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‘Serious failings’ contributed to baby’s death in 12-hour lone prison birth

Serious systemic failings contributed to the death of a newborn baby in a cell at Europe’s largest women’s prison, a coroner has concluded.

Rianna Cleary, who was 18 at the time, gave birth to her daughter Aisha alone in her prison cell at HMP Bronzefield, in Surrey, on the night of 26 September 2019. The care-leaver was on remand awaiting sentence after pleading guilty to a robbery charge.

The inquest into the baby’s death heard that Cleary’s calls for help when she was in labour were ignored, she was left alone in her cell for 12 hours and bit through the umbilical cord to cut it.

In a devastating witness statement read to the court, Cleary described going into labour alone as “the worst and most terrifying and degrading experience of my life”.

She said: “I didn’t know when I was due to give birth. I was in really serious pain. I went to the buzzer and asked for a nurse or an ambulance twice.” Cleary passed out and when she woke up she had given birth.

The senior coroner for Surrey, Richard Travers, said Aisha “arrived into the world in the most harrowing of circumstances”. He concluded it was “unascertained” whether she was born alive and died shortly after or was stillborn.

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Source: The Guardian, 28 July 2023

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NHS virtual wards available for 10,000 patients by September

The NHS has heralded a “new era” of healthcare that will see hundreds of thousands of patients avoid lengthy hospital stays and instead be treated in their own homes.

From September, 10,000 acutely ill patients will be cared for on “virtual wards”, using remote monitoring technology which automatically transmits data on their condition to teams of doctors and nurses several miles away.

Health chiefs believe the massive expansion of the scheme, which is already the largest in the world, is essential to free hospital capacity — preventing another winter A&E crisis and helping to bring down record waiting lists.

Every NHS region has set up virtual wards for frail over-65s, including dementia patients, as well as for respiratory conditions such as asthma or lung disease. From this month the scheme will be rolled out to cover under-18s, allowing terminally ill children to remain at home surrounded by family.

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Source: The Times, 28 July 2023

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NHS in acute condition: the crisis facing the UK’s hospitals

The prospect of waiting at least six weeks for a biopsy was too much for Neil Perkin. In February, the 56-year-old was told that he had suspected prostate cancer which needed to be confirmed by examining a sample of his tissue.

“After the initial appointment with the consultant, there were no letters, texts or anything,” Perkin said. Instead, he decided to pay for it himself: £5,000 – a substantial sum for the part-time ferry operator. The results from a private hospital in Guildford confirmed the cancer.

“I’d lost faith in the NHS by this point and I went private,” he said. “The cancer was spreading and my surgeon made it clear that if I’d waited for the NHS for my prognosis, [the] chances of cancer recurrence would be far worse.”

In May he paid another £22,500 for the prostate to be removed at a private hospital in London, with financial help from his family. “I feel let down. It turned out from the pathology that this was urgent and a delay would have made a huge difference to my outcome, my prognosis and quality of life. They got there in the nick of time.”

Portsmouth Hospitals University Trust said it was sorry to have been unable to meet Perkin’s expectations and strived to provide quality and timely care. “But we recognise that across the NHS there is an increased demand on services and this can impact patient waiting times.”

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Source: The Guardian, 30 July 2023

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Families caring for dementia patients in UK reaching crisis point, says charity

Soaring numbers of families struggling to care for someone with dementia have hit a “crisis point” with nowhere to turn for help when their loved one puts themselves or others at risk of harm, a charity has said.

More than 700,000 people in the UK look after a relative with dementia. Many feel they can no longer cope with alarming situations where they or their relative are at immediate risk of being harmed, according to Dementia UK.

Dementia can affect a person’s ability to manage their reactions to difficult thoughts and feelings. This can lead to them experiencing such intense states of distress that they become verbally or physically aggressive, putting themselves and those around them at risk of harm.

The charity says carers and their loved ones are being failed because health and social care support services are already stretched to their limit, which has led to a surge in calls to its helpline.

Sheridan Coker, the deputy clinical lead at Dementia UK, said: “We’re increasingly being contacted by families who are at risk of harm with no one to turn to. We receive calls where the person with dementia has become so distressed that they have physically assaulted the person caring for them, often a family member."

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Source: The Guardian, 31 July 2023

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Patients less pleased with GP phone access in all but one ICS

Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. 

GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. 

The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May.

An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice.

