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Three girls died after major failings in NHS mental health care, inquiry finds

Three teenage girls died after major failings in the care they received from NHS mental health services in the north-east of England, an independent investigation has found.

“Multifaceted and systemic” failures by the Tees, Esk and Wear Valleys (TEWV) NHS trust contributed to the young women’s self-inflicted deaths within eight months of each other, it concluded.

Christie Harnett died aged 17 on 27 June 2019 at the trust’s West Lane hospital in Middlesbrough. Nadia Sharif, also 17, died there six weeks later, on 5 August. Emily Moore, who had been treated there, died on 15 February 2020 at a different hospital in Durham. All three had complex mental health problems and had been receiving NHS care for several years.

The investigation into their deaths, commissioned by the NHS, found that 119 “care and service delivery problems” by NHS services, especially TEWV, had occurred.

Charlotte and Michael Harnett, Christie’s parents, said their daughter had “lost her life whilst in a hospital run by TEWV trust where there was little or no care or compassion”. Emily’s parents, David and Susan Moore, said she received “horrific care” while at West Lane. Services at the hospital were understaffed, “unstable and overstretched”, the investigation’s final report found.

Both families, and also Nadia’s parents, Hakeel and Arshad Sharif, said the dangerous inadequacy of the care provided by TEWV, and the likelihood that other patients with fragile mental health had died as a result, showed that ministers should order a full public inquiry. “This mental health trust is a danger to the public,” the Moores said.

The report said TEWV failed to properly monitor the girls, given their known risk of self-harm; to take seriously concerns about their care and suicide risk raised by their families; and to remove all potential ligature points.

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Source: The Guardian, 2 November 2022

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Three deaths and ‘severe harm’ at trust with treatment delays

At least three people died and more came to ‘severe harm’ after treatment delays across three specialties at one hospital trust, new reports have revealed.

King’s College Hospital Foundation Trust commissioned harm reviews due to problems with a lack of capacity and poor management of waiting lists in endoscopy, dermatology and ophthalmology pre-pandemic. Most of the problems relate to the trust’s southern site, Princess Royal University Hospital, and took place before the current executive team took over.

The most recent board papers revealed a review of 614 cases at the PRUH’s endoscopy service found seven cases of “serious harm”. This category includes death and the document revealed three patients had died. 

The review also “highlighted delays in endoscopy leading to delayed diagnoses of cancer” in 2018-19 and 2019-20.

Investigators also found a dermatology patient came to “severe harm” after being lost to follow-up twice by the trust.

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Source: HSJ, 17 September 2021

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Thousands with breathing problems undiagnosed due to lack of tests in England

Thousands of people with asthma and other lung problems are going undiagnosed because most GPs in England do not offer tests for them, according to a new report.

The failure to diagnose and start treating people with breathing problems threatens to create “a deluge of hospital admissions this winter” when the NHS is under intense pressure.

Sarah Woolnough, the chief executive of charity Asthma and Lung UK, said: “The abysmal lack of testing and patchy basic care is causing avoidable harm to people with lung conditions and the NHS.”

The report, which the Charity Commissioned from consultants PricewaterhouseCoopers, found that most GP surgeries in England do not provide basic lung function tests.

Patients’ inability to access a test to check if they have asthma or chronic obstructive pulmonary disease (COPD) represents a “crisis in care” that could lead to many being hospitalised this winter “as respiratory viruses take hold and people struggle to heat their homes”, Asthma and Lung UK added.

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Source: The Guardian, 26 September 2023

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Thousands unaware they have diabetes could be diagnosed at A&E, says study

Thousands of people unaware they have type 2 diabetes could be diagnosed and avoid serious complications if screening was introduced in emergency departments, a study suggests.

The prevalence of the disease has risen dramatically in countries of all income levels in the last three decades, according to the World Health Organization. More than 400 million people have been diagnosed, but millions more are estimated to be in the dark about the fact they have the condition.

A study that took place in an NHS trust in England suggests 10% more cases could be picked up with the use of a simple blood test. Screening could also pick up 30% more cases of pre-diabetes – a serious condition where blood sugar levels are higher than normal.

The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany.

“Early diagnosis is the best way to avoid the devastating complications of type 2 diabetes, and offers the best chance of living a long and healthy life,” said Prof Edward Jude, of Tameside and Glossop integrated care NHS foundation trust.

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Source: The Guardian, 3 October 2023

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Thousands still being denied PPE for procedures with ‘high covid risk’

Thousands of frontline workers delivering treatments where the risk of transmitting coronavirus is heightened are still being denied personal protective equipment (PPE), according to multiple unions and professional bodies.

