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Watchdog forced to hand over NHS staff names in safety failure cases

A national safety watchdog has been forced to release almost 100 pieces of evidence, including names of NHS staff, after being ordered to by courts.

A freedom of information request, submitted by HSJ, has revealed the Healthcare Safety Investigation Branch (HSIB) has been required to release 93 interviews with staff, family members and external experts, along with their identities, over the last two years. 

The interviews, which relate to HSIB investigations involving hospital trusts across England, were released to coroner’s courts through eight separate orders dating from February 2019.

A further four court orders compelled HSIB to release other information to coroners, including reports into trusts, findings of internal panel reviews, and evidence from external experts. The orders were made under the Coroners and Justice Act 2009.

When HSJ asked whether any NHS staff or family members were named in open court, HSIB said it was “not able to comment on specific instances”, but added that all those whose evidence was shared with the coroners were notified in advance.

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Source: HSJ, 23 February 2021

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COVID-19: Doctors feel under pressure to work extra shifts unpaid, survey shows

Thousands of doctors feel under pressure from their employers to work extra shifts, often unpaid, to help tackle the backlog of care caused by the covid pandemic, the BMA has warned.

The warning came after results from the BMA’s latest tracker survey showed that more than half its respondents (58%, 2834 of 4876) had worked extra hours in the previous month as part of the response to the pandemic. Almost a third (29%, 1387) said they were not paid for the additional time they worked.

More than two fifths (44%) of respondents (2086 of 4719) said they felt under pressure from their employer to do extra hours in the last month. And more than a third (36%, 1759) had either skipped taking full breaks altogether or taken them on rare occasions in the past fortnight.

Nearly six in 10 doctors who responded (57%, 2889 of 5059) reported a higher than normal level of fatigue or exhaustion because of working or studying during the pandemic.

Chaand Nagpaul, the BMA’s chair of council, said, “To learn that an already depleted and now exhausted workforce feels forced into doing more and more hours, with many reporting higher levels of fatigue than ever, is extremely worrying. It is putting them and their patients at risk. Working ‘flat out’ without a change to rest and recuperate is simply unsustainable and unsafe."

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Source: BMJ, 10 May 2021

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Woman loses seventh baby after concerns about delayed caesarean were ‘dismissed’ by doctors

A woman who suffered six miscarriages lost her seventh baby after doctors delayed her caesarean section, a report has found.

Chyril Hutchinson was admitted to hospital in February 2021 with high blood pressure when she was 37 weeks pregnant with her daughter Ceniyah Cienna Carter, and was told by doctors at Mid and South Essex NHS Foundation Trust she would need a caesarean.

But the procedure was delayed as a result of staffing pressures and because Ms Hutchinson’s blood pressure stabilised. She was then told she would have to wait another two weeks for it to be carried out.

Given her previous miscarriages, Ms Hutchinson said she pleaded for her baby to be delivered earlier, but her concerns were “dismissed” and she was sent home. Days later, a scan revealed that her baby had died.

A trust investigation into Ms Hutchinson’s care found that staff had failed to properly monitor the growth of her baby, which could have indicated the need for an earlier delivery.

The internal report, seen by The Independent, also revealed that on the day Ms Hutchinson was told she should have a casaerean, the hospital was six midwives short and the department was busy - a situation the trust said “places additional pressures and possible overload on medical staff”.

However, the report concluded that staffing levels did not affect Ms Hutchinson’s care, and it did not state whether the wider failings had led directly to her child being stillborn.

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Source: The Independent, 5 June 2022

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Baby died after hospital failings starved her of oxygen at birth

A baby suffered brain damage and died due to failings at a hospital where her mother spent hours alone in pain and suffered crucial delays, according to her family.

Dominic and Ewelina Clyde-Smith told The Independent their daughter, Amelia, was otherwise healthy and poor care led to her being starved of oxygen at birth.

The couple said they experienced a series of failings at Jersey General Hospital in 2018, including a lack of a doctor during a difficult labour and staff taking “too long” to resuscitate their child.

They believe Amelia suffered further harm when a ventilator was not plugged in properly during a transfer.

Amelia was left with brain damage and died aged one month after being put into palliative care.