“However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.”

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Source: HSJ, 31 July 2023

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Surgeon damaged dozens of patients by misplacing screws in their backs

Every day Sharon Smith has to take a strong morphine tablet to dull the excruciating pain she has lived with for more than a decade. 

“I am in chronic pain every day. It’s affected our whole family and I’ve lost all my independence,” said Smith, from Leigh, Greater Manchester.

Over four years from 2009, she endured three operations on her spine at Salford Royal Hospital, which as an NHS trust was once fêted as England’s safest.

But the hospital had a dark secret: an incompetent leading surgeon who, an independent review would later find, had already “contributed” to the death of a girl in 2007.

Now a wider investigation has confirmed that dozens of other patients who went under John Bradley Williamson’s knife were harmed or received poor care.

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Source: The Times, 30 July 2023

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‘We don’t have the bottle’ to hold line on bed numbers, says trust director

A director at a major acute trust said it needs to stop “caving in” to demand pressures by opening extra escalation beds.

Board members at Mid and South Essex were discussing a recent report from the Care Quality Commission (CQC), which rated medical services as “inadequate”.

The CQC flagged significant staffing shortages and repeated failures to maintain patient records, among other issues.

Deputy chair Alan Tobias told yesterday’s public board meeting: “We have just got to hold the line on these [escalation] beds. We never do. Every year we cave in…

“We have just got to hold the line with this… Do what some other hospitals do, they shut the doors then. We have never had the bottle to do that.”

Barbara Stuttle, another non-executive director, said: “Our staff are exhausted… We don’t have the staff to give the appropriate care to our patients when we have got extra beds. To have extra beds on wards, I know we have had to do it and I know why, [but] you are expecting an already stretched workforce to stretch even further.

“And when that happens, something gives. Record keeping, that’s usually the last thing that gets done because they’d much rather give the care to patients.”

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Source: HSJ, 28 July 2023

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Shropshire patient left to change in hospital corridor 'felt exposed'

A woman treated in a hospital corridor says the lack of privacy was "wholly inappropriate" after other patients saw her without a top.

Isabel Aston was taken to Princess Royal Hospital in Shropshire with pneumonia and sepsis and said she spent seven hours on a bed in a corridor.

She said she felt exposed when other patients saw her changing her clothes.

She explained: "People were walking in both directions [and] there aren't screens around your bed so people wanting the toilet who couldn't get out of bed were faced with the thought of using a bed pan in full view."

She added that on feeling hot at one point, she wanted to change her t-shirt, but the process proved lengthy due to cannulas in her arms.

"I did not have anything on underneath," she said. "I'm 64 years of age, I've probably reached an age where I'm not so self-conscious perhaps, but that could have been a much younger patient.

"That could have been a patient for whom perhaps culturally they couldn't have change their t-shirt... or somebody who had mastectomy scars [and] were very self conscious.

"It is wholly inappropriate for patients to be so exposed when they are so ill."

The hospital trust said it aimed to maintain patients' dignity despite being under operational pressures.

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Source: BBC News, 28 July 2023

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Allergy emergencies double in recent years in England

Dangerous allergic reactions are rising in England and now cause some 25,000 NHS hospital stays a year, according to data gathered by the NHS and analysed by the Medicines and Healthcare products Regulatory Agency.

Health officials say the rate has more than doubled over 20 years, prompting them to issue advice reminding people how to recognise allergies and respond.

For severe food-related allergic reactions, the rise in admissions is even greater.

The figures suggest anaphylaxis is on the increase, though some of the rise could be attributed to the growth in population.

Anaphylaxis can be fatal and develop suddenly at any age.

People who know they are at risk should always carry two adrenaline pens which they, or someone else, can administer in an emergency.

In addition, people at risk of an anaphylactic reaction should regularly check the contents of their adrenaline pens have not expired. They should see a pharmacist to get a new one if a pen is close to expiring.

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Source: BBC News, 28 July 2023

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Alarming decline in vaccine update must be tackled, say MPs

The UK’s status as a global leader on vaccination is at risk because of falling uptake rates among children and an “alarming” decline in clinical trial activity, MPs have warned.

