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NHS waiting-list backlog will take years to clear

The waiting list for hospital treatment will not start falling for two years, ministers say, despite unveiling a plan to tackle England's backlog in care.

Six million people are on a waiting list - one in nine of the population. But Health Secretary Sajid Javid said this number would probably increase, with demand expected to rise now Covid pressure was easing.

He also set out plans to reduce waiting times for cancer treatment. These include a 28-day target for cancer diagnosis by March 2024, which should have been introduced last year but was delayed by the pandemic.

The proportion of cancer patients starting treatment within 62 days would return to its pre-pandemic level by March 2023, Mr Javid said, although this would still leave it some way short of the 85% target.*

Waiting times would be cut by a 30% rise in the NHS's capacity for treatment, he said.

Crucial to this will be the establishment of a network of 160 community diagnostic centres along with surgical hubs focused on high-volume routine surgery away from major hospital sites - to increase efficiency and reduce the chance of emergency cases leading to cancellations.

Extra investment of £8bn over the next three years, funded through a national-insurance rise, will pay for these new facilities.

To free up staff time, follow-up appointments would be arranged on a case-by-case basis, rather than for all patients automatically, Mr Javid said. And a new online service, My Planned Care, will inform patients about waiting times and how to prepare for treatment.

The plan would not just "reset" the NHS to where it had been before Covid, Mr Javid said, but build on what had been learned and make it "fit for the future".

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Source: BBC News, 8 February 2022

Delivery plan for tackling the COVID-19 backlog of elective care

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How NHSE’s new transformation directorate will operate

Six directors will lead the different units of NHS England’s new transformation directorate created by merging NHS Digital and NHSX into the organisation.

Documents obtained by HSJ show how the transformation directorate’s senior team will be structured in the interim period until NHSD and NHSX are fully merged with NHSE.

The new directorate is led by Tim Ferris, who was appointed last year as NHSE sought to speed up the digital transformation of NHS services.

The directorate has outlined 10 draft priorities for the next few years, including ambitious proposals to install electronic patient records at every NHS trust, make electronic clinical decision support systems “the norm” for clinicians, and a huge expansion of virtual wards.

The remaining seven priorities are:

  • Expanding the functions and uptake of the NHS App;
  • Increase diagnostics capacity;
  • Data architecture and infrastructure for population health, planning and research;
  • Population health and personalised prevention;
  • Exploiting the NHS’s purchasing power;
  • NHS as a platform for rapid cycle research and innovation; and
  • Redesign pathways using digital tools.

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Source: HSJ, 8 February 2022

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Little evidence that penalties are getting US hospitals to improve

The US federal government has penalised 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications.

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. The punishments, which the Affordable Care Act requires be assessed on the worst-performing 25% of general hospitals each year, are intended to make hospitals focus on reducing bedsores, hip fractures, blood clots, and the cohort of infections that before Covid-19 were the biggest scourges in hospitals. Those include surgical infections, urinary tract infections from catheters, and antibiotic-resistant germs like MRSA.

This year’s list of penalised hospitals includes Cedars-Sinai Medical Center in Los Angeles; Northwestern Memorial Hospital in Chicago; a Cleveland Clinic hospital in Avon, Ohio; a Mayo Clinic hospital in Red Wing, Minnesota; and a Mayo hospital in Phoenix. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.

Eight years into the Hospital-Acquired Condition Reduction Program, 2,046 hospitals have been penalised at least once, a KHN analysis shows. But researchers have found little evidence that the penalties are getting hospitals to improve their efforts to avert bedsores, falls, infections, and other accidents.  

“Unfortunately, pretty much in every regard, the program has been a failure,” said Andrew Ryan, a professor of health care management at the University of Michigan’s School of Public Health, who has published extensively on the programme.  

“It’s very hard to capture patient safety with the surveillance methods we currently have,” he said. One problem, he added, is “you’re kind of asking hospitals to call out events that are going to have them lose money, so the incentives are really messed up for hospitals to fully disclose” patient injuries. Academic medical centers say the reason nearly half of them are penalised each year is that they are more diligent in finding and reporting infections.

