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How is the ADHD medication shortage in the UK affecting people?

ADHD patients around the UK are finding they can't get hold of medication since a national shortage was announced.

Three different medicines are affected, and the government says some supply issues could last until December.

The Department for Health and Social Care (DHSC) says "increased global demand and manufacturing issues" are behind the shortages.

Medication helps to manage symptoms, which can include difficulty concentrating and focusing, hyperactivity and impulsiveness.

Dr Saadia Arshad, a consultant psychiatrist, who specialises in diagnosing and treating people with ADHD.

She says the shortage of medication is "not a new issue, but it's a recurring one".

Dr Saadia says suddenly stopping meds can lead to patients "feeling jittery, finding it difficult to pay attention, staying focused and feeling restless".

Even though she understands the shortage can be worrying, Dr Saadia says it's important that people don't take measures into their own hands.

"These medicines can be quite potent and the response to medication for two individuals is not the same," she says.

"So please do not take any action without discussing it with your clinician."

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Source: BBC News, 6 October 2023

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NHS trust and ward manager appear in court charged with manslaughter of mental health patient

An NHS trust and ward manager have appeared in court charged with the manslaughter of a 22-year-old mental health patient who died in hospital in July 2015.

Alice Figueiredo was found dead at Goodmayes Hospital in east London, and an investigation into her death was opened in April 2016. 

The Crown Prosecution Service (CPS) authorised the Met Police to charge North East London NHS Foundation Trust (NELFT) with corporate manslaughter last month following a five-year investigation.

It is just the second NHS Trust to face manslaughter charges. The Trust is additionally charged with an offence under section three of the Health and Safety at Work Act in connection with mental health patient Ms Figueiredo's death.

Ward manager Benjamin Aninakwa also faces a charge of gross negligence manslaughter and an offence under section seven of the Health and Safety at Work act.

NELFT is just the second ever NHS Trust believed to have been charged with corporate manslaughter, after Maidstone and Tunbridge Wells Trust was charged over the death of a woman who underwent an emergency Caesarean in 2015.

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Source: Mail Online, 6 October 2023

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Physician associates told they must not call themselves doctors

Staff without medical training who fill gaps in the NHS workforce must tell patients they are “not a doctor” when introducing themselves, under new guidance.

The advice has been issued to “physician associates” (PAs), a type of clinical role that requires less training than doctors receive, amid a row over their use in the NHS.

PAs complete a two-year postgraduate qualification, but no medical degree, and can diagnose and treat patients. They can work in A&E or GP surgeries.

NHS England has set out plans to expand the number of PAs to deal with staff shortages, with a workforce of 10,000 PAs wanted over the next decade. The plan has been met with opposition from doctors’ leaders, who say the growing use of PAs instead of fully qualified doctors is leading to missed diagnoses and deaths.

Guidance published by the Faculty of Physician Associates, a part of the Royal College of Physicians, said that PAs must not mislead patients into thinking they are doctors.

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Source: The Times, 6 October 2023

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Mental healthcare in England is a national emergency, say hospital bosses

Mental healthcare in England has become “a national emergency”, with “overwhelmed” services unable to cope with a big post-Covid surge in people needing help, NHS bosses say.

Care is so stretched that thousands of people undergoing a mental health crisis are having to be admitted every year to acute hospitals, even though they are not set up to deal with them.

Hospital bosses claim mental health in England has been “forgotten” by ministers who are giving priority to tackling the record 7.7m-strong care backlog, access to GPs and ongoing NHS strikes.

“Mental health has slipped down the government’s set of priorities and patients and services are being forgotten. This is a national emergency which is now having serious consequences across the board, not least for those patients in crisis,” said Matthew Taylor, the chief executive of the NHS Confederation.

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Source: The Guardian, 9 October 2023

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Cervical cancer: 17,500 women to have smear tests re-checked

About 17,500 women in Northern Ireland are to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008.

Some of these women will be recalled to have new smear tests carried out, BBC News NI can reveal.

The Southern Trust said that the women affected should receive letters by post from Tuesday.

It follows a highly critical report commissioned by the Royal College of Pathologists (RCPath).

