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Mental health crisis referrals leap by almost 75%

Referrals to mental health crisis services in England have increased by almost 75% ‘post-pandemic’, senior NHS leaders have revealed.

Documents submitted to NHS England and Improvement’s November board meeting capture the scale of demand facing the sector, which national director Claire Murdoch described to fellow leaders as “huge”.

Bed occupancy rates in adult acute services have remained above the recommended ‘safe’ level of 85% since June 2020, performance reports suggest.

Above that threshold, experts warn that patient safety, out of area placements, and surge demand risks are likely to increase.

Ms Murdoch wrote in her report to the board that between 180,000 and 200,000 calls per month were being fielded by covid-19 response crisis lines in the first quarter of 2021-22 — more than 6,000 each day.

She added that there had been a 74% increase in referrals to crisis services ‘post-pandemic’: ”We’re now seeing huge demand and we’re back to pre-covid levels.” She said some people had not sought help during pandemic peak periods and this was leading to more severe demand."

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Source: HSJ, 25 November 2021

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Drug and alcohol treatment sees rise in deaths in England

There has been a 27% rise in people dying while in treatment for drug and alcohol addiction during the pandemic, an official report shows.

Changes to support and reduced access to healthcare during lockdowns are likely to have been factors, it says.

Between April 2020 and March 2021, 3,726 people died while in contact with drug and alcohol services - up from 2,929 the year before.

The figures, published by the Office for Health Improvement and Disparities, for England, show a small 2% rise in the overall numbers of adults receiving help for drug and alcohol problems from 2020 to 2021.

Out of more than a quarter of a million people affected, more than half were in treatment for problems with opiates - medicines to treat pain - and a quarter with alcohol problems.

The proportion of deaths in treatment for alcohol addiction rose by 44% to 1,064 and for opiate addiction by 20% to 2,418.

UKAT, a group providing residential detox treatment, said a "concerning" number of services closed their doors to addicts during the pandemic.

"But drug and alcohol treatment is critical care intervention and cannot be simply put on pause," said Nuno Albuquerque, head of treatment for the group.

"It cannot be a coincidence that more people have subsequently lost their lives when they were in fact trying to save it."

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Source: BBC News, 25 November 2021

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Did bad vaccine advice cost Samantha Willis her life?

When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid.

Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment.

When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. 

But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth.

Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant.

But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue.

The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.”

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Source: The Guardian, 23 November 2021

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Health regulator accused of moral corrupt

A doctor has accused England's health and care regulator of "moral corruption".

Consultant orthopaedic surgeon Shyam Kumar says the Care Quality Commission misled the public over patient safety.

Mr Kumar alleges he was unfairly dismissed from his role as a special adviser to the CQC because he acted as a whistleblower.

His claims were made during an employment tribunal hearing in Manchester.

Seconded by his employer, University Hospitals of Morecambe Bay NHS Foundation Trust, Mr Kumar had been giving the CQC expert advice on surgical departments during hospital inspections.

But he was dismissed from this role, in early 2019.

The CQC said a letter he had written to a colleague he had been in dispute with at his trust was incompatible with the standards expected of its special advisers.

But Mr Kumar claims he was dismissed because, in 2018, he raised concerns with senior CQC figures that he was expected to simply rubber-stamp the final report following an under-resourced inspection.

And he accused the regulator of sweeping his concerns under the carpet and providing false assurances on patient safety.

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Source: BBC News, 25 November 2021

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Plan to scrap tens of millions of NHS appointments ‘could put patients at risk’

Plans to scrap tens of millions of “unnecessary” hospital follow-up appointments could put patients at risk and add to the overload at GP surgeries, NHS leaders and doctors are warning.

Health service leaders in England are finalising a radical plan under which hospital consultants will undertake far fewer outpatient appointments and instead perform more surgery to help cut the NHS backlog and long waits for care that many patients experience.

The move is contained in the “elective recovery plan” which Sajid Javid, the health secretary, will unveil next week. It will contain what one NHS boss called “transformative ideas” to tackle the backlog. Thanks to Covid the waiting list has spiralled to a record 5.8 million people and Javid has warned that it could hit as many as 13 million.

