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UK surgical workforce census 2023 opens

The Royal College of Surgeons of England is conducting a census to gain a better understanding of the surgical workforce.

Through the census, they will be able to gather comprehensive information on the composition of the surgical workforce, its demographics and working practices. Most importantly, it allows members of the surgical workforce to share the most pressing challenges they are facing. 

It aims to:

  • Better appreciate the needs, challenges, and working practices of the surgical workforce.
  • More effectively represent and advocate for the workforce.
  • Offer better support
  • Create a better working environment.
  • Enhance sustainability, including measures to improve retention, recruitment and work-life balance.
  • Improve future planning.

Take part in the survey

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Majority of NHS trusts provide no dedicated training to prevent sexual harassment

Only one NHS trust in England provides dedicated training to prevent sexual harassment, according to research, raising concerns that the NHS is failing to adequately protect staff and patients.

According to health union figures, sexual harassment of staff is pervasive. A 2019 survey by Unison found that one in 12 NHS staff had experienced sexual harassment at work during the past year, with more than half saying the perpetrator was a co-worker. In a recent BMA survey, 91% of female doctors reported sexism, 31% had experienced unwanted physical contact and 56% unwanted verbal comments.

Yet research by the University of Cambridge, published in the Journal of the Royal Society of Medicine found that the vast majority of NHS trusts did not provide any dedicated training to prevent sexual harassment.

The report analysed data from freedom of information requests from 199 trusts in England and found that just 35 offered their workers any sort of active bystander training (ABT), while only one NHS trust had a specific module on sexual harassment.

ABT is designed to give individuals the skills to call out unacceptable behaviour, from workplace bullying to racism and sexual misconduct. It is widely used by the military, universities and Whitehall, including the Home Office.

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Source: The Guardian, 5 May 2023

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Whistleblower says career shattered by treatment

A former top medic on the Isle of Man who was unfairly dismissed has said her career has been "shattered" by her treatment.

Rosalind Ranson was the Department of Health and Social Care's (DHSC) medical director from January 2020.

She was awarded a record £3.19m in compensation after a lengthy tribunal which ruled she had been unfairly dismissed for whistleblowing.

Dr Ranson raised a number of serious concerns about the coronavirus advice on the island that was not being passed on to ministers.

She was later marginalised before being dismissed as the island's top medic when the operational services of DHSC transitioned into Manx Care.

Dr Ranson said: "For me it is a tragedy that my 35-year career in medicine has come to an end through these circumstances.

"I was proud of my professional integrity, my resilience, and my strength to stand up for those that I protected through my work as a doctor."

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Source: BBC News, 4 May 2023

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NHS treatment algorithms ‘not taking transgender patients into account’

A host of algorithms used by medics to assess disease risk and help make decisions on treatment are failing to take transgender patients into account, doctors have said.

Many metrics and thresholds in medicine, including ideal body weight, alcohol clearance rates, kidney function and risk of cardiovascular disease vary by gender.

A team of UK doctors and medical students have issued a warning over a lack of evidence as to whether trans patients should be considered for these gender-based scores according to their gender assigned at birth or the gender they have transitioned to – or whether alternative scores are required.

In an effort to tackle the issue, the team have launched a research initiative called Trans Gap Project.

Dr Michael Niman, a junior NHS doctor and chair of the project, said: “Currently, daily medical decisions involving gender-based scores have limited to no research for the trans community. This means that trans patients are often forgotten about or not considered in the medical world, leading to a significant gap in their access to appropriate medical care.”

“When scores that haven’t considered trans people are used, patient autonomy is impaired for trans and gender-diverse patients, as they can’t make true informed decisions on their care – which is one of the bioethic pillars,” Niman said.

In some cases, there could be safety concerns. “Clinicians are currently faced with uncertainty regarding the best clinical practice to address these scenarios, owing to a lack of evidence-based guidance,” Niman said. “It is vital clinicians take a vested interest in the research of gender-based scores for the trans community due to the importance of safe practice considerations within the NHS.”

