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New treatment ‘can help people stop taking opioid painkillers for chronic pain’

A new treatment could help people to stop taking addictive opioid painkillers for chronic pain, research suggests.

Data suggests there are one million people at risk from longer-term continuous opioid prescriptions, and more than 50,000 have been taking these for six months or more.

While recent NHS initiatives have managed to reduce opioid prescribing by 8%, saving an estimated 350 lives, the new research has found evidence that could help many more people stop their opioid painkiller use.

A team of researchers and doctors has developed and successfully trialled a programme designed to guide people in coming off prescription painkillers, tapering their opioid intake and learning how to manage their pain using alternative techniques with a course which combines one-to-one and group support.

According to the findings, after one year, one in five people were able to stop taking opioids without their pain increasing.

The scientists suggest the new treatment is an alternative to opioid use and has potential to give patients a better quality of life.

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Source: The Independent, 23 May 2023

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Essex GP struck off over 'sexually motivated' examination

A GP accused of trying to pull down a patient's gym shorts and of touching her genitalia has been struck off the medical register.

The Medical Practitioners Tribunal Service found Dr Kamran Ali's behaviour towards four women at a surgery in Essex amounted to misconduct.

The tribunal heard he had not practised since the allegations in 2016.

The 44-year-old, of Glendale Gardens, Leigh-on-Sea, was cleared of criminal charges following a trial in 2018.

Panel chairman William Hoskins said at the tribunal on Thursday that erasing him from the register was necessary to "protect public confidence in the medical profession".

A female patient - referred to as Patient C - reported his behaviour to police in the November.

She had complained of spots on her face, white coating on her tongue and wanted a repeat prescription for anxiety medication.

The panel heard Dr Ali began to pull down her gym shorts and examined her genitalia without wearing gloves and without obtaining consent.

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Source: BBC News, 23 May 2023

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People paying for operations up by third since Covid pandemic

The number of people paying privately for operations and treatments in the UK has risen by more than a third since the pandemic started, the latest figures from the Private Healthcare Information Network (PHIN) show.

Last year 272,000 used their own money to pay for treatments, such as knee or eye surgery - up from 199,000 in 2019.

The NHS backlog has been blamed for the trend, with some of the treatments costing more than £15,000.

But there does appear to have been a shift away from private insurance driven by the cost of living crisis.

The numbers treated through that route were just below 550,000 - more than 30,000 fewer than three years ago.

Health providers are reporting patients desperate for treatment because of NHS waits are increasingly turning to the private market.

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Source: BBC News, 24 May 2023

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Menopause: Post-hysterectomy care in NI must improve, says patient

A woman who had a hysterectomy has said she was discharged without sufficient information on its impact on her physical and mental health.

Mechelle Davis, from County Down, said it was crucial women left hospital with appropriate medication and advice.

Her operation involved removal of her womb, ovaries, fallopian tubes, and cervix.

Ms Davis was 48 when she had her operation and said she had no option but to look online for advice, something she described as "unsatisfactory".

"I had the operation in October 2022 and didn't go on HRT until the following February," she told BBC News NI.

"Every woman who is going through the menopause - including surgically induced - needs support.

In its online tool for clinicians, British Menopause Society advise that HRT plays a significant role in managing surgical menopause, especially in women under 45 - provided there are no contradictions such as personal history of hormone dependant cancer.

It also adds that "all women undergoing surgical menopause should have counselling and be provided with information about the hormonal consequences of surgery and the role of HRT, both before surgery and before leaving hospital with clear communication to the primary care team."

BBC News NI has spoken to other women who, after having a hysterectomy, were discharged without advice or a HRT prescription.

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Source: BBC News, 23 May 2023

Further reading on the hub:

World Menopause Day 2022: Raising awareness of surgical menopause

 

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Over 80% of GP practices lack crucial technology, warns NHSE lead

Only 10-15% of GP practices are using all three of the ‘modern’ patient access tools — including overhauling their approach to triage — which are at the centre of NHS England’s primary care recovery plan, its GP lead has told HSJ. 

Amanda Doyle, national director for primary care and community services, told HSJ this was its current estimate of the share of practices which already have in place all three of: digital phone systems; online messaging; and modern triage, response and care navigation.

These are cornerstones of the primary care recovery plan,published by the government and NHS England this month, which says they are prerequisites for offering “modern general practice access”.

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Source: HSJ, 23 May 2023

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Woman died on floor after waiting over five hours for ambulance in Wales

A 58-year-old woman died alone curled up in a blanket on the floor of her bedroom as she waited more than five hours for an ambulance.