Under the plan patients who have spent time in hospital would be offered only one follow-up consultation in the year after their treatment rather than the two, three or four many get now.

“While it is important that immediate action is taken to tackle the largest ever backlog of care these short-term proposals by the health secretary have the potential to present significant challenges for patients and seek to worsen health disparities across the country,” said Dr David Wrigley, the deputy chair of council at the British Medical Association.

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Source: The Guardian, 25 November 2021

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100 people held more than 20 years in ‘institutions’

One hundred people with learning disabilities and autism in England have been held in specialist hospitals for at least 20 years, the BBC has learned.

The finding was made during an investigation into the case of an autistic man detained since 2001. Tony Hickmott's parents are fighting to get him housed in the community near them.

Mr Hickmott's case is being heard at the Court of Protection - which makes decisions on financial or welfare matters for people who "lack mental capacity".

Senior Judge Carolyn Hilder has described "egregious" delays and "glacial" progress in finding him the right care package which would enable him to live in the community. He lives in a secure Assessment and Treatment Unit (ATU) - designed to be a short-term safe space used in a crisis. It is a two-hours' drive from his family.

This week, Judge Hilder lifted the anonymity order on Mr Hickmott's case - ruling it was in the public interest to let details be reported. She said he had been "detained for so long" partly down to a "lack of resources".

Like many young autistic people with a learning disability, Mr Hickmott struggled as he grew into an adult. In 2001, he was sectioned under the Mental Health Act. He is now 44.

In addition to the 100 patients, including Mr Hickmott, who have been held for more than 20 years - there are currently nearly 2,000 other people with learning difficulties and/or autism detained in specialist hospitals across England.

In 2015, the Government promised "homes not hospitals" when it launched its Transforming Care programme in the wake of the abuse and neglect scandal uncovered by the BBC at Winterbourne View specialist hospital near Bristol. But data shows the programme has had minimal impact.

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Source: BBC News, 24 November 2021

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Burnt out staff ‘triggered’ by ‘it’s OK’ messaging from ministers

Frontline staff are being ‘triggered’ by ministers playing down the ‘overwhelming’ pressures facing the health service with “a ‘move along, no story here’-type attitude”, a royal college president has warned.

The Royal College of Emergency Medicine’s Katherine Henderson said the intentions of those making such comments may be “well meaning” but that it was important ministers and NHSE leaders were “humble and transparent about the scale of the problem [facing the NHS] at the moment”.

Katherine Henderson said: “The scale of the problem feels quite overwhelming, and the kind of ‘move along, no story here’-type attitude I think is not great for the people working in healthcare. They need to feel heard.”

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Source: HSJ, 24 November 2021

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NHS Digital and NHSX to merge with NHS England

It has been revealed that both NHS Digital and NHSX are to be incorporated into NHS England and Improvement.

In a letter to staff, NHS England and Improvement’s chief executive, Amanda Pritchard said: “As a single organisation, we can further accelerate the digital transformation of the NHS and redouble our efforts to address health inequalities...”

Pritchard praised NHSX and NHS Digital for their critical role throughout the pandemic delivering the NHS Covid Pass, Covid vaccine systems, virtual wards and many other innovations.

Going forward she said: “Our Transformation Directorate will continue to lead the digital transformation agenda for the NHS and social care at national and ICS level, alongside colleagues from Improvement and Innovation, Research and Life Sciences.”

In other major changes, Pritchard also announced that Health Education England is to merge with NHS England and Improvement.

Secretary of state for health and social care, Sajid Javid, said:  “To ensure our record NHS investment makes a lasting impact, I am bringing workforce planning and digital transformation into the heart of the NHS."

“These reforms will support our recovery from Covid-19 and help us tackle waiting lists to give patients excellent care in years to come.

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Source: Digital Health, 22 November 2021

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‘Humiliated’ trust staff complain of ‘unprofessional behaviour’ and ‘lack of compassion’

‘Unprofessional’ behaviours, a lack of compassion, and tension among staff and managers are all contributing to pockets of ‘poor culture’ at an acute trust.

