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Trust heavily criticised by coroner for delays to death investigations

A coroner has strongly criticised a mental health trust for failing to investigate serious incidents promptly.

Tees Esk and Wear Valleys Foundation Trust has been told that delays in probing serious incidents may “compromise the quality” of these investigations and hence “their value in preventing deaths”.

The warnings, from Jeremy Chipperfield, senior coroner for County Durham and Darlington, come amid an ongoing inquest into the death of TEWV patient Ian Darwin. Mr Darwin died aged 42 in March, and the serious incident review into his death is still ongoing.

A recently published prevention of future deaths report relating to Mr Darwin’s death said TEWV’s serious incident death investigations, “at all levels of seriousness, are routinely (if not invariably) significantly delayed and I understand there is no expectation of immediate, or any timetable for eventual rectification”.

“In permitting delay of ‘serious incident’ investigations, TEWV may permit lethal hazard to persist for longer than necessary, and compromise the quality of such investigations and hence their value in preventing avoidable deaths.”

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BMA writes to trust chiefs over ‘concerns about doctors’ safety’

The British Medical Association has written to trust chief executives warning of ‘concerns regarding the safety of our members and the patients they serve’ due to flawed concrete beams.

The BMA has written to trust chiefs, copying in their medical committee leads, in the wake of a wave of publicity around reinforced autoclaved aerated concrete in recent weeks.

The letter said: “The HSJ has reported that many NHS hospital buildings have been constructed with RAAC, which is in some cases reaching the end of safe use and causing danger to staff and patients.

“Unfortunately, your trust may be one of the affected hospitals. We have concerns regarding the safety of our members and the patients they serve, and would appreciate answers to the following.”

It also requested the trusts provide answers, under the Freedom of Information Act, to questions including whether they had identified RAAC, what assessments they had made, what mitigations were planned or in place, and emergency plans such as evacuation.

It is thought the letter was sent to all or most provider trusts.

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Source: HSJ, 12 September 2023

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Female surgeons sexually assaulted while operating

Female surgeons say they are being sexually harassed, assaulted and in some cases raped by colleagues, a major analysis of NHS staff has found.

The Royal College of Surgeons said the findings were "truly shocking".

Sexual harassment, sexual assault and rape have been referred to as surgery's open secret.

There is an untold story of women being fondled inside their scrubs, of male surgeons wiping their brow on their breasts and men rubbing erections against female staff. Some have been offered career opportunities for sex.

Nearly two-thirds of women surgeons that responded to the researchers said they had been the target of sexual harassment and a third had been sexually assaulted by colleagues in the past five years.

Women say they fear reporting incidents will damage their careers and they lack confidence the NHS will take action.

It is widely accepted there is a culture of silence around such behaviour. Surgical training relies on learning from senior colleagues in the operating theatre and women have told us it is risky to speak out about those who have power and influence over their future careers.

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Source: BBC News, 12 September 2023

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Bristol Spire Hospital widens investigation into mesh surgeon

A hospital review of mesh operations by a surgeon who left dozens of patients in agony is now looking into another type of procedure he carried out.

Tony Dixon, who used mesh surgery to treat bowel problems, has always maintained he did the operations in good faith.

Now it has emerged that other patients who had their rectum stapled are also being written to.

Spire Hospital Bristol said its "comprehensive" review remains ongoing.

Mr Dixon pioneered the use of artificial mesh to lift prolapsed bowels and a review of the care he gave patients receiving Laparoscopic ventral mesh rectopexy has already concluded.

Now the Spire has contacted patients who underwent a Stapled Transanal Rectal Resection (STARR operation) with Mr Dixon.

Many of the affected patients have told the BBC they did not give informed consent for the procedure and are in chronic pain.

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Source: 11 September 2023

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Suicide prevention drive launched in England amid concern for young people

Ministers have vowed to reduce suicide rates in England with the launch of more than 100 new initiatives amid particular concerns over rising deaths and self-harm among children and young people.

The pledge to reverse the trends within two and a half years came as the government launched its first prevention strategy in more than a decade. In 2022, there were 5,275 suicides in England, equivalent to 10.6 suicides per 100,000 people, according to the Office for National Statistics.

