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The serious care failings the NHS tried to keep secret

The NHS has kept secret dozens of external reviews of failings in local services – covering possible premature deaths, unnecessary and harmful operations, and rows among doctors putting patients at risk – an HSJ investigation has found.

At least 70 external reviews by medical royal colleges were carried out from 2016 to 2019, across 47 trusts, according to information provided by NHS trusts, but more than 60 of these have never been published – contrary to national guidance – while several have not even been shared with the Care Quality Commission (CQC) and other regulators. These include reviews which uncovered serious failings.

Bill Kirkup’s review into the Morecambe Bay scandal in 2015 recommended trusts should “report openly” all external investigations into clinical services, governance or other aspects of their operations, including notifying the CQC. 

Since then the CQC has asked trusts for details of external reviews when it reviews evidence, and in July 2018 it began to ask for copies of their final reports, but HSJ’s research suggests this does not always happen.

James Titcombe, the patient safety campaigner whose son’s death led to the inquiry by Bill Kirkup into the Morecambe Bay maternity care scandal, said a review was now needed of whether its recommendations had been implemented.

“It is not acceptable that five years [on], there are still secretive royal college reports and patients are kept in the dark,” he said.

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Source: HSJ, 25 June 2020

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Ian Paterson: Coroner to open inquests into breast surgeon’s victims’ ‘unnatural deaths’

Former patients of rogue breast surgeon Ian Paterson may have died of “unnatural deaths” two senior coroners have said.

Senior coroner for Birmingham and Solihull, Louise Hunt, and area coroner Emma Brown have said they believe there is evidence to suspect victims of Ian Paterson, who was jailed for 17 counts of wounding with intent in 2017, died unnaturally as a result of his actions.

They now plan to open four inquests into the deaths of patients who died from breast cancer after being treated by Paterson.

“Following preliminary investigations, the senior and area Coroner believe there is evidence to have reason to suspect that some of those deaths may be unnatural. In accordance with the Coroners and Justice Act 2009, inquests will now be opened in relation to four former patients of Mr Paterson.”

Deborah Douglas, a victim of Paterson who leads a support group in Solihull, told The Independent: "I have spoken to so many women over the years who have since died. This is what I have always known and fought for.

"Paterson lied about pathology reports and people did develop secondary cancers."

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Source: The Independent, 4 July 2020

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As a paramedic in England, I’m shocked at assaults on ambulance staff during Covid

We have been coughed on and shouted at by people refusing to wear face masks. We need more protection, says NHS paramedic Jake Jones.

The outpouring of appreciation for NHS staff during the COVID-19 crisis has been extraordinary. Yet reports of a recent rise in attacks on emergency workers, including ambulance crews, in England and Wales suggests the Thursday evening applause was hiding a less positive reality. Abuse of emergency workers is a growing issue: a 2018 survey found that 72% of ambulance staff have been attacked on duty, and figures have repeatedly pointed to an upward trend. As an NHS paramedic for 10 years, this aligns with Jake's own experience.

The consultation on increasing sentences for assaults on emergency workers seeks to discourage attacks on them. Jake's hope is that it will also challenge what has become an ingrained view – that being abused and assaulted somehow goes with the territory.

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Source: The Guardian, 1 September 2020

Read Jake's book 'Can you hear me? An NHS paramedics encounters with life and death'

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Coronavirus testing system 'falling over'

People across England have told BBC News they are struggling to access coronavirus tests.

Health Secretary Matt Hancock said last week that no-one should have to travel more than 75 miles for a test, after the BBC revealed some were being sent hundreds of miles away.

But dozens have now reported being unable to book a swab at all.

The Department of Health and Social Care (DHSC) said testing capacity was targeted at the hardest-hit areas.

A significant rise in demand for testing led the government to reduce the number of appointments available in areas of lower prevalence, to prioritise areas with outbreaks. This in turn led to people applying for tests being directed to centres sometimes hundreds of miles away.