A Freedom to Speak Up report presented to the board of Buckinghamshire Healthcare Trust found there had been an increase in bullying and reports of staff members being “humiliated” during the last three months.

The report, which covers the first two quarters of 2021-22, highlighted a “lack of compassion, kindness, and understanding” between colleagues and noted “increasing levels of frustration” that people are not being held to account for “unprofessional” poor behaviours.

The report added the findings were not surprising due to the pressures of the pandemic experienced by staff.

It found: “There appears to be an increase in the proportion of concerns around interpersonal behaviours and communication issues as well as levels of frustration and tension amongst staff and managers.”

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Source: HSJ, 24 November 2021

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Two thirds of hospital’s transplant patients died after five years

Lung transplant patients in Birmingham are facing significantly worse survival rates as a “sobering” report has revealed two-thirds of patients have died within five years, The Independent has learned.

Survival rates for lung transplant patients at University Hospitals Birmingham Foundation Trust after five years are now almost 20 percentage points lower than the other main hospitals specialising in lung transplants.

The latest figures from NHS Blood and Transplant (NHSBT) have revealed Birmingham’s five-year survival rates decreased from 79% in 2015-16 to 31% in 2020-21, and have consistently been the lowest compared to the other four other transplant hospitals in Newscastle, Cambridgeshire, London and Manchester.

The latest NHSBT’s report showed of those patients who had a transplant in Birmingham between 2012 to 2016, 31 per cent survived. During the same period in Newcastle 47 per cent of patients survived, in Papworth and Manchester 51%, while London’s Royal Harefield recorded a 56 per cent survival rate.

Birmingham recorded the lowest patient survival rates 90 days after surgery and for one year after surgery between 2016-17 to 2020-21. Although for these measures the hospital was within the national average, unlike its five-year survival rates.

One transplant surgeon has raised concerns over the continued poor survival rates at Birmingham, claiming they showed the “staggering” failure for the programme in the city to improve.

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Source: The Independent, 23 November 2021

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Treasury’s dead hand over NHS policy is the biggest patient safety threat

Patients are dying in the backs of ambulances or on trolleys in A&E while others languish in beds unable to be discharged due to the collapse in social care. Others waiting in pain are desperate to get a bed for much-needed surgery.

While there are many ingredients mixing together to create the current NHS crisis, a widespread shortage of nurses, doctors and other essential staff is one of the major contributory factors.

Many in the NHS reacted with disbelief on Tuesday after 280 MPs voted with the government to reject a bid to force through better workforce planning for the NHS.

Former health secretary Jeremy Hunt had pulled together a coalition of health organisations and charities who backed his proposal which demanded ministers draw up and publish workforce plans every two years.

Mr Hunt’s amendment fell victim to the fear of the cost of actually training enough doctors and nurses to work in the NHS.

The Treasury’s dead hand over NHS policy has and continues to be one of the biggest patient safety threats in the UK.

As Mr Hunt told MPs, the costs are borne not only from huge bills for locum doctors and nurses who earn incredible pay working alongside exhausted full-time staff, but also in the safety failures caused by staff shortages.

Exhausted nurses will make mistakes. One nurse cannot safely look after a ward of 16 elderly patients. A doctor can only see one patient at a time in A&E.

Speaking to MPs, Mr Hunt pleaded with the Commons to offer some hope to the NHS workforce.

He said NHS staff were “exhausted” but also “daunted” by the challenges they were seeing. He added: “All they ask is one simple request, that they can be confident we are training enough of them for the future.”

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Source: The Independent, 23 November 2021

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G7 presidency statement – patient safety: from vision to reality

On Monday 22 November, the UK under its G7 Presidency convened a meeting on ‘Patient safety: from vision to reality’, co-sponsored with the World Health Organization (WHO). Patient safety is a critical global public health issue and is essential if health systems are to advance and achieve universal health coverage (UHC). This event provided an important opportunity to demonstrate the continued importance of patient safety as an urgent global endeavour, facilitate international collaboration, and support strategic initiatives designed to eliminate avoidable harm in healthcare globally.

