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‘Mothballed beds’ must be brought back into service to boost elective activity says NHSE

NHS England has warned trusts that it is “essential” that elective procedures go ahead over winter, despite acknowledging hospital occupancy is running at an “all time high”.

New winter planning guidance from NHS England, published today, says electives should go ahead “unless there are clear patient safety reasons for postponing activity,” and trusts considering cancelling significant levels of elective activity should escalate to their regional directors to mobilise mutual aid where possible.

NHSE has said bed occupancy “continues to be at all-time highs” and encouraged systems to “take all opportunities” to maximise physical and virtual bed capacity, including the use of “previously mothballed beds”.

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Source: HSJ, 18 October 2022

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‘More than half of my paycheck goes to rent’: young US doctors push to unionise

Young doctors just out of medical school working as resident physicians, fellows and interns at major US hospitals are organising unions at an increasing rate, citing long-running problems highlighted by the Covid-19 pandemic and a need to rethink the struggles young doctors face in the profession.

The Committee of Interns and Residents, an affiliate of SEIU, added five unionised sites in 2022 compared with about one a year before the pandemic and the surge has continued in 2023 with multiple union election filings. It currently represents over 25,000 residents, fellows and interns across the US, comprising about 15% of all resident and fellow physicians.

Hospital management has opposed the unionisation effort, declining to voluntarily recognise the union, encouraging residents not to sign union authorisation cards ahead of the election filing and writing local op-eds in opposition to unionisation.

Since going public with their union plans, staff have been sent emails and been invited to meetings to try to dissuade residents from unionising, “often counting on myths around what unionizing would mean”, said Dr Sascha Murillo, a third-year internal medicine resident at Massachusetts general hospital.

The unionising campaign took off after vulnerabilities in the healthcare system were exposed by the Covid-19 pandemic, she said, with residents working on the frontlines and bearing the brunt of staffing shortages, an influx of Covid-19 patients, and patients who deferred medical care.

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Source: The Guardian, 27 April 2023

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‘Moral distress’ at trust’s ‘persistently underfunded’ neonates service

“Persistent underfunding” and staff shortages at a teaching trust’s neonatal service is likely to have harmed long-term development of newborn babies, an NHS England review has found.

A peer review of the service at Leeds Teaching Hospitals Trust, commissioned by NHSE, also found “burnout and moral distress” among its staff, linked to a lack of psychological support for them.

The review was one of two commissioned by LTHT to look at its neonatal and maternity care, following concerns. HSJ reported in February that MBRRACE-UK, the national mother and baby mortality audit, showed the trust had the highest extended perinatal mortality in the country in 2023, 2022 and 2021.

A summary of the neonatal review, published in LTHT’s September board papers, said: “This shortfall [in allied health professional staff] not only affects compliance with [National Institute for Health and Care Excellence] guidance for the neonatal follow-up programme but also results in non-compliance with the service specification for inpatient neonatal care.

“As a result, there is likely to be a negative impact on long-term neurodevelopmental outcomes for patients and reduced support for families.”

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Source: HSJ, 23 September 2025

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‘Molly never got to hear it’: fury as denials finally end on Glasgow hospital infections

All Molly Cuddihy wanted was recognition of what she had gone through. That was what she told the Scottish hospitals inquiry in 2021, where she described the “frightening” fits and rigors she had suffered after contracting a bacterial infection at Glasgow’s Queen Elizabeth university hospital while undergoing chemotherapy. “I was made sicker by the environment,” the 19-year-old said in her evidence.

Molly had been 15 and revising for her National 5 exams when she was diagnosed with a rare bone cancer. She was treated at the Royal hospital for children and the adjacent QEUH, which are both part of a six-year public inquiry that reached its final stages and heard devastating new admissions this week.

“You had a critically ill teenager who could see what was materially wrong with the hospital building in 2018,” said her father, John. He said the clinical care his daughter received was “world-class” – a sentiment echoed by all the families affected by this scandal – but “the basic principles of providing a safe and secure environment in which those clinicians could operate were simply absent”.

After years of denial, NHS Greater Glasgow and Clyde finally admitted this week that serious infections in 84 child cancer patients, two of whom died, were probably caused by a contaminated water system at its flagship hospital.