But last Thursday Mr Hancock pledged to put in "immediate" solutions to make sure people did not have to travel more than 75 miles, effective from last Friday. Since then, postcodes entered into the government's booking system return a message suggesting there are no testing centres or home kits available - even if you are an essential worker with symptoms.

Frances, in Suffolk, tried to apply for a test when her daughter developed a high temperature. She didn't think it was coronavirus but "the rules are the rules". She had understood that anyone with a temperature should apply for a test, and was not able to send either of her children to school until she did.

"Their teachers need to be kept safe, their classmates need to be kept safe, we need to do the right thing," she said.

But Frances was also not able to get a home kit, and when she tried to get an appointment at a drive-through centre was told no test sites were found.

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Source: BBC News, 12 September 2020

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Police launch investigation into patient death

Police are investigating allegations around the death of a patient who was under the care of Hertfordshire Partnership University Foundation Trust.

The probe by Hertfordshire Constabulary relates to the case of Margaret Molyneux, 69, who according to a review by the trust’s commissioners, was prescribed doses of anti-psychotic medication which were significantly higher than recommended limits.

Police said the investigation is ongoing and no arrests have been made.

Ms Molyneux had been admitted to the trust’s mental health unit in Radlett in 2017, after which her physical health declined and she was admitted to Watford General Hospital with pneumonia and dysphagia, which relates to difficulties swallowing.

She was discharged back to the Radlett unit, but died several weeks later at Watford General Hospital, after choking on her food and developing aspiration pneumonia. 

An inquest in February 2018 ruled she died from natural causes, but an investigation into her case commissioned by East and North Hertfordshire Clinical Commissioning Group, seen by HSJ, subsequently suggested high doses of Olanzapine, an anti-psychotic drug, were “likely to have at least contributed to some of the physical problems she experienced… including low blood pressure, falls and dysphagia”.

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Source: HSJ, 6 May 2021

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‘Heavy-handed, expensive’ inspections wrong way to regulate hospitals, says ex-CQC chair

‘Very heavy-handed, laborious and expensive’ inspections ‘have not been the right way’ of regulating hospitals, according to the Care Quality Commission’s (CQC) former chair.

Speaking at a Royal Society of Medicine event on Wednesday, Lord David Prior, who is now the chair of NHS England, said “very few” physicians will have improved their work after reading a report from the regulator.

He added that there is a role for the CQC to move in when “things are going wrong” although he is “sceptical” the regulator can actually drive improvement in hospitals.

Lord Prior said: “I am highly sceptical as to whether or not CQC or any regulator can really drive improvement and drive the top hospitals to make them better.

“And certainly I think there’ll be very few physicians who will say that their clinical work has improved as a result of reading a CQC report.

“I think the sadness I have about CQC is that we have not been able, or it has not been able, to develop a series of predictive metrics that could replace these very heavy handed, very laborious and very expensive visits that we used to do.”

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Source: HSJ, 9 September 2021

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Medical errors claim lives of 18-20% hospitalised patients in Pakistan

A staggering 18-20% of hospitalised patients in Pakistan lose their lives due to medical errors, negligence, misadministration of drugs, and deadly hospital-acquired infections, experts have warned.

Speaking at a press conference ahead of the Patient Safety and Quality Healthcare Conference hosted by Aga Khan University (AKU) in April and organised by Riphah Institute of Healthcare, leading healthcare professionals called for urgent reforms to improve patient safety in hospitals across the country.

The press conference was addressed by Executive Director of Riphah International, Asadullah Khan, Executive Director of NICVD, Prof Dr Tahir Saghir, Chairman of Patient Safety, Dr Zakiuddin, and Sayed Jamshed Ahmed.

Dr Zakiuddin pointed out that several errors occur during medical treatment, including wrong drug prescriptions, incorrect injections, surgical complications, and hospital-acquired infections.