Her parents said they have spent years trying to get justice through official channels but are now speaking out for the first time as they believe the standard of care received should be public knowledge.

“It happened nearly four years ago,” Ms Clyde-Smith says, adding: “But the whole maternity unit just failed us completely.”

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Source: BBC News, 1 July 2022

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A home help for eight days after giving birth? Why Dutch maternity care is the envy of the world

To new parents processing the shock of delivery and swimming in hormones, newborns can feel like a tiny, terrifying mystery; unexploded ordinance in a crib. “We were totally unprepared,” says Odilia. Neither she or her husband had ever changed a nappy and had no idea the baby needed feeding every three hours. “If you’re a new mum or dad, you have no idea,” recalls Anouk, a new mother. “I’m a doctor,” says Zarah, another new mother, incredulously. “So, you would expect that I’d know something, and I knew some things, but you really don’t have any clue.”

The difference for these new parents, compared to the rest of us, is that they gave birth in the Netherlands. That meant help was instantly at hand in the form of the kraamzorg, or maternity carer. Everyone who gives birth in the Netherlands, regardless of their circumstances, has the legal right – covered by social insurance – to support from a maternity carer for the following week.

These trained professionals come into your home daily, usually for eight days, providing advice, reassurance and practical help. It’s a different role to midwives, who continue to monitor women and babies after the birth in the Netherlands; the maternity carer updates the midwife on the mother and baby’s health and progress as well as supporting the parents as they come to terms with their new child.

A maternity carer in the Netherlands, explains Betty de Vries of Kenniscentrum Kraamzorg, the organisation that registers maternity carers, “takes care of the woman the first week, advises her on breastfeeding and bottle feeding, hygiene, gives advice … everything to do with safe motherhood and a safe baby. She is there for the whole day most of the time so she can see how they are doing.” Her colleague, director Esther van der Zwan, adds: “It’s a lot of responsibility.” To prepare, maternity carers train for three years – a combination of academic and on-the-job placements – and have regular refresher training in everything from CPR to breastfeeding support.

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'Little progress' for NHS patient safety over past 20 years, says chief inspector of hospitals

“Little progress” has been made improving patient safety in the NHS over the past 20 years, said the Chief Inspector of Hospitals at the Care Quality Commission (CQC). 

Professor Ted Baker yesterday revealed he receives between 500 and 600 reports of “never events” a year, incidents that are wholly preventable whatever the circumstances.

This includes an occasion where surgeons operated on the wrong eye of a patient.

Speaking at Patient Safety Learning's annual conference, he said that hospital managers routinely hide evidence from the CQC, because they regard the organisation as out to blame them.

The chief inspector called for a fundamental change in culture whereby NHS bosses drove safety improvements for their own sake, rather than in order to pass an inspection.

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Source: The Telegraph, 2 October 2019

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Trust ‘could have avoided four never events’ if it had acted on alert

A trust which had four ‘never events’ where patients were connected to air rather than an oxygen supply could have avoided them if it had been more proactive when a national patient safety alert was sent out several years earlier, a report has found.

In one case, a baby being investigated for sepsis had oxygen saturation levels of just 75% before the mistake was realised. In another, a woman with COPD and pneumonia had oxygen saturation at 80% when she was connected to the air outlet.

Calderdale and Huddersfield Foundation Trust asked the Royal College of Physicians to carry out an invited review after the four never events at Calderdale Royal Hospital in 2018 and 2019. The earliest incident happened in February 2018 but was not identified until a retrospective audit nearly a year later.

The RCP’s report said that, had this been identified earlier, “steps could have been put in place to avoid such incidents from subsequently occurring”.

But it added: “All four never events could have been avoided if the trust had responded more proactively to the previous NHS Improvement patient safety alert about the dangers of erroneously connecting patients to air instead of oxygen and had subsequently restricted access to air outlets.”

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Source: HSJ, 2 November 2020

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Pfizer vaccine ‘95% effective against coronavirus,’ new data shows

Two doses of the Pfizer-BioNTech vaccine can provide more than 95% protection against infection, severe illness and death from Covid, according to a groundbreaking study in Israel.

The middle eastern country currently leads the world in its inoculation programme, with more than half (56 per cent) of its population having already received both doses of the Pfizer vaccine.

