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NHS compensation payouts have doubled in six years, figures show

NHS Payouts linked to medication blunders have doubled in six years, fuelling record spending, official figures show.

The NHS figures show that in 2019/20, the health service spent £24.3 million on negligence claims relating to medication errors - up from £12.8 million in 2013/14. The statistics show that in the past 15 years, almost £220 million has been spent on claims relating to the blunders.

Previous research has suggested that medication errors may be killing up to 22,000 patients in England every year. Errors occur when patients are given the wrong drugs, doses which are too high or low, or medicines which cause dangerous reactions.

In some cases, patients have been given medication which was intended for another person entirely, sometimes with fatal consequences. Other studies suggest that 1 in 12 prescriptions dispensed by the NHS involve a mistake in medication, dose or length of course. 

In some cases, patients have died after being given a dose of morphine ten times that which should have been administered, with other fatalities involving fatal reactions. Confusion often occurs when drugs are not labelled clearly, or when packaging of different medications looks similar.

Jeremy Hunt, now chairman of the Commons Health and Social Care Committee, said the NHS needed to make far more progress preventing harms, instead of seeing an ever increasing negligence bill.

He said: “It is nothing short of immoral that we often spend more cleaning up the mess of numerous tragedies in the courts, than we actually do on the doctors and nurses who could prevent them."

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Source: The Telegraph, 3 October 2020

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New partnership to improve patient safety in South East London ICS

Guy’s and St Thomas’ NHS Foundation Trust will work with Omnicell to develop a European technology-enabled inventory optimisation and intelligence service which will be initially implemented across South East London Integrated Care System (ICS). This partnership will encompass all six acute hospital sites within the South East London ICS, including Guy’s & St Thomas’, Kings College Hospital NHS Foundation Trust and Lewisham & Greenwich NHS Trust.

The project will have the following goals:

  • Develop analytics and reporting tools with a goal of improving patient safety, achieving increased operational efficiency and cost efficiencies
  • Utilize the analytics and reporting tools with a goal of achieving agreed efficiencies and cost reductions
  • Demonstrate the impact of managing clinical supplies and medicine spend together at scale
  • Build a service model for the ICS which can be scaled up and adopted by other hospital groups in the UK

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Internal memo warns of ‘increasingly common’ deaths in A&E

Senior doctors have raised concerns about the numbers of patients now dying in their A&E department due to extreme operational pressures.

HSJ has seen an internal memo sent to staff at Royal Albert Edward Infirmary in Wigan, which warns it is becoming “increasingly common” for patients to die in the accident and emergency department.

The memo suggests the department has reported five deaths in the latest weekly audit, when it would normally report one or two fatalities.

The memo said: “Of the 72 patients in A&E as I write this, 16 have been there over 24 hours and 34 over 12 hours. The longest stay is almost 48 hours…

“It’s becoming increasingly common to die in A&E. We have included A&E deaths [in weekly audits] for the last 4 years. They used to be 1 or 2. This week there were 5. They used to die at or just after arrival, but that’s changing too…

“There is every reason to think winter will be worse.”

The memo echoes warnings made by numerous NHS leaders in recent months around the intense service pressures and an increased risk of incidents and mistakes. 

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Source: HSJ, 17 August 2022

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Coronavirus: NHS doctors ‘gagged’ over protective equipment shortages

Frontline doctors have told the Independent they have been gagged from speaking out about shortages of protective equipment as they treat coronavirus patients – with some claiming managers have threatened their careers.

Staff have been warned not to make any comments about shortages on social media, as well as avoiding talking to journalists, while NHS England has taken over the media operations for many NHS hospitals and staff.

The Independent has seen a series of emails and messages warning staff not to speak to the media during the coronavirus outbreak.

One GP has been barred from working in a community hospital in Ludlow after making comments about the lack of equipment, while another in London said they were told to remove protective equipment they had purchased themselves.

NHS England confirmed it was controlling media communications, which it said was part of its national emergency incident planning to ensure the public received “clear and consistent information”. 

