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Poorly controlled asthma 'increases Covid risk for children'

Children with poorly controlled asthma are up to six times more likely to be admitted to hospital with Covid than those without the condition, research has suggested.

Scientists involved in the study said 5 to 17-year-olds in this category should be considered a priority for Covid vaccination. About 9,000 children in Scotland would benefit from the jab, researchers said.

Vaccines are offered to the over-12s in Scotland, but not to younger children.

In the study, poorly controlled asthma was defined as a prior hospital admission for the condition, or being prescribed at least two courses of oral steroids in the last two years.

Prof Aziz Sheikh, director of the University of Edinburgh's Usher Institute and Eave II study lead, said: "Our national analysis has found that children with poorly controlled asthma are at much higher risk of Covid-19 hospitalisation.

"Children with poorly controlled asthma should therefore be considered a priority for COVID-19 vaccination alongside other high-risk children."

Prof Sheikh said it was important to consider both the "risks and benefits" from vaccinations.

He added: "Emerging evidence from children aged five and older suggests that COVID-19 vaccines are overall well-tolerated by the vast majority of children."

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Source: BBC News, 1 December 2021

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Unsupportive Government ‘indirectly puts GP patient lives at risk’

A lack of support for general practice is indirectly putting patient lives at risk, amid escalating abuse in GP practices, the England LMCs conference has heard.

A debate around abuse saw 99% of conference delegates agree that ‘the abuse of primary care staff directly affects patient care and puts patient safety at risk’.

And 98% agreed that ‘when Government and [NHS England] choose not to support NHS staff, they directly affect patient safety and knowingly put lives at risk’.

The conference also voted to ‘demand that healthcare policy is decided based on high-quality evidence on population health, and not the whims of a handful of vitriolic media’, with the vote unanimous on the topic.

Speaking in the debate, which focussed on GP abuse and wellbeing, Dr Abel Adegoke of Wirral LMC told delegates that the NHS "runs on the blood of GPs"

He said: "About four weeks ago, my younger sister was being buried and I had to watch via Zoom because that was taking place in Nigeria – yet I was still seeing patients. That was the day I felt so sad about being a GP because despite that sacrifice, I was still abused by a patient who wanted to be seen urgently for an absolutely non-urgent condition."

"We are being taken for granted."

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Source: Pulse, 30 November 2021

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Acutely unwell prisoners left in ‘limbo’ due to lack of mental health beds

People needing acute mental health treatment are being left in prison for extended periods, HSJ can reveal.

Figures HSJ obtained under the Freedom of Information Act show that 3,111 patients were transferred from prisons to mental health facilities between 2018-19 and 2020-21. A total of 481 (15%) of the transfer took more than 14 days from the date the mental health casework section received an application for transfer to the date the transfer took place.

Across these three years, 167 transfers (5%) took more than 28 days. The longest wait for transfer was 161 days, which happened in 2018-19. However, the average number of days taken to transfer a patient has remained consistent at between 10 and 11 days.

Until the summer, NHS England’s guidance recommended a 14-day time limit for transfers of patients from prisons to mental health facilities.

In June 2021, NHSE published new guidance which recommended a 28-day time limit between a person first being referred for inpatient assessment and being admitted to a mental health facility. The timeline, which consists of two sequential 14-day periods, says medical reports should be “completed to be sent to the [MHCS]” between days 15 and 25, while the MCHS should approve and issue a warrant and admission should take place before day 28.

Sophie Corlett, of mental health charity Mind, said: “Nobody who has been assessed as needing specialist inpatient care should be left for extended periods of time in prison, as it’s a completely inappropriate setting for anyone in crisis… When people are a risk to themselves, it’s crucial there are enough staff and beds available to make sure they are cared for in a safe and therapeutic environment.”

Bethan Roberts, British Medical Association forensic and secure environments committee interim chair, said: “A prisoner who is mentally unwell and cannot be adequately cared for in a prison should… be transferred to a forensic mental health unit as soon as possible."

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Source: HSJ, 1 December 2021

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One percent of the population make up a third of ambulance call outs

The British Red Cross have found that that 367,000 people, which equates to around one percent of the population in England attend A&E up to 346 times a year.

These figures accounted for nearly one in three ambulance call outs and over one in six A&E visits.

The research analysis found that a fifth of those repeatedly attending A&E lived alone and also often lived in deprived areas of the country.