Since 2016, the UK has worked closely with international partners, including in the G7, to raise the profile of patient safety issues and work together to drive solutions. This engagement led to the establishment of the annual Global Ministerial Summit on Patient Safety and adoption by the 72nd World Health Assembly (2019) of a UK co-led Resolution on ‘Global Action on Patient Safety’ (creating an annual World Patient Safety Day on 17 September) and WHO’s ‘Global Patient Safety Action Plan 2021 to 2030’ by the 74th World Health Assembly (2021).

The event on 22 November brought together G7 countries, UK devolved administrations, system partners and patient advocates to share learning and reaffirm the importance of this critical issue. With the unprecedented coronavirus (COVID-19) pandemic, patient safety has become an even more crucial area for international cooperation, and the event underlined the importance of countries continuing to work together to maintain momentum on improving patient safety worldwide.

The event was chaired by Dr Aidan Fowler, National Director of Patient Safety for NHS England and NHS Improvement, and was very well attended by global experts. The importance of continued international work to improve patient safety was underlined in the keynote speeches from Dr Tedros Adhanom Ghebreyesus, Director General of WHO, as well as Sajid Javid, Secretary of State for Health and Social Care, and Jeremy Hunt, Chair of the Health and Social Care Committee.

The event also provided an important opportunity for sharing learning from around the world; and highlighted the need for and value of continued collaboration between countries on health issues. Interventions from G7 countries and UK devolved administrations provided important insights into how different countries are tackling this shared aim of eliminating avoidable harm in healthcare. It was clear that although health systems differ from country to country, many threats to patient safety have similar causes and similar solutions.

 

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Source: Department of Health and Social Care, 23 November 2021

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Progesterone recommended to prevent early miscarriage

Women who experience bleeding in early pregnancy and have had at least one miscarriage should be treated with the hormone progesterone.

The new guidance, from the National Institute for Health and Care Excellence (NICE), is based on research suggesting the treatment could lead to 8,450 more births each year in the UK.

The more miscarriages a woman had, the more effective progesterone was, the trial found. The naturally occurring hormone helps prepare the womb for the growing baby.

About one in five women experience bleeding, or spotting as it is sometimes called, in the first 12 weeks of pregnancy. It often causes no problems but they are advised to have it checked out with their doctor or midwife to be sure.

Some may experience a "threatened miscarriage", where bleeding continues along with the pregnancy. Most are told to go home and wait and see what happens next.

The new (NICE) guidance recommends inserting progesterone pessaries into the vagina twice a day.

A trial carried out by researchers at the Tommy's National Centre for Miscarriage Research which the new guidance is based on, found that progesterone didn't make much of a difference for women who just had bleeding and no previous miscarriages. But the more miscarriages a woman had suffered, the more effective progesterone was.

One of those behind the Tommy's National Centre for Miscarriage Research research, Prof Arri Coomarasamy, from the University of Birmingham, said: "This is a very significant moment.

"We have an intervention that works that can stop a miscarriage. This gives hope to thousands of couples throughout UK."

"But it's really important to appreciate that only some miscarriages can be prevented by progesterone."

"There are other causes for miscarriages."

"We still need to study them. We need to find other effective treatment."

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Source: BBC News, 24 November 2021

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NHS to give therapy for depression before medication under new guidelines

Millions of people with mild depression in England should be offered therapy, exercise, mindfulness or meditation before antidepressants, according to the first new NHS guidelines in more than a decade.

Under draft guidance, the National Institute for Health and Care Excellence (NICE) recommends the “menu of treatment options” be offered to patients by health professionals before medication is considered.

Currently, those with mild depression are offered antidepressants or a high-intensity psychological intervention, such as cognitive behavioural therapy (CBT). The shake-up forms part of the first new recommendations to identify, treat and manage depression in adults since 2009.

According to the Office for National Statistics (ONS), about one in six (17%) adults experienced some form of depression this summer. The rate is higher than before the pandemic, when 10% of adults experienced it. Younger adults and women are more likely to be affected, the ONS found.

