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The mystery of the capital’s ‘high-volume’ treatment centres

Next Thursday we’ll see more waiting list data released.

What is contained in it is probably why Sir David Sloman’s office has taken nearly a month to not answer this question: Your letter to system leaders said you would “eliminate” 52-week waits, by when?

The regional director’s office could not answer, nor could it reveal which hospitals were going to be the high-volume centre to burn through the lists in the six major specialities.

There are a couple of likely reasons for their not being able to say when the long waiters would be eliminated.

NHSI/E’s phase three letter set “mad” targets that don’t feel very real to many on the ground. I/E central will know this and have their own reasons for setting stretching-to-the-point-of-snapping targets, but trusts don’t really want to be held to submitting impossible commitments then being chastised for missing them (management teams have been moved on for this kind of thing in less fraught times).

The second reason is that the picture is likely to be scary and also to have an impact on the ongoing three-way negotiation between the NHS, the independent sector - which will be hosting a lot of this work - and the workforce that will actually do it in both places.

There is even less transparency than usual from the regional director’s office and I/E generally when asked anything at all about how effectively private sector facilities are being used, or how much it is costing.

Much more surprising is the fact that Sir David’s office cannot yet name where each of the ICS’s six high-volume centres will be.

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Source: HSJ, 1 October 2020

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CQC to inspect hospitals on food standards after patient deaths

Hospital food standards are set to be put on a statutory footing, with trusts held to account by the Care Quality Commission, according to the chair of a government-commissioned review.

Philip Shelley, who led the review into hospital food following seven patient deaths from listeria last year, told HSJ the incident was an “absolute condemnation” and that trusts must use the review to improve food standards.

The review, published last month, also calls for capital investment to refurbish hospital kitchens and replace old and inefficient equipment, which is likely to cost several hundreds of millions of pounds.

The government has accepted the recommendations and Mr Shelley will lead a group of experts to oversee the review’s implementation across the NHS during the next three years.

Among the review’s recommendations is the “enhanced role” for the CQC when it inspects NHS trusts.

The review states there is currently “very little evidence to prove that food and drink standards are being monitored closely enough” and it therefore recommends placing the standards on a statutory footing from which the CQC can hold trusts to account.

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Source: HSJ, 17 November 2020

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A ‘tsunami’ of coronavirus survivors could overwhelm NHS rehabilitation services, experts warn

The health service will face a “tsunami” of coronavirus survivors discharged from hospitals needing long-term physical and mental support that the NHS will struggle to provide, The Independent has been told.

Coronavirus can leave patients with lasting physical damage and scarring to their lungs, meaning many could struggle to breathe and move around as well as they did before – in some cases permanently.

Patients admitted to intensive care can also suffer physical effects of being paralysed weeks and almost half who are ventilated with a tube in their windpipe will experience a form of delirium that can include terrifying hallucinations and leave survivors with lasting mental problems including post-traumatic stress.

Experts have warned a long-term lack of funding of NHS rehabilitation services and post-discharge care for ITU patients means the health service will struggle to help the thousands of patients who beat the virus but face a long road to recovery.

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Source: 3 May 2020

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Scathing review slams West Suffolk’s ‘intimidating’ hunt for whistleblower

West Suffolk Foundation Trust’s investigation to find a whistleblower was “intimidating…flawed and not fit for purpose”, according to a damning review which is highly critical of the organisation’s leadership.

The long-awaited review, published today, was triggered by ministers back in January 2020 following allegations that trust directors had ordered staff to give fingerprints and handwriting samples during a “witch hunt” for a whistleblower.

The review, led by Christine Outram, has corroborated many of the allegations.

It concluded trust leaders’ investigation to uncover the identity of the author of an anonymous letter sent to a patient’s family was “intimidating, flawed and not fit for purpose… impractical and unwise.”

It said: “The decision to use fingerprinting and handwriting analysis in an NHS hospital, in the context of an anonymous letter and where no crime has been committed, was highly unusual and without doubt extremely ill-judged.”

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Source: HSJ, 9 December 2021

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Forget the pandemic, NHS decline is ‘to blame for record waiting lists’

Record NHS waiting lists cannot be attributed to the pandemic as the health service has been “steadily declining” for a decade, a report says.

