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French pharma firm found guilty over medical scandal in which up to 2,000 died

A French court has fined one of the country’s biggest pharmaceutical firms €2.7m (£2.3m) after finding it guilty of deception and manslaughter over a pill linked to the deaths of up to 2,000 people.

In one of the biggest medical scandals in France, the privately owned laboratory Servier was accused of covering up the potentially fatal side-effects of the widely prescribed drug Mediator.

The former executive Jean-Philippe Seta was sentenced to a suspended jail sentence of four years. The French medicines agency, accused of failing to act quickly enough on warnings about the drug, was fined €303,000.

The amphetamine derivative was licensed as a diabetes treatment, but was widely prescribed as an appetite suppressant to help people lose weight. Its active chemical substance is known as Benfluorex.

As many as 5 million people took the drug between 1976 and November 2009 when it was withdrawn in France, long after it was banned in Spain and Italy. It was never authorised in the UK or US.

The French health minister estimated it had caused heart-valve damage killing at least 500 people, but other studies suggest the death toll may be nearer to 2,000. Thousands more have been left with debilitating cardiovascular problems. Servier has paid out millions in compensation.

“Despite knowing of the risks incurred for many years, … they [Servier] never took the necessary measures and thus were guilty of deceit,” said the president of the criminal court, Sylvie Daunis.

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Source: The Guardian, 29 March 2021

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Freedom to Speak Up: guidance for NHS trust and NHS foundation trust boards

NHS Improvement's revised expectations of boards and board members in relation to Freedom to Speak Up plus supplementary resources and a self-review tool. 

Effective speaking up arrangements protect patients and improve the experience of NHS workers. NHS Improvement's guide contributes to the need, set out by Sir Robert Francis in his Freedom to Speak Up review, to develop a more open and supportive culture that encourages staff to speak up about any issues of patient care, quality or safety.

The importance of workers having the freedom to speak up and the role that executive directors play in this has been recently reaffirmed in the review of Liverpool Community Health NHS Trust, the Kark Report and the interim NHS People Plan. 

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Source: NHS Improvement, 31 July 2019

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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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Free flu jab offered to all over 50s in England

People aged 50 to 64 in England will be able to get a free flu jab from 1 December in an attempt to fight the "twin threats" of flu and COVID-19.

The group has been added to a list of people who are already eligible for a flu jab in England, such as those over 65 and health and social care workers.

Thirty million people are being offered the vaccine in England's largest flu-immunisation programme to date.

Health Secretary Matt Hancock said it was a winter "like no other".

"We have to worry about the twin threats of flu and COVID-19," he said, adding that the coronavirus pandemic meant it was "more important than ever" that people got their flu jabs.

Mr Hancock told BBC Breakfast that all over 50s would be able to get the vaccine by January.

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Source: BBC News, 20 November 2020

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Fraudsters steal £100m from NHS as scammers target hospitals

Fraudsters have stolen more than £100m from the NHS in the past five years, exploiting weaknesses in IT systems to commit crimes ranging from stealing credit card data to hacking supplier emails, The Independent can reveal.

Scams have cost the NHS the equivalent of funding more than 2,000 senior nurses’ salaries for a year or providing over 20,000 rounds of radiotherapy for cancer patients.

Experts warned that the “inexcusable” losses, revealed as part of an Independent investigation, were ones the already overstretched health service can “ill afford”, calling for the NHS to protect itself better against fraud.

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Source: The Independent, 31 December 2024

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Fraudster posed as doctor in UK for 19 years, court hears

A “most accomplished fraudster” was paid between £1m and £1.3m by the NHS during the nearly two decades she posed as a qualified doctor after forging a degree certificate, a court has heard.

Zholia Alemi, believed to be 60 years old, worked as a psychiatrist in the UK for 19 years after claiming to have qualified at the University of Auckland in New Zealand, a trial at Manchester crown court heard. The defendant is accused of 20 offences, including forgery and fraud, which she denies.

The jury heard Alemi’s case was that she was appropriately qualified and documents demonstrating her qualifications were genuine.

She denies 13 counts of fraud, three counts of obtaining a pecuniary advantage by deception, two counts of forgery and two counts of using a false instrument.

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Source: The Guardian (paywalled)

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Frantic action to stop London ‘running out of beds in four days’

Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity.