“The World Health Organization (WHO) has been consistently raising awareness about patient safety, yet many developing countries, including Pakistan, continue to struggle with high rates of medical errors,” he said.

He stressed the need for specialized training for medical staff and the adoption of modern patient safety systems to curb preventable mistakes. “There must be a culture where doctors and nurses acknowledge their errors and work toward rectifying them rather than concealing mistakes,” he added.

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Source: Business Recorder, 3 March 2025

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Patient safety is not a ‘priority’ for NHSE claims watchdog chief

The outgoing chief investigator of the national safety watchdog has described his frustration with the organisation’s ‘ambivalent’ relationship with NHS England.

Keith Conradi, who is due to retire from the Health Safety Investigation Branch in July, said he did not think he had “ever really spoken to any of the hierarchy in NHS England”. He added “their priorities are elsewhere”.

In an interview with health commentator Roy Lilley for the Institute for Health and Social Care Management, Mr Conradi also described HSIB’s relationship with NHSE as “ambivalent”.

“It wobbled along that sort of line and got worse as time has gone on,” he said. “At the very start I had a chat with the permanent secretary of the Department of Health and said we would be better off in the department than NHS England. He disagreed and felt that we’d be too close to [then health secretary] Jeremy Hunt, and particularly at that time that would have a negative effect.”

Mr Conradi was also critical of the decision to ask HSIB to take on investigations into maternity care early in its life. He said he was “shocked” that it happened so quickly “when we hadn’t really got going”.

He continued: “We hadn’t developed a method of doing normal national investigations and suddenly we were being asked to do maternity ones. There was a huge amount of pressure to do this.”

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Source: HSJ, 28 June 2022

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Teeth-whitening: Reports of illegal procedures up 26%

Reports of illegal teeth-whitening that could leave patients at risk of health problems including burns or lost teeth have increased, the BBC has found.

General Dental Council (GDC) figures showed a 26% rise in reports last year.

Teeth-whitening can only be performed legally in the UK by professionals registered with the GDC. One beauty school claimed to have provided "thousands" of candidates with illegitimate qualifications, an undercover investigation found. Failure to comply with the requirement to be registered can result in a criminal record and an unlimited fine.

Untrained beauticians using teeth-whitening kits have been known to cause tooth loss, burns and blisters.

Dr Ben Atkins, president of the Oral Health Foundation, said: "When things go wrong in dentistry, they can really go wrong. I've been that dentist with the full back up service when the patient's had that heart attack. It would be catastrophic for the patient and the person who's been trained and told it's legal to do it."

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Source: BBC News, 10 February 2020

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NHS staff ‘can access covid-19 testing’, government insists

NHS staff are to be given access to testing for covid-19, the government said this morning, but it remains unclear how the policy will be applied.

A Department of Health and Social Care spokesman said at lunchtime: “Our testing regime is set up to provide for those who need tests the most. This includes key workers, such as NHS staff. We will set out more details shortly.”

It remains unclear how this will be applied.

The announcement follows concerns from healthcare professionals they are not being tested for the virus, even if they had been exposed to infected patients.

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Source: HSJ, 17 March 2020

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Providers ‘missed opportunities’ in outbreak which killed 15

An investigation into the outbreak of a bacterial infection that killed 15 people has found there were several “missed opportunities” in their care.

Mid Essex Clinical Commissioning Group has released the outcome of a 10-month investigation into a Strep A outbreak in 2019, which killed 15 people and affected a further 24. The final report was critical of Provide, a community interest company based in Colchester, as well as the former Mid Essex Hospital Services Trust (now part of Mid and South Essex Foundation Trust).

It said: “This investigation has identified that in some cases there were missed opportunities where treatment should have been more proactive, holistic and timely. These do not definitively indicate that their outcomes would have been different.”

Investigators found that 13 of the 15 people that died had received poor wound care from Provide CIC. They reported that inappropriate wound dressings were used and record keeping was so poor that deterioration of wounds was not recognised.

