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Delay mandatory COVID vaccinations until spring, urges NHS leader

Mandating COVID-19 vaccinations for all health service staff should be delayed until spring to enable the health service to get through the busy winter period, an NHS leader has urged.

Ministers have been considering whether or not to introduce mandatory jabs for all NHS staff in England. Health and social care secretary Sajid Javid said last week he is ‘leaning towards’ making the jabs compulsory as there are about 100,000 NHS workers not fully vaccinated.

NHS Providers chief executive Chris Hopson said that if the government was to press ahead, it should delay until April to ensure the NHS can get through the ‘difficult winter’.

Plans for mandatory jabs for staff who work or volunteer in care homes in England were announced in June, with an 11 November deadline for staff to have had both doses of vaccine, unless medically exempt.

However, Loss of vaccine-hesitant staff may compromise patient safety. Mr Hopson cited cases in Cornwall where NHS staff have been drafted in to help the social care sector.

"If we lose large numbers of unvaccinated staff, particularly over the winter period, then that also constitutes a risk to patient safety and quality of care," he told BBC Breakfast.

"We know that we’ve got a very, very difficult winter coming up and we know the NHS is going to be absolutely at full stretch. ‘So it makes sense to set the deadline once that winter period has passed. We know that January, February and often early March is very busy, so that’s why we’re saying that an April 2022 deadline is a sensible time.’

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Source: Nursing Standard, 1 November 2021

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Trusts spending £1m+ a year on settlement deals with gagging clauses

Trusts are still spending at least £1m a year on settlement agreements with staff containing ‘gagging clauses’ despite a crackdown on these conditions in recent years, HSJ research reveals.

Freedom of information responses reveal 214 settlement agreements with confidentiality conditions worth £4.6m across three years

NDAs — which are also known as “confidentiality clauses” or “gagging clauses” and prevent parties to a settlement agreement from disclosing its details — also seem to be becoming less popular. HSJ’s FOIs revealed 119 settlement agreements with an NDA with a total value of £2.16m, in 2018-19. In 2019-20, this fell to 87 such agreements with a total value of £1.5m. In 2020-21, there were 41 settlement agreements with such a clause, with a total value of £1.04m.

A source with knowledge of confidentiality agreements in the NHS said: “Following some high-profile whistleblowing cases a few years ago… NHS organisations have been far more cautious in imposing confidentiality obligations in settlement agreements.”

Numerous health secretaries have issued warnings about NDAs potentially being used to silence staff. In 2019, former health and social care secretary Matt Hancock said: “Settlement agreements that infringe on an individual’s right to speak out for the benefit of patients are completely inappropriate.”

In 2013, then health secretary Jeremy Hunt said he would ban clauses in compromise agreements — as settlement agreements were then known — preventing NHS staff from raising patient safety concerns. After the Mid Staffordshire report was published, he wrote to all trust chairs, asking them to review the confidentiality clauses they were using.

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Source: HSJ, 1 November 2021

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The mesh fightback begins: How thousands of women are being left in agony on waiting lists

"What has happened to us is home-grown, institutionalised female genital mutilation," says Mary Lodato, 63, a mother of three and a university researcher, from Kettering in Northamptonshire.

"It has been a systemic failure in health and care and it was totally avoidable."

What Mary is referring to are complications due to implanted surgical mesh, designed to treat post-childbirth pelvic damage in women, which has left thousands effectively crippled as the material disintegrated inside their bodies, and sheared into the tissue, causing a range of devastating symptoms including pain, difficulty walking and sexual dysfunction.

An eight-year Good Health campaign to get official recognition of the problem led to the establishment of a government inquiry under the leadership of former Conservative health minister Baroness Julia Cumberlege.

Although the inquiry report was published in July 2020, some of its key recommendations have still not been implemented, leaving thousands of women suffering and not getting the help they need.

