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The app that promised an NHS ‘revolution’ then went down in flames

Babylon Healthcare won NHS contracts after being championed by Matt Hancock but the company’s AI tech was oversold and it has now collapsed.
The NHS spent millions of pounds on a flawed AI chatbot whose creator used aggressive sales techniques and overpromised what it could do, former staff have claimed.

Babylon Health, a tech start-up championed by Matt Hancock and advised by Dominic Cummings, promised that its AI chatbot could keep patients who didn’t need to be seen by a health professional out of the overstretched NHS.

But the technology was not as sophisticated as the company claimed, with former staff now claiming that what began as a crude tool based on “decision trees written by doctors, put into an Excel spreadsheet” never realised its promised potential. Concerns — including the fact the app missed clear signs of a heart attack or dangerous blood clots — were raised.

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Source: The Times, 28 October 2023

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‘Misleading’ A&E figures in England hiding poor performance

NHS bosses are using misleading figures to hide dangerously poor performance by A&E units in England against the four-hour treatment target, emergency department doctors claim.

Some A&Es treat and admit, transfer or discharge as few as one in three patients within four hours, although the NHS constitution says they should deal with 95% of arrivals within that timeframe.

How well or poorly A&Es are doing in meeting the 95% target is not in the public domain because the data that NHS England publishes is for NHS trusts overall, not individual hospitals.

That means official figures are an aggregate of performance at sometimes two A&Es run by the same trust or include data for any walk-in centres, minor injuries units or urgent treatment centres that a trust also operates. Forty-eight trusts have two A&Es and many also run at least one of the latter.

The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, wants that system scrapped. It is urging NHS England to start publishing data that shows the true performance of every individual emergency department against the 95% standard.

“The current data is misleading,” Dr Adrian Boyle, the college’s president, told the Guardian. “It’s a good example of a lack of transparency and also of performance incentives. Being open about the long delays in some A&Es would shine a light in some dark places.”

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Source: The Guardian. 28 October 2023

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Trusts may no longer be fined for missing quality standards

Trusts may be spared financial penalties if they fail to meet care quality standards under new proposals from NHS England. 

NHSE is looking at “pausing” the financial element of the Commissioning for Quality and Innovation scheme from next year according to information seen by HSJ. This states “a wider review of incentives for quality” is also under way.

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Source: HSJ, 30 October 2023

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Death of baby after UK hospital missed vitamin jab ‘beyond cruel’, parents say

The parents of a baby boy who died at seven weeks old after a hospital did not give him a routine injection have described the failure as “beyond cruel”.

William Moris-Patto was born in July 2020 at Addenbrooke’s hospital in Cambridge, where it was recorded in error that he had received a vitamin K injection – which is needed for blood clotting. The shot is routinely given to newborns to prevent a deficiency that can lead to bleeding.

His parents, Naomi and Alexander Moris-Patto, 33-year-old scientists from Chatteris, Cambridgeshire, want to raise awareness about the importance of the vitamin after a coroner concluded William would not have died had the hospital administered the injection. On Friday, the coroner Lorna Skinner KC described the omission as “a gross failure in medical care amounting to neglect”.

Alexander Moris-Patto, a researcher at the University of Cambridge who recently co-founded William Oak Diagnostics to test for deficiencies in babies, said: “What’s come out of the inquest for me is that the systems they [the trust] put in place to try to prevent this happening again are not satisfactory.”

He stressed the importance of the vitamin K injection, adding that about 1% of the UK population opt out of it. “We want people to know more about it, to understand how critical it can be, and for hospitals to take seriously the responsibility they have in those first precious hours of a baby’s life,” he said.

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Source: The Guardian, 29 October 2023

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Complaints about poor NHS dental services rise 66% in five years

Record numbers of patients are complaining to the NHS Ombudsman about poor care, exorbitant fees and difficulty getting treatment from NHS dental services in England.

Mistakes by dentists mean some patients are being left in agony – in some cases unable to eat – while others are being landed with huge bills for work on their teeth.

“Poor dental care leaves patients frustrated, in pain and out of pocket,” said Rob Behrens, the parliamentary and health service ombudsman.

