “multiple prescribed conditions” as well as “cognitive impairment due to their age” according to the report. 

The coroner wrote: “It was discovered that she had been taking her husband’s medication instead of her own for several days, including diabetes medication. Her blood sugar levels were found to be extremely low.” 

The cause of death was principally attributed to hyponatraemia “caused by the necessary treatment for hypoglycaemia which was in turn caused by the accidental ingestion of hypoglycaemic medication”.

In her report – which was written in July but made public yesterday (October 15) – the coroner said that both Mrs Chaddha and her husband received separate multi-compartment compliance aids (MCAs) from their local pharmacy, which was then a branch of LloydsPharmacy, adding: “The two patients’ dosette boxes were identical to each other except for a small pharmacist’s label with small type with the relevant patient’s name.”

The inquest found both that there was no “well disseminated” guidance for pharmacies around issuing medicines to patients with dementia and that “dosette boxes of different colours or labels with different colours were not routinely given to elderly or cognitively impaired patients living at the same address”.

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Source: Pharmacy Magazine, 16 October 2024

 

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Better tech: not a ‘nice to have’ but vital to have for the NHS

In a keynote speech at the Healthtech Alliance on Tuesday, Secretary of State for Health and Social Care, Matt Hancock, stressed how important adopting technology in healthcare is and why he believes that it is vital for the NHS to move into the digital era. 

“Today I want to set out the future for technology in the NHS and why the techno-pessimists are wrong. Because for any organisation to be the best it possibly can be, rejecting the best possible technology is a mistake.”

Listing examples from endless paperwork to old systems resulting in wasted blood samples, Hancock highlights why in order to retain staff and see a thriving healthcare, embracing technology must be a priority.

He also announced a £140m Artificial Intelligence (AI) competition to speed up testing and delivery of potential NHS tools. The competition will cover all stages of the product cycle, to proof of concept to real-world testing to initial adoption in the NHS.

Examples of AI use currently being trialled were set out in the speech, including using AI to read mammograms, predict and prevent the risk of missed appointments and AI-assisted pathways for same-day chest X-ray triage.

Tackling the issue of scalability, Hancock said, “Too many good ideas in the NHS never make it past the pilot stage. We need a culture that rewards and incentivises adoption as well as invention.”

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Trust tells clinicians ‘we’ll support you’ over safety risks caused by covid pressures

A trust has written to its registered workforce to reassure them of management support when delivering care in ‘extremely challenging circumstances’.

Derbyshire Community Health Services Trust sent out a “statement of support for professionally registered colleagues”, in which it thanked them for their “continued efforts”, and explained how they would support staff from a “professional and regulatory perspective”, when delivering services that require “a high level of clinical knowledge and autonomous decision-making”.

This week has seen NHS staff absences hit new highs – over 100,000 – and the military brought in to support care in London hospitals, in combination with very high community covid transmission rates and very busy acute trusts. 

The DCHST email, signed by executive director of nursing Michelle Bateman, executive medical director Ben Pearson and interim director of Allied Health Professionals Trish Bailey, said: “When services are at this high level of escalation it can mean that we are not always able to deliver care in the way we would like and that can challenge our professional values.”

Helen Hughes, chief executive of charity Patient Safety Learning, said Derbyshire Community Healthcare’s message needed to be echoed by every trust in the country.

“Without sufficient staffing resources, difficult decisions are required to prioritise care,” Ms Hughes said. “In some cases, delays in treatment as a result of these decisions could lead to avoidable harm.”

She stressed it was “imperative” that future investigations into safety incidents “properly reflect the systemic nature of reasons for error or harm, not simply blaming staff for failures to provide safe care”.

“Health professionals’ codes mean that they are not allowed to work outside their sphere of competence. But what if staff are being tacitly encouraged or required to work in an unsafe system? Staff need to be able to feel secure in raising any concerns they have, being listened to and being supported,” Ms Hughes added.

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Source: HSJ, 10 January 2022

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The Morecombe Bay scandal took my baby’s life – history has repeated itself and the NHS must act now

In March 2015, the Morecambe Bay investigation, chaired by Dr Bill Kirkup, published its report into serious failures in care that led to the avoidable deaths of 11 babies and a mother at Furness General Hospital (FGH) between 2004 and 2012. One of the babies that died was James Titcombe's son, Joshua.

The report described a seriously dysfunctional maternity unit where certain midwives pursued an “over-zealous” approach to promoting “normal” childbirth, relationships between doctors and midwives was poor, midwifery practice fell well below acceptable standards and, unforgivably, instances of avoidable harm and death were covered up – meaning lessons were not learned and similar failures were repeated year after year. 

The report detailed how opportunities to intervene at Morecambe Bay were missed at all levels and how the families who raised concerns were treated as problems to be managed, rather than voices that needed to be heard. More than four years later, it is both tragic and distressing to read about the litany of failures identified in the leaked interim report into care at Shrewsbury and Telford Hospital Trust (SaTH). Far from events at Morecambe Bay being a “one-off”, it is now painfully clear that not only have similar failures in care occurred elsewhere, but that they have happened on an even larger scale.

