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Public health ‘at risk’ as leading Covid surveillance programme ends

Ministers will be left in the dark on Covid spikes just as case numbers reach unprecedented levels if a “world-beating” surveillance programme is scrapped, scientists have warned.

The React-1 study, which played a crucial role in detecting and tracking the spread of the Alpha variant in December 2020 ahead of the second lockdown, has been stopped as part of the government's plan to cut its Covid costs.

But in its last report, the study found 6.37% of the population was infected between 8 and 31 March – the highest figure since it began in May 2020. More worryingly, the scientists behind the research said the prevalence rate has also reached new highs for people aged 55 and over, at 8.31 per cent.

The Royal Statistical Society (RSS) said dismantling the project while cases were at record levels damaged preparedness and put public health at risk.

The spread of Covid within hospitals is also fuelling staff shortages, bed closures and delayed discharges in multiple regions of the country. This is coinciding with delays in ambulance handovers and response times, NHS sources say.

Information seen by The Independent revealed hundreds of beds are currently out of use at Newcastle upon Tyne Hospitals trust due to Covid outbreaks. A senior clinician said the “hospital is coming apart at the seams” and that, across the northeast, even “high” performing emergency departments were “crashing” and “stacking ambulances outside of hospital”.

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Source: The Independent, 6 April 2022

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Procurement of PPE, diagnostics and medical devices to be in-housed by national agency

The national supply chain agency will bring management of significant areas of NHS spend in-house on a permanent basis in a major overhaul of its operating model, HSJ has been told.

NHS Supply Chain’s current operating model, which has existed since 2018, has outsourced day-to-day management of the procurement of most of the goods and services bought by trusts as part of the “category towers” structure.

Under this structure, 11 category towers each cover a different spend area with a service provider to manage the available products and services.

But, in an exclusive interview, NHSSC chief Andrew New said the 11 categories would be reduced to eight. Three of the new categories — personal protective equipment, “medical capital” (which combines large capital diagnostics equipment with smaller scale diagnostics, pathology and point of care testing categories) and “medical clinically complex” surgical products and services — would be managed in-house. 

The new model will come into effect in 2023-24 following a procurement process to find new suppliers for the revamped category structure, which starts on 11 April 2022 with the publication of the contract notice.

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Source: HSJ, 4 April 2022

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Autistic girl, 14, unlawfully detained in hospital, high court judge finds

A 14-year-old autistic girl was unlawfully detained in hospital and restrained in front of scared young patients, a high court judge has found.

On one occasion last month the teenager managed to break into a treatment room where a dying infant was receiving palliative care. She was restrained there by three security guards, Mr Justice MacDonald said in a judgment in the family court that ordered Manchester city council (MCC) to find the girl a suitable community care placement instead of what he described as the “brutal and abusive” and “manifestly unsuitable” hospital environment.

Nurses witnessed the girl screaming “very loudly” and sounding “very scared” when repeatedly held down on her hospital bed so that she could not move her legs, arms or head, before being tranquillised. Other children on the ward were frightened to witness the frequent battles between the girl and security guards, the judge said.

The judge noted that the teenager made “regular and determined” efforts to run away, sometimes using screwdrivers to try to unlock doors and windows, and running away from her family on walks. 

He described the teenager as having an autistic spectrum disorder and a learning disability. She demonstrated “complex and extreme behaviour” that could not be controlled even within a school environment involving six adults to one child supervision, he added.

Despite this, the council and NHS trust decided to have the girl be detained in hospital on a general paediatric ward “solely as a place of safety”, without applying for the necessary court order to do so, the judge found. She did not require any medical treatment, the judge said.

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Source: The Guardian, 5 April 2022

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Lincolnshire Trust fined after patient suffered serious avoidable harm

United Lincolnshire Hospitals NHS Trust has been ordered to pay a total of £111,204 in fines and legal costs after pleading guilty to failing to provide safe care and treatment to an elderly patient, causing them avoidable harm, following a sentencing hearing on Friday, 25 March at Boston Magistrates’ Court.

The case was taken by the Care Quality Commission (CQC) under regulations 12 and 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The case against  United Lincolnshire Hospitals NHS Trust involved the care of an elderly patient, Iris Longmate, who was admitted to the Greetwell Ward at Lincoln County Hospital on 20 February 2019.

