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Women bear brunt of ‘gargantuan challenges’ for health and care services during pandemic

Women are bearing the overwhelming brunt of the “gargantuan challenges” health and care services are grappling with during the Covid pandemic, health leaders have said.

A new study by the NHS Confederation’s Health and Care Women Leaders Network found female health and care workers’s physical and mental health substantially deteriorated due to working during the coronavirus crisis.

The survey, which polled more than 1,200 NHS staff in February and March this year after the virus peaked, found issues with mental and physical health had notably worsened since last summer.

Researchers found more than 80% of women said the pandemic meant their job had greater detrimental repercussions on their emotional wellbeing. This is a significant rise from 72% of female workers who said the same during equivalent research carried out in June.

The report, which polled nurses, doctors, administrative staff, allied health professionals and managers, warned there are “still many mountains to climb” as services strive to cope with the chaos unleashed by the Covid crisis, as well as dealing with the long-term consequences of the pandemic.

The study said: ”This includes tackling the growing issue of long Covid, meeting increased demand for mental health services, continuing to deliver the largest vaccination programme the UK has ever seen, and addressing a backlog of treatment that could extend to nearly seven million people by the end of 2021."

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Source: The Independent, 5 May 2021

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We need to stop calling NHS staff heroes – for a very important reason

When we put people on a pedestal, my experience is that they are less likely to be asked, ‘are you OK?’, writes Samantha Batt-Rawden, a senior registrar in intensive care medicine.

Like many she has been touched by the groundswell of support from the public. But there’s a problem with this hero image, she says. 

"It’s not just that many NHS staff are feeling increasingly uncomfortable with being hailed as heroes for what they see as simply doing their jobs. Of course, we were going to step up to the plate when the COVID-19 pandemic hit. As doctors it was our duty. There was never any question.

"But there’s something more than just feeling undeserving of the cape weighing heavily on our shoulders. The worst thing about being seen as a superhero? Very few think to ask if you’re OK.

And herein lies the problem. Because healthcare workers are not heroes, we are human. Completely, painstakingly, fallibly human."

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Source: The Independent, 2 May 2021

 

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Europe must act now to stop the spread of deadly diseases due to COVID-19

Healthcare workers and patients are being put at risk not only from COVID-19 but other deadly diseases as a result of an increase in sharps injuries due to the pandemic. 

Sharps injuries are accidents where a needle or other medical sharp instrument penetrates the skin with the potential to transfer blood borne viruses, including HIV or hepatitis B or C, from the patient to healthcare worker and vice versa. Sharps injuries cause increased costs and disruption in the healthcare system, which have all been exacerbated by the pandemic anyway. Sharps injuries also have a major emotional and mental impact on staff who always put patients first and literally have put their lives on the line during COVID-19.

The European Biosafety Network has commissioned a survey to be published in June on the impact COVID-19 has had on sharps injuries in Europe. The preliminary findings of the survey by Ipsos MORI, covering more than 300,000 healthcare workers in 80 large public hospitals across Europe, show that the number of sharps injuries has increased by some 276,000 injuries (23%) over the last year: with 98% of respondents saying that the increase was a result of the increased pressure and stress due to COVID-19.

Other recent published survey results also show that the number of reported sharps injuries has increased as a result of the pandemic. We need to ensure that other existing legislation and regulations which prevent sharps injuries are both understood and complied with.

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Source: The Brussels Times, 28 April 2021

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NHS introduces 3D heart scans to diagnose patients in 20 minutes

Patients with life-threatening coronary heart disease will be treated five times faster thanks to 3D scans being introduced on the NHS that allow for a diagnosis in just 20 minutes.

The revolutionary technology can turn a regular CT scan of the heart into a 3D image, allowing doctors to diagnose them rapidly, NHS England said.

It added that about 100,000 people will be eligible to use the HeartFlow technology over the next three years.

Patients – who would previously have had to undergo an invasive and time-consuming angiogram in hospital – will now be seen, diagnosed and treated around five times faster.

The new technology, introduced from last month, is part of the NHS long-term plan to cut the number of heart attacks and strokes by 150,000.

NHS England said more people here will have access to the potentially life-saving technology than anywhere else in Europe, the US or Japan.

