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Legal right to visit patients proposed by government

The government has proposed new legislation to make patient visiting a legal right and also give the Care Quality Commission (CQC) fresh powers to enforce it.

The Department of Health and Social Care has launched a consultation to seek views from patients, care home residents, families, professionals and providers on the introduction of new legislation which will require health and care settings, including hospitals, to accommodate visitors in most circumstances. 

It said the new visiting laws will also provide the CQC with a “clearer basis for identifying where hospitals and care homes are not meeting the required standard”, and enable it to enforce the standards by issuing requirement or warning notices, imposing conditions, suspending a registration or cancelling a registration.

It said although the CQC currently has powers “to clamp down on unethical visiting restrictions”, the expected standard of visiting rules is not “specifically outlined in regulations”.

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Source: HSJ, 21 June 2023

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Warning of suicide risk side effect over common NHS antibiotic after doctor's death

A warning has been made over the possible side effects of a common NHS antibiotic by a coroner after a newly retired senior doctor died by suicide.

"Respected and experienced" consultant cardiologist Robert Stevenson had no history of depression or mental health problems before he started a course of ciprofloxacin.

But just over a week later, the 63-year-old went for a walk and messaged his wife to tell her he had left a note under his pillow.

He was later found dead in a nearby wood.

The note he had left was said to be "uncharacteristically confused and illogical" with "baseless concerns" that he might have AIDS after taking an online HIV tester kit, an inquest heard.

The hearing was told Dr Stevenson hadn't been told about a "potential rare link" to suicidal behaviour in patients who took the drug, as this wasn't in line with medical guidance.

Now, coroner Martin Fleming issued a warning to highlight the risk of taking the antibiotic, which is prescribed by the health service for serious conditions.

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Source: The Mirror, 20 June 2023

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Children to be given single HPV jab instead of two doses

The human papillomavirus (HPV) vaccination given in schools – which is helping to virtually eliminate cervical cancer – will move to a single dose from September, it has been announced.

The UK Health Security Agency (UKHSA) said the change in England follows advice from the Joint Committee on Vaccination and Immunisation (JCVI) and World Health Organisation scientists that a single dose “delivers robust protection” against HPV when compared with the two doses given at present.

The HPV vaccine programme is offered to all children in school Year 8, when they are aged 12 to 13.

Dr Vanessa Saliba, immunisation consultant epidemiologist at the UKHSA, said: “The HPV vaccination programme is one of the most successful in the world and has dramatically lowered the rates of cervical cancer and harmful infections in both women and men – preventing many cancers and saving lives.

“The latest evidence shows that one dose provides protection as robust as two doses. This is excellent news for young people."

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Source: The Independent, 20 June 2023

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More than 5,000 mental health patients sent over 62 miles for treatment

More than 5,000 mental health patients have been sent at least 62 miles from home for treatment in the two years since ministers pledged to banish the “dangerous” practice.

The disclosure prompted calls for the “scandal” of out of area placements in mental health care to end, with claims that it represents “another broken government promise on the NHS”.

Chronic shortages of mental health beds have for years forced the health service in England to send hundreds of patients a month to be admitted for care, sometimes a long way from their own area.

Mental health campaigners, psychiatrists and patients’ families have argued that being far from home can make already vulnerable patients feel isolated, deprive them of regular visits from relatives, increase the risk of self-harm and reduce their chances of making a recovery.

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Source: The Guardian, 21 June 2023

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Fresh review into ‘doctors being bullied with regulatory referrals’

Investigators have begun a further review of how a major trust handles disciplinary and professional standards cases, including allegations leaders had targeted some doctors with referrals to the medical regulator, HSJ has learned.

The claims were part of a raft of concerns raised about University Hospitals Birmingham Foundation Trust over recent months, including BBC Newsnight reporting that a large number of General Medical Council referrals had led to no action; and claims of whistleblowing doctors “being bullied… by the threat of referrals to the GMC”.

One external review of UHB, whose report was published in March, already examined the issue, and said it had identified 17 cases which contradicted Newsnight’s claim, with two referrals resulting in criminal conviction and removal from the medical register.

It said there was “nothing exceptional” about the referral numbers or types at UHB, or their outcomes, but also noted that medical staff told the review about “dysfunctional processes for maintaining higher professional standards”, and “expressed a perception that there was a rather rapid process to escalate to a GMC referral”.

