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New tool could 'help UK doctors spot high-risk Covid patients in seconds'

A risk calculator that takes seconds to produce a score indicating a COVD-19 patient’s risk of death could help clinicians make care decisions soon after patients arrive in hospital, according to a large study conducted by a consortium of researchers across the UK.

As UK COVID-19 cases rise, schools reopen and the weather gets colder, doctors at UK hospitals are expected to see an influx of coronavirus patients.

Patients with COVID-19 behave very differently to patients with other conditions such as flu and bacterial pneumonia, said Dr Antonia Ho of the University of Glasgow, one of the study’s authors, and it is very challenging for doctors managing this unfamiliar disease to accurately identify those who are at high risk of deterioration or who can ride out their illness at home.

“So having a tool that … can help clinicians at the front door to accurately group patients who are coming in with COVID-19 into four distinct risk categories – low, intermediate, high and very high risk – is hugely valuable,” she added. “Having an accompanying low-risk score will provide that doctor with increased confidence that the vast majority of people, patients with that low-risk score, will come to no real harm.”

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Source: The Guardian, 9 September 2020

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Discharge guidance could lead to increased death and disability, warn senior clinicians

Serious patient safety and wellbeing concerns about the latest hospital discharge guidance have been raised to HSJ by senior clinicians and charities.

Senior geriatricians warned that the guidance could prompt an increase in “urgent readmissions”, “permanent disability” and “excess mortality”, while charities said families could be left with “unsustainable caring responsibilities” because of the new rules.

The government guidance, Hospital Discharge Service: policy and operating model, published in August, said clinicians should consider discharging patients when they were “medically optimised” rather than “medically fit”. It said 95% of these patients would return straight home with additional social care and rehabilitation support if needed.

Many of the concerns raised surround the retention of the “criteria to reside”. This was originally agreed in March when there was a push from NHS England to free up acute beds over fears hospitals would become overwhelmed with covid admissions as the pandemic hit the UK. The criteria has, however, been maintained in the new guidance, despite a significant fall in infections and deaths from the virus.

Rachel Power, chief executive of The Patients Association charity, warned: “This guidance makes it clear that the NHS is still having to take drastic emergency action in the face of covid-19, that will continue to take a heavy toll on patients. It is clear that many patients will be rushed home who would normally have had a longer period of hospital care.”

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Source: HSJ, 8 September 2020

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Breast cancer missed in hundreds of women due to covid cancellations

Hundreds of women with breast cancer in London were not picked up by routine screening as services closed during the lockdown, officials have estimated.

Data from NHS England and Improvement’s London office said it expected 450 people to have breast cancer and have gone undiagnosed because of the heavily reduced amount of screening at the height of the outbreak. It was included in a letter from officials to local health system leaders, seen by HSJ.

It said the figure was an estimate based on the 115,000 routine breast screenings that would have taken place between late March and the end of June and which had to be re-scheduled.

London represents around 15% of England’s population, so a nationwide estimate would run into thousands. 

Responding to the figures, Breast Cancer Now chief executive Baroness Delyth Morgan said: ”While it’s encouraging that the breast screening programme in London is now back up and running, we are concerned to hear of the hundreds of potential delayed cancer diagnoses as a result of disruption due to the pandemic. The earlier breast cancer is diagnosed, the more likely treatment is to be successful."

“With over a hundred thousand people missing out on vital breast screening during the pandemic in London alone, we urge the government to ensure there is sufficient capacity in the already-stretched workforce to meet the huge backlog and to avoid any cancers going undetected for longer.”

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Source: HSJ, 9 September 2020

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Pandemic spotlights the urgent need for a National Patient Safety Board

Thursday 17 September is WHO’s World Patient Safety Day. There’s no better moment in history to call for new legislation that finally ensures health worker and patient safety. Today, the Patient Safety Movement Foundation released a detailed white paper urging the creation of a National Patient Safety Board.