Eleven organisations, including Unison and the British Association of Stroke Physicians, believe numerous procedures have been “wrongly excluded” from the list of 13 “aerosol generating procedures” that require PPE, despite the NHS now having adequate supplies.

They say their members are “facing illness and even death” while performing procedures such as chest physiotherapy, introducing feeding tubes, and assessing whether a patient can swallow safely.

The unions have formed an alliance to lobby on the issue, and its chair Dr Barry Jones told HSJ: “We’ve asked ministers and the Department of Health and Social Care again and again to take action and provide PPE to frontline NHS staff carrying out procedures which are not currently listed as AGPs but which the scientific evidence shows should be.

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Source: HSJ, 13 November 2020

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Thousands receive diagnosis after 60 new diseases found

Thousands of children with severe developmental disorders have finally been given a diagnosis, in a study that found 60 new diseases.

Children, and their parents, had their genetic code - or DNA - analysed in the search for answers to their condition.

There are thousands of different genetic disorders. Having a diagnosis can lead to better care, help parents to decide whether to have more children, or simply provide an explanation for what is happening.

The Deciphering Developmental Disorders study, conducted over 10 years in the UK and Ireland, was a collaboration between the NHS, universities and the Sanger Institute, which specialises in analysing DNA.

Among the findings, researchers discovered Turnpenny-Fry syndrome.

Jessica Fisher's son, Mungo - who took part in the study - was diagnosed with the syndrome.

Jessica subsequently started an online support group for the syndrome, which is now made up of 36 families from around the world, including America, Brazil, Croatia and Indonesia.

"It's devastating to learn that your child has a rare genetic disorder, but getting the diagnosis has been key to bringing us together," said Jessica.

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Source: BBC News, 13 April 2023

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Thousands of women left waiting for induction due to staff shortages

Thousands of women are having induction of labour delayed because of a shortage of staff, raising concerns about the safety of them and their babies, HSJ has found.

The issue has been highlighted at seven hospitals in Care Quality Commission reports over the past six months, and HSJ has identified a further three trusts declaring they are concerned about it in their own board papers over the same period. 

 At University Hospitals of Leicester Trust, more than 1,300 “red flags” were raised in a five-month period due to delays in the induction of labour, linked to staffing levels, the CQC said earlier this month. Most were dealys in continuing inductions, and a smaller number were delays between admission and beginning an induction. UHL indicated it had set its own “red flag” bar locally, so all the delays did not represent a national alert. 

Carolyn Jenkinson, CQC deputy director of secondary and specialist healthcare, told HSJ: “At some maternity services we’ve found women having to wait long periods of time to be induced or for transfer to a labour ward once the induction process has started, and in some cases a lack of effective monitoring during periods of delay.

“Where we have found concerns about delayed treatment – including induction of labour – we have made clear to those trusts that effective oversight of the issue is vital and that all action possible should be taken to mitigate any risk and keep people using the service safe.”

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Source: HSJ, 27 September 2023

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Thousands of women had abortions while ‘struggling to access contraception during Covid crisis’

Thousands of women have had abortions after falling pregnant while having difficulties accessing contraception during the pandemic, healthcare providers have warned.

Sexual health clinics have been forced to shut or run reduced services while staff are transferred to work with Covid patients or have to self-isolate – with the profound disruption leaving many women unable to access their usual methods of contraception.

Many women are struggling to get the most effective long-acting contraceptive choices of a coil or an implant due to these requiring face-to-face appointments which have largely been suspended as consultations are carried out remotely via phone or video call to curb the spread of COVID-19.

British Pregnancy Advisory Service, the UK's largest abortion provider, told The Independent they provided the progestogen-only contraceptive pill to almost 10,000 women undergoing an abortion between May and October last year.

Katherine O’Brien, a spokesperson for the service, said: “Many of these women will have fallen pregnant after struggling to access contraception, so there really is a huge unmet need for contraceptive services which will only worsen as lockdown and Covid continues.

“We routinely hear from women during the pandemic who simply can’t access their regular method of contraception because of clinics closing or staff being deployed elsewhere or staff self-isolating.”

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Source: The Independent, 9 January 2021

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Thousands of women given ‘dangerous’ electric shocks as mental health treatment in England

Thousands of women in England with mental health problems are being given electric shock treatment despite concerns the therapy can cause irreparable brain damage.

NHS data seen by The Independent reveals the scale of electroconvulsive therapy (ECT) prescribed disproportionately to women, who make up two-thirds of patients receiving the treatment.

Health professionals have warned the therapy can cause brain damage so severe recipients are unable to recognise family and friends or do basic maths.