A 2019 review showed 17% of the adult population in England (7.3 million people) had been prescribed antidepressants in the year 2017-18.

Dr Paul Chrisp, director of the centre for guidelines at NICE, said: “The Covid-19 pandemic has shown us the impact depression has had on the nation’s mental health. People with depression need these evidence-based guideline recommendations available to the NHS, without delay.”

Nav Kapur, professor of psychiatry and population health at the University of Manchester and chair of the guideline committee, said: “As a committee we have drawn up recommendations that we hope will have a real impact on people who are suffering from depression and their carers. In particular we’ve emphasised the role of patient choice – suggesting that practitioners should offer people a choice of evidence-based treatments and understanding that not every treatment will suit every person.”

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Source: The Guardian, 23 November 2021

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Patient Safety Learning joins the National Voices coalition

Press release: 23 November 2021

We are pleased to announce that Patient Safety Learning is now a member of National Voices, the leading coalition of health and social care charities in England. Members of National Voices work together to strengthen the voice of patients, service users, carers, their families and the voluntary organisations that work for them.

Commenting on today’s announcement, Patient Safety Learning’s Chief Executive Helen Hughes said:

“We are delighted to have joined National Voices. To reduce avoidable harm in health and social care we all need to work in partnership to identify patient safety concerns, highlight where changes are needed and share good practice, to help deliver the systemic change required to create a patient-safe future. We look forward to working closely with partners in National Voices going forward to help improve patient safety.”

Notes to editors:

  1. Patient Safety Learning is a charity and independent voice for improving patient safety. We harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm.
  2. National Voices is the leading coalition of health and social care charities in England. We have more than 180 members covering a diverse range of health conditions and communities, connecting us with the experiences of millions of people. We work together to strengthen the voice of patients, service users, carers, their families and the voluntary organisations that work for them.
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Midwives receiving less training in key areas of safety and equality, new report warns

Midwives across England are still not receiving enough essential safety training with the pandemic leaving hospitals delivering less training than three years ago.

A new report from the charity Baby Lifeline, based on an investigation of 124 NHS trusts in England, found 9 in 10 units had training affected by the pandemic with staff shortages named as a major factor in preventing workers from taking time out for learning. This was cited by 72%  of units as a problem.

The average spend on maternity training was significantly lower in 2020-21 at £34,290 compared to £59,873 in 2017-18, with NHS trusts delivering less training to staff than they did in 2017-18.

Despite concerns over the poor quality of safety investigations in the NHS, fewer than a third of NHS units trained staff in how to carry out investigations.

Judy Ledger, chief executive and founder of Baby Lifeline, said: “Today’s report highlights how gaps and variation in the delivery of maternity training across the NHS continues to impact on the safety and care women and babies receive. Time and again evidence shows that training investment can save lives, and the pandemic has widened existing, detrimental gaps that years of chronic under-funding and staff shortages have created.

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Source: The Independent, 23 November 2021

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Welsh Health Minister rejects frontline staff concerns the NHS is ‘harming patients’

Wales' Health Minister has rejected a suggestion that the NHS is “harming patients” due to the severe levels of pressure on its services. 

Eluned Morgan MS acknowledged that the speed at which patients were receiving treatment was being impacted but said she would “not accept for a moment” that the NHS was harming its patients.

ITV Cymru Wales has spoken to a number of NHS staff and health sector bodies and heard concerns over the sustainability of the health service in its present form.

Ms Morgan said: “I don’t think the NHS is harming patients, no.

“I think our ability to get to patients quickly, that is perhaps compromised by the pressures that we’re under at the moment but no, I would not accept for a moment that the NHS is harming patients. 

“I think the situation is that maybe people have to wait a bit longer for care because of the pressures that have grown as a result of the pandemic and let’s be clear about that, that we’re seeing about 20% more people going to their GPs, we’ve got hugely long waiting lists because, of course, we had to be very careful about who was able to go into hospitals during the height of the pandemic. 