Even wounds that had not improved over 22 days were not escalated to senior team members for help or referred to the tissue viability service for specialist advice, with investigators told this was often due to concerns over team capacity.

The report, commissioned by the CCG and conducted by consultancy firm Facere Melius, said: “[Some] individuals became increasingly unwell over a period of time in the community, yet their deterioration either went unnoticed or was not acted upon promptly. Sometimes their condition had become so serious that they were very ill before acute medical intervention was sought”.

Other findings included delays in the community in the taking of wound swabs to determine if the wound was infected and by which bacteria. It said in one case nine days elapsed before the requested swab took place. Even after Public Health England asked for all wounds to be swabbed following the initial outbreak, this was only conducted on a single patient.

In other cases there were delays in patients being given antibiotics and this “could have had an adverse impact on the treatment for infection”.

It also found that sepsis guidelines were not accurately followed, wounds were not uncovered for inspection in A&E, and some patients were given penicillin-based antibiotics despite penicillin allergies being listed in their health records.

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Source: HSJ, 17 September 2020

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Three deaths and ‘severe harm’ at trust with treatment delays

At least three people died and more came to ‘severe harm’ after treatment delays across three specialties at one hospital trust, new reports have revealed.

King’s College Hospital Foundation Trust commissioned harm reviews due to problems with a lack of capacity and poor management of waiting lists in endoscopy, dermatology and ophthalmology pre-pandemic. Most of the problems relate to the trust’s southern site, Princess Royal University Hospital, and took place before the current executive team took over.

The most recent board papers revealed a review of 614 cases at the PRUH’s endoscopy service found seven cases of “serious harm”. This category includes death and the document revealed three patients had died. 

The review also “highlighted delays in endoscopy leading to delayed diagnoses of cancer” in 2018-19 and 2019-20.

Investigators also found a dermatology patient came to “severe harm” after being lost to follow-up twice by the trust.

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Source: HSJ, 17 September 2021

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Hospitals harm hundreds of patients a year by misidentification

Hundreds of patients are being harmed each year because NHS organisations have incorrectly identified who they are, an HSJ investigation has found.

Responses to Freedom of Information requests from 166 trusts revealed 58,537 cases of patient misidentification logged in Datix or other patient safety systems between 2019 and 2023, including 4,713 causing some sort of harm. This is equivalent to 11,707 incidents a year, with 943 leading to harm.

It includes a wide range of errors, but harm typically happens when patients are given the wrong treatment or medicine, or miss out on the right treatment, as a result of errors in recording and/or miscommunication. A typical example is patients being given a wristband with the wrong name – or ID information resulting in patients not being treated, or the wrong treatment being given.

Some of the worst examples are where the wrong patient, or the wrong part of the body, is operated on.

Patient Safety Learning's CEO Helen Hughes called on NHS England to review cases nationally to identify root causes.

She added: “Where avoidable harm has occurred, it is vital these incidents are investigated, that causes and contributory factors are identified, and steps put in place to prevent their reoccurrence. In some cases, this may require standardisation of approaches to patient identification, while others may highlight contributory factors that are more difficult to address, such as staff fatigue.”

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Source: HSJ, 11 June 2024

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NHSE pushes ‘private patient opportunities’ in leaked guidance

Official draft guidance has encouraged trusts to grow their ‘private patient opportunities’, despite facing huge backlogs of NHS work.

The NHS England document, leaked to HSJ, includes instructions to local leaders for the new financial year starting in April.

It said: “Trusts should continue to actively explore and develop opportunities to grow their external (non-NHS) income… Private patient services continue to be a significant source of material opportunity in the NHS.”

It adds that NHS England and NHS Improvement will work with trusts to “identify and scale-up NHS export opportunities and support development of private patient opportunities to generate revenue and provide benefits for NHS staff and local patients and services”.

