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Leak reveals management consultants’ role in recovery plans

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

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

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

These objectives include:

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

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Source: HSJ, 10 February 2022

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

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

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

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

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

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

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

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

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Source: BBC News, 10 February 2022

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Government plans to remove all remaining restrictions in England

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

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

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

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

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

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

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

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Source: BMJ, 9 February 2022

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Virus almost 'wholly responsible' for spike in dementia deaths

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

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

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

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

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

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

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Source: The Herald, 10 February 2022

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

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

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

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

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

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

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

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

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

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Source: Byline Times, 10 February 2022

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

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

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

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

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

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

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

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

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

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

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Source: Gov.uk, 9 February 2022

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

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

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

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

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

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

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Source: BBC News, 9 February 2022

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

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

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

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

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

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Source: BMJ, 8 February 2022

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Top oncologist says Tayside cancer crisis was 'avoidable tragedy'

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

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

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

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

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

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

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

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

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

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

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Source: BBC News, 9 February 2022

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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.

Read full story (paywalled)

Source: HSJ, 4 February 2022

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