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Contraception shortage 'causing utter chaos'

A shortage of contraception is causing chaos and risks unplanned pregnancies and abortions, doctors are warning.

Leading sexual health experts have written to ministers warning that the supply shortage of contraceptives is beginning to lead to serious problems across the UK.

A number of daily pills and a long-acting injectable contraceptive are thought to be affected, including Noriday, Norimin and Synphase. The problem follows a shortage of hormone replacement therapy for menopausal women last year.

It is unclear how many women use these types of contraception - overall around three million women take daily pills, and more than 500,000 use long-acting contraception, such as coils, implants and injections.

The Royal College of GPs said its members were doing their best to help women find alternatives - there are many different types of daily pill available.

Faculty president Dr Asha Kasliwal said; "We are aware that women are sent away with prescriptions for unavailable products and end up lost in a system. This is causing utter chaos."

The faculty has teamed up with the Royal College of Obstetricians and Gynaecologists and the British Menopause Society to write to ministers, asking them to set up a working group to address the problems. The letter warns women are becoming distressed by having to find alternative products that might not necessarily suit them or go without contraception altogether.

It said this was affecting the "physical and mental wellbeing of girls and women" and could lead to a "rise in unplanned pregnancies and abortions".

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Source: BBC News, 7 February 2020

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Contraception blood-clot risk: ‘public need better access to advice’

Women need more information about contraceptive options, experts said, after concerns over rare blood clots linked to the AstraZeneca Covid jab prompted a debate over side-effects caused by certain forms of the pill.

On Wednesday the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) said that evidence that the jab could be causing a rare blood clotting syndrome was growing stronger. As a result the UK’s Joint Committee on Vaccination and Immunisation (JCVI) recommended that healthy people under the age of 30 who were at low risk of Covid should be offered a different vaccine if possible.

But the announcement prompted numerous posts on social media questioning why there had been little comment on combined hormonal contraceptives.

These methods, which include certain pills, vaginal rings and patches, contain forms of oestrogen and progesterone hormones and have been associated with increased risk of clots, including deep vein thrombosis, pulmonary embolism and cerebral venous sinus thrombosis (CVST) – a very rare clot on the brain.

Speaking on ITV’s Good Morning Britain Adam Finn, a professor who is part of the JCVI, confirmed the difference in risk.

“The risks of thrombosis that come with taking the pill are very much higher than the risks that we were just seeing on those slides [relating to the rare blood clots from the AstraZeneca vaccine],” he said.

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Source: The Guardian, 9 April 2021

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Contaminated blood scandal victims were ‘being used for research without knowing’

Bereaved families who lost loved ones in the contaminated blood scandal have claimed their relatives were being “used for research” after discovering historic notes in medical records.

It is claimed that some patients being treated for the blood clotting disorder haemophilia in the 1970s and 1980s were given blood plasma treatment which doctors knew might be contaminated and infect them with hepatitis.

They wanted to study the links between the haemophilia treatment Factor VIII and the risk of infection, but a number of families have claimed their loved ones were enrolled in these studies without their knowledge or consent.

The Factor 8 campaign group alleges that instead of stopping treatment, clinicians lobbied to continue trials, even after identifying the association between hepatitis and the treatment.

Jason Evans, director of the campaign group, found notes alluding to the research in his father’s medical records. He has since found other families who have discovered the same notes in the records of their loved ones. Mr Evans, whose father died in 1993 after being infected with both HIV and hepatitis C during the course of his treatment for haemophilia, said: “It is appalling that hundreds of people with haemophilia across the country were knowingly infected with lethal viruses under the guise of scientific research. These secret experiments, conducted without consent, show individuals were treated as mere test subjects, not human beings."

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Source: Independent, 9 May 2024

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Contaminated blood scandal payouts to start by end of year, says UK government

Victims of the contaminated blood scandal will begin receiving compensation before the end of the year, and some people will be entitled to more than £2.5m, the government has confirmed.