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Source: Kaiser Health News, 8 February 2022

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Only a third of children in need accessed mental health support in the pandemic

The number of children experiencing mental health problems has risen sharply during the Covid-19 pandemic, but fewer have been able to access support because of disruptions to services, says a report by the Children’s Commissioner for England.

Around one in nine children had a probable mental health disorder in 2017, the report says, but this jumped to one in six in 2021 with only around a third (32%) able to access treatment.

While the number of children referred to mental health services by GPs and teachers has been growing in recent years, referral rates fell back in 2020-21 to 497 502 (equivalent to 4% of all children in England), compared with 539 000 (4.5% of children) the previous year.

“It is likely that even though more children have mental health problems, fewer were being referred to services during lockdowns because of disruptions caused by the pandemic,” said children’s commissioner for England, Rachel de Souza.

“Numbers referred into services are likely to increase again in the coming years. The health secretary will be publishing a review later this year to explore how we can tackle this increased level of need and adopt a more preventive approach.”

Lynn Perry, interim co-chief executive of children’s charity Barnardo’s, said, “Covid-19 has taken a serious toll on children’s mental health and schools are the first place many of them seek help. Being able to reach this support early at school will reduce the number of children who need specialist help from mental health services. This is why Barnardo’s is calling on the government to speed up the rollout of mental health support teams to help pupils and teachers get the support they need, when they need it.”

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Source: BMJ, 7 February 2022

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Ketamine could help suicidal people struggling with dark thoughts, new study claims

The class B drug ketamine could help to treat people suffering from severe suicidal thoughts, a study has suggested.

Researchers from the University of Montpellier in France said the sedative could save lives, as it appears to alleviate dark thoughts in patients admitted to hospital for their mental health.

The finding was based on a controlled trial involving 156 adults with severe suicidal ideas, which ran from April 2015 to March 2019 in seven French teaching hospitals.

The participants included people with bipolar disorder and major depressive disorder. However, patients with a history of schizophrenia were excluded from the study.

Although the team found the side effects of ketamine were minor and had diminished by day four, they cautioned that more research was needed to examine its benefits.

“Ketamine is a drug with a potential for abuse. Longer follow-up of larger samples will be necessary to examine benefits on suicidal behaviours and long term risks,” they wrote.

Commenting on the study, Riccardo De Giorgi, a PhD student at the University of Oxford, said: "These findings indicate that ketamine is rapid, safe, and effective in the short term for acute care in hospitalised suicidal patients.”

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Source: The Independent, 4 February 2022

Ketamine for the acute treatment of severe suicidal ideation: double blind, randomised placebo controlled trial 

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Miscarriage: 'I was in pain and they did not listen'

Research shows black women are at a 40% higher risk of pregnancy loss than white women.

It is an urgent problem, which the Royal College of Obstetricians and Gynaecologists says needs greater attention, with many complex reasons driving this higher risk.

These include a lack of quality research involving all ethnicities - but RCOG head Dr Edward Morris says implicit racial bias is also affecting some women's experience of care.

Isabel Gomes Obasi and her husband, Paulson, from Coventry, are expecting a baby boy in March. They are extremely anxious as almost a year ago their baby boy Andre died four months into Isabel's pregnancy.

Giving birth to Andre was extremely traumatic, Isabel says, but how she was treated when in severe pain and bleeding, in the days before her loss, made the experience worse.

"We knew something was wrong, so we went into hospital and waited five hours to be seen by a doctor," she says. "I remember being laughed at by one of the nurses, who said, 'Just go home. Why do you keep coming in?'"

Isabel was checked over and told the baby was fine but says her intuition and pain were belittled and ignored.

Within 48 hours of going home, Isabel began bleeding heavily.

There is little doctors can do at this relatively early stage of pregnancy to save a baby's life. But the feeling of not being listened to has stayed with Isabel ever since.