Matt Whitty, director of innovation and life sciences for NHS England, said HeartFlow had been a “huge success” in clinical trials and would now help “tens of thousands of people a year receive quick diagnosis and treatment and ultimately save lives”.

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Source: The Guardian. 4 May 2021

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‘It’s terrifying’: parents’ struggle to get help for children with long Covid

On Christmas Day, Gail Jackson’s 16-year-old daughter said she was in so much pain she thought she would die. Liliana had been briefly admitted to hospital with Covid in September. Her symptoms never went away and, as time went on, new ones had emerged.

“For months she had a relentless, agonising headache, nausea, tinnitus, fatigue and insomnia, but the worst thing was the agonising nerve pain,” said Jackson. “I couldn’t even touch her without her screaming in pain.”

On Christmas morning, Jackson drove to hospital with her daughter vomiting from pain in the passenger seat. When they got to the hospital, however, the A&E doctor said there was no such thing as long Covid in children. “He said she just needed to go home and get on with her life,” Jackson said. “It was jaw-dropping.”

It is extremely rare for children and young people to contract severe Covid, but recent research has shown that even mild or asymptomatic infection can lead to long Covid in children. A study at UCL is investigating long Covid in 11- to 17-year-olds who were not hospitalised with the disease.

The National Institute for Health and Care Excellence (NICE) has recommended more research to produce guidance on how children and young people are affected and how they can be treated. However, there is no case definition of long Covid in children and young people in the way there is in adults.

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Source: The Independent, 3 May 2021

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Deaths of people with learning disabilities deserve proper scrutiny

The critical finding at the inquest into Laura Booth’s death raises alarming concerns about the failing system of investigation into the deaths of people with learning disabilities.

Initially, Laura’s death was said to be expected and was attributed to natural causes on the basis of a death certificate signed by a hospital doctor. Without the determination of Laura’s family and the intervention of the media, this inquest would never have happened, and the truth about her death from malnutrition and neglect would not have been uncovered. 

The concerns about how many other avoidable deaths have not been scrutinised because there is no one to speak up on behalf of those who died or because families are obstructed in their search for answers by the prevailing assumption that people will die early. The premature deaths of people with learning disabilities (on average 30 years before their non-disabled peers) demand robust scrutiny particularly as when inquests do take place, they so often reveal basic failings in healthcare. The way in which the Booth family were so nearly failed by the coronial system is a sharp reminder of how urgently reform of these processes is needed.

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Source: The Guardian, 2 May 2021

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NHS faces exodus of doctors after Covid pandemic, survey finds

Thousands of UK doctors are planning to quit the NHS after the Covid pandemic because they are exhausted by their workloads and worried about their mental health, a survey has revealed.

Almost one in three may retire early while a quarter are considering taking a career break and a fifth are weighing up quitting the health service to do something else.

Long hours, high demand for care, the impact of the pandemic and unpleasant working environments are taking their toll on medics, the British Medical Association findings show.

Dr Chaand Nagpaul, the leader of the BMA, said the high numbers of disillusioned doctors could worsen the NHS’s staffing problems and leave patients waiting longer for treatment.

“It’s deeply worrying that more and more doctors are considering leaving the NHS because of the pressures of the pandemic – talented, experienced professionals who the NHS needs more than ever to pull this country out of a once-in-a-generation health crisis,” Nagpaul said.

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Source: The Guardian, 2 May 2021

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Covid: Pregnant women in Wales 'still go it alone'

Pregnant women are facing a postcode lottery over whether they can bring a partner to maternity appointments.

Health boards were given flexibility in November to allow pregnant woman in low Covid rate areas to take their partners to maternity appointments.

But many parts of Wales with the lowest rates are still forcing pregnant women to attend some appointments alone.

There are calls, as lockdown eases, for partners Wales-wide to be allowed to all appointments and during labour.

Emma Fear, 30, was not able to take her partner with her to hospital when she experienced bleeding during pregnancy in June last year and was told, alone, that she was losing her baby.

She then had to repeat the news to her partner, who was waiting outside in the car.

"At the time, he could have come and sat outside a pub with me, but he couldn't come with me when I'd had severe bleeding and knew I had probably lost my baby."