The arduous delay in accepting what patients, families and whistleblowers had been telling hospital and health board management since the £842m super-hospital first opened in 2015 piled “avoidable distress and harm” on already suffering families, John says. “The fact that Molly never got to hear those words is even more painful.”

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Source: The Guardian, 23 January 2026

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‘Misogyny’ and ‘medical patriarchy’ widespread at major trust, reports find

A major teaching trust is dominated by a “medical patriarchy”, while “misogynistic behaviour” is a regular occurrence, two investigations have discovered. 

Two reports into University Hospitals Birmingham Foundation Trust  have been published. They are the outcome of an investigation into the trust’s leadership carried out by NHS England, and an oversight review by former NHSE deputy medical director Mike Bewick.

They follow major concerns being raised over recent months about safety, culture, and leadership at the trust.

The NHSE review said the trust “could do more to balance the medical patriarchy that dominates” the organisation. It noted consultants are invited to observe a chief executive’s advisory group meeting, but nursing, midwifery and allied health professional leaders are not.”

On culture, NHSE said the trust should take steps to ensure staff can work in psychologically safe environments where “poor behaviours are consistently addressed” and to “eradicate bullying and cronyism at all levels of the organisation”. Staff had described “inequity and cronyism” being a feature of recruitment processes at all levels.

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‘Misleading’ A&E figures in England hiding poor performance

NHS bosses are using misleading figures to hide dangerously poor performance by A&E units in England against the four-hour treatment target, emergency department doctors claim.

Some A&Es treat and admit, transfer or discharge as few as one in three patients within four hours, although the NHS constitution says they should deal with 95% of arrivals within that timeframe.

How well or poorly A&Es are doing in meeting the 95% target is not in the public domain because the data that NHS England publishes is for NHS trusts overall, not individual hospitals.

That means official figures are an aggregate of performance at sometimes two A&Es run by the same trust or include data for any walk-in centres, minor injuries units or urgent treatment centres that a trust also operates. Forty-eight trusts have two A&Es and many also run at least one of the latter.

The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, wants that system scrapped. It is urging NHS England to start publishing data that shows the true performance of every individual emergency department against the 95% standard.

“The current data is misleading,” Dr Adrian Boyle, the college’s president, told the Guardian. “It’s a good example of a lack of transparency and also of performance incentives. Being open about the long delays in some A&Es would shine a light in some dark places.”

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Source: The Guardian. 28 October 2023

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‘Milestone’ treatment could reshape future leukaemia care

A UK trial has found that a chemotherapy-free approach to treatment may lead to better outcomes for some leukaemia patients, in what scientists are calling a "milestone".

The groundbreaking UK-wide trial could reshape the way the most common form of leukaemia in adults is treated.

Researchers from Leeds assessed whether two targeted cancer drugs could perform better than standard chemotherapy among patients with chronic lymphocytic leukaemia (CLL).

The Flair trial, which took place at 96 cancer centres across the UK, saw 786 people with previously untreated CLL randomly assigned to receive standard chemotherapy; a single targeted drug, ibrutinib, or two targeted drugs taken together, ibrutinib and venetoclax, with treatment guided by personalised blood tests.

Researchers found that after five years, 94% of patients who received ibrutinib plus venetoclax were alive with no disease progression.

This compares with 79% for those on ibrutinib alone and 58 per cent for those on standard chemotherapy, according to the study, which has been published in the New England Journal of Medicine and presented to the European Haematology Association congress in Milan, Italy.

Dr Talha Munir, consultant haematologist at Leeds Teaching Hospitals NHS Trust, who led the study, said the Flair trial is a “milestone”.

“We have shown that a chemotherapy-free approach can be not only more effective but also more tolerable for patients,” she said.

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Source: The Independent, 16 June 2025

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‘Menu of neglect’: preventative care hits cliff as US health resources diverted to fight Covid

Health resources diverted to fight the COVID-19 pandemic have caused a major drop in critical preventative care in the US, including childhood vaccinations and lead screenings, sexually transmitted disease testing and substance abuse services.

In short, many of the routine measures meant to keep Americans healthy – and keep American health from slipping further behind that of other developed, peer nations – have hit a worrying cliff.