It found:

  • Several cytology staff were "significantly underperforming".
  • Mechanisms to check their work were flawed.
  • Action taken by management was inadequate over many years.
  • While a majority of negative results issued by the laboratory were correct, a "significant number" of these would likely have been identified as "potentially abnormal" by other laboratories.

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Source: BBC News, 9 October 2023

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Rise in A&E visits for hiccups and earaches add to strain on NHS

The NHS in England is facing mounting pressure amid a surge in patients attending A&E departments with minor ailments, health bosses have said.

Emergency departments, which are designed for serious injuries and life-threatening emergencies only, are seeing an increase in people attending with sore throats, insomnia, coughs and earache.

Data analysed by the Press Association news agency also shows more people going to A&E with complaints such as hiccups, nasal congestion, backache and nausea.

Cases where sore throat was the chief complaint rose by 77% between 2021-22 and 2022-23, from 191,900 cases to 340,441. Patients going to A&E with coughs rose by 47%, from 219,388 to 322,500, while attendances for nosebleeds rose by a fifth, from 47,285 cases to 56,546.

Miriam Deakin, the director of policy and strategy at NHS Providers, said: “The rise in A&E admissions is piling even more pressure on to an already stretched NHS. Persistent strain on primary care services, including GPs and dentists, means patients often resort to A&E when they cannot access timely care elsewhere.

“Minor ailments such as coughs, earache, fever, nausea and hiccups can and should be managed through more appropriate services such as pharmacies and NHS 111 online. This could ease pressure on emergency departments, whose priority is to deliver urgent care for those most in need. Boosting capacity of staff, beds and equipment in these settings would also significantly help. However, this requires proper funding and support from the government.”

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Source: The Guardian, 10 October 2023

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Would you want to be treated by a 'medic' with just two years' training?

Peter Marshall was delighted when he finally got an appointment after calling his GP surgery for several days.

On the day, he saw a young medic who said his excruciating stomach pain was caused by irritable bowel syndrome (IBS) and suggested over-the-counter peppermint tablets to ease the discomfort.

And off the 69-year-old retired IT specialist went, happy to have a diagnosis and treatment.

In fact, Peter hadn't had an appointment with a GP — he had been seen by a physician associate (PA).

This is a type of healthcare worker whose numbers are about to soar in the NHS in order to reduce the pressure on doctors so that they can concentrate on the most complex and seriously ill patients.

It all sounds like a great idea. Indeed, PAs are now being employed across areas that are particularly stretched, with around a third of PAs working in GP surgeries and 10% in A&E departments, according to the latest census by the Royal College of Physicians. But they are actually spread across 46 NHS specialties, from urology and surgery to cardiology and mental health.

In this role, they are permitted to carry out a range of medical tasks, from performing physical examinations, diagnosing patients and analysing test results to running clinics and performing minor procedures — as well as doing home visits — all under the supervision of a doctor.

However, in the case of Peter Marshall, although he was reassured by his diagnosis, his symptoms were, in fact, a sign of bowel cancer — and he died nine months later, in January this year.

His sister, who has told Good Health his story, says: 'My brother had no idea that he had seen a PA and not a qualified doctor — he didn't know the word physician associate even existed, no one does.'

The family, from London, later received an apology from the PA. 'Patients are so desperate to get an appointment with their GP, you are grateful to see anyone and whatever they say, you accept,' she says.

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Source: Daily Mail, 9 October 2023

 

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Hospital chief quits in protest at ‘cover-up’ over baby deaths

An NHS hospital has been accused of posing a continuing risk to patients by “covering up” leadership failures, including not properly investigating the deaths of two babies.

Dr Max Mclean, chairman of Bradford Teaching Hospitals trust, has quit in protest at the conduct of the trust’s chief executive, Professor Mel Pickup, after no action was taken over serious concerns about her performance.

In a blistering resignation letter, Mclean said he “cannot, in good conscience, work with a CEO who has fallen so short of the standards expected of her role that there is a genuine safety risk to patients and colleagues”. He is calling for senior national NHS figures to establish new leadership at the trust, and has written to the head of NHS England to share his concerns about Pickup, who has been in post since 2019.

