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‘Global crisis’ of violence: 161 healthcare workers were killed last year, study finds

Violence against healthcare workers has become a “global crisis”, with 161 medics killed and 188 incidents of hospitals being destroyed or damaged last year, according to a new report.

Data collected from 49 conflict zones by the Safeguarding Health in Conflict Coalition (SHCC), also found that 320 health workers were wounded in attacks, 170 were kidnapped and 713 people were arrested in the course of their work.

The US-based group said on Tuesday that, although the total number of attacks was similar to those recorded in recent years, there had been an increase in violence in areas of new or renewed conflict in 2021, “underlining the fact that attacks on healthcare are a common feature in many of today’s conflicts”.

Christina Wille, director at Insecurity Insight, which led the data collection and analysis, said: “Violence against healthcare resulted in widespread impacts on public health programmes, vaccination campaigns and population health, contributing to avoidable deaths and long-term consequences for individuals, communities, countries and global health writ large.”

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Source: The Guardian, 24 May 2022

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‘Get the vaccine’: family of Covid victim’s plea to pregnant women

Saiqa Parveen was eight months pregnant and weeks from welcoming her fifth daughter to the world, but died of Covid after putting off getting the coronavirus jab. Her family have now issued an emotional plea for pregnant women to get vaccinated.

Parveen, 37, had planned to delay having the jab until her baby was born, her family said, but she was admitted to hospital with breathing difficulties in September and put on a ventilator.

A decision was taken by medical staff at Good Hope hospital in Sutton Coldfield, Birmingham, to deliver the baby by emergency caesarean section. Parveen died on 1 November after spending five weeks in intensive care.

Asked what her last words were, her husband Gahfur said: “She couldn’t even talk. She couldn’t breathe properly … She couldn’t talk.”

He added: “I’m going to pass this message to the whole world, I just beg all people to get the vaccine, otherwise it’s very hard for them. It’s a very deadly disease, you know. She planned so many things, and this disease didn’t give her a chance.”

Covid vaccines are recommended for pregnant women. In a letter to midwives, obstetricians and GP practices in July, the chief midwife for England, Jacqueline Dunkley-Bent, said all healthcare professionals had “a responsibility to proactively encourage pregnant women” to get vaccinated.

Parveen chose not to have the vaccine, but concerns have been raised that pregnant women are being turned away from vaccine clinics despite clinical advice.

Members of the Joint Committee on Vaccination and Immunisation told the Guardian that they were urging ministers to focus more on pregnant women because only about 15% in the UK have been fully vaccinated. 

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Source: The Guardian, 7 November 2021

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‘Get stuck into ICSs’, Hewitt tells local leaders

NHS leaders ‘who might be hesitating about whether or not to really commit’ to their local integrated care system should ‘put aside all of those doubts [and] get stuck in’, Patricia Hewitt has claimed.

Ms Hewitt, Norfolk and Waveney Integrated Care Board chair and former health secretary, was speaking at the NHS ConfedExpo conference, the day after government responded to her recent review of ICSs.

The Department of Health and Social Care rejected or ducked several of its most eye-catching recommendations, but did state its support for ICSs and system working; while Labour has also said it would maintain ICSs should it come to power.

Ms Hewitt said the government response was more positive than she had feared at some points, and it “would have been a complete miracle” if ministers had backed all her recommendations.

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Source: HSJ, 15 June 2023

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‘Get on with it’: patient champion demands epilepsy drug redress

Ministers must begin paying compensation to the families of children disabled by the epilepsy drug sodium valproate by next year, a report will say this week.

The report’s author, Dr Henrietta Hughes, England’s patient safety commissioner, says valproate is “a bigger scandal than thalidomide, in terms of the numbers of people affected”.

She will back calls for financial redress for the thousands of children left physically and mentally disabled. Every month, three babies are still being born who have been exposed to the drug.

Speaking before the report’s launch, Hughes, 54, a GP, said the state had failed pregnant women by not telling them about key information regarding the drug’s risks. “These families have already been betrayed, because they weren’t given the right information to be able to make decisions to keep themselves and their family safe,” she said.

