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US nurses to hold informational picket for patient safety at West Anaheim Medical Center

Registered nurses (RNs) at US Prime Healthcare’s West Anaheim Medical Center (WAMC) will hold an informational picket today to protest chronic short staffing and its impact on safe patient care.

Nurses say that the hospital should cancel elective surgeries because those beds and nurses are needed for other emergent patients. RNs in all medical departments are short-staffed, putting patient safety in jeopardy.

“Nurses are under incredible pressure to care for patients beyond the state’s mandated safe staffing ratios due to the staffing crisis in our hospital,” said John Olarte, RN at WAMC. “The employer should be making beds available by canceling elective surgeries for the foreseeable future. Save those beds for the patients who most need them and at the same time give the RNs a chance to truly care for these patients by not forcing nurses to take patients that don’t need to be in the hospital right now. The public needs to know that the hospital is not doing everything they can to help the nurses care for patients.”

“There is a staffing crisis because RNs are leaving,” said Sofia Rivera, RN in the emergency department at WAMC, “To attract and retain quality nurses — just staff the floors so the RNs do not have to pick up multiple extra shifts due to the revolving door of RNs in this hospital.”

Nurses say they want a strong contract so they can recruit and retain RNs and they want to establish a health and safety committee to ensure they have a voice on issues of nurse safety and patient care. They have been in contract negotiations since May 2021. Their contract expired in June 2021.

“We are getting slaughtered in the ER,” said Rasha Tran, RN. “Ambulances are just leaving their patients in the ER instead of waiting for an available bed because they are waiting too long. I don’t even know how we can sustain this demand to care for so many patients. It means less care for each patient. Continuing elective surgeries means that a regular bed is not available for a patient in the ER who is now is being held for hours or days before they are admitted. Even before this most recent Covid surge, nurses have been picking up extra 12-hour shifts to help our coworkers, often without a break for meals or rest periods.”

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Source: National Nurses United, 11 February 2022

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Delayed diagnoses and self-imposed lockdown: Australians living with cancer during Covid

Two years of the pandemic have meant drops in essential screening and detection in Australia, while cancer patients undergo treatments alone and isolate to avoid Covid risks.

When Claire Simpson turned 50 in early 2020, she received a letter telling her to get a mammogram. Then the pandemic hit, and Victoria went into lockdown.

“Like many people, I put it off until we were coming out of that lockdown, but by then it was September and I couldn’t get an appointment until December,” she says.

In February 2021 she was diagnosed with breast cancer and had a mastectomy. Tests showed she was positive for the aggressive HER2 receptor, so she began 12 weeks of chemotherapy as well as a treatment called Herceptin, which she received an IV infusion of every three weeks.

Simpson says the delay in screening “really, really delayed diagnosis for me, by a good six months”.

“I can’t help but feel that [an earlier screening] could have probably saved me from having to have chemotherapy and this Herceptin infusion therapy that I’m having,” she says.

Her last Herceptin treatment was last Wednesday. She has been living in self-imposed lockdown, terrified as the Omicron wave built that she would have to isolate due to Covid and disrupt her treatment. That self-imposed isolation will continue until her final surgery, an elective operation scheduled for mid-year.

Cancer screening dropped by 10% in Victoria alone in the first year of the pandemic. In 2021, referrals to the Peter MacCallum Cancer Centre, a leading treatment and research facility in Melbourne, were down 40%.

“That is certainly going to bounce back at some point,” says Prof Sherene Loi, an oncologist and researcher at Peter MacCallum. “It is potentially going to be a real problem in a few years’ time. At the moment we have a lot of very young cancer diagnoses, a lot of breast cancer … we are just flat chat.”

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Source: The Guardian, 13 February 2022

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Heart-disease risk soars after COVID — even with a mild case

Even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis, a new study1 shows. Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease.

What’s more, the risk was elevated even for those who were under 65 years of age and lacked risk factors, such as obesity or diabetes.

“It doesn’t matter if you are young or old, it doesn’t matter if you smoked, or you didn’t,” says study co-author Ziyad Al-Aly at Washington University in St. Louis, Missouri, and the chief of research and development for the Veterans Affairs (VA) St. Louis Health Care System. “The risk was there.”