An outline of the long-awaited compensation scheme was set out in May, after the final report of the infected blood inquiry laid bare what Rishi Sunak, the then UK prime minister, called “a decades-long moral failure at the heart of our national life”

More than 3,000 people died and many more had their lives ruined because of diseases such as HIV and hepatitis C caused by infusions of contaminated blood given between the 1970s and 1990s. Campaigners spent decades urging successive governments to take responsibility, and compensate victims and their families.

The government is expected to introduce regulations setting up the new scheme by 24 August, allowing survivors who were infected to start receiving payments before the end of the year. For those who have already died, payments will be made to their estates.

A second set of regulations covering victims’ families and others affected will follow in the coming months, with payments for these individuals to be made, starting in 2025.

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Source: Guardian, 16 August 2024

Related reading

Infected Blood Inquiry: The Report (20 May 2024)

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Contaminated blood inquiry: Some patients used as 'guinea pigs'

A public inquiry into the infected blood scandal has been told some patients were used as "guinea pigs" at Belfast's Royal Victoria Hospital.

The inquiry is looking at how haemophilia patients across the UK were treated with Hepatitis C infected blood or HIV in the 1970s and 1980s.

Among the correspondence presented to the inquiry this week was a letter, dated 1988, sent by Dr Elizabeth E Mayne, consultant/director at the Department of Haematology in the Royal Victoria Hospital, to Professor Ludlam at the Royal Infirmary in Scotland.

The letter was part of discussions about a potential switch between an NHS product and a commercial product, Profilate Factor 8.

Dr Mayne explained that "complications may arise with this product or indeed a safer product may become available".

She added: "I am happy for us to try this arrangement as long as the treatment of the children here and the small number of other patients is safeguarded."

She concluded "It would be interesting to see the reactions of the patients to this change over and to see if the number of units consumed is reduced."

After the letter was read into the record of the inquiry, the chairman, Sir Brian Langstaff, said: "There is also the implicit suggestion there that the patients will not have been asked in advance.

"It is going to be given to them and they wait to see what the reaction is."

Counsel to the inquiry, Jenni Richards QC, replied "Yes, there doesn't appear to have been an element of choice."

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Source: The Independent, 1 April 2021

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Contaminated blood inquiry: NHS treatment disaster

From 1974 to 1987, children from Treloar's College, a boarding school for children with physical disabilities, were offered treatment for haemophilia.

However, more than 120 children were given contaminated drug which infected many with HIV and viral hepatitis, with at least 72 having died as a result. 

Treloar's College had a specialist NHS haemophilia centre on site, however, the blood plasma used to make the drug had been imported from overseas. 

Only 32 out of the 122 children with haemophilia are still alive today. 

It is hoped that the public inquiry may shed some light on what happened. 

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Source: BBC News, 21 June 2021

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Contaminated blood inquiry: Matt Hancock to give evidence

The health secretary will face questions about compensation for victims of the contaminated blood scandal on Friday afternoon. Matt Hancock will give evidence at a public inquiry into what's been called the worst NHS treatment disaster.

Around 3,000 people have died after being given blood containing HIV and hepatitis C in the 1970s and 1980s.

Ministers announced a public inquiry into the scandal in 2017 after decades of campaigning by victims and their families. Nearly 5,000 people with the blood disorder haemophilia were infected with potentially fatal viruses after being given a clotting agent called Factor VIII.

Much of the drug was imported from the US, where prisoners and other at-risk groups were often paid to donate the plasma used to make it.

Victims included dozens of young haemophiliacs at a boarding school in Hampshire who died after contracting HIV as a result.

Tens of thousands more victims may have been exposed to viral hepatitis through blood transfusions after an operation or childbirth.