The research, published today in The Lancet journal, also concluded that a single dose of the jab provides 58 per cent protection against infection, 76% against hospital admission, and 77% against death.

The researchers said their study highlights the importance of fully vaccinating adults against the virus but acknowledged challenges remain to get the pandemic under control – including uncertainty around how long immunity lasts, from both vaccines and natural infection, and the emergence of variants that may be resistant to jabs currently on the market.

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Source: The Independent, 6 May 2021

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Increasing management spend does not improve hospital performance, research concludes

There is no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services, research has concluded.

Researchers at the London School of Economics studied the performance of all 129 non-specialist acute trusts between 2012-13 and 2018-19.

They measured hospital performance on five indicators covering financial position, elective and emergency waiting times, level of admissions and mortality. This was then compared to the number of managers each trust employed and the amount spent on management staff.

The researchers also attempted to measure the quality of management based on answers given to relevant questions in the annual NHS staff survey.

Reviewing the evidence they analysed, the LSE team state: “We find no evidence of an association between our measures of quantity of managerial input and quality of management… Furthermore, we find no associations between our measures of quantity of management input and five measures of hospital performance.”

They add: “This holds, irrespective of how we define managerial input, whether by number of managers or expenditure on management. These results are generally robust to how we account for variation between hospitals and within hospitals over time.”

This leads the researchers to conclude: “Hospitals hiring more managers do not see an improvement in the quality of management leading to better performance, and increasing the numbers of managers does not appear to improve hospital performance through any other direct or indirect mechanism.”

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Source: HSJ, 17 January 2022

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NHS management overly ‘task focused’, government review finds

NHS management and leadership are overly ‘task focused’, according to briefings by the senior military leader who has carried out a major review of health and care for the government. 

General Sir Gordon Messenger has nearly completed the work, which had been due to be published shortly before Easter but was delayed by the government, and has briefed several senior leaders on several of his main observations.

According to several senior figures, he has said NHS management and leadership are heavily “task focused” — a management term referring to an approach devoted to completing certain tasks or meeting certain short-term objectives; in contrast to an approach which focuses on people, relationships or skills.

HSJ has spoken to several senior sources who have been briefed on Sir Gordon’s findings so far.

One said the former military figure had observed that “NHS leadership is… very focused on getting things done, and not focused enough on how things get done – which I think is very fair if you think particularly what the last 10, 15 years have been like”.

Another finding, according to those briefed, is the need for better support for NHS leaders running the most difficult local organisations, including providing what has been described as “support packages”.

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Source: HSJ, 26 April 2022

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Record waits for endoscopy as referrals soar

The waiting list for endoscopies has broken the record set during the height of the covid pandemic, as referrals for suspected colorectal cancer surged, HSJ analysis shows.

In November 2022, 110,00 people were waiting for a colonoscopy (or flexible sigmoidoscopy) and the median wait was 4.2 weeks, double the median wait in November 2019. The pandemic peak waiting list for these tests was 107,000 in September 2020.

Nearly a quarter of those waiting as of November 2022, the most recent figures, were on the list for more than 13 weeks. In November 2019 only 2.9 per cent of the list waited this long.

Health policy manager Matt Sample said: “As with all diagnostic services, endoscopies were hit hard by the pandemic, but the service was under considerable strain even before this as staff numbers and equipment simply weren’t rising to match demand.

“The latest data shows that more than two in 10 people who started treatment for bowel cancer in England waited more than 104 days since their urgent referral – this is unacceptable.

“Without continued efforts to expand diagnostic capacity, and in particular investment in addressing chronic workforce shortages, people affected by cancer will not receive the care they deserve.”

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Source: HSJ, 24 January 2023

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Prescribing antidepressants for chronic pain lacks evidence, experts say

Researchers have warned there is a lack of evidence around prescribing antidepressants for chronic pain.

Guidance from the National Institute for Health and Care Excellence (Nice) in 2021 recommends that an antidepressant (amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline) can be considered for people aged 18 and over with pain lasting longer than three months which cannot be accounted for by another diagnosis.

The guidance said the drugs may help with quality of life, pain, sleep and psychological distress, even if the patient is not suffering depression.