The number of complaints he receives every year about NHS dental services has jumped from 1,193 in 2017-18 to 1,982 in 2022-23 – a rise of 66%.

Behrens also disclosed that the proportion of complaints he upholds about NHS dentistry after an investigation has increased from 42% to 78% over the same period. That 78% figure for upheld complaints about dental services is “significantly more” than for any other area of NHS care, such as GP, hospital or mental health care, where the overall average is 60%, he said.

Dentistry has become one of the public’s main concerns about the NHS, especially the obstacles many people face when trying to access NHS care. A BBC survey last year found that 90% of surgeries across the UK were not accepting new adult patients and 80% were not taking on children as new patients.

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Source: The Guardian, 30 October 2023

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“I’ve been mocked, scolded and gaslighted”: a harmed patient’s experience of orthodontic treatment

A patient harmed by orthodontic treatment shares their story

We want to hear from patients with experience of NHS and/or private orthodontists and dentists in any healthcare setting, including community practices and hospitals.

  • Did the orthodontist/dentist give you the treatment and support you needed?
  • If you had ongoing problems, how did the orthodontist/dentist and other healthcare professionals respond?
  • Have you tried to make a complaint?

Share your experience of orthodontist and dentistry services

 

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Michael Watt hearing: Lawyers withdraw over mental health concerns

Lawyers for a doctor at the centre of Northern Ireland's biggest patient recall have withdrawn from his new fitness to practise hearing.

Legal representatives for Michael Watt said they are "concerned about his serious mental health condition".

They told the Medical Practice Tribunal Service that the continuation of the hearing in public "presents a real risk to his mental health".

A new fitness to practise hearing began in September.

The legal team has also formally withdrawn an application to the tribunal for Michael Watt to remove himself from the medical register.

It followed a ruling by the High Court earlier this year to quash a decision where he previously was voluntary erased from the medical register.

 

The tribunal is inquiring into the allegation that, between 7 and 22 of October 2018, Michael Watt underwent a General Medical Council assessment of the standard of his professional performance.

It is alleged that that performance was unacceptable in the areas of maintaining professional performance, assessment, clinical management, record keeping and relationship with patients.

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Source: BBC News, 27 October 2023

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Performance of vital demand management service collapses

The performance of one of the NHS’s flagship strategies to reduce demand on over-stretched hospitals has collapsed, HSJ  can reveal.

Internal NHS figures show the number of processed advice and guidance requests (A&G) from GPs to hospital consultants fell by 28% between June and August, alongside a 32% fall in the number of processed cases where patients were diverted away from secondary care. This comes despite the overall number of A&G requests from GPs only falling by 5% in the same period.

A&G services allow GPs to contact hospital consultants before making a referral in order to ensure only clinically appropriate patients are referred to secondary care.

The model is described by NHS England as a ”a key part of the National Elective Care Recovery and Transformation Programme’s work.”

The data showing the fall in processed requests and diversions from secondary care came from NHSE’s specialist advice activity dashboard, which HSJ has seen.

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Source: HSJ, 26 October 2023

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Women 'angry and frustrated' over smear test review

Women affected by a review of cervical smears in the Southern Health Trust have said they are "angry, frustrated and scared" for their future.

About 17,500 patients in the trust are to have their previous smears re-checked as part of a major review of cervical screening dating back to 2008.

Some of these women will be recalled to have new smear tests carried out. But the process has not started yet and will take at least six months to complete.

Letters were sent out by the trust earlier this month to those affected.

The Southern Trust says it expects to recall around 4,000 women for a new smear test after it reviews 17,368 historic slides.

The Trust's medical director, Dr Steve Austin, told its board meeting that the review of slides was expected to start next week.

It also emerged that the number of calls from concerned women has increased with many asking for more "specialist" answers.

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Source: BBC News, 27 October 2023

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Sunak ‘highly unlikely’ to meet promise to cut NHS waiting lists, warn health leaders

Rishi Sunak is “highly unlikely” to meet his promise to cut NHS waiting lists, health leaders have warned, as a “sobering” analysis suggests the backlog will rise to 8 million and won’t begin to fall until next summer.