In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak.

According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said.

The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. 

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Source: HSJ, 24 March 2020

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France's health system under pressure of increasing demands

The UK's health system is buckling under the weight of staff shortages and a lack of beds. In France, meanwhile, there are more doctors and many more nurses, yet its healthcare system is still in crisis.

President Emmanuel Macron has promised to change the way its hospitals are funded, and to free doctors from time-consuming administration, in a bid to break what he called a "sense of endless crisis" in its health service.

A series of eye-catching measures over the past few years - such as signing-up bonuses of €50,000 (£44,000) for GPs in under-served areas, and ending a cap on the number of medical students in France - have failed to plug healthcare gaps. 

Some hospitals are reporting up to 90% of their staff on "sick leave protest" at the conditions. And France's second-largest health union has called an "unlimited walkout" this week, following a fortnight of strikes by French GPs.

Guillaume Garot, a Socialist MP leading a cross-party bill to tackle the problem of medical deserts, said, "Eight million French people live in a medical desert, and six million don't have an attending doctor," he says. "It takes six months, on average, to find an appointment in my department of Mayenne; in Paris it takes two hours."

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Source: BBC News, 12 January 2023

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Fourteen trusts rated red for ‘capability’

NHS England has rated 14 trusts “red” for “capability” – meaning their management has been unable to “grip” long-running problems.

This week, NHS England published the first “provider capability” ratings, part of its overhauled oversight framework.

According to the framework, a “red” rating means there are “material or long-running concerns” that management “has been unable to grip”.

The 14 providers with this rating are all acute trusts, and include three large hospital groups: Leeds Teaching Hospitals Trust and University Hospitals Sussex Foundation Trust – both of which have seen  serious concerns raised about maternity failings – and Mid and South Essex FT.

The majority (nine) of the “red” trusts are in the north of England, while there are two each from the South East and East of England, and one in the South West. Nine of them serve coastal areas.

The ratings are based on self-assessments, which were then subject to review by NHSE regional teams. The process was carried out from August to December last year. There have already been a number of leadership changes at “red”– rated trusts since the exercise began.

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Source: HSJ, 17 April 2026

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Fourteen patients suffered severe harm and 20 moderate harm after they were “lost to follow-up” by a hospital trust, it has admitted

Maidstone and Tunbridge Wells Trust said two of the patients who were harmed are now pursuing clinical negligence cases against it.

The majority of the 34 cases involved “cancer pathway/referral issues” between January 2022 and April this year. 

The trust has informed patients in all appropriate cases, it said, but has not provided further details to HSJ of the cases where negligence action is being taken.

A “deep dive” review was launched earlier this year after staff noticed they were seeing more serious incidents than usual involving patients being “lost to follow-up”.

People are generally “lost to follow-up” when an appointment should take place – such as after a scan, after a fixed duration, or after an attempt to transfer specialty – but does not. It can result in harm when it means concerns are not picked up and treated, particularly if diagnostics are not properly acted on in cancer pathways.

The trust indicated similar issues are likely to be widespread in the NHS, saying in a statement: “Patients ‘lost to follow-up’ is an issue across the NHS, and this has been acknowledged within national investigations by the Health Services Safety Investigations Body along with recognition of the impact of clinical booking systems as a key theme.

“At a local level the trust recognised [it] needed to be addressed. The deep dive was held to identify areas where improvements could be made, and this work is in progress.”

The review cites the practice of “excess patient related results/paper referrals being left in piles in office environment”, multiple waiting lists in place for some services, and information being lost when lists were transferred to spreadsheets.

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Source: HSJ, 20 December 2024

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Four-year-old girl left with hearing loss for over a year after being left untreated

Kara Dilliway was just three years old when she came down with a common ear infection in October 2022.

She recovered quickly, as was expected, but just days after the infection cleared her parents found she was struggling to hear and talk.

“We’d noticed she’d just started to say yes and no to things, that’s when we thought something is going on,” says her mother Sam Dilliway, a 41-year-old community care worker from Basildon, Essex. Doctors said she could have glue ear, a common condition in children – fluid build-up had started to cause problems with her hearing, and would need draining.

But what should have been a minor ailment has turned into a never-ending ordeal for the family. What was a simple case of glue ear could now leave her with hearing loss for up to two years as she awaits routine treatment.

