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Private hospital rated ‘inadequate’ again amid safety concerns

A privately run mental health hospital put in special measures last year has been rated “inadequate” again following a fresh Care Quality Commission inspection.

Inspectors raised serious concerns about unsafe ward environments and staff not managing patient risks at the Priory Hospital Arnold, which has beds commissioned by Nottinghamshire Healthcare Foundation Trust.

Inspectors said that while the leadership team was experienced, the registered manager had been in post since April last year and the improvements they had made “had not been fully embedded”.

The registered manager had changed after the service was placed in special measures.

Ligature risks were found in patients’ bathrooms despite the provider making “some progress” and undertaking “substantial work” to remove them, the CQC said.

And in one instance, a patient had tried to harm themselves with a plastic bag which was a restricted item on the ward. 

CQC head of hospital inspection for mental health and community services Craig Howarth said staff “had not followed the patient’s risk assessment” and had not searched the patient on their return from a visit off the ward.

He added: “It was also concerning that despite rotas showing enough staff were available across the hospital, staff gave examples of when a lack of staffing had impacted on patient care and safety.

“Despite the measures in place, the risks to patients were not reduced and there was evidence of incidents of harm to patients.”

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Source: HSJ, 15 March 2022

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791 medical graduates could miss out on NHS junior doctor training

The highest ever number of medical students have been told there are no places for them this year, despite the health service’s crippling shortage of medics.

The risk that young would-be doctors may not be allocated to start their training at a hospital in the UK has sparked concern among the medical students affected, as well as medical organisations.

Pressure is growing for action to close the gap between the number of training places available across the NHS and the number of graduates seeking one, so medical talent is not wasted and hospitals hire as many fresh recruits as they can to help tackle the widespread lack of medics.

Doctors are worried that the mismatch between demand for and supply of training places will lead to the NHS missing out on medics it sorely needs and that some of those denied a place will either go to work abroad instead or give up medicine altogether. The most recent official figures showed that the NHS in England is short of almost 8,200 doctors.

Dr Dustyn Saint, a GP in Norfolk, tweeted the health secretary, Sajid Javid, about the situation, saying: “Sajid Javid sort this out! You know how much general practice needs these people in a few years, standing by and doing nothing is inexcusable.”

Another doctor said: “It’s bonkers that 800 would-be doctors could be denied training places at a time when the NHS in England is short of 8,200 doctors.”

The British Medical Association has voiced concern about the large number of unallocated medics. “Now we have a situation where a record number are left with unnecessary uncertainty about where they are headed this August,” said Khadija Meghrawi, the co-chair of its medical students committee. “In a time where student mental health is declining, this additional source of uncertainty and stress is particularly unfair.”

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Source: The Guardian, 15 March 2022

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Keeping electives on same site as A&E is ‘optimal’, says CEO

The chief executive of three NHS trusts says ringfencing elective care within an acute hospital site is potentially more ‘productive’ than sending it to a separate ‘cold’ site.

Glen Burley, who leads a “provider group” in the West Midlands, says his trusts have been grappling with the challenge of how to maximise elective activity without it being disrupted by emergency pressures.

The conventional view – as outlined in the NHS long-term plan – is that performing more elective care on a separate site from emergency can help ensure theatre lists are not disrupted.

But George Eliot Trust, which has been led by Mr Burley since 2018 and only has a single district general hospital, has created a “ringfenced” elective hub within the site.

In an interview with HSJ, Mr Burley said: “So I actually think the most productive model in the NHS is if you can pull that off.

“If you can actually protect your elective capacity and offer it on the same site [as] urgent care, so the clinicians are not having to move between sites, you’ve got optimal productivity.

“The challenge right across the NHS has been avoiding that spillage, of emergency care into your elective capacity.

“As you get busier and you escalate… the order in which you encroach into areas that you should not encroach into, is really key in that. We are saying we are going to protect our elective beds in a way that we haven’t done before."

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Source: HSJ, 14 March 2022

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England mental health referrals at 4.3 million high

The number of referrals for specialist NHS mental health care reached a record high in England by the end of 2021, an analysis suggests.

The Royal College of Psychiatrists says the pandemic has led to unprecedented demand and backlogs and services are struggling to keep up.