Relatives of Rachel Rose Gibson believe she had a heart attack at her home in Wrexham, north Wales, only a short drive away from a hospital, but died before an ambulance reached her.

The Welsh ambulance service said that on the day Gibson died, its crews spent more than 700 hours waiting outside hospitals for patients to be admitted, which meant they could not respond quickly to people needing help.

Family members said Gibson, a grandmother of seven, called an ambulance at 4pm on 5 April as she was coughing up blood and in chronic pain. By the time an ambulance arrived at 9.30pm, she had died.

Her daughter, Nikita, 29, said: “She was lying on the floor curled up in a blanket. It haunts me to know she died alone in so much pain.

“I feel like I can’t fully grieve because I’m so angry. She only lives five minutes away from the hospital, but must have been in too much pain to get into a taxi.”

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Source: The Guardian, 22 May 2023

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35,000 cases of sexual misconduct or violence in NHS in five years

More than 35,000 incidents of sexual misconduct or sexual violence - ranging from derogatory remarks to rape - were recorded on NHS premises in England between 2017 and 2022.

Rape, sexual assault or being touched without consent accounted for more than one in five cases.

Most incidents - 58% - involved patients abusing staff.

The data was collected by the BMJ and the Guardian, and shared with BBC File on 4.

Freedom of Information requests were received from 212 NHS trusts and 37 police forces in England.

The data that came back from trusts showed at least 20% of incidents involved rape, sexual assault or inappropriate physical contact - including kissing. Other cases included sexual harassment, stalking and abusive or degrading remarks. One in five cases involved patients abusing other patients - although not all trusts provided a detailed breakdown.

Meanwhile, police recorded nearly 12,000 alleged sexual crimes on NHS premises in the same time period - including 180 cases of rape of children under 16, with four children under 16 being gang-raped.

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Source: BBC News, 23 May 2023

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Trusts ‘could be sued’ under new strike law

Ambulance chiefs have warned a controversial piece of legislation could lead to legal action against their trusts by patients denied an ambulance.

The Strikes (Minimum Service Levels) Bill, which is currently going through Parliament, would enable the health and social care secretary to set minimum levels of staffing for ambulance call centres and crews. Employers would be able to issue “work notices” compelling staff to provide cover during any strike.

But, in its response to the government consultation on how the system would work, the Association of Ambulance Chief Executives has said it does not support the legislation in its current form as it does not believe it will deliver an improvement for patients, or offer a practical means of delivering minimum service levels.

It said the proposed legislation appears to pass responsibility for the service levels to employers, which could leave them “exposed to patient liability risks to a greater extent than before”.

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Source: HSJ, 22 May 2023

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New NHS training launched as dementia rates increase among Asian and Black people

Healthcare leaders are rolling out new NHS training to help speed up dementia diagnoses among Black and Asian people following criticism about a lack of support for patients from minoritised communities, The Independent has revealed.

An awareness campaign is being launched in England to help those from ethnic minority communities receive a prompt diagnosis and get the support they need at the earliest opportunity.

The announcement follows a critical report which found that thousands of south Asian people with dementia are being failed by “outdated health services designed for white British patients”.

Dr Bola Owolabi, director of the Healthcare Inequalities Improvement programme at NHS England, said: “The pandemic put a greater spotlight on longstanding health inequalities experienced by different groups across the country.

“While there are many factors involved, the NHS is playing its part in narrowing the gap and ensuring equitable access to services through taking targeted action where needed to improve outcomes."

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Source: The Independent, 21 May 2023

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Social Beats networking platform supports people with Long Covid

Social Beats, a networking platform for those living with Long Covid, has been launched by free social community service Biocomm, allowing people to exchange health information from trusted sources, share experiences and interact with other people with Long Covid.

The goal of the platform is to help connect those living with Long Covid so that they can receive and provide emotional and social support to others in the same position.

The platform is the brainchild of BiocommAI and is sponsored by InnoMedica and Normax Biomed.

Peter Jensen, CEO and chairman of Normax, said: “Community is key for anyone dealing with an illness or long-term condition. Biocomm.net is a safe space for people affected by Long Covid – a platform designed to help people living with the condition to connect with others and to build a better life.

“We have recognised that Long Covid has impacted people in many ways and now is the time to help them by enabling them to connect, learn and share knowledge.”

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Source: Digital Health, 22 May 2023

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UK reliance on foreign nurses at critical level

Britain’s reliance on foreign nurses has reached “unsustainable” levels, the government has been warned as new analysis reveals that international recruits has accounted for two thirds of the rise in numbers since 2019.