The Health and Social Care Committee said in a report that it was concerned that England did not meet the 95% target for any routine childhood immunisations in 2021-22.1

Committee chair Steve Brine MP said that new spikes in measles cases in London and the West Midlands because of low uptake of MMR vaccines should be a “massive wake-up call” for the government to take action. “Vaccination is the one of the greatest success stories when it comes to preventing infection. Unless the government tackles challenges around declining rates of childhood immunisations and implements reform on clinical trials, however, the UK’s position as a global leader on vaccination risks being lost,” he said.

The Health and Social Care Committee said, “It is unacceptable that there are people who are unable to take advantage of the important protection that vaccination offers because of practical challenges of time and location that can and must be tackled.”

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Source: BMJ, 27 July 2023

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Scottish Covid inquiry start condemned as ‘shambolic and disrespectful’

Bereaved families in Scotland questioned the credibility of the Covid-19 inquiry on its opening day.

Proceedings started with a presentation in Dundee by the public health physician Dr Ashley Croft, who talked about the scientific and medical understanding of the virus as it existed in late 2019 and how it developed up to the end of last year.

Members of the Scottish Covid Bereaved group were said to be “bewildered” by the choice of Croft as first speaker of the inquiry, having previously raised concerns about his being used as an expert witness.

The lawyer Aamer Anwar, who is representing the group, highlighted a High Court judgment that reportedly described Croft as providing “flawed, unreliable” and “unconvincing” evidence and displaying “a cavalier approach to important evidence”.

Pointing out that no respects were paid to the many people who lost their lives during the pandemic during the presentation either, Anwar described the inquiry’s start as “embarrassing” and “deeply disrespectful”.

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Source: The Times, 27 July 2023

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Drug firms funding UK patient groups that lobby for NHS approval of medicines

Drug companies are systematically funding grassroots patient groups that lobby the NHS medicines watchdog to approve the rollout of their drugs, the Observer has revealed.

An investigation by the Observer has found that of 173 drug appraisals conducted by the National Institute for Health and Care Excellence (NICE) since April 2021, 138 involved patient groups that had a financial link to the maker of the drug being assessed, or have since received funding.

Often, the financial interests were not clearly disclosed in NICE transparency documents.

Many of the groups that received the payments went on to make impassioned pleas to England’s medicines watchdog calling for treatments to be approved for diseases and illnesses including cancer, heart disease, migraine and diabetes. Others made submissions appealing NICE decisions when medicines were refused for being too expensive.

In one case, a small heart failure charity that gave evidence to a NICE committee arguing for a drug to be approved received £200,000 from the pharmaceutical company, according to the maker’s spending records.

In another case, a cancer patient group supplied evidence relating to drugs made by 10 companies – from nine of which it had received funding.

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Source: The Guardian, 22 July 2023

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‘Great’ trust seen as ‘insular and dismissive of integration’

A “great” ambulance trust’s “uncompromising” focus on outcomes and its own performance has been a barrier to system working and affected relationships with partners, an external review has advised it.

The report from the Good Governance Institute on West Midlands Ambulance Service University Foundation Trust found partners felt it was “increasingly out of sync with new ways of working under integrated care” and even “somewhat dismissive of the integrated care agenda”.

It praised the trust overall, saying: “WMAS is seen by all those we spoke to as being a great organisation: well run, with strong leadership and a clear focus on operational delivery.

But it said communications, especially through the press, were seen as “bullish and at times damaging to the reputation of partners and harmful to patients”. Its reputation and performance can create a culture of engagement with external partners that “seems defensive at best and arrogant/dismissive at worst”, with the trust being “prickly towards external challenge”, the consultants’ report added.

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Source: HSJ, 27 July

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Blood-inquiry families heckle PM over compensation

Rishi Sunak says the government will wait for the Infected Blood Inquiry's final report before responding to questions around victim compensation.

Bereaved families heckled the prime minister when he told the inquiry the government would act as "quickly as possible".

Mr Sunak told the inquiry people infected and affected by the scandal had "suffered for decades" and he wanted a resolution to "this appalling tragedy".

But although policy work was progressing and the government in a position to move quickly, the work had "not been concluded".

He indicated there was a range of complicated issues to work through.

"If it was a simple matter, no-one would have called for an inquiry," Mr Sunak said.

Campaign group Factor 8 said Mr Sunak had offered "neither new information not commitments" to the victims and bereaved families, which felt "like a betrayal".

Haemophilia Society chief executive Kate Burt said: "This final delay is demeaning, insulting and immensely damaging.

"We urge the prime minister to find the will to do the right thing and finally deliver compensation which recognises the suffering that has been caused."