A separate guideline on neuropathic (nerve) pain recommends offering a choice of treatments, including amitriptyline and duloxetine, alongside a discussion on possible benefits and side-effects.

However, researchers writing in the BMJ have warned that recommending antidepressants for pain is not always backed by evidence.

Professor Martin Underwood from the University of Warwick, said: “There is a role for antidepressants in helping people living with chronic pain, however, this is more limited than previously thought.

“Antidepressants may have unpleasant side effects that patients may wish to avoid.

“We need to work harder to help people manage their pain and live better, without relying on the prescription pad.”

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Source: The Independent, 1 February 2023

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Health warning as common painkiller linked to kidney damage

Consumers are being urged to exercise caution when using common anti-inflammatory medications such as ibuprofen for pain relief due to potential adverse effects on kidney function.

Those with a higher risk of kidney disease, including individuals with diabetes or high blood pressure, should be especially careful, warn Kidney Care UK and the National Pharmacy Association (NPA).

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and diclofenac can elevate blood pressure and damage blood vessels within the kidneys.

Olivier Picard, chair of the NPA, said: “Medicines have the power to harm as well as to heal.

“Although NSAIDs, such as ibuprofen, are effective and safe medicines, patients should be aware of their impact – particularly if a patient is at increased risk of developing kidney disease – and consider alternative medication where appropriate.

“If a patient has concerns about their usage of NSAIDs, they should speak to their pharmacist who can advise them.

“Pharmacists are experts in medicines and are best placed to offer advice to people who may be concerned about any potential long-term effect of some medicines and can help patients effectively manage pain.”

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Source: The Independent, 13 March 2026

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The NHS Patient Safety Strategy

NHS Improvement and NHS England have published their NHS Patient Safety Strategy. The publication out today describes how the NHS will continuously improve patient safety, building on the foundations of a safer culture and safer systems. The strategy sets out what the NHS will do to achieve its vision to continuously improve patient safety. 

 

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Dementia patients being 'dumped in hospital'

Dementia patients are being dumped in hospitals in England because of a lack of community care, a charity says.

The Alzheimer's Society called for action, highlighting data showing one in 10 dementia patients spends over a month in hospital after being admitted.

The figures also suggested the overall number of emergency admissions among people with dementia is rising - with some patients yo-yoing back and forth.

Ministers said they were "determined" to tackle the problems. Central to this, the government said, would be plans for reforming the social care system, which encompasses care home places and support in people's homes.

Alzheimer's Society Chief Executive Jeremy Hughes said people were falling through the "cracks of our broken social care system".

"People with dementia are all too often being dumped in hospital and left there. Many are only admitted because there's no social care support to keep them safe at home. They are commonly spending more than twice as long in hospital as needed, confused and scared."

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Source: BBC News, 22 January 2020

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Mass cancellations of NHS operations inevitable this winter, say doctors

Mass cancellations of routine operations in England are inevitable this autumn and winter despite an NHS edict that hospitals must not again disrupt normal care, doctors’ leaders have said.

Organisations representing frontline doctors, including the British Medical Association (BMA), also criticised NHS England for ordering hospitals to provide “near normal” levels of non-Covid care in the second wave of the pandemic, and demanded that fines for failing to meet targets be scrapped.

"Things are very, very difficult at the moment, very challenging at the moment. It feels like a juggling act every day,” said one official in the South Yorkshire NHS. “The problem is both the growing numbers of patients coming into hospital with Covid and the numbers of staff we have off sick due to Covid, either because they are ill themselves or because someone in their household has symptoms, so they are isolating.”

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Source: The Guardian, 23 October 2020

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NHS 'riddled with racism' against ethnic minority doctors

The NHS is "riddled with racism", the chair of the British Medical Association's council has told the BBC.

Dr Chaand Nagpaul has spoken out in response to a survey by the BMA, shared exclusively with BBC News.

At least 75% of ethnic minority doctors experienced racism more than once in the last two years, while 17.4% said they regularly faced racism at work, the survey said.

NHS England said it takes a "zero-tolerance approach" to racism.

Racism affects patients as well as doctors' wellbeing, by stopping talented people from progressing fairly and affecting doctors' mental health, Dr Nagpaul warned.

