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‘Devastating, tragic, and deadly’: VA leaders in Arkansas allowed impaired pathologist to harm hundreds of veterans, watchdog finds

Oversight failures, a fearful workplace culture and lax quality standards for years at a Veterans Affairs hospital in Arkansas, USA, allowed a pathologist who was routinely drunk on the job to misdiagnose thousands of veterans — sometimes with dire or deadly consequences, a new investigation has found.

Hospital leaders “failed to promote a culture of accountability” that would have led more of the doctor’s colleagues to come forward with accounts that his behavior was putting patients at risk, according to the report released Wednesday by VA’s Office of Inspector General. But the staff members at the Veterans Health Care System of the Ozarks in Fayetteville feared that reporting their concerns would lead to retaliation from their bosses.

“Any one of these breakdowns could cause harmful results,” Inspector General Michael Missal’s staff wrote in an 86-page report about the failures to stop the pathologist, Robert Morris Levy. “Together and over an extended period of time, the consequences were devastating, tragic, and deadly.”

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Source: The Washington Post, 2 June 2021

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‘Devastated’ doctors warn trust CEO of ‘extremely unsafe situation’

Consultants at a major tertiary centre have written to their chief executive, warning services are in ‘an extremely unsafe situation’ and calling for elective work to be diverted elsewhere.

Surgeons and anaesthetists at the former Brighton and Sussex University Hospitals Trust — now part of University Hospitals Sussex Foundation Trust — said: “We are devastated to report that the care we aspire to is not being provided at UHS… we are forced to contemplate that it is not safe to be open as a trauma tertiary centre and we feel elective activity must be proactively diverted elsewhere.”

The letter from BSUH’s anaesthetist and surgical consultant body is dated yesterday and was sent to UHSussex chief executive Dame Marianne Griffiths. The Royal Sussex County Hospital in Brighton — part of the trust — is the major trauma centre for the South East coast, from Chichester to parts of Kent.

In the letter, seen by HSJ, the consultants claimed a shortage of theatre staff is leading to “clinical safety issues, gross operational inefficiencies and burnout within our remaining depleted staff groups”. 

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Source: HSJ, 21 September 2021

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‘Devastated’ director quits after ‘bullying’ row with consultants

A trust director has stepped down after a row with consultants about the leadership culture within her department, HSJ  has learned.

Pratima Gupta quit as director of women’s services at University Hospitals Birmingham Foundation Trust last week after a group of consultants expressed “no confidence” in her leadership. They claimed there was “intimidating and bullying behaviour” by individual managers.

However, Ms Gupta said the allegations are untrue, and said she has faced “obstruction at almost every step” from some consultants when trying to improve training and culture within the department.

Trainee doctors in obstetrics and gynaecology have previously expressed concerns around a lack of support from consultants, with the trust recently receiving a further warning around this from the General Medical Council and Health Education England.

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Source: HSJ, 1 June 2023

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‘Demoralised’ nurses ‘driven out’ of profession, survey finds

Most nurses warn that staffing levels on their last shift were not sufficient to meet the needs of patients, with some now quitting their jobs, new research reveals.

A survey of more than 20,000 frontline staff by the Royal College of Nursing (RCN) suggested that only a quarter of shifts had the planned number of registered nurses on duty.

The RCN said the findings shone a light on the impact of the UK’s nursing staff shortage, warning that nurses were being “driven out” of their profession.

In her keynote address to the RCN’s annual congress in Glasgow, general secretary Pat Cullen will warn of nurses’ growing concerns over patient safety.

Four out of five respondents said staffing levels on their last shift were not enough to meet all the needs and dependency of their patients.

The findings also indicated that only a quarter of shifts had the planned number of registered nurses, a sharp fall from 42% in 2020 and 45% five years ago, said the RCN.

Ms Cullen will say: “Our new report lays bare the state of health and care services across the UK.

“It shows the shortages that force you to go even more than the extra mile and that, when the shortages are greatest, you are forced to leave patient care undone.

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Source: The Independent, 6 June 2022

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‘Deliberate attempts’ to conceal racism at NHS agency, says leaked report

Deliberate attempts were made to “conceal the extent of racial discrimination” at a national NHS agency, according to a report leaked to HSJ.

A highly critical internal report at NHS Blood and Transplant (NHSBT) also said fewer than half the recommendations made in 2020 by external mediation experts, around issues of racism, had so far been actioned.