Seven specialist NHS mesh removal clinics were meant to open in April this year in London, Cambridge, Manchester, Newcastle, Nottingham, Sheffield and Leicester. But the affected women claim a shortage of specialists has meant that only two are functioning — at University College London Hospital and Southmead Hospital in Bristol (which was not on the original list).

They also say that it's extremely difficult to get a referral to one of these new centres and even if they do, waiting times can stretch into years.

"To the doctors who originally treated us, these operations weren't anything major — but to us it was a catastrophically painful loss of work, family life and intimacy," says Mary. 

Mary's story is one familiar to almost 10,000 women who have joined an anti-mesh group called Sling the Mesh, and a number of other support organisations.

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Source: Mail Online, 1 November 2021

Blogs from Kath Sansom, Sling the Mesh

Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies

Ineffective medical device recalls are a patient safety scandal

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‘Climate of fear’ faces staff who voice bullying concerns at major trust

A major trust’s Freedom To Speak Up Guardian has warned that a failure to address staff concerns about alleged bullying and long-standing ‘dysfunctional behaviours’ is damaging confidence and resulting in the loss of high-quality staff.

Professor Julian Bion, presenting a half-yearly report to University Hospitals Birmingham Foundation Trust’s board, revealed that the majority of the 41 reports to the FTSU service between April and October this year had expressed a “fear of detriment” when raising concerns.

Just under half (44%) of 34 concerns raised by the contacts related to “problematic attitudes and behaviours”, ranging from reports of micro-aggressions to overt bullying.

Professor Bion, UHB’s FTSU guardian since 2019, told HSJ such concerns are always “complex and sensitive issues” and recognised that the trust is handling them during “difficult circumstances” for the NHS. UHB has seen very large numbers of covid patients throughout much of the pandemic.

But he warned the board that several “common themes” were emerging in UHB’s complaints process – including a fear of detriment, “problematic” delays to cases being resolved, and a lack of response from divisional departments.

Suggesting there is a “disinclination” within the trust to address concerns, he said: “Very often, these dysfunctional behaviours are known about for a long time but they haven’t been addressed.”

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Source: HSJ, 2 November 2021

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Scotland to rollout diabetes test for Type 1 patients

Misdiagnosed Type 1 diabetes patients could be freed from the need to take insulin after a new test is rolled out.

Scotland will become the first country to offer the C-peptide blood test to all patients who have had a Type 1 diagnosis for at least three years. The test shows how much insulin a patient's body is producing itself.

A pilot by NHS Lothian allowed some people who had been taking insulin to stop or reduce the treatment. The test will be available from 1 November.

C-peptide testing, which has been used as part of diagnosis for some patients for many years, can help distinguish whether a patient has Type 1 or Type 2 diabetes. C-peptide is made in the body at the same time as insulin. By testing levels of C-peptide, doctors can work out how much insulin a diabetes patient is making themselves.

If C-peptide is present in significant amounts, it might indicate that the person does not have Type 1 diabetes at all, and consequently may not need daily insulin injections.

The tests will be offered at hospital diabetes centres.

Public Health Minister Maree Todd said that tackling diabetes was a priority for the Scottish government and that she wanted everyone living with diabetes to access safe, effective healthcare, treatment and support.

She said: "Type 1 diabetes is a significant health challenge right across the world."

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Source: BBC News, 31 October 2021

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It’s scandalous so few pregnant women in the UK are vaccinated against Covid

It is coming up to a year since the first mRNA vaccines were approved for use against COVID-19, and almost seven months since they were approved for expectant mothers. The initial government advice was was that they should hold off getting a jab, but since more data has become available, medical experts have been encouraging women to get vaccinated. But there has been no big government awareness campaign, despite pregnant women being identified as a vulnerable group. The proportion of fully vaccinated pregnant women in the UK is as low as 15% (in the US, it is more than twice that, at 33.8%).

That such a small porportion of pregnant women are fully vaccinated in the UK, seven months after vaccines were approved for them, is nothing short of a scandal. And more women and their babies are at risk of dying because of it. Recent figures for England show that one in six critically ill patients are unvaccinated pregnant women with Covid. Of the 20 pregnant women requiring the highest level of life-saving care, 19 were unvaccinated and one had received one dose.