The prime minister vowed in January that “NHS waiting lists will fall” as he outlined five pledges upon which he staked his premiership. The backlog was 7.2 million at the time. It is now 7.75 million, the highest since records began in 2007.

But a grim report published today by the Health Foundation, an independent thinktank, will pile further pressure on Sunak over the NHS. The 15-page analysis predicts that the waiting list for hospital treatment in England will continue to rise for at least 10 months and ultimately top 8 million, regardless of whether or not strikes continue.

The thinktank modelled four different scenarios and concluded that, based on current trends, NHS waiting list figures could peak by August 2024 if there was no more strike action by healthcare workers, before starting to come down. If strikes were to continue, the list could increase a further 180,000, it said.

Matthew Taylor, the chief executive of the NHS Confederation, said: “This analysis all but confirms that the prime minister’s pledge to reduce the size of the waiting list is increasingly unlikely to be met.”

He added: “As the Health Foundation report rightly says, the root cause of the delays to treatment that patients are now experiencing is a decade of underinvestment in the NHS.”

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Source: The Guardian, 27 October 2023

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A home help for eight days after giving birth? Why Dutch maternity care is the envy of the world

To new parents processing the shock of delivery and swimming in hormones, newborns can feel like a tiny, terrifying mystery; unexploded ordinance in a crib. “We were totally unprepared,” says Odilia. Neither she or her husband had ever changed a nappy and had no idea the baby needed feeding every three hours. “If you’re a new mum or dad, you have no idea,” recalls Anouk, a new mother. “I’m a doctor,” says Zarah, another new mother, incredulously. “So, you would expect that I’d know something, and I knew some things, but you really don’t have any clue.”

The difference for these new parents, compared to the rest of us, is that they gave birth in the Netherlands. That meant help was instantly at hand in the form of the kraamzorg, or maternity carer. Everyone who gives birth in the Netherlands, regardless of their circumstances, has the legal right – covered by social insurance – to support from a maternity carer for the following week.

These trained professionals come into your home daily, usually for eight days, providing advice, reassurance and practical help. It’s a different role to midwives, who continue to monitor women and babies after the birth in the Netherlands; the maternity carer updates the midwife on the mother and baby’s health and progress as well as supporting the parents as they come to terms with their new child.

A maternity carer in the Netherlands, explains Betty de Vries of Kenniscentrum Kraamzorg, the organisation that registers maternity carers, “takes care of the woman the first week, advises her on breastfeeding and bottle feeding, hygiene, gives advice … everything to do with safe motherhood and a safe baby. She is there for the whole day most of the time so she can see how they are doing.” Her colleague, director Esther van der Zwan, adds: “It’s a lot of responsibility.” To prepare, maternity carers train for three years – a combination of academic and on-the-job placements – and have regular refresher training in everything from CPR to breastfeeding support.

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Scottish Covid Inquiry: Care home residents 'left to starve'

Some care home residents may have been "neglected and left to starve" during the pandemic, Scotland's Covid Inquiry is expected to hear.

Lawyers representing bereaved relatives said they also anticipate the inquiry will hear some people were forced into agreeing to "do not resuscitate" plans.

Shelagh McCall KC told the inquiry that evidence to be led would "point to a systemic failure of the model of care".

The public inquiry is investigating Scotland's response to the pandemic.

Ms McCall is representing Bereaved Relatives Group Skye, a group of bereaved relatives and care workers from Skye and five other health board areas of Scotland.

In her opening statement, she told the public inquiry that families wanted to know why Covid was allowed to enter care homes and "spread like wildfire" during the pandemic.

She added: "As well as revealing the suffering of individuals and their families, we anticipate the evidence in these hearings will point to a systemic failure of the model for the delivery of care in Scotland, for its regulation and inspection.

"We anticipate the inquiry will hear that people were pressured to agree to do not resuscitate notices, that people were not resuscitated even though no such notice was in place, that residents may have been neglected and left to starve and that families are not sure they were told the truth about their relative's death."

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Source: BBC News, 25 October 2023

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Lack of ownership within NHSE for struggling service is ‘complete failure of leadership’

No senior NHS England director is prepared to take responsibility for ADHD services — which are facing waits of up to a decade and severe medication shortages — HSJ has discovered. 