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Source: BBC News, 26 July 2023

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Health officials took months to investigate surgeon Sam Eljamel

Health officials waited six months to speak to the surgeon Sam Eljamel after a complaint was made about his conduct that eventually led to his suspension.

Eljamel, who was head of neurosurgery at NHS Tayside in Dundee between 1995 and 2013, harmed dozens of patients before being suspended in 2013. 

Even as NHS Tayside commissioned an external review into Eljamel’s conduct, the surgeon was not suspended. Instead, the health board allowed him to continue practising as long as he was monitored. However, a letter sent to Eljamel by NHS Tayside’s clinical director, dated June 21, 2013, reveals that the surgeon was able to negotiate the extent of his own supervision.

It was during this period of supervision that Jules Rose attended Ninewells Hospital to have a brain tumour removed by the surgeon. He performed two surgeries on her, in August and December, and she later discovered that he had removed her tear gland instead of the tumour.

Since then she has founded and run the Patient’s Action Group, representing 126 of Eljamel’s patients calling for a public inquiry into how he was able to harm so many patients at NHS Tayside.

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Source: The Times, 25 July 2023

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Cyber attack takes out two trusts’ records access

Two ambulance trusts have been left without a working electronic patient care record system for a week after a cyber attack affecting its Swedish-based supplier.

Staff at South Western Ambulance Service Foundation Trust and South Central Ambulance Service FT have been working on paper since the MobiMed system – supplied by the firm Ortivus – went down last Tuesday. More than 1,700 ambulances and clinical workstations use the system, according to the company.

One employee told HSJ some staff were struggling with a paper-based system which meant they had less information on patients.

”We can’t do summary care record searches or see previous call information,” the staff member said. SWASFT sent a message to staff on Friday saying the system was likely to be down “for a prolonged period”.

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Source: HSJ, 25 July 2023

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Government backs reduction in police response to mental health incidents despite safety warnings

Ministers are backing a potentially “dangerous” new model allowing police to reduce their response to mental health incidents after failing to formally assess the risk of harm or death.

Officials are monitoring any “adverse incomes” from the National Partnership Agreement, which will see police forces stop attending health calls unless there is a safety risk or a crime being committed.

Policing minister Chris Philp said a pilot by Humberside Police gave him confidence in national roll-out, which aims to “make sure that people suffering mental health crisis get a health response and not a police response”.

Mental health charities and experts have warned the plans could be “dangerous”, and a coroner raised the alarm following a woman’s suicide after police failed to respond to her disappearance.

A report published last month said action was needed to prevent future deaths, warning that the new model could “allow each agency to regard such a situation as the other’s responsibility, whilst nobody is on the ground attempting to retrieve a seriously ill patient”.

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Source: The Independent, 26 July 2023

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CQC names worst trusts for experience in A&E

The Care Quality Commission has named the trusts which have performed ‘worse than expected’ on patient experience in urgent and emergency care.

Data from the CQC survey of more than 36,000 people who used urgent and emergency care services in September 2022 shows a total of 10 trusts performed poorly on patients’ overall experience.

Patients reported longer wait times, while only around half felt staff “definitely” did everything they could to help control their pain in the latest survey.

Sean O’Kelly, the CQC’s chief inspector of healthcare, said it “remains extremely concerning that for some people care is falling short”.

“These latest survey responses demonstrate how escalating demand for urgent and emergency care is both impacting on patients’ experience and increasing staff pressures to unsustainable levels."

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Source: HSJ, 26 July 2023

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Faulty concrete fears at 250 NHS Scotland sites

More than 250 NHS buildings in Scotland could contain a potentially dangerous type of concrete that can collapse without warning.

NHS Scotland issued a Safety Action Notice in February and completed a "desktop survey" of its estate in June.

Reinforced autoclaved aerated concrete (RAAC) was used to build roofs, walls and floors from the 1960s to the 1990s.

NHS Scotland has warned the material is potentially vulnerable to "catastrophic failure without warning".

But a Scottish government spokesperson said there was "no evidence to suggest that these buildings are not safe."

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Source: BBC News, 25 July 2023

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Sciensus’s licence partly suspended after death of cancer patient

Britain’s health regulator has partly suspended the manufacturing licence of Sciensus, a private company paid millions by the NHS to provide vital medicines, after the death of a cancer patient who was given the wrong dose of chemotherapy.