"This is about a moral right for anyone who works for the NHS to be treated fairly," he said.

Around 40% of the NHS's 123,000 doctors are from minority backgrounds, compared to about 13.8% of the general population. But despite this diversity, doctors told the BBC that there was a toxic "us versus them" culture in NHS trusts across the UK.

They said they had faced bogus or disproportionate complaints from colleagues, racist comments from superiors, and even physical assault in the workplace. Some said they had tried to lodge complaints which were then ignored or dismissed without investigation.

One consultant, from a black African background, told the BMA that after reporting previous incidents "no action was taken... I feel uncomfortable and anxious of reprisals".

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Source: BBC News, 2 February 2022

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Substantial fall in diabetic health checks as GPs reprioritised during pandemic

The proportion of patients with type 2 diabetes who have had recommended health checks has fallen substantially, provisional data from 2021 suggests, as have the numbers hitting key disease control targets.

In response, primary care experts have called for GP practices to receive targeted investment to focus on the checks, which they had to deprioritise as the vaccination programme was introduced.

There are now 3.24 million people with a diagnosis of type 2 diabetes in England, the data across all GP practices shows.

National Diabetes Audit figures for England from January to September 2021 showed that:

  • 74% of patients had received a HbA1c check and 70% a blood pressure check compared with 93% and 95% respectively in 2019/20.
  • In the first nine months of last year, 61.9% of patients had an HbA1c under 58 mmol/mol, compared with around 66% in previous years.
  • The proportion of patients with blood pressure targets of under 140/80 was 66.5% in the latest figures compared with around 73-74% during 2015 to 2020.

Speaking with Pulse, Professor Partha Kar, NHS England national specialty advisor for diabetes said while this was not the final data, a drop off had been expected for a range of reasons outside GPs control.

‘What we have seen is that there was a massive drop off in wave one. Then around the middle of 2020 it started to pick up again but then it’s dropping off again so irrespective of data cleaning, I suspect you will see a massive drop off compared to where things have been over the last four or five years.

‘We need to be very clear its not because anyone was twiddling their thumbs, it’s because primary care was asked to do something else.

‘We can’t go back to primary care again for the vaccines because they are being taken away from the thing that they’re amazing at which is delivering long-term conditions at scale.’

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Source: Pulse, 2 February 2022

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Patients to receive better care as NHS and social care systems link up

Patients will receive better, more joined-up care under new plans announced to improve the links between health and social care.

The integration white paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff.

Despite the best efforts of staff, the current system means that too often patients find themselves having to navigate complex and disjointed systems. Those with multiple conditions can be left feeling frustrated at having to repeatedly explain their needs to multiple people in different organisations, while others can end up facing delayed discharge because the NHS and local authorities are working to different priorities in a way that is not as joined up as it could be.

The white paper sets out some of the ways health and care systems will draw on the resources and skills across the NHS and local government to better meet the needs of communities, reduce waiting lists and help level up healthcare across the country.

Health and Social Care Secretary Sajid Javid said: "Better integration is vital to stop people falling into the gaps between health and social care. Ensuring our health and care systems work in unison will mean we can support hardworking staff, provide better care to patients and deliver value for the taxpayer."

"Our Integration white paper is part of our wider plans to reform and recover the health and social care system, ensuring everyone gets the treatment and care they need, when and where they need it."

The plans set out in the white paper will ensure care is more personalised and accessible and remove the burdens on patients. Better information sharing will mean people will no longer have to remember key facts such as dates of diagnosis or medicines prescribed, taking pressure off patients to coordinate their own care.

Local health services will be tailored to the specific needs of the community to ensure the right services are available. This could mean for example more diabetes clinics in areas with higher obesity, or additional support for people to stop smoking in communities where there are higher numbers of smokers.

The integration white paper is the next step in delivering the government’s promise of a health and social care system fit for the future. It builds on both the Health and Social Care Bill and the People at the Heart of Care white paper which set out a 10-year vision for social care funded through the Health and Care Levy, and follows the delivery plan for tackling the COVID-19 backlog of elective care. Dedicated plans to tackle health disparities are set to be published in due course.