It comes as the NHS faces huge backlogs of elective patients waiting for treatment. NHSE’s own plan to recover from Covid said the waiting list could rise to 14 million, up from the current 6 million.

Sally Gainsbury, senior policy analyst at the Nuffield Trust, said the guidance was “capitalising” on the surge in people paying for private treatment during the pandemic. 

Ms Gainsbury said: “It is a concern that with over 6 million patients on the NHS waiting list, NHS England is actively encouraging NHS trusts to expand their private patient activity."

“Scarce NHS capacity should be focused and prioritised on treating NHS patients and bringing these unacceptable waits down, not capitalising on the growth in the private treatment market on the back of this unprecedented backlog of care.”

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Source: HSJ, 29 March 2022

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Nurse begs hospital bosses to ‘see for themselves how unsafe it is’

An advanced nurse practitioner working in primary care services at Grimsby Hospital has called on the hospital senior leadership to ‘see for themselves how unsafe it is’.

The nurse, who has penned a letter to bosses at Northern Lincolnshire and Goole NHS Foundation Trust says they are having “worst experience to date” in their career and fears somebody will die unnecessarily unless something is urgently done.

“I have never in my whole career seen patients hanging off trolleys, vomiting down corridors, having ECGs down corridors, patients desperate for the toilet, desperate for a drink. Basic human care is not being given safely or adequately," says the nurse.

Hospital bosses say they are taking the letter seriously and are investigating. Earlier this month it was revealed that some hospitals were being forced to deploy ‘corridor nurses’ in a bid to maintain patient safety while dealing with unprecedented demand.

Dr Peter Reading, Chief Executive, said: “I can confirm we have received this email and that the hospital and North East Lincolnshire CCG are taking these concerns seriously. The person who raised the concerns with us has been contacted and informed that we are jointly investigating what they have told us.

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Source: Nursing Notes, 22 January 2020

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Female ambulance staff subjected to ‘macho and sexualised’ culture

A ‘macho’ culture within ambulance trusts is leading to widespread abuse of female staff.

HSJ has been told of multiple cases including sexual misconduct, harassment or abuse against staff in the last two and a half years. These include:

  • women being told that giving sexual favours would help them get on to paramedic training
  • a woman who was told she would pass her driving course if she gave oral sex to a superior
  • a student on placement who could not take off her jacket without comments being passed on her breasts, and therefore would wear it even on the hottest days
  • a student given a lift by her supervisor who then proceeded to rub his hands up and down her legs during the journey.

In a freedom of information request, the 10 ambulance trusts in England were asked for the number of incidents in which allegations of sexual misconduct, harassment or abuse had been made against staff.

The trusts reported 221 cases since April 2019, of which at least 27 resulted in dismissal and at least 44 resulted in other disciplinary action, with some cases still under investigation.

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Source: HSJ, 7 December 2021

 

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Government plans ‘single set of management standards’ for the NHS

A government review of health and care leadership has recommended a single set of ‘core leadership and management standards’ for NHS managers.

The report by General Sir Gordon Messenger and Dame Linda Pollard calls for “consistent management standards delivered through accredited training”, according to a government statement this morning.

The full document has yet to be published but the statement summarises the findings and says an “institutional inadequacy” has formed in the way leadership and management is trained and developed in the NHS.

It says the report has produced seven recommendations, which have all been accepted in full by the health and social care secretary Sajid Javid, who said they must be taken forward “urgently”.

Among them is a call for a more “effective and consistent” appraisal system to reduce variation in how performance is managed. This is after the review concluded a greater focus was needed on “how people have behaved [and] not just what they have achieved”.

The recommendations do not include any registration system for NHS managers, despite calls from some over many years for more regulation of the roles, nor appear to include specific reform of the “fit and proper person” test, which has been discredited and under review.