Mclean told The Times there were parallels with the Lucy Letby scandal, when management ignored the concerns of whistleblowers. “Patients are at risk, babies are at risk, and there could be avoidable deaths unless there is a change of leadership,” he said.

The former detective chief superintendent who has chaired the trust since 2019, raised nine serious issues about Pickup’s performance, which he said were confirmed by an independent investigation that concluded last month.

However, the trust’s board met on October 2 and decided there would be no further action against Pickup, leaving Mclean with “no option” but to resign and speak publicly.

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Source: The Times, 10 October 2023

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Over 17 000 serious incidents reported in mental healthcare last year

The UK’s largest mental health charity, Mind, has published previously unseen data laying bare the full scale of the emergency in mental healthcare, with staff reporting 17,340 serious incidents in 12 months.

The Care Quality Commission (CQC) figures shows mental healthcare staff across England reported an incident two times every hour in the last year, where people are treated for issues including self-harm, eating disorders and psychosis.

Incidents included:

  • injuries to patients that caused likely long term sensory, movement or brain damage, or physically damaged their body
  • prolonged physical pain or psychological harm, or shortened life expectancy
  • cases of abuse, including those involving the police
  • injuries for which the patient needed treatment to prevent them dying.

All of these incidents involved care providers raising concerns with the CQC under their statutory duty under Regulation 18.

Dr Sarah Hughes, Chief Executive of Mind, says: “It is deeply worrying that healthcare staff across the country are so concerned about the situation in mental health settings that they are reporting a serious incident once every half an hour. We knew this was a crisis – now we know the scale of this crisis. People seek mental healthcare to get well, not to endure harm. Families are being let down by a system that’s supposed to protect their loved ones when they are most sick. The consequences can be and have been fatal".

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Source: Mind, 10 October 2023

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More hips replaced in private hospitals than in NHS

The number of NHS-funded hip replacements carried out last year remained well below pre-covid levels, while the total funded privately nearly doubled to cover the shortfall, new data reveals.

The National Joint Registry annual report, which tracks orthopaedic activity across the NHS, showed the number of NHS-funded elective hip replacements carried out at NHS facilities in 2022 was at its lowest level since 2007.

However, the number of procedures performed in independent hospitals – both funded by the NHS and funded privately – has increased sharply. 

Orthopaedics is the biggest single elective specialty, with 847,000 of the current waiting list of 7.7 million on a trauma and orthopaedics pathway. As of July, 43% of these patients had been waiting longer than 18 weeks. 

The NJR report said: “The independent sector provision has increased hugely [since 2007] particularly in the last few years of covid recovery and there are now more hip replacements carried out in the independent sector than in the NHS.

“Despite the cost-of-living crisis the number of hip replacements paid for privately has almost doubled since 2019.”

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Source: HSJ, 10 October 2023

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News SAS and LE doctors need targeted support, says GMC

The UK’s rapidly growing number of specialist, associate specialist, and specialty (SAS) doctors and “locally employed” (LE) doctors need targeted and specific support to make the most of their expertise, the General Medical Council has said.

SAS and LE doctors are the fastest growing part of the medical workforce, increasing by 40% in four years, from 45 578 in 2017 to 63 740 in 2021, said the regulator.1 This was largely driven by doctors from overseas coming to work in UK hospitals.

SAS doctors are specialty and specialist grade doctors with at least four years of postgraduate training, including two in a specialty relevant to their area of work.

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Source: BMJ, 9 October 2023

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Agency profits growing due to ‘acute shortage of staff’

Two companies supplying staff to the NHS saw large growth in income and profits last year, annual accounts reveal.

Independent Clinical Services, owned by a Canadian private equity firm, saw a growth in turnover of more than 40%, with income growing from £273m to £399m, year on year.

A smaller company specialising in recruiting overseas healthcare staff to the UK also saw a bumper year, according to data released last month.

Your World Recruitment Ltd’s income increased by nearly a third, going from £50.5m to £66.8m (up 32%), with a similar rise in profits.

The company’s strategic report said: “Demand for agency staff and healthcare services in the first half of 2023 has remained strong principally due to staff shortages in the NHS and high waiting lists.