“We’re trying to reign all that back at the same time as dealing with Covid, because that hasn’t finished yet.”

Speaking to ITV Cymru Wales for Wales This Week, looking at the challenges facing the NHS, Dr Pete Williams, a consultant in emergency medicine and paediatric medicine at Ysbyty Gwynedd in Bangor, said he felt the current pressures on services were causing harm to patients. 

He said: “This is not sustainable. We, this department, other departments around the country and the wider NHS, are harming patients because they’re not getting timely care."

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Source: ITV News, 22 November 2021

 

 

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Trust in staffing crisis as eight ICU nurses quit in just two weeks

Eight highly skilled intensive care (ICU) nurses have resigned from one trust in the past two weeks and more could follow, a leading nurse has warned.

More resignations expected as working conditions remain unsustainable

Belfast Health and Social Care Trust in Northern Ireland has confirmed it is redeploying non-specialist nursing staff to fill the gaps in staffing on ICU wards, with experienced ICU nurses expected to provide supervision.

RCN Northern Ireland director Rita Devlin said the college has heard others at the trust are ‘considering their position’.

"These are highly skilled nurses who are difficult to replace and this is a very worrying situation," she said.

"Nursing staff are doing everything they can to keep services going, but it is not sustainable to work under such pressure for long periods of time without a break."

The resignations come just months after it was revealed that 182 nurses and 50 healthcare assistants had quit their jobs at the trust between January and July.

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Source: Nursing Standard, 23 November 2021

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NHS hospital at centre of cover up claims after woman died following repeated paracetamol overdose

The family of a woman who died after being repeatedly overdosed with paracetamol in an NHS hospital have demanded action over her death amid allegations of an NHS cover up.

Laura Higginson, a trainee solicitor and mum of two, died after seeking medical help for sickness and pneumonia. She died two weeks later from multi-organ failure and sepsis.

Whiston Hospital, in Merseyside, has admitted to the overdose but denied it caused her death and rejects any suggestion of wrong doing.

But expert reports, seen by The Independent, including from a liver specialist, questions the trust’s account of what happened, the quality of its post-mortem and concludes the mother-of-two – who only weighed 36kg – suffered liver failure after too much paracetamol in April 2017.

The overdose mistake was recognised by staff on the third day but Laura’s family were never told.

The trust did not record the error as an incident and only started an investigation 14 months later when concerns were raised by Laura’s family. Her husband Antony Higginson says the subsequent investigation report is “littered with inaccuracies.”

He told The Independent: “We just want justice; we don’t care about money. Laura died needlessly and all these institutions charged with ensuring safe care and accountability have point blank failed and have rendered Laura’s life as essentially worthless and that she didn’t matter, when she did matter.”

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Source: The Independent, 21 November 2021

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Calls for support for UK midwives struggling with substance abuse

The Royal College of Midwives is calling for members to be given the same support as doctors when they struggle with drug and alcohol problems.

Research shared with the Guardian – the first of its kind into substance abuse among midwives – has revealed that significant numbers of midwives have problems with drugs or alcohol. It found that 28% said they had problems and 16% said they worked while under the influence of various substances.

Dr Sally Pezaro, the author of the research, found that along with alcohol, midwives used cannabis, cocaine, heroin and sedatives. She said reasons given include work-related stress and anxiety, bullying, traumatic clinical incidents and to maintain overall functioning.

Pezaro, a midwife and fellow of the Royal College of Midwives, said there was no dedicated support programme available for midwives, while doctors struggling with substance abuse can get support from the NHS practitioner health programme. The incidence of substance abuse among midwives, based on the survey of 623 people, appears higher than among doctors – 8%-15% of whom have been found to have substance abuse problems.

Pezaro is calling for more support for midwives. “If midwives seek help they lose their licence to practise. Doctors are treated less harshly by their regulator, the General Medical Council, than we are by ours – the Nursing and Midwifery Council,” she said. Between 2014 and 2016 26% of 1,298 fitness to practise cases that came before the Nursing and Midwifery Council (NMC) involved drugs or alcohol.

