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NHS bosses who silence whistleblowers to be banned from health service

NHS managers who silence whistleblowers will be banned from working in other senior health service roles, the government has announced.

The Department of Health and Social Care (DHSC) is bringing forward a raft of proposals it says will ensure those who commit serious misconduct cannot simply work elsewhere in the NHS in senior management positions.

It said legislation will be put forward to parliament next year to introduce professional standards and regulation of NHS managers.

Currently, there is no regulatory framework for the tens of thousands of clinical and non-clinical NHS managers, as there is for doctors and nurses.

Health Secretary Wes Streeting said the reforms would "slam the door in the face of unsuitable managers".

Mr Streeting added: "I'm determined to create a culture of honesty and openness in the NHS where whistleblowers are protected, and that demands tough enforcement.

"We've got to create the conditions where staff are free to come forward and sound the alarm when things go wrong. Protecting the reputation of the NHS should never be put before protecting patient safety.

"Most NHS leaders are doing a fantastic job, but we need to stop the revolving door that allows managers sacked for misconduct or incompetence to be quietly moved to another well-paid role in another part of the NHS."

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Source: Sky News, 20 July 2025

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Bodies of Nottingham mother and daughter found almost four months after 999 call

A woman who was found dead alongside her “entirely dependent” teenage daughter had called 999 saying she “could not move” almost four months before her body was found but no ambulance was sent to her, an inquest has heard.

Alphonsine Djiako Leuga, 47, suffered from sickle cell anaemia and died from pneumonia, and her 18-year-old daughter, Loraine Choulla, had learning difficulties and Down’s syndrome, relying on her mother for food and hydration.

Nottingham coroner’s court heard that Leuga called 999 on 2 February last year saying she was cold and could not move, and gave details of her address before hanging up.

The hearing was told that during the call Leuga groaned, requested an ambulance, and said: “I need help to my daughter” and: “I’m in the bed, I feel cold and can’t move” before cutting off the line.

She also gave details of her address in Radford, Nottingham, where her body and that of her daughter were found on 21 May last year, almost four months later.

Giving evidence at an inquest into their deaths, East Midlands ambulance service’s head of patient safety, Susan Jevons, said the call should have been referred to the control room dispatch officers.

She said attempts had been made to call Leuga back and that “the call should have been left for an ambulance to attend once we had got the address, which we had.

“The ambulance didn’t go to the address because the emergency medical adviser, thinking it was an abandoned call, closed the call down. So it wasn’t visible to anybody within the emergency operations centre.”

The coroner said she would have to consider the possibility that sending an ambulance to the address “might have been the difference between life or death” for Choulla.

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Source: The Guardian, 21 July 2025

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Three-fold difference in app use by ICS revealed

The share of patients routinely contacting their GP practice using the NHS App is only 6 per cent, and varies more than three-fold between systems, new figures suggest.

The annual GP patient survey found the proportion of patients who used the NHS App the last time they contacted their practice increased nationally by two percentage points on last year, but was still only 6%.

It has increased year-on-year in every integrated care system, by as much as five percentage points (see table below). But there is significant variation.

It comes as the government places the NHS App at the centre of its health reform strategy, aiming to make it a “single front door” to NHS services. It follows rapid take-up in recent years, accelerated by Covid-19. 

Nationally, more people used their practice’s own website than the App (14%). For many practices, there is more functionality for messaging on their website.

But phone was by far largest way people tried to make contact, on 62%. Fourteen per cent visited in person, and the remainder used a different website or app, or “another way”. 

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Source: HSJ, 11 July 2025

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How hard will UK aid cuts hit projects helping women and girls?

The scale of UK cuts to foreign aid means virtually all projects currently being funded in developing countries will be affected. But the cuts are tipped to fall particularly heavily on projects specifically for women and girls.

“The depth of the cuts means that there will definitely be cuts for nearly every programme,” said Ian Mitchell, a senior policy fellow at the Center for Global Development of Prime Minister Keir Starmer’s slashing of international aid from 0.5 to 0.3 per cent of Gross National Income (GNI).