As attention has focused on the immediate crisis of the pandemic and the hundreds of thousands of lives lost in America, this other hidden crisis represents another layer of disaster that also has profound implications.

“This is either the second or first worst pandemic in modern human history,” said Dr Howard Markel, a pandemic historian and pediatrician at the University of Michigan. “We knew there would be repercussions and unintended consequences.”

Now, there is a “whole menu of neglect” to address as a national vaccine campaign allows people to slowly emerge from a year of lockdowns and social distancing. “There is no historical precedent for this,” added Markel.

In the first few months of the pandemic alone, at least 400,000 children missed screenings for lead, a toxic heavy metal. Doctors and nurses ordered 3m fewer vaccines for children and 400,000 fewer for measles specifically.

For the first time, clinics were forced to ration lab tests for sexually transmitted diseases as lab capacity and supplies were diverted to test for COVID-19. Contact tracers were also re-deployed from tracking chlamydia, gonorrhea and syphilis cases to finding people in contact with COVID-19 patients.

Data from one large commercial lab showed 669,000 fewer HIV tests were processed. Compared to 2019, the lab diagnosed nearly 5,000 fewer cases of HIV. Delayed diagnosis can lead to people unwittingly transmitting the virus.

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Source: The Guardian, 26 April 2021

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‘Medically fit’ patients caught covid while waiting for discharge, trust admits

A hospital trust has admitted that ‘medically fit’ patients caught covid on its wards while waiting to be discharged, with some of the cases under investigation.

Bedfordshire Hospitals FT board papers said that a “number” of medically fit patients “acquired [covid] infection while awaiting appropriate and safe discharge”.

Trusts nationwide have struggled to discharge patients as quickly as they wanted, the reasons including a Department of Health and Social Care mandate to only allow designated care homes to accept covid patients; the resumption of NHS Continuing Healthcare tests; shortages of community beds; and capacity in the care sector.

The trust, formed in April by the merger of Luton and Dunstable University Hospital FT and Bedford Hospital FT, said a “significant proportion of [its covid] cases [were] due to acquisition in the hospital”.

It continued: “A significant additional factor was the length of stay for many patients who were medically fit for discharge but were unable to return to their place of residence. Case reviews have shown that a number of these patients acquired infection while waiting appropriate and safe discharge.”

The board papers said its covid serious incident reviews covered “some deaths on both sites… and the majority [were] patients with very severe co-morbidity”. It said six out of 15 serious incidents being investigated at its Bedford hospital site were “of potentially avoidable nosocomial covid infection (hospital acquired)”.

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Source: HSJ, 4 Februrary 2021

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‘Medical misogyny’ condemns women to years of gynaecological pain, MPs told

Women and girls are enduring years of pain because their reproductive conditions are being dismissed due to “medical misogyny”, according to a damning parliamentary report.

The report, by the Women and Equalities committee, found that gynaecological conditions such as endometriosis and adenomyosis are treated with inadequate care due to a “pervasive stigma”, a lack of education by healthcare professionals and “medical misogyny”.

The Commons select committee, which set out to examine the experiences of care women with reproductive conditions get in England, found that symptoms are often “normalised” and it can take years for women to get a diagnosis and treatment.

The substandard gynaecological care cited by the report also includes routine IUD contraceptive fittings, cervical screenings, and hysteroscopies.

The report said women were being left in pain and discomfort that “interferes with every aspect of their daily lives”, including their education, careers, relationships and fertility, while their conditions worsen.

It also found there to be a “clear lack of awareness and understanding of women’s reproductive health conditions among primary healthcare practitioners” and concluded that gynaecological care is not being treated as a priority.

Pervasive stigma associated with gynaecological and urogynaecological health, a lack of education and “medical misogyny” has contributed to poor awareness of these conditions.

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Source: The Guardian, 11 December 2024

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‘Massively reduced’ length of stay emerging at much criticised new hospital, says CEO

The CEO of a troubled trust has said evidence is emerging of ‘massively reduced’ length of stay in a new hospital criticised for being too small.