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Source: The Independent, 1 April 2020

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Cumberlege inquiry: We must not allow this seminal report to gather dust on a shelf, Jeremy Hunt says

Former health secretary Jeremy Hunt has warned ministers not to let the Cumberlege review “gather dust on a shelf”.

The chair of the Commons Health and Social Care Committee told The Independent it was vital action was taken to implement the recommendations.

Mr Hunt, who made patient safety a key focus of his tenure as health secretary, backed the idea of an independent patient safety commissioner that would be outside the NHS and have powers to advocate for patient issues.

Mr Hunt said: “This report should be a powerful wake-up call that our healthcare system is still too closed, defensive and focused on blame rather than learning lessons. It’s truly harrowing to hear of all the women and families who live with permanent anguish because of these medicines and devices, and it has clearly taken too long for their voices to be heard.”

“The NHS is one of the safest health systems in the world, and we’re all rightly in awe of our frontline heroes. But in healthcare getting it right ‘most’ times isn’t good enough because the exceptions wreak lifelong devastation on families. So we must not allow this seminal report to gather dust on a shelf: lessons must be learnt once and for all.”

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Source: The Independent, 8 July 2020

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NHS staff to receive ‘air accident’ safety training to reduce patient harm

Frontline NHS staff will be given specialist ‘air accident investigation’ style training to help improve the way the health service learns from patient safety incidents.

Cranfield University, which has been training air, maritime and rail safety investigators for more than 40 years, is to launch the first intensive course for NHS staff responsible for investigating safety incidents in hospitals.

It is part of a growing effort to install a safety science approach to avoidable harm in the NHS, with the service increasingly looking to other industries to adopt new approaches based on the science of human factors and just culture.

Traditionally the NHS has focused on simpler investigations that too often miss systemic causes of mistakes and instead target individual nurses and doctors for blame.

The new one week intensive course, run in partnership with the charity Baby Lifeline, will start in January and will give students a basic grounding in the science of investigation and using real-life actors and a maternity based scenario, show participants how to get to the real causes of what went wrong.

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Source: The Independent, 20 July 2020

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Sickle cell patients are being ignored because they’re black, warn campaigners

Public services are dismissing sickle cell patients because the illness disproportionately affects Black people, campaigners have warned.

The blood disorder is prevalent among African and Caribbean communities and advocacy groups say this means it remains poorly understood within state institutions, often leading to the needless suffering and even death of those diagnosed.

The issue has gained wider attention following the high-profile cases of two Black men, Richard Okorogheye and Evan Nathan Smith, who lived with the disease and died amid claims their vulnerabilities were overlooked by the NHS and police.

Chris Abdullahi, co-founder of charitable initiative Sound of Sickle, told The Independent it is common for sickle cell patients’ painful symptoms to be ignored by healthcare practitioners.

He said he has heard similar accounts “well over 100 times” from across the UK.

“Just last week someone else mentioned that they were in hospital and had to battle their nurses for pain medication from opioids to something as simple as ibuprofen,” the 27-year-old, who also lives with sickle cell, said.

These experiences serve to further entrench the “massive sense of distrust” in the healthcare system which is evidenced through lower vaccine uptake in Black communities, Mr Abdullahi explained.

A lack of awareness about the disease has led sickle cell patients to often form informal support networks, through which information can be exchanged about the best hospitals at which to maximise the chances of their condition being taken seriously.

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Source: The Independent, 18 April 2021

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CQC to restart inspections today

The Care Quality Commission (CQC) will restart inspections from 1 February with a focus on the urgent and emergency care system, the regulator has announced.

In December, CQC postponed inspections of some services to support the acceleration of the vaccination booster programme. They also prioritised activity to help create more capacity in adult social care.

However, considering the current situation – including the easing of restrictions across the country – they have reviewed and updated their regulatory approach. From 1 February the CQC will inspect where:

  • there is evidence that people are at risk of harm. This applies to all health and social care services, including those where inspections were previously postponed except in cases where we had evidence of risk to life
  • CQC can support increasing capacity across the system, particularly in adult social care
  • a focus on the urgent and emergency care system will help us understand the pressures, where local or national support is needed, and share good practice to drive improvement.

