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HEE’s new £10m critical care workforce training package set for autumn roll-out

Health Education England (HEE) has announced that its new £10 million training programme, intended to ‘boost’ the critical care workforce, will be rolled out this autumn.

According to HEE, the funds it secured earlier this year will provide nurses and Allied Health Professionals with a ‘nationally recognised pathway’ to further their careers in Adult Intensive Care Units (ICUs).

Specialist training, delivered through a ‘blended learning package’ could help to strengthen the ICU workforce across England and will offer around 10,500 nursing staff the chance to undertake courses and ‘further their careers’.

There will be a focus on flexible training – enabling participants to balance family and caring commitments, as well as taking into account those who are unable to travel, when the roll-out of the programme begins.

The learning will be delivered by higher education institutions, Critical Care Skills Networks and acute trusts, and it is expected to take participants up to 12 months to receive the standardised qualification. It’s hoped that the programme could lead staff to career opportunities such as becoming a shift leader or clinical educator, or to lead on research.

Read full article here
Original source: Leading Healthcare News

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CDC publishes rates of COVID-19 cases, deaths by vaccine brand

The agency is now showing disease incidence among unvaccinated people, as well as those who received Johnson & Johnson, Pfizer, and Moderna vaccines.

The U.S. Centers for Disease Control and Prevention has published information on its COVID Data Tracker about rates of cases and deaths among fully vaccinated and unvaccinated people.  In August, according to the data, unvaccinated people had a 6.1 times greater risk of testing positive for COVID-19, and an 11.3 times greater risk of dying from the disease.  

Interestingly, the agency also breaks out case and death rates by vaccine product. In mid-August, at the peak of the latest wave, unvaccinated people made up the greatest percentage of COVID-19 cases, at an incident rate of 736.72 cases per 100,000 people.  Johnson & Johnson had the second-highest incidence rate, at 171.92 cases per 100,000.  Pfizer had the third-highest, at 135.64.  And Moderna had the lowest rate, at 86.28 cases per 100,000 people.  

The death rate mirrored the breakdown in terms of vaccine product and frequency, although the numbers were far lower across the board.  Again, at the peak in mid-August, the death rate among unvaccinated people was 13.23 in 100,000 people.   Rates for vaccinated people were dramatically reduced, at 3.14, 1.43 and 0.73 for Johnson & Johnson, Pfizer, and Moderna, respectively.  

When it came to age groups, peak case rates were highest among unvaccinated 12-17 year olds, followed by unvaccinated 30- to 49-year-olds. And 30- to 49-year-olds also had the highest case incidence among vaccinated people when broken down by age group, followed by fully vaccinated 18- to 29-year-olds.   Those older than 80 had the highest death rates among both unvaccinated and vaccinated individuals.  

The COVID Data Tracker site also includes integrated county views, forecasting and hospitalizations by vaccination status.  

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Original source: Healthcare IT News

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Trust’s directors scapegoated psychiatrist over patient’s death, tribunal finds

A mental health trust ‘scapegoated’ a psychiatrist over the death of a patient amid systemic issues, an employment tribunal has found.

Judges called the conduct of two senior directors — one of whom is a current NHS trust medical director — into question after ruling they had colluded to scapegoat Bernadette McInerney for issues that would have damaged the trust’s reputation.

Nottinghamshire Healthcare Foundation Trust was found unanimously to have unfairly sacked and victimised Dr McInerney, a former consultant forensic psychiatrist at Rampton secure hospital, in a decision published last week.

The judgement was critical of both Chris Packham, a GP at Rampton hospital, and NHFT’s then-executive medical director Julie Hankin, but it also strongly condemned the trust’s former executive director for forensic services Peter Wright. Dr Hankin is now medical director at Cambridgeshire and Peterborough FT.

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

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BMA urges GPs to move to 15-minute consultations and close patient list

The BMA has advised practices to immediately start offering consultations of 15 minutes or more; and apply to close their patient list, as part of the fightback against the Government’s new GP access plan.