In a statement, the Patient Safety Movement said COVID-19 has exposed the safety gaps in our healthcare system that already cause 200,000 deaths a year and that we must put health workers, and thus patients, first by finally establishing a National Patient Safety Board (NPSB). This would solve the problem in three key ways:

  • Data-driven insight and standards: An NPSB would create and maintain a National Patient Safety Database to receive non-identifiable patient safety work product. The Board would facilitate the reporting, collection, and analysis of patient safety data and the development and dissemination of training guidelines and other recommendations to reduce medical errors and improve patient safety and quality of care.
  • Transparency and accountability: The NPSB would also require an on-going analysis of the patient safety data in the Database and other available data to determine performance and systems standards, tools, and best practices (including peer review) for doctors and other health care providers necessary to prevent medical errors, improve patient safety, and increase accountability within the health care system.
  • Align incentives: An NPSB would save lives and taxpayer dollars by aligning incentives, especially Medicare reimbursements, with proven patient safety protocols.

"COVID-19 shouldn’t be the breaking point for our health workers, but it should be the breaking point for our tolerance of the lack of patient safety. Congress must act today on this bipartisan issue.”

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Source: The Patient Safety Movement, 8 September 2020

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Oxford University Covid vaccine trial put on hold due to adverse reaction in participant

The development of a promising COVID-19 vaccine has been put on hold due to an adverse reaction in a trial participant.

A spokesman for AstraZeneca, the company working with a team from Oxford University, told the Guardian the trial has been stopped to review the “potentially unexplained illness” in one of the participants. The spokesman stressed that the adverse reaction was only recorded in a single participant and said pausing trials was common during vaccine development.

“As part of the ongoing randomised, controlled global trials of the Oxford coronavirus vaccine, our standard review process was triggered and we voluntarily paused vaccination to allow review of safety data by an independent committee,” the spokesman said.

“This is a routine action which has to happen whenever there is a potentially unexplained illness in one of the trials, while it is investigated, ensuring we maintain the integrity of the trials. In large trials illnesses will happen by chance but must be independently reviewed to check this carefully."

“We are working to expedite the review of the single event to minimise any potential impact on the trial timeline. We are committed to the safety of our participants and the highest standards of conduct in our trials.”

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Source: The Guardian, 9 September 2020

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Coronavirus: Ministers have ‘lost control of the virus’, says health expert following spike in cases

A leading health expert has suggested ministers have “lost control of the virus”, after the UK recorded it’s largest 24-hour spike in COVID-19 cases since 23 May.

Government figures showed there have been a further 2,988 lab-confirmed cases of coronavirus in the UK as of 9am on Sunday. This brings the total number of confirmed cases in the UK to 347,152.

Sunday's figure is the highest since May 22 when 3,287 cases were recorded, and is also the first 24-hour period when cases passed 2,000 since the end of May. The tally was an increase on Saturday's figures of 1,813 new cases.

Prof Gabriel Scally, a member of the Independent Sage group and a former NHS regional director of public health for the south-west, warned that government ministers had “lost control of the virus”.

“It’s no longer small outbreaks they can stamp on,” he told The Guardian. “It’s become endemic in our poorest communities and this is the result.

Shadow health secretary Jonathan Ashworth called upon the government to respond to the sharp spike.

He added that it was “a stark reminder that there is no room for complacency in tackling the spread of the virus”.

“This increase, combined with the ongoing testing fiasco where ill people are told to drive for miles for tests, and the poor performance of the contact tracing system, needs an explanation from ministers,” he said on Sunday.

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Source: The Independent, 7 September 2020

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Errors at West Suffolk hospital contributed to woman's death

Inquest finds Susan Warby, 57, received insulin she did not need after blood test mistakes. Hospital errors contributed to her death five weeks after bowel surgery, an inquest into her death has concluded.

Susan Warby, 57, who died at West Suffolk hospital in Bury St Edmunds, was incorrectly given glucose instead of saline through an arterial line that remained in place for 36 hours and resulted in inaccurate blood test readings. She was subsequently given insulin she did not need, causing bouts of extremely low blood sugar (hypoglycemia) and the development of “a brain injury of uncertain severity”, recorded Suffolk’s senior coroner, Nigel Parsley.

Speaking after the inquest was adjourned in January, Susan's husband, Jon Warby, said he was “knocked sideways completely” when he received an anonymous letter two months after her death highlighting blunders in her treatment.