On March 3, 2019 Iris fainted and fell unsupervised from a commode, and was found face down on the floor in her room. Iris sustained spinal injuries and a cut to the head as a result of the fall, but then also suffered significant burns to her thigh and left arm as a result of being pressed against a radiator whilst being assessed by staff following the fall.

Iris was subsequently transferred to Queens Medical Centre for assessment and treatment. She sadly contracted pneumonia in hospital and died on March 14, 2019.

United Lincolnshire Hospitals NHS Trust pleaded guilty to a single offence of failure to provide safe care and treatment causing avoidable harm to Iris, for which the trust was fined £100,000. The court also ordered the trust to pay £170 victim surcharge and £11,034 costs to the CQC.

The trust was found to not have taken all reasonable steps to ensure that safe care and treatment was provided, resulting in avoidable harm to Iris. In pleading guilty to the offence of causing avoidable harm to Iris, the trust also acknowledged that other patients on the Greetwell Ward had also been exposed to a significant risk of avoidable harm.

Fiona Allinson, CQC’s deputy chief inspector of hospitals, said: "This death is a tragedy. My thoughts are with the family and others grieving for their loss."

"People have the right to safe care and treatment, so it’s unacceptable that patient safety was not well managed by United Lincolnshire Hospitals NHS Trust," she said. "Had the trust addressed the issues with the exposed heating pipes before Iris fell, she wouldn’t have suffered such awful burns injuries."

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Source: Medscape, 2 April 2022

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Overcrowding, delays, cross infection: Review reveals emergency department issues

Patients in nine hospitals in Ireland were often treated in the wrong places, sometimes corridors, in situations where it was “unclear” who was supposed to be providing their care, a clinical review has found.

It warned of the potential for people to receive inappropriate specialist input and recommended specific wards be used to avoid so-called “safari rounds” where consultants must seek out scattered patients.

The independent review team consisted of clinical and management experts from Scotland and England who undertook a programme of visits between August and November, 2019.

“The review team witnessed widespread boarding and outliers – any bed, anytime, anywhere and including mixed gender,” the document said.

“This does not create extra capacity, leads to safari rounds, increases length of stay, introduces harm by non-specialist care and increases staff absenteeism.”

Although acknowledging often excellent work by staff, the report was commissioned to examine non-scheduled care at nine hospitals found to be “under the greatest pressures” during the winter season of 2018/2019. These had “significant numbers” of patients waiting for long periods on trolleys.

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Source: The Irish Times, 4 April 2022

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Basildon Hospital blood tests contaminated in 'major failure'

THE majority of blood tests taken at Basildon Hospital to identify life-threatening illnesses have been contaminated in a “major failure”.

An investigation has been launched by health bosses, with staff shortages allegedly causing the issue with “blood cultures”.

Blood cultures, which look for germs or fungi in the blood and more deadly bacteria are routinely carried out ahead of operations.

However, latest figures show that 70% of tests taken in the year up to January 2022 were found to be contaminated, leading to treatment being delayed as patients are re-tested.

The normal limit of contaminated tests would be below 3%.

The issue was raised at a joint board meeting of the clinical commissioning groups, which oversee local healthcare, on 24 March.

Katherine Kirk, chairman of quality and governance committee at the Basildon and Brentwood group, said: “If I’m understanding this right and it’s about the effectiveness of blood tests, what’s going on? It’s clearly a major failure.”

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Source: The Echo, 4 April 2022

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NHS not making progress on early cancer diagnosis

The NHS in England is struggling to make progress on its flagship target to diagnose three-quarters of cancer cases at an early stage, MPs are warning.

The Health and Social Care Committee said staffing shortages and disruption from the pandemic were causing delays.

Some 54% of cases are diagnosed at stages one and two, considered vital for increasing the chances of survival.

By 2028, the aim is to diagnose 75% of cases in the early stages, but there has been no improvement in six years.

It means England - as well as other UK nations - lag behind comparable countries such as Australia and Canada when it comes to cancer survival.