It comes after data released in January found that over 10 million people have been left on NHS waiting lists for basic ear care services.

Dr Aymat says that the long-term effects of such conditions being left untreated in children can be severe. While glue ear is unlikely to leave permanent damage, there is always a small risk of permanent hearing loss. However, the developmental effects are far more likely and potentially long-lasting.

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Source: The Independent, 1 April 2024

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Four-year waits to register with NHS dentist revealed

People across Devon and Cornwall are often waiting around four years to register with an NHS dentist, according to information collected by an integrated care board (ICB).

A paper in Cornwall and the Isles of Scilly noted “people waiting an average of 1,441 days to register with a dentist”, which equates to about three years and 11 months.

A spokesperson for NHS Cornwall and Isles of Scilly ICB said: “We are implementing a range of measures locally to address national pressures on NHS dentistry.

“This includes commissioning additional urgent care and stabilisation services, operating an emergency dental service to deliver 20,000 appointments a year, an extensive schools’ dental education programme, free dental treatment for local fishing communities, and a pilot which is helping to retain NHS treatment for children and other vulnerable patients and is treating some of those who have been waiting the longest.”

The British Dental Association said four-year waiting periods are “not unheard of” and it estimates unmet need for NHS dentistry now stands at 13 million, or more than one in four of the adult population. NICE recommends adults should have oral health reviews every two years.

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Source: HSJ, 9 October 2024

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Four-plus pathway patients account for 700k of waiting list

New data suggests around 700,000 cases on the elective waiting list relate to patients who are on at least four different pathways, and NHS England says personalised care plans must be developed to treat them more efficiently.

NHSE has published new data that reveals the overall referral to treatment waiting list, of 7.8 million cases, is made up of 6.5 million individual patients. The difference is due to some patients waiting for more than one treatment.

Stella Vig, NHSE’s clinical director for secondary care, told HSJ around 2-3% of the individual patients on the waiting list are on four to five pathways or more.

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Source: HSJ, 9 November 2023

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Four-hour A&E standard is the ‘wrong target’, claims Javid

The four-hour standard for A&E waits is the ‘wrong target’, which ‘doesn’t work’ and leads to ‘perverse outcomes’, health and social care secretary Sajid Javid has said.

Mr Javid made the claim during an appearance before the Commons health and social care committee yesterday.

He also spoke about the requirement that NHS patient-facing staff must be vaccinated against covid and took the opportunity to restate his belief that radical action was needed to tackle “failing trusts”.

Mr Javid told the MPs: “Targets work if they are the right targets, and in the NHS I have already noticed there are targets which are the wrong targets and we’ve got to change them.

“The four-hour A&E target is the wrong target, it doesn’t work. It leads to really perverse outcomes.

“If you look at some NHS trusts, all of sudden when the individual in A&E has got to three hours and 55 minutes, guess what? They just admit it. That’s a poor outcome.

“There may have been a good reason to have that target in the past, but you’ve got to keep these targets constantly under review and that’s something I’m doing.”

The long-running clinical review of waiting time standards by NHS England had proposed replacing the four-hour target with a suite of other measures but the government has yet to formally respond.

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Source: HSJ, 26 January 2022

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Four-fifths of UK mental health nurses say their workload is unmanageable

Mental health patients in the UK are routinely coming to harm because of high caseloads, understaffing and overwhelming administrative work, according to a poll that found only a fifth of specialist nurses felt their workload was manageable.

Prof Nicola Ranger, the general secretary of the Royal College of Nursing (RCN), said mental health nurses were caught in a “perfect storm” and unable to keep up with rising demand, with patients paying the price by missing out on crucial care.

Half of the specialist nurses who responded to the RCN union’s UK-wide survey said mental health patients “frequently come to harm” because caseloads are too high, with a quarter feeling that time pressures lead to daily issues with patient deterioration, relapse or self-harm.

Nearly two-thirds said their caseloads had risen “a lot” in the past three years, while excessive admin and a “tick box” culture were blamed for taking away valuable time for patient care. The poll also suggests that demand for services has grown more than twice as fast as the number of nurses in the field.