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Source: HSJ, 21 June 2023

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As a black man I wasn't included in cancer stats

What started as a shoulder ache led to a whirlwind diagnosis of stage four cancer and a rare genetic mutation for Spike Elliott.

But his journey also highlighted a worrying ethnicity data gap in our health system.

It comes as research by one charity shows just how few patient records include ethnicity information in Wales.

The Welsh government said it was working to improve the diversity of data collection and health research.

One oncologist said it meant assumptions were made about how patients will respond, despite there being "clear differences" in how certain cancers affect different racial groups.

"I was given a life expectancy of 6 to 12 months. That was statistically supported.

"But I was alarmed when I was made aware that the statistics don't include the BAME (Black, Asian and Minority Ethnic) community.

"Because what was my outcome then?"

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Source: BBC News, 21 June 2023

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Sharp rise in teenage girls with eating disorders during Covid

GP records show a sharp rise in teenage girls in the UK developing eating disorders and self-harming during the Covid pandemic, a study has found.

The increases were greatest among girls living in the wealthiest areas, which could be due to better GP access.

Young women have told the BBC that the lack of control over their lives during lockdown was a behavioural trigger.

Eating disorders and self-harming have been rising among children and young people for a number of years but "increased substantially" between 2020 and 2022, the study found.

Over that period, around 2,700 diagnoses of eating disorders were anticipated among 13-16-year-olds, but 3,862 were actually observed - 42% more than the expected figure.

Dr Shruti Garg, from the University of Manchester - a child and adolescent psychiatrist and the study author - called it a "staggering rise" which highlighted an urgent need to improve early access to support.

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Source: BBC News, 21 June 2023

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Wheelchair waiting times England: disabled people ‘denied fundamental right’ as thousands wait months for NHS chairs

Thousands of disabled adults and children, including those with the highest and most complex needs, are having to wait more than four months for an NHS wheelchair, official health figures show.

In one part of the country more than two-thirds of patients referred to the wheelchair service face waits of more than 18 weeks, or roughly four months, to get the help they need. Besides preventing them from getting around independently, and the mental health problems that can come from the resulting social isolation, a leading disability charity says disabled people can also be left with physical pain if forced to use poorly fitting or unsuitable chairs while they wait for upgrades and adaptations.

Data published by NHS England shows 16.5% of patients – one in six –  were waiting longer than the NHS target time of 18 weeks for a wheelchair, equipment for a wheelchair, or wheelchair modifications between October and December last year. This represents more than 6,000 adults and almost 1,600 children, of which thousands were registered as having high or specialist needs. The figures include new patients as well as re-referred patients whose needs may have changed or whose current equipment needs adjusting or modified.

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Source: National World, 21 March 2023

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NHS England plans not compatible with current GP funding model, says primary care director

The current GP funding model ‘does not sit comfortably’ with NHS England’s plans for primary and community care integration, according to a senior NHS England director.

In a Lords Committee hearing today, NHS England’s national director of primary and community care services Dr Amanda Doyle said a ‘rethink’ was required with regards to the primary care estate, with Integrated Care Boards (ICBs) tasked to draw up local plans.

Asked whether the GP partnership model was compatible with integration, Dr Doyle told the committee that this was ‘one of the challenges’ they are facing.

She said: "One of the challenges that the current predominant ownership model in general practice gives us is that both investment and revenue flows support that model [of] an individual, practice-sized building.

"And lots of the things we want to do as we move forward into co-located primary care services and scaled-up primary care delivery drive the need for bigger premises with a wider range of capacity, and those two models don’t sit comfortably together."

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Source: Pulse, 19 June 2023

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GPs should lose ‘sole patient data controller’ role, says NHSE chief

The government should ‘relieve’ GP practices of being the sole controller for their patients’ data, a senior NHS England director has said. 

Tim Ferris, NHSE director of transformation, said it was a “challenge” that GP practices acted as the sole controllers of their patients’ data. 

Dr Ferris, whose background is as a primary care doctor in the US, was giving evidence to a Lords committee on integration of primary and community care today. He was asked whether it was time to revisit legislation on the control of GP patient data.

He said: “Thirty years ago when the law was created, it made more sense. But I think it might no longer be fit for purpose… The idea that if I were a GP in this country, if I had legal liability for the exchange of data, I would be worried about that.”

Dr Ferris agreed there would be merit to the committee recommending the government “relieve” GPs of the sole responsibility for data protection, and their data controller status.