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Source: BBC News, 2 May 2021

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Young people more likely to suffer rare vaccine blood clots, MHRA says

Younger adults are particularly affected by the rare blood clotting disorder linked to the Oxford-AstraZeneca vaccine, the UK's medicines regulator has said.

The Medicines and Healthcare products Regulatory Agency (MHRA) said there were 209 cases in the UK of the rare combination of blood clots with low platelet counts following being vaccinated the Oxford-AstraZeneca jab, with 41 deaths, up to 21 April.

This is up from 168 cases and 32 deaths the previous week.

The new data also shows 24 cases of clots in people aged 18 to 29, 28 in those in their thirties, 30 in people in their forties, 59 in people in their fifties and 57 in those aged 60 and above, with the age not known in the remaining cases.

The numbers appear to rise with age but that is because more older people have been vaccinated. Fewer than one in five clots was fatal.

The latest NHS England data show that 5.5 million people under 45 had received a first dose by 25 April, while 22.6 million of those 45 and over had done so.

MHRA chief executive June Raine said no medicine or vaccine was without risk, but that blood clots were extremely rare.

She added: “The benefits of the vaccine continue to outweigh the risks for most people. It is still vitally important that people come forward for their vaccination when invited to do so."

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Source: The Independent, 3 May 2021

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NHS trust to improve digital messaging for deaf and deafblind patients

Tees, Esk and Wear Valleys NHS FT has launched a deaf digital inclusion project, to find the best practice for communicating with deaf and deafblind patients.

The project will look at the barriers faced by the patients around digital communications, and how to help the staff become more deaf aware.

The deaf and deafblind patients supported by the trust, their carers, staff, and members of deaf wellbeing groups and networks, are taking part in the project to help provide the best digital communications support to meet deaf patients’ needs.

The project is led by the trust’s deaf services team which provides a range of support to deaf and deafblind people aged 18 and over, who mainly use British Sign Language (BSL) to communicate, who also have mental health problems.

Emmanuel Chan, Clinical Nurse Specialist for the deaf services team, :explained: “People who are oral and require lip reading can find video appointments a challenge if others on the call are not fully deaf aware and talk over one another. Alongside our project, our team aims to help our staff become more deaf aware to avoid this happening.”

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Source: NHE, 26 April 2021

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Consultant who carried out unauthorised research loses challenge over dismissal

A consultant at St Luke’s Hospital in Kilkenny who carried out unauthorised research on five female patients during routine gynaecological procedures has failed in a High Court challenge to prevent his dismissal by the HSE.

Consultant gynaecologist Ray O’Sullivan claimed a decision by the HSE’s chief executive, Paul Reid, on December 23rd, 2019 to recommend his dismissal was “fatally flawed” for reasons including a failure to allow him the opportunity to comment on an expert’s report into his professional performance.

The hospital began an investigation after nursing staff expressed concern about the risk of infection from a procedure carried out on five patients on September 4th and 5th, 2018 under the direction of Prof O’Sullivan.

A catheter and small pressure pad was placed, without their consent and without seeking approval from the hospital’s ethics committee, inside the vagina of five patients who were having a hysteroscopy.

This was done as part of a feasibility study designed to see if certain procedures could be carried out without the use of a speculum (a device commonly used in vaginal exams) .

The court heard the five patients, who were tested for infection including HIV, were greatly shocked and upset when St Luke’s informed them about what happened at open disclosure meetings.

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Source: The Irish Times, 27 April 2021

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Covid restrictions have 'closed door' on NHS appointments

Patients are finding it increasingly hard to see their GPs, with warnings that pandemic restrictions have too often “closed the door” on NHS treatment, a report warns. 

The Patients’ Association survey comes as an investigation reveals that almost 100 GP surgeries closed down or merged with other practices last year.

In total, almost 2.5 million patients were forced to switch to a new surgery because of 788 such closures since 2013, the freedom of information disclosures reveal .

Rachel Power, chief executive of the Patients’ Association, said the findings from its survey were “worrying” and show “clear dissatisfaction” from the public.

The report said: “It is increasingly clear that many patients have found that new methods for arranging appointments do not work for them, or simply that they do not understand how to go about it. GPs are the front door to the NHS, and patients are increasingly perceiving that that door is closed to them.”

