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Firm fined £6m after hackers stole 83,000 patients’ details

The personal details of nearly 83,000 people were stolen during a cyber attack in 2022 that caused a “total system outage” of 111 services and left several trusts without access to their electronic patient records, regulators have revealed.

Software supplier Advanced — now known as OneAdvanced — was targeted by a criminal hacker group in August 2022. It supplies its Adastra system to 85% of NHS 111 providers, while its Careflow EPR is used by around a dozen community and mental health trusts.

On Wednesday, the Information Commissioner’s Office announced it had concluded its provisional findings into the attack and had issued a £6m fine to OneAdvanced, which it said had “failed to implement measures to protect” personal patient information.

According to the ICO, sensitive information such as phone numbers and medical records belonging to 82,946 people was stolen during the attack. Details about how to gain entry to the homes of 890 people who were receiving care at home were also stolen.

In the wake of the attack, NHS England said it had received assurances from OneAdvanced that no data held by mental health trusts had been “breached” from its Careflow system. 

The supplier said that none of the stolen information was ever made public or released on the dark web.

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Source: HSJ, 7 August 2024

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Firefighters rescue gran, aged 83, after seven-hour ambulance delay

A gran was left lying outside in the cold facing a seven hour wait for an ambulance following a fall before finally being rescued — by firefighters. Betsy Hulme, 83, was left in agony with a broken hip when she tumbled in her back garden in Leek, Staffordshire.

Son Steve, 60, a former ambulance technician, dialled 999 only to be told it would be several hours until paramedics could get to them due to long handover delays. After a further three hours of Betsy waiting on cold concrete slabs while soaked in rain water, desperate Steve decided to drive to a nearby fire station to ask for help.

Fire crews then came to rescue to lift gran-of-four Betsy into her son's car who took her to hospital where she remains after undergoing a hip repair operation. Dad-of-two Steve, of Leek, has now branded emergency response times as “absolutely disgusting”.

He said: "It’s opened my eyes if I’m honest. It’s absolutely disgusting. I’m so grateful and thankful to the fire service - but it really isn’t their job. I can't remember in my time working as an ambulance technician going to someone and saying, 'I’m sorry it’s taken us twelve hours to get here'."

“It was never anywhere near those ridiculous times when I worked there until 2000 and something has gone drastically wrong since. I can't speak highly enough of the boys and girls who work in the NHS, it's the people above them. Its systemic change that's needed."

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Source: Wales Online, 4 April 2024

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Fire warnings yet to be fully dealt with at eight hospitals

Eight hospitals in England have fire safety warnings attached to them, with half in place since 2022 or earlier, HSJ can reveal.

All are enforcement notices issued by fire brigades when serious risks are not being managed. Issues raised include risk assessments, maintenance, and emergency routes.

There were more than 1,300 fires across the NHS trust estate in 2022-23, according to official estates data, which was an increase of 18% on the year before.

NHS Providers deputy chief executive Saffron Cordery said the figures highlighted the “urgent need” to address maintenance backlog – which includes fire safety – across the NHS estate. The overall backlog figure has been growing yearly and is approaching £12bn.

Ms Cordery said: “Greater capital investment is essential to enabling a safe environment for patients and staff.”

Rory Deighton from NHS Confederation said more than a decade of underinvestment was behind the “dilapidated” state of the NHS estate.

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Source: HSJ, 5 April 2024

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Finger-prick blood test could be early warning for children with type 1 diabetes

All UK children could be offered screening for type 1 diabetes using a simple finger-prick blood test, say researchers who have been running a large study.

Currently, many young people go undiagnosed and risk developing a life-threatening complication called diabetic ketoacidosis that needs urgent hospital treatment.

Identifying diabetes earlier could help avoid this and mean treatments to control problematic blood sugar levels can be given sooner.

Some 17,000 children aged three to 13 have already been checked as part of the ELSA, external (Early Surveillance for Autoimmune diabetes) study, funded by diabetes charities.

Imogen, who is 12 and from the West Midlands, is one of those found to have diabetes thanks to the screening.