“While overall the current suicide rate is not significantly higher than in 2012, the rate is not falling,” a new government document says. “We must do all we can to prevent more suicides, save many more lives and ultimately reduce suicide rates.”

It highlights how rates of suicide among children and young people have increased in recent years, despite being low overall, adding: “Urgent attention is needed to address and reverse these trends.”

The new measures being launched will also aid other specific groups at risk of suicide, including middle-aged men, autistic people, pregnant women and new mothers.

Steve Barclay, the health secretary, said: “Too many people are still affected by the tragedy of suicide, which is so often preventable. This national cross-government strategy details over 100 actions we’ll take to ensure anyone experiencing the turmoil of a crisis has access to the urgent support they need.”

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Source: The Guardian, 11 September 2023

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Wait-and-see policy on heart devices puts lives at risk, says UK charity

Patients are needlessly being put at risk of dying from heart problems because they have to wait months to be fitted with lifesaving implantable defibrillators, experts have said.

Two million people in the UK live with coronary heart disease, which is a leading cause of heart failure. Those at the highest risk of dying as a result of heart failure may be offered an implantable cardioverter defibrillator device (ICD). These can kickstart the heart and may save their life.

Patients have to wait at least 90 days before they can be fitted with an ICD while doctors wait to see if stents and medication might improve their health. However, a large study funded by the British Heart Foundation suggests there is little or no benefit to waiting, and the charity says lives are needlessly being put at risk as a result.

Dr Sonya Babu-Narayan, an associate medical director at the BHF, said the results had significant implications.

“The findings suggest that the current ‘wait and see’ approach to find out whether a patient’s heart function improves with medication and stents isn’t always best, and that an unnecessary wait could even be the difference between life and death,” she said.

“The results from this large UK-wide trial could lead to re-evaluation of how best to treat people living with severe heart failure due to coronary heart disease.”

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Source: The Guardian, 11 September 2023

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Teaching trust reviewing decisions made under Letby CEO

A trust which hired the former chief executive of the Countess of Chester Hospital as an interim CEO has launched a review of decisions about safety and whistleblowing taken under his leadership.

Jacqui Smith, chair-in-common at Barts Health and Barking, Havering and Redbridge University Hospitals trusts, made the announcement at a board meeting, following the nurse Lucy Letby’s conviction for murdering seven babies, and attempting to murder six more, during a year-long period between June 2015 and June 2016.

Tony Chambers was Countess of Chester Hospital Foundation Trust CEO for six years from December 2012 to September 2018, and resigned shortly after Letby’s initial arrest. His role – and that of fellow senior managers in Chester – in responding to concerns raised by doctors, has come under intense scrutiny since the verdicts.

Mr Chambers served as BHRUT’s interim chief from January 2020 until August 2021, and Ms Smith told BHRUT’s board: “In the light of concerns, particularly around listening to staff and patients, and given the seriousness of the events, we will undertake a look at the periods of Tony Chambers’ tenure.

“To see whether there are, firstly, any significant decisions taken regarding quality and safety that we need to look at again, and [secondly], checking our log of whistleblowing cases and other concerns to make sure that they have been appropriately followed up."

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Source: HSJ, 8 September 2023

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Inquest finds ‘gross’ failures in care of UK student who died after rugby injury

The family of a student who died after hospital staff missed that she had developed sepsis despite a string of warning signs have claimed she was the victim of a “lack of care”, as a coroner ruled there were “gross” failures in her treatment.

Staff at Southmead hospital in Bristol failed to carry out the sepsis screening and observations needed to keep 20-year-old Maddy Lawrence safe after she was taken to hospital with a dislocated hip sustained in a rugby tackle.

Outside court, the student’s mother, Karen Lawrence, said: “It has been a constant struggle to understand how a healthy, strong and fit 20-year-old could lose her life to sepsis which was allowed to develop under the care of professionals.

“Her screams of pain and our pleas for help were merely managed, temporarily quietened with painkillers while the infection progressed unnoticed by hospital staff.