“The board expects the challenging market conditions to continue for the remainder of 2023, although demand is expected to remain due to an acute shortage of healthcare workers in the UK and worldwide.” The NHS has been pushing hard for increased overseas recruitment in recent years, to fill domestic gaps."

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Source: HSJ, 10 October 2023

 

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Patient died and 30 harmed after new IT system launch

A trust saw nearly 1,000 safety reports filed after introducing a new electronic patient record (EPR) – including one where a patient died and 30 others where they suffered harm.

The Royal Surrey Foundation Trust and Ashford and St Peter’s Hospital Foundation Trust installed a new joint EPR system in the middle of last year.

But Royal Surrey’s board was told there had been 927 Datix reports — which are used to raise safety concerns — related to the introduction of the “Surrey Safe Care” system, running up until mid September this year.

The catastrophic harm involved a patient death which the trust says was not “directly linked to technical problems” with the EPR, as “human factors” were involved, including inexperience or unfamiliarity with the electronic prescribing system.

Louise Stead, chief executive of Royal Surrey, said: “Implementing an electronic patient record is a huge shift for any workforce and we experienced some issues with the functionality of the system and getting users sufficiently trained and confident in using it correctly. We have worked hard to address these issues as quickly and responsibly as possible.

“Our fundamental aim is for ‘zero harm’ and any harm caused to a patient is taken extremely seriously and investigated. In the case of these Datix incidents the vast majority (over 99%) resulted in low or no harm to patients.

“However, one case resulted in the tragic death of a patient and we have been working closely with their family to be transparent and learn every possible lesson. This case was not directly linked to technical problems with the electronic patient record system and human factors did contribute. We are sincerely sorry for the failure in their care and devastating impact upon this person’s family.”

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Source: HSJ, 11 October 2023

 

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Patients put ‘at risk’ by NHSE plans to cut follow-ups

NHS England plans to reduce follow-up appointments is leading to patient safety risks and causing waiting lists to grow, an acute trust has warned.

The NHSE plans were set out in the 2023-24 planning guidance which says trusts must cut outpatient follow-ups by 25% against 2019-20 levels by March, to increase capacity for new patients.

But North Cumbria Integrated Care Foundation Trust has raised concerns that adhering to the policy will “exacerbate” its follow-up backlogs, warning that the delays “potentially… pose a risk of harm to patients whose condition may deteriorate when follow-up is late”.

NHS Confederation told HSJ it thought the policy “has risks” because it could mean that patients needing follow-ups will wait for longer, although the organisation also saw benefits. It said hospital leaders had “mixed feelings” about the policy.

The Patients Association also raised concerns that cancelling follow-ups for some patients “will exacerbate health inequalities”.

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Source: HSJ, 12 October 2023

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NHS waiting list hits record high of almost 7.8m

The NHS waiting list in England has hit a new record high, with almost 7.8 million people waiting for treatment, data shows.

An estimated 7.75 million people were waiting to start treatment at the end of August, up from 7.68 million in July. It is the highest number since records began in August 2007.

The waiting list for treatment has been growing for much of the last decade, passing three million in 2014, four million in 2017, five million in 2021 and seven million in 2022.

As the NHS waiting list grows A&E pressures are “ running red hot”, a major think tank has warned, with new figures showing 123,000 patients waited more than 12 hours in emergency departments last month.

Some 8,998 people in England are estimated to have been waiting more than 18 months to start routine hospital treatment at the end of August, up from 7,289 at the end of July, according to data.

A total of 396,643 people in England had been waiting more than 52 weeks to start routine hospital treatment at the end of August, up from 389,952 at the end of July.

The Government and NHS England have set the ambition of eliminating all waits of more than a year by March 2025.

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Source: The Independent, 12 October 2023

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'I'll keep fighting for dad over botched dentistry'

The daughter of a man who took his own life after experiencing years of pain linked to botched dental surgery said she had "lost faith in the system".

Clive Worthington, from Harlow, Essex, travelled to Hungary for dental implants in 2008.

Several follow-up procedures from the same dentist back in the UK over the next seven years were unsuccessful.

The government said it was addressing a so-called loophole which meant the 81-year-old missed out on compensation.

Last week, an inquest concluded Mr Worthington's death in 2022 was a suicide.