It set out a range of measures GPs should take to protect their staff and patients and ‘prioritise’ core work amid pressure to return to pre-pandemic ways of working.

In an email bulletin sent to GPs on Friday, the BMA’s GP Committee said that practices ‘should not feel pressured to return to a traditional 10-minute treadmill of face-to-face consultations that are neither good for patients nor clinicians’.

It said: ‘Instead, they should offer patients consultations that are 15 minutes or more [and] apply to close the practice list to focus on the needs of existing patients.’

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Original source: Pulse

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GPs think older patients cannot handle health apps on phones

Over-55s are not being recommended useful health technology as GPs presume they cannot use a smartphone, say researchers

Older patients are being excluded from beneficial health technology because “ageist” doctors presume they cannot work a smartphone, research has suggested.
Experts have accused doctors of “stereotyping” older people as being incapable of using technology and warned patient safety was being put at risk by a failure to support them in using appropriate online health tools.
 
GPs typically recommend NHS-approved health apps to about one in 10 patients aged under 35 to help them manage their conditions between appointments, such as by reminding them to take medications or monitoring their symptoms. However, doctors recommend the same apps to just one in 25 patients over 55 and one in 50 patients over 65, according to research by the Organisation for the Review of Care and Health Apps (ORCHA), which assesses apps for the health service.
The same research found 55 per cent of over-55s would be happy to try using a health app if it was recommended, while nine in 10 over-55s and eight in 10 over-65s who have used a health app felt satisfied or very satisfied with the experience.
 
The NHS Long Term Plan states that patients should have access to “digital tools” to manage their health and studies have shown NHS-approved health apps can have clinical benefits.

Older people ‘will benefit from digital products’

However, Helen Hughes, the chief executive of the charity Patient Safety Learning, suggested ageist assumptions about older people’s technological ability meant they were missing out.
 
“The data suggests that older people maybe being stereotyped, with assumptions they won’t be computer literate,” she said. “Plenty of older people are tech savvy – or at least willing to learn – and will really benefit from being able to manage their health from home, using digital products. Older patients need to be offered technology solutions with support on how best to use them, if this is needed.”
 
She warned there was also “a significant patient safety issue” with the failure to advise patients about NHS-approved apps, as it left older patients at risk of inadvertently downloading one of the thousands of unreliable health apps available.

To read the full article (paywalled), click here
Original Source: The Telegraph

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Deaths of two children spark ‘urgent’ investigations at leading trust

  • Five serious incidents, including the deaths of two children, spark “urgent” investigations at specialist trust
  • Great Ormond Street Hospital FT has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery
  • Supplier says it followed the correct recall processes for the product

Five serious incidents, including the deaths of two children, have sparked ‘urgent’ investigations into the processes through which clinicians are alerted to potential safety concerns over medical products used on patients.

Great Ormond Street Hospital Foundation Trust has been investigating the incidents which happened between December 2020 and April 2021. The trust has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery. The glue, called Histoacryl, is produced by B. Braun Medical Ltd, and the company issued three separate “field safety notices”, relating to different batches of the product, in March and April this year. The company has stressed that it followed the correct recall processes throughout.

According to a report to GOSH’s public board meeting on 29 September, Histoacryl has been used for the endovascular treatment of brain arteriovenous malformations for more than 30 years, but earlier this year batches of the product were identified as hardening less rapidly than expected. The trust told HSJ in a statement: “A comprehensive serious incident investigation has been carried out to determine the impact of the faulty glue on all patients treated with it.

“The investigation found that whilst the passage of glue through the intended vessel may have been contributory in some instances of harm, it was unlikely to be the sole or main factor. “Both patients who died had serious and complex medical conditions and the procedure to correct these always carries a high degree of risk which is discussed extensively with the families before any treatment takes place.”

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

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HealthWatch's response to the annual CQC 'State of Care' report

The Care Quality Commission (CQC) has published State of Care. The report, which draws on the experiences of care people have shared with Healthwatch England, has found that health and social care services face some highly concerning challenges, including:

  • A workforce drained in terms of resilience and capacity, especially in social care, where the staff vacancy rate has risen;
  • A rising number of people seeking emergency care, leading to unacceptable waiting times; and
  • Tackling the health inequalities that the COVID-19 pandemic has exacerbated.