Among the programmes that could be at risk is the UK-funded Women’s Integrated Sexual Health (WISH) initiative, which provides sexual and reproductive health services across 12 countries in West and Central Africa. The programme has reached 2.6 million people - mostly women in rural communities with no other options.

In the Democratic Republic of Congo, for example, where fewer than 15% of women use contraception, the WISH initiative has introduced access to family planning options and information, for some women for the first time.

The programme has averted an estimated 33,000 maternal deaths and prevented 100,000 children from losing their mothers, according to MSI Reproductive Choices, one of the world’s biggest providers of contraception and abortion services.

Family planning is often not seen as life-saving - certainly by the current US administration - but an unintended pregnancy in a country with high maternal mortality and no access to safe abortion can spell death, and does for tens of thousands each year.

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Source: The Independent, 18 July 2025

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Patients in England’s most deprived areas wait longer for NHS treatment, data reveals

Patients from the most deprived areas of England face longer waits for NHS treatment and make up a higher proportion of those waiting for care, according to figures.

Data released by NHS England on Thursday provides a breakdown of the health service’s waiting lists by ethnicity and deprivation levels for the first time. It shows that people in the most deprived areas of England and people from ethnic minority backgrounds make up a disproportionate and growing proportion of those waiting for NHS treatment.

An average of 3.1% of patients living in the most deprived areas had been waiting more than a year to begin treatment as of June, compared with 2.7% of the least deprived.

The deprivation gap is even wider in certain regions of England, with 2.4% of patients in the most deprived areas in London waiting over a year for treatment, compared with about 4.9% of the most deprived in the east of England.

Patients from an Asian or British Asian background were more likely to be waiting longer than 18 weeks for treatment than any other group, and the east of England and south-west England were regions with the largest ethnicity gap for people waiting more than a year to begin hospital treatment.

Women made up a disproportionate percentage of those on the waiting list for NHS treatment, at 57%, while also being more likely to be waiting more than 18 and 52 weeks than men. People of a working age (between 19 and 64) are also more likely to wait over a year to start treatment, at 3%, compared with 2.5% of those over 65.

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Source: The Guardian, 17 July 2025

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Trust leadership criticised for ‘nepotism’ and disinterest in race discrimination

Staff at a struggling trust believe that executives do not take racial discrimination seriously enough and that “nepotism is rife”, according to an external review. 

The review studied the recruitment and career progression of Black, Asian and ethnic minority staff at Milton Keynes University Hospital Trust. It was commissioned by CEO Joe Harrison following the publication of the annual NHS staff survey in March 2024.

This found that 11.4% of MKUH staff had faced discrimination, compared to the national average of 8.09%. Of those, 69.86% had faced discrimination on racial grounds. The national average was 51.77%.

The review was carried out in July last year, and the trust refused requests from HSJ to share its findings. These were finally revealed when it was discussed at a trust board meeting last week. A second report into the lived experience of minority ethnic staff is still being withheld by the trust.

Other findings from the report included the belief among BAME staff that “the pace of improvement” on tackling racial discrimination was too slow and that they did not have equal career progression opportunities.

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Source: HSJ, 18 July 2025

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Behaviour of NHS leaders toward whistleblowers ‘shocking’, says Francis

NHS leaders continue to exhibit “shocking” behaviour when confronted with concerns raised by whisteblowers, according to Sir Robert Francis.

The veteran patient safety expert – currently interim chair of the Infected Blood Compensation Authority – was speaking at the Whistleblowers UK conference last week. 

He said the NHS still lacked a “system that gives proper justice to those who have been victimised” after raising concerns.

“There remain terrible issues,” he said. ”No one is being held accountable. We will get nowhere on this issue unless there is a consensus to make it perfectly normal, and indeed expected, to speak up if you are worried about something. Recruitment and training have to be on the basis of these values.