Frequent users also accounted for 29% of all ambulance call outs and 16% of non-minor-injury A&E visits.

The data also revealed that people in their twenties were more likely to repeatedly visit A&E than any other age category.

Mike Adamson, chief executive of the British Red Cross, said: 'High intensity use of A&E is closely associated with deprivation and inequalities - if you overlay a map of frequent A&E use and a map of deprivation, they're essentially the same.'

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Source: National Health Executive, 29 November 2021

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Watchdog 'very concerned' about safety of patients at Greater Manchester Mental Health Trust where 3 young people died

A watchdog is "very concerned" about the safety of people using the services of Greater Manchester Mental Health NHS Trust.

The damning report says inspectors found there was not always enough nursing staff and that permanent staff did not feel safe if bank or agency workers were used as they didn't have the relevant training.

It follows an unannounced inspection in September by the Care Quality Commission "due to on-going concerns about the safety of services".

Three young patients died in nine months at Prestwich Hospital, one of the Trust's units.

A campaign group and the families are campaigning for a full investigation into those cases by NHS England.

The CQC's two-day inspection of eight wards across five of the the Trust's seven sites found:

  • The service did not always have enough nursing staff, who knew the patients or received basic and essential training to keep patients safe from avoidable harm.
  • The environment on Poplar ward (Park House) was not clean on the first day of inspection and space on the ward was limited for patients.
  • It was not clear that immediate concerns or learning from incidents was shared across the locations, although local learning and reviews were taking place.
  • The wards did not all have up to date and recently reviewed ligature risk assessments. Staff on two wards could not locate the ligature risk assessments at the time of the inspection.

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Source: Greater Manchester News, 26 November 2021

 

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Precautionary recall of blood pressure drug

A total of 44 batches of irbesartan medicines are being recalled as a precaution from pharmacies and wholesalers due to presence of a chemical substance (AZBT) formed in the manufacturing process that is over the limit permitted for this product.

Irbesartan medicines treat high blood pressure to help prevent heart attacks and stroke. They are also used in patients with heart failure or those who had a recent heart attack.

Patients being prescribed these medicines should continue to take their medication since the risk from stopping is greater than the risk associated with short-term exposure to ABZT above its acceptable level from packs that they already have. Not treating a patient’s high blood pressure or heart problems may lead to harms, so patients should not stop their treatment unless clinically advised.

Laboratory testing has found that long-term exposure to this chemical substance (AZBT) above acceptable limits may potentially increase the risk of cancer, but there is no UK or international evidence that this substance has caused any harm to patients. 

Dr Alison Cave, MHRA Chief Safety Officer, said:

“Patient safety is at the heart of everything we do. This recall is a precautionary measure to prevent further exposure to AZBT above the acceptable safety limit. There is no evidence that this substance has caused any harm to patients. “It’s vitally important that you continue to take your medicine but do contact your doctor or pharmacist if you have any questions.

“It’s important that healthcare professionals check their stock to quarantine and return these batches to their supplier using their supplier’s approved process.

“The MHRA has asked companies to implement control measures to ensure that the levels of the substance are at or below the required level. We are also working with our international counterparts, given this is a global issue, to ensure the safety of patients.”

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Is the NHS in a position to handle the Covid Omicron variant?

How much of a threat does the emergence of Omicron pose to the NHS? Among hospital bosses there is a curious combination of apprehension that the new variant could lead to a surge in infections but also a battle-weary belief, born of negotiating the previous waves of Covid-19, that they can handle a potentially major rise in people seriously ill with the disease.

“Trusts are already making contingency plans for what would happen if there were to be a significant spread of this variant and it turned out that the symptoms and disease produced as a result is as serious as with the Delta variant,” said Chris Hopson, the chief executive of NHS Providers, which represents health service trusts in England.

He added: “If it turns out that this variant does evade vaccines then clearly the NHS will see a significantly higher caseload than it has at the moment.” Hopson pointed out that when the second wave was at its worst in January, hospitals in England were treating 34,000 people with Covid. On Monday, it was far, far fewer – just 6,094.

He said: “The chief executive of a district general hospital told me today that they were going through plans for how they would expand critical care capacity, and their general respiratory support capacity, because that’s exactly what they needed to do last January when we had over 34,000 cases.