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Source: HSJ, 8 June 2022

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PM’s local hospital warned by CQC over covid infection control

A hospital serving the prime minister’s constituency has been issued a warning notice by inspectors over poor infection control, including staff having to share two small toilet cubicles for changing.

The Care Quality Commission (CQC) announced it has issued the notice to The Hillingdon Hospitals FT today following an unannounced inspection in September.

It comes after the watchdog placed urgent conditions on the provider following a coronavirus outbreak among staff at Hillingdon Hospital in August. At least 70 members of staff had to isolate, some of whom had tested positive for covid.

The watchdog said it found there had been improvements, but that “further work is needed”.

The CQC’s inspection report, published today, said there were no staff changing rooms available for people to change in and out of their scrubs, and that they were sharing two small toilet cubicles at the start and end of shifts.

These were not cleaned with an “enhanced” cleaning schedule, it added, and the lack of separate changing rooms “caused a risk of cross-contamination”. However, senior leaders were aware of the risk and were seeking ways to improve access to changing areas for staff.

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Source: HSJ, 4 December 2020

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Review reveals how arrest of Lucy Letby exposed nursing regulator loophole

The nursing and midwifery regulator failed to act quickly enough after Lucy Letby was arrested because of a loophole in its guidance, according to an unpublished review.

The Nursing and Midwifery Council (NMC) asked a top barrister to review how it responded to a referral of nurse Letby in 2018, after concerns were raised internally over an alleged lack of action, according to several sources.

When Letby was arrested over the murders of several babies at the Countess of Chester Hospital, the regulator did not place any temporary suspension order on her right to practice as a nurse until a year later in 2020, when she was charged.

Sources now say the barrister’s review – for the Thirlwall Inquiry – has found the watchdog could have acted earlier after her arrest. The findings are yet to be published – but the NMC changed its guidance in April this year following the review, clarifying that investigators did not have to wait until a nurse is charged to place a temporary suspension order.

The news comes after a series of reports by this publication uncovered a “toxic” culture within the NMC, including its failures to address a whistleblower’s concerns over how it approached sexual assault, domestic violence and racism cases.

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Source: The Independent, 1 September 2024

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First case of new potentially deadly mpox strain Clade 1b detected in UK

The first UK case of a potentially deadly strain of the mpox virus has been detected in London.

The UK Health Security Agency (UKHSA) said the risk to the UK population from the clade 1b mpox strain “remains low”.

The person involved had been on holiday in Africa and travelled back to the UK on an overnight flight on 21 October.

They developed flu-like symptoms more than 24 hours later and, on 24 October, started to develop a rash which worsened in the following days.

The person attended an emergency department in London on 27 October, where they were swabbed, tested and sent home to isolate while waiting for the results.

Fewer than 10 people who are thought to have come into contact with the patient are initially being traced, the UKHSA said. These are household contacts, although the UKHSA is “still working” on the number of people it may have to contact trace.

Professor Susan Hopkins, chief medical adviser at UKHSA, said: “It is thanks to our surveillance that we have been able to detect this virus. This is the first time we have detected this clade of mpox in the UK, though other cases have been confirmed abroad.

“The risk to the UK population remains low, and we are working rapidly to trace close contacts and reduce the risk of any potential spread. In accordance with established protocols, investigations are underway to learn how the individual acquired the infection and to assess whether there are any further associated cases.”

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Source: The Independent, 31 October 2024

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USA: Trump casts psychiatric and weight-loss drugs as threats to children

President Donald Trump has instructed his administration to scrutinize the “threat” to children posed by antidepressants, stimulants and other common psychiatric drugs, targeting medication taken by millions in his latest challenge to long-standing medical practices.

The directive came in an executive order Thursday that established a “Make America Healthy Again” commission led by Health and Human Services Secretary Robert F. Kennedy Jr., who has criticized the use of those drugs and issued false claims about them.

The order said the commission should prepare a “Make Our Children Healthy Again” assessment within 100 days that examines “the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs.” The directive comes as children and teens endure a mental health crisis exacerbated by the covid pandemic.