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Source: The Guardian, 27 April 2026

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Four-day junior doctor strike set for April

Junior doctors are to stage a four-day walkout in April in their fight to get a 35% pay rise in England.

Members of the British Medical Association (BMA) will take strike action from 11 April to 15 April.

Last week's walkout led to the cancellation of 175,000 treatments and appointments, with consultants brought in to provide cover in emergency care.

Hospitals bosses said the fallout from the strike would last weeks given the huge number of bookings that have to be rescheduled.

The new walkout of both planned and emergency care comes directly after the Easter weekend, which tends to be a busy period for the NHS.

Saffron Cordery, of NHS Providers, the membership organisation for NHS trusts in England, said demand would have built up over the bank holiday weekend.

"This threatens the biggest disruption from NHS walkouts so far," she said, adding: "There should be no doubt about the scale of the impact on patients, staff and the NHS."

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Source: BBC News, 23 April 2023

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Four US states consider new laws for people who have abortions to be punished as murderers

South Carolina, Oklahoma, North Dakota, and Indiana legislatures are considering bills that would classify abortion as homicide and therefore allow patients who have abortions to be charged with murder. Three of the states have the death penalty for murder.

All four states already have bans or very strict restrictions on abortion. South Carolina bans abortion after six weeks of pregnancy, North Dakota has a total ban on abortion that is currently in the courts, and Oklahoma and Indiana have complete bans already.

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Source: BMJ, 27 January 2025

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Four trusts report quarter of all ‘critical incidents’

More than a quarter of ‘critical incidents’ have been declared by just four trusts since the start of the crisis in urgent and emergency care.

Data obtained by HSJ shows 241 critical incidents have been declared by organisations due to “operational” or “system pressures” between April 2021, when long waits for urgent care began to surge upwards, and last month. Four trusts account for 68 of these (28%).

Critical incidents are declared when the level of disruption “results in an organisation temporarily or permanently losing its ability to deliver critical services, or where patients and staff may be at risk of harm”. These incidents may require “special measures and support from other agencies, to restore normal operating functions,” according to the NHS England definition. 

Most critical incidents were only in place for a few days before being stood down by the trust or system, but some were in place for much longer – sometimes for several months at a time, the data suggests.

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Source: HSJ, 25 October 2023

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Four trusts rated ‘red’ on baby deaths

Four hospital trusts have been assessed as having higher than expected rates of both stillbirth and neonatal deaths, according to HSJ analysis of a national safety audit.

Only one of those trusts scoring highly on both measures is part of the ongoing national government maternity inquiry. That is University Hospitals of Leicester Trust.

Three other trusts that are not part of Baroness Valerie Amos’ review were also rated “red” for these measures: South Tyneside and Sunderland, East Suffolk and North Essex, and Royal Devon University Healthcare Foundation Trusts.

A red rating means their adjusted death rate was at least 5% cent higher than peers. 

The four trusts are also red rated for “extended perinatal mortality” - which combines the two other metrics - including stillbirths after 24 weeks of pregnancy and “neonatal” deaths up to 28 days after birth.

MBRRACE study author Brad Manktelow, from Leicester University, told HSJ the mortality rates reported are not definitive measures of care quality.

But he added: “However, given the information that is available, the rates reported by MBRRACE-UK are robust and make an important contribution in highlighting those organisations where extra investigations should be targeted [to] improve the quality of perinatal and neonatal care in the UK.”

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Source: HSJ, 26 March 2026

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Four trusts cancel planned operations as covid pressures mount

All non-urgent elective operations are being postponed for at least two weeks in a health system still seeing significant and growing pressure from coronavirus.

The four acute trusts in Kent and Medway will still carry out cancer and urgent electives, but other work is being postponed. Relatively few elective operations are usually carried out around Christmas and New Year, meaning the county is likely to see little or no elective work for the next four weeks.

In a covid update bulletin issued last night, the Kent and Medway Clinical Commissioning Group acknowledged the pressure hospitals across its area were under but stressed cancer and other urgent operations would go ahead.

It added: “However, we are now pausing non-urgent elective services. This will allow staff to move to support the increased number of covid-19 patients.

“Initially this will be for a two-week period. We will keep this under weekly review and will contact individual patients where appointments need to be rescheduled.”

