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USA: Surgery becoming safer in hospitals

Between 2019 and 2024, the mortality risk for hospitalised surgical patients declined nearly 20%, according to an analysis from Vizient and the American Hospital Association. 

Several factors contributed to this improvement in surgical outcomes. Between the first quarter of 2019 and the fourth quarter of 2024, post-operative sepsis declined 9.2%, post-operative respiratory failure by 19% and post-operative hemorrhage by 22.3%. 

The findings come at a time when acuity is projected to continue rising for hospitalized surgery patients, according to Sg2, a Vizient company. 

Infections and falls also decreased between 2019 and 2024, according to the report, which draws from Vizient’s database of more than 1,300 hospitals. The analysis focuses on 713 general, acute care hospitals across the U.S.

Among hospitalised surgical patients, vascular catheter-associated infections fell 9.2%, catheter-associated urinary tract infections decreased 6.6% and falls declined 10.7%. 

“While hospitals are proud of these efforts, we know there is always more work to do to deliver the highest quality care possible,” Rick Pollack, AHA president and CEO, said in a statement.

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Source: Becker's Hospital Review, 6 August 2025

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As my daughter died of ME, the state met in secret to blame me

In the final weeks of Maeve Boothby O’Neill’s life, her mother tried frantically to get her the palliative care that might make her death more comfortable. Maeve was in pain, too weak to chew, and dying of malnutrition from severe myalgic encephalomyelitis (ME).

Sarah Boothby had no idea that at the same time as she begged for help for her daughter, the people she was turning to were holding secret safeguarding meetings, discussing the possibility that Maeve’s condition was in fact caused or fabricated by her — and proposing Maeve’s forcible removal from her care.

Maeve was 27 when she died in October 2021 in the Exeter flat she shared with Boothby. She had discharged herself from hospital because, with no cure or viable treatment, she wanted to die at home.

Boothby and Maeve’s father, the Times journalist Sean O’Neill, knew from bitter experience that there was scant medical support available for ME. But they could not understand why it was so hard to get their daughter the help she needed for a more bearable death.

It was only when council documents were disclosed before Maeve’s inquest last year that they finally got answers.

Safeguarding records for the final year of Maeve’s life show social workers, nurses and a mental health assessor, instead of focusing on managing Maeve’s ME, were investigating concerns about Boothby. That year there were seven safeguarding meetings that neither Maeve, nor her parents, were invited to.

Boothby contacted The Sunday Times after an investigation last month found that hundreds of parents, mostly mothers, are being falsely accused of fabricating or inducing their child’s illness, and facing allegations of abuse when they seek medical care for them.

The ME Association says parents of children with ME or long Covid are “a sitting duck” for allegations of “fabricated or induced illness” (FII, of which FDIA is the most extreme example) because the condition is so poorly understood and it is challenging to get a diagnosis.

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Source: The Times, 10 August 2025

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Scots urged to show Yellow Card to meds side effects

People in Scotland are being encouraged to take part in a national scheme tracking the side effects from taking prescribed medication.

Healthcare Improvement Scotland has made the plea after finding 57% of people surveyed across the country have experienced adverse effects from medicines.

The report, based on survey findings of more than 560 people across Scotland, found 84% of those who had experienced unintended effects from medicines had spoken to a healthcare professional, but only 10% reported it themselves to the national Yellow Card scheme.

It recommends raising awareness of the Yellow Card scheme – run by medicines regulator the Medicines and Healthcare products Regulatory Agency (MHRA) – to improve under-reporting of medicines’ side effects and help new safety issues be identified as early as possible.

The report also recommends NHS Scotland improve the way it uses data from the Yellow Card Scheme to take action to improve medicines safety.

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Source: Health and Care Scotland, 8 August 2025

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

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

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

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

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

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

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

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Source: HSJ, 11 August 2025

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Lucy Letby’s hospital slammed for A&E failings over ‘unsafe’ corridor care that left elderly patients delirious

Lucy Letby’s hospital trust has been slammed for a string of emergency care failings, including unsafe corridor care that led to elderly patients developing delirium.