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Source: Gov.uk, 9 February 2022

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Safety regulator refused to investigate some NHS staff Covid deaths

Britain’s safety at work regulator refused to investigate reports from NHS trusts that 10 frontline staff had died as a result of catching Covid-19 during the pandemic.

The Health and Safety Executive (HSE) declined to look into at least 89 dangerous incidents that NHS trusts said involved healthcare workers being exposed to Covid, including 10 deaths.

The stance taken by the HSE, which oversees workplace health and safety and can bring prosecutions, is disclosed in freedom of information requests by the Pharmaceutical Journal. It has prompted concern that the regulator is too strict in its definition of workplace harm.

It found that 173 trusts in England submitted at least 6,007 reports about employees’ exposure to Covid-19 in the course of their duties to the HSE between 30 January 2020 and 11 March 2022, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR).

They included 213 “dangerous occurrences”, which are incidents that have the potential to cause significant harm; 5,753 cases where a staff member had caught Covid-19; and 41 deaths among people who had been exposed to the disease at their workplace.

However, the HSE refused to look into five Covid deaths reported under the RIDDOR scheme by the Yorkshire ambulance service (YAS) because of what it considered a lack of evidence.

The regulator also decided not to look into the Covid deaths of five staff at University College London hospital acute trust, despite the trust’s belief they had caught it at work. “The HSE found that there was no reasonable evidence that the infection was contracted at work,” a trust spokesperson said.

Shelly Asquith, the health, safety and wellbeing officer at the Trades Union Congress, said the HSE’s decisions and claimed lack of evidence was “really concerning”. It suggested a continued “element of denial about Covid being airborne and it not being possible to necessarily pinpoint where exactly somebody was exposed once it’s in the air”, she added.

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Source: Guardian, 26 May 2022

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IHPN launch “refresh” of medical governance framework for independent providers

The Independent Healthcare Providers Network (IHPN) have today launched a “refresh” of its Medical Practitioners Assurance Framework (MPAF), designed to further improve the safety and quality of care independent providers deliver to patients.

Initially launched in October 2019, the MPAF – led by former National NHS Medical Director Sir Bruce Keogh – contains key principles to strengthen and build upon the medical governance systems already in place in the sector and sets out expected practice in a number of key areas.

Care Quality Commission (CQC) now uses the framework’s principles in assessing how well-led an independent service is, with the framework a requirement of the NHS’ 2022/23 Standard Contract which all independent sector providers of NHS-funded care must adhere to.

The MPAF was always designed to be a “live document” and today’s refresh strengthens the framework to ensure it remains in-keeping with current best practice in the health system. This includes taking into account recommendations from the Bishop of Norwich’s inquiry into Ian Paterson, as well as Baroness Cumberlege’s Independent Medicines and Medical Devices Safety Review (IMMDS). Key areas strengthened in the refresh include giving more prominence to expectations around patient consent, and the need to have greater transparency around conflict of interest declarations.

New initiatives such as the Learn from Patient Safety Events (LFPSE) service are also reflected in the refreshed framework, as well as an IHPN Development Plan which sets how the network will support providers to continue to implement the MPAF.

 David Hare, Chief Executive of the Independent Healthcare Providers Network (IHPN) said:

 “IHPN are delighted to be launching today a new refresh of our Medical Practitioners Assurance Framework (MPAF), reflecting the independent health sector’s commitment to continuously improving the safety and quality of care they deliver to millions of patients every year.

“Since the MPAF was launched in 2019, independent healthcare providers – with the support of CQC and NHS England –  have really embraced the framework, using it to review and update their practices to further raise the bar in medical leadership in the sector.

“With a continued focus amongst the entire healthcare system around improving patient safety and quality, this framework ensures providers adhere to the latest medical governance practices.

“This will not only ensure greater consistency around how clinicians work across the independent sector and NHS, but also give confidence to patients that independent healthcare providers are committed to delivering the safest possible care”.

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Source: Independent Healthcare Providers Network, 26 September 2022

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Women at greater risk of heart attack death due to medical sexism

Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows.

Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades.

It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure.

Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram.

Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers.

Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system."

“The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added.

