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UK needs £102bn boost to NHS and social care, says major report

Spending on the NHS, social care and public health needs to rise by £102bn over the next decade, funded by big tax rises, to improve Britain’s health in the wake of the coronavirus pandemic, an inquiry has said.

The massive funding boost would cut avoidable deaths from cancer and heart disease, tackle glaring health inequalities and rebuild the NHS after Covid exposed weaknesses such as a lack of beds and staff, a team of experts have urged ministers.

The money would come largely from increases in income tax, national insurance and VAT, which evidence suggests the public is willing to pay, according to a four-year commission of inquiry by the London School of Economics and the Lancet medical journal.

“Without concerted action and increased funding we risk the UK falling further behind other high-income countries in health outcomes and life expectancy, continued deterioration in service provision and worsening inequalities, increased reliance on private funding and an NHS that is poorly equipped to respond to future major threats to health,” said Dr Michael Anderson of the LSE, the commission’s joint research lead.

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Source: 6 May 2021

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Covid: Depression rises in young and women during second peak

Women and younger adults were more likely to feel depressed during the second UK coronavirus peak than men and other age groups, Office for National Statistics (ONS) data suggests.

Four in 10 women aged between 16 and 29 were affected, compared to 26% of men. One in five adults experienced depression in early 2021 - more than double pre-pandemic levels.

But GPs in England diagnosed fewer cases of depression in adults in 2020 compared with the year before. Many people may not be seeking medical help, the ONS says.

Health experts have always warned that the combined effects of ill health, isolation and job losses during the pandemic would have a negative impact on people's mental health and wellbeing.

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Source: BBC News, 5 May 2021

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Wards to get ‘star ratings’ under first new NHS cleaning rules for 14 years

The first new hospital cleaning standards for 14 years have been outlined by regulators, including confirmation of new food hygiene-style star ratings.

Wards and theatres will be given ratings from one to five stars – based on audits which score the cleanliness of areas against safe standards – and these ratings will be made visible to patients.

The plans for the new star ratings, which are expected to be easier for patients to understand than the current cleanliness percentage scores, were first revealed by HSJ in 2019.

The ratings are also designed to encourage a more collaborative approach, by reflecting the cleanliness score for whole areas, as opposed to the performance of individual parties responsible for cleaning certain elements.

Areas rated one to three stars would require improvement plans and be automatically placed under review, with “immediate action” being required in one-star rated areas.

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Source: HSJ, 6 May 2021

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Early cancer diagnoses plummeted in England during Covid pandemic

The number of people being diagnosed with cancer early in England has plummeted during the Covid pandemic, sparking fears that many will only be treated when it is too late to save them.

Official figures show a third fewer cancers were detected at stage one, when the chances of survival are highest, in the early months of the pandemic than during the same months a year before.

Cancer experts fear that the figures, which have been collected by Public Health England’s National Cancer Registration and Analysis Service, mean thousands of people have the disease but have not yet started treatment because of “a shift to later diagnosis”. They urged anyone with possible symptoms of the disease to get them checked out immediately.

“While it’s fantastic that Covid rates are dropping and lockdown is easing, the knock-on impact of the pandemic on cancer care cannot be overstated,” said Steven McIntosh, the executive director of advocacy and communications at Macmillan Cancer Support. “We are likely to be dealing with Covid’s long shadow for many years to come.”

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Source: The Guardian, 5 May 2021

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Pfizer vaccine ‘95% effective against coronavirus,’ new data shows

Two doses of the Pfizer-BioNTech vaccine can provide more than 95% protection against infection, severe illness and death from Covid, according to a groundbreaking study in Israel.

The middle eastern country currently leads the world in its inoculation programme, with more than half (56 per cent) of its population having already received both doses of the Pfizer vaccine.

The research, published today in The Lancet journal, also concluded that a single dose of the jab provides 58 per cent protection against infection, 76% against hospital admission, and 77% against death.

The researchers said their study highlights the importance of fully vaccinating adults against the virus but acknowledged challenges remain to get the pandemic under control – including uncertainty around how long immunity lasts, from both vaccines and natural infection, and the emergence of variants that may be resistant to jabs currently on the market.

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Source: The Independent, 6 May 2021

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Half of all hospitals inspected broke covid safety law

Nearly half the hospitals targeted in covid-related spot checks were found to be breaching health and safety laws.

An unpublished Health and Safety Executive report found just five out of 17 acute hospitals inspected had high levels of compliance with measures to manage the risks around covid. 

Meanwhile, letters were sent to eight hospitals “formally requiring them to take remedial action to remedy contraventions of health and safety law”. The remaining four hospitals were given advice.

The inspections — which involved 13 hospitals in England and two each in Scotland and Wales — focused on seven areas: risk assessment; management arrangements specific to covid; social distancing; cleaning and hygiene; ventilation; dealing with suspected covid cases; and personal protective equipment.

The health and safety watchdog highlighted social distancing in non-clinical areas — which covered areas outside of clinical wards such as offices, rest areas, changing rooms and workshops — as needing improvement in some hospitals. 

The inspectors — who visited between November last year and January this year — also found some hospitals needed more robust covid security measures if they were to comply with government guidance.

HSE also noted that, although all the hospitals had adequate supplies of PPE, not all had adequate arrangements in place for ensuring it was used effectively.

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Source: HSJ, 5 May 2021

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GPs are at “breaking point” and in need of respite, leaders warn

General practices are “reaching breaking point” because of the “intense” workload pressure facing doctors and staff, the country’s most senior GP leaders have warned.

The warning came as new figures from NHS Digital showed that practices in England delivered almost five million more appointments in March 2021 than the month before and nearly three million more than in March 2019.

Richard Vautrey, chair of the BMA General Practitioners Committee, said that the figures underlined the huge efforts practices were going to and the workload pressure on staff. He said, “GPs and their teams are consistently telling us they’re busier now than they have ever been, and this data—which does not include a large proportion of the vaccine programme undertaken by practices, nor a vast amount of other daily tasks—backs this up.”

Last week the Ivy Grove Surgery in Derbyshire provided an example of the strain facing some practices in a 16 page open letter to its patients about the huge demand it was facing and the resulting risk of staff burnout. The surgery said it would be reducing its use of the video consultation tool eConsult, as it had seen a doubling of demand over recent months, with some patients submitting several requests a day.

In a statement the practice told The BMJ, “We are aware of the stir our letter has caused but have also been overwhelmed by the kind feedback from our own patients, and the many encouraging messages of support we have received from GP surgeries all around the country. We therefore know that many of our GP colleagues are experiencing the same issues, but they may be fearful of articulating what is happening."

“We feel that open and honest debate about demand and workload in general practice is vital. If this letter goes even a little way towards sparking some much needed discussion then it will have been a good thing.”

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Source: BMJ, 4 May 2021

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Children’s lives at risk from failures in asthma care, warns safety watchdog

Children with asthma are at risk of avoidable deaths in England because of poor NHS systems and a failure to appreciate the dangers posed by the condition.

A new investigation by NHS safety watchdog the Healthcare Safety Investigation Branch (HSIB) has revealed a series of risks to children with asthma, as concerns emerge of the impact of the pandemic on asthma patients more generally.

The latest inquiry was sparked by the deaths of three children between 2014 and 2017. All were caused by asthma attacks which were later the subject of warnings by coroners.

In each case HSIB said there were missed opportunities to recognise asthma as a life-threatening condition as well as problems with how the children were managed by doctors working in different parts of the NHS.

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Source: The Independent, 5 May 2021

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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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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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