The number of people waiting for routine hospital treatment in England has almost tripled from 2.5 million in April 2012 to 6.78 million, after reaching 4.6 million in February 2020.

While Covid accelerated this trend, analysis suggests that even without the pandemic waiting lists for elective care would stand at 5.3 million.

The Quality Watch report, by the Nuffield Trust and Health Foundation think tanks, says the NHS was “already stretched beyond its limits” before Covid struck.

Analysis of performance figures show waiting times for scans, A&E and cancer care have been increasing for many years amid chronic staff shortages.

This deterioration means thousands of cancer patients each month face unacceptably long waits for treatment — damaging their survival chances.

The report found waiting times for 15 key diagnostic tests, such as MRI or CT scans, had also rocketed. In April 2012 632,236 patients were on waiting lists for these tests. This backlog increased to one million by February 2020 before hitting 1.6 million this year.

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Source: The Times, 5 September 2022

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England's poorest 'get worse NHS care' than wealthiest citizens

England’s poorest people get worse NHS care than its wealthiest citizens, including longer waiting for A&E treatment and worse experience of GP services, a new study has shown.

Those from the most deprived areas have fewer hip replacements and are admitted to hospital with bed sores more often than people from the least deprived areas. With regard to emergency care, 14.3% of the most deprived had to wait more than the supposed maximum of four hours to be dealt with in A&E in 2017-18, compared with 12.8% of the wealthiest. Similarly, just 64% of the former had a good experience making a GP appointment, compared with 72% of those from the richest areas.

Research by the Nuffield Trust and Health Foundation thinktanks found that the poorest people were less likely to recover from mental ill-health after receiving psychological therapy and be readmitted to hospital as a medical emergency soon after undergoing treatment.

The findings sparked concern because they show that poorer people’s health risks being compounded by poorer access to NHS care.

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Source: The Guardian, 23 January 2020

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Covid-19: “Huge rise” in deaths at home is not fully explained by virus, say experts

Deaths resulting from COVID-19 infection account for only half of the number of excess deaths taking place in private homes, expert analysis of latest data suggests.

Figures from the Office for National Statistics from the seven weeks to 15 May show that more than 40 000 COVID-19 deaths have now taken place in hospitals, care homes, and private homes in England and Wales. The figures also show 14 418 excess non-covid deaths.

Although COVID-19 was mentioned on death certificates 13 500 times in care homes and private homes over the past seven weeks, some 23 500 more non-covid deaths have taken place in the community than would be expected.

Discussing the data, David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, said that “as soon as the pandemic started we saw a huge immediate spike in non-covid deaths in [private] homes that occurred close to the time hospitals were minimising the service they were providing."

“Over the seven weeks up to 15 May, as the NHS focused on covid, around 8800 fewer non-covid deaths than normal occurred in hospitals.”

He added that these had not been “exported” to care homes, since fairly few care home residents normally died in hospitals. Instead, he said, it seemed that these deaths had contributed to the huge rise in extra deaths in private homes during this period.

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Source: BMJ, 27 May 2020

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NHS set to roll out £160m ‘Covid-friendly’ cancer initiative

As part of a £160m initiative, the NHS will look to roll out and expand ‘Covid-friendly’ cancer treatments which are safer for patients during the pandemic, the health service’s Chief Executive Sir Simon Stevens has announced.

The funding will help pay for drugs which treat patients without having as significant of an impact on their immune system, or which could offer other benefits such as a reduced number of hospital visits.

Almost 50 treatments have been approved for use as ‘swaps’ for existing drugs, with thousands of patients having already benefitted, and more are expected to be made available this week as part of deals struck between the NHS and pharmaceutical companies.

Within these treatments include options which allow patients to take tablets at home or receive medicines with fewer side effects rather than undergoing hospital-based treatment which can leave them more susceptible to coronavirus and other infections.

Sir Stevens said: “Since the first case of Covid in England six months ago, NHS staff have fast tracked new, innovative ways of working so that other services, including A&E, cancer and maternity could continue safely for patients and it is thanks to these incredible efforts that 65,000 people could start treatment for cancer during the pandemic.

“We are now adopting new, kinder treatment options which are not only effective but safer for use during the Covid-19 pandemic and more convenient for thousands of patients, who can take medication at home or be given medicines with less harmful effects on their immune system.”