“There are senior politicians of every stripe who have expressed their sincere sympathy and support for patients who have been harmed. I take the view that people who seek high office need to also accept the responsibility that comes with that high office.

“The time for redress is now. The government is responsible. I’ve been asked to give them options for redress and I’ve done that. They have the recommendations, they have the advice, they have everything they need. Get on with it.”

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Source: The Times, February 2024

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‘Get a lift to hospital,’ ambulance trust tells patients with suspected heart attacks

Ambulance trusts have begun asking patients with heart attacks and strokes to get a lift to hospital with family or friends instead of waiting for an ambulance, because of high covid absences and ‘unprecedented’ surges in demand, HSJ has learned.

An internal note at North East Ambulance Service Foundation Trust said that where there was likely to be a risk from the delay in an ambulance reaching a patient, call handlers should “consider asking the patient to be transported by friends or family”.

This applies to calls including category two, which covers suspected strokes and heart attacks, according to the note seen by HSJ.

It said call handlers should “consider all forms of alternative transport” for patients. 

The note from medical director Mathew Beattie gives the example of a person with chest pain who would normally get a category 2 response – with a target of reaching them within 18 minutes – but where the ambulance response time would be two hours.

In the message to staff, Dr Mathew Beattie said: “To manage [current] unprecedented demand, we have no other option than to try and work differently which I am aware will not sit comfortably but is absolutely essential if we are to sustain a service to those who need it most."

“We need to weigh up the risk of delays for ambulances against alternative disposition or transport options. Where such risks are considered, I want you to be aware that the trust will fully support you in your decision-making under these circumstances.”

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Source: HSJ, 4 January 2022

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‘Gaslit by doctors’: UK women with endometriosis told it is ‘all in their head

Women with endometriosis who have endured years of excruciating pain are being “fobbed off” by doctors and told their symptoms are “all in their head”, leading them to give up seeking NHS treatment, new research has found.

A study carried out by academics at Manchester Metropolitan University found women with the disease felt “gaslit” by doctors due to their lack of understanding of the condition.

The paper, due to be published in the Journal of Health Communication later this month, also found that treatment was subject to a postcode lottery. Patients in rural areas reported travelling for hours to access a specialist with full training in the complex gynaecological condition.

Endometriosis is a painful condition in which tissue similar to the lining of the womb grows around other organs inside the abdomen. It affects 1.5 million women in the UK. The study looked at the experiences of treatment and diagnosis of 33 patients and revealed how doctors’ lack of understanding of the symptoms meant women often spent years in pain before their condition was diagnosed. During this period participants were told they were exaggerating their symptoms, or their pain was dismissed as psychological.

As one 27-year-old participant reported: “I feel a lot of mistrust towards the healthcare system in general, simply because I have been told that the pain was in my head, that I must have a low pain threshold or that I was in pain because I was fat.”

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Source: The Guardian, 21 January 2024

Share your experience of endometriosis: The Guardian newspaper would like to hear how you have been affected by endometriosis and your experience of being diagnosed and treated.

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‘Gamechanging’ HIV prevention jab to be approved for England and Wales

A “gamechanging” injection to prevent HIV is to be approved for use in England and Wales.

The long-acting jab, administered every two months, will offer an alternative to the daily pills used to protect against the virus.

This form of HIV prevention therapy, known as Prep (pre-exposure prophylaxis), is typically taken by HIV-negative people to reduce their risk of infection.

In draft guidance published on Friday, the National Institute for Health and Care Excellence (Nice) recommended cabotegravir (CAB-LA) for adults and young people at risk of HIV who are unable to take oral Prep.

The injection is already available on the NHS in Scotland.

The health secretary, Wes Streeting, said the approval of the injection was “gamechanging”.

“For vulnerable people who are unable to take other methods of HIV prevention, this represents hope,” he said.

“We’re making real progress on HIV, with Prep use up by 8% this year, and our ambition goes even further. England will be the first country to end HIV transmissions by 2030, and this breakthrough treatment is another powerful tool in our arsenal to reach that crucial goal.”