There were 4.3 million referrals, for conditions such as anxiety and depression, in 2021, NHS Digital says. Just under a quarter - 1.025 million - were for children or adolescents.

The college said the NHS had delivered 1.8 million mental health consultations in December 2021, but an estimated 1.4 million people were still waiting for treatment.

And hundreds of adults were being sent far from home for treatment because of a lack of beds in their area.

President Dr Adrian James said: "As the pressure on services continues to ratchet up, the silence from government continues to be of grave concern for the college, the wider mental health workforce and, most importantly, our patients.

"The warning of the long tail of mental ill health caused by the pandemic has not been heeded.

"Many thousands of people will be left waiting far too long for the treatment they need unless the government wakes up to the crisis that is engulfing the country.

"Staff are working flat out to give their patients the support they need but the lack of resources and lack of staff mean it's becoming an impossible situation to manage...

"...We need a fully funded plan for mental-health services, backed by a long-term workforce plan, as the country comes to terms with the biggest hit to its mental health in generations."

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Source: BBC News, 15 March 2022

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‘The real thing’: Delta-Omicron hybrid identified for first time

A newly-discovered Covid variant that combines mutations from both Omicron and Delta is “the real thing,” scientists have said.

Earlier in the year, concern was raised after a lab in Cyprus claimed to have found evidence of a Delta-Omicron recombination event – when the two variants co-infect a patient and exchange genetic material to produce a new viral offspring – but experts said the findings were false.

Now, however, virologists from L’Institut Pasteur in Paris have sequenced the genome of a genuine “Deltacron” variant, which has been detected in several regions of France and appears to have been circulating since early January.

“This one is legit,” said Aris Katzourakis, a professor of evolution and genomics at the University of Oxford. “[It is] one to keep an eye on.”

“The French cluster appears to be a validated occurrence where a recombination event has given rise to a virus fit enough to circulate,” said Dr Stephen Griffin, a virologist at the University of Leeds.

In deriving its spike from Omicron, the Deltacron variant could similarly target the upper respiratory pathway, rather than the lungs, Dr Griffin said. “At the same time, there are some parts of Omicron thought to lessen severity that are missing from the recombinant,” he said.

Dr Griffin said: "This is another clear demonstration that we remain in a dynamic situation with respect to Sars-2, and that the maintenance of genetic surveillance and testing is both relevant and prudent."

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Source: The Independent, 11 March 2022

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Chronic UTI infections: NHS finally recognises debilitating condition exists in online advice for patients

The NHS has publicly recognised that chronic urinary tract infections (UTIs) exist and has updated its advice for patients following pressure from campaign groups.

For many patients who develop a UTI, their experience is extremely painful but short-lived. But for thousands of others, a one-off acute attack turns into a chronic infection that dominates their lives and lasts for months or even years.

NHS Digital updated its website to last week to provide information around chronic bladder infections where previously there was none.

Campaigners say this is a “huge step forward” but there is still a long way to go in improving testing and treatments for the condition. 

Chronic UTI sufferer Leah Herridge has been pushing for the change alongside Chronic Urinary Tract Infection Campaign (CUTIC) and Bladder Health UK.

The NHS website’s Cystitis page has been updated to include mentions of chronic UTI and to acknowledge that current tests may not pick up these infections. 

Previously, the NHS made no mention of chronic UTIs, meaning GPs and even consultants would often default to misdiagnosing patients with interstitial cystitis.

Specialists say the infections, which often begin as an acute bout of cystitis, can occur when bacteria become embedded within the bladder wall and become difficult to treat with short courses of antibiotics.

“People tend to think chronic means really bad. What it means is everlasting,” said Carolyn Andrew, from CUTIC.

In August 2021, Ms Herridge sent a letter to NHS Digital demanding the web page be updated. The campaign was backed by CUTIC and Bladder Health UK as well as 100 other chronic UTI sufferers who also wrote letters.

“NHS Digital has actually been really, really fantastic at working with us and I do feel like they have really co-produced, certainly the interstitial cystitis page with the leading professionals in the area, the charities and myself,” said Ms Herridge.

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Source: iNews, 14 March 2022

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Ireland: Legislation to cover non-disclosure issues that arose in cervical check controversy

More than 200 women were affected by failures in Ireland’s CervicalCheck screening system. It emerged in 2018 that 221 women and families were not told about misreported smear tests.