The Countess of Chester Hosptial, where Lucy Letby worked and was convicted of murdering seven babies and attempting to murder seven others, was criticised by the Care Quality Commission (CQC) over delays in the care of sepsis patients, as well as elderly patients who were left for so long that they developed “corridor-induced delirium”.

The hospital was also criticised for having “visibly dirty equipment” and out-of-date medical devices, including some with damaged wires hanging out.

The watchdog has handed the trust a formal warning notice over the failures identified after the CQC’s inspection in February 2025. Concerns included:

  • Mental health patients being left with staff who were sleeping or on their phones.
  • Patients with fractured hips are forced to sit in wheelchairs when they should have had beds.
  • Inspectors found 59 incidents of delays to providing sepsis treatment, 44 of which were because the trust failed to take patients from ambulances quickly enough.
  • Evidence that “long stays on the corridor” and the deterioration of patients because of this was “normalised”.

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Source: The Independent, 8 August 2025

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Experts warn against DIY Botox-like injections available illegally online

People seeking cheap Botox-like injections have been warned by experts against doing it themselves due to the risk of “eyelid droops”, infection and even botulism.

There are growing concerns over the availability of medication called Innotox that is being sold illegally online in the UK. Unlike Botox, which comes as a powder that must be reconstituted for use in an injection, Innotox is a ready-to-use liquid – making it easier to self-administer.

Wes Streeting, the health secretary, announced plans this week to introduce legislation cracking down on England’s cosmetic “wild west”, where there is scant regulation of who can deliver treatments such as dermatological filler and Botox.

Experts say Innotox is not licensed for use in the UK, unlike some other liquid Botox-like injections, meaning its quality and safety has not been assessed.

Aenone Harper-Machin, a consultant plastic surgeon and spokesperson for the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), said the online availability of Innotox was frightening and appalling, and she cautioned against DIY jabs.

“People could be giving themselves eyelid droops and all sorts of weird asymmetries by injecting it in the wrong place, too deeply, too superficially. You can inject it into your blood vessel and give yourself botulism,” she said.

Health officials have said 41 recent cases of botulism poisoning in England have been linked to unlicensed jabs.

Harper-Machin has had Botox-like injections but said she would not self-administer them. “I wouldn’t have it done by anybody other than a consultant plastic surgeon who has intimate knowledge of facial anatomy,” she said.

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Source: The Guardian, 10 August 2025

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AI tools used by English councils downplay women’s health issues, study finds

Artificial intelligence tools used by more than half of England’s councils are downplaying women’s physical and mental health issues and risk creating gender bias in care decisions, research has found.

The study found that when using Google’s AI tool “Gemma” to generate and summarise the same case notes, language such as “disabled”, “unable” and “complex” appeared significantly more often in descriptions of men than women.

The study, by the London School of Economics and Political Science (LSE), also found that similar care needs in women were more likely to be omitted or described in less serious terms.

Dr Sam Rickman, the lead author of the report and a researcher in LSE’s Care Policy and Evaluation Centre, said AI could result in “unequal care provision for women”.

“We know these models are being used very widely and what’s concerning is that we found very meaningful differences between measures of bias in different models,” he said. “Google’s model, in particular, downplays women’s physical and mental health needs in comparison to men’s.

“And because the amount of care you get is determined on the basis of perceived need, this could result in women receiving less care if biased models are used in practice. But we don’t actually know which models are being used at the moment.”

AI tools are increasingly being used by local authorities to ease the workload of overstretched social workers, although there is little information about which specific AI models are being used, how frequently and what impact this has on decision-making.

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Source: The Guardian, 11 August 2025

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Trump, pharma industry discuss boosting medicine spending abroad to cut US prices, sources say

The Trump administration has been talking to pharmaceutical companies about ways to raise prices of medicines in Europe and elsewhere in order to cut medication costs in the United States, according to a White House official and three pharmaceutical industry sources.

US officials told drug companies it would support their international negotiations with governments if they adopt "most favored nation" pricing under which US drug costs match the lower rates offered to other wealthy countries, the White House official said.

The US is currently negotiating bilateral trade deals and setting tariff rates on the sector.

The Trump administration has asked some companies for ideas on raising prices abroad, two of the sources said, describing multiple meetings over several months aimed at lowering US prices without triggering cuts to research and development spending pharmaceutical companies insist would result.