If the lack of progress continues, the committee warned that it could lead to more than 340,000 people missing out on an early cancer diagnosis.

The Department of Health said it recognised "business as usual is not enough" and said it was developing a new 10-year cancer plan.

But a spokesman said progress was already being made, with a network of 160 new diagnostic centres being opened.R

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Source: BBC News, 5 April 2022

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Repeated maternity failings uncovered in Sheffield NHS trust

Hospital inspectors have uncovered repeated maternity failings and expressed serious concern about the safety of mothers and babies in Sheffield just days after a damning report warned there had been hundreds of avoidable baby deaths in Shrewsbury.

The Care Quality Commission (CQC) found Sheffield teaching hospitals NHS foundation trust, one of the largest NHS trusts in England, had failed to make the required improvements to services when it visited in October and November, despite receiving previous warnings from the watchdog.

As well as concerns across the wider trust, a focused inspection on maternity raised significant issues about the way its service is run. When it came to medical staff at the Sheffield trust, the “service did not have enough medical staff with the right qualifications, skills, and experience to keep women and babies safe from avoidable harm and to provide the right care and treatment”, the report said.

Inspectors found that staff were not interpreting, classifying or escalating measures of a baby’s heart rate properly, an issue that was raised by Donna Ockenden in her review of the Shrewsbury scandal.

Despite fetal monitoring being highlighted as an area needing attention in 2015 and 2021, the most recent inspection “highlighted that the service continued to lack urgency and pace in implementing actions and recommendations to mitigate these risks, therefore exposing patients to risk of harm”.

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Source: The Guardian, 5 April 2022

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New algorithm will improve bowel-cancer patient care

An algorithm which can predict how long a patient might spend in hospital if they’re diagnosed with bowel cancer could save the NHS millions of pounds and help patients feel better prepared.

Experts from the University of Portsmouth and the Portsmouth Hospitals University NHS Trust have used artificial intelligence and data analytics to predict the length of hospital stay for bowel cancer patients, whether they will be readmitted after surgery, and their likelihood of death over a one or three-month period. 

The intelligent model will allow healthcare providers to design the best patient care and prioritise resources.

Bowel cancer is one of the most common types of cancer diagnosed in the UK, with more than 42,000 people diagnosed every year.

Professor of Intelligent Systems, Adrian Hopgood, from the University of Portsmouth, is one of the lead authors on the new paper. He said: “It is estimated that by 2035 there will be around 2.4 million new cases of bowel cancer annually worldwide. This is a staggering figure and one that can’t be ignored. We need to act now to improve patient outcomes.

“This technology can give patients insight into what they’re likely to experience. They can not only be given a good indication of what their longer-term prognosis is, but also what to expect in the shorter term. 

“If a patient isn’t expecting to find themselves in hospital for two weeks and suddenly they are, that can be quite distressing. However, if they have a predicted length of stay, they have useful information to help them prepare.

“Or indeed if a patient is given a prognosis that isn’t good or they have other illnesses, they might decide they don’t want a surgical option resulting in a long stay in hospital.”

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Source: University of Plymouth, 30 March 2022

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Autistic children wait up to five years for an NHS appointment

Children are having to wait up to five years for an NHS autism appointment, according to figures obtained by the Observer that lay bare the crisis in children’s mental health services.

Figures acquired under the Freedom of Information Act show that 2,835 autistic children referrals at Coventry and Warwickshire Partnership NHS Trust have still not had a first appointment an average of 88 weeks after being referred. The longest wait at the time the response was sent in January stood at 251 weeks – nearly five years.

Meanwhile, 1,250 children with attention deficit hyperactivity disorder (ADHD) referrals at the trust have yet to have a first appointment, having waited an average of 46 weeks – and 195 weeks in the worst case.

Across 20 NHS trusts that provided figures, children with outstanding autism referrals have waited nearly six months on average for their first appointment.

Cathy Pyle’s daughter, Eva, spent 20 months waiting for an autism assessment from her local NHS child and adolescent mental health services (CAMHS) in Surrey, having already had to wait 11 months for a mental health assessment after she became increasingly distressed during her first year of secondary school, culminating in self-harm.

