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Mothers at risk of premature birth could be identified as soon as 10 weeks into pregnancy, study finds

According to a new study, mothers at risk of premature birth could be identified as soon as 10 weeks into their pregnancy.

The study, conducted by King's College London and published in the Journal of Clinical Investigation, found that by looking for specific bacteria in the in a pregnant woman’s cervicovaginal fluid, it could reveal warning signs for premature birth, meaning inflammation can be found and treated early to protect mothers and babies.

Study author Andrew Shennan OBE, who is Professor of obstetrics at King’s College London, explained: “Premature birth is very hard to predict, so doctors have to err on the side of caution and mothers deemed to be at risk often don’t actually have their babies early, putting undue strain on everyone involved. My team has developed preterm birth prediction tools that are very accurate later in pregnancy, like fetal fibronectin tests – but at that stage, you can only manage the risks, not stop it from happening. The sooner we can find out who’s at risk, the more we can do to keep mothers and babies safe.”

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Source: The Independent, 23 August 2021

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Covid returns to top 10 causes of death

According to reports, Covid-19 was the 9th biggest cause of death in England in July, and the 26th most common in June, with data showing it was the 22nd leading cause of death in Wales.

Figures from the Office for National Statistics show the number of deaths was 7.6% higher than average in England and 10.4% higher in Wales.

However, when there isn't a pandemic, the top causes of death are usually heart disease and dementia, but in the months when Covid-19 has been dominant, it has been the leading cause by a long way. 

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Source: BBC News, 23 August 2021

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Social care charges: Disabled and vulnerable adults hit by steep rises

BBC News Research has revealed disabled and vulnerable adults in England will face a steep rise in the amount they have to pay towards their care, with Directors of council services blaming years of government funding cuts.

One woman, Saskia Granville earlier this year was shocked when she found her care charges had increased from £92 to £515 per month. A sum of almost £1,500 was also taken out of Saskia's bank account as a backdated payment, in March, leaving her in debt.

Her mother, Bobbie, says: "Without my intervention, she wouldn't have had any food that week. She wouldn't have been able to pay her gas, electricity or water bills."

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Source: BBC News, 24 August 2021

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'Exhausted and broken' midwives at West Suffolk Hospital in Bury St Edmunds speak out about 'substandard care' in whistleblowing letter

Midwives at Suffolk Hospital have spoken out in a whistleblowing letter describing problems in their department as ‘demoralising and heartbreaking’.

In the letter, written by midwives who declined to give their names "for fear of retribution", describe constant staff shortages, a culture of blame and fear, a high pressure environment and substandard care, saying " We entered midwifery to be able to give women centred, holistic care. Instead it feels like we are being overwhelmed by the unmanageable and relentless workload, and as a result are giving substandard care which is demoralising and heartbreaking. We are all feeling like we are now desperate for change. This change is beyond what we can achieve ourselves so we urge you to please help us to generate it. It should not be accepted or tolerated for us to be forced into giving unsafe care entirely due to unsafe staffing". 

In response, Karen Newbury, head of midwifery at the trust, said: “We are working exceptionally hard to recruit additional midwives and we are very grateful for the flexibility and dedication of our staff in ensuring that we provide a safe and caring service – this was recognised by our Care Quality Commission inspection in April which found we managed safety well. We have recently completed recruitment so there will be at least two senior midwives on every shift to provide flexible and experienced support to our maternity teams, and we are working with colleagues regionally to recruit staff both locally and internationally as well as running a full student training programme.”

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Source: Suffolk News, 20 August 2021

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Young people warn of long Covid in NHS vaccination drive

Young people experiencing long Covid have urged people to get their vaccine in a new NHS video, featuring three previously healthy people in their early 20s and 30s.

Quincy Dwamena, a 31 year-old a support worker, described himself in the video as a “healthy young guy”, warned “I ended up being hospitalised and thought I was going to die. My advice is to get the vaccine: don’t put yourself and others at risk, I wish I’d got mine as soon as it was offered.”