The Minister for Health said that non-disclosure issues which arose in the cervical check screening controversy will be legislated for to prevent it from happening again.

Stephen Donnelly said new legislation will address the negligence issues and ensure that the failure to inform the women of the clinical audit of their screening will “never happen again”.

Mr Donnelly was discussing a number of amendments at the committee stage of Ireland's Patient Safety Bill.

The new legislation will require the mandatory open disclosure of serious patient safety incidents, and sets out a list of incidents which must be reported to the health watchdog, Health Information and Quality Authority (HIQA).

Mr Donnelly said that he will introduce an amendment at the report stage of the Bill that will provide for non-disclosure and will deal with issues around delayed diagnosis and delayed screening.

Mr Donnelly said: “I’ve had lengthy discussions with the department on this and it doesn’t fit neatly with this Bill because the serious patient safety issues which result in death or serious harm, they are very clear and binary.

“Legislating around delayed diagnosis and delayed screening, it is really complex and doesn’t fit neatly in this Bill, however my view is that the non-disclosure that happened in cervical check, even though it doesn’t neatly fit here, should still be legislated for."

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Source: The Independent, 11 March 2022

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‘Inadequate’ children’s mental health hospital ‘put safety of patients at risk’ CQC report finds

Serious safety concerns have been raised about a children’s mental health hospital where staff lacked respect for patients, as the provider faces a police investigation into another one of its units.

The Huntercombe Hospital in Stafford has been rated as “inadequate” by watchdog the Care Quality Commission (CQC) after inspectors found the safety of children within the hospital was at risk.

The concerns about this hospital come as The Independent revealed police have launched an investigation into another mental health unit run by the provider in Maidenhead.

Following an inspection in October inspectors sent an urgent warning notice to the provider, after it found there were not enough staff to keep patients safe.

The hospital was described as relaying on agency workers who did not have knowledge of the patients.

The CQC inspectors found children’s wards were dirty with poor hygiene measures in the hospital and patients at risk of infection.

According to the report staff were found “sitting with their eyes closed for prolonged periods of time”, and that staff observations of at risk patients were “undermined by a blind spot where people could self-harm unseen.”

Craig Howarth, CQC head of inspection for mental health and community health services, said: “Further to these issues, we saw that staff sometimes showed a lack of respect to patients and one ward was poorly furnished and maintained and there wasn’t always enough emphasis on some people’s individual requirements.”

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Source: The Independent, 11 March 2022

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GMC admits it needs to do more to reduce racial inequalities

The General Medical Council (GMC) has achieved marginal improvements against its targets to reduce racial inequalities, it said in an annual update on the programme.

However, BAME doctor representatives as well as the GMC itself said the progress was not sufficient against the targets which the regulator had set itself last year.

These included stopping disproportionate complaints from employers about ethnic minority doctors by 2026, and getting rid of disadvantage and discrimination in medical education and training by 2031.

According to the update, the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared to white doctors, has marginally reduced.

The report also acknowledged the judgment by an employment tribunal in June last year, which found that the GMC had discriminated against a doctor based on his race.

Reading Employment Tribunal upheld a complaint that Dr Omer Karim, who previously worked as a consultant urologist in Slough, had been discriminated against during an investigation by the GMC, after the body dismissed charges against a white doctor accused of the same conduct. 

The GMC has appealed the verdict but is still waiting for the appeal to be heard.

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Source: Pulse, 10 March 2022

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Number of women being seen for urgent NHS breast cancer referrals hits record new low

Less than half of women are being seen following an urgent breast cancer referral, as NHS performance drops to a new low.

‘Alarming’ new NHS figures have shown just 47% of women in England referred “urgently” for breast cancer symptoms were seen by a specialist within two weeks.

For women without symptoms but referred urgently to see a specialist, just 49% were seen within two weeks. In both cases this is the first time since records began that less than 50% cent of women were seen.

Within some trusts less than 10% of women referred with symptoms were seen within two weeks, with less than two per cent of women referred to United Lincolnshire Hospitals Trust being seen within this time frame in January.

Wes Streeting, Labour shadow health secretary said: “I know from experience the importance of an early cancer diagnosis and quick treatment. It is appalling that most suspected breast cancer patients are left waiting so long before being seen, with the insecurity of not knowing."

Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “It’s alarming that in January, for the first time, less than half of women 47.5 per cent in England who were urgently referred with potential breast cancer symptoms, were seen by a specialist within two weeks."

“...the government must consider what immediate steps it can take to reverse this rapid decline. Agonising delays must be replaced with prompt diagnoses for all women – and the sooner breast cancer is diagnosed the greater the chance of treatment being successful.”

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Source: The Independent, 11 March 2022

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A women left in ‘hell’ for nine years after poor postnatal care

It has been nine years living “like a prisoner” in “excruciating” pain and Kate is still facing a wait for surgery to tackle the horrifying mistakes in her postnatal care.

Despite a difficult birth at Leeds General Hospital, Kate described the atmosphere at the trust’s labour ward as “lovely”.

However, her experience quickly deteriorated into “hell” after she was told she had third-degree tears and was admitted to a postnatal ward, describing the care she received as “awful”.

A few days following her discharge, which occurred before she’d had a bowel movement, Kate said she was left “screaming in pain” at home, “bleeding a lot from the back passage” and “incontinent”.

Despite reporting these symptoms to the maternity department, Kate was told it was a “normal” experience.

“I felt like nobody was listening to me,” Kate said.

After six months, living in “intense pain”, with “flooding diarrhoea” and not able to leave the house, she was told by the NHS her symptoms were down to postnatal depression.

She was referred to a colorectal surgeon, who found her anal sphincter was “fully open almost as if it wasn’t ever stitched”.

Following an operation in 2015 to fix the issue, Kate developed sepsis, nearly losing her life and meaning it took 18 weeks for her wound to heal.

However, her ordeal did not stop there. She had developed nerve damage, chronic pelvic pain, incontinence, coxalgia and a prolapse as a result of her problems being neglected for so long.

By 2022, nine years later, she is now waiting for a colostomy bag operation – the only option to address her pain.

Kate told The Independent: “Everywhere I go I have to plan the full day. I need to know where the toilets are. I don’t go out of the house. I’ve felt like a prisoner in my own home for nine years.

“It makes me so emotional thinking about everything they have put me through. It hasn’t just affected my life, it’s also affected my partner and family. I have lost so much time that I’ll never get back. I couldn’t enjoy life and do the things that all mothers do with their babies.

“There was no care, no sympathy, nothing. Nobody cared for me apart from my surgeon at Sheffield. I’ve forgotten what it feels like to feel normal. I can’t remember life without pain."

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Source: The Independent, 13 March 2022

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National robotic assisted surgery programme to be established in Wales

A national robotic-assisted surgery programme allowing surgeons to perform complex procedures with more precision and control is being introduced in Wales, the Health Minister has announced.

The All-Wales Robotic Assisted Surgery Network, developed by health boards, the Life Sciences Hub Wales and the Moondance Cancer Initiative, will provide less invasive surgery for thousands of cancer patients across the country.

The surgery involves the use of highly advanced robotic surgical instruments under the control of a surgeon. It will initially be used in Wales for some Colorectal, Upper Gastrointestinal, Urological and Gynaecological cancers.

The Welsh Government will support the network with funding of £4.2m over five years, alongside £13.35m provided by health boards over 10 years.

Health and Social Services Minister Eluned Morgan said: "The All-Wales Robotic Assisted Surgery Network is an ambitious and important programme helping to improve outcomes for patients and the NHS in Wales. It will put Wales at the forefront of international research for the use of robotic surgical techniques. This pioneering service will also encourage specialist staff to come to Wales to train and practice".

It will initially be provided in the Betsi Cadwaladr University Health Board area, with the first patient expected to receive treatment in June. Once fully established, patients in north Wales will no longer need to travel to England to receive robotic-assisted surgery.

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Source: Welsh Government, 14 March 2022

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Seven billion items of pandemic PPE 'not fit for purpose'

Nearly one in five items of personal protective equipment (PPE) the government bought during the pandemic are not fit for purpose and cannot be used by the NHS, it has been revealed – including 1.2 billion items that cannot be used at all.

As of December, almost 7 billion items of personal protective equipment bought for frontline services – 19.1% of the 36.4 billion items bought since February 2020 – had been marked “do not supply” to the NHS by the Department of Health and Social Care.

