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‘Controversial’ A&E policy 'showed we're all shouldering the pain', says CEO

A high-profile shift to admitting patients from A&E to wards irrespective of bed capacity has ‘turned the dial’ for an acute trust’s emergency care, its chief executive has told HSJ.

Since introducing the model in July last year North Bristol Trust has seen a significant improvement in its performance against the national target, with the number of patients seen within four hours rising from 51% to 72% in August 2023 – with a peak of 80% in April 2023.

The model attracted interest from NHS England last year, as well as some concern from the Nuffield Trust over patient safety – but NBT CEO Maria Kane said the trust was “happy, on balance” with the system.

She said the model “won’t be for everyone and we never claimed it would be” but she added: “Engendering whole hospital conversations about the principles of flow and understanding of [the emergency department] is something we could all do.”

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Source: HSJ, 8 November 2023

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‘Continuity risk’ to abortion services triggers national intervention

NHS England has told integrated care board (ICBs) leaders they must intervene over failures in abortion services in their patches amid “unprecedented demand” for such provision, HSJ has learned.

NICE guidance states people should be assessed within a week of requesting an abortion, while procedures should take place within a week of assessment.

However, NHSE said in a letter to ICBs today that “significant service pressures” have driven up waiting times for surgical abortions – approximately 13% of procedures – to three weeks or longer.

NHSE has told ICBs to work with providers to, by July 2024:

  • Respond to cases of “acute service disruption” and instances where rising waiting times risk limiting access to services;
  • Establish referral pathways and procedures to ensure smooth transfers of care between independent and NHS providers when required;
  • Ensure contracts for 2024-25 are sustainable and follow guidance in the NHS payment scheme; and
  • Commission services in a more managed and collaborative way, including coordination of provision locally to bring waiting times in line with NICE standards.

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Source: HSJ, 12 March 2024

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‘Contentious’ US tech firm to harvest patient data in NHSE waiting list push

NHS England has ordered the collection of identifiable patient data from hospitals by US data firm Palantir, for a pilot scheme aimed at accelerating recovery of elective waiting lists.

The regulator has instructed NHS Digital, with which it will merge in January, to use Palantir’s Foundry platform to collect data about patients’ admission, inpatient, discharge and outpatient activity at acute hospitals.

Identifiable data such as patients’ NHS numbers, date of birth, and postcode will be collected through Palantir’s software. Patients cannot opt out of having their data collected.

But NHS Digital’s Caldicott Guardian – who is meant to safeguard use of data – has identified “risks” in the pilot and said it needs additional work before it can meet confidentiality requirements.

The data collected will be “anonymised in accordance with the ICO’s (Information Commissioner’s) Anonymisation Code of Practice”. However, privacy campaigners Medconfidential claimed this code is not fit for purpose and warned that NHS chiefs were making the same mistakes as previous failed efforts to use patient data appropriately.

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Source: HSJ, 1 November 2022

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‘Constructive’ first ambulance strike agreement revealed

Elderly people who fall may only be sent an ambulance after they have spent four hours on the floor, and some category 2 calls may not be responded to under one of the first agreements with ambulance unions about next week’s strikes.

But the deal between South East Coast Ambulance Service and the GMB union will see many union staff continue to work on ambulances and in control rooms – and others may be asked to come off the picket line if operational pressures escalate.

HSJ has seen the details of the deal – thought to be one of the first agreed before next Wednesday’s strike. Some other trusts are hoping to conclude negotiations shortly, but for several — such as in the North West and London — it is thought no strike “derogations” (exceptions) have so far been agreed, and managers are concerned that unions are resistant. Trusts have been pushing for more cover on strike days – especially around category 2 calls.

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Source: HSJ, 15 December 2022

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‘Confusing’ NHS App functions to be standardised

NHS England is planning to dismantle the patient engagement portal supplier market in a bid to save £11m and directly integrate appointment management into the NHS App, HSJ can reveal.