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Source: The Guardian, 5 May 2023

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Ministers missed chances to prepare social care for a pandemic, review finds

Distress and heartbreak for millions could have been avoided if the government had not missed opportunities to prepare social care for a pandemic, according to a big investigation into how the first wave of Covid hit care homes.

A review of events in spring 2020, when almost 20,000 care home residents died with Covid in England and Wales, found it was the result of “letting one of our most important public services languish in constant crisis for years”.

A two-year study by the Nuffield Trust health thinktank and the London School of Economics found successive governments failed to respond to risks already exposed by cross-government pandemic planning exercises, didn’t have enough civil servants working on social care, and failed to appreciate the sector’s fragility when sending patients into ill-prepared care homes.

The study is the latest independent assessment to undermine the claim by the former health secretary, Matt Hancock, to have thrown “a protective ring around social care”. It comes before the Covid-19 public inquiry’s investigation into the care sector, the timing of which has yet to be announced.

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Source: The Guardian, 5 May 2023

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Patient scarred for life after botched operation left him with severe burns

A patient who was left scarred for life when a botched operation left him with horrific burns has received a payout after suing the NHS.

Paul Hickman, 44, underwent routine surgery to improve circulation in his legs when medics at Russell Hall Hospital in Dudley, West Midlands, wrongly used a heated mattress.

He ended up with significant burns on his buttocks after an alcohol-based solution came into contact with the back of both thighs and his backside.

Mr Hickman, of Walsall, West Midlands, said: “I hoped that the surgery would go well and would improve my health.

“However, all I remember afterwards was being in severe pain.

“To be told I had suffered burns was a complete shock and at first was difficult to try and take in. I couldn’t understand how that had happened".

An NHS investigation found the use of heated mattresses was stopped in the type of procedure Mr Hickman underwent after another patient was burnt in 2016.

The report found the use of alcohol-based solution during Mr Hickman’s preparation for surgery and the “inappropriate use” of a heated mattress in surgery led to his burns.

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Source: The Independent, 4 May 2023

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Rise in UK measles cases causing concern

A "very concerning" rise in the number of people catching measles in the UK has been reported by health officials.

There were 54 cases of measles in the whole of last year. However, there have already been 49 in the first four months of 2023.

The UK Health Security Agency (UKHSA) is encouraging parents to ensure their children's vaccinations are up to date.

The main symptoms of measles are a fever and a rash. But it can cause more serious complications including meningitis, and an infection can be fatal.

Vaccination rates had been falling in the UK before the Covid pandemic. However, the disruption caused by Covid has dented vaccination programmes around the world, including in the UK, meaning even more children have missed out.

The World Health Organization has already warned of a "perfect storm" for measles, because the fewer people who receive protection from vaccines, the easier it is for outbreaks to happen.

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Source: BBC News, 4 May 2023

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Sick and tired: Australia's Long Covid inquiry report released

A national Long Covid and Covid-19 database is among the key recommendations of a unanimous report released by an Australian parliamentary Committee for its inquiry into Long Covid and repeated Covid infections.

The House of Representative’s Standing Committee on Health, Aged Care and Sport’s report aims to improve Australia’s response to Long Covid, an often-debilitating condition possibly affecting hundreds of thousands of Australians.

The Chair of the Committee, Dr Mike Freelander MP said: ‘It is clear that the emergence of Long Covid has created challenges for patients and health care professionals alike. People with Long Covid suffer from a lack of information and treatment options. Health care professionals, who worked tirelessly over the acute phase of the pandemic, are now in a difficult situation trying to support patients with this new and poorly understood condition.’

The Committee made nine unanimous recommendations aimed at strengthening the Australian Government’s management of Long Covid, including regarding:

  • A definition of long COVID for use in Australia
  • Evidence-based living guidelines for long COVID, co-designed with patients with lived experience
  • A nationally coordinated research program for long COVID and COVID-19
  • The COVID-19 vaccination communication strategy
  • Access to antiviral treatments for COVID-19
  • Support for primary healthcare providers
  • Indoor air quality and ventilation.