Doctors at the hospital were reportedly asked for fingerprints as part of the hospital’s investigation into the letter, a move described by a Unison trade union official as a “witch-hunt” designed to identify the whistleblower.

Following January’s adjournment, Parsley instructed an independent expert to review the care that Warby received. Warby’s medical cause of death was recorded as multi-organ failure, with contributory causes including septicaemia, pneumonia and perforated diverticular disease, affecting the bowel.

Recording a narrative conclusion, Parsley wrote: “Susan Warby died as the result of the progression of a naturally occurring illness, contributed to by unnecessary insulin treatment caused by erroneous blood test results. This, in combination with her other comorbidities, reduced her physiological reserves to fight her naturally occurring illness.”

Jon Warby said in a statement: “The past two years have been incredibly difficult since losing Sue, and it is still a real struggle to come to terms with her no longer being here. The inquest has been a highly distressing time for our family, having to relive how Sue died, but we are grateful that it is over and we now have some answers as to what happened."

“After learning of the errors in Sue’s care, I wanted to know how these occurred and what action was being taken to prevent any similar incidents in the future. The trust has now made a number of changes which I am pleased about.”

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Source: The Guardian, 7 September 2020

 

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Coronavirus: 'Long Covid' patients need treatment programme, doctors say

Greater NHS support is needed for people chronically ill for months with COVID-19 symptoms, experts have told BBC Radio 4's File on 4.

The Royal College of GPs is calling for a national network of "post-Covid" clinics to help such people. But less than 12% of 86 NHS care commissioning groups asked by the BBC said they were running such services.

NHS England said it was "rapidly expanding new and strengthened rehab centres".

Tim Spector, professor of genetic epidemiology at King's College London and leader of the Covid Symptom Study app, said around 300,000 people in the UK have reported symptoms lasting for more than a month - so called "long Covid".

He added that data from the app showed around 60,000 people have been ill for more than three months. However, many of these people may not have been tested for Covid.

The government moved away from community testing on 12 March, instead only testing those admitted to hospital. That meant people who recovered from suspected coronavirus at home were unable to access tests.

Elly MacDonald, 37, from Surbiton, was training for the London Marathon when she first developed what she believes were Covid symptoms on 21 March. More than five months on, she still suffers from breathlessness and extreme fatigue, but has not received a positive test result - because community testing was re-introduced too late for it to detect her illness.

She changed her GP practice after initially feeling she was not being helped. Elly said: "Just knowing that I actually have people who are taking me seriously - that's been very important for my recovery. I just want my life back."

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Source: BBC News, 8 September 2020

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'I had to be sectioned': the NHS staff broken and burned out by Covid

In April, when the coronavirus outbreak was at its peak in the UK and tearing through hospitals, junior doctor Rebecca Thornton’s mental health took a turn for the worse and she ended up having to be sectioned.

Even now, three months later, she cannot face going back to her job and thinks it will take her a year to recover from some of the horrors she saw while working on a Covid ward in a deprived area of London.

“It was horrendous,” Thornton recalls. “It’s so harrowing to watch people die, day in, day out. Every time someone passed away, I’d say, ‘This is my fault’. Eventually I stopped eating and sleeping.”

Thornton’s case may sound extreme but her experiences of working through Covid are far from unique. More than 1,000 doctors plan to quit the NHS over the government’s handling of the pandemic, according to a recent survey, with some citing burnout as a cause.

A psychologist offering services to NHS staff throughout the UK, who asked to remain anonymous, has witnessed the toll on staff. “I’ve seen signs of PTSD in some healthcare workers,” she says. “Staff really stood up to the plate and worked incredibly hard. It was a crisis situation that moved very quickly ... After it subsided a little bit, the tiredness became very clear.”

Roisin Fitzsimons, who is head of the Nightingale Academy, which provides a platform to share best practice in nursing and midwifery, and consultant nurse at Guy’s and St Thomas’ NHS foundation trust, also worries about the looming threat of an uncertain future. “Are our staff prepared? Do they have the resilience to go through this again? That’s the worry and that’s the unknown. Burnout is hitting people now. People are processing and realising what they’ve gone through.”