This month, NHSE has told suppliers of PEPs – who have been the intermediary between hospital IT systems and patients for appointment booking for years – that within the next three years they would no longer be required to provide core appointment features through the NHS App.

Instead, trusts will move towards direct integration into the NHS App through their electronic patient record, known as Wayfinder direct integration.

It comes as the government pushes for the NHS App – which in December had more than 13 million log-ins – to be the single front door for patients.

The five core features NHSE wants to bring in-house are: viewing appointment details, completing pre-appointment questionnaires, accessing documents, managing or cancelling appointments, and receiving notifications.

Hospital patient administration systems (PAS) and EPRs – which hold appointment booking and scheduling data – will share that data with the NHS App.

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Source: HSJ, 25 February 2026

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‘Confused messaging’ around Oxford vaccine helping fuel Covid spread, says scientist behind jab

Experts have warned misinformation around the Covid vaccine may be helping fuel the spread of the virus. Director of the Oxford Vaccine Group has warned "confused messaging" around the effectiveness to protect the population could threaten confidence in the jab. 

Sir Andrew, together with Professor of vaccinology Shabir Madhi at the University of Witwatersrand in South Africa, have suggested lessons can be learned from South Africa. Writing for The Independent, they said “South Africa was one of the first African countries to procure the Oxford-AstraZeneca vaccine from Serum Institute of India. Unfortunately, these doses were never deployed because of misguided fears over efficacy, allowing the present third wave to occur in a largely unvaccinated population.” 

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Source: The Independent, 26 July 2021

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‘Confidential’ document warns second covid peak could hit NHS five times harder

Modelling being used by NHS officials forecasts that hospital admissions could peak at five times the level seen in April without additional measures to control the virus, HSJ can reveal.

In all scenarios presented, covid hospital admissions would remain high for an extended period of many months, even if new lockdown actions were taken. However, putting multiple measures in place could contain them to a peak of less than that seen in the spring, according to the work.

They were included in a document marked “confidential” and included, apparently by accident, in public papers for Thursday’s meeting of Medway Foundation Trust board. Within hours of HSJ asking for more information, they were removed.

They were badged with Kent and Medway Clinical Commissioning Group, the NHS body which oversees services for that area. The forecasts were marked as being “Kent and Medway level”, but were referred to as “regional scenarios”, indicating they may have been produced by regional teams of NHS England and Improvement. The trust’s board papers said its own planning for the coming months would make use of the three scenarios presented in the document.

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Source: HSJ, 7 September 2020

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‘Concerning’ levels of therapy still carried out by unaccredited staff

Tens of thousands of therapy sessions are still being carried out by unaccredited practitioners in the NHS, data suggests – nearly four years after a deadline to stamp this out.  

The situation has been called “concerning” by a leading psychology body, who warned expansion of mental health care should “not come at the expense” of patient safety. 

The data relates to talking therapies in mental health care, such as cognitive behavioural therapy, typically delivered over a number of sessions.  

More than 40,600 out of 227,800 appointments – nearly a fifth - were carried out by a therapist who was not accredited or in training, according to the latest NHS England data for February this year. This information was unknown for nearly 300,000 more sessions.  

NHSE previously set a deadline for all counsellors delivering NHS-funded care to be accredited or in training by mid-2022. 

But Rebecca Light from the British Association for Behavioural and Cognitive Psychotherapies said: “It is concerning that a substantial number of interventions continue to be delivered by practitioners who are not yet registered or accredited.” 

The chief accreditation officer and registrar said: “As demand for mental health services continues to grow, it is vital that workforce expansion is matched by consistent standards across services. 

“Strengthening the use of accredited registers, alongside supporting practitioners to achieve and maintain accreditation, will help ensure that increased access to care does not come at the expense of quality or patient safety.” 

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Source: HSJ, 7 March 2026

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‘Concerning’ lack of female-only medical trials in UK, say health experts

Health experts are calling for more UK clinical trials to focus on finding new treatments for women, as “concerning” data reveals they are severely under-represented, with 67% more male-only studies than female-only.