"I just shut down," she says. "The experience made me anxious and depressive, if not suicidal."

Asked why she was not listened to, she said: "The colour of my skin,"  the attitude of some staff was: "'You have black skin - you are not from here - you can wait.'"

Dr Morris says it is "unacceptable" women belonging to ethnic minorities face worse outcomes than white women - especially in maternity care.

"Implicit racial bias from medical staff can hinder consultations and negatively influence treatment options," he says.

This can stop some women engaging with healthcare.

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Source: BBC News, 8 February 2022

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Harm to AstraZeneca jab’s reputation ‘probably killed thousands’

Scientists and politicians “probably killed hundreds of thousands of people” by damaging the reputation of the AstraZeneca vaccine, according to an Oxford scientist who worked on the jab.

Prof John Bell said: “They have damaged the reputation of the vaccine in a way that echoes around the rest of the world.”

“I think bad behaviour from scientists and from politicians has probably killed hundreds of thousands of people – and that they cannot be proud of that,” he told a BBC Two documentary

When the Oxford/AstraZeneca jab was rolled out in the UK government advisers recommended under-40s should be offered an alternative due to a link to very rare blood clots.

Fears over the links to blood clots also led other countries, including Germany, France, Spain, Italy, the Netherlands, the Republic of Ireland, Denmark, Norway, Bulgaria, Iceland and Thailand, to pause their use of the vaccine.

The AstraZeneca vaccine has also not played a significant role in the booster programme. The BBC reported it accounted for only 48,000 of the more than 37m booster doses given in the UK.

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Source: Guardian, 7 February 2022

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Free period products at work would relieve anxiety and stress, say nurses

Nurses have spoken of the anxiety and dread of having periods at work, adding that free period products in the workplace would ‘take one giant stressor off your life’.

The comments come as leading nurses from the RCN call for period products to be free and easily available to all healthcare staff. The British Medical Association has also requested that products be available for the well-being and comfort of staff.

Advanced care practitioner in trauma and orthopaedics, Lisa Andrews said she wanted colleagues to understand why she might have to leave the ward during shifts if she starts her period or bleeds through sanitary products.

‘Many times I have had accidents which are embarrassing, and I have to stay at work in the same clothes. I dread the thought of having to wear scrubs as they are a lot thinner than my work clothes.’

Intensive care unit nurse Alicia, based in Scotland, told Nursing Standard that having her period at work is ‘very stressful’.

‘The entire time you are worried that you are bleeding through to your scrubs, everyone will know… to talk about periods is very taboo,’ she said.

A recent survey of 3,000 people by charity Bloody Good Period found nine out of 10 respondents had experienced stress or anxiety at work because of their period. Having an employer who normalises the discussion of menstrual health at work would help, said 63% of respondents.

RCN women’s health forum chair Katharine Gale told Nursing Standard: "The RCN feels that for dignity in the workplace [healthcare staff] need access to menstrual products."

RCN Scotland board chair Julie Lamberth said: "As well as availability of period products, nursing staff need to be able to take their breaks so they can access them."

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Source: Nursing Standard, 7 February 2022

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Incessant noise of tinnitus can feel like torture

Tinnitus Week 2022 is taking place from 7-13 February and the British Tinnitus Association are calling for the establishment of a Tinnitus Biobank

The UK urgently needs a biobank library of human tissue samples so experts can study and find better treatments, or a cure, for "ringing in the ears", says the BTA.

More than seven million adults in the UK are thought to have tinnitus. This stressful and upsetting condition of hearing whooshing, buzzing or other intensely annoying sounds with no external source is poorly understood. For some, it becomes difficult or impossible to lead a normal life.

A survey by the charity, carried out in November with 2,600 people with tinnitus, suggests almost one in 10 living with the condition has experienced thoughts about suicide or self-harm in the past two years. One in three thought about their condition every hour - causing them anxiety and sadness. The BTA says other people with tinnitus share similar experiences of feeling isolated, debilitated and stressed.