The number is more than three times the figure quoted last September, when health minister Lord Bethell admitted 1.9 billion items worth £2.8bn were in the “do not supply” category – 6.2% of the PPE bought up to that point.

The not-fit-for-purpose stock includes 1.2 billion units of PPE that cannot be used in any setting.

This "wastage" – which accounts for 3.3% of pandemic PPE – includes around 800m aprons that DHSC is now looking to recycle, permanent secretary Sir Chris Wormald said in a letter to the Public Accounts Committee.

The revelation comes as a consultation opens on the terms of reference for the public inquiry into the government's response to Covid. The inquiry will look at pandemic preparedness and the healthcare response, among other things.

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Source: Civil Service World, 11 March 2022

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NHS gender identity service for children can’t cope with demand, review finds

The only NHS gender identity service for children in England and Wales is under unsustainable pressure as the demand for the service outstrips capacity, a review has found.

The interim report of the Cass Review, commissioned by NHS England in 2020, recommends that a network of regional hubs be created to provide care and support to young people with gender incongruence or dysphoria, arguing their care is “everyone’s business”.

Led by the paediatrician Hilary Cass, the interim report explains that the significant rise in referrals to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London has resulted in overwhelmed staff and waiting lists of up to two years that leave young people “at considerable risk” of distress and deteriorating mental health. 

Last spring, the Care Quality Commission demanded monthly updates on numbers on waiting lists and actions to reduce them in a highly critical report on GIDS.

Differing views and lack of open discussion about the nature of gender incongruence in childhood and adolescence – and whether transition is always the best option – means that patients can experience a “clinician lottery”, says the new review, which carried out extensive interviews with professionals and those with lived experience.

It notes that the clinical approach used by GIDS “has not been subjected to some of the usual control measures” typically applied with new treatments.

Another significant issue raised with the review team was that of “diagnostic overshadowing”, whereby once a young person is identified as having gender-related distress, other complex needs – such as neurodiversity or a mental health problem that would normally be managed by local services – can be overlooked.

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Source: The Guardian, 10 March 2022

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WHO Foundation chief ‘very concerned’ over UK dismantling Covid testing as pandemic ‘isn’t over’

A leading figure in the World Health Organisation Foundation has criticised the UK’s move to dismantle its Covid testing programme as the disease surges in other parts of the world.

Mr Anil Soni, chief executive of the WHO Foundation, said in an interview with The Independent that maintaining surveillance over Covid-19 was “incredibly important” and the “dismantling of the testing infrastructure here strikes me as very worrying.”

The WHO Foundation chief warned people were “looking the other way” from counties where there is low vaccine coverage to maintain the hope that Covid is over.

He warned low vaccine coverage is a “petri dish” for future variants to breed and that the acute phase of the pandemic could not be over until this is addressed.

When asked about the UK’s plans to end its NHS Test and Trace programme Mr Soni said: “I’m very concerned about it.

“What we’ve seen is, it’s incredibly important to maintain surveillance, and countries in southern Africa should be applauded for detecting Omicron as quickly as they did. Those surveillance systems need to be in place around the world.

“We also want to make sure that testing is widely available so that people, when they become infectious, can be aware of their status and keep others safe. For testing not to be available and for us to be moving too quickly to normalcy creates risk.”

Mr Soni said the world’s position with Covid was “precarious” and highlighted the surge being seen in Hong Kong, where “health centres are at the verge of collapse, because of how many people are sick”.

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Source: The Independent, 10 March 2022

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Midwife struck off over Shropshire baby's death

A midwife found guilty of misconduct over the death of a baby six years ago is to be struck off.

Claire Roberts was investigated by the Nursing and Midwifery Council (NMC) for failures in the care she gave to Pippa Griffiths - who died a day after being born at home in Myddle, Shropshire.

An independent disciplinary panel described the midwife as "a danger to patients and colleagues".

Ms Roberts and fellow midwife Joanna Young failed to realise the "urgency" of medical attention needed, following the birth, the panel said. They had failed to carry out a triage assessment, after Pippa's mother called staff for help because she was worried about her daughter's condition.

The panel concluded Ms Roberts's fitness to practise was impaired.