Details of thousands of studies were collected by the Medicines and Healthcare products Regulatory Agency (MHRA) and the University of Liverpool. The evidence shows the UK is a hub for pioneering research, with one in eight trials testing humans for the first time, and cutting-edge treatments such as gene therapies becoming a new growth area.

But a review of the data by the Guardian found that women were significantly under-represented. Both sexes were included in most trials (90%), but male-only trials (6.1%) were nearly twice as common as female-only studies (3.7%). Pregnant and breastfeeding women were especially under-represented – involved in just 1.1% and 0.6% of trials respectively.

Women’s health experts expressed alarm over the figures, which they said meant women and their doctors were having to make decisions about whether to take a drug in a “vacuum of evidence”. Some areas of research are dominated by men at all levels – funders, researchers, consultants and patients – and as a result there could be a “reluctance” to fund female-only trials, the experts added.

Dr Amy Brenner, an assistant professor in the clinical trials unit at the London School of Hygiene & Tropical Medicine (LSHTM), said: “It is particularly concerning that there are more male-only trials than female-only trials as, while they may be disease-specific, it is certainly not true that there are more male-only than female-only diseases.”

The gender gap had serious implications, Brenner said. “This under-representation means there is a lack of evidence on the safety and effectiveness of many interventions in women.” There was an “urgent need” to correct the disparity in order to improve women’s health outcomes, she added.

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Source: The Guardian, 7 May 2025

Further reading on the hub:

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‘Computer error’ removed 1,800 patients from trust’s elective waiting list

A trust has discovered 1,800 patients who were removed by mistake from its elective waiting list.

Barking, Havering and Redbridge University Hospitals Trust chief executive Matthew Trainer wrote to colleagues in the east London health system today to “apologise for the stress this will have caused those experiencing a delay”.

Of the 1,800 patients involved, 600 have been waiting more than a year and roughly 200 have been waiting for more than two years.

Mr Trainer’s note explained: “The patients have been waiting to see our specialists in routine clinics in gynaecology, neurology, neurosurgery and ophthalmology.”

It continued: “As we have been working through our waiting lists, we have discovered a problem with one of them that was used to deal with the backlog created by the pandemic.

“It contained routine referrals that were submitted by GPs who wanted their patients to be seen by a specialist, but for whom there were no appointments available due to covid-19. Unfortunately, these patients were removed automatically from this list before they had been seen.”

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Source: HSJ, 26 April 2022

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‘Complacent’ health chiefs in England lack drive to transform NHS, say MPs

Plans to radically reform the health service are at risk because senior leaders of both NHS England and the Department of Health and Social Care (DHSC) are “complacent” and lack dynamism, MPs have said.

In a report the public accounts committee (PAC) warns that officials in England have neither the ideas nor the drive to implement the health service transformation required by Keir Starmer and Wes Streeting.

The influential cross-party Commons committee did not identify individuals by name. But it reached its conclusions after questioning in November five top-level civil servants including Amanda Pritchard, NHS England’s chief executive, and Sir Chris Wormald, the DHSC’s then permanent secretary, who has since become the new cabinet secretary.

“The scale of government’s ambitions is great but senior officials do not seem to have ideas, or the drive, to match the level of change required, despite this being precisely the moment where such thinking is vital,” the PAC said in its report on the health service’s financial sustainability.

Their lack of energy and urgency risks wasting “a golden opportunity” to modernise how the NHS works and thus improve the country’s health, the MPs said.

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Source: The Guardian, 29 January 2025

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‘Climate of fear’ faces staff who voice bullying concerns at major trust

A major trust’s Freedom To Speak Up Guardian has warned that a failure to address staff concerns about alleged bullying and long-standing ‘dysfunctional behaviours’ is damaging confidence and resulting in the loss of high-quality staff.