Malcolm Hilton, an ear, nose and throat expert at University of Exeter's Medical School, says a national biobank for tinnitus would be massively beneficial, and might reveal better ways for managing the condition.

"There are many treatments available for tinnitus and it is disappointing that people still come away with the message that they have to 'learn to live with it' without support."

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Source: BBC News, 7 February 2022

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Diabetes kills 100 000 Americans for second year in a row

Diabetes is killing an increasing number of Americans and has accounted for more than 100 000 US deaths in each of the past two years. A national commission has called on the federal government to take a broad approach to the problem, similar to the fight against AIDS.

Lisa Murdock of the American Diabetes Association told The BMJ that diabetes was the most common underlying condition in the US and that Covid-19 was an exacerbating factor. Some 40% of Americans who died from Covid-19 had diabetes, she said.

The Centers for Disease Control and Prevention has reported that 37.3 million Americans—11.3% of the US population—have diabetes, including 8.3 million who have not had it diagnosed.

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Source: BMJ, 3 February 2022

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More than half of NHS paramedics suffering from burnout

Over half of paramedics are suffering from burnout caused by “overwhelming” workloads, record numbers of 999 calls and the public misusing the ambulance service, a study has found.

Frontline crew members also blame lack of meal breaks, delays in reaching seriously ill patients and their shift often not ending when it should for their high levels of stress and anxiety.

The working lives of ambulance staff are so difficult that nine out of 10 display symptoms of “depersonalisation”, characterised by “cynicism, detachment and reduced levels of empathy” when dealing with patients who need urgent medical treatment.

The widespread poor mental welfare of paramedics is a problem for the NHS because it is leading to some quitting, thus exacerbating its shortage of ambulance personnel, the authors said.

The findings, published in the Journal of Paramedic Practice, have prompted concern that the demands on crews, alongside the injury, violence and death they encounter, are storing up serious mental health problems for them, including post-traumatic stress disorder.

“Ambulance staff are passionate about their role. However, burnout is a significant and very real issue that decreases staff efficacy and reduces quality of patient care,” the study said. It was undertaken by Rachel Beldon, who works for the Yorkshire ambulance service, and Joanne Garside, a professor and school strategic director of Huddersfield university’s health and wellbeing academy.

“Participants wanted better resources and staffing levels. The current workload appeared to be overwhelming and negatively affected their mental health and work-life balance.”

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Source: The Guardian, 6 February 2022

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Trust apologises for saying patient’s sexual assault ‘didn’t happen’

A hospital trust has apologised to a mental health patient who reported being sexually assaulted in its A&E department – after it emerged in a safety review that staff wrote ‘this has not happened’ and dismissed her claims of the attack.

The victim was admitted to West Suffolk Hospital’s emergency department following an overdose in January last year. While waiting in A&E for a mental health assessment from a specialist team employed by Norfolk and Suffolk Foundation Trust, she reported being sexually assaulted by a male patient who had also been admitted to A&E.

Yet a review into the incident, published several months later and shared with HSJ, reveals that after the victim reported the attack to a nurse, the staff member recorded “this has not happened”.

They stated that the male suspect in the cubicle next to her had not left his bed and was under constant observation. However, the patient safety review, drawn up after a serious incident probe was launched, adds that this statement was “incorrect, as the [male] patient was not under constant observation”.

“There were witnesses to this incident, and CCTV, and yet it was not escalated until I contacted the trust myself to complain,” the victim said. 

She added that she pursued the complaint, which resulted in a serious incident probe that took several months to conclude, “to prevent others from being failed” in the same way.

She said she was left “shocked, confused and furious” to discover staff had dismissed her assault and claimed the male suspect had not been admitted for an assessment on the day of the attack.

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Source: HSJ, 7 February 2022

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NHS England waiting times for cancer referral and treatment at record high

The numbers of cancer patients facing delays in seeing a specialist for the first time and starting their treatment have hit record highs in England, amid fears that overstretched NHS services can no longer provide prompt care.