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Source: Parliament of Australia, 24 April 2023

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Global hernia repair devices market is estimated to grow at a CAGR

The rising prevalence of hernia disorders, technological advancements in hernia repair devices, growing adoption of mesh in hernia repair surgeries, rising geriatric population and high adoption of hernia repair surgical procedures are some of the key factors driving the global hernia repair devices market, reports Yahoo News.

Leading players operating in the global hernia repair devices market are adopting both organic and inorganic growth strategies such as collaborations, acquisitions, and new product launches to garner a higher market share.

For instance:

  • In February 2023, TELA Bio, Inc announced the launch of two additional configurations of its OviTex LPR device. The new configurations are 15 x 20 cm and 15 x 25 cm ellipses designed for ventral and incisional hernias.
  • In December 2022, Deep Blue Medical Advances announced that they have received an additional 510(k) clearance from the US FDA for its T-Line Hernia Mesh for the subway technique in open hernia surgery.

However, in a recent Tweet, campaign group Sling the Mesh voice their concerns:

mesh.png.05dbffab126c5ce27cc34c789483b633.png

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US drug regulator approves world's first RSV vaccine

The US Food and Drug Administration has approved a vaccine against respiratory syncytial virus (RSV) - an illness that kills thousands of Americans each year.

The vaccine still needs approval from the US Centers for Disease Control and Prevention before it can be rolled out to the public.

Officials say the vaccine, named Arexvy by the manufacturer GSK, is a major breakthrough that will save many lives.

It could be available to people over 60 within months, officials say.

"Today's approval of the first RSV vaccine is an important public health achievement to prevent a disease which can be life-threatening," said Dr Peter Marks, who leads the Center for Biologics Evaluation and Research at the Food and Drug Administration (FDA).

RSV is a respiratory illness that typically results in cold-like symptoms for adults, but can be dangerous for young children, the elderly, and those with underlying health conditions.

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Source: BBC News, 4 May 2023

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The anorexia patients abandoned by the NHS because 'they are too sick to treat'

Charlotte Nolan, 23, has been fighting the deadly eating disorder anorexia for seven years. And in November she hit rock bottom.

The student nurse was having weekly therapy sessions, but they weren’t helping and promised additional weekly visits from a support worker failed to materialise.

Her food obsessions were spiralling out of control and her mental health was plummeting. Hopes were pinned on a meeting with her community mental health team, where it would be decided what to do next.

There were discussions about several different treatment options. But the ultimate decision they made was baffling. Instead of continuing therapy, trying another treatment or hospital admission, they simply discharged her from care. She says: ‘I was sobbing, trying to express to a room full of strangers that I wasn’t sure I could cope, I wasn’t sure I could stay safe.

Charlotte’s story is heartbreaking but, alarmingly, she is not alone.

In fact, there are a rising number of desperately ill anorexia patients being deemed too sick to treat.

Experts have voiced concerns about both NHS and private clinics withdrawing life-saving treatment.

"I’ve been contacted by people who say they are discharged because they’re too sick or not recovering fast enough, and being told there’s nothing more that can be done,’ says Hope Virgo, an eating disorder campaigner and former patient.

"It’s heartbreaking. Some have been referred to palliative care. We don’t give up on patients with physical illnesses, we find different treatment methods which work for them. And yet, with eating disorders, it’s still a case of one-size-fits-all. Why aren’t we setting people up to have a chance of recovery? Instead, if treatment doesn’t work, services are washing their hands of them."

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Source: Mail Online, 29 May 2023

Read a blog Hope Virgo wrote for the hub last year: People with eating disorders should not face stigma in the health system and barriers to accessing support in 2022

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USA: Predictable, preventable medical errors kill thousands yearly. Is it getting any better?

Two years ago, administrators and caregivers at St. Bernard Hospital in Chicago were stunned when they flunked a basic standard for patient safety.

"It was a real jolt," said Charles Holland, the hospital's president and CEO. "We thought we were doing patient safety and we thought we were doing it well."

But the Leapfrog Group, a nonprofit health care watchdog organisation, found the hospital fell short on documenting and having comprehensive approaches to hand-washing, medication safety systems and fall and infection prevention.

The wake-up call led Holland to hire a Patient Safety and Quality Officer and to use Leapfrog's criteria as a roadmap for improving patient safety.