“The sensory aspects of her autism are really significant,” Pyle told the Observer. “So she found the crowding in the corridors, the jostling, being pushed and shoved – she found the noises really, really unbearable.”

Dr Rosena Allin-Khan MP, Labour’s shadow cabinet minister for mental health, said: “The NHS does an incredible job with the resources that it has, however, long waits for treatment have a considerable impact on patients and families. It’s unacceptable that a six-month wait has become the standard for autism referrals, with many others waiting years to be seen, on the Conservatives’ watch. Waiting so long for treatment will have a detrimental impact on a child’s development.”

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Source: The Guardian, 4 April 2022

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Police investigating deaths of two babies last year at scandal-hit trust

Detectives have begun an investigation into the deaths of two babies at the hospital trust at the centre of the largest maternity scandal in NHS history.

The babies died in separate incidents last year at the Shrewsbury and Telford Hospital NHS Trust, both during birth. One of them was a twin.

The cases were among 600 examined by West Mercia police alongside an inquiry by Donna Ockenden, a senior midwife and manager, into failings at the trust. Her report revealed last week that 201 babies had died and 94 suffered brain damage as a result of avoidable mistakes. Nine mothers also died because of errors in care.

Detectives are working with prosecutors to determine whether charges should be brought over the two deaths last year, after years of warnings that maternity services were in crisis. West Mercia police said they were investigating the trust as an organisation as well as individuals.

The trust could face a charge of corporate manslaughter if it is found that the way the hospital organised and managed its services caused a death that amounted to a “gross breach” of its duty of care. If found guilty, the trust would face an unlimited fine. Individuals charged with gross negligence manslaughter could go to jail if convicted.

The move by the police comes amid growing fears that the unsafe care identified in the report could be taking place in maternity services in other parts of the country.

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Source: The Times, 3 April 2022

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Nurse's conviction should be wake-up call for health system leaders, IHI says

RaDonda Vaught's conviction for a fatal medical error has already damaged patient safety and should serve as a wake-up call for health system leaders to improve harm prevention efforts, the Institute for Healthcare Improvement has said.

Ms. Vaught was convicted 25 March of criminally negligent homicide and abuse of an impaired adult for a fatal medication error she made in December 2017 while working as a nurse at Vanderbilt University Medical Center in Nashville, Tenn. 

"We know from decades of work in hospitals and other care settings that most medical errors result from flawed systems, not reckless practitioners," IHI said. "We also know that systems can learn from errors and improve, but only when those systems encourage reporting, transparently acknowledge their mistakes and are held accountable for those errors."

The organization said criminal prosecution of errors over-focuses on the individual and diverts attention from necessary system-level issues and improvements. 

"Were this practice to be repeated in future cases of a serious or fatal error, there will be more damage, less transparency, less accountability and more lives lost," IHI said. "Instead, this case should be a wake-up call to health system leaders who need to proactively identify system faults and risks and prevent harm to patients and those who care for them."

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NHSE warned of ‘inaccurate’ and ‘unethical’ investigation into man’s death

An independent investigation into the death of a man with autism and learning difficulties in NHS care may never be published in full as his sister has rejected several drafts as inaccurate, telling NHS England they were ‘totally unethical’.

Anthony Dawson died from a burst gastric ulcer in Ashmount, a residential care home run by Surrey and Borders Partnership Foundation Trust, in May 2015. The jury at an inquest into his death found there were gross failings in his care and his death was contributed to by neglect.

NHS England commissioned an independent investigation into the incident from Sancus Solutions in June 2017. But seven years after Mr Dawson’s death the investigation’s report has yet to be published, despite several reports being submitted.

His sister, Julia Dawson, has written to NHS chief executive Amanda Pritchard in recent weeks saying: “The investigation has not had my brother at its heart which we were assured would be the case” and that its reports had been “totally unethical”.

Ms Dawson has asked that only the executive summary of the latest draft of the investigation be published, alongside a statement saying that she feels it has inaccuracies and misses out important points.

She says that successive drafts have misrepresented her brother’s situation and failed to address what she believes was the real cause of his death – the frequent use of NSAIDs (ibuprofen) without any measures taken to protect his stomach. This ultimately led to the undiagnosed gastric ulcer bursting. An expert witness told the inquest into his death that treatment with proton pump inhibitors and stopping NSAIDs would have eradicated the ulcer.