Emergency staff have raised concerns about a lack of space and bed capacity at the new Royal Liverpool Hospital, which opened in October, as services have come under severe pressure this winter. The new building, on a next-door site to the old hospital, has fewer beds, although more have opened elsewhere in the city.

In an interview with HSJ, Liverpool University Hospitals Foundation Trust chief executive officer James Sumner acknowledged aspects of the new building have created difficulties, including in relation to accident and emergency configuration and capacity, but added the move’s benefits are beginning to be seen.

He said a new care model and single rooms throughout the whole hospital are helping to reduce length of stay, as well as eliminating bed closures due to infection outbreaks.

He said: “We’ve got really good evidence of massively reduced length of stay in this new building, [with] about 70 fewer people every day waiting over seven, 14 and 21 days in hospital.

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Source: HSJ, 1 February 2023

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‘Massive’ cybersecurity risk in NHS supply chain, trust and ICB leader warns

The NHS supply chain contains “absolutely massive” cybersecurity risks which have not “really been talked about”, an integrated care board and trust chair has warned.

Lena Samuels, who is chair of two London trusts and of Hampshire and Isle of Wight Integrated Care Board, said: “We’ve been talking internally about our own organisations but we haven’t really talked about the supply chain and the risks within that – and that is absolutely massive.”

Ms Samuels, speaking at the NHS Confed Expo conference yesterday, said many NHS organisations still needed to question: “How do our risk registers capture what our supply chain resilience looks like in terms of cyber protection?”

She said NHS organisations also needed to be considering “who on my board is going to ask that question” and “whether they’re going to even think of asking that question”, adding: “There’s so much that we’ve got to think about.”

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Source: HSJ, 14 June 2024

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‘Many, many’ Australian doctors advertising as general physicians without required qualifications

Some doctors in Australia are using the title “specialist general physician” despite not having completed the training required by law, potentially misleading patients with complex and chronic health conditions that require specialised care, physicians say.

After completing a medical degree and postgraduate work experience, graduates can apply to the Royal Australasian College of Physicians (RACP) fellowship training program. All RACP trainees complete similar foundational training before choosing areas of advanced training to specialise in such as geriatrics, cardiology, general medicine or other areas.

General physicians are different from general practitioners (also known as GPs). General physicians care for patients with unusual or complex conditions and see patients either in hospital or those who are referred to them, usually by the patient’s GP.

Medical practitioners can only use titles such as “specialist general physician”, “specialist geriatrician” or “specialist cardiologist” if they have completed the advanced specialist RACP training in the corresponding field of practice and have registered with the Australian Health Practitioner Regulation Agency (Ahpra).

But Dr Jenna Paterson, a specialist general physician working in Victoria and South Australia, said there are “many, many” doctors who advertise their services to patients as a “general physician” without the qualifications to do so.

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Source: The Guardian, 13 June 2023

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‘Ludicrous’ expectation pushes trusts to plan savings of up to 9%

NHS trusts are signing up to deliver efficiency savings of up to 9% of costs, HSJ  has found.

The Queen Elizabeth Hospital King’s Lynn has a cost improvement programme of nearly £30m in 2024-25, equivalent to 9% of spending, which is three times higher than the amount it delivered last year.

Trusts and commissioners were last month issued with new financial targets as NHS England attempted to bring down a £3bn forecast deficit for local organisations.

A spokeswoman told HSJ the trust had already identified three-quarters of the £30m, and said “we believe that there are further efficiencies in our system, which would see us go further than the 3.1% achieved last year.”

She added: “All cost-saving initiatives go through a robust process to make sure that they will not impact patient safety or clinical care provided by the trust.”

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Source: HSJ, 1 July 2024

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‘Low priority’ community cases to be deferred as staff redeployed

NHS England has told local systems to defer ‘low priority’ cases across 11 community services, because of the pressures created by the omicron wave. 

NHSE has issued guidance for the prioritisation of the community health workforce “given the increasing pressures on the health system due to the omicron wave of COVID-19 this winter and the need to provide booster jabs as quickly as possible”.

It is hoped the guidance will encourage the redeployment of community staff to help reduce the strain on acute services.

Staff working in musculoskeletal services are being asked to deprioritise some low priority rehabilitation work, with patients enabled to self-manage at home.