The report welcomes the additional funding that the Government has allocated to help the NHS and social care address their challenges. However, CQC has called for the extra investment to be used to:

  • Develop new ways of working and don’t just prop up existing approaches and plug demand in acute care; and
  • Improve the training, career development and terms and conditions of social care workers to help attract and retain more staff.

CQC has also recommended that the short-term funding - currently in place to help discharge patients who are no longer in need of hospital care but may still require care services - be extended. 

The HealthWatch response

Responding, Sir Robert Francis QC, Chair of Healthwatch England said:

“During the pandemic, people have told us about the challenges they have faced. Whether this not being able to access dental care, problems using online GP services or being discharged from the hospital without the proper support. It’s great to see this report drawing so much on the experiences people have shared with us. 

“We urge Government to act on this report. The health and care system upon which we all depend is facing a hard winter, but, as this report makes clear, the longer-term picture is also challenging.

“The steps the CQC are recommending, like extending the extra funding to help people leave hospital safely and ensuring there is enough dental capacity, will help give services the breathing space they need to get through this winter.

“However, come spring we need to grasp the opportunity to build a better NHS and social care system. A system that tackles heath inequalities head-on, ensuring that no matter who you are or where you live, you can access high-quality care that meets your needs. A system that is sustainable, is designed round the needs of people and breaks perennial cycle of winter crises.”

Original source: HealthWatch
CQC report here

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NHS England denies claim eligible patients can’t use its Covid jab booster booking service

NHS England has said that there is no ‘widespread issue’ with the national booking system for Covid vaccinations, despite eligible patients claiming they have been unable to book their booster jabs.

It comes as Sajid Javid yesterday urged people to ‘come forward’ for their Covid vaccines if they are eligible and have not had an invite six months after their second jab, and the Government launched a new campaign to promote boosters and flu vaccines.

Daisy Cooper, liberal democrat MP for St Albans, said yesterday in the House of Commons: ‘Many of my constituents are desperate to get their third jabs and their boosters. The Minister said that if their invitation has not arrived, they can book on the national booking service or 119, but that is simply not working. 

‘When they get on to the national booking service, it says they are not eligible if they have not received an invitation letter. If they call 119, it is telling them it cannot override the system.’

Vaccines minister Maggie Throup assured Ms Cooper: ‘I will definitely look into that. If there is a problem in the system, we will get it fixed.’

But NHS England told Pulse: ‘There isn’t a widespread issue with the system not recognising people who are eligible.’

The NHS website currently says: ‘If you haven’t received an invite by 6 months and 1 week, you can try to book your appointment online without an invite.’

Patients have also taken to Twitter to complain about not being able to book Covid boosters, despite receiving invitations to do so.

Read full article here
Original source: Pulse Today

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English children put into care in Scotland amid lack of capacity

A LACK of capacity is meaning vulnerable kids in England are being put into foster care and children’s homes in Scotland, a new report has revealed. An investigation by the Competition and Markets Authority (CMA) into social care in the UK found that stakeholders are raising concerns about the practice.

They warned that young people are facing disruption at school after being placed into different legal and educational systems – all due to a lack of spaces near their home area. It could mean some kids from as far away as London are being placed into care in Scotland.

The investigation also revealed difficulties in Scotland placing children with disabilities or complex needs. And it found Scottish children in the care system were more likely to be separated from their siblings than their counterparts in England. The CMA reported that in England in 2019/20, 1400 (13% of all siblings in care) siblings were not placed according to their plan. In Scotland, there were 200 sibling groups separated after being placed into foster care - more than 20% of all sibling groups in foster care.

For the full article, click here
Original source: The National

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Adult inpatient survey 2020

This survey looks at the experiences of people who stayed at least one night in hospital as an inpatient.

