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Clinically vulnerable Covid patients denied access to life-saving antivirals

Clinically vulnerable people infected with Covid are being denied access to potentially life-saving antiviral medicine, patients, health officials and charities say.

Around 1.3 million people with underlying health conditions in England have been identified by the NHS as at-risk and sent letters explaining they will be assessed for antiviral treatment if infected with Covid.

The NHS said “tens of thousands of the most vulnerable patients” have received the medication to date, but told The Independent it was “aware of some local issues” in which clinically vulnerable people have struggled to access the antivirals. It comes at a time of record-breaking infection levels.

Patients seeking the treatment, which suppresses an infection to prevent disease escalation and hospitalisation, have reported being turned away by GPs and hospital doctors, while others say they’ve been “pushed from pillar to post” in an attempt to access the medication.

An NHS manager told The Independent that only 15% of eligible patients cared for by Kent and Medway Clinical Commissioning Group received antiviral medication in February.

Anthony Nolan, the blood cancer charity, and Kidney Care UK both said they had received reports that Covid Medicine Delivery Units (CMDUs), which are responsible for ensuring antiviral medication reaches patients, were overwhelmed and struggling to provide treatment.

“Weekends are a particular problem and it causes a lot of stress,” said Fiona Loud, a policy director a Kidney Care UK. “We have had reports from people in different parts of the country.”

Paxlovid, molnupiravir and remdesivir are available via the NHS as antiviral medicine. All three have been shown to be effective in reducing the risk of hospitalisation among infected vulnerable patients. Antibody treatment, administered intravenously, is also available.

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Source: The Independent, 4 April 2022

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‘Global crisis’ of violence: 161 healthcare workers were killed last year, study finds

Violence against healthcare workers has become a “global crisis”, with 161 medics killed and 188 incidents of hospitals being destroyed or damaged last year, according to a new report.

Data collected from 49 conflict zones by the Safeguarding Health in Conflict Coalition (SHCC), also found that 320 health workers were wounded in attacks, 170 were kidnapped and 713 people were arrested in the course of their work.

The US-based group said on Tuesday that, although the total number of attacks was similar to those recorded in recent years, there had been an increase in violence in areas of new or renewed conflict in 2021, “underlining the fact that attacks on healthcare are a common feature in many of today’s conflicts”.

Christina Wille, director at Insecurity Insight, which led the data collection and analysis, said: “Violence against healthcare resulted in widespread impacts on public health programmes, vaccination campaigns and population health, contributing to avoidable deaths and long-term consequences for individuals, communities, countries and global health writ large.”

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Source: The Guardian, 24 May 2022

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High court judge ‘deeply frustrated’ by NHS delays in suicidal girl’s care

A high court judge has expressed her “deep frustration” at NHS delays and bureaucracy that mean a suicidal 12-year-old girl has been held on her own, in a locked, windowless room with no access to the outdoors for three weeks.

In a hearing on Thursday, Mrs Justice Lieven told North Staffordshire combined healthcare NHS trust “you are testing my patience”, after she heard that a proposal to move Becky (not her real name), could not progress until a planning meeting that would not be held until next week, and that a move was not anticipated until 2 March.

Three sets of doctors at the hospital trust have disagreed as to Becky’s diagnosis; at her most recent assessment doctors said she was not eligible to be sectioned, which would trigger the protections provided by the Mental Health Act, because her mental disorder was not of the “nature and degree” as to warrant her detention.

In a robust exchange, the judge demanded: “Where’s the urgency in this … I cannot believe that the life and health of a 12-year-old girl is hanging on an issue of NHS procurement, when you cannot tell me what it is you’re trying to procure.

“If the delay is procurement, I’m not having it,” Lieven continued. “I will use the inherent jurisdiction to make an order. We have a 12-year-old child in a completely inappropriate NHS unit for about three weeks, and it’s suddenly dawned on your client that ‘actually we’ll put her in a Tier 4 unit and we might have to do some [building] work.’”

Sometimes, the judge said, “public bodies have to move faster”.

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Source: The Guardian, 17 February 2023

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One patient dies every 23 minutes in England after long delay in A&E

One patient is dying every 23 minutes in England after they endured a long delay in an A&E unit, according to analysis of NHS figures by emergency care doctors.

In all, 23,003 people died during 2022 after spending at least 12 hours in an A&E waiting for care or to be admitted to a bed, according to the Royal College of Emergency Medicine (RCEM).

That equates to roughly 1 every 23 minutes, 63 every day, 442 a week or 1,917 each month.