Her mum Amy says knowing what's coming, rather than being taken by surprise, has made a massive difference to their confidence and peace of mind.

"Imogen took part in the study to further research and help others, but it has helped her too – being forewarned is being forearmed.

"She was always going to develop type 1 diabetes, but through ELSA we've been able to slow down the process and prepare. We know what's coming, but we're not scared."

Imogen is being given ongoing support to prepare her for what is to come.

Amy, who is 44 and has type 1 diabetes herself, is aware of the risks with the disease. She was diagnosed aged 13 after developing diabetic ketoacidosis.

"When I was diagnosed, I had no warning and ended up quite poorly in hospital," she recalls.

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Source: BBC News, 21 January 2026

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Finance directors need to do more to keep patients safe, warns watchdog

Financial directors need to take responsibility for safety, which should be at the core of how the NHS runs services, the leadership of the Health Services Safety Investigations Body (HSSIB) said at its launch Wednesday.

The Healthcare Safety Investigation Branch is now an independent body – and has been renamed HSSIB – although maternity investigations are hosted by the Care Quality Commission.

Questioning how many finance directors across the NHS take responsibility for safety, HSSIB’s interim chief investigator Rosie Benneyworth said: “We need a position where finance directors in every organisation are as responsible for safety as the person leading the safety agenda and vice versa, the safety person works with the finance agenda to support them.

“Often you see the finance director and safety lead don’t work effectively together and we need to change that.”

Dr Benneyworth said progress will not be made unless operational delivery, financial delivery and safety are tackled “in the same breath”.

HSSIB’s new chair Ted Baker also called for safety to become a core part of running services “in the way running the accounts is”, as it is currently still seen “as an add-on”.

He stressed that safety “drives efficiencies, enables innovation and saves costs”.

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Source: HSJ, 19 October 2023

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Finance directors ‘incensed’ at comments by safety watchdog

The Health Services Safety Investigation Branch has been accused of taking “divisive potshots” at NHS finance directors.

Speaking at an event to mark the watchdog becoming an independent body, HSSIB chief investigator Rosie Benneyworth said: “We need a position where finance directors in every organisation are as responsible for safety as the person leading the safety agenda and vice versa… Often you see the finance director and safety lead don’t work effectively together and we need to change that.”

Dr Benneyworth said progress on safety would not be made unless it was tackled “in the same breath” as operational and financial matters.

In response, the Healthcare Financial Management Association said Ms Bennyworth’s views had “incensed” its members.

Commenting below the story, HFMA chief executive Mark Knight said: “I have been contacted by a number of finance directors who are incensed by the comments in this article. To gain a fuller picture of the views of the newly created HSSIB we will be asking for a meeting with Dr Benneyworth and [HSSIB chair Ted] Baker. The HFMA would like to understand the evidence on which the assertions in the article are based, which are completely at odds with how I know the vast majority of finance directors and their teams behave.”

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Source: HSJ, 23 October 2023

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Finance and efficiency £6bn underlying deficit ‘could derail 10-Year Plan’

The underlying deficit in the NHS provider sector has returned to pre-covid levels and could derail the government’s reform plans, HSJ analysis has found.

As they head into the 2025-26 financial year, the gap between trusts’ regular income and expenditure is north of £6bn.

Adjusted for turnover, the gap appears to have returned to the same level as in 2018-19, when NHS Improvement, which no longer exists, last published an official estimate.

The underlying deficit is the difference between recurrent annual income and costs, which is often plugged by one-off savings and funding injections.

Sally Gainsbury, lead analyst at the Nuffield Trust, warned the scale of financial distress would undercut efforts to reform the NHS through its 10-Year Plan.

Ms Gainsbury said: “There is a worrying disconnect between the huge ambition in the forthcoming 10-Year Health Plan – which centres around shifting care out of hospital, improving digital care and preventing ill health – and the financial realities.

“With the average CEO or finance director worrying about how to find the cash to pay staff for 17 days of the year, they’re probably not going to have the bandwidth – let alone the resource – to think about asking those staff to double-run clinics in the community or upgrade to the latest tech.”