These are frightening statistics, but on their own they do not seem to be enough to persuade pregnant women to get vaccinated. In order to do that, it’s important to understand why we are seeing such high levels of hesitancy...

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Source: The Guardian, 29 October 2021

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GPs to follow new digital standard for sending medicines and allergy information

A new information standard has been developed for sharing digital information on medication and allergies across different parts of health and social care services.

The standard, which aims to reduce medicines errors comes into effect this month. NHS and social care organisations will have to show compliance by March 2023.

GP practices, hospitals, mental health trusts, pharmacists, community teams and residential care homes will all have to meet the standard when transferring medication and prescription information between teams.

The standard will be particularly helpful in reducing medication errors when patients transfer between care locations NHS Digital said.

Having specific requirements in place for how medicine and allergy information is transferred will also provide clinicians with a more detailed and consistent source of medicines related information across all care settings and allow them to obtain medicines information more quickly and efficiently, they added in a document outlining the changes. 

The standard defines how the send and receive messages involving medicines information are constructed, and how the data within is structured so that it is machine-readable when sent between different IT systems.

Dr Simon Eccles, deputy CEO of NHSX and national chief clinical information officer said:

‘This new standard will make medicine prescribing safer for patients and easier for clinicians, reducing errors in prescription and improving the monitoring of medications that can cause harm.

‘This is the result of a true collaborative effort between NHSX, NHS Digital, industry and the frontline that will make a real difference to the care and support local clinicians can provide to their patients."

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Source: Pulse, 28 October 2021

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Patients must be warned of breast implant risks, FDA says

A decade after scientists identified a link between certain implants and cancer, the US Food and Drug Administration has ordered “black box” warnings and a new checklist of risks for patients to review.

Federal regulators have placed so-called black box warnings on breast implant packaging and told manufacturers to sell the devices only to health providers who review the potential risks with patients before surgery.

Both the warnings and a new checklist that advises patients of the risks and side effects state that breast implants have been linked to a cancer of the immune system and to a host of other chronic medical conditions, including autoimmune diseases, joint pain, mental confusion, muscle aches and chronic fatigue.

Startlingly, the checklist identifies particular types of patients who are at higher risk for illness after breast implant surgery. The group includes breast cancer patients who have had, or plan to have, chemotherapy or radiation treatments.

That represents a large percentage of women who until now were encouraged to have breast reconstruction with implants following their treatment.

Reactions to the new requirements were mixed. While some doctors welcomed the new warning system, others worried that the potential risks and side effects would not be conveyed adequately by plastic surgeons who were eager to reassure patients the procedure is safe and that the new checklist would be handled in a dismissive manner.

But Dr. Mark Clemens, a professor at M.D. Anderson Cancer Center in Houston who serves a liaison to the F.D.A. for the American Society of Plastic Surgeons Society, said the black box warning and checklist represented “a huge step forward for patient safety and implants.”

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Source: The New York Times, 27 October 2021

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Covid booster jabs offered at NHS walk-in clinics in England

Covid booster jabs are now being given at walk-in clinics in England as the NHS aims to increase vaccine uptake before what is expected to be a challenging winter.

From Monday, anyone in an eligible group who had their second dose of a coronavirus vaccine at least six months ago can turn up at one of hundreds of sites to get their top-up without making an appointment. The walk-in centres are also offering vaccinations to 12- to 15-year-olds.

The move follows criticism of the booster campaign, with only about half of the 12 million people in England eligible so far for a third vaccine dose having received one. The vaccine rollout to teenagers has lagged behind that of countries including France, Italy and Spain.

People entitled to a booster jab are: those aged 50 and over, people who live and work in care homes; frontline health and social care workers; people aged 16 and over with a health condition that puts them at high risk of getting seriously ill from Covid-19; those aged 16 and over who are a main carer for someone at high risk from the virus, and; people aged 16 and over who live with someone who is more likely to get infections.