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Source: The Guardian, 8 September 2020

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COVID-19 patients may have prolonged gut infection, study finds

COVID-19 patients have active and prolonged gut viral infection, even in the absence of gastrointestinal symptoms, scientists in Hong Kong showed.

The coronavirus may continue to infect and replicate in the digestive tract after clearing in the airways, researchers at the Chinese University of Hong Kong said in a statement Monday. The findings, published in the medical journal GUT, have implications for identifying and treating cases, they said.

SARS-CoV-2 spreads mainly through respiratory droplets -- spatters of virus-laden discharge from the mouth and nose, according to the World Health Organization. Since the first weeks of the pandemic, however, scientists in China have said infectious virus in the stool of patients may also play a role in transmission.

The finding “highlights the importance of long-term coronavirus and health surveillance and the threat of potential fecal-oral viral transmissions,” Siew Chien Ng, associate director of the university’s Centre for Gut Microbiota Research, said in the statement.

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Source: Bloomberg, 7 September 2020

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Government deal for clear face masks to help people with hearing loss

Around 250,000 clear face masks are set to be delivered to frontline NHS and social care workers to allow for better care to be provided to those who use lip-reading and facial expressions to communicate, whilst still ensuring staff and patients remain safe during coronavirus.

The clear face masks will allow for improved communication with people with certain conditions like hearing loss, autism and dementia.

Designed with an anti-fogging barrier to ensure the face and mouth are always visible, the see-through masks will help doctors, nurses and carers get important messages across to all patients clearly.

An estimated 12 million people in the UK are thought to have hearing loss, while those who rely on facial expressions to support communication – such as people with learning disabilities, autism or dementia, or foreign language speakers and their interpreters – will also see benefit from the government deal.

Minister for Care Helen Whately said: “Everyone using our remarkable health and care system deserves the best care possible and communication is a vital part of that."

“This pandemic has posed numerous challenges to the sector, so we are always on the hunt for simple solutions to support those giving and receiving care."

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Source: National Health Executive, 7 September 2020

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Two-thirds of black Britons believe NHS gives white people better care, finds survey

Almost two-thirds of black Britons think the NHS does less to protect their health than that of white people, research has found.

That negative view of the health service is shared by a majority of black people of almost all ages, and is held especially strongly by black women, according to findings of a study commissioned by a parliamentary committee.

Overall, 64% of black people do not believe that their health is as protected by the NHS compared with white people’s. When asked if they thought it was, 34.3% disagreed and another 29.6% disagreed strongly, while just 19.9% agreed and a further 2.4% agreed strongly.

The survey was commissioned by MPs and peers on the joint committee on human rights as part of its inquiry into black people, racism and human rights in the UK. The report will be published and debated with the authors at an evidence session today.

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Source: The Guardian, 7 September 2020

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‘Confidential’ document warns second covid peak could hit NHS five times harder

Modelling being used by NHS officials forecasts that hospital admissions could peak at five times the level seen in April without additional measures to control the virus, HSJ can reveal.

In all scenarios presented, covid hospital admissions would remain high for an extended period of many months, even if new lockdown actions were taken. However, putting multiple measures in place could contain them to a peak of less than that seen in the spring, according to the work.

They were included in a document marked “confidential” and included, apparently by accident, in public papers for Thursday’s meeting of Medway Foundation Trust board. Within hours of HSJ asking for more information, they were removed.

They were badged with Kent and Medway Clinical Commissioning Group, the NHS body which oversees services for that area. The forecasts were marked as being “Kent and Medway level”, but were referred to as “regional scenarios”, indicating they may have been produced by regional teams of NHS England and Improvement. The trust’s board papers said its own planning for the coming months would make use of the three scenarios presented in the document.

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Source: HSJ, 7 September 2020

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Coronavirus: Lung damage in COVID-19 patients appears to improve after several months, study shows

The lungs and hearts of patients damaged by the coronavirus improve over time, a study has shown.

Researchers in Austria recruited coronavirus patients who had been admitted to hospital. The patients were scheduled to return for evaluation 6, 12 and 24 weeks after being discharged, in what is said to be the first prospective follow-up of people infected with COVID-19, which will be presented at today's European Respiratory Society International Congress.