Data from Public Health England has shown young people aged 16 to 29 at more likely to develop long Covid, however, vaccine uptake among this age group is lower than average, particularly within the London area. 

Speaking in the NHS video, Dr Emeka Okorocha, an emergency medicine physician said, “As an A&E doctor, I’ve seen a lot during the pandemic. But nothing has shaken me like the sight of young, otherwise healthy adults being rushed into our hospitals with Covid-19. As well as their age, many of them have one other thing in common: they are unvaccinated.”

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Source: The Guardian, 23 August 2021

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COVID-19: Antibody testing programme to be rolled out across the UK for COVID positive people

A new antibody testing programme has been launched where participants will be sent two finger-prick tests to complete at home and then inform the UK Health Security Agency of the antibody response to different coronavirus variants.

The new programme was created in order to generate new data on antibody protections for people following infection by different coronavirus variants, and from Tuesday, anyone over the age of 18 in England, Wales, Northern Ireland and Scotland, will be able to opt into the programme.

Health Secretary Sajid Javid has said "Our new national antibody testing will be quick and easy to take part in [and by] doing so you'll be helping strengthen our understanding of COVID-19 as we cautiously return to a more normal life. I'm proud to see all parts of the UK uniting around this new initiative and working together to arm ourselves with even more valuable insights into how COVID-19 vaccines are protecting people up and down the UK."

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Source: Sky News, 22 August 2021

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Covid: ‘Harrowing’ rise in child deaths since coronavirus lockdowns

There has been a "harrowing" rise in child deaths and serious cases of harm linked to to abuse or neglect of children since the first Covid lockdown, according to reports from the Local Government Association (LGA).

Data has revealed there were 536 serious incident notifications in England between April 2020 and March 2021, with LGA saying it was a "huge cause for concern" and it is extremely concerned about children’s safety.

Councillor Anntoinette Bramble, chair of the LGA’s children and young people board, has said, "The pandemic has put extra pressure on families, particularly those living in difficult circumstances, which can fuel harmful acts of abuse or neglect on children. Councils have been working hard with their partners to identify this and provide the help children need, but it is vital that children’s social care services are funded to meet this need.”

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Source: The Independent, 21 August 2021

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Army supporting ambulance services in England

Almost 100 members of the army have been brought in to help four ambulance trusts amid staff shortages in the South Central, South West, North East and East areas of England, with Unison saying it was a sign "things were not right".

Vicky Court, assistant chief operating officer at North East Ambulance Services has said "It will ensure everyone continues to get the care they need by freeing up paramedics to be more available to attend potentially life-threatening incidents."

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Source: BBC News, 21 August 2021

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Trust served with CQC warning notice over ‘culture’ and governance concerns

Nottingham University Hospitals Trust has been served with a section 29a warning notice by the Care Quality Commission requiring it to ensure a ‘more positive culture’.

A CQC spokeswoman confirmed: “The trust was issued with a warning notice requiring it to take action to improve corporate and clinical governance and oversight of risk, and to ensure a more positive, open and supportive culture across the organisation. We will report on the full findings from the inspection as soon as we are able to.”

Although it is still not clear why the warning was issued, the trust is currently engaged in concerns over their accident and emergency department and maternity services. 

“We accept the CQC’s comments and work is already underway to learn from the findings and make improvements so that the organisation is led as effectively as possible and we continue to provide world class care for our patients.” Nottingham University Hospitals Trust acting chief executive and chief finance officer Rupert Egginton has said. 

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Source: HSJ, 18 August 2021

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Trust reviewing harm to 175 patients after referrals breakdown

Ashford and St Peter’s Hospitals Foundation Trust, has apologised after nearly 1,000 patients faced delays due to a breakdown of referral systems. It was found 175 of these patients were considered urgent cases by their GPs and are now being reviewed for clinical harm. 