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Source: National Health Executive, 3 August 2020

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Why so many Long Covid patients are reporting suicidal thoughts

Last year, Diana Berrent—the founder of Survivor Corps, a US Long COVID support group—asked the group’s members if they’d ever had thoughts of suicide since developing Long Covid. About 18% of people who responded said they had, a number much higher than the 4% of the general US adult population that has experienced recent suicidal thoughts.

A few weeks ago, Berrent posed the same question to current members of her group. This time, of the nearly 200 people who responded, 45% said they’d contemplated suicide.

While her poll was small and informal, the results point to a serious problem. “People are suffering in a way that I don’t think the general public understands,” Berrent says. “Not only are people mourning the life that they thought they were going to have, they are in excruciating pain with no answers.”

Long Covid, a chronic condition that affects millions of Americans who’ve had COVID-19, often looks nothing like acute COVID-19. Sufferers report more than 200 symptoms affecting nearly every part of the body, including the neurologic, cardiovascular, respiratory, and gastrointestinal systems. The condition ranges in severity, but many so-called “long-haulers” are unable to work, go to school, or leave their homes with any sort of consistency.

Long COVID can also be incredibly painful, and research has linked chronic physical pain to an increased risk of suicide. Nick Güthe has been trying to spread that message since his wife, Heidi Ferrer, died by suicide in 2021 after living with Long Covid symptoms for about a year. Among her most disruptive symptoms, Güthe says, were foot pain that prevented her from walking comfortably, tremors, and vibrating sensations in her chest that kept her from sleeping.

“My wife didn’t kill herself because she was depressed,” Güthe says. “She killed herself because she was in excruciating physical pain.”

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Source: Time. 13 June 2022

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Trusts to ‘run out of gowns this weekend’

London trusts have been warned not to expect deliveries of gowns from the national supply chain for at least the next few days, HSJ understands.

Without central deliveries, providers risk running out of gowns ahead of the Easter weekend. Trusts will have to rely on existing supplies and any new stock they procure independently. 

Staff performing or assisting aerosol-generating procedures on confirmed or suspected covid-19 patients should wear gowns, according to the latest guidance from Public Health England.

But supplies have been an issue for weeks, with trust procurement leads raising concerns about dwindling gown stocks last month. It recently emerged that gowns were not included in national pandemic stockpiles, unlike other forms of personal protective equipment like masks and gloves.

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Source: HSJ, 9 April 2020

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Covid: How a £20 gadget could save lives

One of the mysteries of COVID-19 is why oxygen levels in the blood can drop to dangerously low levels without the patient noticing.

It is known as "silent hypoxia" and as a result, patients have been arriving in hospital in far worse health than they realised and, in some cases, too late to treat effectively.

But a potentially life-saving solution, in the form of a pulse oximeter, allows patients to monitor their oxygen levels at home, and costs about £20.

They are being rolled out for high-risk Covid patients in the UK, and the doctor leading the scheme thinks everyone should consider buying one.

A normal oxygen level in the blood is between 95% and 100%.

"With Covid, we were admitting patients with oxygen levels in the 70s or low-or-middle 80s," said Dr Matt Inada-Kim, a consultant in acute medicine at Hampshire Hospitals.

He told BBC Radio 4's Inside Health: "It was a really curious and scary presentation and really made us rethink what we were doing."

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Source: BBC News, 21 January 2021

See hub resource on the 'Covid Oximetry @home' project

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‘Hepatitis in children: Any delays in diagnosis could lead to negligence claims, say lawyers

Parents whose children have mysteriously fallen ill with hepatitis and received a delayed diagnosis could be entitled to negligence claims, lawyers believe.

Officials are no closer to explaining a recent and unusual outbreak in cases of liver inflammation recorded among young children across the UK.

To date, a total of 163 children have been diagnosed. Eleven of these have received liver transplants, while 13 are currently in hospital. Globally in recent months, 300 children have been struck down by the illness, which has no clear cause.

Because the UK cases have been identified retrospectively, there is potential that doctors and medics may have “missed signs” which would have led to earlier hepatitis diagnoses and treatment, lawyers say.

“There are a significant number of these diagnoses which are actually retrospective,” said Jonathan Peacock, a partner at VWV specialising in clinical negligence.