Roughly half of those who had telephone consultations said the experience was worse than a traditional appointment, with three times as many saying they were unhappy about their experience, compared with those offering praise. 

The report warns: “The data does not show a ringing endorsement of new or remote methods for accessing NHS care; indeed, in most cases patients rated these methods worse than traditional contact.”

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Source: The Telegraph, 30 April 2021

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Frontline training programme on diabetes ‘improves patient safety’

A concise training programme aimed at informing healthcare staff about diabetes has the potential to significantly improve patient safety, according to researchers.

The programme, which was developed by the North West London Collaboration of Clinical Commissioning Groups, has been linked with a reduction in diabetes-related errors.

The Diabetes 10 Point Training Programme was initially created with the aim of improving inpatient safety by ensuring frontline staff have access to diabetes training.

Researchers from the CCG collaboration noted that the annual National Diabetes Inpatient Audit (NaDIA) had made for “grim reading with errors, harm, increased length of stay and mortality”.

They highlighted that a workforce with knowledge of diabetes was “crucial to inpatient safety”, and said that complex diabetes care could be delivered by non-specialists with adequate training.

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Source: Nursing Times, 29 April. 2021

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Private provider fined after failing to disclose treatment errors

A private healthcare provider has been ordered to pay £20,000 after failing to disclose errors in the treatment of patients under the care of a surgeon.

Spire Healthcare was prosecuted today in what the Care Quality Commission (CQC) said was “the first prosecution of its kind against an independent provider of healthcare”.

The CQC said concerns around the treatment of four patients were initially raised by Leeds Clinical Commissioning Group, several physiotherapists at the hospital and another surgeon.

The patients had surgical procedures carried out by Michael Walsh, a shoulder surgeon who held practising privileges at Spire Leeds until his suspension in April 2018. The procedures resulted in the patients suffering prolonged pain and requiring further remedial surgery.

The CQC said it brought the prosecution after Spire failed to share details of what happened to the patients who were being treated by Mr Walsh, in line with their duty of candour responsibilities to be transparent and provide timely apologies when serious incidents occur.

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Source: HSJ, 29 April 2021

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We can now prevent mental ill-health in the same way we fight cancer

A cutting-edge child and adolescent mental health centre hopes to help prevent young people from experiencing mental health problems. 

As we look hopefully towards a June bonfire of pandemic regulations and restrictions, many recognise that soaring rates of mental health problems and distress amongst our children and young people must be near the top of a 21st century list of challenges in “building back better”.

School closures, uncertainty and being cut off from friends and social and sporting events have seen more children and young people referred to CAMHS — a service that was facing growing demand even before the pandemic.

The long-term impact is obviously still unknown.

However, a cutting-edge child and adolescent mental health centre opening in south London two years from now will play a big role in responding to the likely increased demand for ongoing support — and in developing innovative treatment responses.

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Source: HSJ, 27 April 2021

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Innovative technology improves staff and patient safety

Chelsea and Westminster Hospital NHS Foundation Trust announce the successful pilot of ThermaFY Protect and the subsequent roll-out of the unique thermal screening technology across its hospitals.

As part of its CW Innovation programme, run jointly with its charity CW+, the Trust approached ThermaFY at the beginning of the COVID-19 outbreak to codevelop and install automated temperature scanning stations at Chelsea and Westminster Hospital and West Middlesex University Hospital to help reduce the spread of infection.

A unique project, ThermaFY Protect, was developed to provide bespoke thermal screening that combines temperature readings with staff identification. Following a successful pilot which involved six ThermaFY Protect screens being installed across the Trust’s main hospital entrances, the Trust and CW+ will now roll out the programme at all hospital entrances and off-site clinics.

Amanda Pickford, Founder and Chief Executive of ThermaFY, explains: “It’s been fantastic working with the team at Chelsea and Westminster, who share our entrepreneurial vision and have acted quickly and collaboratively to improve patient and staff safety. During the first pilot, our systems scanned over 500,000 people; now the stations are a permanent feature, scanning over 8,000 patients and staff every day putting patient and staff safety at the centre.”

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Source: Digital Health, 27 April 2021

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Influenza drug ‘good contender’ for at-home treatment against COVID-19

An antiviral typically used to treat influenza is a “good contender” for a drug that could be taken at home by people infected with COVID-19, according to a scientist who is trialling the medicine.