“When things go wrong people need to say that and take responsibility. What happens when they don’t do that? Very little, I’m afraid. The behaviour on the part of some senior people is shocking. They don’t end up being disciplined. That is something that needs to change.”

The barrister said a systemic problem was that trusts often treated a whistleblower’s concerns as a disciplinary or HR matter, rather than a clinical issue that needed to be investigated. This meant safety problems were often not examined until HR matters had been concluded.

He said: “The problem with so many cases is that there is no authoritative internal and impartial investigation of the facts. This needs to happen at the earliest stage.

“Safety concerns raised should be treated as incidents to be investigated, not HR issues to be ‘managed’.”

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Source: HSJ, 17 July 2025

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NHSE admits ‘really poor’ management and HR

Persistently poor management and HR processes have been reported to NHS England’s board today.

The Freedom to Speak Up Guardian’s report from this month’s NHSE board meeting highlighted “reportedly poor experiences” of grievance processes. It also reported “an unusually large number of staff who appear to be stranded” without a suitable substantive role, in some cases after they had raised concerns or relationships had broken down in their team.

The report – authored by NHSE medical director Sir Stephen Powis and Tom Grimes, deputy director for FTSU and organisational health – said there had been a 60 per cent rise in FTSU concerns raised in 2024-25 compared to the previous year in NHSE. The service is dealing with 32 cases which are more than a year old.

It pointed out that NHSE did not carry out a staff survey in 2024, but its results for 2023 showed only 53 per cent of staff felt safe to speak up about concerns, compared with an average of 62 per cent across the NHS.

Only 36% thought NHSE would do something if concerns were raised. “We are not able to say whether this changed [since 2023] but we fully recognise that staff continue to experience barriers to speaking up,” the report added.

The strongest themes raised in concerns in 2024-25 were bullying and harassment by line managers, senior leaders and within teams; cultural leadership including lack of empowerment and collaboration; adherence to HR policies; and recruitment practices.

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Source: HSJ, 17 July 2025

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Key themes emerging from our ‘Speaking up for patient safety’ interview series

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'Over-complex' NHS led to man's death

An "over-complex" NHS system played a "major" role in the death of a 79-year-old man, a coroner has said.

Thomas Mallinson died on 23 November at Cumberland Infirmary in Carlisle following a lack of "effective response or treatment" from health services for four days, according to assistant coroner for Cumbria Dr Nicholas Shaw.

He said the case was an example of how "over-complexity has lost sight of a man's urgent care needs".

The coroner issued a future deaths report on Tuesday, outlining the various treatment delays that Mr Mallinson faced.

Dr Shaw said the 79-year-old became unwell on 17 November with vomiting and diarrhoea.

The following day, his wife called to request a GP appointment but was told there were none available that day and to call 111 instead.

Following the 111 call, an ambulance was sent and Mr Mallinson was found to be healthy enough and told to call again if his symptoms persisted.

Still feeling ill the next day, Mr Mallinson attended a telephone GP appointment and was prescribed anti-diarrhoeal medicine.

On the fourth day, Mr Mallinson continued to get weaker and so his wife called 111 again. She was told he would get a GP appointment the same day and to wait for a call back.

Dr Shaw said that call never came.

Mr Mallinson's wife then called 999 just before midnight. She was told by North West Ambulance Service (NWAS) that a doctor from Cumbria Health, the out-of-hours provider, would call back within two hours.

Mr Mallinson's wife waited up until 04:00 GMT, but that call also never came.

On the fifth day, following a night of "continuous vomiting and diarrhoea", Mr Mallinson's wife called the GP and was offered an afternoon appointment.

She then called 999 again and an ambulance was sent.

Mr Mallinson was taken to hospital immediately, where he was found to have symptoms including hypothermia and failing kidneys.

He died in hospital two days later, the coroner said, adding that if Mr Mallinson had received treatment in a "timely manner" he most likely would have survived.