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Source: HSJ, 4 April 2022

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‘She died in excruciating pain, instead of being properly treated,’ says sailor’s father

Seaman Danyelle Luckey “didn’t die in combat or any military operation. She died from gross negligence of the medical providers on the ship she served, the USS Ronald Reagan,” said her father, Derrick Luckey.

Danyelle Luckey died from sepsis on 10 October 2016. The 23-year-old had been on the ship for two weeks, and had been going back and forth to medical from 3 to 9 October with worsening symptoms. “Her death was very preventable. She died in excruciating pain, instead of being properly treated,” Derrick Luckey told lawmakers during a hearing about patient safety and the quality of care in the military medical system.

“If the medical providers had given her a simple treatment of antibiotics instead of turning her away, she would be alive today,” he said.

Luckey and Army veteran Dez Del Barba, who said he lost part of his left leg and suffered 70% muscle and tissue damage after his strep infection went untreated, urged lawmakers to make changes so others in the military community don’t have to suffer.Both contend this could have been avoided if proper medical care, such as antibiotics, had been provided. And both said they haven’t been able to get any information on investigations, or any actions to hold anyone accountable.Read full story

Source: Yahoo News, 31 March 2022

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Clinically vulnerable Covid patients denied access to life-saving antivirals

Clinically vulnerable people infected with Covid are being denied access to potentially life-saving antiviral medicine, patients, health officials and charities say.

Around 1.3 million people with underlying health conditions in England have been identified by the NHS as at-risk and sent letters explaining they will be assessed for antiviral treatment if infected with Covid.

The NHS said “tens of thousands of the most vulnerable patients” have received the medication to date, but told The Independent it was “aware of some local issues” in which clinically vulnerable people have struggled to access the antivirals. It comes at a time of record-breaking infection levels.

Patients seeking the treatment, which suppresses an infection to prevent disease escalation and hospitalisation, have reported being turned away by GPs and hospital doctors, while others say they’ve been “pushed from pillar to post” in an attempt to access the medication.

An NHS manager told The Independent that only 15% of eligible patients cared for by Kent and Medway Clinical Commissioning Group received antiviral medication in February.

Anthony Nolan, the blood cancer charity, and Kidney Care UK both said they had received reports that Covid Medicine Delivery Units (CMDUs), which are responsible for ensuring antiviral medication reaches patients, were overwhelmed and struggling to provide treatment.

“Weekends are a particular problem and it causes a lot of stress,” said Fiona Loud, a policy director a Kidney Care UK. “We have had reports from people in different parts of the country.”

Paxlovid, molnupiravir and remdesivir are available via the NHS as antiviral medicine. All three have been shown to be effective in reducing the risk of hospitalisation among infected vulnerable patients. Antibody treatment, administered intravenously, is also available.

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Source: The Independent, 4 April 2022

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Swamped NHS mental health services turning away children, say GPs

Children and young people who are anxious, depressed or are self-harming are being denied help from swamped NHS child and adolescent mental health services, GPs have revealed.

Even under-18s with an eating disorder or psychosis are being refused care by overstretched CAMHS services, which insist that they are not sick enough to warrant treatment.

In one case, a crisis CAMHS team in Wales would not immediately assess the mental health of an actively suicidal child who had been stopped from jumping off a building earlier the same day unless the GP made a written referral. In another, a CAMHS service in eastern England declined to take on a 12-year-old boy found with a ligature in his room because the lack of any marks on his neck meant its referral criteria had not been met.

The shocking state of CAMHS care is laid bare in a survey for the youth mental health charity stem4 of 1,001 GPs across the UK who have sought urgent help for under-18s who are struggling mentally. CAMHS teams, already unable to cope with the rising need for treatment before Covid struck, have become even more overloaded because of the pandemic’s impact on youth mental health.

Mental health experts say young people’s widespread inability to access CAMHS care is leading to their already fragile mental health deteriorating even further and then self-harming, dropping out of school, feeling uncared for and having to seek help at A&E.