While some patients say the therapy profoundly helped them, leading mental charities have branded it “damaging” and “outdated” and called for its use to be halted pending an urgent review or banned entirely.

Statistics obtained through Freedom of Information requests by Dr John Read, a professor at the University of East London and leading expert on ECT, showed 67% of 1,964 patients who received the treatment in 2019 were female.

ECT was given to women twice as often as men across 20 NHS trusts in the UK, his research found. The trusts also said some 36% of their patients in 2019 underwent ECT without providing consent.

A spokesperson added patients should be fully informed of the risks associated with ECT and the decision to deploy the treatment “should be made jointly with the person with depression as far as possible”.

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Source: The Independent, 19 June 2022

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Thousands of ventilators pulled as electrical faults put UK patients’ lives at risk

Two thousand ventilators being used in UK hospitals are at risk of suddenly shutting down due to electrical faults that have led to a global safety alert.

Hospitals have been ordered to source replacement ventilators after Philips Respironics said its breathing support devices could suddenly stop working, in some cases without activating a warning alarm.

The Medicines and Healthcare products Regulatory Agency (MHRA) said the problem related to “a number of electrical faults in the devices, which can result in an unexpected shutdown, leading to loss of ventilation”.

It said there had been five reported cases of shutdowns in the UK so far, none of which involved patient harm. Globally, there have been 389 reports of failures, including one where the patient died and four where they were seriously injured. In six of the total cases, the warning alarm didn’t sound.

Philips Respironics is one of several manufacturers that increased production of ventilators during the pandemic. The MHRA brought in a fast approval process for ventilators and other medical devices in response to Covid-19.

The MHRA said the root cause of the problem was not yet known and remained under investigation, but that Philips Respironics currently had “no permanent solution” to correct it.

Helen Hughes, chief executive of Patient Safety Learning, said there was a “significant patient safety concern” that some Philips devices could remain in use until replacements were sourced.

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Source: The Guardian, 9 April 2022

National Patient Safety Alert: Philips Health SystemsV60, V60 Plus and V680 ventilators – potential unexpected shutdown leading to complete loss of ventilation

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Thousands of US nurses tired of working with too many patients will walk out of hospitals in a four-state strike

Over 6,500 nurses in hospitals around California, Arizona, Florida, and Illinois will strike today. The strike will mark the first ever nurse strike in Arizona, and the first hospital registered nurse strike in Florida's history.

Nurses who are part of the National Nurses United union are asking for better nurse retention and nurse-to-patient ratios. 

"The strike is first and foremost about patient care and patient advocacy," Dominique Hamilton, a registered nurse at St. Mary's Hospital in Arizona, said. "We want the hospital to invest in the nursing staff, and we want to have more input into the recruitment and retainment of experienced [registered nurses]."

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Source: Business Insider, 

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Thousands of urgent operations building up across London as Covid pressures continue

Hospitals across London are racing to tackle a backlog of tens of thousands of urgent operations that need to be carried out in the coming weeks to prevent patients dying or losing limbs, The Independent has learnt.

The slow decline in Covid patient numbers means many hospitals across the capital are warning they will still be relying on extra staff, and “surge” beds opened at the height of the crisis, well into March.

NHS bosses have been briefed that across the city there are about 15,000 priority two (P2) patients. These are classed as needing urgent surgery, including for cancer, within 28 days, or they could die or be at risk of losing a limb.

But the lack of available operating theatres, nurses and anaesthetists mean the city has a shortfall of more than 500 half-day surgical lists a week.

The Independent has spoken with multiple NHS insiders and seen briefing documents detailing the challenges facing the capital’s hospitals, which are expected to last up to 21 March in some areas.

One briefing warned: “Hospitals have insufficient capacity to meet urgent elective demand for P2. P2 demand is intended to be seen within 28 days, the surge has occurred for over 28 days. Patients who would normally have been seen are waiting longer than clinically advisable."

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Source: The Independent, 25 February 2021

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Thousands of treatments lost during nurse strikes

Thousands of NHS operations and appointments have had to be cancelled because of the nurses' strikes in England this week.

Over the two days, NHS England said 27,800 bookings had to be rescheduled, including 5,000 operations and treatments.

There were more than 30 hospital trusts affected with some saying between 10% to 20% of normal activity was lost.

They warned the dispute was hampering progress in reducing the backlog.

Saffron Cordery, of NHS Providers, which represents hospital bosses, said the strike days caused "significant disruption" and were "some of the hardest" hospitals have had to cope with this winter.

She said it would have a "big knock-on effect on efforts to tackle the backlog".

"The ramifications go well beyond the day itself. We are deeply concerned by this pile-up of demand, which will only continue with more strikes on the horizon."