The college said its findings, while “shocking”, were also “unsurprising” and reflected the fact that emergency departments are often overwhelmed and unable to find patients a bed in the hospital.

Rosie Cooper, the Liberal Democrats’ health spokesperson, said “patients are now dying in their droves” due to successive Conservative governments neglecting the NHS, and added that the lives lost due to A&E snarl-ups constituted a “national disaster”.

“Long waiting times are associated with serious patient harm and patient deaths,” said Dr Adrian Boyle, RCEM’s president. “The scale shown here is deeply distressing.”

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Source: The Guardian, 28 February 2023

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Jeane Freeman launches partnership between Ireland and Scotland amid ongoing health crisis in NHS Scotland

Health Secretary Jeane Freeman announced the launch of a Joint Learning Fellowship programme between Ireland and Scotland, as the NHS in Scotland reels from one crisis to the next.

Ms Freeman and the Irish Health Minister, Simon Harris, announced the initiative, which will offer two three-month placements for Scottish and Irish senior policymakers or health service workers so they can learn more about what works in each system.

However, the move came on the same day The Times reported that Glasgow's 'super-hospital' was permitted to open despite the ventilation systems failing to meet the necessary safety standards.

Outbreaks of infection which are thought to have spread through the ventilation system at the Queen Elizabeth University Hospital (QEUH) have led to the deaths of two patients.

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Source: The Scotsman, 20 September 2019

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Coronavirus: NHS staff off work due to testing shortages, say bosses

A lack of coronavirus tests for NHS staff is leading to staff absences and services being put at risk, hospital bosses have warned.

NHS Providers, which represents hospital trusts in England, said staff are having to self-isolate rather than work because they cannot get tests for themselves or family members. It comes after widespread reports of people struggling to get tested.

The home secretary defended the system, saying capacity was increasing.

The government's testing system - part of its test, track and trace operation which Prime Minister Boris Johnson promised would be "world-beating" - has faced criticism in recent weeks. An increase in demand for coronavirus tests has led to local shortages - with some people being directed to test sites hundreds of miles from their homes.

One doctor working in a coronavirus hotspot said she applied for a test for herself and her partner after they developed coughs and fevers. After refreshing the website for five hours, she managed to get an appointment but on arrival was told no booking had been made.

She had taken screenshots of a confirmation code but was not sent a QR code to scan. "I showed the screenshots but I was told that the appointments weren't happening," she said.

"I have to say I burst into tears. I was meant to be seeing patients and I feel guilty."

Dr Rachel Ward, a GP in Newbury, told BBC Breakfast she was seeing a lot of patients who were struggling to get tests, saying a lot of families were "at the end of their tether" as it was "very stressful when you are faced with two weeks off work".

She said if the staff at her practice were unable to get tests and had to self-isolate it would have a "huge impact" on patients as some of their healthcare workers are booked in to administer 100 flu jabs in a day.

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Source: BBC News, 14 September 2020

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CQC orders staffing and safety improvements at trust scrutinised over deaths

A mental health trust has been told to make ‘urgent improvements’ by regulators after a fourth inpatient death occurred with similar themes to three other patients dying within 12 months.

The warning, issued by the Care Quality Commission (CQC) to Devon Partnership Trust, was made after an unannounced inspection at the trust’s Langdon Hospital – following the death of a patient who died by suspected suicide in July.

Last week HSJ revealed how the death was the fourth inpatient death within the last 12 months at the trust, with each incident having recurring themes.

The latest death happened at Langdon Hospital in Dawlish, on one of the trust’s medium secure wards (Ashcombe), with the patient using a ligature point. It was a similar incident to another serious incident in May on a different ward (Holcombe) at the hospital, and it prompted the inspection from the CQC in mid-August.

While the death remains under investigation by the trust, early details shared with the CQC reveal that the incident happened in an area of the ward which had been changed to an “isolation area” under the trust’s COVID-19 infection prevention strategy. However, this meant there were not “good lines of sight” for staff monitoring patients – according to the CQC’s inspection report.

There were also “low staffing levels on the wards”, according to staff which spoke to the CQC. The staff also told inspectors they were “stressed, exhausted and burnt out following the demands of the pandemic”.

According to the CQC, some staff had concerns about areas on the ward where patients had “unrestricted access to items including sports equipment that could be used as weapons for self-harm”.

Although the ward’s ligature assessment claimed those areas were always supervised by staff, this was disputed by the staff themselves, the report said.