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Source: BBC News, 17 July 2025

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Large numbers of medical trainees uncomfortable raising concerns with senior colleagues

More than a quarter of medical trainees in some specialties reported feeling apprehensive or hesitant about escalating a patient to the supervising clinician, a “deeply troubling” finding that the General Medical Council says could put patient safety at risk.

This year’s GMC national training survey was completed by around 50 637 doctors in training and 21 289 trainers. For the first time the survey asked about escalation of care.

Among doctors in training, 21% reported feeling uncomfortable raising concerns with their senior colleagues. The figure was even higher among trainees in certain specialties—with 26% of trainees in emergency medicine, 27% in obstetrics and gynaecology, and 29% in surgery.

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Source: BMJ, 15 July 2025

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Calls for urgent regulation of weight loss surgery tourism after 28 Britons die from medical complications in Turkey

Medical tourism for weight loss is rising in popularity, with around 5,000 Britons a year travelling overseas for cut-price surgery.

But experts have warned the industry is putting patients' lives at risk and is in urgent need of regulation.

Botched surgery can lead to infections “leakage, sepsis, and even death,” a report by the BMJ highlights.

At least 28 British people had died between 2019 and March 2024, due to complications from elective medical procedures performed in Turkey figures provided by the Foreign Office revealed.

Dr Jessica McGirr of the Obesity Research and Care Group RCSI University of Medicine and Health Sciences, Dublin, Ireland and Imperial College London highlight that although cheaper often these packages do not cover care after the operation or long-term nutritional or psychological support that you would be offered in the UK.

An inquest into 40-year-old Hayley Butler, a dog groomer from Norwich who died of organ failure after a sleeve gastrectomy at the Ozel Gozde Hospital in Izmir, revealed the surgery “had not been done properly”.

A doctor Tanveer Adil, who works at Luton & Dunstable Hospital, explained she died as a result of the procedure and the "lack of safety netting" afterwards.

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Source: The Independent, 16 July 2025

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Hospital ‘finally says sorry’ over care in brain death tragedy

The hospital which treated a young woman who died unexpectedly four years ago has said her care fell below their usual “high standards” – but the admission is “a complete cop out”, her mother said.

Gaia Young, 25, was admitted to University College London Hospital (UCLH) in July 2021 when she was taken ill following a bike ride, and died 17 hours later.

Doctors know that Gaia died from a cerebral oedema – a brain swelling – but even after an inquest the underlying cause of her sudden illness remained unexplained.

Her mother, Lady Dorit Young, has continued to fight and campaign for the hospital to take accountability for what she says are failings in its care.

She described the hospital’s latest statement, a partial apology via a short comment in a news article, as “pathetic”, adding: “It came completely out of the blue. I didn’t even notice it at first, then I was extremely furious. Why, four years after Gaia died, why now? Why did they let us do all this work and fight and push? I think it’s cruel.

“They could have done it at court, in the inquest. They could have said it to me in person, but the fact that they put it into a rather unknown publication, it’s very sneaky, it’s pretty shameful. It’s a complete cop out.”

The UCLH comment was made in response to an article called “Failing the dead: How medical ignorance is killing Britain’s coroner service”, by journalist Angela Walker in online political magazine The Lead.

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Source: Islington Tribune, 14 July 2024

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Family of woman who died after misdiagnosis by 'substitute doctor' criticise govt review

The parents of a woman who died after her blood clot was misdiagnosed by someone who she thought was a doctor have called a government-ordered review "a missed opportunity".

Marion and Brendan Chesterton have welcomed many of the recommendations in Professor Gillian Leng's review of the role that physician associates (PAs) perform in the NHS, but say "they don't go far enough".

Emily, 30, died in November 2022 after suffering a pulmonary embolism. She went to see her GP at a north London surgery twice in the weeks before her death - and on both occasions was seen by a physician associate who missed the blood clot and instead prescribed propranolol for anxiety.