Nikki Kanani, a GP and the deputy lead for the NHS Covid-19 vaccination programme, said: “NHS staff are making it as easy as possible for people to get their top-up vaccination, and from today people can now go online, find their nearest site and go and get their booster without delay.

“The booster is not just nice to have. It is really important protection ahead of what we know will be a challenging winter.”

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Source: The Guardian, 1 November 2021

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Three trusts whose struggling maternity departments were supported and supposedly improved by a national safety programme have since fallen back into the scheme

A freedom of information request by HSJ has for the first time revealed a complete list of participants in NHS England’s maternity safety support programme, with 28 trusts involved since its inception in 2018.

London North West University Healthcare Trust, Northern Lincolnshire and Goole Foundation Trust, and Worcestershire Acute Hospitals Trust all entered the scheme at the start, due to pre-existing quality and safety concerns. The trusts were all subsequently removed, having been deemed to have made improvements, but have since been placed back in it following inspections by the Care Quality Commission (see table below).

HSJ asked the trusts to explain why they had re-entered the scheme, and why it had failed to deliver sustainable improvements the first time, but they declined to comment.

NHSE said in a statement: “Trusts are placed on the maternity safety support programme according to complex criteria, including local insight and external performance measures, including CQC ratings. “Following the success of the programme since its creation in 2018, its criteria was widened to strengthen its role in proactively improving safety and enabling earlier intervention where there are concerns — this has allowed support to be offered to more trusts than in previous years.” However, it would not provide further details on the new entry criteria.

Three further trusts — Barts Health, North Devon Healthcare, and the Queen Elizabeth Hospital King’s Lynn — have previously exited the programme and not so far re-entered. Trusts such as Shrewsbury and Telford and East Kent — which have been at the centre of major maternity scandals — have been on the improvement scheme for all four years.

Peter Walsh, chief executive of the patient safety charity Action against Medical Accidents, said: “The number of NHS maternity services being found to be needing improvement is worrying. We welcome the fact that NHS England is devoting resources to support trusts to improve their maternity services, but there should be much more transparency about this.

“The criteria for needing this support should be published, and indeed should have been subject to consultation.”

Helen Hughes, chief executive of patient safety charity Patient Safety Learning, said there should be transparency about resource allocation and the criteria used to make decisions, adding: “It doesn’t appear that this information is easily accessible and in the public domain and rather begs the question, why not?” 

NHSE said trusts receiving support from the programme detail this in their board papers, although HSJ found this is not always the case. It added trusts are made aware of the rationale for inclusion on an individual basis.

NHSE and the Department of Health and Social Care last year described the maternity safety support programme as the “highest level of maternity-specific response”. They have said the programme “involves senior clinical leaders providing hands on support to provider trusts, through visits, mentoring, and leadership development”.

Full article here (paywalled)

Original source: Health Service Journal

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Chronic fatigue syndrome advice scraps exercise therapy

A health watchdog has scrapped a previous recommendation of graded exercise therapy for ME.

The National Institute of Health and Care Excellence (NICE) has published a long-awaited and contentious final update to guidance on treatment.

Many patients with ME or chronic fatigue syndrome (CFS) say the therapy, which encourages patients to slowly increase their levels of activity, makes their condition worse.

The advice was due out in August, but NICE pulled the publication at the last minute.

At that time, NICE said the delay was necessary to allow more conversations with patient groups and professionals, so that its advice would be supported.

There are strong and varied views on how the illness should be best managed.

The updated guidance for England and Wales recommends people judge their own "energy limit" when undertaking activity of any kind, and a physical activity programme should only be considered in specific circumstances.

It warns practitioners: "Do not advise people with ME/CFS to undertake exercise that is not part of a programme overseen by an ME/CFS specialist team, such as telling them to go to the gym or exercise more, because this may worsen their symptoms."