A Royal College of Midwives spokesperson said: “It is a brave decision to step forward and say you have a problem and are grappling with substance misuse, which blights the lives of people and their families. For anyone who does this, including healthcare professionals, there should be a compassionate approach.

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Source: The Guardian, 22 November 2021

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Calls for major overhaul of the Welsh NHS

More than 20 different health organisations have joined forces to call for a complete overhaul of the National Health Service in Wales.

It comes after the worst ever performance figures for hospital emergency departments and the ambulance service were published, as well as warnings from doctors across the country that patients are dying in ambulances and waiting rooms due to overcrowding.

The group of 22 organisations working across health and social care say Wales needs a single national body with a strategic oversight of the Welsh NHS in order to drive improvements in patient care and hold health boards to account.

They have launched the 'Ending the postcode lottery' campaign which calls for "an end to fragmented health services".

Those involved include the the Royal College of Physicians Wales, the British Heart Foundation, Parkinson's UK and Cancer Research UK. They claim that a single, independent national NHS Wales executive would be better placed to improve patient care and deliver on the aims of a healthier Wales.

The organisations are calling for an independent body with the right powers would have the authority to:

  • Support system transformation across health board boundaries
  • Play a national leadership role in service improvement
  • Collect and analyse data to improve performance
  • Improve patient outcomes across clinical specialties, public health and inequalities
  • Provide strong governance and accountability to ensure that the NHS in Wales gets the best value from its combined resources.

Dr Abrie Theron, chair of Academy of Medical Royal Colleges in Wales, said: "I cannot see how the Welsh NHS is going to implement the changes needed for a Covid recovery without a NHS Executive team facilitating health boards working together as one for the patients of Wales."

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Source: The National, 22 November 2021

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System for assessing who needs to pay for NHS care ‘incentivises racial profiling’

The system for assessing who should be asked to pay for NHS services “incentivises racial profiling”, an investigation has found.

A study by the Institute for Public Policy Research found that overstretched NHS staff sometimes racially profile patients in order to determine who is not “ordinarily resident” in the UK, and therefore must pay for their care.

The report is critical of the more stringent charging regime introduced by NHS England over the past decade as part of a series of measures devised to create a hostile environment for people living in the UK without the correct immigration status. Overseas visitors officers have been appointed by NHS trusts, responsible for identifying chargeable patients, as part of a cost recovery programme launched in 2014.

One of the officers told the IPPR study they had felt forced to discriminate between patients based on their name. “If you’ve got a, I don’t know, Mohammed Khan and a Fred Cooper, you’re obviously going to go for [investigating] the Mohammed Khan … Even for someone who’s, you know, well I’d like to think hopefully open-minded, like myself, you’re just trying to save yourself time because there’s not enough hours in the day,” the officer said.

A hospital employee also reported that discrimination on the basis of ethnicity was used to determine who should be billed for treatment. “It’s a system that is designed to benefit [white] people like me, not people like … the patient on intensive care who is black and British and was unconscious and sent a bill. So why did someone think he was not eligible for care? Given he was unconscious most of the admission, significantly unwell, probably not his accent, more likely his skin colour,” the health worker said.

Under the rules, anyone “not ordinarily resident” in the UK should be charged 150% of the NHS national tariff for most secondary (non-urgent) healthcare, but the report found that processes varied across the country, with a lack of consistent training and widespread confusion over the 130-page rules for the charging system.

Some healthcare staff told IPPR researchers that they disliked the extra burden of having to consider whether to refer a patient for charging, which they felt distracted them from their core medical responsibilities.

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Source: The Guardian, 23 November 2021

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People with long Covid facing months-long wait for treatment at specialist NHS clinics

Only 5,000 people a month are being referred to specialist long Covid clinics each month despite more than a million people having the condition – and a third of those are having to wait at least 15 weeks for their first appointment, NHS figures reveal.

Over the last year the NHS has set up dozens of specialist long Covid clinics in England to assess and diagnose people who visit their GPs with symptoms of the condition.