Inaccurate record-keeping by Ms Roberts represented "serious dishonesty", panel chair David Evans said, adding she had carried it out "in order to protect herself from disciplinary action".

Her failures had represented a "significant departure from standards expected by a registered midwife," he added.

Her colleague Ms Young, whose case was also heard by the panel, faced strong criticism on Wednesday, but was told she would face no sanction after the hearing concluded she had shown remorse and undergone extra training since 2016.

Kayleigh Griffiths said she and her husband welcomed the findings and sanctions.

"We're really relieved that one of the midwives has been struck off and actually we're also relieved to find that the other midwife has learnt and feels significant remorse for the event that took place," she said.

"We realise people do make mistakes and I think how you deal with those mistakes is really important.

"All we do ask is that learning was made from those and I think in one of the instances it did occur and in the other it didn't - so I think the right outcome has been found."

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Source: BBC News, 10 March 2022

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UK Covid inquiry draft terms of reference set out

The draft terms of reference for the UK public inquiry into the government's handling of the Covid-19 pandemic have been published.

The inquiry, due to start in the spring, will play a key role in "learning lessons" from the pandemic and for the future, it said. 

The terms of reference were published after a consultation with inquiry chairwoman and former High Court judge Baroness Hallett, and with ministers in the devolved nations.

The Scottish government has already published the terms of reference for its own Covid-19 inquiry, to be led by Judge Lady Poole.

The UK-wide inquiry proposes examining a broad range of issues including:

  • the UK's preparedness for the pandemic
  • the use of lockdowns and other 'non-pharmaceutical' interventions such as social distancing and the use of face coverings
  • the management of the pandemic in hospitals and care homes
  • the procurement and provision of equipment like personal protective equipment and ventilators
  • support for businesses and jobs, including the furlough scheme, as well as benefits and sick pay.

The inquiry aims to produce "a factual, narrative account" covering decision-making at all levels of government and the response of the health and care sector as well as identifying the "lessons to be learned".

Becky Kummer, spokesperson for Covid-19 Bereaved Families for Justice, said the publication was a "huge step forward" and the organisation looked forward to contributing to the consultation on the terms.

Chris Hopson, chief executive of NHS Providers, which represents hospital trusts, said there was much the NHS did well during the pandemic but: "It is right the inquiry looks at areas where there were major challenges - such as infection prevention and control, access to PPE, testing, and robust epidemiological modelling."

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Source: BBC News, 11 March 2022

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NHS England to replace cancer targets

The two-week wait cancer target should be scrapped and replaced with a different measure, as part of an overhaul of cancer standards, NHS England has said.

After piloting a new measure which aims to see 75% of patients given the all-clear or a diagnosis within 28 days of referral, NHS England has recommended .The new “faster diagnosis target” would replace the current ‘two-week wait’ target, which is for 93% to have seen a specialist within two weeks, but not necessarily had a diagnosis.

This proposal, and other changes to the way cancer waiting time targets are organised, will be consulted on until 6 April.

The nine current cancer targets were created in 2000. The current headline measure along with the two-week wait — a two-month wait from urgent GP referral to first treatment — has not been hit since December 2015.

The document containing the proposals said the current two-week standard saw some patients given an appointment at which no test was taken, purely to hit the target. For some suspected cancers, “many trusts… offer outpatient appointments to ensure they hit the target”, without improving diagnosis.

The move to scrap the two-week wait was welcomed – with significant caveats — by Cancer Research UK

Cancer Research UK chief executive Michelle Mitchell said: “The new Faster Diagnosis Standard is a more meaningful target than the current two-week wait that will hopefully improve early diagnosis. If all trusts met the 75 per cent target, it would be an improvement to where we are now. However, in the long-term to improve cancer survival, we’d like to see a 95 per cent target originally proposed in the 2015 cancer strategy in Sajid Javid’s upcoming 10-year plan for cancer.

“We recognise the target was set lower because of a shortage of cancer specialists, critical to diagnosing cancer across the NHS. The government must provide the extra investment they have promised to grow the NHS workforce. Every moment of delay risks more people waiting for diagnosis and treatment.”