Despite soaring demand for assessments and widespread drug shortages recently triggering a national patient safety alert, responsibility for attention-deficit/hyperactivity disorder services does not sit within any NHS England directorate.

HSJ understands that none of NHSE’s mental health, learning disability, or autism programmes have been given any resources for ADHD. It is also claimed that the medical and long-term conditions teams “are not very interested” in taking responsibility, and “assumed someone else was doing it”.

A senior source, very close to the issue, told HSJ that no NHS senior director had taken “ownership” of the issue, and there was a widespread misapprehension that responsibility for ADHD services was part of the autism remit given to the mental health directorate. 

“We haven’t got the attention we need around ADHD,” said the source, “we need a [dedicated] neurodiversity programme.”

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Source: HSJ, 26 October 2023

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Several hospitalised in Austria after using suspected fake diabetes drug

Several people have been admitted to hospital in Austria after using suspected fake versions of Novo Nordisk’s diabetes drug Ozempic, the country’s health safety body has said, the first report of harm to users as a European hunt for counterfeiters widened.

The patients were reported to have suffered hypoglycaemia and seizures, serious side-effects that indicate that the product contained insulin instead of Ozempic’s active ingredient semaglutide, the health safety regulator Bundesamt für Sicherheit im Gesundheitswesen (BASG) said on Monday.

The European Medicines Agency (EMA) warned last week that pens falsely labelled as Ozempic were in circulation, and Austria’s criminal investigation service said on Monday that the fake injection pens could still be in circulation.

The Danish maker of the drug, Novo Nordisk, has warned of a rise in the online offers of counterfeit Ozempic as well as its weight-loss drug Wegovy, both based on semaglutide.

“It appears that this shortage is being exploited by criminal organisations to bring counterfeits of Ozempic to market,” said BASG.

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Source: The Guardian, 24 October 2023

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NHS England to investigate why dead people invited for Covid and flu jabs

The NHS has launched an investigation after it sent “priority” letters to people who died years ago, in some cases decades, urging them to book flu and Covid-19 jabs to reduce their risk of serious illness.

The health service is asking eligible patients to arrange appointments for both vaccines to avoid a potential “twindemic” of flu and coronavirus this winter, which would pile further pressure on hospitals and GP surgeries.

“You are a priority for seasonal flu and Covid-19 vaccinations,” the two-page letter tells recipients. “This is because you are aged 65 or over (by 31 March 2024).

However, some of the letters, which contain personal information such as NHS numbers, have been sent to people who died years ago. Others have been sent to people who are not eligible for the vaccines, with no connection to the addressee.

In a statement, NHS England told the Guardian it was investigating. It declined to answer questions about when the error was first discovered, what had caused it and how many people had been affected.

“We have been made aware of some letters sent in error and appreciate this may have been upsetting for those who received it – we are working as quickly as possible to investigate this,” a spokesperson for NHS England said.

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Source: The Guardian, 24 October 2023

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Four trusts report quarter of all ‘critical incidents’

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

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

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

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

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Source: HSJ, 25 October 2023

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Jasper Brooks inquest: Baby died due to 'neglect' at hospital

A coroner has found neglect contributed to a baby's death at the hospital where he was born.

Jasper Brooks died at the Darent Valley Hospital in Kent on 15 April 2021. The coroner found gross failures by midwives and consultants at the hospital and says Jasper's death was "wholly avoidable".

Jasper was a second child for Jim and Phoebe Brooks. Due to a complication during pregnancy of her first child, Phoebe was booked in to have an elective Caesarean section to deliver Jasper. But in April 2021 those plans changed overnight.

A check-up found Phoebe had raised blood pressure. She was told to remain in hospital and that the C-section would happen the following morning - nine days earlier than planned - when there were more staff on duty.

Jasper's parents say the midwives caring for Phoebe repeatedly failed to listen to her and Jim's concerns - that she was shaking violently, feeling sick, and thought she was bleeding internally.