A return to that number of hospital beds taken up with Covid patients would again force hospitals to cancel planned operations, he said. “If we get anywhere near the 34,000 cases we saw in January, then something would have to give. Elective surgery could be cancelled. As we saw last January, we would need to prioritise [care] on the basis of clinical need.”

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Source: The Guardian, 29 November 2021

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Covid inquiry must look at NHS 111 ‘mishandling’, bereaved families say

The inquiry into the government’s handling of the Covid pandemic should look at the “mishandling” of the NHS 111 service, families bereaved during the crisis have said.

In a scathing report, the COVID-19 Bereaved Families for Justice group said the service was inappropriately used to “alleviate the burden on the NHS” with “horrific” consequences.

The report, based on a survey of families, said many believed that the service “failed to recognise how seriously ill their relatives were and direct them to appropriate care”.

They argue that the service was also quickly “swamped” during the first wave despite the addition of 700 new call handlers, many of who were making life or death decisions with just 10 weeks training.

The phone line is one of a number of areas the groups want the government’s inquiry to cover. Other areas include No 10’s level of pandemic preparedness, particularly PPE shortages, as well as an investigation into the disproportionate impact on ethnic minority groups and those with disabilities.

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Source: The Independent, 30 November 2021

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Covid jab clinics held for people with learning disabilities

Two specialist Covid vaccination clinics for people with learning disabilities are to be held in Leicestershire.

Local health bosses said the sessions would provide a calm environment, longer appointment times and extra support.

They will take place at Loughborough Hospital later and at Leicester's Peepul Centre on 15 December.

Pre-booked visitors can receive their first, second or booster jabs.

Sam Screaton, learning disability vaccination clinical lead at the Leicestershire Partnership NHS Trust, said: "It is extremely important to us to ensure the Covid-19 vaccines and boosters are accessible to everyone.

"All staff working at these clinics will go the extra mile to ensure patients feel comfortable, calm and able to have the vaccine."

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Source: BBC News, 30 November 2021

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Closures and soaring waiting lists: crunch time for social care services

Social care services across England are “rapidly deteriorating”, with waiting lists soaring and councils struggling with care home closures, social services chiefs have warned.

Long-term waiting lists have almost quadrupled and 1.5m hours of necessary home care were not delivered in the three months to November, amid a deepening staffing crisis going into winter.

“Red lights are flashing right across our dashboard,” said Stephen Chandler, president of the Association of Directors of Adult Social Services (Adass), which ran a survey of 85 councils. “Older and disabled people are suffering.”

A survey of care workers by the trade union Unison also found that staff shortages meant people were “dying without dignity” and in some cases there were not enough staff to sit with people in their final hours. A third of those surveyed said staffing levels were “dangerously low”.

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Source: The Guardian, 29 November 2021

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Government does not fully understand risks of relaxing covid infection control

The government has been warned that changes to covid-related infection prevention and control guidance will not enable a ‘rapid’ increase in the NHS’ capacity to tackle the elective care backlog and could pose significant ‘risks’.

Trust leaders have been told they no longer have to segregate patients into separate pathways according to “high”, “medium”, or “low” risk of covid-19 in updated IPC guidance issued by the Department of Health and Social Care, NHS England and UK Health Security Agency.

Following this guidance means the treatment of every patient without symptoms of a respiratory illness will be subject to the same precautions – such as one, rather than two, metre physical distancing. This, in theory, could create more capacity to treat larger numbers of patients.

A subsequent letter from NHS England highlighting the changes said: ”This guidance supports efficient delivery of NHS services to meet wider patient needs, via the return to pre-COVID-19 social distancing and standard IPC measures for patients who do not have infectious respiratory diseases.”

However, NHS Providers chief executive Chris Hopson told HSJ that many trusts are currently losing between 10 and 20% of their capacity due to “essential” IPC measures, and would not be able to abandon this approach quickly. 

He said: “There is a conception in some people in central government’s minds that by having got this guidance changed, we are now going to see a rapid recovery of activity levels and we’ll be able to more successfully manage the infection risk. That’s what people need to be realistic about – there is a risk here."

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Source: HSJ, 29 November 2021

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UK health trusts suspend home birth services as midwives shortage deepens

A severe shortage of midwives has led to home birth services being closed or reduced by a number of hospital trusts across the UK, with pregnant women frequently left in limbo as to where they will be able to give birth.