Senior Essex coroner Lincoln Brookes said the "long-term consequences" of Mr Worthington's unsuccessful dental surgery "impacted significantly on his mental health and ability to cope with daily life".

In 2017, the General Dental Council (GDC) found Dr Eszter Gömbös, who was employed by Perfect Profiles, at fault for the work.

Mr Worthington was awarded £117,378 in damages and legal costs at Chelmsford County Court in November 2019 - one of the highest pay-outs for dental negligence in the UK.

But the insurer which covered Dr Gömbös - the Dental Defence Union (DDU) - argued "discretionary indemnity" and refused to pay.

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Source: BBC News, 12 October 2023

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We want to hear from patients with experience of NHS and/or private orthodontists and dentists in any healthcare setting, including community practices and hospitals.

  • Did the orthodontist/dentist give you the treatment and support you needed?
  • If you had ongoing problems, how did the orthodontist/dentist and other healthcare professionals respond?
  • Have you tried to make a complaint?

Share your experience of orthodontist and dentistry services

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Safety warnings to be provided to all patients with every valproate-containing medicine they receive under new law

Valproate-containing medicines will be dispensed in the manufacturer’s original full pack, following changes in regulations coming into effect on Wednesday 11 October 2023. The Medicines and Healthcare products Regulatory Agency (MHRA) has published new guidance for dispensers to support this change.

Following a government consultation, this change to legislation has been made to ensure that patients always receive specific safety warnings and pictograms, including a patient card and the Patient Information Leaflet, which are contained in the manufacturer’s original full pack. These materials form a key part of the safety messaging and alert patients to the risks to the unborn baby if valproate-containing medicines are used in pregnancy.

The changes follow a consultation on original pack dispensing and supply of medicines containing sodium valproate led by the Department of Health and Social Care (DHSC), in which there was overwhelming support for the introduction of the new measures, to further support safety of valproate-containing medicines.

Minister for Public Health, Maria Caulfield, said:

“This safety information will help patients stay informed about risks of valproate, and I encourage all dispensers of valproate to consult the new guidance carefully.

“This continues our commitment to listening and learning from the experiences of people impacted by valproate and their families and using what we hear to improve patient safety.”

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Source: MHRA, 11 October 2023

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Three patients died after doctor failed to ensure bowel test follow-up treatment

Three patients have died after being given a bowel test by a doctor who failed to ensure treatment needed was carried out, a health board has said.

NHS Greater Glasgow and Clyde (NHSGGC) said three more patients suffered harm.

The six patients were identified in a clinical review the health board carried out of 2,700 people the consultant carried out a colonoscopy on between 2020 and 2022.

The consultant, who has not been named, was suspended in November 2022 and has since left the health board.

NHSGGC deputy medical director Professor Colin McKay said: “We would like to offer our sincere apologies to patients who were not followed up appropriately and our condolences to the families of those patients who have died."

“Our investigations found that the doctor did not consistently follow up the results of investigations that had been completed or requested and therefore missed the opportunity for patients to be treated, including a number of patients who went on to develop malignancy."

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Source: The Independent, 11 October 2023

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Community waiting list surges back above 1 million

The community services waiting list has risen sharply to more than 1 million, with children suffering the longest waits, new data has revealed.

NHS England figures published today show the adult community waiting list increased from 704,000 to 781,000 between October 2022 – the first published data available – and August. The children and young people’s list rose from 207,000 to 221,000. 

This means the overall community waiting list for England has exceeded 1 million for the first time since figures were first published in October last year.

Waits for musculoskeletal services dropped to a low of 255,000 in January. But this progress has since reversed – and, in July, the number of people waiting for care climbed to a high point of 319,000.

The waiting for podiatry and podiatric services, meanwhile, has climbed by 7% since October from 117,000 to 126,000, adding an extra 8,000 people to the waiting list. These services also account for 46 per cent – or 5,635 – of the waiting list over 52 weeks. 

Waiting lists for smaller adult specialties have also significantly worsened.

For example, nursing and therapy support for long-term conditions saw large increases in three areas: continence and colostomy, rising by 16%; respiratory and COPD, rising by 27%; and diabetes, rising by 37%.