The results show that, generally, people’s experiences of inpatient care were positive and overall differences between COVID-19 and non-COVID-19 patients were small, suggesting that care provided was consistent. Most people said they were treated with respect and dignity, had confidence and trust in the doctors and nurses that treated them and observed high levels of cleanliness.

Survey findings were less positive, however, for areas of care including people’s experiences of receiving emotional support, information sharing and hospital discharge.

For the detailed findings, click here
Original source: Care Quality Commission

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GPs to vote on industrial action over ‘name and shame’ reforms

GPs are set to be balloted on industrial action over controversial reforms proposed by health secretary Sajid Javid.

The “outraged” doctors in England have voted unanimously to reject the government’s plans at a British Medical Association (BMA) meeting.

The government wants to see GP surgeries ranked in league tables to “name and shame” those that do not carry out enough face-to-face appointments with their patients.

From early November, GPs will have to have their names and wages published if they earn an NHS salary of more than £150,000.

The BMA says that forcing GPs to publish their earnings “provides no benefit to patients or their care, yet will potentially increase acts of aggression towards GPs, will damage morale amongst the profession, and only worsen practices’ ability to recruit and retain GPs”.

GP surgeries will not be eligible for new funding if they fail to provide an “appropriate” number of in-person consultations. Patients will also be asked to rate their GPs via text message.

Mr Javid has insisted that his plans would improve patients’ access to primary care – but the union representing the GPs says it has been “left with no alternative” but to ballot over whether to take industrial action.

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Source: The Independent, 22 October 2021

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NHS hospital declares ‘critical incident’ as demand higher ‘than any time during pandemic’

A major hospital has declared a “critical incident” after a surge in demand saw more than 100 patients awaiting treatment in A&E and 25 ambulances queueing outside.

The Royal Cornwall Hospital Treliske, in Truro said “unprecedented” pressure this week is worse “than at any point during the pandemic.”

It urged “families, friends and neighbours” to collect any patients who are able to “to leave hospital sooner.”

Managers at Cornwall’s main hospital raised the operating level from OPEL4 — known as a ‘black alert’ — to an ‘internal critical incident’ to allow for greater cooperation to ease the crisis.

It comes as the government is under intense pressure to reimpose some COVID-19 measures amid a surge in cases, with many other NHS clinics and hospitals across the country facing similar pressure.

Allister Grant, medical director of the RCHT, said: “There is unprecedented demand on health and care services in Cornwall, more so this week than at any point during the pandemic.

“As a result, we have escalated our operational level from OPEL4 to an internal critical incident.

“Pressure will always be most visible at the Emergency Department where ambulances are waiting, and our priority here is to move people into wards as soon as we can.”

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Source: The Independent, 21 October 2021

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Cardiac arrest: Thousands of defibrillators unknown to 999 service

Tens of thousands of defibrillators across the UK risk being unusable because 999 call handlers do not know about them.

When someone has a cardiac arrest, ambulance staff can only direct bystanders to the nearest defibrillator if it is on a central register.

"That could be the difference between life and death," said Adam Fletcher, head of British Heart Foundation Cymru.

A campaign to register defibrillators on The Circuit has now been launched.

Survival rates are low in the more than 30,000 out-of-hospital cardiac arrests each year in the UK, according to the British Heart Foundation (BHF) - with fewer than one in 10 people surviving.

BHF said early CPR and defibrillation could double the chances of surviving and it was often down to 999 call handlers being aware that a defibrillator was nearby.

"If we don't know a defibrillator is there, we can't send somebody to get it, to potentially save somebody's life," said Carl Powell, the clinical support lead for cardiac care with the Welsh Ambulance Service.

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Source: BBC News, 22 October 2021

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Cancer patients face ‘perfect storm’ as Covid piles pressure on NHS

Progress in clearing the NHS cancer treatment backlog in England has gone into reverse amid high Covid cases and staff shortages, analysis suggests.

The NHS has been striving to catch up with the pandemic backlog of cancer care but the analysis by Macmillan Cancer Support of official data suggests the drive has recently suffered a setback, with growing numbers of potential cancer diagnoses missed.