It adds: “Where possible, provide capacity to support other community resources focused on rehabilitation and recovery for those discharged from acute care and those whose functioning is deteriorating at home, and/or the administration of vaccines.”

A host of other services have been advised to continue, but with “prioritised” waiting lists and a deferral of provision considered for “low priority cases” to “free up workforce capacity”, including children’s therapy interventions, children’s community paediatric services and audiology services for older adults.

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Source: HSJ, 11 January 2022

 

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‘Longest ever strike’ announced by junior doctors for next month

Junior doctors will take part in what is “thought to be the longest single period of industrial action in the history of the health service” for five days next month.

The British Medical Association junior doctor committee announced this morning there would be a walkout from 7am on Thursday 13 July and 7am on Tuesday 18 July in its ongoing pay dispute with government.

It comes amid growing expectation that a Royal College of Nursing ballot on further strike action over the Agenda for Change pay award, which ends this week, is likely to fail to secure a mandate.

But junior doctors’ strikes are continuing to hit elective recovery, and strain relationships, with workload on other groups increased as they are asked to provide cover. 

Junior doctors have allowed no “derogations” (exemptions) from the action, as they say other staff groups can cover emergency care, and one move to call them in to a busy hospital in the south west, in an earlier round, was abandoned. 

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Source: HSJ, 23 June 2023

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‘Long-COVID’ in our community – new call for research proposals

Up to £20 million is available for new research projects which aim to understand and address the longer-term physical and mental health effects of COVID-19 in non-hospitalised individuals. 

Increasing medical evidence and patient testimony has shown that some people who contract and survive COVID-19 may develop longer-lasting symptoms.

Symptoms can range from breathlessness, chronic fatigue, ‘brain fog’, anxiety and stress and can last for months after initially falling ill. 

These ongoing problems, commonly termed ‘Long-COVID’, may be experienced by patients regardless of how severe their COVID-19 infection was and irrespective of whether they were hospitalised.

UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) are launching a call to fund two or three ambitious and comprehensive proposals and a small number of study extensions that will address ‘Long-COVID’ in the community. 

This work will complement other major studies already funded by UKRI and NIHR which focus on long covid in hospitalised patients. Projects are expected to start early in the new year and may be funded for up to three years in the first instance.

The call will open on 12 November and close on 9 December 2020.

Further information

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‘Long flu’: study finds flu patients at higher risk of longer-term illness

People who have been hospitalised with flu are at an increased risk of longer-term health problems, similar to those with long Covid, data suggests.

While the symptoms associated with such “long flu” appear to be more focused on the lungs than ongoing Covid symptoms, in both cases the risk of death and disability was greater in the months after infection than in the first 30 days.

“It is very clear that long flu is worse than the flu, and Long Covid is worse than Covid,” said Dr Ziyad Al-Aly, a clinical epidemiologist at Washington University in St Louis, Missouri, who led the research.

He was motivated to study the phenomenon after observing the scale of long-term illness experienced by people who have recovered from Covid.

“Five years ago, it wouldn’t have occurred to me to examine the possibility of a ‘long flu.’ But one of the major lessons we learned from this pandemic is that a virus we all initially thought could only cause acute disease is leaving millions of people with long Covid, he said. “We wondered whether this could be happening with other things. Could this be happening with the flu, for example?”

The research, published in the Lancet Infectious Diseases, found that while Covid patients faced a greater risk of death or hospital readmission in the following 18 months, both infections carried a significant risk of ongoing disability and disease.

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Source: The Guardian, 14 December 2023

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‘Long covid’ clinics still not operating despite Hancock claim

The government and NHS England appear unable to identify units set up to treat ‘long covid’, contrary to a claim by Matt Hancock in Parliament that the NHS had ‘set up clinics and announced them in July’. 

There are growing calls for wider services to support people who have had COVID-19 and continue to suffer serious follow-up illness for weeks or months. Hospitals run follow-up clinics for those who were previously admitted with the virus, but these are not generally open to those who were never admitted.

Earlier this month the health secretary told the Commons health committee: “The NHS set up long covid clinics and announced them in July and I am concerned by reports from Royal College of General Practitioners that not all GPs know how to get into those services.”