It also clarifies advice on a talking therapy, known as CBT, stressing that it is only helpful in treating anxiety around the condition, not the illness itself.

And it emphasises the need for early and accurate diagnosis.

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Source: BBC News, 29 October 2021

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Patient harm 'almost certain' due to ambulance handover delays

Patients are being put at "catastrophic risk" of harm due to ambulance handover delays, health bosses say.

West Midlands Ambulance Service (WMAS) has raised its risk rating for such delays to its highest level for the first time in its history. The risk rating shows the trust believes patient harm is "almost certain" due to the handover hold-ups.

Mark Docherty, director of nursing and clinical commissioning, said it was a "completely unacceptable situation".

It comes as a patient died after waiting more than five hours in the back of an ambulance in Worcestershire.

At a meeting on Wednesday, the ambulance service's board of directors heard the amount of time being lost to delays had reached previously unseen levels, the Local Democracy Reporting Service said.

Mr Docherty warned the situation was set to get worse over the coming months as a result of winter pressures.

"Despite everything we are doing by way of mitigation, we know that patients are coming to harm as a result of delays," he said.

"We know that there are patients that are having significant harm and indeed, through our review of learning from deaths, we know that sadly some patients are dying before we get to them."

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Source: BBC News, 28 October 2021

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Jeremy Hunt warns NHS spending ‘will unravel’ without workforce plan

Former health secretary Jeremy Hunt has warned extra funding for the NHS “will unravel quickly” without the extra doctors and nurses needed.

The health committee chair said today that the lack of any mention of workforce training budgets in the Chancellor’s speech on Wednesday was “the big gap” in news for the NHS.

Before the budget, Mr Hunt, who served as health secretary for six years and who has accepted he did not do enough to increase staffing levels in the NHS, said a workforce plan for the NHS was needed.

In the budget documents, released after the Chancellor Rishi Sunak had finished speaking, the Treasury confirmed only that it would continue to fund workforce training and repeated existing promises around 50,000 extra nurses.

But many experts including the Health Foundation and think tanks as well as NHS leaders have said what is needed is a properly costed long term workforce plan so that the NHS can train enough staff to meet future patient demand.

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Source: The Independent, 28 October 2021

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COVID-19: Trump’s “distraction” by the 2020 election led to thousands of deaths, says pandemic response adviser

Deborah Birx, who was the White House coronavirus response coordinator under President Donald Trump, has told a congressional inquiry that at least 129 000 lives could have been saved if his administration had provided adequate testing and properly communicated the gravity of the situation to the public.

But the election year “just took people’s time away and distracted them from the pandemic,” she told the House Select Subcommittee on the Coronavirus Crisis. “I felt like the White House had gotten somewhat complacent through the campaign season.”

Asked if Trump did everything he should have to counter the pandemic, she said, “No. And I’ve said that to the White House. I believe I was very clear to the president in specifics of what I needed him to do.”

“If we had fully implemented the mask mandates, the reduction in indoor dining, the getting friends and family to understand the risk of gathering in private homes, and we had increased testing, then we probably could have decreased fatalities by 30-40%.” That would amount to at least 129 000 preventable covid deaths over the course of the Trump presidency, which saw roughly 429 000 reported deaths attributed to the coronavirus."

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Source: BMJ, 28 October 2021

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Children’s intensive care at near full national occupancy amid rising RSV

A senior doctor has warned that paediatric intensive care units (PICUs) are ‘as pressured as I can ever recall’ – despite the absence of cold weather, which typically leads to higher demand levels.

James Fraser, president of the Paediatric Critical Care Society, said national bed occupancy in PICUs has “often been greater than 95 per cent” over recent weeks, while several units have reported 100 per cent occupancy. He said some children have had to be transferred between regions in order to admit them to a bed.

PICUs are often under more pressure during winter, due to seasonal RSV and other viral infections.

But high demand levels have started earlier this year, which has meant severely ill children have occasionally waited longer in local hospitals before being admitted to PICUs, and have sometimes had to be transferred to another site.

