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GPs in England may stop monitoring vulnerable patients

Ministers may allow GPs in England to halt regular monitoring of millions of patients with underlying health problems as part of the urgent new blitz on delivering Covid booster jabs.

Sajid Javid and NHS bosses are locked in talks with GP representatives at the British Medical Association (BMA) about relaxing rules which mean family doctors undertake checks on people with diabetes, high blood pressure and other conditions that mean they are at higher risk of having a heart attack or stroke.

It came as the health secretary announced the government has secured contracts to buy 114m more vaccine doses for next year and 2023. The deals, accelerated in the wake of the Omicron variant, will see the UK purchase 54m more Pfizer/BioNTech jabs and 60m from Moderna to “future-proof” the inoculation programme, Javid said.

The BMA, the doctors’ union, has been lobbying Javid for months to suspend or scrap the Quality Outcomes Framework (QOF), which it says is “bureaucratic” and interferes with GPs’ right to judge how they care for patients.

Officials with knowledge of the talks told the Guardian that those involved spent much of Tuesday discussing the suspension of part or all of the requirements under QOF. “They’re talking about a partial suspension of QOF. But they may well just bin it,” one said.

However, sources stressed that ministers are nervous about approving a move that could lead to claims that vulnerable patients could see any deterioration in their condition go undetected by GPs.

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Source: The Guardian, 1 December 2021

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Dental patients 'might never' get 6-month check-ups again

Dentists may never catch up with the backlog of patients waiting for check-ups, a leading dentist has warned.

Dr Russell Gidney said around 6,000 of his patients had not been given a routine check-up in the past year because of Covid restrictions.

NHS Wales figures show courses of dental treatment dropped by over three quarters in 2020-21. The Welsh government said dental services would get an extra £3m this year to support pandemic recovery.

Dr Gidney said fatigue among colleagues and recruitment problems threatened the return of regular appointments.

At his practice in Chepstow, Monmouthshire, he said check-ups have not been going ahead because patients who need urgent treatment were prioritised. 

Dentists are limited in number of patients they treat because of increased safety measures - such as wearing more PPE and cleaning between patients.

New operating procedures were announced last week, relaxing the safety measures for patients who show no signs of respiratory illness, such as colds and flu. But Dr Gidney said although new guidelines may increase patient volumes, they will "barely make a dent" into the "unprecedented backlogs".

Wales' Health Minister Eluned Morgan said there have been "long-standing issues" with access to dentistry, due to practices experiencing difficulties with recruitment and retention of dentists.

She said these issues were "impacting on the provision of NHS dental services".

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Source: BBC News, 2 December 2021

 

 
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HSIB launches national investigation into ambulance delays

The national patient safety watchdog has launched an investigation into the “significant patient harm” caused by ambulances being forced to wait with patients outside of A&E.

The Health and Safety Investigation Branch (HSIB) has confirmed it intends to launch an investigation after it received several alerts expressing concerns over the issue of ambulance delays this year.

The investigation comes after The Independent revealed 160,000 patients had either died or come to harm as a result of delayed ambulance response times during 2020-21, which were being driven by delays in paramedics being able to hand over patients to hospitals.

The damning report, from the Association of Ambulance Chief Executives, included examples of severely ill patients not being treated properly, being forced to go to the toilet in ambulances, and being denied food and drink, as well as antibiotics and fluids.

There have been multiple reports of patients dying while waiting for ambulances or while waiting outside of A&Es on the back of ambulances.

In a statement to The Independent, HSIB said: “We recognise that handover delays pose a serious safety risk, potentially leading to significant patient harm and impacting on the wellbeing of NHS staff. We welcome the review by AACE as they have provided detailed insight and highlighted key safety concerns. HSIB has already received several referrals expressing similar concerns, which will be taken forward to a national investigation. We will work with AACE and others across the NHS to provide systemic safety learning to help address the challenges created by handover delays.”

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Source: The Independent, 2 December 2021

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Race watchdog says trusts must be held to account for progress on health inequalities

Efforts to end health inequalities should be ‘in the mix’ of metrics used to determine the NHS’ progress against key performance targets, say race inequality experts.

In an exclusive interview with HSJ, NHS Race and Health Observatory (RHO) director Habib Naqvi said organisations’ performance on the issue should be scrutinised by an external body to ensure they are held accountable and “not marking their own exam answer”.

It comes as the RHO publishes a report that warns the appointment of health inequalities leads across the NHS risks becoming “tokenistic” if they are not adequately supported and held accountable.

The report by The King’s Fund think tank has recommended several actions to prevent the introduction of board-level leads from becoming a “hollow gesture”.

In August 2020, NHS England asked all NHS organisations to have a named executive board member responsible for tackling inequalities by October that year. The RHO estimates there to be more than 450 of these named leads across the country.

The report welcomed this but added “frameworks” of support and accountability should exist to “empower individuals and motivate change”.