Asked by HSJ for details, DHSC and NHS England declined to comment on how many clinics had been set up to date, where they were located, how they were funded or how many more clinics were expected to be “rolled out”.

However, two charities and support groups — Patient Safety Learning and the Long Covid Support Group — told HSJ they were not aware of dedicated long covid clinics for community patients. An enquiry from Patient Safety Learning to NHS England has not been answered.

The number of people affected by long covid is unclear due to a lack of research but there are suggestions it could be half a million or more. Symptoms can include fatigue, sleeplessness, night-time hypoxia, “brain fog” and cardiac problems. It appears to affect more people who were not hospitalised with coronavirus than those who were were. There is some evidence that small clinics have been set up locally on a piecemeal basis, without national funding.

HSJ has only been able to identify only one genuine “long covid clinics” open to those who have never been in hospital with covid. 

Trisha Greenhalgh, an Oxford University professor of primary care health sciences who has interviewed around 100 long covid sufferers, told HSJ: “Nobody I have interviewed had been seen in a long covid clinic but there is an awful lot of people who would like to be referred and who sound like the need to be but they haven’t.”

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Source: HSJ, 23 September 2020

Read the letter Patient Safety Learning sent to NHS England

hub Community thread - Long Covid: Where are these clinics?

 

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‘Long covid’ – The under-the-radar coronavirus cases exhausting thousands

We’re swiftly learning the symptoms of Covid-19 may last longer than previously thought. One in 10 people are reporting a longer tail of symptoms, which exceeds the suggested two-week recovery time.

It’s thought around 30,000 people in the UK could be impacted by a prolonged version of the illness – what some are calling ‘long covid’. These people are months into their recovery from the virus and still fighting a range of persistent symptoms. In some cases, the symptoms disappear for a while before coming back. In others, they’re gradually improving over time.

Research from the Covid-19 Symptom Study in the UK, led by Professor Tim Spector of King’s College London, shows after three weeks of first reporting symptoms, a group of people continue to experience fatigue, headaches, coughs, loss of smell, sore throats, delirium and chest pain.

People with mild cases of the disease are more likely to have a wide range of symptoms that come and go over an extended period, Prof Spector found. And these people are often flying under the radar because they’re not in hospital.

Those who believe they’ve had ‘long covid’ are now calling on the government to recognise their plight, invest in research and put support in place.

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Source: Huffpost, 2 July 2020

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‘Living with Covid plan’ will hamper NHS patient care, doctors warn as restrictions lift

Senior doctors say the government’s “Living with Covid” plan will hamper the ability of the NHS to provide care.

Michelle Drage, chief executive of the Londonwide Local Medical Committee, which represents the majority of practices in the city, has said the government’s changes may discourage vulnerable patients to seek care when they need it, while David Nicholl, a neurologist and spokesperson for Doctors’ Association UK, said it could exacerbate health inequalities.

It comes as the legal requirement to isolate after testing positive is lifted from Thursday, while free Covid testing ends on 1 April.

NHS England sent a letter to all healthcare providers confirming workers would have to continue with current rules and not come into work after testing positive.

Staff were told they should continue to carrying out regular testing, and access this through national routes until 31 March, but were not given guidance on testing requirements beyond this.

Dr Drage said the changes in isolation and testing rules could put off vulnerable patients.

“We may well see people not being able to access the services they need to because they’re afraid to attend,” she said.

“Then to make people pay for those tests for what looks like a fiver a pop, when the people that can least afford it and the people who can least afford to take time off... suggests to me we’re increasing the risk of inappropriate transmission.”

“It’s a perfect storm that could be brewing that will have a further impact on the ability of patients to be properly cared for… It feels like, yet again, the government gambling with people’s health to sustain the economy.”

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Source: The Independent, 25 February 2022

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‘Lives at risk’ in Britain’s crumbling hospitals

Patients’ lives are at risk because NHS hospitals have been allowed to crumble into disrepair, with ceilings collapsing and power cuts disrupting surgery.

The number of clinical incidents linked to the failure to repair old buildings and faulty equipment has tripled in the past five years, an investigation by The Times found.