It worked. In its latest annual review of hospital safety, released Wednesday, Leapfrog awarded the century-old charity hospital an A.

The fact that St. Bernard could turn around so quickly and so effectively without spending a fortune in the process shows that patient safety is an attainable goal, said Leah Binder, Leapfrog's president and CEO.

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Source: USA Today, 3 May 2023

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Regulator withdraws midwifery programme accreditation

The Nursing and Midwifery Council (NMC) has withdrawn its accreditation of the midwifery programme at a Kent university due to fears over quality and safety.

The regulator highlighted concerns that Canterbury Christ Church University students were not gaining the expertise needed to deliver safe, effective and kind care.

An NMC director said the decision was made in the “best interests of women, babies, and families”.

The university said the decision had “devastating consequences” for their student midwives.

“Our absolute priority is the wellbeing of our students and staff, and ensuring that our students can continue to complete their studies and begin their future careers, to be the high quality, much needed midwives that this region needs,” a university spokesperson said.

Sam Foster, NMC executive director of professional practice, said while the decision would impact students and the local workforce, the regulator's role was to uphold the high standards that “women and families have the right to expect”.

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Source: BBC News, 4 May 2023

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Senedd could investigate Wales' Covid response in Labour-Tory deal

Wales' response to the pandemic could be investigated by a new Senedd committee under a deal between Welsh Labour and the Welsh Conservatives.

A special committee will see if there are any gaps in what the UK Covid-19 inquiry says about Wales.

It follows a long-running row over whether Wales needs its own probe into the pandemic.

The Welsh Conservatives welcomed the "halfway-house" compromise.

The Welsh government has continued to resist calls for a Wales-specific public inquiry into Covid, supporting instead the UK-wide effort chaired by Baroness Hallett.

The inquiry has a sub-module specific to Wales and will hold public hearings in the country this autumn.

Campaigners fear the UK inquiry will not be comprehensive enough.

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Source: BBC News, 4 May 2023

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NHS must ‘urgently’ publish data on mental health checks for pregnant women, say top doctors

The NHS must start sharing figures on mental health checks for pregnant women and new mothers amid gaps in hospital data, top doctors warn.

One in six NHS trusts is not able to say whether they screen pregnant women for mental health issues at all, despite national guidelines recommending these checks be done at 10 weeks. Suicide has been recorded has one of the leading drivers in post-natal deaths.

The findings come as the latest NHS figures show 51,000 women accessed specialist perinatal mental health services in the 12 months prior this fell short of a target for the NHS to see 66,000 mothers in 2022-23. Access levels have. however, improved from 31,000 a year in March 2022.

The Royal College of Psychiatrists has called for NHS England to “urgently” publish data on every hospital in the country showing whether they are carrying out this vital screening.

Last November the latest national report into maternal deaths, from researchers led by Oxford University, found suicide was again the leading cause of direct deaths in women a year after the end of their pregnancy.

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Source: The Independent, 4 May 2023

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Watchdog hits out at DHSC ‘ambiguity and delay’

The national patient safety commissioner has hit out at government for failing to confirm her budget a month into the financial year, warning that she is ‘incredibly limited’ in what she can achieve.

In an strongly worded letter released today, Henrietta Hughes states: “Despite it now being the end of April the Department has still not provided me with a budget for this financial year.”

She added: “This ambiguity and delay is impacting on my ability to arrange patient engagement events as these require a budget”.

It appears to be an almost unprecedented public intervention from an official who is appointed and hosted by the DHSC.

In the letter to Commons Health and Social Care Committee chair Steve Brine, she also says she does not have enough resources to fulfil the role, and is only able to employ four members of staff.

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Source: HSJ, 3 May 2023

 

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World ‘on cusp of first generation of treatments for Alzheimer’s’ as new drug ‘slows symptoms’

The world is “on the cusp of a first generation of treatments for Alzheimer’s disease”, experts have said, as a new drug was found to slow cognitive and functional decline.

The drug donanemab, made by Eli Lilly and Company, slowed decline by 35% to 36% in a late-stage phase 3 clinical trial, the company said.