The actress from Salford had told her worried parents that she had been seen by a doctor, but she had not.

Her father Brendan told Sky News: "If she come out and said I've seen someone called the physician's associate I'm sure we would have insisted that, you know, let's go back and insist that you see a doctor. She never knew."

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Source: Sky News, 14 July 2025

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Ambulance staff being 'pushed beyond breaking point' as 2.7m hours of overtime revealed

Scottish ambulance staff have worked more than 2.7 million hours of overtime, costing taxpayers almost £74 million - with concerns raised the pressures are “pushing already exhausted staff beyond breaking point”.

The statistics come amid separate analysis of cancer waiting times showing patients waited a year for treatment to begin and a warning from a senior doctor that “the Scottish NHS is struggling to provide the care patients need, when they need it”.

New statistics revealed under freedom of information legislation, showed 2,718,922 hours of overtime were worked by paramedics, ambulance technicians, care assistants and specialist nurses between 2020 and 2024.

Scottish Conservative health spokesman, Dr Sandesh Gulhane, said the situation was “completely unacceptable”, and claimed the ambulance service was being “kept afloat” by overtime.

He added: “This will be pushing already exhausted staff beyond breaking point and is completely unsustainable.

“Relying on overstretched staff to plug gaps in shift will be putting staff as well as patients at serious risk.

“Ambulance crews have been left dangerously understaffed because of years of dire workforce planning by successive SNP health secretaries who are clueless to the scale of the emergency facing them.”

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Source: The Scotsman, 15 July 2025

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‘Life-changing’ therapy now available for cystic fibrosis patients

Hundreds of people with cystic fibrosis are to be offered a new pill which has been hailed as “life changing” by health experts.

The National Institute for Health and Care Excellence (NICE) has given the green light for the NHS to give patients Alyftrek, a type of modulator therapy which works to tackle the underlying cause of cystic fibrosis (CF).

CF is caused by a faulty gene that affects the production of a protein called CFTR.

Modulator drugs work by helping to make the CFTR protein work effectively.

Helen Knight, director of medicines evaluation at NICE, said: “CFTR modulators are already revolutionising the way cystic fibrosis is treated so we’re pleased to be able to recommend Alyftrek, the latest of this type of treatment that has been shown to be effective, with significant benefits for people with the condition.”

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Source: The Independent, 15 July 2025

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New at-home heart monitors to slash NHS hospital waiting lists

The NHS has started rolling out a new at-home heart monitor designed to detect heart rhythm problems.

Unlike traditional monitors that can require lengthy set-up by a trained physiologist, the innovative kit can be posted to patients for them to attach themselves at home and used to investigate conditions including atrial fibrillation, tachycardia or heart blocks.

The device itself is a small patch that adheres to the skin, while traditional devices see patients hooked up to numerous wires and monitors during hospital visits.

After the new tool is worn for a few days, patients simply post the monitor back, removing the necessity for appointments to fit and remove the equipment.

The collected data is then analysed by an artificial intelligence (AI) tool called Cardiologs, which generates a report for assessment by a physiologist or doctor.

Frimley Health NHS Foundation Trust is the first hospital in the country to roll out the device, with hopes that the device will soon be used across other NHS trusts.

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Source: The Independent, 14 July 2025

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Weight loss surgery tourism needs urgent regulation, say UK experts

A booming trade in medical tourism for weight loss surgery is placing patients at risk and needs urgent regulation, experts have warned.

Despite the growing popularity of injections such as Mounjaro to treat obesity, the number of patients travelling to other countries for surgery is increasing, the latest analysis suggests.

And, with the wider medical tourism industry set to be worth about £300bn annually, with anticipated year-on-year growth of 25%, international regulation is urgently needed, according to a commentary in the journal BMJ Global Health.

“We are seeing this ongoing increase, linked to the globalisation of healthcare and long wait lists,” said Dr Jessica McGirr of the University of Medicine and Health Sciences in Dublin and Imperial College London, adding that many are being marketed bariatric surgery through “before and after” images on TikTok and Instagram.