“As a clinician it is particularly worrying that children and young people with psychosis, eating disorders and even those who have just tried to take their own life are condemned to such long waits”, said Dr Nihara Krause, a consultant clinical psychologist who specialises in treating children and young people and who is the founder of stem4.

“It is truly shocking to learn from this survey of GPs’ experiences of dealing with CAMHS services that so many vulnerable young people in desperate need of urgent help with their mental health are being forced to wait for so long – up to two years – for care they need immediately.

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Source: The Guardian, 3 April 2022

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Gynaecology waits soar by 60% during pandemic

Gynaecology waiting lists in England have risen by 60% during the pandemic - more sharply than any other specialty.

Across the UK, more than 570,000 women are waiting for help.

The Royal College of Obstetricians and Gynaecologists (RCOG) said patients were "consistently deprioritised and overlooked".

NHS England says hospitals are making progress on dealing with the Covid backlog and average waiting times for elective treatment are coming down.

The RCOG is calling for much greater attention to women's views, and for care to be designed around their needs.

Chetna Mistry says she is a "prisoner" to endometriosis, a painful condition in which tissue similar to the lining of the womb grows in other places, like the ovaries.

She described it as "a whole-body disease which affects you physically and mentally". It has left her infertile, and, at 42, she needs a hysterectomy.

Chetna said she was referred to a specialist in June 2020, but 21 months later still does not have a date for surgery.

RCOG president Dr Edward Morris said he felt helpless not being able to speed up access to care for women and people on his waiting lists.

"There is an element of gender bias in the system. I don't think believe that we are listening to voices of women as well as we should be. The priority they urgently need is not being given to them."

The Royal College asked 830 women on waiting lists about the other impacts on their lives.

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Source: BBC News, 4 April 2022

 

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Patient care and safety put at risk in A&E at brand new £350m hospital

Patients visiting Wales' newest emergency department were likely to have been put at risk of harm due to the lack of processes and systems in place, inspectors found. Healthcare Inspectorate Wales (HIW) carried out an unannounced inspection of The Grange University Hospital in Cwmbran between 1 and 3 November last year and published its findings on 29 March.

On the day of their arrival inspectors said The Grange was at full capacity with no empty beds in A&E or in the hospital in general. Despite the best efforts of staff who were "working hard under pressure" the report stated the emergency department had several issues which could have compromised the privacy and dignity of patients. This included problems with the physical environment of the waiting room, which was described as a "major cause of anxiety" for visitors, as well as with the flow of patients through the hospital in general.

It found that patients were not triaged and medically managed in A&E in a timely fashion with many being placed on uncomfortable chairs or in corridors for hours on end. Between 1 April 2021 and 1 November 2021, the average waiting time in the department was six hours and seven minutes.

The report said some issues required immediate action including the fact patients in the waiting area were often left to "deteriorate without being overseen". There were also infection control failures which could have led to the cross-contamination of Covid-19. "We were not assured that all the processes and systems in place were sufficient to ensure that patients consistently received an acceptable standard of safe and effective care," the report stated.

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Source: Wales Online, 1 April 2022

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Bullying among top surgeons sparks two national investigations

‘Horrifying and upsetting’ reports of bullying in prestigious heart units are being probed by national officials and professional leaders, HSJ can reveal.

Health Education England told HSJ it was “undertaking a national thematic review of training in cardiothoracic surgery”, while the Society for Cardiothoracic Surgery separately revealed it was investigating concerns about “bullying, harassment and undermining behaviour” in the specialty following high-profile recent cases in Newcastle and Wales.

Society president consultant surgeon Simon Kendall, who is based at James Cook University Hospital in Middlesbrough, told HSJ he has been made aware of wider problems beyond those identified in the North East and Wales.

Mr Kendall revealed allegations reported to the society have included people being shouted at in public, problems resulting from a “legacy culture of sarcasm and public humiliation”, and more personal disputes between individuals.

The consultant surgeon told HSJ: “The job is hard enough for all of us, without picking on each other and making it worse."

He added: “It’s the extended team that is affected by these behaviours and it will have an impact on patient safety and patient care.