The Office for National Statistics estimates there are 1.2 million people in the UK – about a million of them in England – with long Covid, meaning they have had symptoms for 12 weeks or more. However, only 4,846 to 5,182 patients a month were referred to the clinics from July to September this year, the first period for which figures are available.

Of those patients who are referred, 33% are having to wait at least 15 weeks to be seen for their first assessment – with another 15% waiting for 10 to 14 weeks, the figures show.

Sarah Woolnough, chief executive of Asthma UK and the British Lung Foundation, said she was extremely concerned by the NHS figures – which tally with anecdotal evidence and her foundation’s own research.

“We’ve heard first-hand from thousands of people whose lives have been turned upside down by long Covid, who have had to quit their jobs and most-loved hobbies as they battle wide-ranging and disabling symptoms like persistent breathlessness,” she said.

“If that wasn’t tough enough, many people are then forced to deal with the debilitating effects of long Covid on their own, because of a lack of support and huge wait times for specialist care,” she added.

“The Government needs to train and recruit more specialist NHS staff, so that people with long Covid can access the specialist care they so desperately need.”

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Source: iNews, 20 November 2021

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Covid: Sajid Javid orders review of medical device racial bias

A review into whether medical devices are equally effective regardless of the patient's ethnicity has been ordered by Health Secretary Sajid Javid.

Research suggests oximeters, which are clipped to a person's finger, can overstate the level of oxygen in the blood of people from ethnic minorities.

Ministers want to know whether bias could have prevented patients receiving appropriate Covid treatment.

Mr Javid said any bias was "totally unacceptable".

But the doctors' union the British Medical Association (BMA) said the review should not simply look at equipment, but also "structural issues" within healthcare that affect ethnic minorities.

Mr Javid announced the review in the Sunday Times, saying he was determined to "close the chasms that the pandemic has exposed".

Asked later on the BBC's Andrew Marr show whether he thought people had died of Covid because of pulse oximeters, Mr Javid said: "I think possibly yes, yes. I don't have the full facts."

He said there was racial bias in some medical instruments, adding: "It's unintentional but it exists."

"And the reason is that a lot of these medical devices, even some of the drugs, some of the procedures, some of the textbooks, most of them are put together in majority white countries and I think this is a systemic issue around this," he said.

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Source: BBC News, 21 November 2021

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Trust fined £2.5m after deaths of two patients

An acute trust has been fined £2.5m after pleading guilty to charges of failing to provide safe care after the deaths of two patients.

The Care Quality Commission brought charges against The Dudley Group Foundation Trust earlier this year over care failings in two separate cases which the regulator said exposed two patients to “significant risk of avoidable harm”.

The trust pleaded guilty to the charges in July and was fined during a sentencing hearing today.

The cases, involving 33-year-old mother of six Natalie Billingham, and 14-year-old Kaysie-Jane Bland [also known as Kaysie-Jayne Robinson], were both in 2018 and  related to care at the trust’s Russells Hall Hospital in Dudley.

Ms Billingham was admitted to Dudley’s Russells Hall Hospital with numbness in her right foot on 28 February 2018 and died on 2 March of organ failure caused by a “time critical” infection.

The court was told she was initially thought to have a deep vein thrombosis after a three-minute triage that failed to identify "disordered" observations. The hospital then had multiple reasons to reconsider the initial diagnosis, but opportunities for review were "missed or ignored".

In the case of Kaysie-Jane, who had cerebral palsy, an "early warning score" was inaccurate, meaning a sepsis screening tool was not triggered.

The CQC said the care both patients received at Russells Hall Hospital was undermined by the Dudley Group’s failure to address known safety failings which the regulator repeatedly raised with the trust in the months before their deaths. The CQC said the trust did not take all reasonable steps to make improvements, despite its intervention. The trust has denied it did not react to the concerns raised. 

Failings included errors in the hospital’s initial assessments and monitoring of both patients, which hindered the timely escalation of concerns.

A lawyer acting on behalf of the Dudley Group NHS Foundation Trust had admitted the trust failed to provide treatment in a safe way, resulting in harm, in February and March 2018.

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Source: HSJ, 19 November 2021

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