Ministers have repeatedly promised to boost the domestic supply of health staff amid warnings that reliance on international workers leaves the NHS at the mercy of global labour markets.

Overall, a fifth of the UK’s nursing, midwifery and nursing associate workforce originally trained overseas.

The figures will reignite concerns that nations such as the Philippines, traditionally a key source for the NHS, are being increasingly targeted by countries including Germany and Canada. Senior NHS leaders fear the health service could be left in a precarious position if increased competition results in nurses choosing alternative destinations, resulting in a shortfall for the UK. The health service in England already has one post in ten vacant.

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Source: The Times, 18 May 2023

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Mental health patients forced to travel hundreds of miles for treatment despite government pledge

Some mental health patients in England are still having to travel more than 300 miles for hospital treatment two years after the government pledged to end the “completely unacceptable” practice.

The number of patients in crisis forced to move potentially hundreds of miles for NHS help is rising again after falling during the pandemic, separating them from family and support networks and potentially delaying their recuperation.

According to official data seen by the Observer, 420 so-called “out of area” treatments started in February because no local beds were available – up from 240 in February last year. The most recent NHS England records show there are 720 out of area placements deemed “inappropriate”, risking the patient’s recovery.

Dr Mayura Deshpande, an associate registrar for policy at the Royal College of Psychiatrists, said targets for eliminating the practice had been “widely missed” and called for an urgent plan for the proper funding of mental health services. “It’s completely unacceptable that some mental health patients are having to travel hundreds of miles for care at a time when they are at their most vulnerable,” she said.

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Source: The Guardian, 20 May 2023

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More than 23,000 people died in A&E in England last year, Labour estimates

About 23,000 people died in accident and emergency departments last year, according to an estimate by Labour based on Freedom of Information requests to every NHS trust in England.

Half of the trusts responded to the party’s requests and, based on that information, it calculated that just over 23,000 people had died – an increase of more than 20% on 2021, and nearly 40% on 2020.

The increase in deaths corresponds with a sharp rise in NHS waiting times, as hospitals struggle with high demand and a lack of resources after the Covid-19 pandemic.

Wes Streeting, the shadow health secretary, said: “People turning to the NHS in an emergency should know they will be seen and treated before it’s too late. The Conservatives’ failure over 13 years to properly staff or reform the NHS has a cost in lives.”

Maria Caulfield, the health minister, defended the government’s record, however, saying: “We are delivering a record number of tests, speeding up discharge from hospitals, and cutting waiting lists as we also work to halve inflation, grow the economy, reduce debt, and stop the boats.”

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Source: The Guardian, 19 May 2023

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ICB sends trust five safety warnings in six weeks

An integrated care board (ICB) has sent multiple warnings to a local trust highlighting ‘serious issues’ with the safety and quality of care provided.

East Kent Hospitals University Foundation Trust had had severe and widely reported issues in its maternity services but the five emails and letters from Kent and Medway ICB, sent across a six-week period in February and March, flagged concerns extending into other parts of the organisation. These included:

Serious incidents had “recurrent themes” and there was a “lack of evidence the trust is learning” from them. A spot audit had revealed more than one in five patients at the Queen Elizabeth The Queen Mother Hospital in Thanet had overdue modified early warning scores, which can show if a patient is deteriorating.

Further concerns about adult safeguarding “have been raised in relation to 18 allegations of abuse against people in positions of trust” despite the provider implementing a review on the issue 18 months earlier.

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Source: HSJ, 22 May 2023

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Trust execs accused of creating a ‘cult of the individual’

Regulators are probing a series of whistleblowing claims about the leadership culture of a trust which is rated ‘outstanding’ for its management, HSJ has learned.

It is understood multiple current and former staff members at Bolton Foundation Trust, including people in senior positions, have been in contact with NHS England and the Care Quality Commission in recent months.

The claims include a dramatic worsening in leadership culture at the trust, particularly around the FTSU process and people who speak up being bullied, side-lined and silenced. And investigations and meetings are stage-managed and tightly controlled by executives, with constant “sugar-coating” and positive spin on board reports, and intolerance of people who disagree.

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Source: HSJ, 22 May 2023

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Labour vows to reverse rise in suicides in England and Wales within five years

A Labour government would reverse the rise in the number of deaths from suicide as part of a health plan to replace pain and anxiety with a “hope of a renewed NHS”, Keir Starmer will pledge.