“The obvious issue there from a negligence point of view is if you have missed signs, which ought to have led you to a diagnosis of hepatitis earlier, as a result of which it’s gone untreated and the outcome is worse, then potentially you’re negligent.

“There’s two stages: was the care diagnosis, treatment, intervention, was that of a reasonable standard? If the answer is no – there was clearly a negligent delay, or a breach of duty of care, then the second question that then arises is has the individual been harmed by that delay?”

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Source: The Independent, 10 May 2022

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NHS trust to review all suicides since 2017

The deaths of dozens of people who took their own lives while patients of an NHS trust will be reviewed after concerns were raised.

Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) will review all 63 suicides since 2017.

It comes after the trust was accused of adding to the records of a patient the day after he took his own life to "correct their mistakes".

The patient, who was diagnosed with paranoid schizophrenia and substance misuse, had been under CPFT's care for two months when he died in Ely in 2017.

Last month, his mother Angelina Pattison, from Newmarket, Suffolk, told the BBC his care plan "was done when he died - when they were running around to correct their mistakes, which they have done".

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Source: BBC News, 25 July 2023

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NHSE to act over fears covid-19 focus could ‘do more harm than virus’

National NHS leaders are to take action over growing fears that the “unintended consequences” of focusing so heavily on tackling covid-19 could do more harm than the virus, HSJ has learned. 

NHS England analysts have been tasked with the challenging task of identifying patients who may not have the virus but may be at risk of significant harm or death because they are missing vital appointments or not attending emergency departments, with both the service and public so focused on covid-19. 

A senior NHS source familiar with the programme told HSJ: “There could be some very serious unintended consequences [to all the resource going into fighting coronavirus]. While there will be a lot of covid-19 fatalities, we could end up losing more ‘years of life’ because of fatalities relating to non-covid-19 health complications.

“What we don’t want to do is take our eye off the ball in terms of all the core business and all the other healthcare issues the NHS normally attends to."

“People will be developing symptoms of serious but treatable diseases, babies will be born which need immunising, and people will be developing breast lumps and need mammograms.”

HSJ understands system leaders are hopeful that in the coming days they will be able to assess the scale of the problem, and the key patient groups, and then begin planning the right interventions and communications programme to tackle it.

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Source: HSJ, 5 April 2020

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WHO chief urges immediate action to tackle ‘devastating’ Long Covid

Long Covid is “devastating” the lives and livelihoods of tens of millions of people, and wreaking havoc on health systems and economies, the head of the World Health Organization (WHO) has warned as he urged countries to launch “immediate” and “sustained” efforts to tackle the “very serious” crisis.

The world has never been in a better position to end the Covid-19 pandemic, but it is also “very clear” that many of those infected by the virus, which first emerged in China in late 2019, are still experiencing “prolonged suffering”, the WHO director general, Dr Tedros Adhanom Ghebreyesus, said.

With the absence of evidence about how best to treat it, Long Covid is turning people’s lives upside down, and many face “often lengthy” and “frustrating” waits for support or guidance, Tedros said. The large numbers of those cruelly affected by the long tail of Covid is also having a dangerous impact on health systems and economies still reeling from waves of infections.

“While the pandemic has changed dramatically due to the introduction of many lifesaving tools, and there is light at the end of the tunnel, the impact of long Covid for all countries is very serious and needs immediate and sustained action equivalent to its scale,” Tedros said, writing for the Guardian.

Countries must now “seriously ramp up” both research into the condition and access to care for those affected if they are to “minimise the suffering” of their populations and protect their health systems and workforces.

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Source: The Guardian, 12 October 2022

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COVID-19: Working in medicine is “pretty awful” right now, says college president

The second wave of COVID-19 has put doctors under huge pressure, the Royal College of Physicians has warned, as two thirds of physicians report feeling tired or exhausted.

A survey of 25 500 members of the college from across the UK, conducted on 2 November, received 1890 responses. It found that two thirds (64%, 931) felt tired or exhausted, 48% (687) felt worried, and just under a third (29%, 424) felt demoralised. Almost a fifth (19%, 280) said they have sought informal mental health support, such as speaking to colleagues or friends, during the pandemic. Just 10% (155) said they had sought formal mental health support from either their employer, GP, or external services.

College president Andrew Goddard said he was concerned about the mental health of doctors, “There is no way to dress it up—it is pretty awful at the moment in the world of medicine. Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, it seems a long way away.”