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Source: HSJ, 7 April 2025

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Final infected blood inquiry report delayed until May

The publication of a final report into the infected blood scandal has been delayed until May.

The chairman of the public inquiry, Sir Brian Langstaff, said more time was needed to prepare "a report of this gravity".

Victims and their families were initially told they would learn the findings in autumn last year.

That date was pushed back until March, and the inquiry has now confirmed the further delay to 20 May 2024.

"I am sorry to tell you that the report will be published later than March. That is not what I had intended," added Sir Brian.

"When I reviewed the plans for publication, I nonetheless had to accept that a limited amount of further time is needed to publish a report of this gravity and do justice to what has happened."

It is thought about 30,000 people were infected with HIV and hepatitis C through contaminated blood products in the 1970s and 1980s.

More than 3,000 have died in what has been described by MPs as the worst treatment disaster in NHS history.

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Source: BBC News, 17 January 2024

Further reading on the hub:

UK Infected Blood Inquiry

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Figures show maternal death rate race disparity

Figures showing the risk of maternal death being almost four times higher among women from black ethnic minority backgrounds compared with white women in the UK have been published.

The figures, which relate to 2019 - 2021, have been released by MBRRACE-UK, a collaboration involving the University of Leicester.

The MBRRACE-UK collaboration (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries), led from Oxford Population Health's National Perinatal Epidemiology Unit, looked at data on women who died during, or up to six weeks after, pregnancy between 2019 and 2021 in the UK.

The report showed the risk of maternal death in 2019 - 2021 was almost four times higher among women from black ethnic minority backgrounds compared with white women.

Marian Knight, professor of Maternal and Child Population Health at Oxford Population Health and maternal reporting lead, said: "Persistent disparities in maternal health remain.

"It is critical that we are working towards more inclusive care where women are listened to, their voices are heard, and we are acting upon what they are telling us."

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Source: BBC News, 11 May 2023

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Figures show 10,000 fewer people starting breast cancer treatment

It has been found there are 10,000 fewer patients starting treatment for breast cancer over the past year in England. 

Experts are advising patients to go to their GP if they notice anything unusual and not to wait to get screened or checked. 

Although breast cancer deaths were found to be at an all time low during the pandemic, experts are worried there may be more to the low figures than previously thought. 

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Source: Sky News, 15 June 2021

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Fifty senior doctors ask CEO for protection against bullying

Fifty senior consultants from a minority ethnic background at University Hospitals North Midlands have written to Tracy Bullock and trust chair David Wakefield asking for action to ‘protect’ staff from bullying behaviours following an internal survey in which 348 medics claimed to have experienced bullying and harassment.

In a subsequent letter on 5 August, seen by HSJ, 50 doctors have now said: “We are forced to express our concerns over the prevailing poor culture within our organisation with most senior medical staff presently reporting they have suffered or witnessed first-hand discrimination, bullying, harassment, or victimisation. We… ask for urgent action by the executive and non-executive boards to immediately implement measures to protect senior medical staff from unacceptable ill-treatment.”

A separate external review is now understood to have been commissioned amid concerns over bullying within ophthalmology services. 

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Source: HSJ, 19 August 2021

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Fifth of UK hospices cutting services amid funding crisis, finds report

One in five hospices in the UK are cutting services amid the worst funding crisis in two decades, a report has warned, with soaring numbers of patients being pushed back into the NHS.

Research by Hospice UK found “small and wildly varying” state funding had failed to keep pace with growing demand and rising running costs.

That means inpatient beds are being cut, staff made redundant and community services restricted, with fewer visits to dying patients in their own homes, according to the charity, which represents more than 200 hospices across the country.

Hospice UK said the sector’s finances were in their worst state in 20 years. A fifth of hospices have cut or closed their services in the last year or are planning to do so, the charity said.

Toby Porter, its chief executive, said: “Too many hospices are in crisis. The small and wildly variable amount of state funding they receive has failed to keep pace with rising costs.

“Many hospices are therefore running deficits that can only mean one thing – more cuts to essential care services, or even service closures. We’re already seeing redundancies at some major hospices.”