In a speech today, the Labour leader will say his plan for reforming the NHS will focus on the biggest causes of death in the UK including suicide.

He will point to coroners’ statistics showing that deaths from suicides have been rising since 2008, and reached a record high last year in England and Wales. If the party takes power Labour will reverse this rise within five years, Starmer will say.

A segment of his speech previewed by the party says: “Suicide is the biggest killer of young lives in this country. The biggest killer. That statistic should haunt us. And the rate is going up. Our mission must be and will be to get it down.”

Labour has not provided details on how it proposes to meet this pledge other than an aspiration to shift from “sickness to prevention”.

Starmer will also propose introducing new NHS targets on cutting deaths in England from heart disease and strokes by a quarter over 10 years.

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Source: The Guardian, 21 May 2023

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Gloucestershire maternity units still shut after staff shortages

Maternity services in Gloucestershire will remain shut for months because of staff shortages, it has been confirmed.

The Aveta Birth Unit in Cheltenham and Stroud's post-natal facilities are not expected to re-open until at least October, bosses say.

The announcement by Gloucestershire Hospitals NHS Foundation Trust means women will have been unable to use the services for more than a year.

Maternity campaigners say new mothers are not getting support they need.

The trust said it had a long-term commitment to both units, but they cannot reopen safely at the moment.

The Aveta unit has been shut since last June and Stroud's six postnatal beds have been closed since September.

It means new mothers are forced to go home 12 hours after giving birth, or if they have medical needs being sent to Gloucestershire Royal Hospital.

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Source: BBC News, 19 May 2023

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Leak shows NHSE ‘sorry’ for endorsing service which ‘hurt patients’

NHS England is ‘sorry’ for backing a mental healthcare model which it now admits has caused hurt to patients, according to a leaked draft policy document.

The serenity integrated mentoring model was launched in 2013 in the Isle of Wight and Hampshire. It quickly became viewed by mental health trusts as an “innovative approach” to helping support frequent users of the emergency services.

A core element of the scheme involves placing a local community police officer within the healthcare team charged with supporting those patients. 

In 2021, the pressure group StopSIM raised concerns about the model, which included a belief that police involvement was potentially coercive, criminalised mental health crises, and could result in withholding healthcare from people, which would breach human rights legislation. The group also argued the SIM programme had not been robustly and clinically evaluated.

As a result, NHSE committed to co-producing policy guidance on SIM with StopSIM. 

The draft document states: “NHS England did not apply sufficient scrutiny to the decision [to endorse SIM] and involve the voice of lived experience sufficiently. This compromised the safety and quality of care for service users and has caused hurt to patients. For this, NHS England is sorry.”

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Source: HSJ, 19 May 2023

Further reading on the hub:

The High Intensity Network (HIN) approach and SIM model for mental health care and 'high intensity users' – what are your views?

 

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Warning as baby dies and seven more fall critically ill with ‘usually mild virus’

A baby has died and seven others were left requiring intensive care after a “usually mild” virus appeared to trigger a serious heart condition, health officials have said.

The World Health Organization (WHO) said it had been notified of an “unusual” increase in myocarditis –inflammation of the heart – among newborns in south Wales infected with an enterovirus over the past year.

While enteroviruses are common and often asymptomatic, they are known to cause “occasional outbreaks in which an unusually high proportion of patients develop clinical disease, sometimes with serious and fatal consequences – in this instance myocarditis”, the UN health agency said.

While prior to the recent cluster of cases, south Wales had experienced only two similar cases in six years, the 10 months to April saw 10 cases of myocarditis in babies under the age of 28 days who tested positive for enterovirus, according to WHO.

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Source: The Independent, 19 May 2023

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Inquiry into major UK maternity scandal slams NHS for failure to consult Black and Asian families

An inquiry into maternity care failings at an NHS trust that left dozens of babies dead or brain-damaged is “wholly insufficient” because only a fraction of Black and Asian women have come forward, its chair has warned.

Donna Ockenden, who is leading a review into Nottingham University Hospitals NHS Trust, suggested the health service must do more to increase the number of responses from ethnic minorities if the trust is to learn from the scandal.

Less than 20 families from Black and Asian communities are currently involved in the inquiry, compared to more than 250 white families, The Independent understands.

It is understood letters have only been sent out in English, while Ms Ockenden pointed to examples of women being unable to access translation services and expectant Muslim mothers being turned away if they objected to male sonographers.

She said the communities’ “mistrust” towards the trust had “deepened”, leaving the review team “climbing a mountain” to engage with them.