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Source: HSJ, 20 June 2023

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Stop discrimination at ‘first hurdle’, race case victim tells trust leaders

A trust has been told to not “shut down” staff who raise concerns by a former employee whom a tribunal found was racially discriminated against.

Moorfields Eye Hospital Foundation Trust racially discriminated, victimised and harassed Samiriah Shaikh, who worked at the trust as an ophthalmic technician, according to a recent judgment.

Judges said Ms Shaikh was described as “aggressive” by her boss Peter Holm, and stereotyped by managers as a “loud ethnic female” after she and fellow colleagues raised allegations of racism in the promotion of in-house staff.

Mr Holm, who is listed as a chief ophthalmic and vision science practitioner at the trust, is said to have responded to staff members’ concerns by making jokes during a team meeting. It is unclear whether he is still at the trust.

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Source: HSJ, 20 June 2023

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Cancer test and treatment delays in UK have put ‘100,000 lives at risk’ since 2014

At least 100,000 people across the UK have had their lives put at risk over the last decade because of delays to them getting tested or treated for cancer, a new report claims.

In some cases, patients’ treatment options narrowed or their cancer spread or became incurable as a direct result of their long waits for NHS care, according to Macmillan Cancer Support.

The “inhumane” impact of delays on patients is “shameful”, it said, blaming ministers across the four home nations for underfunding and not tackling staff shortages in cancer services.

“I’ve had patients arrive for their radical chemotherapy appointment, who wait three hours only to be told that because of staff shortages we can’t deliver their treatment today. It’s inhumane”, said Naman Julka-Anderson, an advanced practice therapeutic radiographer who is also an allied health professional clinical adviser for Macmillan.

Many waited longer than 62 days to start treatment – surgery, chemotherapy or radiotherapy – after a GP referred them as an urgent case, the charity’s analysis of official NHS data found.

At least 100,000 of those 180,000 people have seen their symptoms worsen, or their cancer progress or their chances reduce of successfully being treated because they have had to wait.

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Source: The Guardian, 20 June 2023

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Calls for public inquiry into 'systemic failings' across mental health hospitals in England

The government is being urged to launch a public inquiry into "systemic failings" at mental health hospitals across England.

Leading mental health charity Mind says "immediate political action" is needed as NHS mental health facilities are "at breaking point".

Mind claims "patients' human rights are being violated" and "wrongly restrained" across "run-down, understaffed" mental health wards.

Its Raise the Standard campaign argues that a "full statutory inquiry" is the "first step" into resolving widespread issues.

Dr Sarah Hughes, chief executive of Mind, said: "One case of abuse, neglect or unsafe care is too many, people are suffering because of the shocking state of care in mental health hospitals.

"People should go to hospital to get well, not to endure harm. This is wholly unacceptable and must be addressed urgently."

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Source: Sky News, 20 June 2023

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Self-propelling robot endoscope ‘could make bowel cancer screening comfortable’

A soft robotic device that moves through the body like a worm could make bowel cancer screening much more comfortable by reducing pain and and discomfort, according to the scientists developing it.

Researchers at Imperial College London said they have created a new type endoscope that is soft, flexible, and capable of extending and curling on its own inside the body.

Around 900,000 colonoscopies – which involves an endoscope being passed through the bottom – are performed every year in the UK, the majority of which are for screenings for bowel cancer.

The procedure is invasive and more than 75% of patients develop significant pain, according to Nisha Patel, a consultant gastroenterologist at Imperial College Healthcare NHS Trust in London, who is running clinical trials with the device.

She said: “We know patients experience either discomfort or pain during the procedure and this affects uptake of further procedures and patient experience.

The experts are also hoping that compared to current endoscopes, which requires specialist skills, their self-propelling robotic version will be easier to use and could, in future, be deployed in GP surgeries or outpatient clinics.

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Source: The Independent, 18 June 2023

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Two-thirds of GPs refuse to register homeless patients

Two-thirds of GP practices from a sample of 100 in London declined to register a patient without an address, contrary to national rules which are meant to ensure homeless and excluded people can get healthcare, HSJ has found.

NHS England guidance states anyone can register with a GP without proof of address, and that people without a permanent address “can still register using a temporary address or the address of the GP surgery”.

Practices normally need to record an address, but the exception rule is meant to ensure people who are homeless, or living in unstable or short-term accommodation, are still able to access primary care or referrals for secondary services.