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Source: The Guardian, 16 July 2024

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Fifth of patients at two north of England surgeries have long Covid, study finds

One in five patients registered to a pair of GP surgeries in the north of England have Long Covid, according to a report that lays bare stark regional inequalities.

The north-west of England had higher than average numbers of people reporting Long Covid symptoms, with just over one in 20 people (5.5%), followed by the north-east and Yorkshire (5.1%).

According to the analysis, a fifth of patients at Parklands medical practice in Bradford and Margaret Thompson medical centre in Liverpool are living with Long Covid, and the 10 GP surgeries with the highest prevalence of Long Covid are in the north of England.

The report also found the prevalence of Long Covid among the most deprived areas of England was 6.3%, almost double the rate in the least deprived areas.

Dr Stephanie Scott, the lead author of the report and senior lecturer in public health at Newcastle University, said: “Long Covid is a complex condition that goes beyond physical and mental symptoms, affecting other parts of people’s lives including their sense of self and professional identity. This can then lead to experiences of social isolation.

“Currently, there is little evidence-based treatment for Long Covid and the health system focuses on symptom management. This needs to change. Our research has offered a glimpse into the reality of what it is like to live with this often-debilitating condition and the knock-on effects it has on people’s personal and professional lives."

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Source: The Guardian, 23 August 2024

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Fifth of health and care workers to leave sector due to work pressures and cost of living crisis

A study of over 1,000 health and social care workers, conducted by Florence, the tech platform providing health & social care workers access to available shifts, found that almost a third of healthcare workers admit to feeling overwhelmed at least once a week, with 17% feeling burnt-out every day. A staggering 97% believe the cost-of-living crisis has caused further stress or burnout among healthcare professionals. 

It comes after more than half of healthcare workers (56%) admit to working more than 2-3 times a week over their contracted hours, with 7% working overtime every day. Not having enough staff is causing the most pressure in their role (50%), followed by low pay (39%) and high workload (35%).   

The study revealed nine in ten NHS and social care workers state chronic staff shortages are affecting the quality of care. Analysing this deeper, three quarters of respondents stated that the quality of care is already being ‘severely’ impacted as high vacancy rates sweep across the industry.  

Dr Charles Armitage, Former NHS doctor and CEO and Founder of Florence, observed: “If you’ve got fewer people there on-shift to look after people, the quality of care decreases because the people that are there are overstretched, they’re trying to do too many things and are suffering from severe burnout. As a result, mistakes are made as they’re not able to just spend as much time with people and provide that really important patient-centred care.” 

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Source: Hospital Times, 17 August 2022

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Fifth of GP partners remove BAME staff from patient-facing work in pandemic

More than one in five GP partners said they removed practice staff away from face-to-face care due to ethnicity during the pandemic, a Pulse survey has revealed. 

The survey in June revealed that 84 of the 378 respondents said that ‘ethnicity was a crucial factor in removing anyone in your practice away from face-to-face assessments’.

Around 70% of respondents said they had been counting ethnicity as a factor when risk assessing staff.

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Fifth NHS trust declares critical incident as winter bugs lead to overwhelming demand

A fifth NHS hospital trust has declared a critical incident in the last 24 hours as it is overwhelmed by demand for its services.

Nottingham University Hospitals Trust said it was facing “severe and sustained pressure” caused by rising patient numbers, winter infections and staff sickness.

The combination has led to “significant and unacceptable” delays in A&E and on hospital wards, according to trust chiefs.

A “critical incident” is the highest alert level used by the NHS, and when one is declared, hospitals may redirect resources, postpone non-urgent treatments and seek external support.

Bosses at Nottingham University Hospitals Trust pleaded with the public to go to A&E only in emergencies or serious accidents, and to use other services instead.

Patients were facing what they said were “unacceptable and lengthy” waits in corridors.

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Source: The Independent, 14 January 2026

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Fifth cyber incident in a week under investigation

Cyber security teams are investigating the fifth suspected attack on the NHS to have taken place last week.

HSJ can reveal Medway Community Health shut down some systems last week after suspicious activity.