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Source: The Guardian, 17 October 2025

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‘Fuzzy’ NHS management standards to be revised

The NHS’s first proposed skills framework for managers has too much “fuzzy language” and needs to be simplified, the NHS England board has decided.

It is meant to give clinical and non-clinical NHS management its first “code of practice, defined set of standards and competencies [and] a national development curriculum” and to “elevate NHS management and leadership as a recognised professional discipline”.

It should “work alongside” the government’s proposed management regulation and “any potential future accreditation [system]”, a board paper said.

It responds to recommendations from a 2019 review of the “fit and proper person test” by Tom Kark KC, and the 2022 Messenger review of NHS leadership, as well as renewed support for management standards and accountability after Lucy Letby’s conviction for murdering babies in Chester.

But NHSE chair Penny Dash told the NHSE board meeting that officials needed to “tighten up” the current document and its language, and include clearer methods for measuring leaders’ performance.

She said: “I have to say I had a bit of a personal problem with some of the language in here. This one on self-effectiveness [says], ‘keep safe’.

“What does that mean? Does that mean I walk slowly down the corridor? We keep using that word, I wouldn’t know what that meant.

“We’ve also got things in here like ‘patient-centred care’, I don’t know what that means. We’ve got a whole lot of really good patient experience metrics, which we could be aspiring to, so we’ve got a bit too much fuzzy language in here.

“I think we need to be much clearer on the sorts of things we have been talking about [at the board] today, like ‘do we have a group of managers who can really think about resource allocation?’

“We do refer to that but I’m not sure it’s quite tight enough.”

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Source: HSJ, 24 September 2025

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‘Fundamental’ changes to London’s NHS in wake of COVID-19

The NHS in London is planning to “fundamentally shift the way we deliver health and care” in the wake of coronavirus, according to documents obtained by HSJ.

The plans from NHS England and Improvement’s London office say leaders should:

  • Plan for elective waiting times to be measured at integrated care system level, rather than trust level.
  • Accept “a different kind of risk appetite than the one we are used to”.
  • Expect decisions from the centre on the location of cancer, paediatric, renal, cardiac, and neurosurgical services.
  • Plan for a permanent increase in critical care capacity.
  • Transform to a “provider system able to be commissioned and funded on a population health basis”.
  • Work towards “a radical shift away from hospital care”.
  • Expect “governance and regulatory landscape implications” plus “streamlined decision-making”.

The document, titled Journey to a New Health and Care System, says there are three “likely” phases, with the final new system in place “from November 2021”.

The preceding two phases are “action programmes” over the next 12 to 15 months which will be about reconfiguring services to deal with “immediate covid, non-covid and elective need”, and “transition” when the move to new configurations is evaluated and “public consent” sought.

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Source: HSJ, 11 May 2020

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‘Free’ NHS makes people ‘lazy’ says pharmacy chief

The director of a leading pharmacy chain invited to advise the prime minister on healthcare reform has claimed the NHS makes people too “lazy” to take responsibility for their health.

Day Lewis director Sam Patel also said the fact the NHS was “free” meant there was little “jeopardy” discouraging people from becoming ill, and encouraged people to accept a lower level of care.

Mr Patel’s fellow Day Lewis director Jay Patel was one of the private healthcare leaders invited to Rishi Sunak’s Downing Street health summit this January. The company has more than 250 branches concentrated in London and the south of England.

Speaking at an event organised by strategy advisory firm Global Counsel last week, Mr Patel said: “Having an NHS fundamentally makes too many people lazy about taking care of their own health.

“Anything that’s free we just accept a lower level of care…. [We should be] making sure we’re taking good care of ourselves with vitamins, minerals, supplements, staying fit."

”... the jeopardy of feeling ill is not that bad because you get taken care of. In other countries, even in emerging markets like India where my parents originally come from, people spend vast amounts to make sure they don’t get ill because there is jeopardy in doing so. We need to change the population’s mindset to take care of themselves.”