The disclosure comes as a new row over how quickly hospitals can clear the record 6 million-strong NHS backlog has forced ministers to delay publication of the long-awaited plan to tackle it.

Half a million people in England with suspected cancer will have to wait longer than the supposed two-week maximum to see an oncologist this year, an analysis for the House of Commons library reveals.

The number of patients confirmed to have the disease who are unable to start treatment such as surgery or chemotherapy within the 31 or 62 days that hospitals try to guarantee is expected to exceed 75,000 for the first time.

Experts, who claim significant shortages in the NHS cancer workforce are to blame, fear delays in getting diagnosed and starting care could reduce a patient’s chances of survival. Cancer charities highlighted the “unimaginable distress and anxiety” they induce in patients.

“Cancer care is in crisis,” the shadow health secretary, Wes Streeting, said. “As this new analysis shows, terrifyingly large numbers of people are waiting longer than they should to receive vital cancer care and treatment with the insecurity of not knowing.”

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Source: The Guardian, 6 February 2022

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New mothers left alone and in pain as maternity crisis worsens

Unable to move and with her newborn baby crying out of reach, Neya Joshi was left alone for hours on an understaffed maternity ward and had to beg for a glass of water.

“It was awful, I was so helpless and so desperate, and no one was interested in helping me. I have never felt fear like it,” she said.

The medical copywriter, 30, was diagnosed with post-traumatic stress disorder months after giving birth to her son Arjun at Croydon University Hospital in May 2020 and had therapy for a year to recover from the trauma.

She is one of thousands of mothers across the country experiencing poorer care because maternity units lack enough staff.

Data from 122 NHS trusts in England shows maternity units were forced to shut their doors to women in labour more than 323 times in 2020-21, with units shut for a total of 16,294 hours, the equivalent of 679 days. When this happens women are forced to go to an alternative hospital to give birth. Staffing shortages were given as a reason in more than two-fifths of the closures.

Joshi saw first hand the impact of a lack of midwives when she was admitted to hospital to be induced after her waters broke at the height of the pandemic. Visiting restrictions meant she was alone on a ward for 24 hours and, despite being told she was a high priority, there were no free beds.

“After they had started the induction I was told someone would come and check me within six hours but no one came and I was just left on my own for hours,” she said. Eventually, after concerns over her baby’s heart rate, she had an emergency caesarean section but her husband was then made to leave an hour later.

“I was taken to the postnatal ward and that’s where it all really went downhill,” she said. “It was awful. I was just lying there. I couldn’t move because I had the epidural and my baby was crying."

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Source: The Times, 6 February 2022

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Surgical mesh centres not working, warn MPs

Specialist centres to help women who have experienced complications following a pelvic mesh repair are "not working", MPs say.

A network of nine mesh centres was set up in the wake of a report about how three health treatments caused thousands of women avoidable harm.

However, a debate in Westminster Hall has heard that GPs are not always aware of the referral process. And some patients are experiencing long waits and living in "agony".

In 2020, the First Do No Harm report recommended specialist mesh centres should be set up to treat complications and carry out removals.

However, Alec Shelbrooke, co-chair of the surgical mesh all-party parliamentary group, has told MPs the centres are "not working".

"GPs are unaware of mesh complication centres and the referral process," he said

"Many patients are denied access and are offered physio and pain management instead, they pay thousands of pounds for private care and face extremely long delays for appointments.

"Many women end up seeing their implanting surgeons, who then dismiss them."

Sharing accounts of women's experiences, Mr Shelbrooke said one waited four years for a referral only to face more "gaslighting" and "suffering".

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Source: 4 February 2022

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Sorry, not sorry

Public figures accused of wrong-doing announce they are “sorry if” people have been offended, outraged, confused etc by their words or actions. The implication is that it is people’s reactions that have inspired the sorrow, not shame about the actions themselves – and often that those reactions are disproportionate to whatever perceived wrong has occurred.

Nearly as common is the “sorry but” tactic in which the public figure expresses sorrow, but adds some qualification that effectively absolves themselves of blame and, again, perhaps suggests the concern is disproportionate.