“Our daughter was failed by a number of nurses and medical staff; symptoms were ignored, observations were not taken, on one occasion for 16 hours. There was no curiosity, basic tests were not completed even when hospital policy required them.

“Maddy herself expressed concern on multiple occasions but her pain was not being taken seriously. As well as failing to fulfil their duty, those nurses and medical staff offered no sympathy, no compassion and little attention.

“This failure meant Maddy was not given the chance to beat sepsis. Significant delays in its discovery meant the crucial window for treatment was missed. Maddy did not die due to under-staffing or a lack of money. Her death was the result of a lack of care.”

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Source: The Independent, 8 September 2023

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Woman accused of faking symptoms of debilitating illness dies aged 33

A 33-year-old New Zealand woman who was accused of faking debilitating symptoms has died of Ehlers-Danlos Syndrome (EDS).

Stephanie Aston became an advocate for patients' rights after doctors refused to take her EDS symptoms seriously and blamed them on mental illness. She was just 25 when those symptoms began in October 2015. At the time, she did not know she had inherited the health condition.

EDS refers to a group of inherited disorders caused by gene mutations that weaken the connective tissues. There are at least 13 different types of EDS, and the conditions range from mild to life-threatening. EDS is extremely rare.

Aston sought medical help after her symptoms—which included severe migraines, abdominal pain, joint dislocations, easy bruising, iron deficiency, fainting, tachycardia, and multiple injuries—began in 2015, per the New Zealand Herald. She was referred to Auckland Hospital, where a doctor accused her of causing her own illness.

Because of his accusations, Aston was placed on psychiatric watch. She had to undergo rectal examinations and was accused of practising self-harming behaviours. She was suspected of faking fainting spells, fevers, and coughing fits, and there were also suggestions that her mother was physically harming her.

There was no basis for the doctor’s accusations that her illness was caused by psychiatric issues, Aston told the New Zealand Herald. “There was no evaluation prior to this, no psych consultation, nothing,” she said.

She eventually complained to the Auckland District Health Board and the Health and Disability Commissioner of New Zealand. “I feel like I have had my dignity stripped and my rights seriously breached,” she said.

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Source: The Independent, 6 September 2023

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YouTube starts verifying health workers in the UK

YouTube has launched a verification system for healthcare workers in the UK as it battles disinformation online.

In 2022, health videos were viewed more than three billion times in the UK alone on the video-sharing platform.

Doctors, nurses and psychologists have been applying for the scheme since June and must meet rigorous criteria set by the tech giant to be eligible.

Successful applicants will have a badge under their name identifying them as a genuine, licensed healthcare worker.

But YouTubers have warned the system is only meant for education purposes, not to replace medical advice from your GP.

Vishaal Virani, who leads health content for YouTube, said it was important simply due to the sheer number of people accessing healthcare information on the video-sharing platform.

"Whether we like it or not, whether we want it or not, whether the health industry is pushing for it or not, people are accessing health information online," he told the BBC.

"We need to do as good a job as possible to bring rigour to the content that they are subsequently consuming when they do start their care journey online."

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Source: BBC News, 8 September 2023

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Public inquiry to be held into disgraced brain surgeon

A public inquiry will be held into the disgraced brain surgeon Sam Eljamel, the Scottish government has confirmed.

Eljamel harmed dozens of patients at NHS Tayside, leaving some with life-changing injuries.

He was head of neurosurgery at Ninewells Hospital in Dundee until December 2013, when he was suspended.

Health Secretary Michael Matheson said he was persuaded of the need for the inquiry after reading a damning due diligence review into NHS Tayside.

It follows a long-running campaign which saw almost 150 former patients of the surgeon calling for the inquiry.

Mr Matheson said he had concluded that a public inquiry was "the only route to get to the bottom of who knew what and when, and what contributed to the failures described by NHS Tayside".

The health secretary said he also wanted to see individual cases reviewed independently of NHS Tayside in a "person-centred, trauma-informed" manner.

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Source: BBC News, 7 September 2023

 

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Trust and manager charged with manslaughter

North East London Foundation Trust has been charged with corporate manslaughter – making it only the second NHS provider to be prosecuted for the crime.