Hundreds of vital NHS operations and appointments are being cancelled as a result of outdated infrastructure, undermining attempts by doctors to tackle record waiting lists.

Recent incidents include an unconscious patient on a ventilator being trapped in a broken lift for 35 minutes and power running out as a patient lay in an operating theatre.

On Saturday, April 23, a five-hour power cut at the Royal London Hospital in east London led to the cancellation of operations including two lifesaving kidney transplants, and meant women giving birth had to be transferred to different maternity units in the backs of taxis.

Hospitals have also recorded hundreds of rat and pest infestations, and some rooms containing patients have been left “overflowing with raw sewage”.

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Source: The Times, 2 May 2022

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‘Little evidence’ whether or not most antidepressants work for chronic pain

Antidepressants commonly used to treat chronic pain lack evidence as to whether or not they work, researchers have said, declaring the situation a global public health concern.

Chronic pain, typically defined as pain lasting three months or more, is a widespread problem affecting up to one in three people, with conditions ranging from osteoarthritis to fibromyalgia.

While exercise is often recommended, this is difficult for some patients, while there are concerns that opioids and other painkillers such as aspirin and paracetamol could do more harm than good.

Increasing numbers of patients are prescribed antidepressants to treat their pain, with hundreds of thousands in the UK estimated to be taking amitriptyline. Antidepressants affect chemicals known as neurotransmitters, which is how they are thought to relieve pain.

But a new Cochrane review, led by Prof Tamar Pincus, professor in health psychology at the University of Southampton, has revealed there is little evidence whether or not amitriptyline and many other common antidepressants work when it comes to tackling chronic pain.

“The fact that we don’t find evidence whether it works or not, is not the same as finding evidence that it doesn’t work,” she said. “We don’t know. The studies simply are not good enough.”

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Source: The Guardian, 10 May 2023

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‘Likely’ supplier for ‘first of its kind’ EPR revealed

An integrated care board has named Oracle Health as the “likely” supplier of an electronic patient record that will be the first to be used across acute, mental and health services.

Mid and South Essex Integrated Care Board is planning to procure a single electronic patient record for both its sole acute, Mid and South Essex Foundation Trust and mental health and community service provider Essex Partnership University Trust. 

Details of the move were revealed in the integrated care system’s “joint forward plan” for 2024-2029 which was presented to the ICB’s July board.

Mid and South Essex Foundation Trust – which was formed by a merger of three trusts – currently uses seven different EPRs, while Essex Partnership University Trust has three. The new unified EPR is expected to go live in 2026-2027.

NHS England has encouraged ICSs to “converge” their EPR system for over two years. A number of acute trusts operating within the same system have already launched plans to share the same EPR. This includes Bath and North East Somerset, Swindon and Wiltshire and Norfolk and Waveney.

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Source: HSJ, 12 July 2024

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‘Life-or-death consequences’: families in the US fear rollback of school vaccine requirements under RFK Jr

With vaccine sceptic as Trump pick to lead US health policy, parents and advocates anticipate devastating changes.

Apolitical battle over school-based Covid protocols in early 2021 quickly turned personal for one Colorado family, whose son’s cystic fibrosis – a life-threatening genetic disease affecting the lungs and other vital organs – made him susceptible to complications from the virus.

Kate Gould said the classroom became a dangerous place for her son after hardline conservatives took over the Douglas county school board and the district removed masking requirements.

Almost four years later, Gould and her family live in southern California – where they moved during the pandemic for the mask and vaccine requirements in place at the time – and they and other parents, advocates and health experts are gearing up for what could be the next front of the school culture wars: a broader attack on school vaccine mandates by the incoming Trump administration.

Currently, all 50 states have vaccine requirements for children entering childcare and schools. But with Robert F Kennedy Jr – who has peddled baseless conspiracy theories and once said: “There’s no vaccine that is safe and effective” – potentially at the helm of the Department of Health and Human Services, advocates and parents are right to fear a rollback of requirements, enforcements and funding, according to interviews with about a dozen experts.

Kennedy’s legitimisation and the different levers he could pull, experts told the 74, could have an immense impact on vaccination rates and the spread of preventable, contagious diseases in school-aged children.

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Source: The Guardian, 16 January 2025

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