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Source: BBC News, 21 May 2021

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Contaminated blood inquiry: Manslaughter claim against consultant

A deceased NHS consultant could have been charged with manslaughter over the deaths of haemophiliac patients given blood infected with HIV and hepatitis C, a lawyer for families has claimed. Des Collins said the reputation of Prof Arthur Bloom "cannot remain intact". The role of Prof Bloom has been mentioned by families of a number of victims giving evidence to the ongoing contaminated blood inquiry in Cardiff. 

Cardiff and Vale University Health Board said it was co-operating fully with the inquiry. It added: "We cannot comment on historical allegations at this stage and will await the findings of the inquiry and then take any necessary steps. "We are committed to an open and transparent approach and have been working with Haemophilia Wales to support patients and families who are likely to be involved in the inquiry."

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Source: BBC News, 26 July 2019

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Contacting the Patient Safety Commissioner for England

Dr Henrietta Hughes was appointed as the first ever Patient Safety Commissioner for England in July. She began her role on 12 September.

Dr Hughes is an independent point of contact for patients so that patients’ voices are heard and acted upon. She will use patients’ insight to help the government and the healthcare system in England listen and respond to patients’ views and promote patient safety, specifically with regard to medicines and medical devices.

For more information on the role of the Patient Safety Commissioner see the fact sheet and the government’s response to a consultation regarding the post.

The privacy notice sets out how the Patient Safety Commissioner collects and uses personal data to fulfil the role.

Please contact the Patient Safety Commissioner at [email protected].

Source: Department of Health and Social Care, 28 September 2022

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Contact tracing system rolled-out across Wales

A contact tracing system has this week been launched in Wales, initially a telephone based process, followed by an online system next week.

Anyone who has a positive coronavirus test result will be contacted by a team of contact tracers and asked for details of everyone they have had close contact with while they have had symptoms.

From Monday 8th June, a new online system will be used to support the process. People will have the option to use the system to provide details of their close contacts electronically.

The system has been trialled in four health board areas over the last two weeks and more than 600 contact tracers have so far been employed, with more to be employed.

Health Minister,  Vaughan Gething said “Today’s roll-out of the contact tracing element of our Test, Trace, Protect strategy is a significant step forward in the gradual move out of lockdown.”

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Source: HTN, 2 June 2020

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Contact tracing app to give users COVID-19 ‘risk score’

The new version of the government’s contact tracing app will give users a ‘risk score’ based on how many people they interact with and where they live.

The news comes as the Department of Health and Social Care launches a trial for the latest model of the contact tracing app, two months after the initial version was scrapped. 

According to the DHSC, the new app will tell users whether their risk of contracting coronavirus is unknown, low or high based on how many people they are in significant contact with. They will also be told what the coronavirus risk level is in their local authority area and will be alerted if it changes.

Government guidance said the risk levels and alerts will be based on a local authority watchlist – which highlights areas that are of particular concern across the country, based on the number of coronavirus cases.

People will also be able to check into venues – such as restaurants, pubs and leisure centres – using the app by scanning a QR code. If there is then an outbreak in a venue those who have checked in via the app will be alerted and told to isolate.

The new NHS Test and Trace app trial was launched today for residents on the Isle of Wight and will expand to the London borough of Newham next week.

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Source: HSJ, 13 August 2020

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Consumer genetic test results ‘causing unnecessary breast cancer alarm’

Women are being unnecessarily alarmed about their risk of breast cancer by consumer genetic test results that do not take family history into account, researchers have said.

Women who discover outside a clinical setting that they carry a disease-causing variant of the BRCA1 or BRCA2 genes may be told that their risk of breast cancer is 60-80%. But analysis of UK Biobank data suggests the risk could be less than 20% for those who do not have a close relative with the condition.

Dr Leigh Jackson, of the University of Exeter’s medical school, who is the lead author of the analysis published in the journal eClinical Medicine, said that in extreme cases this could result in women unnecessarily undergoing surgery.

“Being told you are at high genetic risk of disease can really influence levels of fear of a particular condition and the resulting action you may take,” he said. “Up to 80% risk of developing breast cancer is very different from 20%.”