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Source: Reuters, 7 August 2025

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Over-the-counter health test results accessible via the NHS App

Patients are now able to view the results of at-home blood and DNA tests from MyHealthChecked on the NHS App, through an integration with Patients Know Best (PKB). 

PKB is a personal health record which integrates data sources from NHS and non-NHS health providers as well as devices and information from patients.

The integration with over-the-counter test provider MyHealthChecked, which went live on 25 July 2025, also allows patients to securely share their test results with healthcare professionals. 

The service is available for customers wherever PKB is live with the NHS App, which includes 22 integrated care systems in England, and Swansea Bay University Health Board in Wales.

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Source: Digital Health, 8 August 2025

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AI chatbots ‘highly vulnerable’ to repeating false medical information, experts warn

AI chatbots are frequently prone to repeating false and misleading medical information, according to new research.

Experts have warned of a “critical need” for stronger safeguards before the bots can be used in healthcare, adding models not only repeated untrue claims but also “confidently” expanded on them to create explanations for non-existent medical conditions.

The team from the Mount Sinai School of Medicine created fictional patient scenarios, each containing one fabricated medical terms such as a made-up disease, symptom, or test, and submitted them to leading large language models. In a study published in journal Communications Medicine, they said that the chatbots “routinely” expanded on the fake medical detail, giving a “detailed, decisive response based entirely on fiction”.

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Source: The Independent, 7 August 2025

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A walk-in fishermen's clinic saved Tom from sepsis - and could transform the NHS

Tom Parker was working alone three miles (4.8km) off the Devon coast when his fishing boat hit a wave and lurched to one side.

He didn't know it at the time, but Tom, 37, had broken his fibula and badly damaged his ankle ligaments. He somehow hauled in his fishing gear and made it to hospital to get patched up, but months after the accident his wound just wouldn't heal properly.

It was only after he turned up at an innovative clinic on the quayside in Brixham that he was put on strong antibiotics and told he needed a second operation.

"Without that service, I would have probably ended up with my leg turning septic and I'm not too sure what would have happened after that," he says.

Under the 10 Year Health Plan, published last month, health officials said the NHS in England needed to undergo a radical shift, away from hospitals to community care, and away from treating sickness to preventing it in the first place.

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Source: BBC News, 8 August 2025

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A massive US measles outbreak has slowed but the start of the school year brings renewed risk of spread

There have been more measles cases reported in the US in the past month – at least 89 confirmed cases since the start of July – than in most years since the disease was declared eliminated a quarter century ago, according to data from the US Centers for Disease Control and Prevention.

And this year’s total – 1,356 confirmed cases since January – is higher than it’s been in more than 30 years. There have been 32 outbreaks this year, accounting for nearly 90% of all cases since January. Only 10 states remain at zero cases reported this year.

Experts say that declining childhood vaccination rates across the US coupled with ongoing spread of measles in the US – and large outbreaks in neighbouring Canada and Mexico – are raising concerns as children start to gather for the new school year.

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Source: CNN, 6 August 2025

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Nearly half of doctors in Scotland witness care failings every week

A General Medical Council survey has found that 46 per cent of clinicians in Scotland see care failings weekly, a higher proportion than elsewhere in the UK.

The survey showed a reduction in the number of doctors noting safety incidents weekly in England, Wales and Northern Ireland since 2023 — but an increase in Scotland.

Backlogs in accident and emergency departments, resulting in thousands of patients stuck on trolleys for hours queueing for beds, are thought to be one of the issues driving potential errors.

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Source: The Times, 7 August 2025

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Patients whose lives were ruined after being ‘needlessly given cancer drug for years’ sue NHS trust

More than 20 patients who say their quality of life was wrecked when they were needlessly given a highly toxic cancer drug are suing the NHS trust involved.

Some people were prescribed temozolomide – which should normally be used for only six months – for more than a decade during treatment by the University Hospitals Coventry and Warwickshire NHS Trust.

They say the overprescribing left them with side-effects including secondary cancers and crippling fatigue.