He said that before the pandemic, few physicians would have expected to need formal mental health support during their career.

After the pandemic, staff will be in desperate need of a break, Goddard said, and will need specific time away if they’re to be at their best. “Doctors have demonstrated remarkable resilience throughout the pandemic, working under the most challenging conditions the NHS has ever faced, but they can’t continue working this way forever,” he said.

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Source: The BMJ, 21 January 2021

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Social care ‘on its knees’ as vacancies hit record high

Social care services face an “absolute crisis” over record vacancies as unfilled jobs have risen by more than 50% in a year, a new analysis reveals.

New data on social care workers shows at least 165,000 vacancies across adult social care providers at the end of 2021-22.

This is the highest on record according to the charity Skills for Care, which has collected the data since 2012.

Leading think tanks have warned the figures to point to the “absolute crisis” facing social care with the “system on its knees”.

At the same time the demand for care has risen, highlighting that social care is facing a complex challenge with recruitment and retention which will be impacting on the lives of people who need social care. The annual report by Skills for Care predicts social care services will need an extra 480,000 workers by 2035 to meet the demand but could be set to lose 430,000 staff to retirement over the next decade.

Simon Bottery, senior fellow at The King’s Fund, said the report was evidence “of the absolute crisis social care faces when trying to recruit staff, a crisis that has profound consequences for people needing care”.

He added: “A key reason for that is pay, which continues to lag behind other sectors including retail and hospitality, as well as similar roles in the NHS. Our recent analysis found that nearly 400,000 care workers would be better paid to work in most supermarkets."

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Source: The Independent, 11 October 2022

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‘I felt doomed’: social media guessed I was pregnant – and my feed soon grew horrifying

Kathryn Wheeler can't remember where she was when her TikTok feed showed her a video of a woman holding her stillborn baby, but she remembers how she felt. "At first, it appeared like any other video of a woman holding a newborn. It was tightly wrapped in blankets while she cradled it in her arms. She was crying, but so are most of the women in these post-birth videos. It wasn’t until I read the caption that I realised what I was looking at. Her baby had been delivered at 23 weeks. I was 22 weeks pregnant. I felt doomed," she says.

Her social media algorithms knew she was pregnant before family, friends or her GP. Within 24-hours, they were transforming her feeds.

"On Instagram and TikTok, I would scroll through videos of women recording themselves as they took pregnancy tests, just as I had done. I “liked”, “saved”, and “shared” the content, feeding the machine, showing it that this is how it could hold my attention, compelling it to send me more. So it did. But it wasn’t long before the joy of those early videos started to transform into something dark."

The algorithm began to deliver content about the things you fear the most while pregnant: “storytimes” about miscarriages; people sharing what happened to them and, harrowingly, filming themselves as they received the news that their baby had no heartbeat. Next came videos about birth disfigurements, those found by medical professionals early on, and those that were missed until the baby’s birth.

On TikTok, there are more than 300,000 videos tagged under “miscarriage”, and a further 260,000 under “miscarriageawareness”. One video with the caption “live footage of me finding out I had miscarried” has almost half a million views. Another showing a woman giving birth to a stillborn baby has just under five million.

For Dr Christina Inge, a researcher at Harvard University specialising in the ethics of technology, these experiences are not surprising. “Social media platforms are optimised for engagement, and fear is one of the most powerful drivers of attention,” she says. “Once the algorithm detects that a person is pregnant, or might be, it begins testing content – the same as it does with any other information about a user. If a user lingers on an alarming video on pregnancy, even if just for a second, that is interpreted as interest. The system then feeds you more of the same.

“Distressing content isn’t a glitch; it’s engagement, and engagement is revenue,” Inge continues. “Fear-based content keeps people hooked because it creates a sense of urgency; people feel they need to keep watching, even when it’s upsetting. The platforms benefit financially, even as the psychological toll grows.”

The negative effect of social media on pregnant women has been widely researched. In August, a systematic review into social media use during pregnancy considered studies from the US, the UK, Europe and Asia. It concluded that while social media can offer peer-to-peer advice, support and health education, “challenges such as misinformation, increased anxiety and excessive use persist”. The review’s author, Dr Nida Aftab, an obstetrician and gynaecologist, highlights the role healthcare professionals should play in helping women make informed decisions about their digital habits.