When the error was discovered, the patients were added to the referral tacker by 9 July, however until that point, they had not been on any patient waiting list, nor were they visible to either operational management or clinical teams.

Trust chief executive Suzanne Rankin said in a statement: “We are very sorry for any inconvenience these delays may have caused patients and we contacted all concerned and issued appointments where necessary.”

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Source: HSJ, 19 August 2021

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Fifty senior doctors ask CEO for protection against bullying

Fifty senior consultants from a minority ethnic background at University Hospitals North Midlands have written to Tracy Bullock and trust chair David Wakefield asking for action to ‘protect’ staff from bullying behaviours following an internal survey in which 348 medics claimed to have experienced bullying and harassment.

In a subsequent letter on 5 August, seen by HSJ, 50 doctors have now said: “We are forced to express our concerns over the prevailing poor culture within our organisation with most senior medical staff presently reporting they have suffered or witnessed first-hand discrimination, bullying, harassment, or victimisation. We… ask for urgent action by the executive and non-executive boards to immediately implement measures to protect senior medical staff from unacceptable ill-treatment.”

A separate external review is now understood to have been commissioned amid concerns over bullying within ophthalmology services. 

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Source: HSJ, 19 August 2021

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Jabbed adults infected with Delta ‘can match virus levels of unvaccinated’

According to new data, those who have been vaccinated against Covid-19, can still  harbour virus levels as high as unvaccinated people if infected with the Delta variant. This new data suggests that hitting the threshold for herd immunity remains unlikely. However, it evidence does show vaccination still offers protection against hospitals and infection. 

“We don’t yet know how much transmission can happen from people who get Covid-19 after being vaccinated – for example, they may have high levels of virus for shorter periods of time, but the fact that they can have high levels of virus suggests that people who aren’t yet vaccinated may not be as protected from the Delta variant as we hoped.” said Sarah Walker, a professor of medical statistics and epidemiology at the University of Oxford.

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Source: The Guardian, 19 August 2021

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NHS Digital receive approval for the pathology information standards

In a positive step towards the future of pathology, NHS Digital has received approval from the Data Alliance Partnership Board (DAPB) for a new set of pathology information standards, and as part of NHS England CCIO7 workstreams, NHS Digital are delivering the ability to share pathology results across health and care.

This move will enable clinicians to share and access critical information about pathology tests and results and receive the right information when they need it, which will help support improved clinical decision making and patient safety. 

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Source: Wired Gov, 19 August 2021

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NHS Wales: Waiting times hit record levels

According to recent reports, the number of patients on waiting lists for non-urgent hospital treatment in Wales has again hit record levels. Data has revealed there were 624,909 people waiting in June, and those waiting the longest, more than nine months, rose again to 233,210.

A Welsh government spokesperson said: "Waiting times for treatment continue to grow. However, it is encouraging to see progress being made with the number of patients waiting over 52 weeks falling for the third month in a row. We also saw the largest number of specialist consultations completed and treatments started in any month since the start of the pandemic."

A&E time performance has been at its worst on record, with 94,176 attendances to emergency units over the month. Health spokesman Russell George said: "To record the worst ever A&E waiting times and the longest NHS treatment waiting list in the same month shows a complete lack of leadership."

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Source: BBC News, 19 August 2021

Related Reading

Patient Safety Learning blog: Tackling the care and treatment backlog safely (19 August 2021)

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School nurse sounds alarm over planned cuts to Hampshire nursing services

Selena Brash, a clinical team lead with the East Hampshire school nursing team, has spoken out about the controversial plans to cut back public health nursing services in Hampshire.

Ms Brash, in response to the Hampshire County Council plans to save £6.8m from its public health budget, started a petition earlier in the summer calling for increased funding “to protect the provision of school nurses”, warning that cuts to to public health school nursing services would “result in a detrimental effect on children and young people’s health and wellbeing, with lifelong consequences”.