"We felt like an inconvenience - no-one wanted to deal with me that night," Phoebe says. "The doctor didn't want to do my C-section, the midwife that's meant to be looking after me, she just doesn't really care.

"I remember saying clearly to her, 'my whole body is shaking - something's happening, and no-one's taking the time to listen to what I'm saying or listen in on my baby'."

At the inquest hearing, midwife Jennifer Davis was accused by the family's barrister, Richard Baker KC, of "failing to act on signs of blood loss, failing to determine if Phoebe was in active labour, and failing to call a senior doctor when necessary".

Jasper was born without a heartbeat, so a resuscitation team was called. But during the inquest, the family learned that further errors were made because the correct people failed to attend the resuscitation.

There was no consultant neonatologist on site - a doctor with expertise in looking after newborn infants or those born prematurely. Intubation, the process of placing a breathing tube into the windpipe - which should only take a few minutes - did not occur for 18 minutes. There was also a delay in administering adrenaline to try to stimulate Jasper's heart.

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Source BBC News, 24 October 2023

 

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Confirm there is no plan to ‘replace doctors’, NHSE told

The medical regulator has told NHS England to ‘directly tackle’ a perception there is a plan to replace doctors with physician associates amid an ‘intense’ debate about their future.

General Medical Council chief executive Charlie Massey wants NHS England and health systems in the devolved nations to address several issues surrounding the expansion of medical associate roles.

This follows intense debate over recent weeks, including multiple media reports of safety incidents where the involvement of physicians and anaesthesia associates has been questioned. The debate has been partially prompted by ambitions in the long-term workforce plan to increase their numbers, and the impact this would have on post-graduate medical training.

Last week almost 90% cent of Royal College of Anaesthetists members voted to pause the rollout of anaesthesia associates, after an extraordinary general meeting. This prompted NHSE leaders to stress to trusts that associates should be working within established guidelines and have appropriate supervision.

In response, Mr Massey has written to NHSE, calling for it to: “Directly tackle the perception that there is a plan for the health services to ‘replace’ doctors with PAs or AAs by convening and leading a system-wide discussion on an agreed vision for these roles.”

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Source: HSJ, 25 October 2023

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Sepsis killing too many as lessons not learned, warns NHS watchdog

Sepsis is still killing too many patients due to the same hospital failings that occurred a decade ago, a damning report by the NHS ombudsman has warned.

Avoidable mistakes include delays in spotting and treating the condition, poor communication between health staff, sub-standard record keeping and missed opportunities for follow-up care, according to Rob Behrens, the parliamentary and health service ombudsman (PHSO).

Despite some progress since a previous report on sepsis by the ombudsman in 2013, lessons are not being learned and repeated mistakes are putting people at risk, Behrens said. Major improvements are urgently needed to avoid more fatalities, he added.

“I’ve heard some harrowing stories about sepsis through our investigations, and it frustrates and saddens me that the same mistakes we highlighted 10 years ago are still occurring,” said Behrens. “It is clear that lessons are not being learned. Losing a life through sepsis should not be an inevitability.”

Melissa Mead, whose one-year-old son, William, died from sepsis in 2014 after concerns were dismissed by doctors, said: “I think this report, nine years on from William’s death, really lays bare the incidences of sepsis cases.”

Mead, who peer-reviewed the study, added: “Too many lives are being lost in preventable circumstances.”

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Source: The Guardian, 25 October 2023

Further reading on the hub:

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Government progress against recommendations on patient safety in the NHS to be evaluated

The Health and Social Care Select Committee have commissioned an Expert Panel to consider the Government’s progress against accepted recommendations from public inquiries and reviews on patient safety.

The Panel will consider a range of recommendations made by public inquiries and reviews on both patient safety and whistleblowing and subsequently select a number of these for evaluation. The Panel will in its final report provide a rating of the Government’s progress against each of these recommendations.

Panel members are:

  • Professor Dame Jane Dacre (Chair).
  • Sir Robert Francis KC
  • Anita Charlesworth
  • Professor Stephen Peckham
  • Sir David Pearson
  • Professor Emma Cave

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Source: House of Commons Health and Social Care Select Committee, 24 October 2023

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Plan to pump 10,000 fake doctors into the NHS is insane and dangerous

You might not have heard of a ‘physician associate’ - and that’s not your fault. They probably won’t tell you. A physician associate walks and talks like a doctor, but they are no replacement for one.