Despite this, when HSJ called 100 randomly selected practices in London (about 9 per cent of the total), 64 refused to register the caller.

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Source: HSJ, 19 June 2023

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Families legal action against scandal-hit hospitals over ‘systemic abuse’

Dozens of former patients are launching legal action against a group of scandal-hit children’s mental health hospitals after The Independent exposed a culture of “systemic abuse”.

More than 30 people, some of who are still children, are taking action after claiming they were mistreated at children’s hospitals run by The Huntercombe Group between 2003 and 2023.

Allegations include children being injured during restraint, inappropriate force-feeding and patients being over-medicated.

Among the claimants are:

  • A boy who has been left “traumatised” after being “drugged out of his mind” while staying at one of the hospitals.
  • A girl who alleges she was groped by a member of staff and now needs more intensive inpatient care.
  • A woman who says she was “forced to wee in bins” as there were not enough staff to take patients to the toilet.

A mother of one claimant told The Independent: “It is diabolical, I hope [the claims] can stop them from doing any more damage because it is just awful. Our beautiful girl has just been so ruined by them.”

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Source: The Independent, 18 June 2023

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CQC in legal battle with private provider over ‘inadequate’ report

An independent patient transport provider is taking legal action against the Care Quality Commission (CQC) after an inspection led to it being unable to operate for nearly three months.

The company, called Specialist Medical Transport (SMT), transports many mental health patients between hospitals, and is used by numerous NHS commissioners and trusts.

Its “north” division, which is based in North Shields, North Tyneside, was unable to operate between the middle of January and the end of March, which it says has led to reputational damage and loss of revenue. 

The inspectors, who visited in response to concerns raised by a whistleblower, found issues with paperwork on employment, risk assessments, and use of restrictive practices, including of some patients effectively in a “cell”, or handcuffed, in an ambulance. The CQC was also critical of the lack of processes to ensure patients had medicines, food, drink and access to toilets during the journey.

However, SMT successfully appealed the CQC’s notice of decision at a first tier tribunal, which found the regulator’s decision “was not necessary, reasonable or proportionate”. 

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Source: HSJ, 19 June 2023

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Antidepressants: Two million taking them for five years or more

More than a quarter of patients on antidepressants in England - about two million people - have been taking them for five years, the BBC has found.

This is despite there being limited evidence of the benefits of taking the drugs for that length of time.

A doctor who runs an NHS clinic helping people off the pills says withdrawal symptoms can make it hard for some to stop taking their medication.

Withdrawal guidance was updated in 2019, but he says little has changed.

More than eight million people in England are on antidepressants - which are prescribed for depression, anxiety and obsessive compulsive disorder and other conditions. That's one million more people than five years previously, NHS prescribing figures show.

The investigation also uncovered evidence that a leading drug company attempted 27 years ago to conceal possible withdrawal effects that one drug could cause.

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Source: BBC News, 19 June 2023

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Ayrshire MSP Katy Clark wants ban on surgical mesh use in hernia ops

AN Ayrshire MSP has called for an end to surgical mesh being implanted in hernia patients in Scotland.

A Freedom of Information request by Labour's Katy Clark has revealed that one in 12 of all hernia patients in NHS Ayrshire and Arran who have been implanted with surgical mesh since 2015 have been readmitted to hospital due to complications.

And the West of Scotland MSP has backed a petition by constituents calling for the suspension of the use of surgical mesh until an independent review has been carried out.

It follows the recent public health scandal over the pain and suffering endured by many women across Scotland implanted with transvaginal mesh.

It took years of tireless campaigning by affected women before the Scottish Government took action, last year creating a mesh removal reimbursement scheme.

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Source: Irvine Times, 9 June 2023

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‘Get stuck into ICSs’, Hewitt tells local leaders

NHS leaders ‘who might be hesitating about whether or not to really commit’ to their local integrated care system should ‘put aside all of those doubts [and] get stuck in’, Patricia Hewitt has claimed.

Ms Hewitt, Norfolk and Waveney Integrated Care Board chair and former health secretary, was speaking at the NHS ConfedExpo conference, the day after government responded to her recent review of ICSs.

The Department of Health and Social Care rejected or ducked several of its most eye-catching recommendations, but did state its support for ICSs and system working; while Labour has also said it would maintain ICSs should it come to power.

Ms Hewitt said the government response was more positive than she had feared at some points, and it “would have been a complete miracle” if ministers had backed all her recommendations.