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Source: The Guardian, 3 September 2025

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‘Insufficient’ national response to deaths review programme, report finds

The latest annual report into the deaths of people with learning disabilities has criticised the “insufficient” national response to past recommendations and called for “urgent” policy changes.

The national learning disabilities mortality review programme has criticised the response from national health bodies to its previous recommendations.

To date, just over 7,000 deaths have been notified to the programme and reviews have been completed for just 45%.

There have been four annual reports for programme to date, and in the latest published today, the authors warned: “The response to these recommendations has been insufficient and we have not seen the sea change required to reassure [families] that early deaths are being prevented."

“It is long over-due that we should now have concerted national-level policy change in response to the issues raised in this report and previous others. A commitment to take forward the recommendations in a meaningful and determined way is urgently required.”

The latest report also warns that black, Asian and ethnic minority children with learning disabilities die “disproportionately” younger compared to other ethnicities.

It also found system problems and gaps in service provision were more likely to contribute to deaths in BAME people with learning disabilities. 

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Source: HSJ, 16 July 2020

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Major concerns over funding and staffing of new ‘long covid’ clinics

There are serious concerns over the funding and staffing numbers available for new ‘long-covid’ clinics, while patient groups ‘remain in the dark’ over their locations.

Last month, NHS England announced there would be 40 clinics around the country, to start opening at the end of November, with £10m of funding to cover set-up and operational costs until March 2021.

But several speakers at HSJ’s inaugural virtual respiratory forum last week said there were still uncertainties and concerns about the capacity to provide the clinics.

Dr Jon Bennet, a respiratory consultant and chair of the British Thoracic Society, said staffing the respiratory rehabilitation services within the clinics would be challenging, as “there isn’t at the moment sufficient capacity”.

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Source: HSJ, 29 November 2020

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‘Robot paramedics’ carry out chest compressions on patients in ambulances

A robot paramedic is to be used for the first time to carry out chest compressions on ambulance patients to free up the emergency team who can perform other vital treatments.

The device is known as LUCAS 3 and is able to deliver consistent, high-quality CPR chest compressions whilst the patient is on their journey to hospital. CPR is essential to maintaining oxygen levels in the body and flow of blood when someone is no longer breathing.

South Central Ambulance Service (SCAS) is the first ambulance service in the country to use the robots, which cost about £12,000.

An SCAS spokesman said: “Once paramedics arrive and begin CPR or take over from bystanders who may have initiated it, the transition from manual compressions to LUCAS can be completed within seven seconds, ensuring continuity of compressions.”

Data of the event can also be collected which can be reviewed at a later date.

Dr John Black, medical director at SCAS, said: “We know that delivering high quality and uninterrupted chest compressions in cardiac arrest is one of the major determinants of survival to hospital discharge but it can be very challenging for a number of reasons.

“People can become fatigued when performing CPR manually which then affects the rate and quality of compressions, and patients may need to be moved from difficult locations, such as down a narrow flight of stairs, or remote places which impedes the process.”

Dr Black went on to explain that these devices don’t “fatigue or change” their delivery as a human might. This means “high quality CPR can be delivered for as long as is required.”

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Source: The Independent, 22 May 2020

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Doctors practising despite sexual assault and rape allegations

Hundreds of doctors and nurses have been left free to practise unchecked despite being accused of serious sexual assault and rape in the last six years, The Independent can reveal.

Between 2018 and 2024, some 248 doctors faced allegations of rape, sexual assault or attempted rape without their licences being suspended, according to new figures from the General Medical Council (GMC).

The Independent can reveal:

  • Between 2018 and 2024, 11 doctors were accused of possessing indecent images of children but no interim orders were made.
  • Over the same period, 261 doctors faced no restrictions despite allegations of physical assault.
  • In 2018, one doctor accused of murder had no restrictions placed on their ability to practise.
  • A doctor found to have sexually assaulted colleagues was able to practise as long as he informed the GMC of his job movements.

The shocking figures, obtained via a freedom of information (FOI) request, call into question the decision-making of the UK’s two biggest health watchdogs after a series of exposés by The Independent.

Helen Hughes, chief executive of the charity Patient Safety Learning, said the figures were “deeply troubling” from both patient and staff safety perspectives.