Mr Fraser told HSJ: “[PICUs] are really busy, as pressured as I can ever recall them.

“Every winter PICUs are under huge pressure due to seasonal RSV bronchiolitis. This usually happens between November and February. This year we always anticipated it would be a much longer season. It’s putting a lot of pressure on our national bed base.

“What is different is we have been under this pressure earlier in the year with RSV and other viral chest infections. We have been under this pressure for a month. The pressure is both the number of patients and there are a lot of staff off having to self-isolate."

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Source: HSJ, 29 October 2021

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NHS and private hospitals told to improve after patient death

The NHS and private hospitals need to improve how they work together after the death of an NHS patient treated privately during the pandemic, a watchdog has warned.

An investigation by the Healthcare Safety Investigation Branch (HSIB) found some private hospitals took on more complex patients than they were used to, while problems with communication and confusion over responsibilities created safety risks.

It has called on the Care Quality Commission to do more to inspect how the two sectors work together and how patients are transferred between hospitals safely.

It launched an inquiry after the death of a patient, known as Rodney, aged 58, who was due to have keyhole surgery to remove part of his bowel due to cancer.

His NHS operation was cancelled and rebooked at a nearby private hospital after cancer services were transferred to the independent hospital due to COVID-19.

Rodney was asked to sign a consent form for open bowel surgery, rather than the less invasive keyhole procedure, due to guidance at the time around a "potentially increased risk of COVID-19 transmission with laparoscopic surgery", the HSIB said.

The cancerous part of his bowel was removed but eight days later his condition he deteriorated rapidly and was transferred to the local hospital so he could receive intensive care - which was not available at the private hospital.

When he arrived at the NHS hospital, a scan and more surgery showed a leak in his bowel which led to sepsis and organ failure. He died later that day.

As a result of the case, the HSIB launched a wider investigation into NHS surgical services being carried out in independent hospitals.

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Source: The Independent, 28 October 2021

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Care for allergy patients ‘inadequate’, report warns

There is a “lack” of NHS services available to people with allergies, a group of MPs has said.

Despite increasing rates of hospital admissions for severe allergic reactions – also known as anaphylaxis – allergy services “have largely been ignored”, the All Party Parliamentary Group for Allergy said.

The group warned allergies are “poorly managed” across the health service due to a “lack of training” and only a small number of allergy experts.

“This mismatch has continued despite millions of patients having significant allergic disease,” it said.

In its latest report, which is to be delivered to Government on Wednesday, MPs said there are 20 million people in the UK who are living with allergic disease, including five million whose illness is severe enough to need specialist care.

“Yet our allergy services remain inadequate, often hard to access and are failing those who need them the most,” the report adds.

The group made a series of recommendations including: devising a “national allergy plan” to address problems; expanding the specialist workforce and ensuring all GPs get training in how to deal with allergies.

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Source: ITV News, 27 October 2021

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Cancer drug developed over 20 years ago ‘could help patients living with chronic pain’

A drug developed over 20 years ago to treat cancer could help patients living with crippling pain, according to new research.

Kenpaullone switches on a gene that douses chronic inflammation, say scientists.

Experiments on mice and humans found it was remarkably successful at alleviating nerve injury and bone tumour symptoms.

The US team is hopeful clinical trials will see equally successful results in humans suffering a host of conditions.

Up to 8 million people in the UK live with chronic pain. Major causes include arthritis and spine damage.

Lead author Professor Wolfgang Liedtke said: “New drugs and other therapies against chronic pain need to be safe, i.e., the fewer side effects the better.

“It’s especially important they be non-addictive and non-sedative, while being effective against nerve injury pain and cancer pain, preferably with a minimal time to official approval."

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Source: The Independent, 27 October 2021

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Covid lab returned four positive results from 2,400 Sheffield tests

The laboratory at the centre of the Covid testing fiasco returned just four positive results out of more than 2,400 tests sent to it from one city, the Guardian has learned, raising questions about why it was not discovered sooner.