People who had recovered from COVID-19 showed stark increases in 20 cardiovascular problems over the year after infection. For example, they were 52% more likely to have had a stroke than the contemporary control group, meaning that, out of every 1,000 people studied, there were around 4 more people in the COVID-19 group than in the control group who experienced stroke.

The risk of heart failure increased by 72%, or around 12 more people in the COVID-19 group per 1,000 studied. Hospitalization increased the likelihood of future cardiovascular complications, but even people who avoided hospitalization were at higher risk for many conditions.

“I am actually surprised by these findings that cardiovascular complications of COVID can last so long,” Hossein Ardehali, a cardiologist at Northwestern University in Chicago, Illinois, wrote in an e-mail to Nature. Because severe disease increased the risk of complications much more than mild disease, Ardehali wrote, “it is important that those who are not vaccinated get their vaccine immediately”.

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Source: Nature, 10 February 2022

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Vulnerable women are being failed by maternity services, report finds

Current models of maternity care in the UK are failing to reach pregnant women living in adverse social circumstances, research commissioned by the Royal College of Obstetricians and Gynaecologists has found.

Georgina Jones, one of the report’s authors and professor of health psychology at Leeds Beckett University, told The BMJ, “Women are often living in a tangled web of complex inequalities that is beyond their control, and this impacts on the care they receive and the outcomes of that care . . .We’ve really been letting down these women in the way that our maternity and reproductive health services are currently delivered, and strategies and care pathways need to be identified and put in place to remedy this.”

A number of recommendations have been made in the paper including:

  • Understanding it is the vulnerable, minoritised and disadvantaged women in society that have an increased risk of maternal death. These women are often living in an entangled web of complex inequalities that is beyond their control, which impacts on the care they receive and the outcomes of that care.
  • Strategies and care pathways need to be identified and put in place to improve their situation. These women have been let down in the way that our maternity and reproductive health services are currently delivered.
  • We need to find a better way of recording social determinant data. The current way of doing this is inadequate and not fit for purpose, and it doesn’t provide us with enough information to really understand how the complex circumstances of the woman impacts on her maternal outcomes.
  • The research shows current models of care are still failing pregnant women who have lived in adverse social circumstances prior to, during and after pregnancy. Maternal outcomes are particularly poor for socially disadvantaged women affected by pre-existing physical or mental health problems; those who misuse substances; those who have a lower level of education; those who are overweight, undernourished or poorly sheltered; and those who are at increased risk due to the threat of abusive and unsupportive partners, families and peers.

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Source: BMJ, 10 February 2022

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Staff on prolonged leave with long covid could be dismissed, says NHSE

Staff on prolonged sick leave due to long covid could be dismissed if ‘redeployment is not an option’ and they are unable to fulfil their contract, new NHS England guidance says.

The advice was set out in guidance published this month and follows the government’s temporary, non-contractual guidance that was issued in response to the coronavirus pandemic during its first waves.

The government’s advice aimed to provide a temporary enhancement of covid sick pay and meant that staff who were absent with covid would remain on full pay, therefore, did not feel pressured to return.

However, NHSE’s guidance warned that “while this provision is still available, it is possible that it may change”.

The move has been seen as an inevitable step as the guidance was brought in as an emergency measure, while some employers may have been holding off dismissing staff with long covid or covid-related absences due to guidelines in place.

NHSE’s new Guidelines for supporting our NHS people affected by long covid said: “According to [the] guidance, periods of covid-19 sick pay would not be counted towards a colleague’s normal sickness entitlements.

“However, if a colleague is approaching long-term sickness (for a period of 12 months or more), the employing organisation would be expected to complete a review at 12 months to understand the ongoing need and potential challenges with a return to work.

It adds: “Consideration of dismissal due to the colleague being unable to fulfil their contract should only be considered if redeployment is not an option.”

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Source: HSJ, 11 February 2022

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NHS hospital doctor arrested on suspicion of sexual assault

Two NHS hospital trusts are working with police after a doctor was arrested on suspicion of sexual assault.

Staffordshire Police has launched a major incident review of the doctor's work at hospitals in Dudley, West Midlands, and Stoke-on-Trent, The Sunday Times reported.

The force said the 34-year-old man from the West Midlands was arrested in December and released on bail.

It is reviewing an investigation into the same suspect it undertook in 2018.

The doctor was suspended from seeing patients at the Royal Stoke University Hospital in Staffordshire when the parents of a vulnerable female raised concerns about his examination of her, the Sunday Times reported.