Clinical examinations, laboratory tests, analysis of the amounts of oxygen and carbon dioxide in arterial blood, and lung function tests were carried out during these visits. 

At the time of their first visit, more than half of the patients had at least one persistent symptom, predominantly breathlessness and coughing, and CT scans still showed lung damage in 88% of patients. But by the time of their next visit, 12 weeks after discharge, the symptoms had improved, and lung damage was reduced to 56%.

Dr Sabina Sahanic, a clinical PhD student at the University Clinic in Innsbruck and part of the team that carried out the study, said: "The bad news is that people show lung impairment from COVID-19 weeks after discharge; the good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves."

A separate presentation to the congress said that the sooner COVID-19 patients started a pulmonary rehabilitation programme after coming off ventilators, the better and faster their recovery.

Yara Al Chikhanie, a PhD student at the Dieulefit Sante clinic for pulmonary rehabilitation and the Hp2 Lab at the Grenoble Alps University in France, used a walking test to evaluate the weekly progress of 19 patients who had spent an average of three weeks in intensive care and two weeks in a pulmonary ward before being transferred to a clinic for pulmonary rehabilitation.

She said: "The most important finding was that patients who were admitted to pulmonary rehabilitation shortly after leaving intensive care progressed faster than those who spent a longer period in the pulmonary ward where they remained inactive. The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients' walking and breathing capacities and muscle gain."

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Source: The Independent, 7 September 2020

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More than 1,000 doctors want to quit NHS over handling of pandemic

Over 1,000 doctors plan to quit the NHS because they are disillusioned with the government’s handling of the COVID-19 pandemic and frustrated about their pay, a new survey has found.

The doctors either intend to move abroad, take a career break, switch to private hospitals or resign to work as locums instead, amid growing concern about mental health and stress levels in the profession.

“NHS doctors have come out of this pandemic battered, bruised and burned out”, said Dr Samantha Batt-Rawden, president of the Doctors’ Association UK, which undertook the research.  The large number of medics who say they will leave the NHS within three years is “a shocking indictment of the government’s failure to value our nation’s doctors,” she added. “These are dedicated professionals who have put their lives on the line time and time again to keep patients in the NHS safe, and we could be about to lose them.

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Quarter of women say their decisions weren’t respected during childbirth, new study reveals

A new study shows a quarter of mothers say their choices were not respected during childbirth, with some left with life-changing injuries as a result, despite Britain’s highest judges establishing women should be the primary decision makers during labour five years ago.

A poll of 1,145 women, carried out by leading pregnancy charity Birthrights and shared exclusively with The Independent, also found that a third said healthcare professionals did not even seek their own opinions on the childbirth process, while 14& said their choices were overruled.

One woman told The Independent she had been forced to give up her career as a lawyer following what she described as a “violent delivery”, while her baby daughter also sustained serious injuries to her face which can still be seen now – 12 years after she gave birth.

Birthrights, which campaigns for respectful pregnancy care for women, pointed to the fact half a decade has passed since Nadine Montgomery’s Supreme Court case proved mothers-to-be are the primary decision-makers in their own care yet this is still not the reality for the majority of women.

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Source: The Independent, 3 September 2020

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Covid death rates dropped as doctors rejected ventilators

Death rates among seriously ill COVID-19 patients dropped sharply as doctors rejected the use of mechanical ventilators, analysis has found.

The chances of dying in an intensive care unit (ICU) went from 43% before the pandemic peaked to 34% in the period after.

In a report, the Intensive Care National Audit & Research Centre said that no new drugs nor changes to clinical guidelines were introduced in that period that could account for the improvement. However, the use of mechanical ventilators fell dramatically.

Before the peak in admissions on 1 April, 75.9% of COVID-19 patients were intubated within 24 hours of getting to an ICU, a proportion which fell to 44.1% after the peak.

Meanwhile, the proportion of ICU patients put on a ventilator at any point dropped 22 percentage points to 61% either side of the peak.

Researchers suggested this could have been a result of “informal learning” among networks of doctors that patients on ventilators were faring worse than expected.