The positivity rate of just 0.2% from Sheffield tests sent to the Wolverhampton lab run by Immensa contrasts sharply with the national rate of about 5-8% at the time of the scandal.

Data released under freedom of information laws by Sheffield city council showed there were four positive results, 2,391 negative and 13 void results processed by the lab from 1 September until it was suspended in mid-October.

The disclosure also shows the scandal covers local authorities as far away from Wolverhampton as Yorkshire, with the UK Health Security Agency refusing to disclose which areas are affected beyond saying they are mostly in south-west England.

One expert suggested there should have been about 200 positive results based on prevalence figures from the time. Kit Yates, a senior lecturer in mathematics at Bath University, said the country needed to see a full list of all the walk-in/drive in centres that were affected.

“It’s all well and good notifying those people who were tested, but because of the nature of this communicable disease, this scandal now reaches well beyond those people,” he said. “The public deserve to know if their area was affected.”

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Source: The Guardian, 27 October 2021

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NHSE tells trusts to ‘immediately stop all ambulance handover delays’

  • ·        Trusts told to identify actions to “immediately stop all delays”
  • ·        Letter calls for issue to be discussed at every board meeting
  • ·        It follows concern over harm to patients from delays

Trusts and integrated care systems are being told by NHS England and Improvement to take urgent action to ”immediately stop all delays” to ambulance handovers, which will require “difficult choices”.

A letter yesterday from NHS England’s medical director, director for emergency and elective care, and its regional directors was sent to all local chief executives and chairs yesterday.

It also says they should discuss the issue of ambulance handovers at every board meeting they hold, warns that “corridor care” is “unacceptable as a solution”, and says ambulances should not be used as “additional ED cubicles”.

The move comes amid signs of large numbers of very long handover delays, and concern about the risk to patients from this and the knock-on damage to ambulance response times.

Read the full article here (paywalled)
Original source: Health Service Journal

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Liverpool NHS trust ordered to improve amid safety concerns

A Liverpool NHS trust has been rated as "requires improvement" by the health service watchdog due to concerns over care and safety.

The moves comes following inspections at Aintree University Hospital and Royal Liverpool University Hospital.

Inspectors said Liverpool University Hospitals NHS Foundation Trust required improvement in safety while it was classed as inadequate for leadership.

The trust said "immediate action" had been taken to address the concerns.

Ted Baker, chief inspector of hospitals at the Care Quality Commission, said the inspections in June and July highlighted concerns that the trust's leadership team "had a lack of oversight of what was happening on the frontline".

Mr Baker said "lengthy delays" and "poor monitoring" were putting patients at serious risk of harm, and the trust was rated as requires improvement overall.

He added: "We were particularly concerned about how long people were waiting to be admitted onto medical wards and by the absence of effective processes to prioritise patients for treatment based on their conditions.

"There weren't always the right number of staff with the right skills and training to treat people effectively or keep them safe in the trust's emergency departments and on medical wards."

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Source: BBC News, 27 October 2021

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Shrewsbury nurse struck-off after medicine error and cover-up attempt

A nurse from scandal-hit Shrewsbury and Telford Hospital ordered a pregnant woman to take medication she was allergic to.

Christine Speake, who had worked in the NHS for almost 40 years as a midwife and nurse, has been struck-off the Nursing and Midwifery Council (NMC) register after a tribunal heard she told the mother to “just take it” and then tried to cover-up her mistake after the woman suffered a reaction.

The NMC hearing was told the 11-week pregnant patient and her unborn child could have died after being prescribed the Buscopan by a junior doctor to treat severe nausea and vomiting in January 2019.

The woman – named only as 'Patient A' – was given the drug by Speake despite her allergy being included in her medical records. Speake was employed as a sister on the gynaecology ward at the Princess Royal Hospital.

When the mother questioned what she was being given, Speake, who has worked as a midwife and nurse since 1985, snapped "just take it".