The Crown Prosecution Service has authorised the Metropolitan Police to bring a charge of corporate manslaughter against the mental health provider in regard to the death of Alice Figueiredo at the trust’s Goodmayes Hospital on 7 July 2015.

Goodmayes ward manager Benjamin Aninakwa has also been charged with gross negligence manslaughter, and an offence under the Health and Safety at Work Act.

The trust and Mr Aninakwa will appear at Barkingside Magistrates’ Court on Wednesday, 4 October. The prosecution follows a five year investigation by Met detectives.

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Source: HSJ, 7 September 2023

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Crumbling estate impacting patient care ‘day in, day out’, NHSE boss tells MPs

NHS England’s finance boss has said patient treatment areas are being closed “all the time” due to crumbling estates, fire risks and flooding.

Julian Kelly told MPsthe health service had “examples all the time where hospitals are having to shut units, decant patients into other spaces, where we are losing theatres… which limits our capacity to treat patients”.

It comes amid the national controversy around the government’s investment into public buildings, sparked by the sudden closure of dozens of school buildings with unsafe structures known as ‘reinforced autoclaved aerated concrete’.

He said: “We have hospital teams which are managing these sort of issues day in and day out. And so we have examples of managing fire risk, flooding… a lot of this is because we know we’ve seen a big increase in backlog maintenance and we know there was a pause in investment in new hospital infrastructure.”

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Source: HSJ, 7 September 2023

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Police to launch inquiry into maternity unit deaths

A police investigation is to be launched into failings that led to dozens of baby deaths and injuries at a hospital trust.

The maternity units at Nottingham University Hospitals (NUH) NHS Trust are already being examined in a review by senior midwife Donna Ockenden.

The review will become the largest ever carried out in the UK, with about 1,800 families affected.

Nottinghamshire Police said its decision to investigate followed discussions with Ms Ockenden.

Her team is looking into failings that led to babies dying or being injured at Nottingham City Hospital and the Queen's Medical Centre.

Chief Constable Kate Meynell said: "On Wednesday I met with Donna Ockenden to discuss her independent review into maternity cases of potentially significant concern at Nottingham University Hospitals NHS Trust (NUH) and to build up a clearer picture of the work that is taking place.

"We want to work alongside the review but also ensure that we do not hinder its progress.

"However, I am in a position to say we are preparing to launch a police investigation.

"I have appointed the Assistant Chief Constable, Rob Griffin, to oversee the preparations and the subsequent investigation."

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Source: BBC News, 7 September 2023

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California pharmacies are making millions of mistakes. They’re fighting to keep that secret

Sharri Shaw walked out of the CVS on Vermont Avenue in South Los Angeles in 2019 believing she had a prescription for the pain reliever acetaminophen.

Instead the bottle held a medicine to treat high blood pressure, a problem she did not have.

Shaw began taking the pills, not learning of the mistake until six days later when a CVS employee arrived at her home, according to a lawsuit she filed last year. The employee told her not to take the tablets, the lawsuit said, before leaving the correct prescription at her door. The mistake, she said, left her stunned.

Shaw’s experience is far from an isolated event. California pharmacies make an estimated 5 million errors every year, according to the state’s Board of Pharmacy.

Officials at the regulatory board say they can only estimate the number of errors because pharmacies are not required to report them.

Most of the mistakes that California officials have discovered, according to citations issued by the board and reviewed by The Times, occurred at chain pharmacies such as CVS and Walgreens, where a pharmacist may fill hundreds of prescriptions during a shift, while juggling other tasks such as giving vaccinations, calling doctors’ offices to confirm prescriptions and working the drive-through.

Christopher Adkins, a pharmacist who worked at CVS, and then at Vons pharmacies until March, said that management policies at the big chains have resulted in understaffed stores and overworked staff.

“At this point it’s completely unsafe,” he said.

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Source: Los Angeles Times, 5 September 2023

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‘Cowboy’ Rishi Sunak hit by new concrete crisis as it threatens pledge to cut NHS backlog

Rishi Sunak’s pledge to cut the NHS waiting list backlog is being threatened by the crumbling concrete crisis as affected hospitals warn they will be forced to shut wards and theatres.