James, speaking to The Independent, says "Worryingly, the reason why we are reading about these issues now isn’t because the regulatory system identified a problem and called for further scrutiny, but rather because of the extraordinary efforts of bereaved families."

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Source: The Independent, 21 November 2019

 

 

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Patients at risk’ from ‘hastily rolled out virtual wards’

NHS England’s plans to rapidly expand virtual wards are being ‘hastily rolled out’ and could put patients at risk while taking up significant staffing capacity, leading clinicians have warned.

The Society for Acute Medicine and the Royal College of Physicians are among those who have raised concerns to HSJ about the huge increase in the use of the virtual wards model, under which patients are discharged home and given oximeters that fit on their finger so they can be remotely monitored by clinical staff.

The concerns follow NHSE ordering trusts to ensure a minimum of 15% of hospital covid patients were being treated in virtual wards, in plans to help ease pressures on hospital wards announced just before Christmas.

At the time NHSE announced the plans there were around 7,000 covid inpatients in English NHS hospitals, meaning around 1,000 patients should be in virtual wards. But the covid inpatient figure had more than doubled to nearly 16,000 by 5 January.

The project is hugely significant because NHSE and trust chiefs want to use virtual wards much more widely – including for non-covid patients – and believe they represent a potentially game-changing option when it comes to alleviating pressure on hospitals and speeding up discharges.

Many of the clinicians who spoke to HSJ were supportive of the principle of virtual wards but had serious concerns about the speed and timing of the rollout. They said there was a lack of evidence the approach was safe.

Society for Acute Medicine president Tim Cooksley said virtual wards had potential for the future but that they “simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic”.

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Source: HSJ, 7 January 2022

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Hospital bosses launched ‘witch hunt’ to find whistleblower who revealed blunders in woman’s treatment, inquest told

Hospital bosses have been accused of launching a witch hunt to find a whistleblower who told a widower about blunders in the treatment his wife received.

The row emerged as an inquest began into the death of Susan Warby who died five weeks after bowel surgery. The 57-year-old died at West Suffolk Hospital in Bury St Edmunds after a series of complications in her treatment.

Her family received an anonymous letter after her death highlighting errors in her surgery, the inquest in Ipswich heard, and both Suffolk Police and the hospital launched investigations. These investigations confirmed that there had been issues around an arterial line fitted to Ms Warby during surgery, Suffolk’s senior coroner Nigel Parsley said.

Doctors were reportedly asked for fingerprints as part of the hospital’s investigation, with an official from trade union Unison describing the investigation as a “witch hunt” designed to identify the whistleblower who revealed the blunders.

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Source: The Independent, 17 January 2020

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NHS not ‘human’ enough to get greater role in social care, says government review

The NHS should not be given greater control of social care because it is ‘hierarchical, centralised and not person-centred’, according to a government-commissioned review which is repeatedly scathing about the health service.

The review was ordered by then health and social care secretary Matt Hancock in June 2020. Cross-bench peer, writer and former Number 10 adviser Baroness Camilla Cavendish was asked “to make recommendations for social care reform and integration with health in the wake of the Covid-19 pandemic, which could fit alongside the funding reforms planned by the department in the context of the NHS long-term plan.”

In her final report, Baroness Cavendish wrote that “one answer” to the problems facing the sector “would be to let the NHS take over social care. On paper, this would join up the care continuum.”

However, she rejected the idea because of the NHS’ “hierarchical” and “centralised” nature. Baroness Cavendish also suggested the NHS’ role should be limited because it is “still struggling to join up primary and secondary care”.

In contrast to the NHS, she claimed: “Social care is more innovative, more responsive and human.”

She added: “The culture of the NHS is still largely one of ‘doing to’ patients, and the NHS has much to learn from social care about how to be responsive and human facing.”

Referencing “recent attempts to import the successful [Buurtzorg] model of self-managing teams into the NHS”, the cross-bench peer said these “have foundered, because the NHS culture cannot seem to cope with giving staff the autonomy required”.

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Source: HSJ, 23 February 2022

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Cornwall hospital to discharge patients early despite saying it may be harmful

A major NHS hospital is under such pressure that it has decided to discharge people early even though it admits that patients may be harmed and doctors think the policy is unwise.

The Royal Cornwall Hospitals NHS trust has told staff to help it reduce the severe overcrowding it has been facing in recent weeks by discharging patients despite the risks involved.

In a memo sent on 8 January, three trust bosses said the Royal Cornwall hospital in Truro, which is also known as Treliske hospital and has the county’s only A&E department, “has been under significant pressure for the last two weeks and it is vital that we are able to see and admit our acutely unwell patients through our emergency department and on to our wards”.