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Source: HSJ, 3 November 2020

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Major trust ‘weeks away’ from running short of blood collection tubes

According to reports, Barts Health Trust and most other providers in the north east London health system may run out of blood tube collection products by the end of August. Though, according to notes seen by HSJ, a “mitigation plan with demand management in place this may extend into September”.

After warning colleagues in north east London that the shortage of blood collection tubes made by Becton Dickinson affects “all NEL areas” except acute trust Barking, Havering and Redbridge University Hospitals Trust, Diane Jones, chief nurse of the NEL integrated care system has said “NHSE are looking at mitigations, but nothing confirmed as yet, and [they] may take a few weeks to come on stream. The mitigation may get us up to 50 per cent of usual supply in the short term.” 

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Source: HSJ, 13 August 2021

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GPs think older patients cannot handle health apps on phones

Over-55s are not being recommended useful health technology as GPs presume they cannot use a smartphone, say researchers

Older patients are being excluded from beneficial health technology because “ageist” doctors presume they cannot work a smartphone, research has suggested.
Experts have accused doctors of “stereotyping” older people as being incapable of using technology and warned patient safety was being put at risk by a failure to support them in using appropriate online health tools.
 
GPs typically recommend NHS-approved health apps to about one in 10 patients aged under 35 to help them manage their conditions between appointments, such as by reminding them to take medications or monitoring their symptoms. However, doctors recommend the same apps to just one in 25 patients over 55 and one in 50 patients over 65, according to research by the Organisation for the Review of Care and Health Apps (ORCHA), which assesses apps for the health service.
The same research found 55 per cent of over-55s would be happy to try using a health app if it was recommended, while nine in 10 over-55s and eight in 10 over-65s who have used a health app felt satisfied or very satisfied with the experience.
 
The NHS Long Term Plan states that patients should have access to “digital tools” to manage their health and studies have shown NHS-approved health apps can have clinical benefits.

Older people ‘will benefit from digital products’

However, Helen Hughes, the chief executive of the charity Patient Safety Learning, suggested ageist assumptions about older people’s technological ability meant they were missing out.
 
“The data suggests that older people maybe being stereotyped, with assumptions they won’t be computer literate,” she said. “Plenty of older people are tech savvy – or at least willing to learn – and will really benefit from being able to manage their health from home, using digital products. Older patients need to be offered technology solutions with support on how best to use them, if this is needed.”
 
She warned there was also “a significant patient safety issue” with the failure to advise patients about NHS-approved apps, as it left older patients at risk of inadvertently downloading one of the thousands of unreliable health apps available.

To read the full article (paywalled), click here
Original Source: The Telegraph

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Change to sepsis advice after mums' herpes deaths

Advice on how new mothers with sepsis should be treated is to change after two women died of a herpes infection.

The Royal College of Obstetricians and Gynaecologists says viral sources of infections should be considered and appropriate treatment offered. This comes after the BBC revealed one surgeon might have infected the mothers while performing Caesareans on them.

The East Kent Hospitals Trust said it had not been possible to identify the source of either infection.

Kimberley Sampson, 29, and Samantha Mulcahy, 32, died of an infection caused by the herpes virus 44 days apart in 2018, shortly after giving birth by Caesarean section.

Their families were told there was no link between the deaths but BBC News revealed on Monday that both operations had been carried out by the same surgeon.

Documents we uncovered showed that the trust had been told two weeks after the second death that "it does look like surgical contamination".

Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, which set standards in maternity care, said routine investigation and management of maternal sepsis "should always consider viral sources of infection, and appropriate changes should be instituted to support earlier diagnosis and treatment".

Medics treating Ms Sampson and Mrs Mulcahy assumed they were suffering from a bacterial infection and didn't prescribe the anti-viral medication that may had saved their lives.

The Royal College said the two deaths should be "fully investigated" as "surgical infection appears to be a significant possibility".

But BBC News has learned that the East Kent Hospitals Trust, which treated both women, never told the coroner's office that the same surgeon had carried out both operations or that an investigation they had ordered had suggested the virus strains the two women had died from appeared to be "epidemiologically linked".

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Source: BBC News, 23 November 2021

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NHS whistleblower Shyam Kumar wins case against regulator

A doctor who was sacked for raising patient safety concerns has won a case against England's hospital regulator, the Care Quality Commission (CQC).

Orthopaedic surgeon Shyam Kumar worked part-time for the CQC as a special adviser on hospital inspections, but Manchester Employment Tribunal found that he was unfairly dismissed.