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Source: HSJ, 12 October 2023

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Wheelchairs and weight: 'I haven't been able to weigh myself for 22 years'

Weight management is a sensitive topic. Nevertheless, the measurement is often used as a marker to inform medical decisions or for someone's personal interest. But for many wheelchair users, accessing scales has proved near impossible.

"The last time I was weighed was about 22 years ago, " Lizzie tells the BBC podcast, Access All. "I think I was about 15."

As a result, now aged 37, Lizzie has been through three successful pregnancies, all without knowing how her body was adapting or how her baby was growing.

Based in Devon, she has a degenerative muscle-related impairment and uses a wheelchair. This makes weighing herself on traditional bathroom scales, which require you to stand still and independently on a small platform, a challenge.

There is equipment out there to help wheelchair users, like Lizzie. Chair scales enable someone to sit on a seat which records their weight and there are similar bed and hoist versions too. There are also wheel-on scales which are very large and involve subtracting the weight of the chair afterwards. But none of these seem widely available.

Dr Georgie Budd, who is based in Merthyr Tydfil, says this worries her. A wheelchair user herself she appreciates how difficult it can be for people to access scales.

"There's a lot of things that we use weight for in health - anaesthetics and drug dosing - and just to keep an eye on it as well for someone's general health. During pregnancy for example, if someone was losing weight I, as a GP, would actually be really quite concerned," she says.

Neither NHS England nor the government have guidance for doctors nor advice on what equipment to use and no figures are kept on how many hospitals have access to such equipment and where they are.

The National Institute for Health and Care Excellence (NICE) previously considered the issue in 2014 and requested more research be carried out. But so far nothing has been started.

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Source: BBC News, 13 October 2023

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Muckamore inquiry: Staff accused of ignoring TB symptoms

The mother of a patient at Muckamore Abbey Hospital has described how her son contracted tuberculosis (TB) while at the hospital.

She said he had been left severely disabled after a series of associated strokes.

Patient P116 is now 40 years old and has suffered from severe epilepsy since he was a baby.

His mother told the inquiry into abuse at the hospital that her concerns over her son's health were ignored.

She said that even after he began developing symptoms - including losing six stone (38kg) of weight - staff seemed "not to care".

In the end, he was only diagnosed with TB after his mother took him to hospital herself.

Due to the delay in the diagnosis and the way the family's complaint was handled, a serious adverse incident review was carried out and P116's mother received a letter of apology from the then permanent secretary at the Department of Health, Richard Pengelly, and Theresa Villiers, who was Northern Ireland secretary at the time.

His mother told the inquiry her son's time in Muckamore remained a "major trauma" for the family and she still found it very difficult to talk about.

She told the inquiry she felt strongly that "independent expert support" should be given to patients abused or neglected in Muckamore, including specialist counselling for the patients and their families.

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Source: BBC News, 12 October 2023

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NHS Wales: Thousands of hours missing from A&E figures

The true picture of A&E waiting times in Wales has been seriously under-reported for a decade, the BBC can reveal.

The Royal College of Emergency Medicine (RCEM) has established thousands of hours are missed from monthly figures.

Senior A&E doctors have been raising the issue for months.

The Welsh government said it would ask health boards for assurances they were following the guidance "to ensure the data is absolutely transparent".

The RCEM said it could not measure "how bad" things were because thousands of patients subject to so-called "breach exemptions" were not included in the overall A&E waiting times.

The Welsh government initially disputed the RCEM's claim, but after seeing detailed figures - which were obtained through freedom of information (FOI) requests to health boards - it changed its position.

Wales' health minister has repeatedly claimed A&E waiting times in Wales have "bettered English performance".

But once the missing data is taken into account, it suggests the performance in Wales is worse.

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Source: BBC News, 16 October 2023

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NHS psych ward period provision criticised by patients

Imagine being on your period and "forced to beg for pads and tampons". According to 24-year-old Lara, that's common for her and others on mental health hospital wards in the UK.

When she posted about her experience online, people from across the country responded with their own similar stories.

Mental health hospitals have various rules in place for safety reasons, including access to certain items. However, NHS guidance states that period products should be available to anyone who needs them. Lara says this hasn't always been the case for her.