Four key cancer measures have fallen back, with two dropping to their worst ever recorded level.

Figures published by NHS England, and analysed by Macmillan for the Guardian, show the number of patients starting treatment in August following a decision to treat fell to 25,800. The figure was above 27,000 in June and July. The proportion of patients who began treatment within one month of the decision to treat fell to 93.7% – the lowest percentage ever recorded.

Data published last week also shows that in August there was a record-high number of patients forced to wait for more than two months after an urgent referral from their GP before they started cancer treatment.

Macmillan said it was concerned that rising Covid hospitalisations were making it “even harder for the system to cope”. Efforts to tackle the backlog are also being hit by a shortage of cancer nurses, the charity said.

Steven McIntosh, the executive director of advocacy at Macmillan, said: “We know that many patients are entering an overstretched system that was on its knees even before the pandemic. This risks a perfect storm, as the system experiences a considerable influx of patients alongside an overwhelmed workforce struggling to provide the care and support that people urgently need.”

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Source: The Guardian, 22 October 2021

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Tackling inequalities often not a main priority in healthcare, says CQC

Tackling inequalities was “often not a main priority” for local health and care systems over the past year, the care regulator for England has said.

The Care Quality Commission (CQC) said the pandemic had exposed and exacerbated inequalities, and most services demonstrated some understanding of these.

But it found that tackling inequalities “was often not a main priority for systems, or strategies to identify and tackle health inequalities were not yet well established”. Issues included poor accessibility of information in different languages for some people, varying service provision and access, and a lack of understanding of how people’s individual characteristics affected the care they needed.

The regulator said an example of this was the specific needs of people with a learning disability from black and minority ethnic groups. It also flagged that an increase in remote or digital care could be a barrier to people who cannot access technology or do not feel comfortable doing so.

The report found inequalities had also been exposed by the coronavirus vaccine rollout, with take-up lower in all minority ethnic groups compared with in the white population, and variances according to levels of deprivation.

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Source: The Guardian, 22 October 2021

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NHS 111 'failed' teenager who died following delays

Failings by NHS 111 contributed to the death of an autistic teenager, a coroner has ruled.

Hannah Royle, 16, suffered a cardiac arrest as she was driven to hospital by her parents after a 111 algorithm failed to notice she was seriously ill.

A coroner said her death had exposed a risk people were being misled about the capability of the system and its staff.

An NHS spokesperson said it would act on the findings and learnings "where necessary".

Hannah's father Jeff Royle said he regretted dialling 111 and wished he had taken his daughter straight to hospital.

"I feel so dreadful, that I have let her down and she has been let down by the NHS," he said.

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Source: BBC News, 20 October 2021

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Social care: Staff shortages will leave many without help

There will be "a tsunami" of people without the care they need this winter unless staff shortages are tackled, England's care watchdog is warning.

Social care staff are "exhausted and depleted," says Care Quality Commission (CQC) chief executive, Ian Trenholm.

In a report, the CQC urges immediate work to address the problem of rising numbers of unfilled care sector jobs.

On Thursday, the government announced an extra £162.5m to boost the adult social care workforce.

This is in addition to £5.4bn earmarked for social care over the next three years from the government's health and social care levy, which already includes £500m to be spent on the workforce.

The CQC welcomes the money but has a warning: "It must be used to enable new ways of working that recognise the interdependency of all health and care settings, not just to prop up existing approaches and to plug demand in acute care."

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Source: BBC News, 

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Slow rollout of third doses ‘endangering immunocompromised patients’

The government’s failure to quickly roll out third doses of the Covid vaccine to clinically vulnerable people and those with weakened immune systems is endangering thousands of lives, patient groups and experts have warned.

Immunocompromised individuals currently account for one in 20 Covid patients being admitted to intensive care, according to a new analysis by Blood Cancer UK.

These people are less able to mount an immune response after two doses, so are therefore being offered a third to keep them protected. This is separate from the ongoing booster programme, applicable to all over-50s and health care workers.