The Observer has found more than 20 trusts that have had disrupted home birth services in the past three months. Eight confirmed their services remain suspended due to staff shortages. They include East Kent Hospitals, Swansea Bay University Health Board and NHS Dumfries and Galloway – all of which report that the situation is under constant review.

Home birth services at some trusts, such as Walsall Healthcare NHS Trust and University Hospitals of Derby and Burton, have been closed since August. Others have reopened after short suspensions or have written to expectant parents to say they cannot guarantee sending a midwife when there is high demand or staff shortages.

The findings come a week after midwives across Britain staged protests to call on the government to address the “crisis” in maternity care, with staff suffering from chronic burnout and stress.

Midwives are being driven out of the NHS by understaffing and fears they cannot deliver safe care, according to a recent survey published by the Royal College of Midwives (RCM).

Maria Booker, programmes director at the charity Birthrights, said: “Staffing pressures in maternity services are very real right now. But for many women the option to give birth at home is not a luxury but the only option that feels safe to them."

“Some know they will labour better at home while some do not want to visit hospital during a pandemic. Others have a had a previous traumatic hospital birth. We cannot just accept that home birth and other choices go out the window every time a maternity service is squeezed.”

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Source: The Guardian, 28 November 2021

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Mesh implant patients challenge government over surgery delays

Women requiring the surgical removal of mesh implants have said "very little" has happened since a landmark Scottish government announcement in the summer.

The pledge means patients can now receive free treatment from specialists in America and England. But campaigners said initial assessments in Glasgow were taking up to two years.

The Scottish government said it was working with NHS Specialist Services to improve waiting times.

Implant use was stopped in Scotland after hundreds of women were left with painful, life-changing side effects. In July, the Scottish government announced surgery and travel costs to Spire Health Care in Bristol and the Mercy Hospital in Missouri in the United States would be covered. The cost of each procedure is estimated to be £16,000 to £23,000.

Marian Kenny, who is waiting on surgery to remove a mesh implant. joined the protest outside the New Victoria Hospital and admitted she felt "deflated" by the lack of progress in recent months.

She told BBC Scotland: "For so much of this fight, we have been fighting to get it stopped and this is the only time we have been fighting for ourselves. We don't want to be guinea pigs any more."

Health Secretary Humza Yousaf acknowledged the pain, suffering and distress mesh survivors have been through.

He said he hoped to finalise contracts with the clinics in Bristol and Missouri "as quickly as we possibly can".

Mr Yousaf added: "I would hope to have an update relatively soon.

"I know they have been waiting too long and I promise them I don't want them to be waiting any longer than they have to."

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Source: BBC News, 24 November 2021

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Dying patients go without care as community nurses ‘on their knees’

Dying patients are going without care in their own homes because of a collapse in community nursing services, new data shared with The Independent reveals.

Across England a third of district nurses say they are now being forced to delay visits to end of life care patients because of surging demand and a lack of staff. This is up from just 2% in 2015. The situation means some patients may have to wait for essential care and pain medication to keep them comfortable.

Other care being delayed includes patients with pressure ulcers, wounds which need treating and patients needing blocked catheters replaced.

More than half of district nurses said they no longer have the capacity to do patient assessments and psychological care, in an investigation into the service.

Professor Alison Leary, director of the International Community Nursing Observatory, said her study showed the country was “sleepwalking into a disaster,” with patients at real risk of harm.

She said the situation was now so bad that nurses were being driven out of their jobs by what she called the “moral distress” they were suffering at not being able to provide the care they knew they should.

“People are at the end of their tether. District nurses are reporting having to defer work much more often than they did two years ago. What they are telling us is that the workload is too high. This is care that people don’t have time to do.”

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Source: The Independent, 29 November 2021

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Did bad vaccine advice cost Samantha Willis her life?

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

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

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

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

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

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

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

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Source: The Guardian, 23 November 2021

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Covid vaccines safe in pregnancy, data shows

The UK's Health Security Agency says its analysis of English data shows Covid vaccines are safe in pregnancy, reinforcing international evidence.

The agency found similar rates of stillbirths and preterm births for vaccinated and unvaccinated mothers.

Researchers say women should feel confident the jabs will help protect them and urge more to take them.

Their report shows just 22% of women who gave birth in August had had at least one jab.