The case was referred to police in 2018 who said there was "insufficient evidence to take further action" at the time.

The Staffordshire force has now reported itself to the Independent Office for Police Conduct.

University Hospitals of North Midlands NHS Trust, which runs the Royal Stoke, said it was working with police and had set up a helpline for any patient and guardian who may have concerns.

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Source: BBC News, 13 February 2022

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Doctors repeatedly told a woman stress was causing her symptoms. Then they pulled out a volleyball-size tumor.

Again and again, Hannah Catton told doctors something was wrong with her body. Again and again, she said, the doctors dismissed her concerns.

They didn’t listen in late 2018 when she told them about her frequent urinary tract infections. They didn’t listen months later when she returned to tell them she was having irregular periods. And they didn’t listen when she complained of bloating, constipation, diarrhea and extreme pain.

Catton was telling them her body was in rebellion. Almost a dozen physicians told her otherwise: She was young and healthy, so it was probably nothing — just a little too much stress. One told her she was overweight and losing a few pounds might ease her symptoms.

Almost three years passed after Catton’s symptoms first emerged, during which she saw about 10 doctors. Then, in October, she collapsed in pain and took herself to the emergency room. From one of her ovaries, surgeons pulled a cancerous blob weighing roughly 4½ pounds and stretching nearly eight inches — about the size of a volleyball.

After her years-long crusade to be heard, Catton, now 24, wants other women and doctors to learn from her experience. Women should learn the warning signs of ovarian cancer and forcefully advocate for themselves, she said, while doctors need to become better versed in recognizing the symptoms. More importantly, Catton said, physicians need to listen to patients instead of dismissing them.

Catton knew early on that something was wrong, that it wasn’t just stress. Despite that, she acquiesced to the doctors because she didn’t “want to be a patient that wastes time.”

She’s not alone, clinical psychologist Bella Grossman told Northwell Health’s Katz Institute for Women’s Health in the article “Gaslighting in women’s health: No, it’s not just in your head.” Men tend to be more persistent with their doctors when they have concerns about their health, Grossman said.

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Source: Washington Post, 9 February 2022

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7,469 research nurses and midwives across the UK and Ireland, new census reveals

There are at least 7,469 research nurses and midwives across the UK and Ireland working within all areas of healthcare, reveals a landmark new census initiated by a group of NIHR 70@70 Senior Nurse & Midwife Research Leaders.

The census, incorporating responses from research nurses and midwives across all four UK nations and the Republic of Ireland, reveals nurses and midwives are working at every level in healthcare from Bands 5 – 9 in the UK, and from staff nurse to Directors of Nursing or Midwifery in the Republic of Ireland. This suggests there are opportunities to join the profession at every level, with continued potential for career progression. Clinical research nurses and midwives are a specialist workforce, with knowledge, skills and expertise in both clinical practice and research delivery.

The census shows that:

  • 33.7% reported working in joint posts, for example as a clinical research nurse for part of their role as well as a clinical nurse specialist;
  • 72% are working within a single disease/area specialism; 
  • 28% reported covering multiple disease areas. 

NIHR Director of Nursing & Midwifery Professor Ruth Endacott said: “This census reveals the true breadth and depth of our research nursing and midwifery community. We know there are scores of people working incredibly hard day and night helping to bring us new treatments and medicine alongside their healthcare colleagues but we now have a much clearer idea of the size of the workforce. Research nurses and midwives are making a difference to the health of people across the UK and Ireland."

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Source: National Institute for Health Research, 9 February 2022

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Soaring trolley waits spark warnings A&E pressures getting ‘worse and worse’

The number of 12-hour waits in accident and emergency departments rose by 27% in one month to reach record levels in January amid warnings overcrowding is harming an increasing number of patients.

Official monthly performance data prompted the Royal College of Emergency Medicine’s president to warn that the problems facing emergency departments were getting “worse and worse”, while pointing out the real number of 12-hour A&E breaches is likely higher than official data records. 

The figures also revealed the waiting list had hit a new high of 6.1 million, while the number of two-year breaches also rose a record level.

Trusts recorded 16,558 patients last month waited 12 hours or more in an emergency department from decision to admit to being discharged or admitted. This was up from 12,986 in December.