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Source: BBC News, 21 January 2023

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Thousands of surgeons blame burnout as half consider leaving NHS

Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows.

More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed.

As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge.

RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased.

“The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery.

“There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.”

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Source: The Independent, 18 January 2024

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Thousands of referrals for sick babies turned down due to lack of beds

More than 1,000 referrals to admit very sick or premature babies to neonatal units were rejected in the last year due to a lack of beds, data obtained by HSJ has revealed.

Nineteen trusts turned down a total of 2,721 requests to admit a baby to their level three neonatal intensive care unit – those for the most serious cases – specifically due to a lack of a bed, between 2019-20 and 2021-22, with 1,345 such refusals taking place in 2021-22.

Experts told HSJ the issue – which appears to have led to families having to travel very long distances from their homes – was due to a shortage of staff, especially nurses, meaning insufficient beds (normally referral to as cots in neonatal care) can be opened.  

A British Association of Perinatal Medicine spokesperson told HSJ: “Neonatal intensive care units should run at less than 80% occupancy on average to allow for peaks and troughs in activity. There are a significant number which are having to run over that capacity limit which can cause flow problems – we’re a bit like an A&E that can’t stack the ambulances outside – once the baby is there, it has to come and we’re not able to control those admissions.”

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Source: HSJ, 1 December 2022

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Thousands of patients recalled over eye damage concerns

Thousands of patients are being recalled for urgent eye checks after regulators raised safety concerns related to a product used in cataract surgery.

It is thought around 20 trusts have suspended use of the EyeCee One lenses, after the Medicines and Healthcare Products Regulatory Agency warned of links to higher pressure in the eye, which can cause lost vision.

The MHRA has issued an alert ordering trusts to recall patients who have had surgery since October, and estimates between 2 and 4 per cent of patients could have complications. The watchdog stressed reduced vision would only occur if patients were not treated.

It is thought the complications could be down to the way the implant was being used in surgery, rather than the product itself.

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Source: HSJ, 7 February 2023

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Thousands of patients potentially harmed by undelivered NHS mail

The NHS has launched a patient safety inquiry after a private contractor failed to send more than 28,000 pieces of confidential medical correspondence to GPs. 

NHS bosses are trying to find out if any patients have been harmed after 28,563 letters detailing discussions at outpatient appointments were not sent because of a mistake by Cerner, an IT company. The letters should have been sent by doctors at Barnet and Chase Farm hospitals in north London to GPs after consultations with 22,144 patients between June last year and last month. However, a “clinical harm review” is under way after it was found they had not been dispatched.

The incident has prompted concern among GPs and patient representatives. “Patients who have attended these two hospitals will now be very worried about whether their care might have been compromised by this IT bungle”, said Rachel Power, the chief executive of the Patients Association.

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Source: The Guardian, 18 February 2020

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Thousands of patients go missing from NHS care

Police have carried out more than 5,500 investigations into patients who have been reported missing from NHS facilities in Scotland since 2019.

The figures were outlined in a written response from Keith Brown, the justice secretary, to Jamie Greene, the Conservative MSP.

Greene, who is the justice spokesman for the Conservatives, said the figures gave serious cause for concern. He said that the complete figure could be much higher because the data provided only included those reported to police. He urged Brown and Humza Yousaf, the health secretary, to provide adequate resources for policing and the health sector to ensure vulnerable patients were not slipping through the cracks.

Greene said: “These figures are deeply alarming. Relatives expect their loved ones to be safe while they are staying, or being treated in, an NHS facility. It gives serious cause for concern that over 200 investigations have had to be launched in just the last few years to determine the whereabouts of young people who went missing from NHS grounds.”

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Source: The Times, 3 January 2023

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Thousands of patients face cancelled NHS appointments or operations due to Queen’s funeral

Thousands of hospital and GP appointments have been cancelled due to the public holiday surrounding the Queen's funeral on Monday.

Many hospitals are to postpone outpatient appointments and planned operations because of reduced staffing, while most GP surgeries will also close.

NHS hospitals in England have been urged to contact patients who could be affected, whether or not their appointment has been postponed.

Some hospitals have said they will be operating as usual, while others have said that they will postpone some non-urgent appointments.

Some patients and doctors have expressed concern about their appointments being postponed.

One doctor told The Independent: “I have the greatest respect for the Queen ... but when patients are waiting up to two years to be seen ... really?

One GP leader in London said practice staff were now getting “abuse” over the bank holiday closures.

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Source: The Independent, 14 September 2022

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Thousands of patients could lose the ability to see their GP because of virus fears

Hundreds of thousands of NHS patients could lose the ability to see their GP face to face because their doctors may have to protect themselves from coronavirus.