Much of their approach is unchanged and remains in line with the update from the Chief Inspectors on 10 December 2021.

This includes:

  • achieving their ambition to complete 1,000 infection prevention and control (IPC) inspections in adult social care
  • rapid response to requests to set up new Designated Settings
  • activity to rate adult social care services that are registered and not yet rated
  • inspections of adult social care providers currently rated as Requires Improvement to identify where improvement has taken place and re-rate where possible.

Alongside their risk-based activity, CQC will undertake ongoing monitoring of services. This helps to identify where CQC may need to take further action to ensure people are receiving safe care and offer support to providers. It also remains important that people share concerns or examples of good practice, CQC said.

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Source: CQC, 27 January 2022

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NHSE tries to put £2.3bn cap on agency staff spend

NHS England is introducing a new ceiling on the amount spent within each integrated care system on agency staff — cutting it by at least 10% in each area in one year — as part of a drive to find further savings across the health service.

Integrated Care Services (ICSs) have been told to cut spending on temporary staff by providers in their area by at least 10%, or £257m, on 2021-22 levels, taking expenditure down to a total of £2.3bn nationally. A letter to finance directors sent today, seen by HSJ says: “This will mean that some systems will need to go beyond their current financial plans to reduce agency expenditure.”

The move is part of a wider efficiency crackdown from NHS England, with further national control measures to be introduced over the next 18 months. HSJ understands that the renewed drive will focus on five other areas in addition to agency spend: medicines, pathway redesign, corporate services, procurement and specialised commissioning.

The extra savings ask comes on top of ICSs already committing to £5.5bn in efficiencies over 2022-23, which Nuffield Trust CEO Nigel Edwards said was “not a credible savings target”.

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Source: HSJ, 20 July 2022

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Disabled woman who died in Sheffield hospital ‘ignored’, parents tell inquest

The parents of a young disabled woman who died after she went into hospital for a routine eye operation have told a coroner that doctors ignored their daughter’s attempts to communicate.

Laura Booth, 21, stopped eating after she was admitted to the Royal Hallamshire hospital in Sheffield, her mother told an inquest hearing in the city on Monday.

Patricia Booth, from Sheffield, said her daughter was ignored by clinicians after she went into the hospital in October 2016 despite her being able to communicate to some extent, including using Makaton signing. She said this was in contrast to her treatment at the Children’s hospital in the city.

Sitting next to her husband, Ken, on a remote link, Booth told the inquest: “They never discussed anything with Laura. They just ignored her. She couldn’t speak but she could understand everything.”

Booth explained how her daughter could make herself understood to her family and would hold her hands out to the doctors, but did not get a response.

“They never gave her a chance,” she said. “They never spoke to her.

“It’s really heartbreaking. Laura was trying to communicate with them but they just wouldn’t listen … It just upset Laura that the doctors ignored her.”

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Source: The Guardian, 12 April 2021

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AI skin cancer diagnoses risk being less accurate for dark skin – study

Artificial intelligence (AI) systems being developed to diagnose skin cancer run the risk of being less accurate for people with dark skin, research suggests.

The potential of AI has led to developments in healthcare, with some studies suggesting image recognition technology based on machine learning algorithms can classify skin cancers as successfully as human experts.

NHS trusts have begun exploring AI to help dermatologists triage patients with skin lesions. But researchers say more needs to be done to ensure the technology benefits all patients, after finding that few freely available image databases that could be used to develop or “train” AI systems for skin cancer diagnosis contain information on ethnicity or skin type. Those that do have very few images of people with dark skin.

Dr David Wen, first author of the study from the University of Oxford, said: “You could have a situation where the regulatory authorities say that because this algorithm has only been trained on images in fair-skinned people, you’re only allowed to use it for fair-skinned individuals, and therefore that could lead to certain populations being excluded from algorithms that are approved for clinical use."