Favipiravir, licensed as a flu treatment in Japan since 2014, has already shown potential in reducing lung damage in hospitalised Covid patients and speeding up the time taken to clear the virus from the body.

But two UK trials, in Glasgow and London, are investigating whether the drug could be taken by people in the community before their disease has progressed, therefore keeping them out of hospital.

The government has promised to “supercharge” the search for and development of a new generation of easy-to-take, at-home drugs that can reduce transmission and quicken recovery from COVID-19.

A new taskforce, modelled on the team behind Britain’s vaccine procurement programme, is to oversee this work. It intends to deliver two effective treatments - offered in tablet form - to the public as early as autumn.

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Source: The Independent, 22 April 2021

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Trust 'failed to act' on cancer patient's X-rays

A man who died from lung cancer might have been saved if a hospital trust had not "failed to act" on two abnormal chest X-rays, an investigation found.

Growths identified in the patient's examinations were not followed up for three years and were then untreatable, the health ombudsman said.

North Cumbria University Hospitals NHS Trust also failed to correctly handle a complaint from the man's daughter.

The trust, which runs hospitals in Carlisle and Whitehaven, apologised.

The investigation was carried out by the Parliamentary and Health Service Ombudsman (PHSO), which deals with unresolved NHS England complaints.

The patient, referred to only as Mr C, was admitted twice to hospital with stroke-like symptoms in 2014 and 2015. On both occasions X-rays were carried out which found abnormal growths in his lungs, but no action was taken. In July 2017, Mr C was found to have advanced lung cancer and he died weeks later.

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Source: BBC News, 29 April 2021

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Landmark legal agreement sees Equality Rights Commission monitor trust’s record on sexual harassment

The Equality and Human Rights Commission has required an ambulance trust to sign a legally-binding agreement stating how it will protect its staff from sexual harassment.

This is thought to be the first time the EHRC has taken such action against an English NHS organisation and follows repeated concerns about the culture at East of England Ambulance Service Trust.

As a result, EHRC will now monitor the trust’s action plan for protecting staff from sexual harassment.

The Care Quality Commission asked the EHRC to consider taking enforcement action against the trust last summer, after a CQC investigation found evidence of “bullying and predatory behaviour” and warned the trust’s leaders were not adequately promoting patients’ and staff’s wellbeing.

The CQC also found at least 10 incidents in 2019-20 involving allegations of sexual assault, harassment or inappropriate behaviours, and 13 instances of staff, including those working for subcontractors, being referred to the police for sexual misconduct and predatory behaviour. The trust was subsequently placed in special measures for quality.

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Source: HSJ, 28 April 2021

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Three hospitals placed in special measures following infection control concerns

Three private mental health hospitals have been placed in special measures after the Care Quality Commission found concerns over infection control.

John Munroe Hospital and Edith Shaw Hospital, both in Staffordshire and run by the John Munroe Group, were inspected after the CQC received several whistleblowing complaints over poor covid-19 infection control and covid deaths. 

A third hospital, Priory Hospital Arnold, based in Nottinghamshire, was criticised over hygiene and infection control failures after the regulator found dried blood, faeces, food and sputum on seclusion room walls.

In reports published this week, the CQC revealed it had placed all three hospitals in special measures and imposed urgent enforcement action against the providers. 

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Source: HSJ, 29 April 2021

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Long Covid: 'I'm not the same person'

A nurse says the effects of "long Covid" mean she is "not the same person any more".

Lynne Wakefield from Holyhead is still suffering with fatigue and "brain fog" after contracting Covid in June 2020. She said her employer had been "very good" supporting her, but other NHS staff told BBC Wales they felt pressurised to go back to work.

The NHS Confederation said there was a package of support for staff affected by "longer term effects of Covid".

A recent survey suggested about 56,000 people in Wales have symptoms of long Covid, which include fatigue, headaches and coughing.

Other NHS workers with long Covid symptoms, who did not want to be named, told BBC Wales Live how they feel about the ways they are being treated by their employers:

"I knew that returning to work would put my recovery at risk, but it was work or starve. On my return, I was informed that any further days absent in the next 12 months would result in a formal warning."