Since mid-April, mothers-to-be have been offered the Pfizer-BioNTech or Moderna jab, with the second dose recommended eight weeks after the first. But women first eligible for vaccination were more likely to be older or have an underlying medical condition - putting them at higher risk of premature births, researchers say.

Meanwhile, studies suggest about one in five women admitted to hospital with the virus have their babies delivered early and some of these babies need special intensive care. And evidence suggests the risks of stillbirths are higher if a woman has Covid in pregnancy.

UKHSA immunisation head said the new information on safety was reassuring.

"Every pregnant woman who has not yet been vaccinated should feel confident to go and get the jab and that this will help to prevent the serious consequences of catching Covid in pregnancy," she said.

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Source: BBC News, 26 November 2021

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NHS race body commits to avoiding blanket terms such as ‘BAME’

An independent body set up by the NHS to tackle health inequalities has formally committed to never use blanket acronyms such as “BAME” after feedback that they are not representative.

The NHS Race and Health Observatory launched a four-week consultation with the public in July on how best to collectively refer to people from black, Asian and minority ethnic groups.

The Observatory said it has become the norm in public policy to use initialisms to refer to a “hugely diverse” group of people, but that renewed scrutiny has been spurred on by the Black Lives Matter movement.

It said terminology that “crudely conflates” different groups “does not just erase identities; it can also lead to broad brush policy decisions that fail to appreciate the nuance of ethnic inequality in the UK”.

Generic collective terms such as “BAME”, “BME” and “ethnic minority” are “not representative or universally popular”, the Observatory said after receiving responses from 5,104 people.

It found no single, collective umbrella term to describe ethnic groups was agreed by the majority of respondents.

The body had previously said it was committed to avoiding the use of acronyms and initialisms, but has now formalised this as one of five key principles it is adopting in its communications.

Where possible it will be specific about the ethnic groups it is referring to, but where collective terminology is necessary it will “always be guided by context and not adopt a blanket term”.

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Source: The Independent, 26 November 2021

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Mental health crisis referrals leap by almost 75%

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

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

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

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

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

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

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Source: HSJ, 25 November 2021

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Late diagnosis of breast cancer rises as NHS struggles in Covid crisis

Soaring numbers of women are being diagnosed with advanced breast cancer, undermining their chances of survival, because of Covid’s disruption of NHS care, a charity has warned.

The number of women being diagnosed with the disease at stage 4 is as much as 48% higher in some months than expected, with the pandemic to blame, says Macmillan Cancer Support.

At the same time, fewer women are being confirmed as having breast cancer at stage 1, when their chances of responding well to treatment and living longer are much higher.

Macmillan estimates that there is now a backlog of 47,300 people across the UK who have not yet been diagnosed with some form of cancer, as a direct result of Covid. They include people who could not access care in the usual way because many NHS services were scaled back, and also those who were too scared to seek help or did not want to add to the pressure the health service was already under. None have had a confirmed diagnosis of cancer, though some may be undergoing tests or screening.

Steven McIntosh, Executive Director of Advocacy and Communications at Macmillan Cancer Support, says:

“Nearly two years into the pandemic, there is still a mountain of almost 50,000 people who are missing a cancer diagnosis. Thousands more are already facing delays and disruption as they go through treatment. While hard-working healthcare professionals continue to do all they can to diagnose and treat patients on time, they are fighting an uphill battle. Cancer patients are stuck, waiting in a system that doesn’t have the capacity to treat them fast enough, let alone deal with the backlog of thousands who have yet to come forward.”

“The Government has promised an NHS Elective Recovery Plan. This must show how it will tackle spiralling pressures on cancer services. It has never been more crucial to boost NHS capacity to treat and support everybody with cancer, so people receive the critical care they need now and in the years to come.”

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Source: The Guardian, 26 November 2021

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Drug and alcohol treatment sees rise in deaths in England

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

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

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

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

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

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

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

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

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

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Source: BBC News, 25 November 2021

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Health regulator accused of moral corrupt

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

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

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

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

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

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

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

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

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

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Source: BBC News, 25 November 2021

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

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

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

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

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

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

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Source: The Guardian, 25 November 2021

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100 people held more than 20 years in ‘institutions’

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

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

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

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

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

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

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

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

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Source: BBC News, 24 November 2021

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

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

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

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

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Source: HSJ, 24 November 2021

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NHS Digital and NHSX to merge with NHS England

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

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

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

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

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

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

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

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Source: Digital Health, 22 November 2021

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