Earlier this year the Care Quality Commission was looking into at least 14 cases, but lawyers say more are emerging all the time. An investigation by lawyers Brabners found that, over the past two decades, numerous patients with brain and spinal tumours under the care of Professor Ian Brown were routinely exposed to prolonged and in some cases “unnecessary” use of the chemotherapy drug, which has severe side-effects including extreme fatigue, confusion, sickness and seizures.

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Source: The Independent, 6 August 2025

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UK warned it risks exodus of 'disillusioned' doctors

Nearly one in five doctors is considering quitting in the UK, new figures show, while one in eight is thinking about leaving the country to work abroad.

The General Medical Council (GMC), which commissioned the research, is warning that plans to cut hospital waiting lists will be at risk unless more is done to retain them.

The main reason doctors gave for considering moving abroad was they are "treated better" in other countries, while the second most common reason was better pay.

Some 43% said they had researched career opportunities in other countries, while 15% reported taking "hard steps" towards moving abroad, like applying for roles or contacting recruiters.

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Source: Sky News, 7 August 2025

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Crackdown on unsafe cosmetic procedures to protect the public

New measures to crack down on cowboy cosmetic procedures that have left people maimed, injured and in need of urgent NHS care will be introduced by the UK Government.  

Only qualified healthcare professionals will be able to perform the highest risk procedures – such as non-surgical Brazilian Butt Lifts. 

Other lower risk cosmetic treatments - including Botox, lip fillers and facial dermal fillers - will also come under stricter oversight through a new local authority licensing system. Practitioners will be required to meet rigorous safety, training, and insurance standards before they can legally operate.  Once regulations are introduced, practitioners who break the rules on the highest risk procedures will be subject to CQC enforcement and financial penalties.

The planned crackdown follows a series of incidents where people have had high-risk treatments from people with little or no medical training, leading to dangerous complications, permanent scarring and even death. These new rules will seek to protect people from unqualified, rogue operators and reduce the cost to the NHS of fixing botched procedures.  This follows growing alarm over unqualified individuals performing invasive treatments in unsafe environments—including homes, hotels, and pop-up clinics. Many of these procedures are marketed as non-surgical but, in reality, are invasive and carry serious risks.  

The new regulations will be subject to public consultation and parliamentary scrutiny before they are introduced.  

Read the full press release.

Source: Department of Health and Social Care, 7 August 2025

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Surgeon struck off after patients left in agony

A surgeon who performed unnecessary bowel operations using artificial mesh on more than 200 patients - leaving dozens in agony - has been struck off.

In two separate tribunals, Tony Dixon was found to have performed operations on five patients without obtaining or documenting informed consent and that one of these procedures was not clinically indicated and that he failed to provide post operative care.

Mr Dixon denied the allegations at the two tribunals, in 2024 and this year.

The Medical Practitioners Tribunal Service ordered for Dixon to be removed from the medical register. The tribunal report said he "demonstrated a persistent lack of insight into the seriousness of his actions".

This was the case "not only for patients and colleagues, but also for public confidence in the medical profession", it said.

Mr Dixon, a fully registered doctor of 41 years, was also found to have dishonestly created patient records long after he was involved in their care.

A former patient of Dixon, who was found to have had an unnecessary operation but wishes to remain anonymous, said they were "delighted" with the outcome.

"It's been just such a long time, he's harmed so many people.

"He shouldn't be allowed to do it to anyone else, so being struck off is amazing.

"It should have happened a long time ago. To get that result is brilliant."

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Source: BBC News, 6 August 2025

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AI catches one-third of interval breast cancers missed at screening

An AI algorithm for breast cancer screening has potential to enhance the performance of digital breast tomosynthesis (DBT), reducing interval cancers by up to one-third, according to a study published in Radiology, a journal of the Radiological Society of North America (RSNA).

Interval breast cancers - symptomatic cancers diagnosed within a period between regular screening mammography exams - tend to have poorer outcomes due to their more aggressive biology and rapid growth. DBT, or 3D mammography, can improve visualization of breast lesions and reveal cancers that may be obscured by dense tissue. Because DBT is relatively new as an advanced screening technology, long-term data on patient outcomes are limited in institutions that have not transitioned to DBT until recently.