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Source: The Times, 5 October 2023

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‘Catastrophic’ threat to cancer ops at England’s third largest hospital trust

Cancer services at large hospital trust have been at ‘catastrophic’ risk of being overwhelmed, after two of its hospital sites had to suspend life-saving cancer surgeries in the last month due to COVID-19.

In its latest board papers Mid and South Essex Foundation Trust rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic”. It said the expected consequences at this risk level include “permanent disability or death, serious irreversible health effects” and an “unacceptable… quality of service”.

The trust runs three general acute hospitals in the county. Its 2,000 plus beds make it the third largest trust in England after University Hospitals Birmingham FT and Leeds Teaching Hospitals.

The same board papers, dated 28 January, said cancer surgery at Southend University Hospital, one of three hospital sites run by the trust, “ceased on 24 December”. At a second hospital site, Mid Essex Hospital covid “hit hard just before Christmas” and elective work was “dramatically impacted with short period of life and limb only carried out on site”. This meant all P2 cancer surgery — which requires treatment in less than four weeks — did not take place. 

Both hospital sites said they hoped the independent sector could help them restart cancer surgeries this month with a focus on “long waiting and clinical urgent patients”. It is not clear how much capacity the sector has to work through waiting lists and the board papers said “some of this capacity may be reduced” because of recent changes to a new national contract for the independent sector.

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Source: HSJ, 29 January 2021

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'There’s a lot of nasty stuff': the people living with long Covid

Sufferers say they have had little specialist help despite NHS England setting up dedicated clinics.

“It’s not that I feel I have been abandoned, I think that is perfectly obvious,” says Rachel Pope. “If you speak to any long Covid patient, they have been abandoned.”

Until exactly a year ago – 5 March 2020 – Pope was “an incredibly fit woman”. A senior lecturer in European prehistory at the University of Liverpool, her work and lifestyle were very active. But after falling ill to Covid, she spent four months unable to walk, then three more when she could manage little more than “a sort of shuffle”.

She still has a host of symptoms, “but the most debilitating is the fact that I still can’t do more than 2,000 steps in a day. Until a few weeks ago, I was still choking every day. There’s a lot of nasty stuff that [long Covid sufferers] are living with, without treatment.

“It’s not a great situation to be in. I mean, we didn’t die. But this isn’t exactly living either.”

A year into the pandemic, accounts such as Pope’s have become dispiritingly familiar, as the experiences of the many thousands who have struggled for months with long Covid, often alone and unsupported, are emerging.

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Source: The Guardian, 5 March 2021

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Patient safety and the right of the sick to reject care from unvaccinated staff

The question of whether to impose a policy requiring mandatory vaccination for NHS staff has raised countless ethical and practical considerations, but with many healthcare workers still unvaccinated and the Government set for a U-turn over mandatory Covid jabs for NHS staff in England, has enough thought been given to the perspective of patients?

Various legal experts and health groups have argued that while doctors and nurses can reject the offer of vaccination, patients should also have the right to refuse treatment from a healthcare worker who is not jabbed, instead requesting that their care is placed in the hands of someone who is protected.

With the February deadline pushed back, could patients start to grow weary of staff who have not been vaccinated? Will they feel as though the chance for refuseniks to get jabbed has come and gone, and that it is therefore justified that they are stripped of their right to deliver treatment?

“Patients have a right to safe care, so it’s reasonable for patients to expect any health or social care professional caring for them to have had a Covid-19 vaccine,” says Rachel Power, chief executive of the Patients Association.

Most patients may not be overly concerned about the vaccination status of those caring for them, but in a world in which we’re expected to live alongside the threat posed by Covid, there are undoubtedly certain groups who will be more invested in these matters.

“A person who is ‘vulnerable’ by way of disability or chronic illness (eg immunocompromised) may well have an argument under the Equality Act that the NHS failing to provide vaccinated staff to them constitutes disability-based discrimination,” says one barrister who specialises in mental health capacity law.

After all, these individuals are most at risk from COVID-19 – and will be for years to come. Clinically vulnerable people who do find themselves in hospital for whatever reason will know that a Sars-CoV-2 infection could further exacerbate their condition, or endanger their lives.

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Source: The Independent, 30 January 2022

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