Sometimes, of course, the non-apology is just that - ‘I’ve done nothing to feel sorry about’. This is again, often followed by, ‘which is more than can be said for…’

It now appears as if the non-apology is being adopted by some NHS leaders.

In the space of seven days we have seen:

  • The Christie react to a report saying it had been “dismissive” of whistleblowers by – appropriately – dismissing the report as inaccurate and out of date.
  • The leadership of Walsall Healthcare Trust and Royal Wolverhampton Trust deploy the “sorry if” defence against accusations of “poor behaviour” by implying they needed to bang some heads together to drive improvement.
  • The chief executive of University Hospitals Birmingham express irritation about his referral to the General Medical Council, stating that he could “live with” the “admin error” which he said had sparked it.

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Source: HSJ, 4 February 2022

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Drug firms fined for fixing price of drug used by NHS cancer patients

Several drug companies have been fined £35 million for colluding to raise the cost of an anti-nausea drug used by cancer patients, taking the total fines stemming from a Times investigation to £400 million.

The price paid by the NHS for prochlorperazine 3mg dissolvable tablets rose by 700%, from £6.49 a packet to more than £51, between December 2013 and December 2017, costing the NHS an extra £5 million a year.

The Competition and Markets Authority (CMA) has ruled that several companies broke the law by fixing the market and agreeing not to produce a rival version of the drug, which is used to treat nausea and dizziness and can be prescribed to patients having chemotherapy.

Andrea Coscelli, chief executive of the CMA, said: “The size of the fines reflects the seriousness of this breach. These firms conspired to stifle competition in the supply of this important medication, so that the NHS — the main buyer of the drugs — lost the opportunity for increased choice and lower prices.”

He said the CMA would not “hesitate to take action like this against any businesses that collude at the expense of the NHS”.

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Source: The Times, 3 February 2022

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Deaf people diagnosed with cancer face 'big barriers'

Coleen McSorley, who has been deaf from birth, was left upset and struggling to understand the details of her cancer diagnosis. Now one care centre is hoping to offer more support to others facing a similar challenge.

Coleen was diagnosed with breast cancer in September 2020. At the time, Covid restrictions meant she was unable to bring an interpreter or her hearing parents to hospital appointments.

The 56-year-old said she was given wads of literature about her cancer - but like many people who have been deaf from birth, she struggles to read.

"English is my second language after British Sign Language," said the cleaner, from Stirling.

"At the hospital a big barrier was they were wearing too many masks. They were all talking at me but I didn't understand what they were saying, it was horrendous.

"I felt frustrated because I wanted them to pull down their masks so I could try to lip read a little bit, but they wouldn't and it was very confusing."

Coleen, who had stage three cancer, was treated with chemotherapy and had a mastectomy, found a local Maggie centre who supported her. Yvonne McIntosh, an oncology nurse and centre head at the Maggie's Forth Valley cancer care drop-in centre, says that even with an interpreter, a lot of information could be lost in translation.

"A lot of sense and meaning is lost and things can land differently so they don't come across with the same context," she said.

"When Coleen came to us she didn't know what the pills were that she was taking.

"She didn't understand about her treatment and didn't know how her medication worked for her."

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Source: BBC News, 4 February 2022

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Warnings over NHS mental health care issued in 14 young deaths in five years

Children with mental health problems are dying because of failings in NHS treatment, coroners across England have said in what psychiatrists and campaigners have called “deeply concerning” findings.

In the last five years coroners have issued reports to prevent future deaths in at least 14 cases in which under-18s have died while being treated by children’s and adolescent mental health services (CAMHS).

The most common issues that arise are delays in treatment and a lack of support in helping patients transition to adult services when they turn 18.

Coroners issue reports to prevent future deaths in extreme cases when it is decided that if changes are not made then another person could die.

Dr Elaine Lockhart, the chair of the Royal College of Psychiatrists’ faculty of child and adolescent psychiatry, said the findings were “deeply concerning” and every death was a tragedy.