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Source: HSJ, 8 December 2020

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Four trusts added to NHSE ‘help list’

NHS England has revealed the latest list of trusts which it has identified as needing the most support to meet electives and cancer targets.

The national body identified 15 trusts which have been assessed as being at most risk of not meeting the key targets of either having no patients waiting 78 weeks or more for elective treatment by April 2023, or returning their 62-day cancer waiting list backlog to pre-pandemic levels by March 2023.

The 15 challenged trusts, which make up around 12% of acute trusts in England, are receiving “tier one” support which involves oversight from national teams, on-site expertise, extra funding and recruitment, and possible calls between their CEOs and government ministers.

NHS England said it has recently added four trusts to “tier one” for electives and cancer – York and Scarborough Teaching Hospitals Foundation Trust, Sheffield Teaching Hospitals FT, North West Anglia FT, and Royal Devon and Exeter FT. York and Scarborough FT, Sheffield FT, and North West Anglia FT has previously been in tier two for cancer services only, while Royal Devon and Exeter FT had previously been in tier one for electives only but is now in tier one support for cancer as well.  

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Source: HSJ, 23 December 2022

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Four of UK’s top countries for nurse recruitment on WHO ‘red list’

Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used.

Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022.

All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers.

Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer.

But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees.

Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”.

“It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said.

“This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce.

“They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.”

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Source: Nursing Times, 4 October 2022

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Four nurses investigated over death of boy, 5, at flagship children’s care home

Four nurses are facing a fitness to practice probe after the death of a five-year-old boy at a flagship care home for disabled children, The Independent can reveal.

The Nursing and Midwifery Council (NMC), the UK’s nursing watchdog, initially found there was no case to answer over the death of Connor Wellsted, who suffocated in his cot in 2017 while being cared for at the Children’s Trust facility in Tadworth, Surrey.

The nurses were referred to the NMC in May 2022, but the watchdog later closed the investigations. It reopened the probe in November 2023 and, this month, after a 19-month-long investigation, decided all four nurses should face fitness to practice tribunals.

No interim conditions have been placed on the nurses, meaning they can continue to work while awaiting the outcome. If the committee finds the nurses are unfit to practice, they could be struck off or suspended. However, the committee can also decide that the nurses’ fitness to practice is not impaired and give no sanction.

It comes after The Independent revealed that Surrey police had reopened a probe into the handling of Connor’s death following a litany of failings over the little boy’s care.

Connor died at Tadworth Children’s Trust (TCT), the UK’s largest brain injury rehabilitation centre for children, which can care for up to 66 young people, having suffocated when a cot bumper became lodged under his chin. He had been there for six weeks, receiving care for neuro-rehabilitation.

He was the first of three disabled children to die while in the care of TCT. Raihana Oluwadamilola Awolaja and Mia Gauci-Lamport died in June and September 2023, respectively.

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Source: The Independent, 22 June 2025

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Four NHS trusts declare ‘critical incidents’ amid surge of flu and norovirus cases

Four NHS hospital trusts in south east England have declared a “critical incident” as they struggle to cope with a surge in admissions due to flu and norovirus.

Three trusts in Surrey and one in Kent said the escalations have come after a “surge in complex attendances to A&E departments” driven in part by soaring numbers of patients with winter illnesses.

Health secretary Wes Streeting has warned the NHS is “not out of the woods yet”, as flu cases spiked once again last week, following two weeks where admissions had fallen after high numbers of cases were seen before Christmas.

In a statement on Monday, NHS Surrey Heartlands added the situation had been “exacerbated by increases in flu and norovirus cases and an increase in staff sickness” as well as the impact of the recent cold snap on more frail patients.

The three Surrey trusts affected are Royal Surrey NHS Foundation Trust, Epsom and St Helier University Hospitals NHS Trust ,and Surrey and Sussex Healthcare NHS Trust.

East Kent Hospitals University NHS Foundation Trust (EKHUFT) also declared a critical incident due to what it called “sustained pressures” at the Queen Elizabeth The Queen Mother Hospital in Margate.

It said its hospitals are experiencing “exceptionally high demand, driven by a continued high admission rate and a large number of patients with winter illnesses and respiratory viruses”.

NHS Surrey Heartlands urged patients to ensure they are using services “appropriately” and only attending A&E in an emergency.

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Source: The Independent, 13 January 2025

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