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Source: The Telegraph, 3 September 2020

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Plans for 150 new diagnostic hubs to cut rising waits

Plans for up to 150 new community diagnostic hubs to tackle the NHS’ ballooning diagnostic waiting lists are included in NHS England ‘blue print plans’ leaked to HSJ.

The document pointed out the hubs “were highlighted in the phase 3 letter [from Sir Simon Stevens] and will be recommended as part of new service models for diagnostics in the forthcoming [Sir Mike] Richards’ Review of Diagnostics Capacity”.

It said “at least 150 community diagnostic hubs should be established in the first instance (broadly equivalent to the number of acute hospitals)” although it appears many of these may be temporary facilities.

The phase 3 letter said systems should mange the “immediate growth in people requiring cancer diagnosis and/or treatment returning to the service by… the development of community diagnostic hubs” among other measures

The Richards review was commissioned by NHS England in 2019 as it had long been recognised that England has one of the lowest levels in Europe of diagnostic equipment as well as a shortage in facilities and staff. Last month think-tanks warned of significant worsening of cancer outcomes because of the backlog in diagnosis and treatment created by a fall in referrals during the pandemic..."

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Source: HSJ, 4 September 2020

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Rights watchdog backs court action over Covid deaths in English care homes

The human rights watchdog for England and Wales has backed a grieving daughter’s court action against the health secretary, Matt Hancock, over his handling of the coronavirus pandemic in care homes.

Cathy Gardner, who lost her father, Michael Gibson, to COVID-19 in a care home that accepted hospital discharges, is seeking a judicial review of policies that she alleges “failed to take into account the vulnerability of care home residents and staff to infection and death, the inadequacy of testing and PPE availability”.

The government denies acting illegally over care homes in England, where more than 15,000 people have died with confirmed or suspected COVID-19. But the Equalities and Human Rights Commission said the case “raises potentially important issues of public interest and concern as to the way in which the rights of care home residents have been and will be protected during the current coronavirus pandemic”.

“The bereaved families group isn’t backing down in its call for a public inquiry and I am not backing down in my call for a judicial review into policies I believe led to deaths in care homes,” Gardner said. ”I am delighted the EHRC have written to the court. This is a Human Rights Act case.”

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Source: The Guardian, 3 September 2020

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Gene-edited babies: Current techniques not safe, say experts

Current scientific techniques are not yet safe or effective enough to be used to create gene-edited babies, an international committee says.

The technology could one day prevent parents from passing on heritable diseases to children, but the committee says much more research is needed.

The world's first gene-edited babies were born in China in November 2018. The scientist responsible was jailed, amid a fierce global backlash. The committee was set up in response.

Gene-editing could potentially help avoid a range of heritable diseases by deleting or changing troublesome coding in embryos. But experts worry that modifying the genome of an embryo could cause unintended harm, not only to the individual but also future generations that inherit these same changes.

It made several recommendations, including:

  • Extensive conversations in society before a country decides whether to permit this type of gene-editing.
  • If proven to be safe and effective, initial uses should be limited to serious, life-shortening diseases which result from the mutation of one or both copies of a single gene, such as cystic fibrosis.
  • Rigorous checks at every stage of the process to make sure there are no unintended consequences, including biopsies and regular screening of embryos.
  • Pregnancies and any resulting children to be followed up closely.
  • An international scientific advisory panel should be established to constantly assess evidence on safety and effectiveness, allowing people to report concerns about any research that deviates from guidelines.

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Source: BBC News, 4 September 2020

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Patients don’t feel safe in A&E, research finds

Visiting A&E or relatives is considered much riskier than attending hospital for other reasons, according to the first in-depth piece of research into the subject. 

The research, authored by the University of Leicester and NIHR Leicester Biomedical Research Centre Bioinformatics Hub, asked 400 participants how they felt about attending hospital across a range of scenarios during the pandemic. It also revealed that consistent staff use of PPE is seen as a top priority by patients, with staff testing receiving significant but much less support. 

Participants in the Leicester research were asked to rank how ”safe and confident” they felt coming into hospital for a number of reasons on a scale 1-100. The median score given to “visiting a friend or family member” was 49. The score for attending accident and emergency was 50.