A review conducted by Globis Mediation Group in 2020 found “systemic racism” among management at the agency’s large Colindale site in north London, with ethnic minority staff being “ignored, being viewed as ineligible for promotion and enduring low levels of empathy”.

It made nine recommendations, including exploring whether similar issues existed at the other 15 NHSBT sites.

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Source: HSJ, 16 March 2023

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‘Defining moment’ for nursing in the USA: Joint Commission recognises staffing as quality component

Starting in 2026, The Joint Commission will formally recognise nurse staffing as a national performance goal, meaning hospitals seeking accreditation must meet certain standards related to staffing and oversight. 

Under the new element of performance, known as Goal 12, healthcare organisations must have a nurse executive responsible for overseeing staffing policies and procedures. The goal stipulates that hospitals have a registered nurse on duty to either directly provide care or supervise nursing services provided by other staff 24/7. This marks the first time the organization has included nurse staffing as a core component of quality.

“There must be an adequate number of licensed registered nurses, licensed practical nurses and other staff to provide nursing care to all patients, as needed,” the rule states. 

The American Nurses Association celebrated the move, calling it a “defining moment” for the profession. The change also could influence how payers and policymakers approach reimbursement tied to care quality.

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Source: Becker's Clinical Leadership, 14 October 2025

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‘Deficient’ processes and ‘poor’ safety culture found in trust review

A trust’s drugs control department was found to have a “significant under-appreciation of safety” and “a culture of unwillingness”, after it lost track of at least two bags of fentanyl. 

The Royal Free London Foundation Trust launched an internal incident investigation after two rejected bags of the controlled drug were reported missing from a quality control quarantine store.

Fentanyl is a strong opioid used to treat severe and/or long-term pain. But its effect is similar to heroin, it is highly addictive, and there is therefore significant illicit  use of it.

While it was not possible to ascertain if foul play contributed to the incident, the review said the incident “is most likely to represent a failure in documentation and of subsequent escalation”.

Investigators said there appeared to be a “culture of unwillingness” to train and develop staff due to the fear of losing them to other organisations. They said a “culture of fear” was inhibiting the team’s ability to “progress, innovate, and grow”.

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Source: HSJ, 24 June 2024

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‘Deeply flawed’ watchdog fails to act in 182 cases

Bereaved parents have described maternity investigations carried out by a watchdog as “deeply flawed” after it failed to make recommendations to trusts in 182 cases of deaths and harm. 

The Maternity and Newborn Safety Investigations programme investigates certain cases of early neonatal deaths, stillbirths and severe brain injury in babies born at term following labour, alongside maternal deaths. Last year, it moved to the Care Quality Commission having previously been hosted by the Health Services Safety Investigation Branch.

Now a Freedom of Information request has revealed a third (182) of 556 MNSI reports completed between April 2023 and March 2024 did not contain recommendations.

Officials said in the 182 reports, none of the findings of the investigation contributed to the outcome for the mother or baby, and therefore no recommendations were made.

However, Emily Barley, whose daughter Beatrice died during labour in 2022, said it was “very concerning” to see that so many investigations result in no safety recommendations at all.

She added: “It is hard to believe that when a full-term baby dies or suffers a serious brain injury there is nothing for providers to learn. 

“I do not have any confidence in the MNSI, its investigations, or its conclusions. Having been through an MNSI investigation following the death of my daughter… it is clear to me the entire process is deeply flawed.”

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Source: HSJ, 25 November 2024

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‘Deeply flawed’ CervicalCheck tribunal sees just 26 claims, with 385 taken through courts

Only 26 claims have been sent into the CervicalCheck tribunal – while 385 claims have now been taken through the courts, new figures reveal.

The 26 claims taken through the tribunal represent only 6% of the cases taken through the courts.

The CervicalCheck tribunal was set up to hear legal cases from women who developed cancer after they got wrong smear test results.

While it was designed to provide fast-track compensation without having to go to court, it has been criticised by campaigners, as most women who were affected still opted to go through the courts system instead.

Dozens of Irish women were diagnosed with cervical cancer after being incorrectly told by the State’s CervicalCheck screening programme that their smear tests were clear.

The scandal emerged when Vicky Phelan revealed she had settled her case against a US laboratory.

The new figures were set out to Aontú leader Peadar Tóibín in response to a parliamentary question to Health Minister Stephen Donnelly.

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Source: Irish Independent, 7 August 2023

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‘Deeply concerning’ backlog of thousands of cancer patients waiting months for treatment revealed

Thousands of patients with suspected cancer have been left waiting more than two months for treatment, according to new data that exposes the “deeply concerning” state of NHS urology cancer care.