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Source: HSJ, 1 April 2022

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RCM response to Ockenden review into maternity services at Shrewsbury and Telford

Poor culture and leadership must be addressed if we are to make our maternity services the safest place to give birth. This statement from the Royal College of Midwives (RCM) came as the final report of the largest ever review of NHS maternity services was published. The RCM acknowledged that the pain and suffering of the families had been worsened by having to fight for answers and vowed to work with NHS bodies and other professional organisations to ensure lessons are learned from these tragic failings.

Today the RCM has pledged to continue its work to be part of the solution to safety improvements and support its members to do the same not only at Shrewsbury and Telford NHS Trust, but throughout all maternity services across the UK.

Commenting, the Royal College of Midwives’ (RCM) Chief Executive, Gill Walton said:

“It is heartbreaking that this report only came about because of the determination of the families. We owe them a debt that I fear can never be repaid. What we can do - all of us who are involved in maternity services – is work together to ensure we listen, and we learn from this and ensure that women and families have trust in their care."

“This review must be a turning point for all those working in maternity services. The actions recommended are measured and sensible and reflect much of what the RCM has been calling for. We hope that those in a position to enact them – NHS England and the Department for Health & Social Care – will do so in partnership with organisations like ours and with haste.”

"A poor working culture, where staff were afraid to raise concerns, has been cited by the report as a key factor in many of the cases. Earlier this year the RCM called for a seismic NHS cultural shift to improve maternity safety as it published guidance for its members to raise concerns about maternity care which outlined steps staff can take and what to do if they feel they are not being listened to or their concerns are ignored."

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Source: Royal College of Midwives, 30 March 2022

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Experts warn of racial disparities in the diagnosis and treatment of Long Covid

It has long been clear that Black Americans have experienced high rates of coronavirus infection, hospitalisation and death throughout the pandemic.

But those factors are now leading experts to sound the alarm about what will may come next: a prevalence of Long Covid in the Black community and a lack of access to treatment.

Long Covid — with chronic symptoms like fatigue, cognitive problems and others that linger for months after an acute coronavirus infection has cleared up — has perplexed researchers, and many are working hard to find a treatment for people experiencing it. But health experts warn that crucial data is missing: Black Americans have not been sufficiently included in Long-Covid trials, treatment programmes and registries, according to the authors of a new report released on Tuesday.

“We expect there are going to be greater barriers to access the resources and services available for Long Covid,” said one of the authors, Dr. Marcella Nunez-Smith, who is the director of Yale University’s health equity office and a former chair of President Biden’s health equity task force.

“The pandemic isn’t over, it isn’t over for anyone,” Dr. Nunez-Smith said. “But the reality is, it’s certainly not over in Black America.”

In the first three months of the pandemic, the average weekly case rate per 100,000 Black Americans was 36.2, compared with 12.5 for white Americans, the authors write. The Black hospitalisation rate was 12.6 per 100,000 people, compared with 4 per 100,000 for white people, and the death rate was also higher: 3.6 per 100,000 compared with 1.8 per 100,000.

“The severity of Covid-19 among Black Americans was the predictable result of structural and societal realities, not differences in genetic predisposition.” 

"Many Black Americans who contracted the coronavirus experienced serious illness because of pre-existing conditions like obesity, hypertension and chronic kidney disease, which themselves were often the result of “differential access to high-quality care and health promoting resources,” the report says.

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Source: New York Times, 29 March 2022

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Guilty verdict for nurse RaDonda Vaught’s dosing mistake could cost lives

Patient safety and nursing groups around the country are lamenting the guilty verdict in the trial of a former nurse in Tennessee, USA.

The moment nurse RaDonda Vaught realised she had given a patient the wrong medication, she rushed to the doctors working to revive 75-year-old Charlene Murphey and told them what she had done. Within hours, she made a full report of her mistake to the Vanderbilt University Medical Center.

Murphey died the next day, on 27 December 2017. On Friday, a jury found Vaught guilty of criminally negligent homicide and gross neglect.

That verdict — and the fact that Vaught was charged at all — worries patient safety and nursing groups that have worked for years to move hospital culture away from cover-ups, blame and punishment, and toward the honest reporting of mistakes.

The move to a “Just Culture" seeks to improve safety by analyzing human errors and making systemic changes to prevent their recurrence. And that can't happen if providers think they could go to prison, they say.