Between 2015 and his dismissal in 2019, Mr Kumar wrote to senior colleagues at the CQC with a number of serious concerns.

They included a hospital inspection, at which he claims patient safety was significantly compromised when a group of whistleblowing doctors was prevented from discussing their concerns.

Mr Kumar said, on many occasions, he reported concerns about a surgeon at his own trust, Morecambe Bay, who had carried out operations that were "inappropriate" and of an "unacceptable" quality and harmed patients.

He warned the CQC that the trust management wanted to bury it "under the carpet". The tribunal noted that his concerns were found to be justified and the surgeon eventually had conditions placed on his licence to practise.

The CQC "accepted the findings".

Mr Kumar, who has been awarded compensation, says his concerns were ignored.

"The whole energy of a few individuals in the CQC was spent on gunning me down, rather than focusing on improvement to patient safety and exerting the regulatory duties," he said.

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Source: BBC News, 5 September 2022

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Patients Know Best launches education programme for medical students

Patients Know Best has launched an education programme which can be used by medical schools. 

Among the first to use the programme are undergraduate Pharmacy students at Liverpool John Moores University (LJMU).

The Patients Know Best platform, which recently became the first personal health record to be fully integrated into the NHS App, has been incorporated into the curriculum to facilitate simulated interactions between patients and pharmacists.

This has involved training the students to use Patients Know Best to enable their use of the platform to interact and collaborate with each other.

Read the full article here.

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Like thousands of others I have ‘long Covid’ — it’s time doctors started taking us seriously

"It’s March and I’m lying awake at 3am struggling to breathe. There’s a heaviness in my chest. I’m terrified at the speed and inconsistency of my heartbeat, but I’m too afraid to call for medical help again. They’ve told me that it will get better and I need to persevere. I live on my own, and I’m trying to control my panic."

Six months later Louise Cole is still dealing with the symptoms. Like thousands of others, it turns out she has “long Covid”. Like them, Louise has struggled to be taken seriously by doctors. 

"While for some life is slowly returning to normal, the same cannot be said for long-term COVID-19 patients. Forgetting us is not an option — not least because the burden of caring for people like me is something the NHS and government will have to reckon with. Something must be done to ease our suffering — and that starts with paying us some attention."

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Source: Evening Standard, 11 September 2020

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Staff at specialist care unit 'failed to give CPR'

Staff at a specialist care unit did not attempt to resuscitate a woman with epilepsy, learning difficulties and sleep apnoea when she was found unconscious, an inquest heard.

Joanna Bailey, 36, died at Cawston Park in Norfolk on 28 April 2018. Jurors heard she was found by a worker whose CPR training had expired, and the private hospital near Aylsham - which care for adults with complex needs - had been short-staffed that night.

Support worker Dan Turco told the coroner's court he went to check on Ms Bailey just after 03:00 BST and found she was not breathing and had blood around her mouth.

The inquest heard he went to get help from colleagues, including the nurse in charge, but no-one administered CPR until paramedics arrived. 

It was heard Mr Turco's CPR training had lapsed in the weeks before Ms Bailey died, unbeknown to him.

Mr Turco said he had since received training and has had his first aid qualifications updated.

Cawston Park, run by the Jeesal Group, a provider of complex care services within the UK, is currently rated as "requires improvement" by the Care Quality Commission.

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Source: BBC News, 23 November 2020

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Ministers and NHS bosses clash over surgery waiting list targets in England

A “very tense” behind-the-scenes row over how quickly hospitals in England can be expected to reduce the massive backlog of surgery has broken out between NHS bosses and ministers.

The dispute has delayed publication of the government’s “elective recovery plan”, which Downing Street had indicated would be part of Boris Johnson’s “Operation Red Meat” political fightback this week.

No 10, the Treasury and Department of Health and Social Care are pressing NHS England to ensure that hospitals do as many operations as they can, as quickly as possible, in order to tackle the backlog, which now stands at a record 6 million patients.

They want to impose “stretching and demanding” targets on hospitals, sources with knowledge of the discussions said.

However, NHS trust bosses say the ongoing impact of treating patients sick with Covid, due to the current Omicron surge, longstanding gaps in their workforce, exhaustion at the frontline and record levels of staff sickness, mean they need time to get back to doing as much surgery as they did before the pandemic.

The Treasury is said to be frustrated with NHS England and privately believes it is “foot-dragging” over the targets. NHS bosses for their part fear the plan is being driven by “political expediency”, given the growing concern at the sheer number of people facing long delays for care.