“Alternatively, if the regulators are a bit more relaxed and say: ‘OK, you can use it [on all patients]’, the algorithms may not perform as accurately on populations who don’t have that many images involved in training.”

That could bring other problems including risking avoidable surgery, missing treatable cancers and causing unnecessary anxiety, the team said.

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Source: The Guardian, 9 November 2021

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CQC admits it is failing to keep patients safe

The Care Quality Commission has admitted it is failing to keep patients “safe” and is losing the confidence of ministers and the NHS, HSJ  has discovered.

HSJ has seen part of an internal “problem statement” produced by interim chief executive Kate Terroni. It says that “stakeholders and the Department of Health and Social Care are losing confidence in our ability to deliver our purpose”.

The statement adds: “The way we work is not working and we are not consistently keeping people who use services safe.

“Our people are not able to effectively identify and manage risk and encourage improvement and innovation.

“Our organisational structure, flow of decision making, roles, internal and external relationships do not promote a productive and credible way of working.” 

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Source: HSJ, 26 June 2024

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Testing for coronavirus in UK care homes a ‘complete system failure’

Care home operators have accused the UK government of “a complete system failure” over testing for COVID-19 after officials repeatedly deflected responsibility for the task and left vulnerable residents unchecked.

As ministers admitted it will be more than three weeks before all homes are offered tests, care home managers said lives have been put at risk and conditions for dementia sufferers worsened because of the government’s failure so far to test hundreds of thousands of staff and residents.

The programme was announced by the health secretary, Matt Hancock, two weeks ago but only tens of thousands of people have been tested.

Public Health England (PHE), the Care Quality Commission (CQC) and the Department of Health and Social Care (DHSC) have repeatedly passed the buck about who should carry out the tests, according to correspondence with care homes seen by the Guardian.

When Nottingham Community Housing Association (NCHA) tried to get tests for its care home residents and staff, a PHE official said it didn’t know anything about testing residents, before pointing them to the CQC. PHE then changed its mind again saying it would send the tests, but when they failed to arrive, PHE reversed again saying CQC was responsible.

“It is very frustrating because we can’t effectively manage the risk without knowing [who has the virus],” said Holly Dagnall, director of homes and wellbeing at NCHA.

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Source: The Guardian, 12 May 2020

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More than half of England’s coronavirus-related deaths will be people from care homes

Care home residents are on course to make up more than half the deaths caused directly or indirectly by the coronavirus crisis in England, according to a new analysis.

The study warns that the death toll by the end of June from OVID-19 infections and other excess deaths is “likely to approach 59,000 across the entire English population, of which about 34,000 (57%) will have been care home residents”.

The estimate, produced by the major healthcare business consultancy LaingBuisson, includes people who list a care home as their primary residence, wherever they died – including those who died in hospital.

It is based on data from the Office for National Statistics, as well as the analyst’s own modelling of the number of care home resident deaths likely to have occurred in the absence of the pandemic.

The new study coincides with mounting concerns over the failure to protect care homes earlier in the pandemic. Senior care industry figures point to the decision to move some hospital patients back to care homes in mid-March. There have also been complaints that non-Covid-related healthcare became less accessible to homes during the height of the pandemic, leading to extra deaths.

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Source: The Guardian, 7 June 2020

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Telemedicine saves chronic pain patients time and money

Patients who saw a pain medicine specialist via telemedicine saved time and money and were highly satisfied with their experience, even before the COVID-19 pandemic, according to a study presented at the ANESTHESIOLOGY® 2020 annual meeting.

Results of the study confirm many chronic pain patients are confident they will receive good care via telemedicine, while avoiding lengthy commutes and time spent in traffic.

"This era of contactless interactions and social distancing has really accelerated the adoption of telemedicine, but even before the pandemic, patient satisfaction was consistently high," said Laleh Jalilian, M.D., lead author of the study and clinical assistant professor at the University of California, Los Angeles (UCLA).

"Patients who are being evaluated for new conditions may be better off having office visits initially. But once patients establish a relationship with providers, follow-up visits can occur efficiently with telemedicine, while maintaining patient rapport and quality outcomes. We believe 50% of our visits could be conducted via telemedicine."