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Source: HSJ, 3 April 2023

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‘Free and impartial’ addiction helplines paid secret commission by rehabs

Helplines that claim to offer “free” and “impartial” addiction support have been reprimanded by the advertising watchdog for hiding the fact they are paid thousands in commission by private rehabilitation clinics.

Amid record drug death rates and high demand for services, one website is promising “free, impartial, expert” advice for those trying to find the best treatment.

Another “advisory service”, listed high in Google search results, said it will help people “choose the best drug & alcohol rehab for you”. “We will give you guidance on the best options for your circumstances,” it claimed.

But while they look like nonprofit services and claim to offer unbiased help, the websites are fronts for brokers that direct people to partner facilities in exchange for a referral fee.

Last week, the Advertising Standards Authority (ASA) issued rulings against seven companies, accusing them of misleading vulnerable people about the true nature of their businesses.

The ASA said that six brokers – Which Rehab?, Help 4 Addiction, Rehabs.UK, Rehab Guide, Action Rehab and Serenity Addiction Centres – had posed as direct treatment providers or impartial advice services when they were principally referral companies earning commission from partner facilities.

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Source: The Guardian, 22 December 2024

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‘Fragile’ IT blamed for critical incidents and patient harm

Outdated clinical IT systems at a large Midlands hospital trust are harming patients and causing delayed diagnoses and cancelled appointments, its CEO has admitted.

University Hospitals of North Midlands Trust’s chief executive Simon Constable warned the trust was continuing to experience “significant challenges with our digital clinical systems” and described an “excessive number of ‘priority 1’ [serious] incidents over the last 24 months.”

He said the incidents — linked to a long-term lack of funding for upgrades — had been escalated to the Stoke-On-Trent and Staffordshire Integrated Care Board and NHS England.

Mr Constable, who took over as CEO in the autumn, said the digital services team had worked to troubleshoot and create short-term fixes, but the trust’s systems were “highly complex and extremely fragile”, with one platform, called iPortal, more than a decade old and running on “unsupported code”.

He told the board: “As a result, we have experienced ongoing disruption, numerous periods of working in business continuity, and a loss of clinical confidence – all alongside significant winter pressures.” 

Mr Constable said at a “virtual risk summit” held last month about the issues, clinicians “described cancelled appointments, delayed discharges, diagnosis and treatment, staff impact and potential harm”. He said the trust’s business case for a new electronic patient record system had been updated to include the current high risk. 

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Source: HSJ, 20 January 2025

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‘Four-hour rush’ continuing at top A&Es

Hospital trusts are still treating many patients just before the four-hour A&E target deadline, whose proposed abolition was reversed by government last week, HSJ analysis has revealed. 

Several of those still treating large proportions of attenders in the 10 minutes before the cut-off are among the top performers on the target.

NHS England’s 2019 clinical review of standards had proposed to scrap the four-hour target, claiming it was no longer the most appropriate or effective measure. NHSE had planned to replace it with a new bundle of measures, such as the average time spent in emergency departments. It has been trialling these at 14 trusts for more than two years, with enforcement of the four-hour target by NHSE being substantially wound down.

The move to end use of the four-hour target was never officially endorsed by government, but both Matt Hancock and Sajid Javid indicated they backed the idea. However, their successor as health and social care secretary, Therese Coffey, announced that she would not be abolishing it.

Royal College of Emergency Medicine president elect Adrian Boyle warned this “target-associated” patient flow could be “diverting clinicians away from more sick cases to people with lower acuity”. He added “the scrutiny and managerial grip that used to go with [the target]” has been “taken away”.

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Source: HSJ, 27 September 2022

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‘Four in five Britons concerned about patient safety during NHS strikes’

Four out of five Britons are worried about the NHS’s ability to provide safe care for patients during strikes by nurses and ambulance workers, a new poll has found.

While around half of those surveyed said they support the planned industrial action, the majority expressed concern about the impact on patient safety.

The Ipsos poll of 1,100 adults found that 80% were very or fairly concerned about the ability of the NHS to provide safe care for people during the nurses’ strike, which began on Thursday.

Meanwhile, 82% of those questioned in the survey said they are very or fairly concerned about patient safety during the ambulance workers’ industrial action, with the first strike planned for 21 December.