An analysis by the Health Foundation charity has found around a third of GPs who run their practice on their own are at high risk from the virus themselves.

If they are forced to abandon face-to-face consultations the charity warned it could deny 710,000 patients access to their doctor.

Dr Rebecca Fisher, senior policy fellow at the Health Foundation and a GP said: “The ongoing risk of Covid-19 to the safety of both patients and GPs means hundreds of thousands of people may find it much harder to get a face-to-face GP appointment.

“It’s particularly worrying that GPs at higher risk from Covid-19 are far more likely to be working in areas of high deprivation. Those are precisely the areas with the greatest health need, the biggest burden from Covid-19, and an existing under-supply of GPs relative to need. Unless urgent action is taken this could become another way in which poorer communities become further disadvantaged, and risks further widening health inequalities.”

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Source: The Independent, 6 August 2020

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Thousands of operations likely to be cancelled during NHS strikes, trusts chiefs warn

Thousands of hospital surgeries are likely to be cancelled as NHS leaders prepare for unprecedented strike action, The Independent has been told.

Most operations apart from cancer care are likely to be called off when nurses take to the picket line, with NHS trusts planning for staffing levels to be similar to bank holidays.

Multiple sources say they are almost certain that the upcoming Royal College of Nursing ballot will result in strike action. Results are expected to be finalised on Wednesday.

“Trusts are looking at the totality of it. It’s the waiting list that is going to be hit, massive questions over waiting lists, and we’re going to lose days of activity in terms of addressing that growing pressure.

“The more we see strike action the harder it is, the risk is [that] the rate of recovery [of waiting list] slows.”

They added: “The unions normally provide bank holiday cover and maintain emergency service basically.”

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Source: The Independent, 7 November 2022

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Thousands of NHS-funded appointments still carried out by unaccredited practitioners

Thousands of NHS-funded talking therapy sessions are still being carried out by unaccredited practitioners every month, despite NHS England trying to stop the practice for at least five years.

NHS Digital data for January this year showed 44,170 sessions involved practitioners who were neither in training nor had done an accredited course. The actual figure could be higher as, of the 517,027 sessions in total carried out, data about who was involved was missing for more than half (328,433).

Since last June, practitioners delivering NHS-funded “low intensity” talking therapies – previously known as Improving Access to Psychological Therapies – are required to be part of either the British Psychological Society or the British Association for Cognitive and Behavioural Psychotherapies’ registers. The registers, which were set up in 2021, confirm practitioners have completed an accredited course, ensure continuous professional development and provide a framework for striking off. 

Meanwhile, NHSE’s IAPT manual – first published in 2018 – states all clinicians should have completed an accredited training programme and a “robust and urgent” plan should be in place to train those who have not, including the possibility of those without accreditation being prevented from working alone. 

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Source: HSJ, 3 May 2023

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Thousands of NHS staff with long Covid risk losing their pay

Thousands of NHS staff across the UK are facing pay cuts because of a change in Covid sickness policy.

Analysis by BBC Panorama suggests that between 5,000 and 10,000 NHS workers could be off sick with Long Covid.

Unions are accusing the government of failing to support health staff who worked during the coronavirus pandemic.

The government says the Covid-19 public inquiry will examine these issues when it begins taking evidence in May.

Changes to special sick pay rules introduced during the pandemic mean that some NHS staff unable to work due to Long Covid may soon no longer receive full pay.

Enhanced provision ended last year. Many had a six-month transition, so expect their wages to go down soon.

Some face losing their jobs.

Professor David Strain is the chair of the Board of Science at the British Medical Association (BMA) and says this makes him "genuinely angry".

He explains: "We've got a group of people that have put themselves forward to look after the population, they've been left with an illness and they're not being supported.

"They're just in a no man's land."

He believes that health workers with long Covid should be allowed to focus on their recovery without money worries.

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Source: BBC News, 30 January 2023

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Thousands of mental health patients readmitted within a month in England

Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide.

Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health.

Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving.

The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover.

Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely.

“Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.”

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Source: The Guardian, 12 January 2024

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Thousands of men miss out on life-extending prostate cancer drug

Thousands of patients in England and Northern Ireland are missing out on a life-extending prostate cancer drug that is more widely available on the NHS in Scotland and Wales, say experts.

Charity Prostate Cancer UK said it was "unacceptable" that men in parts of the UK were facing a postcode lottery.

Although not a cure, abiraterone can help stop prostate cancer spreading to other parts of the body.

NHS England said it would review the drug's use for more men next year.

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Source: BBC News, 23 October 2023

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