"Now that telemedicine is more widespread, it may become a valued part of care delivery in chronic pain practices," said Dr. Jalilian. "Clearly many patients benefitted from remote consultations and follow-up appointments using telemedicine. We hope it will encourage policymakers and insurance providers to continue to support these platforms and inspire more innovation in this developing field of research and patient care."

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Source: EurekAlert, 5 October 2020

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Acutely unwell prisoners left in ‘limbo’ due to lack of mental health beds

People needing acute mental health treatment are being left in prison for extended periods, HSJ can reveal.

Figures HSJ obtained under the Freedom of Information Act show that 3,111 patients were transferred from prisons to mental health facilities between 2018-19 and 2020-21. A total of 481 (15%) of the transfer took more than 14 days from the date the mental health casework section received an application for transfer to the date the transfer took place.

Across these three years, 167 transfers (5%) took more than 28 days. The longest wait for transfer was 161 days, which happened in 2018-19. However, the average number of days taken to transfer a patient has remained consistent at between 10 and 11 days.

Until the summer, NHS England’s guidance recommended a 14-day time limit for transfers of patients from prisons to mental health facilities.

In June 2021, NHSE published new guidance which recommended a 28-day time limit between a person first being referred for inpatient assessment and being admitted to a mental health facility. The timeline, which consists of two sequential 14-day periods, says medical reports should be “completed to be sent to the [MHCS]” between days 15 and 25, while the MCHS should approve and issue a warrant and admission should take place before day 28.

Sophie Corlett, of mental health charity Mind, said: “Nobody who has been assessed as needing specialist inpatient care should be left for extended periods of time in prison, as it’s a completely inappropriate setting for anyone in crisis… When people are a risk to themselves, it’s crucial there are enough staff and beds available to make sure they are cared for in a safe and therapeutic environment.”

Bethan Roberts, British Medical Association forensic and secure environments committee interim chair, said: “A prisoner who is mentally unwell and cannot be adequately cared for in a prison should… be transferred to a forensic mental health unit as soon as possible."

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Source: HSJ, 1 December 2021

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US faces deficit of 450,000 nurses by 2025

The United States could see a deficit of 200,000 to 450,000 registered nurses available for direct patient care by 2025, a 10 to 20% gap that places great demand on the nurse graduate pipeline over the next three years.

The new estimates and analysis come from a McKinsey report published this week. The shortfall range of 200,000 to 450,000 holds if there are no changes in current care delivery models. The consulting firm estimates that for every 1% of nurses who leave direct patient care, the shortage worsens by about 30,000 nurses.

To make up for the 10 to 20%, the United States would need to more than double the number of new graduates entering and staying in the nursing workforce every year for the next three years straight. For this to occur, the number of nurse educators would also need to increase.

"Even if there was a huge increase in high school or college students seeking nursing careers, they would likely run into a block: There are not enough spots in nursing schools, and there are not enough educators, clinical rotation spots or mentors for the next generation of nurses," the analysis states. "Progress may depend on creating attractive situations for nurse educators, a role traditionally plagued with shortages."

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Source: Becker's Hospital Review, 12 May 2022

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Half of all deaths of people with a learning disability ‘avoidable’

Nearly half (49%) of all deaths of people with a learning disability in 2021 were deemed to be avoidable, a major annual report has found.

By comparison, just 22% of deaths were classified as avoidable among the overall general population in 2020.

A new report, led by King’s College London and produced for NHS England – identified that of those avoidable deaths among people with learning disabilities, 65.5% died in hospital.

The learning from life and death reviews programme (LeDeR) report also revealed that the Midlands and North West showed the greatest difference in avoidable to unavoidable deaths at 53%, compared to 48% in London.

And when looking at individual long-term conditions, 8% of avoidable deaths were related to cancer, 17% to diabetes, 14% to hypertension, and 17% to respiratory conditions.