The new poll comes as the NHS continues to face high demand and widespread staffing gaps, with health leaders fearing this winter will be the most difficult in the health service’s history.

Ambulances have been struggling to meet response times targets, while new data published on Thursday shows handover delays at hospitals in England have hit a new high.

But the Ipsos survey suggests that, nevertheless, more people are supportive of the industrial action than are opposed to it.

Some 50% of those questioned said they either strongly support or tend to support the industrial action by nurses, while 47% are supportive of the ambulance worker strikes.

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Source: The National, 15 December 2022

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‘Flurry’ of whistleblowers raise concerns at troubled trust

A ‘flurry’ of whistleblowers have raised concerns about the culture within an NHS trust which is grappling with finance and governance problems, its directors were told today.

Staff at Cornwall Partnership Foundation Trust have reported a “command and control” culture at the trust, which last week apologised to its employees for overtime payments made to board members for extra hours worked during the first peak of the pandemic.

It comes as the trust’s new chair and interim chief executive both pledged to communicate “openly and honestly” with staff.

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Source HSJ, 12 April 2021

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‘Fix poverty, fix health’: A day in the life of a ‘failing’ NHS

A GP surgery in one of the most deprived areas in the north-east of England is struggling to provide care for its patients as the health system crumbles around them.

In the depths of the winter flu season, the Guardian video producers Maeve Shearlaw and Adam Sich went to Bridges medical practice to shadow the lead GP, Paul Evans, as he worked all hours keep his surgery afloat.

Juggling technical challenges, long waiting lists and the profound impact austerity has had on the health of the population, Evans says: 'We are seeing the system fail'.

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Source: The Guardian, 18 February 2025

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‘Fit-notes’ from nurses and physios to ease GP pressure

Nurses and physiotherapists can now provide ill patients with “fit-notes” to stay off work in an attempt to ease pressure on GP services. A range of health staff including pharmacists and occupational therapists are certifying illness sign-offs under moves to free up doctors to tackle the treatment backlog.

NHS Grampian has successfully completed a pilot scheme at a GP practice which staff described as “really positive” and a step in the right direction.

David Cooper, a GP from Old Machar Medical Practice in Aberdeen, said: “It is a more efficient way for us to work as a practice. For the nurses, physiotherapists and others who are working closely with a patient, it makes sense for them to be able to work on fit-notes without having to refer back to a GP for sign off. “We have found it works particularly well for those with chronic, long-term conditions or illness and the process behind the scenes is also now electronic so it saves paper, time and energy.”

Paul Gray, a physiotherapist at Old Machar, said: “It makes the patient’s journey easier and it is better for people to access them from those who are assessing your physical capabilities."

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Source: The Times, 6 April 2023

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‘First-of-a-kind’ daily pill for endometriosis treatment approved for NHS in England

A new daily pill that could transform the way endometriosis is treated has been approved for use on the NHS across England, the medicines watchdog has announced.

About 1,000 women a year living with endometriosis will be able to access relugolix-estradiol-norethisterone. The “first-of-a-kind” treatment, which was initially rejected by the National Institute for Health and Care Excellence (Nice), works by blocking the specific hormones that contribute to endometriosis while providing necessary hormone replacement.

The medication eliminates the need for multiple medications and regular trips to clinics for injections.

Unlike current injectable treatments which can initially worsen symptoms, the pill can be taken at home, works more quickly and combines hormones in one pill.

Endometriosis care has also long been recognised as substandard, with a previous report finding that on average women are waiting nearly nine years for a diagnosis in the UK.

A spokesperson for Endometriosis UK welcomed the decision by Nice, adding: “Endometriosis UK believes that women and those assigned female at birth in the UK should be able to choose the right treatment and management options for them.

“We recommend that treatment decisions are always made in partnership with the individual and their medical practitioner. There are far too few options available due to the historic lack of research into endometriosis.”

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Source: The Guardian, 13 March 2025

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‘First of its kind’ guidance sees BMA set out PA ‘scope of practice’

Physician associates should never see ‘undifferentiated’ patients in a GP setting, the BMA has declared in new ‘first of its kind’ guidance.