The incident comes after declared cyber incidents at Alder Hey Children’s Foundation Trust, Royal Liverpool University Hospital and the Liverpool Heart & Chest Hospital last week.

Last week also saw the end of an incident from a fortnight ago at Wirral University Teaching Hospital FT.

The three NW trusts with an ongoing incident last week said in a statement: “Criminals gained unlawful access to data through a digital gateway service hosted by Alder Hey. This digital gateway is shared by Alder Hey and Liverpool Heart and Chest Hospital.

“This has resulted in the attacker unlawfully getting access to systems containing data from Alder Hey Children’s, Liverpool Heart and Chest Hospital, and a small amount of data from Royal Liverpool University Hospital. We have launched an investigation which is still ongoing to determine the full facts around what data has been obtained unlawfully.”

The trusts would not confirm how many patient records had been accessed online, but said “we do not believe the data published or accessed unlawfully relates to children and young people”.

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Source: HSJ, 9 December 2024

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Fife simulator helping medics across the world to prevent late miscarriage and premature labour

A new training aid, developed in Fife, is helping to equip trainee medical staff from around the world with the skills to prevent late miscarriage and premature labour.

It was invented by Dr Graham Tydeman, consultant in obstetrics and gynaecology at Kirkcaldy’s Victoria Hospital, in conjunction with the St Thomas’ Hospital, London, and Limbs and Things.

The lifelike simulator allows trainees to perform hands on cervical cerclage in advance of a real-life emergency. The procedure involves an emergency stitching around the cervix and is necessary when the cervix shortens or opens too early during pregnancy, helping to prevent late miscarriage or extreme premature labour.

It is not a common event and the simulator was developed by Dr Tydeman following a request from medical trainees across the UK.

The device has already been warmly received by hospitals and training institutions across the world – with orders from countries including New Zealand and India.

Dr Tydeman said: “The reason this was developed is that it is not a common procedure and is very difficult to teach trainees."

“Increasingly women are understandably asking  about the experience of their surgeon and anyone having this procedure understandably does not want it to be the first one that a doctor has ever done because if it goes wrong there could be tragic consequences with loss of the baby. However, if a trainee has shown suitable skills using this simulator, I would be able to confidently reassure women that the doctor had been adequately trained, although a more experienced person would always help during the actual operation for the first few procedures on real women."

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Source: The Courier, 19 December 2020

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Fewer than half of pharmacists issue warning cards for patients using valproate

It is a requirement that patient cards detailing information on the risks are issued every time valproate is dispensed, under Medicines and Healthcare products Regulatory Agency (MHRA) guidance.

Only 40% of pharmacists are meeting a patient safety requirement when dispensing valproate to women, an audit carried out by the Company Chemists’ Association (CCA) has found.

The drug can cause birth defects in women who take it when pregnant.

In April 2018, the Medicines and Healthcare products Regulatory Agency (MHRA) stated that valproate must not be used by women and girls of childbearing age unless a pregnancy prevention programme (PPP) is in place.

Duncan Rudkin, Chief Executive of the General Pharmaceutical Council (GPhC), said pharmacies must do more to ensure the safe dispensing of valproate.

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Source: The Pharmaceutical Journal

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Fewer than 1% of U.S. clinical drug trials enroll pregnant participants, study finds

A new study by researchers from the Brown University School of Public Health found that pregnant women are regularly excluded from clinical drug trials that test for safety, raising concerns for the efficacy of these medications for maternal and child health.

The study, published in the American Journal of Obstetrics and Gynecology, analyzed 90,860 drug trials involving women ages 18 to 45 from the past 15 years and found that only 0.8% included pregnant participants. About 75% of the studies excluded them, potentially leaving critical safety and efficacy questions unanswered.

“When pregnant women are excluded from drug trials, it is harder to know if the medication is safe for mothers and their children,” said Alyssa Bilinski, an assistant professor of health services, policy and practice and of biostatistics at Brown’s School of Public Health. “In practice, this means that some people might decide to take medications even absent rigorous evidence, which could lead to harmful side effects. At the same time, others might avoid medications that could actually help them because there’s not enough data to give them confidence about safety.”