It also found that:

  • More than 50% of people with a learning disability died in areas rated as some of the most deprived in England
  • Around six out of 10 people with a learning disability die before age 65, compared to 1 in 10 from the general public
  • On average, men with a learning disability die 22 years younger than men from the general population.

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Source: Healthcare Leader, 18 July 2022

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More people dying at home during COVID-19 pandemic – UK analysis

About 8,000 more people have died in their own homes since the start of the coronavirus pandemic than in normal times, a Guardian analysis has found, as concerns grow over the number avoiding going to hospital.

Of that total, 80% died of conditions unrelated to COVID-19, according to their death certificates. Doctors’ leaders have warned that fears and deprioritisation of non-coronavirus patients are taking a deadly toll.

Doctors’ leaders have warned that some sick people are too scared to go to hospital and are aware that much of the usual NHS care had been suspended in the pandemic. “These figures underline that the devastation wrought by Covid-19 spreads far beyond the immediate effects of the illness itself,” said Dr Chaand Nagpaul, the council chair of the British Medical Association.

“While all parts of the NHS have rallied round in a bid to meet the immediate rocketing demand caused by the pandemic, more than half of doctors in a recent BMA survey have told us that this is worsening the care of non-Covid patients.”

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Source: The Guardian, 8 May 2020

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NHS to give therapy for depression before medication under new guidelines

Millions of people with mild depression in England should be offered therapy, exercise, mindfulness or meditation before antidepressants, according to the first new NHS guidelines in more than a decade.

Under draft guidance, the National Institute for Health and Care Excellence (NICE) recommends the “menu of treatment options” be offered to patients by health professionals before medication is considered.

Currently, those with mild depression are offered antidepressants or a high-intensity psychological intervention, such as cognitive behavioural therapy (CBT). The shake-up forms part of the first new recommendations to identify, treat and manage depression in adults since 2009.

According to the Office for National Statistics (ONS), about one in six (17%) adults experienced some form of depression this summer. The rate is higher than before the pandemic, when 10% of adults experienced it. Younger adults and women are more likely to be affected, the ONS found.

A 2019 review showed 17% of the adult population in England (7.3 million people) had been prescribed antidepressants in the year 2017-18.

Dr Paul Chrisp, director of the centre for guidelines at NICE, said: “The Covid-19 pandemic has shown us the impact depression has had on the nation’s mental health. People with depression need these evidence-based guideline recommendations available to the NHS, without delay.”

Nav Kapur, professor of psychiatry and population health at the University of Manchester and chair of the guideline committee, said: “As a committee we have drawn up recommendations that we hope will have a real impact on people who are suffering from depression and their carers. In particular we’ve emphasised the role of patient choice – suggesting that practitioners should offer people a choice of evidence-based treatments and understanding that not every treatment will suit every person.”

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Source: The Guardian, 23 November 2021

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Trust apologises for saying patient’s sexual assault ‘didn’t happen’

A hospital trust has apologised to a mental health patient who reported being sexually assaulted in its A&E department – after it emerged in a safety review that staff wrote ‘this has not happened’ and dismissed her claims of the attack.

The victim was admitted to West Suffolk Hospital’s emergency department following an overdose in January last year. While waiting in A&E for a mental health assessment from a specialist team employed by Norfolk and Suffolk Foundation Trust, she reported being sexually assaulted by a male patient who had also been admitted to A&E.

Yet a review into the incident, published several months later and shared with HSJ, reveals that after the victim reported the attack to a nurse, the staff member recorded “this has not happened”.

They stated that the male suspect in the cubicle next to her had not left his bed and was under constant observation. However, the patient safety review, drawn up after a serious incident probe was launched, adds that this statement was “incorrect, as the [male] patient was not under constant observation”.

“There were witnesses to this incident, and CCTV, and yet it was not escalated until I contacted the trust myself to complain,” the victim said. 

She added that she pursued the complaint, which resulted in a serious incident probe that took several months to conclude, “to prevent others from being failed” in the same way.

She said she was left “shocked, confused and furious” to discover staff had dismissed her assault and claimed the male suspect had not been admitted for an assessment on the day of the attack.