Today, the union has published a national scope of practice laying out how physician associates (PAs) and anaesthesia associates (AA) should work safely in GP practices and secondary care. 

According to the BMA, the guidance is different from what it describes as the current ‘piecemeal or fragmented approach’ whereby individual organisations set their own guidelines for how PAs should be supervised.

In general practice, the guidance said a GP ‘should first triage’ all patients and ‘decide which ones a PA can see’, suggesting annual health checks as an appropriate contact. 

The union is also clear that PAs ‘must not make independent management decisions for patients’ and must be clear in all their communications that ‘they are not doctors’. 

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Source: Pulse, 7 March 2024

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‘Fifth of UK hospitals cancelled operations’ during three days of 2022 heatwave

A fifth of UK hospitals were forced to cancel operations during the three days in July last year when temperatures soared, research suggests.

The findings, published in a letter to the British Journal of Surgery, are based on surveys from surgeons, anaesthetists and critical care doctors working during the heatwave from July 16-19 2022, when temperatures reached as high as 40C in some parts of the country.

The researchers received 271 responses from 140 UK hospitals – with one in five (18.5%) reporting elective surgeries being cancelled due to the heatwave.

The respondents also said surgical services were poorly prepared for heatwaves, with 41% of operating theatres having no means to control ambient temperature, while more than a third (35.4%) reported making changes to maintain routine surgical activity during the period.

These include delayed discharge of high-risk patients, changes to surgical teams, selecting lower-risk patients to have surgery, and restricting surgical activity to day cases.

Other measures included longer staff breaks, extra fluids to patients, and surgeries earlier in the morning when temperatures were lower.

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Source: The Independent, 23 March 2023

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‘Feminist approach’ to cancer could save lives of 800,000 women a year

Health experts are calling for a “feminist approach” to cancer to eliminate inequalities, as research reveals 800,000 women worldwide are dying needlessly every year because they are denied optimal care.

Cancer is one of the biggest killers of women and ranks in their top three causes of premature deaths in almost every country on every continent.

But gender inequality and discrimination are reducing women’s opportunities to avoid cancer risks and impeding their ability to get a timely diagnosis and quality care, according to a new Lancet Commission on women, power and cancer.

The largest report of its kind, which studied women and cancer in 185 countries, found unequal power dynamics across society globally were having “resounding negative impacts” on how women experience cancer prevention and treatment.

Gender inequalities are also hindering women’s professional advancement as leaders in cancer research, practice and policymaking, which in turn perpetuates the lack of women-centred cancer prevention and care, the report adds.

It is calling for a new feminist agenda for cancer care to eliminate gender inequality.

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Source: The Guardian, 26 September 2023

 

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‘Falling to bits’: NHS faces £16 billion maintenance crisis

Patient safety is being put at risk by “decrepit” NHS buildings, experts have warned, as new figures show the maintenance bill has risen by more than 15% to almost £16 billion.

The sum outstrips the total cost of running the NHS estate, which was £14 billion in 2024-2025, according to NHS England data.

Health commentators warned that hospitals with “flooded corridors” and “roofs at risk of falling in” are impacting care and patient safety.

The latest Estates Return Information Collection (ERIC) shows that the cost to eradicate the backlog of NHS repairs in England increased to £15.9 billion in 2024-2025.

This is up by 15.7% on £13.8 billion reported a year earlier.

The backlog bill is a measure of how much funding is needed to restore buildings to a good state. It refers to maintenance work that should already have taken place rather than any that is planned.

Daniel Elkeles, chief executive of NHS Providers, said: “Critical parts of the NHS are falling to bits, literally, after years of underinvestment nationally. The safety of patients and staff is at risk.

“We can’t keep wasting money propping up ageing buildings not fit for purpose.”

He added: “Eye-watering sums are needed just to patch up buildings and equipment which are in a very bad way right across hospital, mental health, community, and ambulance services. We need to make the NHS as modern and winter-proof as possible, but the waiting list of essential repairs keeps getting longer and costs are soaring.”