“Incorrectly, surgery is often marketed from an aesthetic point of view,” McGirr said. “This is complex surgery for treatment of a chronic disease with potentially significant health complications.”

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Source: The Guardian, 15 July 2025

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Why the UK is lagging behind other countries on measles vaccinations

The UK is the worst-performing G7 country for coverage of measles vaccines, as rates lag behind Europe, with experts warning declining health budgets and the spread of misinformation are putting children at risk.

Now, health officials in the UK have sounded the alarm over our waning vaccine coverage after a child with measles died in Liverpool.

On Monday, health secretary Wes Streeting said that the child’s death shows the nation needs to “redouble its efforts” to vaccinate more children and said improvements promised in the NHS’s 10-year plan, such as giving parents access to digital health records, could help.

One expert told The Independent a multitude of issues have impacted the UK’s measles vaccination rates, including declining public health budgets, lower access to GP services, and the increased circulation of misinformation on social media.

Speaking with The Independent, Adam Finn, Professor of Paediatrics at the University of Bristol, and a member of the government’s Joint Vaccinations and Immunisations Committee, explained there were several factors, including the fact that there has been a general decline in immunisation over the past 15 years, which had initially been ignored.

He said: “The public health authority officials favour the idea that it’s because there’s been a waning of resource in the health service to deliver the vaccine programme, so as primary care in particular has become more stretched the capacity to chase people up and go after the people that are otherwise not getting their act together has disappeared and that’s resulted in the vulnerable edge getting worse and worse.”

“The competing hypothesis, which is quite convenient for the politicians, is that it's mad internet misinformation, and in a sense, people are somehow to blame for believing it and that it’s not really a governmental problem, it's myth and legend, as it were.”

“My view is that those two things are not mutually exclusive.”

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Source: The Independent, 15 July 2025

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We are entering 'golden age' of cancer treatment - and also facing a less gilded era too

Cancer treatment is becoming increasingly personalised and oncologists know their enemy in more intimate detail than ever before.

So the outgoing medical director of the NHS, Sir Stephen Powis, is not wrong: we are entering a "golden era" of cancer treatment, if we're not living in it already.

Cancer treatment is becoming increasingly personalised to the specific mutations in the cancer itself. Oncologists know their enemy in more intimate detail than ever before.

Tools like AI can sift through that detail to identify new vulnerabilities in cancer cells and techniques like gene editing allow scientists to design previously impossible new ways of exploiting them to slow, or reverse the spread of cancers.

But we're entering a parallel and less gilded era too.

Cancer is primarily a disease of ageing and our population is doing that rapidly.

It is also more common in those who eat and drink too much and exercise little - which is most of us - and explains why cancer rates are now, perhaps for the first time in human history, increasing in younger people too.

As Sir Stephen points out, prevention must play an important role in reducing that increasing burden. It already has for some: smoking-related lung cancer is declining, so too is cervical cancer thanks to HPV vaccination in schools.

But the bulk of cancers linked to poor diet, poor air quality, or poverty in general are not.

We're also failing to make sure everybody benefits from the incredible new treatments available and those yet to come.

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Source: Sky News, 14 July 2025

While people are now getting cancer diagnosed faster in the NHS, many start treatment too late. More than 30% of patients wait more than two months to see a cancer specialist following an "urgent" referral from their GP (well below the NHS target that has not been met since it was introduced in 2015).

Cancer survival is increasing, but so too is the disparity between those benefitting from the latest treatments and those who aren't.

Specialist treatment in some parts of the UK is far better than in others - often those in poorer places where cancer rates are higher.

And the latest, and best, cancer treatments - which are largely bespoke-tailored to the patient's needs - are increasingly expensive.

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NHS cuts could lead to another Baby P or Victoria Climbie as safeguarding staff face axe, doctors warn

NHS cuts to key safety roles could trigger more abuse and child deaths, such as those of Baby P and Victoria Climbié, doctors and experts have warned.