Attendance at A&E’s fell sharply during the pandemic peak. It is now rising, but has not reached pre-covid levels. The research suggests that fear could still be playing a significant part in the drop off.

Attending hospital for elective care received a median score of 61. Participants were most confident in visiting hospital for essential surgery (median score 78), and clinical scans or x-ray (77).

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Source: HSJ, 3 September 2020

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Steroids reduce risk of death in critically ill COVID-19 patients, new study shows

The use of inexpensive steroids in treating patients hospitalised with COVID-19 has been found to reduce the risk of death by 20%, according to a new international study.

The research encompassed seven clinical trials, which focused on three different types of anti-inflammatory corticosteroids, and was co-ordinated by the World Health Organization (WHO).

Following the publication of the findings, the WHO issued new guidelines in which it recommended the use of corticosteroids as standard treatment for patients with “severe and critical” COVID-19.

The study, analysed by the National Institute for Health Research (NIHR) at the University of Bristol, looked at patient mortality over a 28-day period after treatment. It found that corticosteroid treatment led to an estimated 20% reduction in the risk of death.

Researchers said it was equivalent to about 68% of critically ill patients surviving after treatment with the steroids, compared to approximately 60% surviving without them.

Jonathan Sterne, professor of medical statistics and epidemiology at the University of Bristol, said: “Steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by COVID-19."

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Source: The Independent, 2 September 2020

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Twenty-one ‘wholly preventable’ patient safety incidents reported in private hospitals last year

There were 21 “wholly preventable” patient safety incidents of the most serious category at private hospitals last year, new data has shown, as NHS bosses prepare to invest up to £10bn in the sector.

This is the first time that a comprehensive dataset of 'never events’ within private hospitals has been published in the UK, and comes ahead of plans to outsource both inpatient and outpatient services, routine surgery operations and cancer treatment to private providers.

The audit conducted by the Private Healthcare Information Network (PHIN), established in 2014 to bring greater transparency to the private health sector, showed that 287 out of 595 private hospitals and NHS private patient units (PPUs) provided information on Never Events between 1 January and 31 December 2019.

This group accounts for an estimated 86 per cent of privately-funded admitted patient care, PHIN said. It attributed the “gaps in the data” to NHS PPUs, rather than independent hospitals.

The fact that more than 300 hospitals or PPUs were unable or unwilling to hand over this data highlights the private sector’s continuing lack of transparency, said the Centre for Health and the Public Interest, a social care and health think tank.

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Source: The Independent, 2 September 2020

Private Healthcare Information Network press release

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Nasal swab followed by antibody test may catch incorrect COVID-19 diagnoses

Testing people twice for the coronavirus, with a nasal swab followed by an antibody finger prick test, would catch most of those people who fail to get the right COVID-19 diagnosis, researchers believe.

Nose and throat swabs miss around 30% to 50% of infections, say the University of Cambridge team, as the virus can disappear from the upper respiratory tract into the lungs. But they say adding an antibody test can plug that gap. Antibodies show up from about six days after infection.

A team at Addenbrooke’s hospital in Cambridge has piloted the use of combined tests for patients arriving at the hospital. Many arrive with flu-like symptoms and need an accurate diagnosis to ensure they are put on the right wards, so that there is no risk of COVID-19 patients infecting others.

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Source: The Guardian, 2 September 2020

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Coronavirus: Charity seeks judicial review on care home visit guidance

A dementia charity is seeking a judicial review of the government guidance on care home visits.

John's Campaign says many care homes in England are still refusing regular face-to-face visits, often essential for people with severe dementia. Dr Angela McIntyre, a retired doctor backing the campaign, has not seen her 92-year-old mother since March.

A Department of Health spokesman said: "We know limiting visits in care homes has been difficult for many families."

He added: "Our first priority is to prevent infections in care homes, and this means that visiting policy should still be restricted with alternatives sought wherever possible.

"Visiting policies should be tailored by the individual care home and take into account local risks in their area."

But John's Campaign believes the guidance does not take into account how important visits from family members are for dementia patients and believes it could be in breach of the law.

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Source: BBC Health, 3 September 2020

 

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