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Source: HSJ, 7 February 2022

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Matching drugs to DNA is 'new era of medicine'

We have the technology to start a new era in medicine by precisely matching drugs to people's genetic code, a major report says.

Some drugs are completely ineffective or become deadly because of subtle differences in how our bodies function. The British Pharmacological Society and the Royal College of Physicians say a genetic test can predict how well drugs work in your body.

The tests could be available on the NHS next year.

It would have helped Jane Burns, from Liverpool, who lost two-thirds of her skin when she reacted badly to a new epilepsy drug.

She was put on to carbamazepine when she was 19. Two weeks later, she developed a rash and her parents took her to A&E when she had a raging fever and began hallucinating.

The skin damage started the next morning. Jane told the BBC: "I remember waking up and I was just covered in blisters, it was like something out of a horror film, it was like I'd been on fire."

Jane's experience may sound rare, but Prof Mark Caulfield, the president-elect of the British Pharmacological Society, said "99.5% of us have at least one change in our genome that, if we come across the wrong medicine, it will either not work or it will actually cause harm."

"We need to move away from 'one drug and one dose fits all' to a more personalised approach, where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines," said Prof Sir Munir Pirmohamed, from the University of Liverpool.

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Source: BBC News, 29 March 2022

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Trust board backs medical director who wrongly dismissed whistleblower

A trust board has backed the medical director who oversaw the dismissal of a whistleblower in a case linked to patient deaths.

Portsmouth Hospitals University Trust told HSJ John Knighton had the full support of the organisation when asked if he faced any censure over the wrongful dismissal of a consultant who raised the alarm about a surgical technique.

Jasna Macanovic last month won her employment tribunal against the trust with the judge calling its conduct “very one-sided, reflecting a determination to remove [her] as the source of the problem”.

The judgment found that the disciplinary process Dr Knighton oversaw was “a foregone conclusion” and as such had broken employment rules. The nephrologist was twice offered the opportunity to resign with a good reference, once during her disciplinary hearing and again on the day the outcome of that hearing was delivered.

The trust told HSJ nothing in the judgment suggested Dr Knighton should face any action about his conduct and none had been taken. It said there were no reasons to doubt his credibility or probity.

The trust did not respond when asked if any apology had been offered to Dr Macanovic.

A spokesperson said: “We are committed to supporting colleagues raising concerns, so they are treated fairly with compassion and respect.”

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Source: HSJ, 13 April 2022

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Trust drops from ‘outstanding’ to ‘requires improvement’

A teaching hospital that was lauded for its culture and championed by ministers has been downgraded from ‘outstanding’ to ‘requires improvement’ by the Care Quality Commission.

CQC inspectors found multiple issues at Salford Royal Hospital during an inspection in August and September. These included nurse staffing, governance, and some cultural concerns. The trust’s urgent and emergency services were rated “inadequate” for safety.

The hospital in Greater Manchester had been rated “outstanding” since 2015, and was frequently hailed as a leader on the patient safety agenda, particularly by former health secretary Jeremy Hunt.

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Source: HSJ, 22 December 2022

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Hospital alert after fake doctor-endorsed videos

A hospital trust in south London has issued an alert after fraudulent videos were circulated online claiming its staff endorsed weight loss products.

Guy's and St Thomas' NHS Foundation Trust said that the videos, found on social media platforms like Facebook and TikTok, "falsely claim a number of our clinicians are using and endorsing these products".

The videos, which show doctors applying weight loss patches to their bodies and losing weight over a period of time, appear to be AI-generated, the Trust said, and do not show doctors who work there.

The BBC has approached the company and a doctor claiming to be behind the products, but has had no response.

Speaking to the BBC Dr Daghni Rajasingam, deputy chief medical officer at the Trust, said staff were "actively working" to try and get the videos taken down.

"They are fraudulent and they're misleading," Rajasingam said.

"NHS clinicians would never endorse or promote commercial products such as this."

The doctor urged the public to seek health advice on weight loss from "trusted NHS sources".

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Source: BBC News, 15 January 2025

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