Until recently, women who received BRCA results did so because they had attended clinic due to symptoms or a family history of disease. However, an increasing number are now learning of their genetic risk after paying for home DNA testing kits or taking part in genetic research, without ever having any personal link with breast cancer. 

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Source: The Guardian, 15 September 2023

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Consultants express no confidence in trust chair and board

Consultants at a prestigious teaching hospital have written a letter of no confidence in its chair and board, and have made a string of serious allegations against members of the trust’s leadership team.

The senior medics at Moorfields Eye Hospital Foundation Trust sent the letter, obtained by HSJ, to the organisation’s governors on 26 February.

Allegations in the letter include: there was a bullying culture at the organisation, including “coercive behaviour” by the trust’s chair; the trust’s reputation as a research institution was being damaged; and there was “a lack of corporate integrity”.

The letter, from consultants’ committee chair Hari Jayaram, said more than half of the senior doctors — more than 80 consultants — at the trust had contacted him to “voice a lack of confidence in the organisation by the current chair and board”.

It also said morale among these senior doctors was “at a significant nadir, which most colleagues do not ever recall experiencing in their consultant careers” and that senior staff have lost confidence in the trust’s Freedom to Speak Up process.

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Source: HSJ, 27 February 2025

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Consultants blow whistle on 10,000 ‘hidden’ follow-up cases amid trust merger

An acute trust is reviewing thousands of gastroenterology cases for possible patient harm, after details emerged of an ‘extremely concerning’ list of patients who have not had follow-up appointments for up to six years since being treated.

HSJ understands major concerns have been raised internally at Liverpool University Hospital Foundation Trust, over 9,500 patients who received treatment at Aintree University Hospital as far back as 2015, but have not had a follow-up appointment.

Whistleblowers have also contacted the Care Quality Commission, which has confirmed it is looking into the issues.

Well-placed sources said around 7,000 of the cases have “target dates” for an outpatient follow-up that are in the past. Around 20 of these cases were supposed to be seen in 2015 or 2016, with around 400 dating back to 2017, and around 900 to 2018, the sources said.

The remaining 2,500 cases either have no target date or have not yet had a follow-up appointment booked.

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Source: HSJ, 8 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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Consultant refused to carry out urgent surgery at trust facing criticism from CQC

A consultant surgeon refused to attend hospital to carry out urgent surgery at a trust which later had upper gastrointestinal surgery suspended after an unannounced Care Quality Commission visit.

The CQC report into upper GI surgery at the Royal Sussex County Hospital in Brighton – based on an inspection in August – said incident reports revealed occasions when upper GI surgeons could not be contacted or refused to come into hospital to treat patients. In one case, a consultant would not come in to carry out urgent surgery, it added.

Low numbers of surgeons meant the on-call rota for upper GI was shared with the lower GI surgeons. This meant an upper GI specialist was not always available immediately, despite guidance from a professional body that 24/7 subspecialty cover was needed at centres which carry out major resectional surgery. This surgery was suspended at the RSCH after the August inspection and has yet to be reinstated.

Mortality at both 30 and 90 days for patients with oesophago-gastric cancer was twice the national average between 2017 and 2020 – though the trust was not an outlier – and there was an increasing number of emergency readmissions for patients who had undergone upper GI surgery, the report said.

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Source: HSJ, 1 December 2022

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Consultant carried out 'unnecessary' surgery for financial gain, tribunal hears

A doctor who worked for the same private healthcare company as rogue surgeon Ian Paterson performed unnecessary shoulder operations for financial gain, a medical tribunal has heard.

Orthopaedic consultant Michael Walsh worked at a Spire Healthcare hospital in Leeds from 1993 until 2018, when he was suspended after concerns were raised about his work.

Spire, which runs 38 hospitals around the UK, reported him to the General Medical Council (GMC) after an investigation found he carried out operations unnecessarily or badly, with many patients left suffering pain or trauma.