RCEM president Katherine Henderson warned on Twitter: “This is [decision to admit] plus 12 – a concept which must be retired as a performance metric. We should have 0-12 hour data. You cannot fix a problem if you [are] unwilling to face up to what it actually is. We estimate reality is 20 x more. This is getting worse and worse.”

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Source: HSJ, 10 February 2022

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CDC proposes new guidelines in the US for treating pain, including opioid use

The federal government on Thursday proposed new guidelines for prescribing opioid painkillers that remove its previous recommended ceilings on doses for chronic pain patients and instead encourage doctors to use their best judgment.

But the overall thrust of the recommendations was that doctors should first turn to “nonopioid therapies” for both chronic and acute pain, including prescription medications like gabapentin and over-the-counter ones like ibuprofen, as well as physical therapy, massage and acupuncture.

Though still in draft form, the 12 recommendations, issued by the Centers for Disease Control and Prevention (CDC), are the first comprehensive revisions of the agency’s opioid prescribing guidelines since 2016. They walk a fine line between embracing the need for doctors to prescribe opioids to alleviate some cases of severe pain while guarding against exposing patients to the well-documented perils of opioids.

“We are welcoming comments from patients who are living with pain every day and from their caregivers and providers,” said Christopher Jones, a co-author of the draft and acting director of the National Center for Injury Prevention and Control, the arm of the CDC that released the new guidelines.

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Source: The New York Times, 10 February 2022

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Record levels of self-harm found at Derbyshire women’s prison

Inmates held in a women’s prison are making 1,000 calls a month to Samaritans amid record levels of self-harm, increased violence and low safety levels usually only seen in men’s facilities, a damning report has found.

Nearly a third of women held at Foston Hall in Derbyshire, which holds 272 residents, told inspectors they felt unsafe, while the use of force in the prison has doubled over nearly three years and is the highest on the women’s prison’s estate.

The women’s prison and youth offender institute is the first to be given a score of “poor” – the lowest – for the safety of female prisoners, since HM Inspectorate of Prisons developed its current framework more than a decade ago.

Charlie Taylor, HM chief inspector of prisons, said the rating of “poor” for safety levels was a “rare and unexpected finding” in a women’s prison.

Recorded levels of self-harm were also the highest in the women’s estate and two prisoners had taken their own lives since the last official inspection in February 2019, he said.

“As an indicator of the level of distress, women were making 1,000 calls a month to Samaritans. The prison had no strategy to reduce self-harm or improve the care for those in crisis,” Taylor said.

The response to women in crisis was too reactive, uncaring and often punitive, Taylor observed. “This, taken with other safety metrics and observation, meant it was no surprise that in our survey nearly a third of women told us they felt unsafe,” he said.

The report also found that the majority of women who harmed themselves did not have enough support or activity and faced daily frustration in getting the help they needed. 

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Source: The Guardian, 9 February 2022

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Lack of hospital beds makes Covid spread 'inevitable'

A lack of beds in Welsh hospitals meant it was "inevitable" Covid patients would come into contact with others, a doctor has said.

"Seeing patients in bed at the time of admission is becoming a rarity," Dr Nicky Leopold said.

Some patients, including those with Covid, have had to spend nights on chairs in A&E due to a lack of beds.

The Welsh government said it aimed to deliver 12,000 more staff by 2024-25.

Health Minister Eluned Morgan and the chief executive of the Welsh NHS are due to give evidence to the Senedd's health committee on winter pressures..

Dr Leopold, a consultant geriatrician, who is a member of the BMA union in Wales, said there had been recent improvements since the number of NHS staff testing positive for Covid fell, but the flow of patients through hospital was still a problem.

She said: "So many patients are stranded in hospital and that's very difficult and frustrating. There just aren't the staff in the community to support the increased level of need."

Outpatient appointments had also been affected by shortages, she added. A lot of patients were in "dire need" and staff were "desperately" trying to keep clinics running.

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Source: BBC News, 10 February 2022

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Role of NHS national and regional teams under review as ICSs develop, says Confed chief

The role of the centre and region of NHS England is under review because trusts will increasingly be accountable to and challenged by their integrated care systems, the NHS Confederation chief executive has said. 

Matthew Taylor, CEO of Confed, also told HSJ people should “guard against scepticism” about the emerging ICSs, which are a “bold experiment” and need to be given time.