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Source: HSJ, 10 March 2022

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‘Lack of respect’ for children at ‘inadequate’ hospital

Staff failed to provide kind and compassionate care and did not treat children with respect at a private hospital downgraded from ‘good’ to ‘inadequate’, a report by health inspectors has revealed.

Huntercombe Hospital Stafford was placed in special measures in 2016, but was rated “good” by the Care Quality Commission two years later.

Now, its first inspection under provider Huntercombe Young People Ltd in October 2021 has exposed a raft of safety concerns and instances of poor care. Huntercombe Young People Ltd took over the service in February 2021. 

Heavy reliance on agency staff, workers spotted with their “eyes closed” on observations, and staff not respecting young people’s pronouns were among concerns inspectors flagged.

Staff observation of patients was also found to be “undermined” by a blind spot where people could self-harm unseen, the CQC report, published today, said.

Children also told the CQC they felt staff did not always understand their mental health condition or know how to support them, particularly those on the psychiatric intensive care ward with eating disorders or autism.

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Source: HSJ, 10 March 2022

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Antipsychotics are increasingly prescribed for personality disorder, against NICE guidelines, researchers find

Antipsychotics have been frequently and increasingly prescribed for extended periods to people with recorded personality disorder but no history of severe mental illness, a study looking at UK general practice data has found.

Researchers from University College London looked at 46 210 people who had had personality disorder recorded in their GP record between January 2000 and 31 December 2016. Of these, 15 562 (34%) had been prescribed antipsychotics.

The study, published in BMJ Open, also found that 36 875 people with a record of personality disorder had no record of severe mental illness.

An urgent review of clinical practice is warranted, including the effectiveness of such prescribing and the need to monitor for adverse effects, including metabolic complications.

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Source: BMJ, 10 March 2022

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British women are facing a quiet crisis in contraceptive care

Delays in being able to get contraception and abortions can wreck women’s lives. It’s time women ignored the stigma and started complaining more loudly, writes Nell Frizzell in the Guardian. 

"When a friend recently told me that there was a 10-week waiting list to have a copper coil fitted, my shock turned quickly into anger. Ten weeks is a hell of a long time to wait for adequate, hormone-free, affordable contraception.

We are experiencing a quiet crisis in contraceptive care in this country. 

According to a report by the Advisory Group on Contraception: “Going into lockdown, services had faced years of budget cuts by the government, leading to an 18% decrease in real-terms contraception spend since 2015.”

The same report points out that there has also been a huge reduction in sites commissioned to deliver contraception (26% of local authorities cut sites in 2018-2019), meaning people are having to travel further to get the medical help they need, simply not to have an unplanned, unwanted, unaffordable or unsafe pregnancy.

Unfortunately, the stigma still attached to contraception and reproductive health means people are less willing to complain publicly about the huge waiting times, the travel costs and the difficulty they face in accessing contraception and abortion. Subtly and overtly, we are told that this is our lot and we must bear it.

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Source: The Guardian, 9 March 2022

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'Urgent action' needed on hospital waiting times in Ireland

Urgent action is required to tackle hospital waiting times on both sides of the Irish border, according to the Economic and Social Research Institute (ESRI).

A report into the primary healthcare systems of Ireland and Northern Ireland found that both jurisdictions are experiencing similar problems.

These include workforce shortages and increasing expenditure.

On hospital waiting times the problem is worse in Northern Ireland. 

The proportion of people on the waiting list in Northern Ireland for more than one year increased from 20% to 60%. In the Republic of Ireland, during the same period between 2017 and 2021, the figure increased from 12% to 20%.

A key distinction between the healthcare systems is the absence of a universal healthcare system in Ireland, write the authors.

That means in Northern Ireland, all residents are entitled to a wide range of free health care services, while in Ireland, the majority pay to see their GP and for other services.

But despite this key difference, both systems are currently facing similar challenges, including shortages in key areas of the workforce and long waits for a range of healthcare services.

Cross-border collaboration in healthcare across the island is an interesting but contentious issue. At present, according to the ESRI report, that work is relatively limited.

It points to a 2011 report which identified the potential benefits to be gained from increased co-operation in healthcare including collaboration in cystic fibrosis, ear, nose and throat surgery, paediatric cardiac surgery and acute mental health services.