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Source: The Independent, 18 May 2023

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Male GPs in England less likely to refer patients for IVF, report finds

Male GPs are less likely to refer eligible patients for IVF, research by a fertility charity suggests, raising concerns about access to NHS-funded treatment.

The Progress Educational Trust’s (PET) report highlights “utter confusion” and a lack of knowledge among GPs about eligibility criteria for NHS-funded treatment, which it says is exacerbating the so-called IVF postcode lottery. GPs typically make the initial referral to fertility clinics, meaning that they play a crucial role in access.

“For NHS treatment, GPs are the main initial gatekeeper. If you’re not getting pregnant, that’s who you go to for advice and support,” said Sarah Norcross, the director of PET. “It struck me that, when people have a known cause of infertility, male GPs still weren’t passing them on.”

The report is based on a survey of 200 GPs and commissioners across England, carried out by an independent research company, which investigated knowledge of national fertility guidelines and criteria they use for referral decisions.

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Source: The Guardian, 19 May 2023

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150 ‘sexual safety incidents’ reported at ‘inadequate’ service in six months

A mental health trust’s acute and intensive care wards have been downgraded to “inadequate”, following a series of incidents including sexual assaults, fire setting, and patients taking their own lives while on leave.

The Care Quality Commission (CQC) inspection was prompted by reports of several serious incidents involving patients in these services. These included three occasions where patients had taken their own lives while on leave from wards, and four incidents where fires had been set at the Redwoods Centre in Shrewsbury.

Inspectors also identified a steep rise in mixed accommodation breaches, with just one ward out of the four inspected at St George’s Hospital in Stafford and none of the three inspected at Redwoods providing single sex units. 

The CQC report added “there were concerns about the implications of mixed sex ward environments contributing to sexual safety incidents”, with 158 such incidents recorded in a six-month period leading up to the inspection. These included assaults, verbal threats of sexual assault, and sexual orientation related abuse, with 126 recorded at Redwoods and 32 at St George’s.

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Source: HSJ, 19 May 2023

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Use private sector more for NHS patients, says Labour

The government in England should increase its use of the private sector to tackle the NHS backlog, Labour says.

It said as many as 300,000 patients have missed out on treatment since it called for greater use of private clinics in January 2022.

And the party said it was unjust that the lack of action meant only those who could afford to pay for treatment themselves were being seen on time.

The government said it was delivering by cutting long waits. However, data published by NHS England last week showed key targets to tackle the backlogs in cancer care and routine treatment had been missed.

Overall, there are now a record 7.3 million people on a hospital waiting list, which is nearly three million higher than it was before the pandemic started.

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Source: BBC News, 19 May 2023

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'Multiple systemic failures' found at Royal Infirmary of Edinburgh A&E

Patients spent up to 25 hours on trolleys in corridors waiting for treatment and in some cases were left lying on "urine-soaked sheets" and in another on a "blood-stained pillow for several hours" at the Royal Infirmary of Edinburgh.

Healthcare Improvement Scotland (HIS) inspectors also raised concerns over fire safety in the overcrowded A&E after two visits to the hospital - the first of which was carried out between February 20 to 22 and a further unannounced follow-up in March.

The watchdog found "multiple systemic failures" in a report published on Thursday but NHS Lothian said a major improvement drive was already underway.

The health board added that the hospital was had just endured its busiest winter on record ahead of the inspections.

At the time of the inspection, the emergency department was on some days operating at over three times its capacity.

The report described this as unsafe and a "fire safety risk" with the evacuation plan in place at the time not reflecting the "significant" impact of overcrowding. 

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Source: The Herald, 18 May 2023

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Call for national guidelines on discussing past trauma in maternity appointments

National guidelines are needed to help maternity care professionals navigate discussions with pregnant women about past traumas, experts have said.

Their study, published in the journal Plos One, also found that while talking about previously experienced traumas can be valuable, they can also trigger painful memories if not approached sensitively.

The authors also raised concerns about the support available for professionals who may not feel equipped to explore challenging topics such as domestic or sexual abuse, childhood trauma and birth trauma without adequate guidelines or referral pathways.

Joanne Cull, a midwife and PhD student at the University of Central Lancashire’s School of Community Health and Midwifery, who is corresponding author on the study, said: “As awareness of the long-term effects of trauma on health and wellbeing has grown, there has been a move toward asking pregnant women about previous trauma, usually at the first appointment.

“No national guidance on this has been published in the UK so NHS Trusts have implemented this on a piecemeal approach.”

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Source: The Independent, 17 May 2023

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