“The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent,” the American Nurses Association said. “Health care delivery is highly complex. It is inevitable that mistakes will happen. ... It is completely unrealistic to think otherwise.”

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Source: The Independent, 31 March 2022

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Sajid Javid: Doctors too often ‘ignore’ women’s pain

Doctors too often "ignore" women's pain, Sajid Javid said as he called for change in the wake of the Shrewsbury maternity scandal.

Writing for The Telegraph, the Health Secretary said the wider NHS needed to do much more to listen to women, adding that too many are left in pain and ignored by clinicians.

On Wednesday, the Ockenden report revealed that the deaths of 201 babies and nine mothers at Shrewsbury and Telford NHS Trust could have been avoided, citing a failure to listen to women.

Mr Javid wrote: "This week we have seen the tragic reality of what can happen when women's voices are not listened to when it comes to their care. 

"Donna Ockenden's report into maternity failings at Shrewsbury and Telford Hospitals raises specific concerns for maternity services, but more widely we must address issues across the whole of the health and care system when it comes to listening to women's concerns and recognising their pain."

In the joint piece with Maria Caulfield, the minister for women’s health, Mr Javid welcomed a "shift in the way we talk about women's health", with more open discussions about areas once seen as taboo.

But the pair said more needed to be done – specifically to improve the treatment of endometriosis, an extremely painful gynaecological condition.

"We must ensure all women feel confident in going to their GP when they experience symptoms of endometriosis and, when they do, that they are listened to," they said. Too many were "spending too long in pain waiting for a diagnosis, often feeling ignored by clinicians", they warned.

Later this year the Government will publish a women's health strategy, which will examine issues including fertility, menopause, and prevention and treatment of diseases.

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Source: The Telegraph, 31 March 2022

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Stroke and heart patients routinely waiting over an hour for ambulance

Stroke and heart attack victims are now routinely waiting more than an hour for an ambulance, after a further fall in performance in recent weeks, and with hospital handover delays hitting a new high point, HSJ reveals.

Figures for ambulance performance this week, seen by HSJ, showed average response times for category two calls at more than 70 minutes for successive days. 

3,000 patients may have suffered “severe harm” from delays in February, ambulance chief executives say.

Several well-placed sources in the sector said response times had deteriorated further this month, and that more than half of ambulance trusts were this week seeing average category two responses of longer than an hour. 

Some cited an average category two response last week of around 70 minutes, with the services under huge pressure from a combination of demand, long handover delays, and covid-related sickness.

Category two calls include patients with suspected heart attacks and strokes, and the national target for reaching them is 18 minutes.

The figures seen by HSJ for this week showed average response times for category one calls — the most serious, including cardiac arrests and other immediately life threatening emergencies — of more than 10 minutes on Wednesday, against a target of just 7 minutes. Monthly average performance for category one has never reached 10 minutes.

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Source: HSJ, 1 April 2022

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Artificial pancreas to revolutionise diabetes care in England

Nearly 900 patients with type 1 diabetes in England are testing a potentially life-changing artificial pancreas.

It can eliminate the need for finger prick tests and prevent life-threatening hypoglycaemic attacks, where blood sugar levels fall too low.

The technology uses a sensor under the skin. It continually monitors the levels, and a pump automatically adjusts the amount of insulin required.

Six-year-old Charlotte, from Lancashire, is one of more than 200 children using the hybrid closed loop system.

Her mother, Ange Abbott, told us it has made a massive impact on the whole family.

"Prior to having the loop, everything was manual," she said. "At night we'd have to set the alarm every two hours to do finger pricks and corrections of insulin in order to deal with the ups and downs of Charlotte's blood sugars."

Prof Partha Kar, NHS national speciality adviser for diabetes, said: "Having machines monitor and deliver medication for diabetes patients sounds quite sci-fi like, but technology and machines are part and parcel of how we live our lives every day.

"It is not very far away from the holy grail of a fully automated system, where people with type 1 diabetes can get on with their lives without worrying about glucose levels or medication."

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Source: BBC News, 1 April 2022

Further reading on the hub

How safe are closed loop artificial pancreas systems?

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