Speaking about the respective roles of ICSs and NHS England’s national and regional teams, Mr Taylor said: “One of the challenges for ICSs is that [while] they will be about convening, they’ll be about developing collaboration, they will be developing a shared vision, there will be an element of challenge as well.

“If things go wrong and ICSs and [integrated care boards] are in place, then ICBs will need demonstrate they can tackle those things.”

He added: What we don’t want is another layer [in addition to the] centre and region. I’ve spoken to quite a lot of acute leaders over the last few months about ICBs and ICSs, and when I say to them, ‘do you want another level of accountability that you’ve got to report to?’ They say ‘no’.

“But when I say, ‘what if it replaced - and you had less regulation from - the centre and from the regions, and more from the system level, would that be okay?’ And they say, ‘that’ll be fine, that will be good’.

“Because I think they would feel a level of engagement then. Nobody wants to see more regulation - it’s a question of trying to make sure that challenge function primarily takes place at system level.”

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Source: HSJ, 10 February 2022

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Why America needs a National Patient Safety Board

Within hours of the catastrophic Fern Hollow bridge collapse in Pittsburgh, USA, the National Transportation Safety Board was on the scene, finding answers to “Why?” and “How can we keep this from ever happening again?” What could be more obvious than the value of having a team of experts on the alert — and empowered with the authority — to provide promising solutions to dangerous situations?

Transportation industries embraced the recommendations because they know what its corporate mission and obligation to the public is: to get people from place to place as efficiently and safely as possible.

Sadly, we cannot say the same for health care, says Karen Wolk Feinstein. 

There is no single federal agency entrusted with a sole mission: to make health care as safe as possible by investigating solutions to major threats. Therefore, there has been comparatively little progress to protect patients from medical mistakes.

We don’t understand well enough the preconditions and root causes of adverse events, making it difficult to prevent harm before it happens; we haven’t deployed the safety technology and analytics we have available; and we often don’t share existing lessons learned or actionable solutions, says Karen.

That’s why a coalition of US experts, including leaders from hospitals, insurers, patient safety groups, consumer advocates, foundations, universities, technology companies and employers has formed to promote the establishment of an independent, nonpunitive federal agency dedicated to finding data-driven solutions to the problem of medical error. A National Patient Safety Board, modelled after the National Transportation Safety Board, would identify patient safety events, study the root causes of these events and issue recommendations to prevent future lapses.

More than 80% of the NTSB’s recommendations are acted upon. Imagine if this occurred in health care: How many lives could be saved? How much needless suffering could be prevented?

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Source: Pittsurgh Post-Gazette, 10 February 2022

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FDA: Potential risk of strangulation in children who use enteral feeding delivery sets

The US Food and Drug Administration (FDA) is warning healthcare providers, parents and caregivers of pediatric patients (children) who receive enteral feeding that there is a risk of strangulation from the use of enteral feeding delivery sets. The feeding set tubing can become wrapped around a child’s neck and cause strangulation or death. The FDA has received reports of two toddlers who died after being strangled by the tubing. 

Recommendations for parents and caregivers of children who use enteral feeding delivery sets:

  • Be aware that the feeding set tubing can get wrapped around a child’s neck, which can lead to strangulation or death. 
  • To the extent possible, avoid leaving the feeding set tubing where infants or children can become entangled.
  • Discuss with your child's health care provider:
  • If your child has been tangled in their tubing before.
  • Steps you can take to help ensure that tubing does not get wrapped around your child’s neck, such as keeping the tubing away from the child as much as possible.
  • Any other concerns you may have about the risk of strangulation from feeding set tubing. 
  • If your child is injured by feeding set tubing, please report the event to the FDA. Your report, along with information from other sources, can provide information that helps improve patient safety.

Recommendations for healthcare providers:

  • Review this topic and the information noted above with your colleagues, care teams, and caregivers of pediatric patients who use enteral feeding delivery sets, to ensure they are aware of the potential risk of strangulation with the associated tubing and are taking appropriate measures to keep the tubing away from the child as much as possible.
  • When caring for pediatric patients who receive enteral feeding and as part of an individual risk assessment, be aware of the risk of strangulation from the feeding set tubing and follow protocols to monitor medical line safety.
  • If a patient experiences an adverse event related to enteral feeding set tubing, you are encouraged to report the event to the FDA. Prompt reporting of adverse events can help the FDA identify and better understand the risks associated with medical devices.