Mr Walsh, who also worked at another private hospital in Leeds run by Nuffield Health but is now retired, is facing dozens of medical negligence claims from patients, with some already having received payouts.

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Source: Medscape, 8 November 2023

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Consultant ‘cliques’ and ‘unacceptable behaviours’ put patients at risk

Deep-rooted relationship problems between consultants in a major trust’s neurosurgery department distracted from patient care, according to a review leaked to HSJ.

A review by the Royal College of Surgeons (RCS) into neurosurgery services at University Hospitals Birmingham FT last year found serious concerns over consultant “cliques” and relationship problems across the department.

It comes as a new review has been launched into the care of 23 patients in the deep brain stimulation service, which is a sub-speciality in the department.

According to the RCS report, which was completed in May last year, there have been wide-ranging problems within the department for several years.

The report said: “Poor team working and inter-relational difficulties, which had been deep-rooted and recognised to have existed for some time, have had the potential to compromise patient care and will be likely to continue to do so if these issues remain unresolved.”

It suggested some consultant neurosurgeons had prioritised their personal or professional differences over patient care, with the relationship issues being “amplified” within the wider surgical workforce.

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Source: HSJ, 7 April 2021

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Consultancy called in to review trust's staff 'experience'

A trust grappling with concerns over culture has commissioned an independent review into staff experience.

Doncaster and Bassetlaw Teaching Hospitals Foundation Trust has brought in consultancy The Value Circle to carry out the work.

In a message to staff seen by HSJ, trust CEO Richard Parker said: “We are undertaking an independent review of what it feels like to work at DBTH to help us understand what’s working well, and what could be improved to make it even better for all of us.

“For this to really make a difference, it’s important that the independent team hears from as many colleagues as possible… everything you share will be treated in complete confidence.”

The trust confirmed it was broadening a mandatory well-led review to also look at “colleague experience”.

HSJ previously reported that the trust is in a row with the British Medical Association over the circumstances surrounding a senior clinician being off work. It has also faced criticism from a departing governor and consultants.

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Source: HSJ, 7 July 2025

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Consider statins for millions more people in England, NHS told

About 15 million more people in England could be prescribed daily cholesterol-lowering statin pills to cut their risk of heart attacks and stroke, new advice for the NHS says.

Given the very cheap price of the tablets and the possible health gains, they should be considered more often, the draft guidance says.

There can be side effects though and there is debate about how widely this long-term treatment should be given and what associated risks are acceptable.

The National Institute for Health and Care Excellence (NICE), which advises the NHS, says people should be thoroughly assessed before statins are prescribed, warning the pills are not a quick fix or substitute for a healthy diet and exercise.

The previous advice was for anyone with a one in 10 chance of having a cardiovascular event, such as a heart attack or stroke, within the next 10 years - based on factors such as age, blood pressure and cholesterol levels - to be offered a statin.

But NICE now says including adults with a one in 20 chance could save 2% of them from having a heart attack or stroke during that period.

Spokesman Paul Chrisp said patients should discuss the benefits and risks with their doctor, adding: "The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice."

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Source: BBC News, 12 January 2023

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Confirm there is no plan to ‘replace doctors’, NHSE told

The medical regulator has told NHS England to ‘directly tackle’ a perception there is a plan to replace doctors with physician associates amid an ‘intense’ debate about their future.

General Medical Council chief executive Charlie Massey wants NHS England and health systems in the devolved nations to address several issues surrounding the expansion of medical associate roles.

This follows intense debate over recent weeks, including multiple media reports of safety incidents where the involvement of physicians and anaesthesia associates has been questioned. The debate has been partially prompted by ambitions in the long-term workforce plan to increase their numbers, and the impact this would have on post-graduate medical training.