Hospitals were told they had buildings prone to collapse in 2019 but four years later they are still dealing with the issue.

In a report last year, West Suffolk NHS Foundation Trust leaders said that work to replace reinforced autoclaved aerated concrete (Raac) in its hospitals would hit general surgery, urology, gynaecology and orthopaedic care.

Wards have had to close, piling pressure on a crowded A&E as patients can’t be offloaded due to lack of beds, and threatening its ability to hit government targets to reduce waiting lists, it added.

The warning comes as Sir Keir Starmer used Prime Minister’s Questions to attack Mr Sunak over the crisis. He argued that “the cowboys are running the country” and asked the PM if he was “ashamed” of the scandal caused by 13 years of “botched jobs”.

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Source: The Independent, 6 September 2023

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Turkey surgery warning as mother-of-four dies after gastric sleeve

A father whose daughter died after travelling to Turkey for weight-loss surgery has urged people to think again before doing the same.

Shannon Meenan Browse from Londonderry was 32 when she died in August.

The mother-of-four travelled for a gastric sleeve operation 18 months ago but, according to her father, got sick almost straight away.

The family were told she died in Altnagelvin Hospital from "malnutrition due to gastric sleeve".

A BBC investigation in March found that seven British patients who travelled to Turkey for weight-loss surgery died after operations there, while others returned home with serious health issues.

One of the UK's leading bariatric surgeons, Prof David Kerrigan said people are taking a "massive risk" by travelling abroad for weight-loss surgery.

In the UK, he said, patients undergo a rigorous preparatory process that includes a psychological assessment and there is "a proper after-care programme".

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Source: BBC News, 6 September 2023

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Misinformation preventing women from getting effective menopause treatment, study finds

Most women going through menopause are not receiving effective treatment for their symptoms, in part because of widespread misinformation, according to new research.

A comprehensive literature review led by Prof Susan Davis from Monash University in Australia calls for more personalised treatment plans that address the greatly varying physical and mental symptoms of menopause.

After adverse affects were reported from the landmark 2002 Women’s Health Initiative study into menopausal hormone therapy (MHT), Davis said there was a blanket fear that “hormones are dangerous” and as a result, “menopause [treatment] just went off the radar”.

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Source: The Guardian, 6 September 2023

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Young autistic people still dying despite coroner warnings over care

Dozens of young autistic people have died after serious failings in their care despite repeated warnings from coroners, BBC News has found.

Their investigation found issues that were flagged a decade ago are still being warned about now.

Two bereaved mothers said lessons had not been learned by their local health authority after the deaths of their teenage sons, two years apart.

The coroner who oversaw both cases, noted a repeated failure in care.

After the first death, the coroner criticised NHS Kent and Medway for "inadequate support" and said a similar incident may happen if this continued.

Two years later, the second autistic teenager died under the care of the same authority. The same coroner found that had the victim received the recommended level of care, he might have got the therapy he needed.

In the first piece of research of its kind, the BBC combed through more than 4,000 Prevention of Future Death (PFD) notices delivered in England and Wales over the past 10 years.

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Source: BBC News, 7 September 2023

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Execs accused of ‘bullying culture and misuse of power’

Former commissioning chiefs have been accused of presiding over a ‘culture of bullying’ at the predecessor organisation to Norfolk and Waveney Integrated Care Board, as part of a legal claim from a former employee.

The accusations, which have been made in an employment tribunal case, relate to former chief executive Melanie Craig and other former executives at what was then Norfolk and Waveney Clinical Commissioning Group. Ms Craig now leads Suffolk Community Foundation, a local voluntary sector organisation.

The claims have been made by a former long-standing assistant director for mental health services, Clive Rennie, who has claimed unfair dismissal. However, the integrated care board said it disputes the claims and is defending the case.

In a witness statement to the tribunal, which began this week, Mr Rennie alleges there was an “authoritarian and dictatorial style of management” and described a “culture of bullying and misuse of power that had emerged under the leadership of Melanie Craig and which included the executive team”.