The medication review joins a slew of Trump administration policies upending the government’s approach to health, many of which are embroiled in legal challenges. They include attempts to remove vaccine information from health agency websites, to ban gender transition care for children and to cut billions in biomedical research funding.

Kush Desai, a White House spokesman, said the order follows concerns about doctors overprescribing the drugs and harming Americans of all ages. The president called for a review of prescription practices and use of the drugs to determine whether the government should offer new guidance on the medication.

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Source: The Washington Post, 18 February 2025

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Nearly half of cancer patients don’t feel involved in treatment decisions, survey finds

Almost half (47%) of patients with cancer do not think that they have been sufficiently involved in deciding which treatment option is best for them, a new survey shows. The survey of nearly 4000 patients across 10 countries also found that around four in 10 (39%) said that they were never or only sometimes given enough support to deal with symptoms and side effects.

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Source: BMJ, 25 July 2019

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‘I had the coronavirus months ago but I’m still too ill to work... or even watch TV’

When Dan Scoble came down with the coronavirus in March, all the classic symptoms landed in one fell swoop. “I had everything under the sun: a fever, temperature, fatigue and chest pain,” he said. “My head felt like a balloon.”

The 22-year-old, a personal trainer from Oxford who normally breezed through 10-mile runs, suddenly found himself bed-bound. He presumed it would soon blow over, but 12 weeks after falling ill as the country went into lockdown, he is still not back to normal.

Dan has left his house just five times in three months — twice to see his GP and three times to hospital. He still suffers from crippling fatigue, recurrent migraines and a persistent sore throat, as well as abdominal and musculoskeletal pain.

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Source: The Times, 14 June 2020

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Is the CQC giving the NHS an easy ride?

The purpose of Care Quality Commission (CQC) ratings has been a hotly contested question since the creation of the four category classifications in the last decade.

The original idea was to give the public a sense of how good their local hospital was, as well as providing commissioners, system managers and government with an idea of whether the local, regional or national health services they had responsibility for were getting better or worse.

The practicality of the first aim was always questionable given the public’s inability and unwillingness, in most cases, to take their custom elsewhere. The second ran into the lack of desire and/or courage on behalf of most commissioners to challenge their local provider, but it did seem to have traction at the top of the shop.

Jeremy Hunt, told HSJ, once they had been dished out across the sector, that their CQC classification now mattered much more then whether or not it had achieved foundation status or not.

Another function, whether intended or not, was that by splashing “inadequate” and unsafe care on the front pages, in the wake of the Francis report, CQC ratings fuelled a drive to put more staff on the wards (forcing the Treasury to pay for the consequent agency bills and deficits, and curtailing Simon Stevens’ transformation funds).

Whatever your take on their purpose, however, they only make sense if they accurately reflect the state of the service. And the latest data suggests that may not be the case.

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Source: HSJ, 17 March 2022

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ER doctors in the US misdiagnose patients with unusual symptoms

As many as 250,000 people die every year because they are misdiagnosed in the emergency room, with doctors failing to identify serious medical conditions like stroke, sepsis and pneumonia, according to a new analysis from the US federal government.

The study by the Agency for Healthcare Research and Quality estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result.

Researchers from Johns Hopkins University analysed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake.

While these errors remain relatively rare, they are most likely to occur when someone presents with symptoms that are not typical.

“This is the elephant in the room no one is paying attention to,” said Dr. David E. Newman-Toker, a neurologist at Johns Hopkins University and director of its Armstrong Institute Center for Diagnostic Excellence, and one of the study’s authors.

The findings underscore the need to look harder at where errors are being made and the medical training, technology and support that could help doctors avoid them, Dr. Newman-Toker said. “It’s not about laying the blame on the feet of emergency room physicians,” he said.

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Source: New York Times, 15 December 2022

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