“If the cuts go ahead, then this could set a precedent for other local authorities to follow suit, meaning there would be a massive impact on the health and wellbeing of our young people and future generations,” Ms Brash told Nursing Times. 

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Source: Nursing Times

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‘Unprecedented’ rise in drug overdoses in England linked with synthetic opioid

According to public health reports, there has been a sharp rise in drug overdoses, particularly heroin, over the past 10-14 days with the synthetic opioid isotonitazene implicated in some cases. In several areas of the country including five London boroughs, Hampshire, Essex, West Sussex, Dorset and Thames Valley, there has been 46 poisonings, resulting in 16 deaths, although currently, investigations are still ongoing. 

In a National Patient Safety alert issued on 18 August 2021, Public Health England (PHE) have instructed all NHS organisations to ensure staff are made aware of the risk of severe toxicity resulting from the synthetic opioid, and that all organisations that treat emergency cases should ensure staff are able to treat suspected cases “using naloxone and appropriate supportive care”.

Roz Gittins, director of pharmacy at the charity Humankind, said "People also need to know where they can get hold of naloxone, as well as being reminded to carry it with them and to let people know where they keep it. If advice and support is required then the local substance misuse service should be contacted for specialist support. We hope that the current consultation to widen naloxone provision will be successful and that improved funding will lead to naloxone being distributed more widely to help reduce the risk of accidental opioid overdoses."

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Source: The Pharmaceutical Journal, 18 August 2021

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All NHS hospitals could get tougher guidelines on using ventilators after deaths of THREE Covid patients who were given wrong equipment at make-shift Nightingale in London

After three Covid-19 patients died at the make-shift Nightingale Hospital in London following a breathing tube mix-up, NHS trusts in England could be issued tougher ventilation guidance. In each of the cases, filters which prevent the build-up of fluid were not attached to the machines, resulting in dangerous blockages, but it has not yet been determined if these incidents contributed to their deaths. 

Coroner Nadia Persaud has said the way the machines vary from model to model can be "confusing" and may lead to future deaths, also ruling that the classification and colour coding was "worthy of review, simplification, and standardisation". 

The original coroners report, carrying advice from an independent expert said "In my opinion, the non-standardised colour coding used by manufacturers of these filters, the number of different types of filters with different names, the variable optimal position of the filters, and whether a wet or a dry breathing system is being used, results in an extremely confusing situation. One of the leading manufacturers of these filters produces HMEs that are blue, which is the same colour as the non-HME filters supplied by another company. In my experience, few doctors and nurses working in ICU are knowledgeable about all these different filters and which ones should be used for any given breathing system."

Inquests into the deaths are scheduled for October. 

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Source: The Daily Mail, 17 August 2021

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Record numbers of children with eating disorders left waiting for NHS help

According to reports, the number of children being treated by the NHS has soared, with waiting times tripling in a year, and experts warning the pandemic may have set back treatment for young people "by years".

The Royal College of Psychiatrists have also said services are struggling to provide timely treatment due to an "overwhelming" demand. 

Dr Agnes Ayton, the chair of the Royal College of Psychiatrists Faculty of Eating Disorders Psychiatry, said: “The pandemic has had a huge impact on children and young people with disruption to their schooling, social lives and home lives. Many young people have not received support early enough, causing their eating disorders to become much worse and harder to treat. Delays to treatment can put lives at risk. Services are struggling with soaring demand, fewer beds because of social distancing and an ongoing shortage of specialist doctors.”

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Source: The Independent, 19 August 2021

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How nurse practitioners are changing American healthcare

This interview with April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, a critical care nurse, discusses how Nurse Practitioners are changing healthcare, the likelihood of all states granting full practice authority to NPs, and what the American Association of Nurse Practitioner members can expect from her for the next two years.

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Source: American Medical Association, 16 August 2021

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Vaccinated nurses will now be ‘expected to return to work’ instead of isolating

Vaccinated nurses will now be expected to return to work instead of isolating as new rules are set to relax.