Professor Julian Bion, presenting a half-yearly report to University Hospitals Birmingham Foundation Trust’s board, revealed that the majority of the 41 reports to the FTSU service between April and October this year had expressed a “fear of detriment” when raising concerns.

Just under half (44%) of 34 concerns raised by the contacts related to “problematic attitudes and behaviours”, ranging from reports of micro-aggressions to overt bullying.

Professor Bion, UHB’s FTSU guardian since 2019, told HSJ such concerns are always “complex and sensitive issues” and recognised that the trust is handling them during “difficult circumstances” for the NHS. UHB has seen very large numbers of covid patients throughout much of the pandemic.

But he warned the board that several “common themes” were emerging in UHB’s complaints process – including a fear of detriment, “problematic” delays to cases being resolved, and a lack of response from divisional departments.

Suggesting there is a “disinclination” within the trust to address concerns, he said: “Very often, these dysfunctional behaviours are known about for a long time but they haven’t been addressed.”

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Source: HSJ, 2 November 2021

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‘Cinderella’ postnatal care leaves women ‘forgotten’ after birth

Women and NHS staff have warned that mothers are being “forgotten” after giving birth, with a staff crisis only making matters worse.

Kate, a 32-year-old from Leeds, says she has been left in “excruciating” pain for nine years after horrifying postnatal care.

Other women have told The Independent stories of care ranging from “disjointed” to “disastrous”.

It comes as midwives warn there are “horrendous” shortages in community services, which have prevented women from accessing adequate antenatal and postnatal care.

Mary Ross-Davie, the Royal College of Midwives’ director for professional midwifery, said that with each Covid wave midwifery staffing has been hit worse than the last.

To provide safe care during labour, antenatal and postnatal care, teams are sent into wards putting “huge pressure on care”.

She said this could mean clinicians end up “missing things”, such as women struggling emotionally after birth.

The warnings over poor antenatal and postnatal care come after experts at the University of Oxford said in November there were “stark” gaps in postnatal care, despite the highest number of deaths being recorded in the postnatal period.

Dr Sunita Sharma, lead consultant for postnatal care at Chelsea and Westminster Trust, said that when NHS maternity inpatient staffing overall is in crisis “often the first place staff are moved from is the postnatal ward, which is clinically very appropriate, but it can come at a cost of putting more pressure on postnatal care for other mothers”.

Dr Sharma said postnatal teams were doing their best to improve services but need national drivers and funding to sustain improvement.

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Source: The Independent, 16 March 2022

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‘ChatGPT listened when my GP didn’t’: why women turn to AI on health

When Katie finally sat down in her GP’s surgery in November she had been in pain for years. Since the birth of her daughter in July 2023, sex had been agony. Yet the mother of three, a teacher, had delayed booking an appointment — she simply didn’t have the time.

After explaining her pain to a stranger, she was met with a shrug. “I was told that this is just what happens after kids. I felt so ignored and so awful. I cried; I felt invisible.”

Feeling failed by a human doctor, she turned to ChatGPT. “I know that AI is programmed to acknowledge me; it said something like, ‘that must be really stressful and tough to deal with right now,’ and then gave me a list of things my pain could be attributed to. It instantly put me at ease,” Katie, 28, said.

She is now in the majority. A study of 1,000 UK women aged 20 to 50 found that 53% would use a free AI tool for medical advice, even while acknowledging the 20 per cent error rate.

The report by Intimina, a Swedish company that makes women’s health products, Sixty-six per cent of women admitted they had avoided booking a GP appointment or collecting a prescription to avoid associated costs and 47% said the cost of living had led them to delay buying treatments until symptoms felt “severe”.

However, a London School of Economics study last year found that AI models systematically downplayed women’s symptoms compared to men’s.

Dr Susanna Unsworth, a women’s health expert with Intimina, said: “AI lacks the clinical nuance essential in intimate health. Self-treating based on a chatbot’s guess can lead to inappropriate treatment and prolonged suffering.”