However, this 2022 report concludes that despite some notable exceptions such as the Congenital Heart Disease Network and the North West Cancer Centre at Altnagelvin Hospital in Londonderry, "collaboration has been relatively limited".

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Source: BBC News, 10 March 2022

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British Sign Language to be used in NHS mental health service

The charity SignHealth has been awarded a national contract with NHS England to supply the mental health service Talking Therapies in British Sign Language.

The new specialist service will help to support deaf people who are experiencing anxiety, depression and other mental health issues.

This marks the first time NHS England have granted a national contract to a deaf specialist service and will hope to bridge the gap and tackle the health inequalities recognised after a recent freedom of information (FOI) request found that around 100 NHS trusts do not comply with accessible information standards (AIS).

Prior to the contract, deaf people experiencing mental health related issues would have to rely on funding from their Clinical Commissioning Group (CCG) to approve additional communication assistance on an individual basis.

Waiting for approval of the funding for British Sign Language (BSL) therapy services meant that many deaf patients were having to wait considerably longer than their able hearing counterparts.

Many CCGs do not grant additional funding and would not offer these kinds of services to deaf people, often resulting in ‘postcode lottery’.

Dr Sarah Powell, Clinical Lead at SignHealth, said: "Deaf people are twice as likely to experience mental health challenges such as depression and anxiety compared to hearing people. This is a serious and sometimes life-threatening health inequality. Therapy delivered in sign language has been proven to have higher recovery rates and we are delighted that this contract removes the funding barrier so that more Deaf people are able to access life-changing treatment."

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Source: NHE, 9 March 2022

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‘Angry’ NHSE pressures prestigious trust to make ‘public apology’

NHS England is trying to force a prestigious cancer trust to publicly apologise to a group of whistleblowers, after being ‘shocked’ by the way it responded to a review into their concerns.

As HSJ reported in January, an external review into The Christie Foundation Trust supported multiple concerns which had been raised by staff about a major research project with pharma giant Roche.

The review had also noted how 20 current and former employees, some of whom were “long-standing, loyal, senior staff”, had described bullying behaviours and felt they had suffered detriment because they spoke out.

In response to the review, trust chair Christine Outram and chief executive Roger Spencer issued a bullish report listing numerous “inaccuracies” and characterised the concerns as being limited to a “small number of staff who are dissatisfied or aggrieved”.

It did not thank the staff for raising the issues, nor apologise for the experiences they had. However, HSJ has now learned that NHSE is trying to ensure the trust issues a public apology.

At a meeting with some of the whistleblowers on 11 February, David Levy, medical director for NHSE North West, said he was “shocked” and “frankly a bit angry” at the trust’s response, saying it reflected badly on the organisation, HSJ understands.

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Source: HSJ, 9 March 2022

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USA: Covid long-haulers face grueling fights for disability benefits

Deepa Singh, 30, of Louisville, USA, has been seriously ill for two years, racked with extreme fatigue, racing heartbeat and memory problems from Long covid that she says prevent her from working. Adding to her distress, she says, has been a grueling — and so far unsuccessful — battle for disability payments.

Singh, who worked as a project manager, is among a cohort of Long Covid patients who have been denied disability benefits, either by private insurance companies, which operate benefit plans offered by employers, or by the Social Security Administration, which manages government disability benefits.

Tasked with sorting legitimate health claims from fraudulent or marginal ones, these gatekeepers now face a novel challenge as the coronavirus pandemic drags on: a flood of claims citing a post-infection syndrome that is poorly understood by the medical community and difficult to measure.

Patients cite a litany of symptoms that defy verification through basic medical tests. They become exhausted at the merest exertion. They can’t remember simple words. Their hearts feel like they are fluttering. Yet neurological exams, ECGs and chest X-rays come back clean.

Doctors said in interviews they are treating Long Covid patients who are clearly too sick to work but who have difficulty meeting the evidence threshold insurers demand: objective medical test results showing an inability to perform work.

Specialized tests can measure a few Long Covid-related problems, such as a central nervous system disorder called dysautonomia, which affects the body’s ability to regulate itself. But there are months-long waiting lists for the tests, doctors and patients said.

The challenges are similar to those faced for years by people claiming disabilities based on chronic fatigue syndrome. But the pandemic has given rise to such claims on a far greater scale.

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Source: The Washington Post, 8 March 2022

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