"I'm so worried about losing my job as I've been off work for so long and I'm still nowhere near well enough to return."

"If they say I have to come back or be dismissed, I'll have to do it, I'll have to try [and go back] and survive. I am so emotional at the moment, I can't stop crying - I feel I am going crazy."

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Source: BBC News, 28 April 2021

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We can now prevent mental ill-health in the same way we fight cancer

A cutting-edge child and adolescent mental health centre hopes to help prevent young people from experiencing mental health problems.

As we look hopefully towards a June bonfire of pandemic regulations and restrictions, many recognise that soaring rates of mental health problems and distress amongst our children and young people must be near the top of a 21st century list of challenges in “building back better”.

School closures, uncertainty and being cut off from friends and social and sporting events have seen more children and young people referred to CAMHS — a service that was facing growing demand even before the pandemic.

The long-term impact is obviously still unknown.

However, a cutting-edge child and adolescent mental health centre opening in south London two years from now will play a big role in responding to the likely increased demand for ongoing support — and in developing innovative treatment responses.

Read full story (paywalled)

Source: HSJ, 27 April 2021

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Care home staff COVID vaccination levels below target in more than half LAs

The vaccination rate for staff at older care homes is below the recommended level set by scientists in more than half of England’s local authorities, analysis of NHS England data has revealed.

Data as of 18 April shows that 76 out of 149 LAs had not reached the 80% vaccination threshold for care home staff to provide a minimum level of protection against COVID-19, according to the PA news agency.

In 17 areas, less than 70% of staff had received a first jab. Lambeth, where 23 cases of a South African COVID variant have been recently reported in a care home, had the lowest uptake at 52.4%.

The government last week announced the launch of a five-week consultation on mandatory staff vaccination as a result of the failure in some areas to reach the designated threshold.

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Source: Care Home Professional. 23 April 2021

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Trust ‘reviewing hundreds of patients’ after failings discovered

The suicide of a woman with severe mental illness has prompted a review into the care of hundreds of other patients, according to her family.

Frances Wellburn, 56, was under the care of Tees, Esk and Wear Valley Foundation Trust’s community mental health team in York, which before the coronavirus pandemic had categorised her as “medium risk”.

This meant she should have had regular contact from the service, but an internal serious incident report into her death, seen by HSJ, found no contact was made with her for three months.

In June 2020 she required admission to an inpatient unit for three weeks, but she deteriorated again after being discharged and took her own life in August.

Her family have said Ms Wellburn was making a “good recovery” from episodes of psychosis prior to the pandemic, but the lack of support in the spring of last year had contributed to a major deterioration in her condition.

According to sister, Rebecca Wellburn, the trust’s director of nursing Elizabeth Moody confirmed in a meeting with the family that a wider review had now been launched into the care of hundreds of patients under its York-based community services.

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Source: HSJ, 28 April 2021

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Glasgow NHS whistleblowing review highlights 'concerning' impact on staff

NHS whistleblowers have required counselling and medication and a quarter would not raise concerns again due to the stress and lack of support, a report found.

A review of existing policy at NHS Greater Glasgow and Clyde found “concerning” evidence of  a significant impact on the mental health of both whistleblowers and managers with little support provided.

It found  there was “no clear documented process” to highlight serious, urgent issues to the appropriate manager.

Healthworkers’ union Unison said staff were often labelled ‘trouble-makers’ with senior managers "defensive from the outset".

Sixty percent of staff reported that their mental health was negatively impacted by whistleblowing with some requiring counselling or medication to cope with the stress of disclosures.

The report said it was of concern that a quarter of staff stated that they would not raise concerns such as unsafe clinical practices again given their experiences, a figure which it said was likely to be higher as this information was only recorded if it was volunteered by staff.

Unison’s Regional Organiser Matt McLaughlin said, “Unison welcomes this paper and the Boards commitment to follow the updates national guidance. 

“However it will take more than a new policy for whistleblowers to feel valued within NHS GGC. The organisation is too defensive and staff who whistleblow often do so out of shear frustration that legitimate concerns are ignored – or worse, where the whistleblower is seen as a trouble maker. "

"NHS Greater Glasgow and Clyde needs to embrace and welcome staff speaking out; rather than being defensive from the outset."

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Source: The Herald, 28 April 2021

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