"I've had a number of hospital admissions to psychiatric units and on one of my first they confiscated my period products," she says.

Lara's currently on one-to-one observations for her own safety, which means someone has to escort her to the toilet and watch her change a pad or tampon.

But she says her worst experience was when she's had to wear anti-ligature clothing - again for safety reasons.

"I was forced to remove my pants and sanitary pad - which meant I just had to bleed into the clothing," she says.

"I understand the need for safety to come first, but this experience was unhygienic, traumatising and embarrassing for people to see."

Eleanor is 20 years old and recently spent time in a mental health hospital.

At her "most unwell", she says she didn't have access to her own clothing and had to wear the same special clothing Lara spoke about.

"I'd have two or three people watching me changing and even though I know it's for my own safety, it's dehumanising," she says.

Newsbeat asked a number of unions, organisations and charities to comment on the experiences described but none wanted to provide one.

But one mental health professional, Kasper, did agree to discuss it.

Kasper agrees that safety is always a top priority but adequate period provision is often overlooked."I'm sure all trusts have a policy, but don't think it's always applied - and my observation is that it very much depends on what staff are on shift, especially when there can be lots of agency workers," Kasper says."We do keep products on my ward, but there's not much of a range.

"Patients can't access them and some staff don't know where they are either - so the onus is very much on patients, which can be tricky when they're unwell."

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Source: BBC News, 16 October 2023

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Alarm at rise in use of mixed-sex wards in NHS England hospitals

NHS England has recorded more than 120,000 breaches of its mixed-sex hospital accommodation guidance in the past six years, a 257% increase.

Guidance added to the NHS constitution in 2012 states that hospital patients will not share sleeping accommodation with members of the opposite sex “except where appropriate”. Exemptions include critical care wards or patients receiving treatment, such as chemotherapy, where they “may derive comfort from the presence of other patients with similar conditions”.

The guidance also says patients should not share toilet or bathroom facilities with members of the opposite sex and should not “have to walk through an area occupied by patients of the opposite sex to reach toilets or bathrooms”.

However, data from NHS England analysed by the Observer shows thousands of breaches every month, with patient dignity and safety put at risk. 

Caitlin (not her real name) worked on an acute mental health ward in a private hospital which switched from 12 women-only beds to 15 mixed beds. “Women on our ward often had a history of sexual or domestic abuse,” she said. “Some had tried to end their life in the wake of this, and a lot of them felt intimidated by the level of aggression shown by some men on the ward.”

Women and men had separate wings but shared a communal area. “A lot of the women were really fearful of the men,” she added.

Caitlin said the use of mixed-sex accommodation had a negative impact on some women’s recovery. “Women would stay in their rooms, not even coming out to watch TV,” she says. “Some acutely unwell women would display sexually disinhibited behaviour in the communal areas, which is a symptom of their diagnosis. They were put in a position where their dignity could not be protected.”

“Women make hundreds of conscious and unconscious decisions to keep ourselves safe from men,” said Karen Ingala-Smith, author of Defending Women’s Spaces. “Women should not have to be on their guard like this when they are in hospital.” 

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Source: The Guardian, 15 October 2023

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Be careful of celebrating staff as ‘heroes’, NHSE advises trusts

Trusts haven been warned to be careful of “contentious” approaches to staff recognition, such as those that mimic the “clap for carers” initiative organised during the pandemic.

NHS England has published a Staff Recognition Framework which stresses marking staff achievements is important. However, it also warns staff could also be demoralised by recognition they felt was derisory.

The framework says: ”During the pandemic, studies suggested the weekly 8pm ‘clap for carers’ movement and use of the word ‘heroes’ were contentious approaches to staff recognition. The NHS is always in the media spotlight. Don’t let this put you off but do consider the broader political and economic context.”

Recent strikes saw clinicians make the point that organised clapping was no substitute for increase-linked pay increases.

The document for senior leaders recommends “developing a recognition strategy” which takes a triple track “formal, informal and everyday” approach to celebrating staff achievement.

It said “evidence shows that pay alone will not influence staff wellbeing, engagement, and retention in the long-term – praise and social approval have also proved to be critical factors”. 

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Source: HSJ, 12 October 2023

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