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Source: The Times, 8 March 2026

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‘Chaotic’ service given ‘inadequate’ rating

A hospital maternity service has dropped two ratings to ‘inadequate’ after the Care Quality Commission warned of a ‘chaotic environment’, where leaders normalised poor practices and failed to act on safety concerns.

The Care Quality Commission inspected Hull Royal Infirmary’s maternity services earlier this year, and imposed urgent conditions on the service, requiring Hull University Teaching Hospitals Trust to make “rapid improvements” to keep people safe.

The overall maternity rating fell from “good” to “inadequate”, the CQC announced today, although it only reviewed the “safe” and “well led” domains. The inspection was part of an ongoing national CQC maternity inspection programme, which has downgraded numerous services to “inadequate” over the last year. 

The regulator said the antenatal day unit and triage department was a “chaotic environment which was not fit for purpose”, and found some staff described “unkindness” from peers. Women and service users waited long periods without an offer of food or water, it said.

Significant concerns were raised about safeguarding, with staff unable to identify adults and children suffering or at risk of significant harm.

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Source: HSJ, 9 August 2023

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‘Chaotic’ maternity service was warned of same problems years earlier

A trust given an “inadequate” rating for its “chaotic” maternity service last week had been criticised for many of the same failings only last year by another regulator, it has emerged.

Bethan Harris died in a hospice 10 days after her birth at St George’s Hospital in South London in 2018. She had suffered hypoxic ischemic encephalopathy – a brain injury caused by lack of oxygen – during delivery, according to the coroner’s report.

HSJ has now seen the conclusions of a Parliamentary and Health Service Ombudsman report into her death, completed and sent to the trust just last year.

It found that if Ms Heatley had had better care Bethan might have been born in a better condition, as did a 2019 inquest into Bethan’s death, which led to the coroner issuing a “prevention of future deaths” report.

It also shows St George’s University Hospitals Foundation Trust was warned about major problems in the maternity services in 2019 and in the 2022 ombudsman report, but had apparently not dealt with them when the Care Quality Commission inspected in March this year.

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Source: HSJ, 23 August 2023

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‘Challenged’ trust plans to move patients to chairs to free up beds

An acute trust in the Midlands is planning to move patients to chairs on wards to free up beds for people waiting in its emergency department, following one of its “most challenged” days.

In an email sent to staff at Nottingham University Hospitals on Tuesday, interim chief operating officer Rachel Eddie and chief medical officer Keith Girling wrote: “We are asking wards to transfer [patients confirmed as ready for discharge] to the discharge lounge, or if that isn’t possible, move them to a chair on the ward so that a patient waiting for a bed in ED or in an emergency pathway assessment area can be brought up.”

“This is referred to as going ‘one over’,” the email added. “We will ensure that on each ward that has been designated as being able to go ‘one over’, a chair has been added to their Nervecentre ward layout so patients are all visible.”

The email describes how Monday was one of the “most challenged Mondays we have seen” and confirmed the trust remains in ‘Opel 4’, the most severe level of operational pressure.

It also said nursing staff have “shared concerns” about the amount of time they are able to spend with their patients.

“This does mean that at times you will be asked to work at a higher patient to nurse ratio than we would like,” the email said. “We know this isn’t where any of us want to be, but it is unfortunately the reality of balancing risk.”

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Source: HSJ, 1 December 2021

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‘Centralise tech procurement’ says 10-Year Plan advisory group

Ministers have been told to “centralise” decisions on – and purchasing of – NHS technology by one of the groups drawing up the 10-Year Health Plan, HSJ  has learned.

A late draft report from the government’s data and technology working group, seen by HSJ, says that “rather than being totally devolved to local health and care systems”, technology and data should be “a more centralised service”.

It calls for local tech deployment to be guided by new “national frameworks linked with [a] technology blueprint”.

Currently, technology procurement is led by integrated care boards and trusts, which choose which digital systems and products they wish to deploy. 

But the data and technology working group said this was leading to misaligned strategy and disjointed local systems.