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Source: FDA, 8 February 2022

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Leak reveals management consultants’ role in recovery plans

Consultants will set strategy, provide analytics and help lead the creation of integrated care systems’ elective recovery plans, a leaked document reveals.

HSJ reported that seven management consultancy firms would be paid up to £21m to “support” every ICS design its elective recovery plans by April. According to internal NHS documents, leaked to HSJ, the firms will provide “tailored skills and expertise” to help ICS teams develop their plans.

The document, shared with ICS and regional chiefs in a presentation by NHS elective care chief Sir Jim Mackey, states the consultancies will work alongside ICS teams to “ensure” the ICS plans achieve many objectives.

These objectives include:

  • Delivering or exceeding the expected performance ambitions… and are “triangulated across activity, finance and workforce capacity”;
  • Making “full use of transformational opportunities” to manage demand, increase capacity or improve productivity; 
  • Having a clear link to the health inequalities agenda; and
  • Maximising elective activity through all available options including making use of the available independent sector capacity. 

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Source: HSJ, 10 February 2022

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Woman with agonising burns sent away from two hospitals: new rules mean people have to get urgent care at unit closest to home

Patients needing urgent care may be sent to the unit closest to their homes under new rules, the Manchester Evening News revealed.

Hospital bosses admitted the ‘protocol’ after one patient, suffering horrific burns, reported being sent away from two hospitals before receiving any care.

The Northern Care Alliance NHS Group has introduced the directive as part of a ‘reconfiguration of services across Greater Manchester’, saying that patients will be sent to the 'most appropriate place for their needs', 'closest to their home', in the 'quickest time possible'.

However, anyone needing care for emergency and life-threatening conditions can still go to their nearest A&E department for treatment, hospital chiefs have stressed.

The group operates Salford Royal Hospital, the Royal Oldham Hospital, Fairfield General Hospital, and Rochdale Infirmary, among other local care services.

The instructions come as a 64-year-old woman from Norden in Rochdale suffered with severe burns after accidentally tipping scalding water on herself while on holiday in Northumberland.

The woman - a former nurse of more than 30 years - was unable to treat the burns alone, and she returned home with her husband, immediately attending Rochdale Infirmary's Urgent Care Centre.

Noting that there would be a 'five-and-a-half hour wait' for urgent care, a staff member sent the patient to Fairfield General's Accident and Emergency Department in Bury, she says.

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Source: Evening Manchester News, 29 September 2021

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Advisor to Government Agency demands police investigation into ‘criminal’ healthcare worker COVID deaths

A formal complaint accuses the British Government of facilitating ‘the largest single health and safety disaster to befall the United Kingdom workforce since the introduction of asbestos products’.

An expert letter to the UK Government’s Health & Safety Executive (HSE) from one of its own advisors accuses the agency of failing to use its statutory authority to correct “seriously flawed” guidance on infection protection and control (IPC), imperilling “the health and safety of healthcare workers by failing to provide for suitable respiratory protection”.

The continued failure to protect healthcare workers by ensuring they are wearing the appropriate form of PPE (personal protective equipment) to minimise the risk of infection from COVID-19 airborne transmission, the letter says, has led to thousands of avoidable deaths. The failures amount both to “gross negligence” and serious “criminal offences”, claims the letter seen by Byline Times.

The letter addressed to HSE chief executive Sarah Albon is authored by 27-year chartered health and safety consultant David Osborn, who is a ‘consultee member’ of the HSE’s COSHH (Control of Substances Hazardous to Health) Essentials Working Group, where he has helped HSE to prepare guidance for employers and employees. 

Written in his own personal capacity, the letter is a formal complaint accusing the members of the Government’s “IPC Cell” – a group of experts behind official guidance on infection protection and control – along with other senior Government officials of committing a “criminal offence… ultimately punishable by fine and/or imprisonment” by breaching Section 36 of the Health and Safety at Work Act. The letter argues that a police investigation is needed.

The guidance, Osborn writes in his letter, has failed to ensure that healthcare workers understand that they should wear and have access to respiratory protection equipment (RPE) designed to protect from COVID-19 airborne transmission. 