In a letter on the latest rule change from NHS England chief nursing officer Ruth May, chief people officer Prerana Issar, and medical director for primary care Dr Nikita Kanani said “Fully vaccinated staff and students who are identified as a contact of a positive Covid-19 case will no longer be expected to isolate and will be expected to return to work.”

Staff returning to work are required to have been double jabbed, have no Covid-19 symptoms and receive a negative PCR test. This latest change in rules go in line with changes for the wider population. 

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Source: Nursing Times, 16 August 2021

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Outrage at chronic fatigue syndrome advice update pause

With just hours left to go, a health watchdog has paused a final update to ME treatment guidance due to disagreement on some of it's contents. Charities have expressed their anger over this decision as NICE says it needs more discussions with patient groups and professionals so that the advice is supported.

Although it is not yet clear when the guidance will be published, the advice on CBT (cognitive behavioural therapy) has been changed as it was only helping with anxiety around the condition rather than the illness itself, with NICE acknowledging the controversy over the best treatment has served only to alienate many people with the condition.

"We were extremely concerned that the final guidelines proposed by NICE may not have taken into consideration the extensive comments we made to the draft version, particularly in relation to treatments we know to have significantly benefited many patients." Andrew Goddard, president of the Royal College of Physicians, has said. 

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Source: BBC News, 17 August 2021

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Night shifts linked to heart problems, study finds

A new study has found night shifts are "significantly associated" with health issues related to the heart, particularly atrial fibrillation, finding that women may be at a greater risk. The research, published in the European Heart Journal also found working night shifts is linked to an increased risk of coronary heart disease (CHD). 

“Night shift exposure also increased the risk of CHD (coronary heart disease) but not stroke or HF (heart failure). Whether decreasing night shift work frequency and duration might represent another avenue to improve heart health during working life and beyond warrants further study,” the paper said.

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Source: The Independent, 16 August 2021

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Hundreds of maternity incidents in one year prompt 1,500 safety instructions to hospitals

1,500 safety recommendations have been made to NHS trusts a year after hundreds of babies were left brain damaged and dozens of mothers and infants died.

Safety watchdog Healthcare Safety Investigation Branch (HSIB) has outlined key themes from 760 investigations of maternity incidents, taking over investigations for NHS trusts in 2018 after concerns were raised over the poor quality of investigation by trusts and a lack of involvement in families. 

Sandy Lewis, associate director of maternity said: “The publication of the HSIB maternity programme year review provides crucial details of the work that has been undertaken in the last year. We would like to thank all of those who have worked with us in the past year, sharing their experiences, insights and expertise. Many families have not only told us their stories but have also trusted our investigators to reflect their perspectives and share their experience. Trusts have responded promptly to this insight, this has contributed to improving safer care of mothers, babies and families across the country.”

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Source: The Independent, 16 August 2021

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Trusts fear ‘fragmentation’ of specialised services under Health Bill reforms

Providers fear 'fragmentation' of specialised services as NHS England begins delegating specialised services budgets to integrated care systems under reform plans.

One leader of a specialist trust told HSJ: “There is a real risk of fragmentation. You can already see some of the conversations around various services around how people want to keep patients within their own ICS. There is the potential there for systems to buck the trend of centralising specialist services. Rather than bringing expertise and quality together, systems looking after budgets will look to set up their own specialist services.” 

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Source: HSJ, 17 August 2021

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UK blood supplies to be used to make life-saving drug

Plasma from blood donations in England will be used to make a life-saving drug whilst also helping to secure NHS plasma stocks to make the antibody-based medicines, called immunoglobulins. The service will begin roll-out in the coming months, with other parts of the UK potentially following suit. 

Gerry Gogarty, from NHS Blood and Transplant, welcomed the decision, calling it a huge step forward. "By recovering plasma from blood donations, we can improve long-term supplies of immunoglobulin medicine, and each generous blood donation will go even further in helping to save the lives."

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Source: BBC News, 17 August 2021

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