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Source: Medscape, 17 October 2025

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‘Failure to act with candour’ over unsafe gas, report finds

There was an “unacceptable delay” and “failure to act with candour” in how a trust responded to a serious risk from staff nitrous oxide exposure, an independent investigation has found.

Mid and South Essex Foundation Trust found levels of nitrous oxide far above the workplace exposure limit at Basildon Hospital’s maternity unit during routine testing in 2021. However, staff were only notified and a serious incident declared more than a year later.

The exposure related to a mixture of nitrous oxide and oxygen, commonly known as gas and air, used during births. While short-term exposure is considered safe, prolonged exposure to nitrous oxide could lead to potential health issues.

Chief executive Matthew Hopkins has apologised, after a report by the Good Governance Institute said: “The inquiry found that there was an unacceptable delay in responding to and mitigating a serious risk that had been reported… As a result of this failure to act on a known risk, midwives and staff members on the maternity unit were exposed to unnecessary risk or potential harm from July 6 2021 to October 2022."

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HSJ, 14 February 2024

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‘Extremely disturbing and unethical’: new rules allow VA doctors to refuse to treat Democrats, unmarried veterans

Doctors at Department of Veterans Affairs (VA) hospitals nationwide could refuse to treat unmarried veterans and Democrats under new hospital guidelines imposed following an executive order by Donald Trump.

The new rules, obtained by the Guardian, also apply to psychologists, dentists and a host of other occupations. They have already gone into effect in at least some VA medical centers.

Medical staff are still required to treat veterans regardless of race, color, religion and sex, and all veterans remain entitled to treatment. But individual workers are now free to decline to care for patients based on personal characteristics not explicitly prohibited by federal law.

Language requiring healthcare professionals to care for veterans regardless of their politics and marital status has been explicitly eliminated.

Doctors and other medical staff can also be barred from working at VA hospitals based on their marital status, political party affiliation or union activity, documents reviewed by the Guardian show. The changes also affect chiropractors, certified nurse practitioners, optometrists, podiatrists, licensed clinical social workers and speech therapists.

In making the changes, VA officials cite the president’s 30 January executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. The primary purpose of the executive order was to strip most government protections from transgender people. The VA has since ceased providing most gender-affirming care and forbidden a long list of words, including “gender affirming” and “transgender”, from clinical settings.

Medical experts said the implications of rule changes uncovered by the Guardian could be far-reaching.

They “seem to open the door to discrimination on the basis of anything that is not legally protected”, said Dr Kenneth Kizer, the VA’s top healthcare official during the Clinton administration. He said the changes open up the possibility that doctors could refuse to treat veterans based on their “reason for seeking care – including allegations of rape and sexual assault – current or past political party affiliation or political activity, and personal behavior such as alcohol or marijuana use”.

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Source: The Guardian, 16 June 2025

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‘Extra appointments’ celebrated by government deliver ‘modest impact’ on waiting lists

The “4.6 million extra NHS appointments” championed by the prime minister and health secretary have only had a “modest impact” on reducing waiting list clock stops, a vital part of cutting the NHS’s elective care backlog, according to new analysis shared exclusively with HSJ.

Last month, the government announced that “NHS staff have now delivered 4.6 million extra elective appointments since July – more than double the 2 million the government promised in its first year”.

Health and social care secretary Wes Streeting commented that NHS elective waiting lists had dropped by “more than 260,000 since we took office”. He added: “This is not a coincidence – it is because this government has delivered on the Plan for Change and put in the work to finally get our NHS moving in the right direction.”

However, analysis by The Health Foundation shows the extra activity has produced a much lower impact on waiting list clock stops than could have been expected based on the ratio between the two measures in the previous year.

The research concluded the “extra 4.6 million appointments” would have resulted in 1.2 million extra “clock stops” between July 2024 and April 2025, if the NHS had continued to convert average appointments to completed pathways at the rate it had done between July 2023 and April 2024.

But the analysis shows instead only around 340,000 additional pathways were completed between July 2024 and April 2025.

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Source: HSJ, 11 August 2025

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