"Given the lack of long-term data on breast cancer-related mortality measured over 10 or more years following the initiation of DBT screening, the interval cancer rate was often used as a surrogate marker," explained study author Manisha Bahl, M.D., M.P.H., breast imaging division quality director and co-service chief at Massachusetts General Hospital and associate professor at Harvard Medical School. "Lowering this rate is assumed to reduce breast cancer-related morbidity and mortality."

In a study of 1,376 cases, Dr. Bahl and her colleagues retrospectively analysed 224 interval cancers in 224 women who had undergone DBT screening. On those DBT exams, the AI algorithm (Lunit INSIGHT DBT v1.1.0.0) correctly localized 32.6% (73/224) of cancers that were previously undetected.

"My team and I were surprised to find that nearly one-third of interval cancers were detected and correctly localized by the AI algorithm on screening mammograms that had been interpreted as negative by radiologists, highlighting AI’s potential as a valuable second reader," Dr. Bahl said.

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Source: Digital Health News, 1 August 2025

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‘Unjust’ NHS ethnic pay gap to be reviewed

A long-awaited review into “unjust and unfair” pay disparities between white and minority ethnic staff across the NHS has been launched. 

The NHS Race and Health Observatory has commissioned the first-ever study of the issue. The project will be carried out in partnership with the University of Surrey.

It will examine differences in pay, career progression, and pension contributions - as well as the potential impact on cumulative financial earnings - between staff from different ethnic backgrounds.

The review will also explore the potential explanations for any differences and make recommendations to “reduce and eliminate unwarranted inequalities where they are found to exist”, the RHO has said.

The final report is due in December 2026.

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Source: HSJ, 6 August 2025

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Thousands of patients miss out on weight loss jab due to NHS ‘postcode lottery’

Thousands of obese patients are missing out on a key weight loss jab due to a “postcode lottery” of provision in the NHS, according to a report.

Mounjaro, dubbed the “King Kong” of weight loss medicine, was supposed to be available through GP surgeries from 23 June under an agreement between NHS England and NICE.

But just eight out of 42 NHS Integrated Care Boards (ICBs) in England were able to provide treatment to patients, according to Sky News, who obtained the data using a Freedom of Information request. Many other ICBs were reportedly unable to confirm when treatment would be available.

Dr Jonathan Hazlehurst, an endocrinologist and obesity physician at University Hospitals Birmingham, said patients were “set up for failure” and have been treated unfairly.

"Giving people open promises and setting them up for disappointment and failure is clearly grossly unfair. That's what the current system is doing,” he told the broadcaster.

NICE said in December that the NHS should offer Mounjaro to patients with a BMI of over 40 and at least four clinical conditions related to their weight, such as heart disease or type 2 diabetes.

It calculated from NHS England data that there were 97,500 patients who should be treated in the first year.

But Dr Hazlehurst claims NHS England has only provided funding for just over 22,000 patients.

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Source: The Independent, 5 August 2025

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NHS issues vaccination warning for pregnant women over dangerous virus currently surging in Australia

Expectant mothers and people over 75 are being urged to get vaccinated against a potentially deadly virus following a record number of cases in Australia.

Health chiefs say the Australian winter often predicts how viruses will spread in the UK, and already this year cases of respiratory syncytial virus (RSV) have steadily risen in many areas.

The virus, which is a common cause of coughs and colds, may also cause a chest infection called bronchiolitis.

Some people have a high risk of becoming seriously ill with it, including babies and adults over 75.

According to NHS England, RSV is a leading cause of infant deaths worldwide and a main cause of children being taken into hospital.

NHS England is encouraging pregnant women to get a jab that protects against RSV so their babies are protected after birth.

Kate Brintworth, chief midwifery officer for NHS England, said: “While for most adults RSV only causes mild, cold-like symptoms, for older adults and young children it can lead to serious breathing problems that can end up in hospitalisation.

“Getting vaccinated while pregnant is the best way to protect your baby from the moment they are born, and now is the time for mums to act, to make sure their babies are protected ahead of their first few months this winter, when there tends to be more bugs circulating.”

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Source: The Independent, 5 August 2025

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Suicidal teen warned mental health hospital staff ‘slept on shifts’ and urged ‘shut this place down’

A suicidal teenager revealed that staff “slept on shifts” and said the scandal-hit mental health hospital she was being held in should be “shut down” in a note she wrote before her death, an inquest has heard.