She said there were too often lengthy delays and services were under strain as demand rises and the NHS faces workforce shortages.

“In child and adolescent mental health services in England, 15% of consultant psychiatrist posts are vacant,” Lockhart said, calling for more support, investment and planning to grow staff levels.

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Source: The Guardian, 3 February 2022

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People in England surviving cancer for longer, NHS reports

Growing numbers of adults and children in England are surviving for longer after being diagnosed with cancer, with increases in lifespan seen in almost all types of the disease.

Survival for one year and five years rose among adults diagnosed between 2015 and 2019 compared with those whose illness was identified between 2006 and 2010, NHS Digital reported.

Survival is highest in adults who have melanoma of the skin, one of the main forms of skin cancer. Nine out of 10 men now survive for five years, as do almost 95% of women.

However, survival remains stubbornly low for other forms of the disease, including pancreatic cancer and mesothelioma, which is mainly caused by prolonged exposure to asbestos. Just 6.3% of men and 7.8% of women who develop mesothelioma are still alive five years later.

NHS Digital found that “in England one-year non-standardised net survival has improved, with patients diagnosed between 2015 and 2019 having a higher one-year survival than patients diagnosed between 2006 and 2010.

“This trend was seen for all cancers and both genders except for bladder cancer. The largest improvement was 1.6 percentage points on average per year for lung cancer in females.”

Greater survival after five years “was seen for all cancers and both genders except for bladder cancer and colon cancer,” the NHS’s statistical arm added. “The largest improvement was myeloma in females, [which was up] 1.4 percentage points on average per year.”

However, Anna Jewell, the chair of the Less Survivable Cancers Taskforce, warned that the chances of survival remained low for people with a number of some forms of the disease.

“Although overall cancer survival rates have generally increased in the past decades, we are not seeing the same improvements in prognosis for patients diagnosed with less survivable cancers, including those of the lung, liver, brain, oesophagus, pancreas and stomach.”

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Source: The Guardian, 4 February 2022

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Improving cancer care a huge challenge post-pandemic

Improving cancer care will be a huge challenge, ministers are being warned as they promise a new 10-year strategy for England.

Figures suggest there have been 34,000 fewer diagnoses since Covid hit - 50,000 if you include the whole UK. It risks an increasing number of late diagnoses which reduces the chances of survival, cancer charities said.

It comes as the government is promising to invest in new technologies and equipment to spot cancer quicker.

Health Secretary Sajid Javid said the new "war on cancer" strategy will be published later this year.

"It will take a far-reaching look at how we want cancer care to be in 2032. Looking at all stages from prevention, to diagnosis, treatment and vaccines," he said.

Mr Javid pointed out the NHS was already taking steps, including evaluating new blood tests to spot cancers early and opening a network of testing centres.

Lynda Thomas, of Macmillan Cancer Support, said given the impact of the pandemic people with cancer needed "support more than ever".

"We have been sounding the alarm for a long time," she added.

But she said while improving diagnosis and treatment was crucial, it was like "building sandcastles while the tide comes" without extra staff to tackle the backlogs and demand for care.

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Source: BBC News, 4 February 2022

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Substantial fall in diabetic health checks as GPs reprioritised during pandemic

The proportion of patients with type 2 diabetes who have had recommended health checks has fallen substantially, provisional data from 2021 suggests, as have the numbers hitting key disease control targets.

In response, primary care experts have called for GP practices to receive targeted investment to focus on the checks, which they had to deprioritise as the vaccination programme was introduced.

There are now 3.24 million people with a diagnosis of type 2 diabetes in England, the data across all GP practices shows.

National Diabetes Audit figures for England from January to September 2021 showed that:

  • 74% of patients had received a HbA1c check and 70% a blood pressure check compared with 93% and 95% respectively in 2019/20.
  • In the first nine months of last year, 61.9% of patients had an HbA1c under 58 mmol/mol, compared with around 66% in previous years.
  • The proportion of patients with blood pressure targets of under 140/80 was 66.5% in the latest figures compared with around 73-74% during 2015 to 2020.