“There is sufficient prima-facie evidence to suggest that the offence has led to the potentially avoidable deaths of hundreds of healthcare workers and the debilitating disease known as Long COVID in thousands of other healthcare workers,” the letter says.

“I firmly believe that the primary source of infection was the inhalation of aerosols whilst caring for infected patients at close quarter,” says Osborn in his letter.

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Source: Byline Times, 10 February 2022

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Post-natal depression in men: 'The darkest time of my life'

About 1 in 10 fathers will experience a depressive episode within the first year after a baby is born but no Scottish health board has any specific measures to monitor their mental health, BBC Scotland has learned.

Peter Divers, 39, says he hid his feelings of depression for months after his second child was born in November 2016.

"It was the darkest time of my life," he says.

"I woke up every morning with a knot in my stomach. I felt like there was a big dark cloud following me about."

Peter didn't tell anyone what he was experiencing, including his wife, for five months. He did not feel comfortable going to see his GP. His feelings came to a head one day when he arrived to pick his older daughter up from his mother's house, and started crying on her couch.

Dr Selena Gleadow-Ware, a consultant psychiatrist who chairs the perinatal faculty at the Royal College of Psychiatrists in Scotland, said research showed about 8-10% of men experience depression in the postnatal period.

"Men may be much less likely to talk about or feel comfortable sharing how they're feeling, so it often goes as an under-recognised or hidden problem," she says.

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Source: BBC News, 10 February 2022

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Government plans to remove all remaining restrictions in England

The government plans to end all remaining covid restrictions in England—including the legal obligation to self-isolate—ahead of schedule later this month, the prime minister, Boris Johnson, has said.

The current restrictions, including the requirement that anyone who tests positive for Covid-19 must self-isolate for at least five days, are due to expire on 24 March. But Johnson, addressing MPs during prime minister’s questions on 9 February, said that the remaining rules could end early if recent trends in the data continued.

In response to the prime minister’s statement healthcare leaders said that they understood the importance of wanting to return to normal but called for a cautious approach.

Chris Hopson, chief executive of NHS Providers, said, “It is important to remember that Covid-19 has not gone away. Though cases have fallen significantly in recent weeks and the NHS’s very successful booster campaign has made a massive difference to the numbers of seriously ill patients, the number of people testing positive for Covid-19 remains high by previous standards."

“Any steps to de-escalate our precautionary approach—including ending requirements for self-isolation for positive tests—must be proportionate to the risks.”

Matthew Taylor, chief executive of the NHS Confederation, said, “Around 40% of NHS staff absences are due to covid currently, and so removing the self-isolation requirements could bolster capacity significantly at a time when the service is committed to tackling its waiting lists—but we have to be mindful that it could also lead to higher rates of transmission, which could then lead to more admissions into hospital alongside more ill health in the community."

“The government must take a cautious approach as we move onto the endemic stage of covid, be guided by the evidence, engage the NHS appropriately, and be prepared to review its decision if new threats emerge.”

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Source: BMJ, 9 February 2022

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Virus almost 'wholly responsible' for spike in dementia deaths

People with dementia, particularly care home residents early in the pandemic, were “disproportionately” vulnerable to fatal Covid infections, according to a new report.

The analysis, commissioned by the Scottish Government, also found that excess deaths involving dementia during 2020 were “almost wholly” attributable to Covid.

Of the 2,154 deaths where both dementia and Covid were listed on the death certificate, 95 per cent had Covid as the main underlying cause.

This contradicts previous suggestions that a rise in dementia deaths early in the pandemic may have been linked indirectly to the virus as a result of “lockdown distress” or an increased use of potentially harmful sedation in elderly people confused by restrictions.

The report also found that 73% (1,577) of those who died with both Covid and dementia mentioned on their death certificates had passed away in care homes.

Henry Simmons, chief executive of Alzheimer’s Scotland, said their loved ones had been “torn apart by grief and loss” and that the report “raises many more questions as to why so many people with dementia living in care homes quickly became victims of Covid-19”.

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Source: The Herald, 10 February 2022

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Patients to receive better care as NHS and social care systems link up

Patients will receive better, more joined-up care under new plans announced to improve the links between health and social care.

The integration white paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff.

Despite the best efforts of staff, the current system means that too often patients find themselves having to navigate complex and disjointed systems. Those with multiple conditions can be left feeling frustrated at having to repeatedly explain their needs to multiple people in different organisations, while others can end up facing delayed discharge because the NHS and local authorities are working to different priorities in a way that is not as joined up as it could be.