Last week almost 90% cent of Royal College of Anaesthetists members voted to pause the rollout of anaesthesia associates, after an extraordinary general meeting. This prompted NHSE leaders to stress to trusts that associates should be working within established guidelines and have appropriate supervision.

In response, Mr Massey has written to NHSE, calling for it to: “Directly tackle the perception that there is a plan for the health services to ‘replace’ doctors with PAs or AAs by convening and leading a system-wide discussion on an agreed vision for these roles.”

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Source: HSJ, 25 October 2023

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Confidence and trust in hospital staff high but no improvement in inpatient experience

Findings from the Care Quality Commission's (CQC’s) latest annual survey of people who stayed as an inpatient in hospital show that most people had confidence in the doctors and nurses treating them and felt that staff answered their questions clearly. However, just over a third (40%) of patients surveyed left hospital without written information telling them how to look after themselves after discharge (up from 38% in 2017), and of those who were given medication to take home, 44% were not told about the possible side effects to watch out for. 

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Conference highlights racial disparity in UK maternal healthcare

Unconscious bias in the UK healthcare system is contributing to the stark racial disparity in maternal healthcare outcomes, a conference has heard.

The Black Maternal Health Conference UK, also heard that black women not being listened to by healthcare professionals was also a contributing factor.

The conference, organised by The Motherhood Group, was arranged to highlight the racial inequality in maternal healthcare and the disparity in maternal mortality between white, ethnic minority and black women in the UK.

Black women in the UK are four times more likely to die in pregnancy and childbirth than white women, according to a report published by MBRRACE-UK. Asian women are twice as likely to die in pregnancy or childbirth.

Sandra Igwe, who founded the NGO The Motherhood Group in 2016 after the traumatic birth of her daughter, told the PA Media that the event was an opportunity to “bridge the community, stakeholders, professionals, [and] government”, de-stigmatise mental health and bring about change to improve black maternal health.

“There are so many stats – so why wouldn’t we have a whole day’s conference dedicated to addressing these, just scratching the surface of some of the stats?”

Charities and activists have been raising alarm bells about the dangerous consequences of unconscious bias in maternal healthcare for many years. Igwe co-chaired the Birthrights inquiry, a year-long investigation into racial injustice in the UK maternity services, which heard testimony from women, birthing people, healthcare professionals and lawyers and concluded that “systemic racism exists in the UK and in public services”.

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Source: The Guardian, 20 March 2023

Sandra Igwe is our hub topic lead for Black Maternal Health. Read our recent interview with Sandra.

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Confed chair: Trusts lacking senior diversity should not get top CQC ratings

Trusts underperforming on leadership diversity should not be rated “good” or “outstanding” by the Care Quality Commission (CQC), the NHS Confederation chair has told HSJ.

Victor Adebowale said he did not understand how organisations can achieve the top CQC ratings if they do not demonstrate sufficient diversity at senior levels.

Lord Adebowale was speaking to HSJ alongside Marie Gabriel, following Ms Gabriel being appointed last month to chair the new NHS Race and Health Observatory, which is being hosted by the confederation.

The influential peer’s comments also follow the new People Plan tightened criteria around equality, diversity and inclusion in the “well-led” aspect of the care quality regulator’s inspections.

He said: “I struggle to see [how] any NHS trust that performs badly, [on] racial equality and leadership, can be considered to be good and outstanding. I don’t get it.

“It seems to me there is enough regulation to take into account the requirement to lead all the people, all the time. But, obviously, if you’re not, then you shouldn’t be [getting] slaps on the back, and [be rated] outstanding or good in anything else.”

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Source: HSJ, 28 August 2020

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Concerns raised with speak-up guardians are steadily rising

The number of concerns reported to the NHS’s Freedom to Speak Up Guardians has been steadily increasing since the guardians were introduced in England in 2017. Since April that year thousands of concerns have been reported to the guardians at NHS trusts, data from the National Guardian’s Office shows.

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Source: BMJ, 19 November 2019

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