The report says: “The decentralised structure of the health and care system means that local organisations operate independently, decision-making authority is often contested, and various special interests have considerable influence.

“When procurement decisions are not aligned with overarching policies and standards, they contribute to infrastructure diversity and result in numerous legacy systems that lack interoperability. This significantly hinders the realisation of a unified vision for services.”

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Source: HSJ, 18 March 2025

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‘Catastrophic’ threat to cancer ops at England’s third largest hospital trust

Cancer services at large hospital trust have been at ‘catastrophic’ risk of being overwhelmed, after two of its hospital sites had to suspend life-saving cancer surgeries in the last month due to COVID-19.

In its latest board papers Mid and South Essex Foundation Trust rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic”. It said the expected consequences at this risk level include “permanent disability or death, serious irreversible health effects” and an “unacceptable… quality of service”.

The trust runs three general acute hospitals in the county. Its 2,000 plus beds make it the third largest trust in England after University Hospitals Birmingham FT and Leeds Teaching Hospitals.

The same board papers, dated 28 January, said cancer surgery at Southend University Hospital, one of three hospital sites run by the trust, “ceased on 24 December”. At a second hospital site, Mid Essex Hospital covid “hit hard just before Christmas” and elective work was “dramatically impacted with short period of life and limb only carried out on site”. This meant all P2 cancer surgery — which requires treatment in less than four weeks — did not take place. 

Both hospital sites said they hoped the independent sector could help them restart cancer surgeries this month with a focus on “long waiting and clinical urgent patients”. It is not clear how much capacity the sector has to work through waiting lists and the board papers said “some of this capacity may be reduced” because of recent changes to a new national contract for the independent sector.

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Source: HSJ, 29 January 2021

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‘Catastrophic’ gaps in tech regulation plans

Proposed amendments to UK medical device regulations are “a disgrace” and risk creating the lowest barrier to entry for high-risk AI devices in the developed world, sector experts have told HSJ.

Under the draft rules, which have been submitted to the World Trade Organisation ahead of being laid before Parliament, software designed to diagnose a condition can face greater regulatory scrutiny than software designed to treat one.

This means a company could deploy an AI chatbot designed to treat patients with severe mental health problems without independent regulatory scrutiny by self-certifying its own safety in the same category as a walking stick.

The Medicines and Healthcare products Regulatory Agency (MHRA) has published draft pre-market regulatory requirements for medical devices and in vitro diagnostic devices entering the market.

This was the most significant update to the UK Medical Device Regulations (MDR) 2002 since Brexit, when the UK left the EU MDR.

However, regulatory leaders have aired concerns about the draft amendments, particularly around the risk classification of software.

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Source: HSJ, 18 May 2026

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‘Burdensome’ patient safety inquiries taking up too much time, says NHSE chief

NHS England’s head of patient safety has suggested too much time and resource is being spent on “burdensome” inquiries to investigate failings in the system.

Aidan Fowler said national chiefs want to see a shift away from “looking back 10 years and asking ‘what did we miss’”, and instead wants teams to be resolving problems in real time.

At trusts where safety concerns have been highlighted, he said “people descend, and there are a lot of asks, and the pressure mounts, and they end up with an action list of hundreds of things, and it becomes very burdensome – we have to avoid that”.

Speaking at a session at the NHS Confederation Expo event in Manchester this week, he encouraged organisations to report concerns early so NHSE can respond more quickly, supporting them and working through problems to prevent public inquiries from needing to happen in the first place.

Mr Fowler added: “We have to get more proactive. We will spend less of our time in the future, is the plan, than we are now – doing what I call driving in the rear view mirror.

“We don’t want to be looking back 10 years and asking, ‘what did we miss’, we want to be seeing things in real time… we don’t want to be spending our time in big inquiries into failings in the system.”

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Source: HSJ, 14 June 2024

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‘Bullying, intimidation and reprisals’ undermined patient care at trust, review concludes

A ‘culture of distrust’ between consultants and the use of incident reporting as a tool of ‘reprisal’ impacted patient care at a trust’s cardiology department, a review has concluded.