Medical staff responsible for safeguarding in their area are legally required to flag concerns about vulnerable patients, but their roles are at risk of being axed as local NHS bodies scramble to make government-imposed cost savings, doctors have told The Independent.

Almost two dozen healthcare professionals, medical royal colleges, alongside children’s charity the NSPCC, have written to health secretary Wes Streeting urging him to protect the roles.

The letter to Mr Steeting, shared with The Independent, said: “The NHS has a crucial role to play in protecting children.

“Given the scale and pace of reform, we ask you to urgently send a clear message to the public and all those who work to protect babies. This should guarantee that keeping children safe will remain a priority for the NHS and that ICBs will be fully resourced to carry out their child safeguarding duties.”

Dr Peter Green, chair of the national network of designated health professionals and doctors for child safeguarding, told The Independent there was a risk that cases such as Baby P and Victoria Climbie will occur more frequently as a result of any cuts.

Dr Green said: “There is a clear risk of those cases significantly increasing. The risk of those cases is obviously going to increase by not having the [NHS’] oversight and learning when things go wrong.”

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Source: The Independent, 16 July 2025

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'Confusion' over mortuary oversight still 'widespread' four years after necrophilia scandal

There is “widespread confusion” among which senior executive is accountable for mortuary services, with many CEOs blind to potential criminal liability, according to the final report into the abuse of dozens of deceased patients at an NHS trust.

The latest phase of the independent inquiry into the crimes of convicted sex offender David Fuller was released today. It is highly critical of the lack of oversight exercised by trust boards over the operation of their mortuaries despite the national profile of the scandal.

Maintenance supervisor Mr Fuller sexually violated 100 women’s and girls’ bodies in hospital mortuaries at Maidstone and Tunbridge Wells Trust over a 12 year period before his crimes were finally uncovered in 2020 when he was arrested and then convicted for two murders committed before he started to work for the NHS.

The inquiry was headed by Sir Jonathan Michael, former chief executive of Oxford University Hospitals Foundation Trust. The final report highlighted confusion among executives about who held accountability for mortuary services, but also stressed “this confusion was one aspect of the limited oversight of the performance of the mortuary service”.

The inquiry investigated the arrangements at 24 trusts in detail. It found many significant inconsistencies in who directors thought was accountable for mortuary services, with some at the same organisation saying it was the medical director and others the chief operating officer. 

Senior executives also believed their trusts’ safeguarding policies included the care of dead people, but failed to ensure that policies did so.

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Source: HSJ, 15 July 2025

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NHS physician associates should not diagnose untriaged patients, review finds

NHS physician associates should be banned from diagnosing patients who have not already been seen by a doctor, a government review has concluded.

The review calls for the government to overhaul the role of physician associates (PAs), who it says have been substituted in for doctors to fill staffing gaps despite having significantly less training.

Prof Gillian Leng, the president of the Royal Society of Medicine, spoke to more than 1,000 people for the review and concluded there were “no convincing reasons to abolish the roles of AA or PA” but there was also no case “for continuing with the roles unchanged”.

She wrote in the report: “Despite the significantly shorter training, PAs and to a lesser extent AAs have sometimes been used to fill roles designed for doctors. The rationale for doing this is unclear, and was probably one of pragmatism and practicality, relying on medical staff to provide the additional expertise when required.

“This lack of planning may have been responsible for driving the resentment felt by some resident [doctors] and potentially exposed patients to unnecessary risk.”

One of her main recommendations is that PAs should not see “undifferentiated or untriaged patients”, meaning those who have not yet been diagnosed by a doctor. Leng recommended further work to establish which patients they should be able to see and to set clinical protocols that would enable PAs to diagnose patients with mild ailments.

The report found that “relatively few doctors felt it was appropriate for PAs to diagnose illness” and it identified disparities between the tasks PAs considered right for them to carry out and what doctors thought.