Ruth Szymankiewicz, 14, died on 14 February 2022 after she was left alone at Huntercombe Hospital, near Maidenhead in Berkshire, despite requiring constant one-to-one observation, Buckinghamshire Coroner’s Court was told.

In the 15 minutes she was left alone, Ruth, who had an eating disorder, made her way to her room, where she self-harmed. She was found and resuscitated before being transferred to hospital, but died two days later from a brain injury.

In a note written before she died, which was read aloud on Tuesday at the inquest into her death, Ruth said there was a lack of therapy at the hospital, which she said had an “unsafe number of staff”.

On Monday, the court heard that the support worker responsible for monitoring Ruth was working under a false identity and had completed just a day or a day and a half of online training the day before his first shift at the children’s psychiatric hospital.

Evidence presented at the inquest also revealed that on the day of Ruth’s death, he was working on another ward in the hospital, but had been assigned to Ruth as Thames Ward, where she was being cared for, was short-staffed.

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Source: The Independent, 5 August 2025

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Schools and hospitals ‘very likely’ to be hacked

Britain’s schools and hospitals are “very likely” to suffer a “large-scale loss or hijack” of their websites, the government has admitted.

Officials have said that the internet domains of public sector websites are particularly vulnerable to being exploited by “hostile actors”.

A hack could lead to a “significant loss of information and reputation”, officials concluded.

The Department for Science, Innovation and Technology (DSIT) also said it was “likely” not to be prepared for a significant cyberattack that could “potentially contribute to a national crisis”.

The NHS has faced a series of damaging cyberattacks. Last year, doctors at two big hospital trusts in London were forced to cancel all elective inpatient procedures and admissions after a lab that processes pathology tests was hacked.

Richard Horne, the chief executive of the National Cyber Security Centre, wrote in a letter to The Times in May that organisations “must operate in a way that minimises the risks”, adding that freely available advice is “not being followed nearly enough across the UK”.

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Source: The Times, 3 August 2025

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We will no longer tolerate ‘negative behaviours’, pledges ICB

An integrated care board has apologised to staff and pledged to no longer tolerate a range of “negative behaviours” identified by a report into the organisation’s culture. 

The report into management behaviour at Kent and Medway ICB, obtained by HSJ, reveals staff were reluctant to speak up due to the “perceived futility or fear of consequences”. Executives were perceived as “defensive, remote, and closed-off” by staff, while poor behaviour often remained “unaddressed” or was met with “a lack of action”.

The report added this had led to “colleagues avoiding direct challenge and relying on processes such as the [Freedom to Speak Up] Guardian, even when these methods are not appropriate or best suited to addressing these issues”. 

The ICB commissioned consultancies Kaleidoscope Health and Care and Absolute Diversity to conduct a joint review last November, following concerns expressed in internal staff surveys and FTSU Guardian reports. These included “differential and poorer” work experience for staff with a protected characteristic and low morale.

The report identified “a number of significant and widespread cultural challenges”. These included:

  • A “loss of civility” in parts of the organisation, particularly between some staff and executives;
  • Senior leaders of band 8 and above felt “disempowered, deskilled and devalued by executives, with excessive decision escalation and micromanagement hindering their ability”; and
  • Executive team members “publicly disagreed with and undermined collective decisions”, leading to inconsistent briefing of teams on executive decisions.

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Source: HSJ, 5 August 2025

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‘Growing cultural tension’ could turn hospital’s staff against leaders

A hospital has uncovered concerns about “toxic behaviours” and racism, and been warned that “growing cultural tension” could turn “staff against each other or against leadership”.

The review was ordered by Medway Foundation Trust after it identified concerns about culture and potential racism and bias. Staff at Medway Maritime Hospital also reported increasing violence and aggression from patients and relatives.

The resulting report – by a company called Absolute Diversity – details concerns around bullying, toxic behaviour and discrimination. It also found some signs of hope, however, with a sense of pride among staff and a commitment to patient care.

It called on the trust to make it safe to speak up, review staff experience of employee relations processes, and increase leadership accountability and clarity with “clear expectations for leadership behaviours”.

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Source: HSJ, 5 September 2025

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