To become a physician associate you need to complete a two-year postgraduate course or three-year apprenticeship. But despite much less learning than the five years a junior doctor must undergo to be qualified, they are often paid more than them.

Which is why the government’s plan to flood the NHS with 10,000 more of them over the next 15 years doesn’t make any sense. There’s certainly no money-saving aspect. This is simply another corner-cutting exercise to quickly plug gaps in a struggling NHS that will put patients at risk.

Far from saving doctors work (their original purpose), they often create more. Physician associates are unregulated so cannot be held accountable for their mistakes, meaning doctors must recheck any critical decisions they make. Critical decisions are made quite frequently in hospitals.

But they’re not just overstretching doctors and creating more work; they’re harming patients. A recent Daily Mail investigation has found brain bleeds misdiagnosed as inconsequential headaches and lung disease mistaken for a chest infection.

Doctors say they are “increasingly concerned” by this.

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Source: LBC, 16 October 2023

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Crumbling concrete: Raac found in 18 more hospitals in England

Eighteen more hospitals in England contain potentially crumbling concrete, bring the total affected to 42, the Department of Health and Social Care has confirmed.

The reinforced autoclaved aerated concrete (Raac) has also been found in 214 schools and colleges in England as well as thousands of other buildings.

NHS Providers, which represents hospitals, said the concrete "puts patients and staff at risk".

Full structural surveys are taking place at all newly confirmed sites.

The government said it was committed to eradicating Raac from NHS buildings completely by 2035.

Seven of the worst-affected hospitals will be replaced by 2030 as part of the programme to build 40 new hospitals in England, it added.

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Source: BBC News, 21 October 2023

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Whistleblower raises alarm over ‘inadequate’ investigation into 60 suicides

A trust pressured into commissioning an external review of dozens of suicides faces fresh criticism and questions about the probe’s credibility after it emerged the investigation will not investigate each case but instead look to ‘identify themes’.

Cambridgeshire and Peterborough Foundation Trust originally said it would carry out the review of more than 60 patient suicides internally. But following criticism, it U-turned on this decision and last month agreed to an externally-led process.

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Source: HSJ

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As RSV cases tick up, CDC warns that a key drug to keep babies safe is in short supply

The Centers for Disease Control and Prevention alerted doctors nationwide Monday about a limited availability of certain doses of a newly approved antibody drug given to infants to prevent RSV infection.

Cases of RSV, or respiratory syncytial virus, have started to rise as cold and flu season begins.

"RSV season is here," said Dr. Buddy Creech, a pediatric infectious disease doctor at Vanderbilt University Medical Center in Nashville, Tennessee. "We are seeing a substantial increase in the amount of RSV such that in many areas, it has become the most commonly identified respiratory virus causing disease in children.

"This is one of the reasons why there's probably a lot of scrambling going on," he said, "to identify those babies at highest risk and to try to prioritize them, since it's such a limited resource right now."

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Source: NBC News, 23 October 2023

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Welsh Ambulance Service declares extraordinary incident due to delays

An ambulance spent 28 hours outside a hospital after an "extraordinary incident" was declared due to delays.

The Welsh Ambulance Service said 16 ambulances had waited outside the emergency department at Morriston Hospital, Swansea, at one time.

It said multiple sites across Wales were affected.

The extraordinary incident, which asked people to only call 990 if their emergency was "life or limb threatening", is now over.

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Source: BBC News, 23 October 2023

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Thousands of men miss out on life-extending prostate cancer drug

Thousands of patients in England and Northern Ireland are missing out on a life-extending prostate cancer drug that is more widely available on the NHS in Scotland and Wales, say experts.

Charity Prostate Cancer UK said it was "unacceptable" that men in parts of the UK were facing a postcode lottery.

Although not a cure, abiraterone can help stop prostate cancer spreading to other parts of the body.

NHS England said it would review the drug's use for more men next year.

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Source: BBC News, 23 October 2023

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