However, a recent Blood Cancer UK survey suggested that less than half of people with blood cancer, who make up about 230,000 of the 500,000 immunocompromised people in the UK, had been invited to receive their third dose by the second week of October.

Other clinically vulnerable people have reported struggling to book an appointment via their GP practices after being told by NHS England to come forward for a third vaccine dose.

With the situation in Britain reaching a “tipping point”, charities and scientists are fearful the number of immunocompromised in intensive care could further worsen in the weeks to come if they remain unable to access booster jabs.

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Source: The Independent, 21 October 2021

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UK launches new system to achieve 100% clinical trial registration

Clinical trials run in the UK will be automatically registered from 2022, the country’s Health Research Authority has announced.

The new system seeks to ensure that every single clinical trial with be listed on a trial registry from the outset. UK researchers have been formally required to register trials since 2013, but that rule was never enforced, and many trials remained unregistered.

Trial registration is a key pillar of clinical trial transparency. It helps scientists to gain an overview of who is currently researching which treatments, preventing needless duplication of medical research efforts . In addition, because investigators have to specify in advance what exactly they will be measuring, trial registration supports research integrity by discouraging post hoc statistical shenanigans and evidence distortion.

While there are various rules and regulations around trial registration, no other country currently enforces these nationwide.

The new trial registration system forms part of the wider UK national Make it Public strategy, which aims to ensure that every single clinical trial run in the UK is registered and makes its results public.

The strategy was developed in the wake of a 2018-2019 parliamentary enquiry into clinical trial transparency.

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Source: TranspariMED, 20 October 2021

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BMA says government is ‘wilfully negligent’ for ruling out Plan B despite Covid surge

The government is being “wilfully negligent” by not introducing measures to suppress the recent rise in coronavirus cases, the chair of the British Medical Association (BMA) has said.

Dr Chaand Nagpaul made the comments after the health secretary ignored NHS leaders’ pleas for the implementation of ‘Plan B’, which could see the return of mandatory mask wearing in indoor spaces and the need to work from home where possible.

Speaking at a No 10 press conference on Wednesday afternoon, Sajid Javid said the current pressure on the NHS was not “unsustainable”, noting that the contingency plan would only be introduced if hospitals were at risk of being “overwhelmed”.

However, Dr Nagpaul disagreed with the minister’s assessment, suggesting that the NHS was already reaching breaking point and that the government should follow through on its promise to protect the health service.

“By the health secretary’s own admission we could soon see 100,000 cases a day and we now have the same number of weekly Covid deaths as we had during March, when the country was in lockdown,” he said.

Dr Nagpaul described the government’s decision not to take further preventative action as “wilfully negligent”, branding the current rate of coronavirus infections and deaths as “unacceptable”.

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Source: The Independent, 21 October 2021

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Clapped Out: Is the NHS Broken?

Eighteen months into the worst pandemic in a century, this hard-hitting Dispatches special travels the country asking some tough questions about the performance of our much-loved NHS.

Watch programme (you will need to sign in)

Source: Channel 4, 18 October 2021

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Gene silencing medicine transforms crippling pain

An innovative type of medicine - called gene silencing - is set to be used on the NHS for people who live in crippling pain.

The drug treats acute intermittent porphyria, which runs in families and can leave people unable to work or have a normal life. Clinical trials have shown severe symptoms were cut by 74% with the drug.

While porphyria is rare, experts say the field of gene silencing has the potential to revolutionise medicine.

Sisters Liz Gill and Sue Burrell have both had their lives turned around by gene silencing. Before treatment, Liz remembers the trauma of living in "total pain" and, at its worst, she spent two years paralysed in hospital. Younger sister Sue says she "lost it all overnight" when she was suddenly in and out of hospital.

Both became used to taking potent opioid painkillers on a daily basis. But even morphine could not block the pain during a severe attack that needed hospital treatment.

Gene silencing gets to the root-cause of the sisters' disease rather than just managing their symptoms. Their porphyria leads to a build-up of toxic proteins in the body, that cause the physical pain. Gene silencing "mutes" a set of genetic instructions to block that protein production.