The recommendations include putting inequalities on an “equal footing” with key performance metrics, as well as a long-term policy focus that puts addressing inequalities “at the heart of system development”.

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Source: HSJ, 1 December 2021

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Elizabeth Dixon: Lessons not learned after baby death cover-up, says family

The family of a baby who died after errors in her care have criticised the failure of the NHS to learn lessons.

Elizabeth Dixon died due to a blocked breathing tube shortly before her first birthday and a subsequent independent investigation found a 20-year cover-up.

A year on, Elizabeth's mother Anne told the BBC: "My daughter has not been a catalyst for change."

The Department of Health said it was working on the report's recommendations and will publish "a full response".

Elizabeth Dixon, known as Lizzie, was born prematurely at Frimley Park Hospital, in Surrey, in December 2000. But a series of errors by the hospital and by Great Ormond Street Hospital, which took over her care shortly after birth, left Elizabeth with brain damage and needing to breathe through a tracheostomy. She was further let down by Nestor Primecare, a private nursing agency, which was hired to support her parents when Elizabeth returned home. She died 10 days before her first birthday.

An official investigation, published last year, found a "20 year cover-up" by health workers, with some of those involved described as "persistently dishonest".

"I would have expected them to take it seriously," Mrs Dixon said in response to the lack of action.

She believes that if a similar incident happened today, there would be a danger it would also be covered up.

"That's the default option - if its bad enough, they'll cover up," she said.

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Source: BBC News, 1 December 2021

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Israeli doctor believes he caught Omicron variant of Covid in London

A doctor who was one of the first people in the world to become infected with the Omicron variant says he believes he caught the virus when he was in London for a major medical conference attended by more than 1,200 health professionals.

The disclosure from Elad Maor will raise fears that the variant may have been in the UK much earlier than previously realised – and that other medics could have been exposed to it too.

In an exclusive interview with the Guardian, Maor, a cardiologist at Sheba Medical Centre near Tel Aviv, described how he returned to Israel on 23 November after the three-day meeting at ExCeL London, a large convention centre in Newham, east London. He began experiencing symptoms within days, and tested positive on 27 November.

The time from exposure to symptom onset (known as the incubation period) is thought to be up to 14 days, though symptoms typically appear within five days of exposure.

Maor has so far shown mild COVID-19 symptoms, including a fever, muscle ache and a sore throat.

The revelation will raise fresh questions about how early the new variant may have been present in the UK and Europe. Governments around the world are urgently scouring databases for recent cases of Covid infections, screening travellers and decoding the viral genomes of the new variant as they try to measure how far it has spread and where it originated.

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Source: The Guardian, 1 December 2021

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Mid and South Essex NHS Foundation Trust told it must improve

Changes must be made across services at one of England's biggest NHS trusts following its first wide-ranging inspection, a health watchdog said.

Mid and South Essex NHS Foundation Trust - which runs Basildon, Southend and Broomfield hospitals - has been rated as "requires improvement".

The Care Quality Commission (CQC) turned up unannounced after concerns over standards were raised.

Philippa Styles, the CQC's head of hospital inspection, said they "found a mixed picture" of positive improvements and areas of concern.

"Following the trust's formation in 2020, leaders should now be able to work together effectively to ensure care is consistent across all services," she said.

"I recognise the enormous pressure NHS services are under... and that usual expectations cannot always be maintained, especially in the urgent and emergency department, but it is important they do all they can to mitigate risks to patient safety."

The report said:

  • Patients had not always been protected from harm.
  • Staff had not all received mandatory training.
  • There had been nine "never-should-happen" medical events.
  • Records were sometimes inaccurate and not kept securely.
  • Nursing and medical staffing was a "challenge across the trust", with shifts regularly below planned staffing numbers.
  • There had been a high number of whistle-blowers raising concerns.

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Source: BBC News, 1 December 2021

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Up to 740,000 cancer cases needing urgent GP referrals could have been missed since first lockdown

The NHS may be missing more than 9 million referrals, while patients face a “postcode lottery” for cancer treatment and routine operations, a parliament watchdog has warned.

Millions of patients have either avoided or been unable to obtain healthcare during the pandemic leaving the NHS with a potential unknown backlog of operations, which could push the national waiting list to 12 million by 2025.

A report from the government’s National Audit Office today also warned patients across England are facing a postcode lottery in terms of waits with some hospital waiting lists far larger than others following the pandemic.

Eve Byrne, head of campaigns and public affairs, at Macmillan Cancer Support, said: “This report confirms what we hear day in, day out from people living with cancer. Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that is only set to worsen without urgent action.

She said the government’s plan to tackle operations backlog must be backed up by steps to ensure enough nurses staff.

“Without these critical pieces of the puzzle, we risk increasing numbers of people facing later diagnoses, poorer care and potentially worse chances of survival. This has to change,” she added.

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Source: The Independent, 1 December 2021

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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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