Almost half of the patients urgently referred for suspected urology cancer, such as kidney or bladder, have been left waiting too long, with leaked figures obtained by The Independent showing an “urgent backlog” of 4,237 patients who have waited more than the 62-day national target as of August.

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Source: Independent, 26 October 2024

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‘Deep-rooted cultural problems’ found within trust’s ‘inadequate’ maternity services

The Care Quality Commission (CQC) has raised serious concerns about a major teaching trust’s maternity services and taken action to prevent patients coming to harm.

The watchdog has imposed conditions on the registration of Nottingham University Hospitals Trust’s maternity and midwifery services at Nottingham City Hospital and Queen’s Medical Centre and rated them “inadequate”. 

Following an inspection in October, the CQC identified several serious concerns, including leaders lacking the skills to effectively head up the service, a lack of an open culture where staff could raise concerns, and staff failing to complete patient risk assessments or identify women at risk of deterioration. 

In its findings, the CQC reported how “fragile” staff wanted to escalate their concerns directly to the regulator, particularly around the leadership’s response to the “verbal outcome of the inspection”. The regulator called this “further evidence of the deep-rooted cultural problems” and escalated these concerns directly to trust CEO Tracy Taylor, who would be “personally overseeing the improvement process required”.

Inspectors also found the service did not have enough staff with the right skills, qualifications and experience to “keep women safe from avoidable harm”.

The CQC also issued the trust a warning notice over concerns around documenting risk assessments and IT systems. The trust has three months to make improvements. 

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Source: HSJ, 2 December 2020

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‘Deadly postcode lottery’ restricting new cancer treatments in England, doctors say

Cancer patients are being denied access to cutting-edge treatments on the NHS because of a “deadly postcode lottery” in access, doctors have warned.

Patients in England are missing out on two innovative forms of radiotherapy that are known to be effective against several forms of the disease and are widely available in other countries, due to “red tape” and lack of funding.

The Royal College of Radiologists (RCR) and Radiotherapy UK want Wes Streeting to use the government’s new cancer plan, being published this week, to make them widely available.

They are urging the health secretary to end what they say are “bureaucratic hurdles” that NHS England imposes, through its complex funding and commissioning policies, on hospitals that want to provide stereotactic ablative body radiotherapy (SABR) and molecular radiotherapy (MRT).

Unlocking the potential of the novel treatments would help improve cancer survival, which is poor in Britain by international standards, both organisations said.

Dr Nicky Thorp, the RCR’s vice-president for clinical oncology, said: “A number of innovative cancer treatments exist and are known by cancer doctors to be effective, but they are in only limited use in the NHS in England.

“This means that some cancer patients are missing out on treatments that cancer specialists know are effective and which could treat their cancer in fewer doses with fewer side effects.

“Doctors want to do our best for our patients, so it is incredibly frustrating for us to be in a situation where some patients aren’t getting access to the full range of treatments that are proven to help tackle cancer.”

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Source: The Guardian, 1 February 2026

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‘Deadly cancer timebomb’ as thousands more than expected killed by the illness since pandemic

Nearly 8,900 more people have died of cancer than expected in Britain since the start of the pandemic, amid calls for the Government to appoint a minister to deal with the growing crisis. 

In an essay in The Lancet Oncology, campaigners and medics said the upward trend of cancer deaths is likely to continue, with 3,327 in the last six months alone. 

They urged the Government to tackle the crisis with the same focus and urgency given to the Covid vaccine rollout, and called for a cancer minister to get on top of the backlog.

NHS data from November showed that in the last 12 months, 69,000 patients in the UK have waited longer than the recommended 62-day wait from suspected cancer referral to start of treatment.

Professor Gordon Wishart, a former cancer surgeon and chief medical officer of Check4Cancer, said: “The Covid-induced cancer backlog is one of the deadliest backlogs and has served to widen the cracks in our cancer services". 

“Now we face a deadly cancer timebomb of treatment delays that get worse every month because we don’t have a sufficiently ambitious plan from policymakers. I urge the Government to work with us.”

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Source: The Telegraph, 15 December 2022

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‘Dangerous and alarming’: Google removes some of its AI summaries after users’ health put at risk

Google has removed some of its artificial intelligence health summaries after a Guardian investigation found people were being put at risk of harm by false and misleading information.

The company has said its AI Overviews, which use generative AI to provide snapshots of essential information about a topic or question, are “helpful” and “reliable”.