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Source: HSJ, 6 September 2023

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Steve Barclay names Lucy Letby inquiry lead amid patient safety address

Health secretary, Steve Barclay, has named Lady Justice Thirlwall as the chair of the independent inquiry into the crimes committed by former Countess of Chester Hospital nurse, Lucy Letby.

The inquiry was given statutory powers last week and will be led by one of the country’s most senior judges, who currently sits on the Court of Appeal.

The announcement came during Barclay’s speech in the House of Commons, where he also announced that the chair of the Essex mental health inquiry will be Baroness Lampard, who investigated the crimes of Jimmy Saville in a similar inquiry led by the Department of Health and Social Care (DHSC).

The rest of the health secretary’s address centred around patient safety and what the government has done, is doing and will do.

Barclay drew attention to the appointment of Dr Aidan Fowler as NHS England’s first ever national director of patient safety in 2018, and thus the following patient safety strategy in 2019.

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Source: National Health Executive, 4 September 2023

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The agony of women suffering with topical steroid withdrawal

Rhiannon Kennedy-Chapman’s early twenties could hardly be described as the best years of her life. Covered in grazes, open sores and dry skin, she was at a loss as to why her body was continuously failing her, despite her efforts to follow medical advice and take her steroid medication.

Having used both steroid cream and oral tablets since suffering from eczema as a child, she had little concern about the medication when she was once again prescribed it for small patches of eczema.

“It worked for a bit and then it would stop working. The GP would give me a higher dose and the pattern went on for many months. I went through four different strengths – it would work for a short period of time and when I stopped using it, it would come back even fiercer.

Little did she know that she was suffering from topical steroid withdrawal (TSW), a rare skin condition caused by the repeated use and cessation of steroid creams.

A 2021 report by the Medicines and Healthcare Products Regulatory Agency (MHRA) gave guidance on the risks of TSW and it is now included as patient information for all prescribed topical steroids.

Patients can now also report their suspected reactions to topical steroids via the MHRA’s “yellow card scheme” and eczema charities have called for further research into the causes and long-term effects of TSW.

Andrew Proctor, chief executive of the National Eczema Society, said it was calling on the UK medicines regulator, the MHRA, to introduce clearer strength and potency labelling of topical steroids to support their safe and effective use.

“This change needs to happen and is supported by patients and healthcare professional bodies,” he said.

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Source: The Independent, 5 September 2023

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NHS staff to be asked about sexual harassment for the first time

NHS staff will be asked if they have experienced sexual harassment or inappropriate behaviour in the workplace for the first time.

In a letter, NHS England chief delivery officer Steve Russell said the upcoming annual staff survey would include the following question: “In the last 12 months, how many times have you been the target of unwanted behaviour of a sexual nature in the workplace? This may include offensive or inappropriate sexualised conversation (including jokes), touching or assault.”

Mr Russell said the anonymous answers to the new question would “help us understand the potential prevalence of sexual misconduct in your organisation and inform further action to protect and support staff across the NHS”. 

It comes as NHSE launches the health service’s first sexual safety charter to help protect staff from harassment and inappropriate behaviour.

The charter is an agreement comprising 10 pledges, including commitments to provide staff with clear reporting mechanisms, training, and support from managers.

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Source: HSJ, 6 September 2023

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Trust told it ‘lacks skills or integrity’ to carry out suicides review

A senior clinician has raised fundamental concerns about a trust’s probe into dozens of suicide cases, which was sparked by his allegations that staff had tampered with the notes of a patient.

Cambridgeshire and Peterborough Foundation Trust announced in July there would be an internal review of 60 suicide cases dating back to 2017.

But a key whistleblower told HSJ he fears it could be a “whitewash” and it should be carried by an external, independent investigator rather than led by the trust.

The suicides review was prompted by allegations staff had added a care plan into the patient record of Charles Ndhlovu, a day after the 33-year-old had died by suicide in 2017.

The allegations, not contested by the trust, were based on the findings of an internal investigation in 2021 of the trust’s conduct around Mr Ndhlovu’s case.

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Source: HSJ, 6 September 2023

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