The white paper sets out some of the ways health and care systems will draw on the resources and skills across the NHS and local government to better meet the needs of communities, reduce waiting lists and help level up healthcare across the country.

Health and Social Care Secretary Sajid Javid said: "Better integration is vital to stop people falling into the gaps between health and social care. Ensuring our health and care systems work in unison will mean we can support hardworking staff, provide better care to patients and deliver value for the taxpayer."

"Our Integration white paper is part of our wider plans to reform and recover the health and social care system, ensuring everyone gets the treatment and care they need, when and where they need it."

The plans set out in the white paper will ensure care is more personalised and accessible and remove the burdens on patients. Better information sharing will mean people will no longer have to remember key facts such as dates of diagnosis or medicines prescribed, taking pressure off patients to coordinate their own care.

Local health services will be tailored to the specific needs of the community to ensure the right services are available. This could mean for example more diabetes clinics in areas with higher obesity, or additional support for people to stop smoking in communities where there are higher numbers of smokers.

The integration white paper is the next step in delivering the government’s promise of a health and social care system fit for the future. It builds on both the Health and Social Care Bill and the People at the Heart of Care white paper which set out a 10-year vision for social care funded through the Health and Care Levy, and follows the delivery plan for tackling the COVID-19 backlog of elective care. Dedicated plans to tackle health disparities are set to be published in due course.

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Source: Gov.uk, 9 February 2022

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Mothers beg for their sons to be released from locked hospital units

Three mothers whose sons have been locked in hospital psychiatric units in Scotland for years have spoken to the BBC because they’re desperate to get them out.

The three young men did not break the law but have autism and learning disabilities.

Jamie has autism and was sectioned after becoming distressed at 19. Although he was free to go after 3 months there was no where for him to go so he has lived in hospital units since then. He is now 24.

The Scottish government said it was unacceptable to hold people with complex needs in hospital when they could be cared for in the community.

"He's left to rot", says his mother.

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Source: BBC News, 9 February 2022

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Health leaders question absence of workforce strategy in NHS elective care recovery plan

The government has promised to build more surgical and community diagnostic hubs in England and to give patients greater control over their healthcare provider as part of its long awaited recovery plan for elective care to reduce the NHS backlog and tackle waiting times.

But the targets set out on 8 February will not be met without the staff to run the expanded services, health leaders have warned.

Andrew Goddard, president of the Royal College of Physicians, said that the plan depended on the “recovery of urgent and emergency care, as the two are intimately entwined both with respect to workforce and estate.”

He added, “We will also need to build on it with a full plan for recruiting enough new staff to meet patient demand and the steps we’ll take to retain existing staff, including flexible and remote working for those returning to practice."

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Source: BMJ, 8 February 2022

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Top oncologist says Tayside cancer crisis was 'avoidable tragedy'

A crisis in cancer care at NHS Tayside could have been averted if the health board had publicly supported doctors who were criticised by an official report, according to a top oncologist.

The last remaining breast radiotherapy specialist left at the end of January, with the board unable to replace him. Patients must now travel to Aberdeen, Glasgow or Edinburgh for radiotherapy.

The situation has emerged three years after an investigation into chemotherapy treatment at Ninewells Hospital.

NHS Tayside apologised to patients in 2019 after an investigation found doctors deviated from national standards on chemotherapy dosages given to breast cancer patients after surgery.

A subsequent review found that the lower dosages were highly unlikely to have led to the deaths of any patients.

Last year the doctors involved were cleared of any wrongdoing by the General Medical Council (GMC), who also found no fault with the treatment patients received.

Some clinicians close to those involved told BBC Scotland the cancer doctors felt they had no choice but to leave because they did not have the backing of the board.

Colleagues who support the oncologists say none of this needed to happen.

Prof Alastair Munro, emeritus professor of radiation oncology at Dundee University, who previously worked as a cancer doctor in the department, said: "It's a totally avoidable tragedy, this should not have happened.

"The first thing the health board need to do is to come clean, and say we got it wrong, we put our hands up, we want to start again with a clean slate and we want to attract good people to come to Tayside to deliver breast cancer services to the patients whose needs we serve."

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Source: BBC News, 9 February 2022

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