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Source: HSJ, 15 June 2023

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Junior doctors strikes will escalate to ‘indefinite with-drawl of labor’, union lead warns

Junior doctors could indefinitely withdraw labor, and strike for three days a month until next year, the medics’ union leaders have warned.

Hundreds of junior doctors gathered outside the largest NHS conference of the year, NHS Confedexpo, on Thursday chanting “pay us fair, pay right, we don’t want to have to strike”.

The British Medical Association’s junior doctor committee co-chair Dr Rob Laurenson warned junior doctors may next escalate strike action in an “indefinite withdrawal of labour”.

NHS England boss Amanda Pritchard said the strike is a “serious risk to patient safety” and industrial action “creates risk and upheaval”.

She said tens of thousands of appointments will be affected.

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Source: The Independent, 15 June 2023

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Forty children admitted to hospital for vaping amid rising ‘epidemic’

Forty children were hospitalised for vaping last year, prompting NHS bosses to warn we risk “sleep-walking into a crisis”.

Amanda Pritchard, NHS England boss, said it was "right" for paediatricians to call for action on vaping among young people, as the Royal College of Paediatrics and Child Health called for an outright ban on disposable vapes.

She said the 40 children admitted to hospital in England in 2022 due to “vaping-related disorders” was up from 11 two years before.

The RCPCH’s call for action comes as NHS data revealed one in five 15-year-olds said they used e-cigarettes in 2021, while charity Action on Smoking (ASH) reported the experimental use of e-cigarettes among 11 to 17-year-olds had risen by 50 per cent compared to last year.

The college warned: “Youth vaping is fast becoming an epidemic among children, and I fear that if action is not taken, we will find ourselves sleep-walking into a crisis.”

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Source: The Independent, 16 June 2023

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Menopause doctor says hormone scam endangers women's health

A menopause doctor says scammers using her name to illegally sell testosterone online are damaging women's health.

Dr Louise Newson, who founded Newson Health, has warned patients a website has stolen her brand and logo and is selling the sex hormone unlawfully.

"We do not sell medication directly to anyone online," she adds.

Testosterone is illegal to sell or supply without a prescription from a health professional and currently unlicensed in the UK for use by women.

However, the National Institute for Health and Care Excellence (NICE) recommends it can be considered as a supplement for menopausal woman to treat low sexual desire if HRT alone is not effective.

Dr Newson, whose private clinics operate in Stratford-upon-Avon, London, Southampton and Bournemouth, said medication was only prescribed after a consultation with a clinician.

"As far as we are aware no Newson Health patients have fallen victim to this scam and we sincerely hope this remains the case," she said.

The practice is working with relevant organisations to have the fraudulent website taken down, she added.

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Source: BBC News, 16 June 2023

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Trust leadership accused of lack of ‘oversight’ hits out at CQC ‘algorithm’

Mid and South Essex Foundation Trust has received a Care Quality Commission warning notice about the medical care provided by its three hospitals. 

It has been told to make urgent improvements after inspectors found a deterioration in quality across its Broomfield, Basildon and Southend hospitals. 

The overall ratings for Broomfield and Basildon hospitals have dropped to “inadequate” as a result.

The CQC carried out a focused inspection in January and February that was prompted by concerns over the safety and quality of medical care and older people’s services, including over people’s nutrition and hydration.

Hazel Roberts, CQC deputy director in the east of England, said inspectors “found a leadership team who didn’t have complete oversight of the issues they’re facing”. 

Among the concerns raised by the CQC’s report were the safety of the premises and equipment, a lack of nursing and support staff, staff not always respecting people’s dignity and privacy, and risk assessments not always being completed and updated.

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Source: HSJ, 16 June 2023

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Blood test to detect 50 types of cancer could be given to 1m people on NHS

A blood test which can detect 50 cancers before symptoms start to show could be offered to a million people in a pilot programme from next summer, according to the head of the NHS.

Amanda Pritchard, NHS chief executive, said the Galleri test has the potential to “transform cancer care forever”, according to reports.

The liquid biopsy detects tiny fragments of tumour DNA in the bloodstream and alerts doctors as to whether a cancer signal has been detected and predicts where in the body that signal may have originated.

If early results are successful, a pilot screening programme involving one million patients over two years is scheduled to begin next summer.

The test is expected to find 5,000 potential cases of the disease every year.

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Source: The Guardian, 15 June 2023

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