Speaking with Pulse, Professor Partha Kar, NHS England national specialty advisor for diabetes said while this was not the final data, a drop off had been expected for a range of reasons outside GPs control.

‘What we have seen is that there was a massive drop off in wave one. Then around the middle of 2020 it started to pick up again but then it’s dropping off again so irrespective of data cleaning, I suspect you will see a massive drop off compared to where things have been over the last four or five years.

‘We need to be very clear its not because anyone was twiddling their thumbs, it’s because primary care was asked to do something else.

‘We can’t go back to primary care again for the vaccines because they are being taken away from the thing that they’re amazing at which is delivering long-term conditions at scale.’

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Source: Pulse, 2 February 2022

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‘We’ve broken the social contract between the NHS and its people’

‘We’ve broken the social contract between the NHS and its people’. That was the blunt conclusion of one senior NHS figure surveying the aftermath of the government’s U-turn on the mandatory vaccination of staff.

Most of the NHS’ leadership at national and local level were behind the policy of mandatory vaccination. They believed it was the right thing to do for patients, colleagues and the service.

But they were also acutely aware of the reluctance of some staff to get the jab and that changing their minds would be tough – and in some cases unsuccessful. They were also prepared to deal with the consequences of the failure to convert the waverers.

They put their credibility and reputations on the line to give the vaccination push as much chance of success as possible. They found time to have and facilitate difficult conversations, even though those discussions were bound to impact on morale at a time of huge pressure.

…and then the government pulled the rug from under them.

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Source: HSJ, 2 February 2022

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Trust CEO ‘behaved poorly’ and chair was ‘complicit’, NHS England review concludes

An NHS England review into the behaviour of high-profile senior leaders who took over a Midlands trust has concluded that the interim CEO “behaved poorly and inappropriately” while its chair was “complicit with” and failed to address problems.

NHS England had commissioned an independent probe into allegations about the behaviour of new executives, who had recently been appointed to the board of Walsall Healthcare Trust.

David Loughton and Professor Steve Field, who hold the same roles at the Royal Wolverhampton Trust, were brought in as interim chief executive and chair respectively in spring 2021.

Walsall has faced care quality concerns for some years and it was hoped the pair from neighbouring Wolverhampton would bring improvements. 

Dr McLean wrote in her review: “Leadership changes can, understandably, represent a period of anxiety for those affected but this can be minimised if changes are made in line with appropriate values and processes. 

“Whilst I conclude that the joint chair and interim CEO were motivated to act in the best interests of patients, I was saddened by much of what I heard.

”In the narratives I heard, there was a consistent lack of compassion or respect for people.”

She concluded: “The interim CEO, while motivated by the safety and care of patients, has behaved poorly and inappropriately … the joint chair has been complicit with and failed to address this behaviour.”

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Source: HSJ, 2 February 2022

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Electronic decision support ‘to be the norm for all clinicians’ under NHSE plan

Electronic systems and clinical decision support software must become “the norm” for all NHS clinicians, under plans being drawn up by NHS England’s new transformation directorate, HSJ has revealed.

The massive increase in clinicians’ use of technology forms a major part of the draft plans, seen by HSJ, with the new directorate set to launch ambitious targets for the health service.

Other targets include every integrated care system creating virtual wards which are the equivalent size of a district general hospital — around 500 beds each — and installing electronic patient records at every NHS trust.

The proposals are led by former US healthcare chief Tim Ferris, NHSE’s new transformation director, who was appointed last year.

According to the plans, NHSE’s ambition is to increase the “safe and effective use” of computer assisted processes and clinical decision support so it becomes the “expected norm for all clinicians”.

NHS leaders have welcomed the use of virtual wards to improve home care and reduce hospital occupancy, but clinicians have warned of safety issues within virtual wards, with some prominent doctors calling for a careful implementation of the policy.

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Source: HSJ, 2 February 2022

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