But some of the summaries, which appear at the top of search results, served up inaccurate health information, putting users at risk of harm.

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Source: Guardian, 11 January 2026

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‘Cuts will result in patient deaths’: hospitals shed medical staff after being told to balance the books

Hospitals are being forced to cut medical staff, threatening their ability to care for patients, senior health leaders have warned.

NHS trusts are reporting budget deficits after the chancellor Jeremy Hunt gave England’s health service £2.5bn extra funding, which only covers inflation and pay increases.

The UK’s ageing population and the impact of having more than 6 million patients waiting for more than 7.5m treatments means that demand on the health service has increased substantially.

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Source: Guardian, 5 May 2024

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‘Culture of fear’ at Sussex hospitals trust, Royal College of Surgeons reports

Bosses at hospitals where police are investigating dozens of deaths have been criticised for “bullying” and fostering a “culture of fear” among staff in a damning review by the Royal College of Surgeons in England.

The review focused on concerns about patient safety and dysfunctional working practices in the general surgery departments at the Royal Sussex County hospital in Brighton and the Princess Royal hospital in nearby Haywards Heath.

But the reviewers were so alarmed by reports of harassment, intimidation and mistreatment of whistleblowers that they suggested executives at the University Hospitals Sussex trust may have to be replaced.

They concluded: “Consideration should be given to the suitability, professionalism and effectiveness of the current executive leadership team, given the concerning reports of bullying.”

The report comes as Sussex police continue to investigate allegations of medical negligence and cover-up in the general surgery department and neurosurgery department, involving more than 100 patients, including at least 40 deaths, from 2015 to 2021.

The investigation was prompted by concerns from a general surgeon, Krishna Singh, and a neurosurgeon, Mansoor Foroughi, who lost their jobs at the trust after blowing the whistle over patient safety.

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Source: The Guardian, 6 February 2024

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‘Culture of bullying and undermining’ uncovered in trust’s maternity service

Trainee midwives at a struggling trust have raised serious concerns about bullying and feeling afraid to speak up, an NHS England report has revealed.

Experiences of pre-registration midwifery trainees at Birmingham Heartlands Hospital and Good Hope Hospital, part of University Hospitals Birmingham Foundation Trust, are detailed in a recent NHS England workforce, education and training report following a visit in January.

The report said learners at BHH reported a “concerning culture of bullying and undermining”, with some midwives displaying hostility and rudeness, and one student constantly feeling like they were in “fight or flight mode”.

At GHH, students were aware how to raise concerns but described it as a “waste of time”, telling NHSE qualified midwives had informed them they frequently raised concerns about staffing levels without these being resolved.

Meanwhile, at BHH trainees said lack of action taken when they tried to raise concerns had created an environment where learners were reluctant to voice fears about patients or seek guidance on patient care.

The NHSE report said students provided multiple instances of trying to raise concerns which were either not acted on or they experienced repercussions for having attempted to speak up.

One person expressed concerns about a woman who had experienced severe bleeding following birth but their supervising midwife dismissed their concern. 

They then escalated the matter to another staff member and was taken more seriously, but as a result, the student said their supervising midwife “made my life hell” for the rest of the shift.

NHSE said it heard examples where midwives made derogatory comments about students in public, including about one person’s weight, which caused them to leave the building in tears. 

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Source: HSJ, 24 May 2024

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‘Culture of blame’ found at troubled health trust

The former police chief who investigated mental health services in a crisis-hit health board was “shocked” by the poor working relationships and “blame shifting” he uncovered.

David Strang, who led the independent inquiry into the issues in NHS Tayside, said staff felt isolated and unsupported and people complained about each other’s practices without coming together to sort the issues out.

He described asking staff questions based on information he had received and being met with the response: “Who told you?” He added: “A lot of staff felt there was a real blame culture and that risk and blame fell to the front line.”

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Source: 6 February 2020, The Times

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‘Culture battle’ over NHS England’s emergency recovery plans

Senior sources have described a ‘culture battle’ in NHS England’s approach to urgent care recovery after systems were told to carry out “maturity” self-assessments, and appoint “champions” to drive improvements.

Systems were last week told by NHSE to ”self assess” their compliance against key asks in the UEC recovery plan, and asked to nominate urgent care “recovery champions” to “create a community, close to the front line, who can help drive improvement” in emergency care.

The “champions” and self-assessments are part of a new “universal offer” of support being drawn up by NHSE under its scheme for urgent care recovery, in which Integrated Care Boards are also being placed in “tiers” of intervention.