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Source: Brown University School of Public Health, 17 January 2025

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Fewer NHS staff feel able to raise clinical safety concerns, data show

The number of NHS staff who feel able to raise concerns about clinical safety has fallen for the second year in a row, an analysis of NHS staff survey data has shown.

A report by the NHS’s National Guardian’s Office, which represents local “freedom to speak up guardians” who help NHS workers to raise concerns, said that staff were increasingly disillusioned and that they believed that speaking up was “futile,” which had “worrying implications for patient safety.”

Dr Jayne Chidgey-Clark, National Guardian for the NHS said: “It is not acceptable that two in five workers responding to the NHS staff survey do not feel able to speak up about anything which gets in the way of them doing their job.

“These survey responses show us that there is a growing feeling that speaking up in the NHS is futile – that nothing changes as a result. When workers speak up about concerns, including the impact of under staffing and a crumbling infrastructure, their leaders themselves may struggle to be heard when trying to address these concerns.

“I would add my voice to that of others that this urgently needs to be addressed".

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Source: BMJ. 9 June 2023

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Few staff using wellbeing hubs despite rise in sick days

Only 53,500 staff have used a flagship NHS staff wellbeing initiative in its first year of operation, HSJ can reveal, while separate analysis finds mental health sick days have soared in the last five years. 

Figures obtained via Freedom of Information requests reveal the NHS’s staff mental health and wellbeing hubs, set up in February 2021 in response to covid pressures, received 53,549 contacts from NHS and social care staff between then and January 2022.

It is the first time such data has been published and it comes as HSJ’s analysis of separate figures shows mental health sick days taken across acute and specialist NHS trusts have risen sharply in the past five years (see box below). 

The total number accessing the hubs, which is inclusive of social care staff, equates to less than 4 per cent of the NHS workforce as of January 2022. 

Sean Duggan, mental health chief executive at NHS Confederation, said: “Given what we know about the pandemic and the toll it has paid on NHS staff, I would have expected bigger numbers.

“We need to encourage more people to come forward. To me, this number says we certainly need to sustain the hubs with funding for years to come.”

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Source: HSJ, 3 May 2022

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Few may mourn NHS England's demise, but what comes next is uncertain

After Prime Minister Sir Keir Starmer's announcement this week that NHS England (NHSE) is to be disbanded, the BBC looks at whether the changes present a new opportunity to improve patient safety within the NHS.

A hospital chief executive once described NHSE as "the biggest kiss up, kick down, organisation in public life."

The comment came to mind when Health Secretary Wes Streeting on Thursday said the scrapping of NHSE would "end the infantilisation of frontline NHS leaders."

Time and again, NHS trusts have complained about the total control that NHSE, the body responsible for the day-to-day running of the health service in the country, exerted over their actions – the lack of freedom they had to either showcase their good work or respond to particular challenges.

"You won't find many who shed a tear over its demise," said one NHS official, "but there is concern as to what the re-organisation will mean for patient care."

But for many patients who have been failed by the NHS, there is a feeling that it was always more a part of the problem than the solution.

Protecting the reputation of the NHS brand often seemed to matter more than doing the right thing. Rarely has a major patient safety failure been uncovered and proactively admitted by NHSE.

Many of the patient safety scandals – the deaths of people with learning disabilities and mental health problems at Southern Health, maternity failures in Shrewsbury and Telford, East Kent and Nottingham – were only revealed after the skilled and active campaigning of grieving and committed families, who felt compelled to turn to the media when other efforts had failed.

Helen Gittos, who lost her daughter Harriet in 2014 at East Kent, is glad that NHSE is being scrapped.

"When families met with Wes Streeting to talk about maternity safety in the autumn, one of our messages was that NHSE was part of the problem, not part of the solution.

"It has been incredibly frustrating to see NHSE's response to successive reviews of maternity services. It's almost as if they haven't read the reports", she said.

The Maternity Safety Improvement Programme, led by NHSE, has not brought the kind of improvements "women and families so desperately need", she added.

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Source: BBC News, 15 March 2025

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