Leng recommended that newly qualified PAs work in hospitals for two years before they are allowed to work in GP surgeries or mental health trusts, enabling them to start their careers where there are more training opportunities and supervision.

She also recommended more leadership training for doctors, who shared concerns about the lack of preparation for supervision duties, and better career development for PAs and AAs. She suggested a named doctor supervise each PA, while uniforms, lanyards, badges and staff information should be standardised to “distinguish physician assistants from doctors”.

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Source: The Guardian, 16 July 2025

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Mental health care ‘being rationed’ over failure to cut spiralling waiting list, top doctor warns

Mental health care is being rationed because the government is failing to tackle the spiralling waiting list, the UK’s top psychiatrist has warned, with 48,000 people facing delays of more than two years for treatment to start.

Nearly 1.7 million people were waiting for community care, such as a psychologist or psychiatrist appointment, for treatments including everything from severe depression to serious personality disorders at the end of December 2024.

That is up from 1.3 million in March 2024 and is in addition to the 7.4 million people on the countrywide NHS waiting list, which only counts patients with physical health problems.

Dr Lade Smith, president of the Royal College of Psychiatrists, said the figures proved that mental health care was being downgraded in favour of other services.

She said: “It’s very clear that there has been a prioritisation of services; mental health care is not one of those services. As far as I’m concerned, it’s been rationed for years. It’s not been prioritised, full stop. I say that because we’ve got 1.7 million people who were waiting for mental health services.

“They are not being prioritised and so there is rationing of mental health care, full stop.”

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Source: The Independent, 14 July 2025

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Many cancers no longer 'a death sentence' as treatment on 'cusp of golden era', NHS England medical director says

Many people with a cancer diagnosis "should be confident that it's not a death sentence and that more treatments will become available", according to the outgoing medical director of NHS England.

In his final interview before retiring, Professor Sir Stephen Powis said our understanding of the genetics of cancer and how it can be targeted is being "revolutionised".

Sir Stephen, 64 and a kidney specialist who has been the national medical director since 2018 and throughout the COVID pandemic, told The Times: "We are at the cusp of a golden era in terms of the way we treat a range of cancers.

"For many cancers now, people should be confident that it's not a death sentence and that more treatments will become available."

"We can't prevent all cancers, but there are cancers that we can certainly prevent," he said, adding that he hopes lung cancers will become "a lot rarer".

Cancer treatment, he said, would be "driven by genetics" to become more individualised with the increased ability to pinpoint mutations in cells.

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Source: Sky News, 14 July 2025

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Late attendance 'driving trust’s high stillbirth rate'

Delays in seeking help among women from deprived communities or with poor English are a major contributor to high stillbirth rates, according to a review by a trust trying to reduce deaths.

A report by the Calderdale care partnership quality group, part of West Yorkshire Integrated Care Board, said that in Calderdale and Huddersfield Foundation Trust’s two maternity units “reduced foetal movements is a significant cross cutting theme… [and] delay in attendance to the hospital to seek midwifery support and advice”.

It said delays were more common among women who lived in areas of higher deprivation or where English was not their preferred language. They were less likely to contact a hospital midwife and more likely to reach out to their GP or family when they were concerned during pregnancy.

Benash Nazmeen, an assistant professor of midwifery at Bradford University and a co-founder of the Association of South Asian Midwives, warned trusts against “making assumptions” about communities without understanding “the realities of their lives”.

She said: “For example, worse outcomes for Black and Asian mothers and babies have previously been attributed to higher levels of deprivation and complex care needs.

“Recent MBRRACE reports and the 2022 Confidential Inquiry into Maternal deaths show that these disparities persist even in affluent areas and that complex care needs are not exclusive to any one ethnic group.

”We cannot continue to rely on outdated assumptions. Instead, we must work collaboratively with communities to build trust, relationships and locally informed solutions to address the barriers which remain poorly understood.”

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Source: HSJ, 14 July 2025

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