She said: “In healthcare, patients are often faced by a significant power imbalance. When serious allegations are made against healthcare professionals, there must be robust processes in place to safeguard both staff and patients while these are being investigated.”

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Source: The Independent, 12 August 2024

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Nurse shortage causes Nightingale hospital to turn away patients

Dozens of patients with Covid-19 have been turned away from the NHS Nightingale hospital in London because it has too few nurses to treat them, the Guardian can reveal.

The hospital has been unable to admit about 50 people with the disease and needing “life or death” care since its first patient arrived at the site, in the ExCeL exhibition centre, in London’s Docklands, on 7 April. Thirty of these people were rejected because of a lack of staff.

The planned transfer of more than 30 patients from established London hospitals to the Nightingale was “cancelled due to staffing issues”, according to NHS documents seen by the Guardian.

The revelation raises questions about the role and future of the hospital, which up until Monday had only treated 41 patients, despite being designed to include almost 4,000 beds.

One member of staff said: “There are plenty of people working here, including plenty of doctors. But there aren’t enough critical care nurses. They’re already working in other hospitals and being run ragged there. There aren’t spare people [specialist nurses] around to do this. That’s the problem. That leads to patients having to be rejected, because there aren’t enough critical care nurses.”

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Source: The Guardian. 21 April 2020

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Hospital declared it may ‘refuse critical care’ as ‘overwhelmed’ by covid

A hospital in the South East today declared a level of critical care alert meaning that it may be forced into ‘refusal or withdrawal of critical care due to resource limitation’ because it has been ‘overwhelmed’ — but later claimed it was an ”administrative error”.

Data from an internal NHS dashboard for critical care, seen by HSJ, showed today Darent Valley Hospital, near Dartford in Kent, declared it was at “CRITCON level four”. 

CRITCON level four declarations are extremely rare. In guidance they are known as “Triage - emergency” and defined as: “Resources overwhelmed. Possibility of triage by resource (non-clinical refusal or withdrawal of critical care due to resource limitation).”

The definition continues: “This must only be implemented on national directive from [NHS England] and in accordance with national guidance.”

Dartford and Gravesham Trust, which runs the hospital, replied to HSJ more than five hours after it was contacted, and after publication of the story, to say: “This was a purely administrative error which was quickly rectified.” The level has not however been changed so far on the live dashboard, HSJ has confirmed.

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Source: HSJ, 7 January 2021

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UK faces medicine shortages

Many feared that the UK leaving the EU would cause shortages and limitations to the medicine supply throughout England, Scotland, Wales and Northern Ireland. Now ten months on from Brexit are we finally seeing the short fallings?

Ninety percent of the UK's medicines are imported from abroad meaning disruptions caused by the outcomes of Brexit and a lack of HGV drivers has caused a significant problem in transporting drugs into the country.

Leaked Department of Health and Social Care documents revealed two hundred and nine medicines had supply “issues” in 2019, more than half of these remained in short supply for over three months. Drugs such as hepatitis vaccines and anti-epileptic drugs, faced “extended” problems.

A document published by the NHS Nottinghamshire Shared Medicines Management Team compiled a list of shortages and disruptions to supply due to COVID.

The following 5 products had long-term manufacturing issues:

  • AstraZeneca’s Zyban (bupropion, anti-smoking drug)
  • Par’s Questran (colestyramine, a bile acid sequestrant)
  • Diamorphine (a painkiller, used for cancer patients)
  • Metoprolol (used for high blood pressure)
  • Co-Careldopa (given to people with Parkinson’s disease)

A further thirty medicines had short-term manufacturing issues, including end of life medicines such as morphine and anti-vomiting drug, levomepromazine.

NHS Scotland and NHS Wales have published lists of drugs in low supply which are available to view on their NHS websites. NHS England consider this to be ‘sensitive information’ and have not published any shortfalls.

An amendment to The Human Medicines Regulations 2019 legislation has added a ‘Serious Shortage Protocol’ (SSP). This allows for pharmacists and contractors to supply patients with a ‘reasonable and appropriate substitute’ if their prescription has an active SSP.

Currently, shortages on Fluxoetine, (anti-depressive drug) and Estradot patches, (hormonal replacement therapy) have active SSP’s according to the NHS Business Service Authority.

Original source: National Health Executive

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