It is the first project carried out under NHSE’s new service improvement banner, called “NHS Impact” or “improving patient care together”, which was established after an internal review recommended it should focus on a “small number of shared national priorities”.

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Source: HSJ, 18 July 2023

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‘Critical decision-making’ at major cancer centre left to trainees

Trainee oncologists at a major cancer centre covered clinics and made “critical” decisions without senior supervision, including for cancers they were not trained for, HSJ has revealed.

A Health Education England (HEE) reviews aid: “The review team was concerned to hear that trainees were still expected to cover clinics where no consultant was present, including clinics relating to tumour sites that they were unfamiliar with.”

Guy’s and St Thomas’ Foundation Trust’s trainee clinical oncologists felt “they could only approach 50–75% of the consultants for critical decision-making”, the document said.

The HEE “urgent concern review” report said: “The trainees also reported that there was a continued lack of clear consultant supervision for inpatient areas in clinical oncology, which meant that they were not able to access senior support for decision-making.”

A trust spokesman said: “We recognise that senior support to the clinical team is a vital part of keeping our patients safe.”

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Source: HSJ, 16 January 2020

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

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

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

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

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

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

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Source: The Independent, 6 September 2023

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‘Covert filming could get you prosecuted’, trust warns staff after undercover exposé

An ambulance trust that was the subject of a documentary involving covert filming by an employee has warned staff they could be subject to ‘disciplinary action and even prosecution’ if they take this type of action.

East of England Ambulance Service Trust sent an all staff email yesterday outlining the potential consequences of filming covertly and reminding staff they must adhere to the trust’s social media and digital guidelines.

The email, seen by HSJ, followed Channel 4 broadcasting a documentary called Undercover ambulance: NHS Chaos – Dispatches which featured footage filmed covertly by one of the trust’s apprentice emergency technicians, and laid bare the extreme pressures on hospital and ambulance staff.

The message sent on Thursday by the trust’s interim officer Melissa Dowdeswell, said the apprentice who carried out the filming had since resigned and then set out what support staff could access from the trust if they had been affected by “an incredibly difficult couple of weeks”.

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Source: HSJ, 17 March 2023

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‘Cover-ups’ leave staff scared to report sexual safety concerns

A trust’s staff “fear raising concerns about attitudes, behaviours and sexual safety”, particularly about senior managers and doctors, a review by NHS England has found.

Black Country Healthcare Foundation Trust’s “Freedom to Speak Up” arrangements have been reviewed by NHSE, following a series of cultural concerns  and the departure of multiple senior directors.

The review, published in board papers this month, said: “We consistently heard that staff feel that ‘cover-ups’ take place and raising a concern sometimes feels like ‘reporting a friend to a friend’.”

Staff gave recent examples of where they had experienced, or seen others experience, “disadvantageous and demeaning treatment” after raising concerns.

Examples of this included inconsistent application of HR policies such as annual leave and flexible working to disadvantage the person raising concerns, unkind and unprofessional behaviour by senior staff members such as ignoring individuals, and not including them in conversations.

Others said they did not want to raise concerns for fear of detriment, such as bank staff members who thought they would not be given shifts.

Some staff felt as if they had a “target on their back” after speaking up.

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Source: HSJ, 10 February 2026

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‘Cover-up’ fears over trust’s toxic culture

An independent group overseeing the reviews into a toxic culture at University Hospitals Birmingham have raised concerns over a possible ‘cover up’ of key reports.

The cross-party reference group, which includes MPs, council and Healthwatch officials, has demanded transparency over key decisions, and says there are continuing concerns over the trust’s leadership. It has been scrutinising a review into patient safety concerns at UHB, which found the trust’s executive had become “overzealous and coercive”.

On the day this review was released, it was revealed that UHB’s former CEO David Rosser had decided to retire.

The group, chaired by MP Preet Gill, said in a statement: “The allegations made by whistleblowers were not isolated incidents, but the result of a deep-seated and toxic culture. While Dr Rosser has recently announced his retirement, one member of staff, albeit a chief executive, cannot be responsible for this alone. Feedback from staff has made it clear that there must be collective accountability by the senior leadership for the distressing culture afflicting the trust."

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Source: HSJ, 5 April 2023

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‘Cost of living crisis’ contributing to stillbirths, research finds

The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas.

The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. 

The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend.

The research findings include:

  • ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments;
  • “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”;
  • Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and
  • “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.”

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Source: HSJ, 25 August 2023

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