Donanemab appeared to slow the decline associated with Alzheimer’s compared to placebo in 1,182 people with early-stage disease based on those with intermediate levels of a protein known as tau.

The drug also resulted in 40% less decline in the ability to perform activities of daily living, according to the firm.

Dr Susan Kolhaas, executive director of research and partnerships at Alzheimer’s Research UK, said: “This is incredibly encouraging, and another hugely significant moment for dementia research".

“The treatment effect is modest, as is the case for many first-generation drugs, and there are risks of serious side effects that need to be fully scrutinised before donanemab can be marketed and used.

“However, this news underlines the urgency of preparing the NHS to make these treatments available should regulators deem them safe and effective".

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Source: The Independent, 3 May 2023

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Thousands of NHS-funded appointments still carried out by unaccredited practitioners

Thousands of NHS-funded talking therapy sessions are still being carried out by unaccredited practitioners every month, despite NHS England trying to stop the practice for at least five years.

NHS Digital data for January this year showed 44,170 sessions involved practitioners who were neither in training nor had done an accredited course. The actual figure could be higher as, of the 517,027 sessions in total carried out, data about who was involved was missing for more than half (328,433).

Since last June, practitioners delivering NHS-funded “low intensity” talking therapies – previously known as Improving Access to Psychological Therapies – are required to be part of either the British Psychological Society or the British Association for Cognitive and Behavioural Psychotherapies’ registers. The registers, which were set up in 2021, confirm practitioners have completed an accredited course, ensure continuous professional development and provide a framework for striking off. 

Meanwhile, NHSE’s IAPT manual – first published in 2018 – states all clinicians should have completed an accredited training programme and a “robust and urgent” plan should be in place to train those who have not, including the possibility of those without accreditation being prevented from working alone. 

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Source: HSJ, 3 May 2023

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Calls for 11,000 more school nurses in UK as children’s needs grow

The UK needs at least 11,000 more school nurses to deal with the increasingly complex needs of young people after the pandemic, and help prevent them from developing serious mental health problems, researchers and campaigners say.

The number of school nurses has fallen by 35% in the last five years to about 2,000, and research by Oxford Brookes University, the University of Birmingham and the Oxford Health NHS foundation trust has found that a lack of long-term investment has resulted in many local areas scrapping the roles altogether.

The researchers surveyed 78 school nurses who shared feelings of exhaustion, stress and low morale, said Dr Georgia Cook, a researcher at Oxford Brookes University.

“Policymakers need to recognise and promote the integral role of school nurses in carrying out preventive public health work,” Cook said. “This should be supported by a sufficient workforce though, and bolstering school nurse numbers will be key to meeting the increasingly complex needs of children and young people in the wake of the pandemic.”

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Source: The Guardian, 2 May 2023

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'Dire' lack of dentists prompts self-medication

A "dire" lack of dentists has led to people "self-medicating every night", an MP has said.

Barrow and Furness MP Simon Fell said his constituents included seven-year-olds who had never seen a dentist and pregnant women who could not get an appointment.

“That simply is not good enough," he said.

"I now have constituents who have not seen a dentist in years," he said.

“There are pregnant mothers who are unable to make their appointments, constituents who are self-medicating every night because they cannot find care, seven-year-olds who have never seen a dentist and constituents performing their own dental care with packs they buy from Boots the Chemist."

Mr Fell told Parliament dental practices had told him they were unable to recruit enough dentists, especially in "rural, isolated areas such as mine".

He had been told the process for bringing in dentists from overseas "does not meet demand" and the administration for recording patient care, and the resulting payment to dentists, was "long-winded and overly complex", he said.

 

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Source: BBC News, 3 May 2023

 

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Poor mental health support during pregnancy risks UK women’s lives

Women’s lives are being put at risk by substandard mental health care during their pregnancy and in the first year after childbirth in most parts of the UK, a report has found.

About one in every five women develops a mental illness at some point during the perinatal period, the stage from pregnancy up to a year after giving birth. However, none of the health and social care boards in Northern Ireland or Wales met the national quality standards created by the Royal College of Psychiatrists’ Perinatal Quality Network (PQN).