The panel heard Patient A then had a violent reaction and broke out in a rash and started vomiting.

But Speake, who realised her mistake, then failed to tell her colleagues in a bid to “cover up” what she had done and later resigned, the NMC tribunal heard.

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Source: The Independent, 26 October 2021

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Nurse shortages leave people dying in pain, charity warns

People are dying at home without the correct nursing support or pain relief because of staff shortages, according to the end-of-life charity Marie Curie.

One in three nurses, responding to a survey by the charity and Nursing Standard, say a lack of staff is the main challenge providing quality care to dying people.

More than half of the nurses said they feel the standard of care has deteriorated during the coronavirus pandemic.

Some 548 nursing staff across acute and community settings in the UK completed the survey in September.

They raise concerns about the increased number of people dying at home and insufficient numbers of community nurses to support these people and their families.

One nurse who responded to the survey said: "If more [people] are dying at home then there is a huge pressure on local district nursing teams which struggle with staffing as it is."

Julie Pearce, chief nurse and executive director of quality and caring services at Marie Curie, said: "The pandemic has accelerated change across many care settings.

"More people are dying at home and staffing to support this shift isn't there.

"The data shows a hidden crisis happening behind closed doors and people dying without access to pain relief or the dignity they deserve."

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Source: The Independent, 27 October 2021

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1-in-10 adults living with diabetes by 2030

New analysis from Diabetes UK predicts that, without significant government action, up to 5.5m people in the UK could be living with diabetes by 2030. 

The prediction is based on analysis of statistics from Public Health England and The Association of Public Health Observatories. It means that as many as 1-in-10 UK adults could be living with diabetes within a decade.  

Additional analysis carried out shows that up to 17 million people - 1-in-3 UK adults - could be at an increased risk of developing type 2 diabetes by 2030, unless there's commitment from the governments of the UK to urgently invest in diabetes care and prevention. 

It is known that there's been progress in diabetes care, such as the hundreds of thousands of people who have been supported by the NHS Diabetes Prevention Programme. But we need more action to stop our prediction from coming true. 

That's why Diabetes UK are calling on the UK Government to: 

  • Make more funding available to enable more people to avoid a diagnosis of type 2 diabetes through increasing access to proven preventative measures, such as the NHS Diabetes Prevention Programme 
  • Support far more people diagnosed with type 2 diabetes to go into remission where possible 
  • Improve access to weight management services  
  • Ensure that everyone has the access to the care and diabetes checks they need – including tackling the backlog – as we move out of the pandemic. 

The effects of the pandemic are still being felt in diabetes care. Millions of people with type 1 and type 2 diabetes haven't had vital health checks when they needed them, and thousands of diagnoses of type 2 diabetes have been delayed or missed. 

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Original source: Diabetes UK

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Why women may wait decades for an ADHD diagnosis

Gender bias is leaving many women with attention deficit hyperactivity disorder undiagnosed, leading psychologists are warning.

The prevailing stereotype ADHD affects only "naughty boys" means at least tens of thousands in the UK, it is estimated, are unaware they have the condition and not receiving the help they need.

"I used to tell doctors and therapists all the time, 'You've got to make this constant noise in my head stop. I can't think. I can't sleep. I can't get any peace,' but this was always dismissed as anxiety or women's problems," Hester says.

Diagnosed with depression at 16, she spent much of her 20s unsuccessfully battling to be referred to a psychiatrist.

And she constantly felt she was not reaching her true potential.

Hester was finally diagnosed with ADHD in 2015, aged 34, and only, she says, because her husband had discovered he had the condition, a year earlier.

His diagnosis took 12 months.

"At no point did anyone say to Chris, 'This sounds like anxiety,' or 'Have some tablets,'" Hester says. "He was taken seriously."

"Whereas with me, I was on the doctor's radar from the age of 16.

"Bluntly, it took so long for me to be diagnosed because I'm a woman."

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Source: BBC News, 26 October 2021

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