The memo added: “One of these mitigations was to look at the level of risk that clinicians are taking when discharging patients from Treliske hospital either to home or to community services, recognising that this may be earlier than some clinicians would like and may cause a level of concern.

“It was agreed, however, that this would be a proportionate risk that we as a health community were prepared to take on the understanding that there is a possibility that some of these patients will be readmitted or possibly come to harm.”

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Source: 14 January 2020

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Unit put into special measures after ‘inadequate’ rating

A low secure unit for people with learning disabilities and autism has been put into special measures after inspectors found the use of restraint and segregation affected the quality of life for some patients.

Cedar House, in Barham near Canterbury, houses up to 39 people and had been rated “good” by the Care Quality Commission early last year.

But at an inspection in February this year inspectors rated the service – run by the Huntercombe Group — “inadequate,” saying it was not able to meet the needs of many of the patients at the unit. It was issued with three requirement notices.

One patient had been subject to prolonged restraint 65 times between September and February. Each time he was restrained by between two and 19 staff, for an average of nearly two hours. On one occasion, this restraint lasted for eight hours.

But the inspectors were told that in the six months before the inspection 29 staff had been injured during these restraints, and the hospital had been trying to refer the patients to a more secure environment.

“The impact of this inappropriately placed patient was considerable for both the patients and the hospital,” the report said. “The staff who were regularly involved in restraining the patient were tired and concerned about the welfare and dignity of the patient.”

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Source: HSJ, 21 July 2020

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US Patients can order ‘don’t weigh me’ cards to take to doctors

 

Patients in the US are able to order “don’t weigh me” cards to take to the doctors in a move aimed at reducing anxiety and stress on a visit.

The US group behind the initiative said being weighed and talking about weight “causes feelings of stress and shame for many people”.

The cards say: “Please don’t weigh me unless it is (really) medically necessary.”

It adds: “If you really need my weight, please tell me why so that I can give you my informed consent”.

On the other side, it explains why the patient may not want to be weighed, including “when you focus on my weight I get stressed” and “weighing me every time I come in for an appointment and talking about my weight like it’s a problem perpetuates weight stigma”.

It also says most health conditions can be addressed without knowing the patient’s weight.

Public Health England guidance to health and care professionals says they are in a “unique position to talk to patients about weight management to prevent ill-health” and recommends brief interventions.

It says the first step in a brief intervention over a patient’s weight is to weigh and measure them. “You should view this as a normal part of a routine consultation,” it says.

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Source: The Independent, 23 December 2021

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Coronavirus: Every hospital in England must create secure zones for patients

All NHS hospitals in England have been ordered to create secure areas for coronavirus testing to “avoid a surge in emergency departments”, according to a leaked NHS letter.

Hospitals have been told to create “coronavirus priority assessment pods”, where people will be checked for the virus, which will need to be decontaminated each time they are used.

The letter, seen by The Independent and dated 31 January, instructs all chief executives and medical directors to have the pods up and running no later than Friday 7 February.

It comes as the global death toll from the virus has reached 565 with around 28,000 infected.

One hospital chief executive told The Independent he believed the requirement was “an overreaction”, adding: “I think we should be sending teams out to swab in patients homes as the advice is to stay at home and self-manage as with any other flu".

In the letter, Professor Keith Willett, who is leading the NHS’s response to coronavirus, told NHS bosses: “Plans have been developed to avoid a surge in emergency departments due to coronavirus. “Although the risk level in this country remains moderate, and so far there have been only two confirmed cases, the NHS is putting in place appropriate measures to ensure business as usual services remain unaffected by any further cases or tests of coronavirus.”

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Source: 5 February 2020

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Mental health services in the England are being ‘Uberised’ – and that’s bad for patients and therapists

There is a mental health crisis in England, with rates of depression doubling since the COVID pandemic began. Strategies of “speaking up”, mindfulness sessions at work, and national “happiness” campaigns have been touted as an effective approach to tackling mental health at work, but therapists are unconvinced.

But what of mental health services offered by the state? This has been equally unconvincing. Over the past decade or so, mental health services in England have been undergoing a process of “Uberisation”. This refers to how services are effectively treated as commodities marketed through online platforms, changing the way they are delivered as well as making the jobs of the people delivering them more precarious – similar to the effect of ride-hailing apps on taxi drivers.

Specifically, this has happened through the introduction of a standardised and digitalised model of therapy called Increased Access to Psychological Therapies (IAPT). This Uberisation appears to be contributing to a mental health crisis within the therapy profession itself.

IAPT, which was introduced in 2008, provides psychotherapy for depression and anxiety to over a million people each year – the largest NHS programme in England. It uses a model of cognitive behavioural therapy – made up of short-term interventions of four to 12 sessions – that use techniques, such as relaxation exercises, to encourage positive mood and behaviour.

With extremely high levels of depression and anxiety among therapists, there is a genuine question about patient safety that is being overlooked. If the mental health model itself is broken, are services deepening the mental health crisis, rather than solving it?

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Source: The Conversation

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