Maternal deaths due to mental health problems are also increasing, with maternal suicide being the lead cause of deaths in the first year after childbirth. Despite this, the report by the Maternal Mental Health Alliance (MMHA) found that many specialist perinatal mental health services do not receive adequate attention or investment, or meet the quality standard of care.

The minimum standard of care that women, babies and families should receive is defined as PQN standards type 1. In England, only 16% of the specialist perinatal mental health community teams met these standards.

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Source: The Guardian, 2 May 2023

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Safety reporting overhaul faces fresh delay, despite Barclay’s ‘personal interest’

Fresh concerns have been raised about the launch of the national incident reporting system, despite Steve Barclay taking a ‘personal interest’ in hitting the tight timetable, HSJ has learned.

NHS England already delayed the launch of the “learning from patient safety events” database by six months, to September this year. It is due to replace the existing national reporting and learning system (NRLS)  which is considered to be outdated and at risk of failing.

But serious concerns are now being raised again by trust safety managers about whether the revised launch date can be met, HSJ has been told, with calls for it to be extended again until next year.

HSJ  has heard concerns from several managers that an upgrade due in July to the RLDatix risk management system – which is used by the majority of trusts – will cause knock-on problems implementing LFPSE in September. They said the timeframe was too short for testing and delivering the upgrade in time to make the transition and decommission the old NRLS.

The creation of LFPSE is a key part of NHSE’s safety strategy, along with replacing the serious incident reporting system, with an aim of making it easier for staff to record safety events across all services, including primary care, which is excluded from NRLS.

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Source: HSJ, 3 May 2023

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Health inspectors: North Midlands NHS Trust maternity unit 'requires significant improvement'

Maternity services at a trust in Staffordshire have been rated as 'requires significant improvement' by the Care Quality Commission (CQC).

University Hospitals of North Midlands NHS Trust in Stoke-on-Trent must now make urgent changes by June 30th 2023, to ensure patients are cared for safely.

It follows an inspection in March where inspectors said staff did not have enough effective systems in place to ensure patients were looked after to the standard they should be.

Staff also failed to implement a prioritisation process to ensure delays in the induction of labour were monitored and effectively managed, according to the review of services.

The CQC said midwives evaluating patients and handling triage processes did not effectively assess, document and respond to the ongoing risks associated with safety through triage.

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Source: ITV News, 28 April 2023

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NHS unions vote to accept government pay deal after months of strikes

Health unions representing the majority of NHS workers have voted to accept the government’s pay deal after months of strikes.

In a joint statement, members of the NHS Staff Council said the unions agreed to the deal for staff on the Agenda for Change contract, which includes all NHS workers apart from doctors, dentists and senior managers.

Unison and GMB unions - as well as smaller unions representing midwives and physiotherapists - voted to accept the deal, while the Royal College of Nursing voted against it. However, those in favour of the deal had the majority.

This bank holiday weekend saw the most extreme strikes yet from nurses with no exceptions for A&E, critical care and and cancer agreed nationally

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Source: The Independent, 2 May 2023

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Australia to ban recreational vaping in major public health move

Recreational vaping will be banned in Australia, as part of a major crackdown amid what experts say is an "epidemic".

Minimum quality standards will also be introduced, and the sale of vapes restricted to pharmacies.

Nicotine vapes already require a prescription in Australia, but the industry is poorly regulated and a black market is thriving.

Health Minister Mark Butler says the products are creating a new generation of nicotine addicts in Australia.

Also known as e-cigarettes, vapes heat a liquid - usually containing nicotine - turning it into a vapour that users inhale. They are widely seen as a product to help smokers quit.

But in Australia, vapes have exploded in popularity as a recreational product, particularly among young people in cities.

Vapes are considered safer than normal cigarettes because they do not contain harmful tobacco - the UK government is even handing them to some smokers for free in its "swap to stop" programme.But health experts advise that vapes are not risk-free - they can often contain chemicals - and the long-term implications of using them are not yet clear.Read full story

Source: BBC News, 2 May 2023

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