An external review undertaken for Hull University Teaching Hospitals Trust has made a series of recommendations after looking into allegations of bullying and several examples of poor care within its cardiology services.

In a report published in the trust’s board papers, the Royal College of Physicians reported a “perceived tendency to downplay clinical incidents, and, to undermine those who wanted to raise patient safety issues”.

It added: “We met a group of individual consultants who did not work well as a team. There is a culture of distrust, a lack of departmental cohesion and allegations of bullying in the department. All of which reinforce a clear divide between the interventional and non-interventional consultant cardiologists."

“There have been a number of allegations of belittling, intimidation and undermining…The review team heard accounts of a culture where datix has been used as a tool for possible personal reprisal along with ignoring/downplaying incidents that have been raised.”

The review concludes: “This behaviour is impacting on patient care and therefore, all medical staff should be reminded of good medical practice as the [General Medical Council] code of conduct of how doctors must work collaboratively with colleagues.”

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Source: HSJ, 16 November 2021

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‘Bullying and racism’ provider faces NHSE investigation

A community services provider at the centre of bullying and racism allegations is being formally investigated by NHS England over its governance arrangements, HSJ can reveal.

The investigation will look into the governance of Sirona Care and Health, an NHS and council-funded social enterprise which is the main provider of community health services for the Bristol, North Somerset, and South Gloucestershire Integrated Care System.

HSJ last month reported that Sirona had launched an internal investigation into its staff culture following allegations of “unacceptable behaviours”, including racism and bullying.

In an internal staff message sent this month, seen by HSJ, Sirona interim chief executive Julie Sharma said NHSE “has a duty to make sure our governance is working well” and is therefore “undertaking a formal investigation” into how the provider is run, and its decision-making processes.

Ms Sharma said: “We know that some things could be better. For instance, too many of our executive directors are on interim contracts and our board is short of non-executive directors. We are addressing both of these.”

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Source: HSJ, 24 October 2024

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‘Buckling’ NHS fails to treat 250,000 children with mental health problems

A quarter of a million children in the UK with mental health problems have been denied help by the NHS as it struggles to manage surging case loads against a backdrop of a crisis in child mental health.

Some NHS trusts are failing to offer treatment to 60% of those referred by GPs, the research based on freedom of information request responses has found.

The research carried out by the House magazine and shared with the Guardian also revealed a postcode lottery, with spending per child four times higher in some parts of the country than others, while average waits for a first appointment vary by trust from 10 days to three years.

Olly Parker, head of external affairs at YoungMinds, said the freedom of information findings showed a “system is in total shutdown” with “no clear government plan to rescue it”, after the 10-year mental health plan was scrapped.

“In the meantime, young people are self-harming and attempting suicide as they wait months and even years for help after being referred by doctors,” he said. “This is not children saying ‘I’m unhappy.’ They are ill, they are desperate and they need urgent help.”

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Source: The Guardian, 16 April 2023

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‘Broken’ health system failing to tackle ‘unsustainable’ emergency care pressures

An integrated care system which has some of England’s worst waiting times for emergency care lacks “delivery structure and processes” to make desperately needed improvements, according to an external report.

Research by consultancy Prism into the Cornwall and Isles of Scilly integrated care system (ICS) concluded it had “unclear governance” for management and recovery of urgent and emergency care, with “multiple disconnected structures in place to manage tactical and strategic recovery of performance”.

The report comes as the ICS grapples with record waits for emergency care, with stroke and heart attack victims waiting three hours for an ambulance  and patients stuck for two days in Royal Cornwall Hospital’s emergency department.

The review was commissioned by the Cornwall Integrated Care Board to look at patient flow across the system and make recommendations about how this can be improved. 

Prism interviewed leaders from the organisations within the Cornish ICS. One leader described the system as “so broken”, while another commented that the role of the ICB in supporting and delivering urgent and emergency care “is not clear”.

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