The Medicines and Healthcare products Regulatory Agency (MHRA) said it had taken “immediate” action under regulation 28 of the Human Medicines Regulations 2012 law “where it appears to the MHRA that in the interests of safety the licence should be suspended”.

The MHRA found “significant deficiencies” in standards at Sciensus during an investigation triggered by the death of one patient and the hospitalisation of three others. 

All four patients were administered “incorrect” doses of an unlicensed version of cabazitaxel, a licensed chemotherapy used to treat prostate cancer, according to people familiar with the matter.

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Source: The Guardian, 25 July 2023

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Surgeon who exposed safety failings ‘driven out of NHS’ after 43 years

An award-winning hospital consultant says he has been “hunted” out of the NHS after 43 years for flagging patient safety failings.

Peter Duffy, 61, performed his final surgical procedure, supervising a bladder cancer removal, earlier this month at Noble’s Hospital on the Isle of Man.

He said he had “been looking forward to a good few more years of full-time work — another five, at least”. But the cumulative toll of a long-running whistleblowing dispute with his former employer, Morecambe Bay NHS Trust (UHMBT), instead pushed him into “an abrupt, even savage termination of my calling”.

The General Medical Council watchdog recently dropped a 30-month probe into Duffy prompted by emails that he alleges were falsified. The emails, which were apparently sent by Duffy in December 2014 but did not surface until 2020, appeared to implicate him in the string of clinical errors that led to the death of Peter Read, a 76-year-old man from Morecambe.

The GMC concluded that it could not attach weight to the emails as evidence. However, Duffy says the ordeal of “having the responsibility for an avoidable death I’d reported being flipped and of having the finger pointed back at me” drove him to contemplate suicide.

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Source: The Times, 24 July 2023

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Bisexual people ‘experience worse health outcomes than other adults’

Bisexual people experience worse health outcomes than other adults in England, a study has found.

Data from lesbian, gay or bisexual (LGB) patients indicates these groups have poorer health outcomes compared to those who identify as heterosexual.

The new findings indicate that bisexual people face additional health disparities within an already marginalised community.

Experts from the Brighton and Sussex Medical School, and Anglia Ruskin University who led the analysis of more than 835,000 adults in England, suggest the differences could result from unique prejudice and discrimination that can come from both mainstream society and LGBTQ+ communities.

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Source: The Independent, 25 July 2023

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NHS trust to review all suicides since 2017

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

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

It comes after the trust was accused of adding to the records of Charles Ndhlovu, 33, the day after he took his own life to "correct their mistakes".

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

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

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Source: BBC News, 25 July 2023

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Ministers reject Hunt’s plans for general practice

The Government has rejected several policy proposals to promote “continuity of care” in general practice which were put forward by Jeremy Hunt. 

The now chancellor championed significant policy changes to strengthen the link between patients and an individual, named GP, when he was Commons health and social care committee chair.

However, the government’s response to the report rejects several of the key proposals.

The committee under Jeremy Hunt said “NHS England should champion the personal list model” – under which each patient is linked to a particular GP – “rather than dismiss it as unachievable”.

The Department of Health and Social Care response said: “The department does not accept this recommendation. We agree that continuity of care is important within general practice but do not agree that requiring a return to the personal list model is the correct approach.

Government also rejected recommendations from Mr Hunt’s committee to introduce a new national measure to track continuity of care by practice; and to fund primary care networks to appoint a GP “continuity lead” for a session a week.

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Source: HSJ, 24 July 2023

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Two-thirds of people administering cosmetic surgery injections are not qualified medical doctors, survey finds

More than two-thirds of people who are administering cosmetic surgery injections such as Botox in the UK are not qualified medical doctors, a new study suggests.

The study is the first survey of who is providing cosmetic injectable services, including botulinum toxin (Botox) and dermal fillers, in the country.

Dr David Zargaran, UCL Plastic Surgery, an author of the study, said: “There are well-documented, yet to-date unaddressed challenges in the UK cosmetic injectables market.

“Without knowledge of the professional backgrounds of practitioners, we cannot adequately regulate the industry.

“Our research highlights that the majority of practitioners are not doctors and include other healthcare professionals, as well as non-healthcare professionals such as beauticians.

“The range of backgrounds opens a broader question relating to competence and consent.

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Source: The Independent, 24 July 2023

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