Both had been taking the therapy as part of a clinical trial and are still getting monthly injections.

The National Institute for Health and Clinical Excellence (NICE), which approves drugs for use in England, said the therapy "would improve people's quality of life" and was "value for money".

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Source: BBC News, 21 October 2021

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Three in five Australian GPs say vaccine rollout changes among biggest Covid challenges

Almost three out of five GPs reported managing patient expectations about vaccinations to be one of the most challenging issues of the pandemic, with multiple changes to vaccine eligibility requirements leaving many people confused and overwhelmed, the president of the Royal Australian College of General Practitioners, Dr Karen Price, said.

In her foreword to the college’s Health of the Nation report, published on Thursday, Price said: “Unfortunately, some of these patients took their frustrations out on general practice staff”.

“Differing eligibility requirements across jurisdictions added to the strain.”

Schools should stay open as greatest risk of Covid transmission is in households, research finds

The report is published annually and provides an insight into the state of general practice in Australia. It includes the findings of a survey of 1,386 GPs between April and May, of which 70% were in major cities, 20% inner-regional, 8% outer‐regional, and 2% remote and very remote.

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Source: Guardian, 21 October 2021

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Deaths among the double vaccinated: what is behind the Australian statistics?

On Tuesday, there were 356 COVID-19 patients being treated in intensive care wards throughout Australia. Of those, 25 were fully vaccinated.

While the data points to the extraordinary efficacy of COVID-19 vaccines in preventing people from becoming severely unwell, being hospitalised and dying, it does raise the question: why do a small number of people become seriously ill and, in rare cases, die, despite being fully vaccinated?

An intensive care unit staff specialist at Nepean hospital in Sydney, Dr Nhi Nguyen, said those who are fully vaccinated and die tend to have significant underlying health conditions. Being treated in intensive care, where people may be on a ventilator and unable to move, added to any existing frailty, especially in elderly people, she said.

“If we think about intensive care patients in general, whether they are there due to COVID-19, pneumonia or any other infection, we know that those who have underlying disorders, those who are frail, and those with co-morbidities will have a higher risk of dying from whatever the cause of being in intensive care is,” she said.

“Being fully vaccinated against Covid protects you from getting severe disease, yes, but it doesn’t completely protect you from getting Covid. So if you are someone with chronic health conditions, what might be a mild disease or mild infection in a young person or a person who is in good health, will have a greater impact on you.”

She said this was why the Australian Technical Advisory Group for Immunisation (Atagi) had recommended boosters for those people who are severely immunocompromised. On Wednesday the government said it intended booster shots to be rolled out to the aged care sector within weeks, and to be available to the whole population by the end of the year.

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Source: The Guardian, 20 October 2021

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Trainee doctors 'scared to come to work'

Some trainee doctors and consultants at one Welsh health board are "scared to come to work", a report has found.

A report by the Royal College of Physicians (RCP) described "frightening experiences" staff faced at Aneurin Bevan University Health Board. Chronic understaffing and excessive workloads at the Grange hospital in Cwmbran were causing "very serious patient safety concerns", it added.

The Health Board said it had taken the findings of the report very seriously.

The report, obtained by BBC Wales, said that some trainee doctors and consultants were worried about working in case they lost their licence to practise. It also said the problems had caused some consultants to feel demoralised and on the brink of leaving.

One trainee told the authors of the report: "On one overnight shift, I treated a four-year-old with seizures. The ambulance took six hours. Colleagues treated an 18-month-old with burns. Lots of kids come in with respiratory distress. Paediatric cases are not uncommon. We've treated stabbing victims. Colleagues delivered a baby earlier in the minor injuries unit. These things shouldn't happen at all."

Another trainee said: "There's so much patient movement with [this] model. I recently sent someone from Nevill Hall to the Grange to get a scan, then to the [Royal] Gwent to get a follow-up procedure, then back to Nevill Hall.

"That's three bed moves, three ambulance crews and three medical people dealing with the same patient. It's extremely inefficient."

And another added: "I worry about the safety of the patients coming into this hospital."

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Source: BBC News, 

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