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Source: The Guardian, 20 January 2022

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‘Shocking’: cystic fibrosis patients should not have to pay for drugs that keep them alive, says MP

MPs will be asked this week to end the “shocking” practice of making cystic fibrosis patients in England pay prescription charges for the drugs that they need to stay alive. The condition is the nation’s most common inherited, life-threatening disease and affects more than 7,000 people.

Prescription charges, first introduced in 1952, were abolished in 1965; then, when they were reintroduced in 1968, exemptions were made for those suffering from long-lasting ailments such as cancers, diabetes and epilepsy. But children with cystic fibrosis were not expected to live to adulthood and so the condition was not exempted.

As a result of new medicines and the creation of special physiotherapy regimes, cystic fibrosis patients now live well into their 40s.

“Medicine and society have moved on, so should the exemption list to reflect modern-day experience,” said Paul Maynard, the Conservative MP for Blackpool North and Cleveleys, who will call for an end to prescription charges for the disease at a special Commons debate on the illness this week. “As someone who has a long-term medical condition – epilepsy – it has always amazed me that adults with cystic fibrosis have to pay for their prescriptions whilst I do not.”

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Source: The Guardian, 30 January 2022

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AI software predicting daily A&E admissions rolled out in 100 NHS hospitals

New artificial intelligence software being rolled-out in NHS hospitals will be able to predict daily A&E admissions weeks in advance.

The software, which launched in 100 hospitals across England on Monday, analyses data, including Covid infections rates, 111 calls and traffic to predict the number of patients that will seek emergency care.

It also takes into consideration public holidays, such as New Year’s Eve, when A&E is more likely to be busy.

The AI software is being rolled after trials showed an “impressive” ability to forecast admissions up to three weeks in advance.

The NHS believes it will help tackle the record waiting list and allow hospitals to more easily manage their patient and bed capacity, prepare for busier days and staff up when needed.

Nine trusts were given the software to use during the pandemic which notified them of expected spikes in cases, staff levels and numbers of beds and equipment necessary.

However, hospitals receiving the new equipment have also been warned uncertainties within the data mean the system should be used as a “starting point to consider an operational response, not as a definite signal for action.”

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Source: The Independent, 28 March 2022

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Stroke and heart patients routinely waiting over an hour for ambulance

Stroke and heart attack victims are now routinely waiting more than an hour for an ambulance, after a further fall in performance in recent weeks, and with hospital handover delays hitting a new high point, HSJ reveals.

Figures for ambulance performance this week, seen by HSJ, showed average response times for category two calls at more than 70 minutes for successive days. 

3,000 patients may have suffered “severe harm” from delays in February, ambulance chief executives say.

Several well-placed sources in the sector said response times had deteriorated further this month, and that more than half of ambulance trusts were this week seeing average category two responses of longer than an hour. 

Some cited an average category two response last week of around 70 minutes, with the services under huge pressure from a combination of demand, long handover delays, and covid-related sickness.

Category two calls include patients with suspected heart attacks and strokes, and the national target for reaching them is 18 minutes.

The figures seen by HSJ for this week showed average response times for category one calls — the most serious, including cardiac arrests and other immediately life threatening emergencies — of more than 10 minutes on Wednesday, against a target of just 7 minutes. Monthly average performance for category one has never reached 10 minutes.

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Source: HSJ, 1 April 2022

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Coronavirus: Care home staff struggling to get tests

Care homes looking after thousands of vulnerable residents have said none of their staff has been tested for coronavirus. Out of 210 care providers spoken to by the BBC, 159 said none of their workers had had a test.

BBC England spoke to care homes and companies across the country, who between them employ nearly 18,000 staff and have almost 13,000 residents. Many said they had seen no testing at all, while others have spoken of struggles to access official test centres after reporting online that they have symptoms. Some have told how staff face long journeys to test centres, with one reporting a three-hour round trip.

On Sunday it was announced that the military will begin testing essential workers in mobile units operating at sites in "hard to reach" areas, including care homes.

Anna Knight runs Harbour House Care Home on the Dorset coast and said getting enough personal protective equipment (PPE) and testing for coronavirus were her biggest challenges.

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Source: BBC News, 26 April 2020

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‘Ventilator challenge’ to equip NHS for Covid lost £143m of public money

£140m that was spent on developing ventilators has been written off by ministers. According to the Observer, the ventilators were never put to use in the NHS in the months after the pandemic began. 

The 'ventilator challenge' was launched to help provide more machines where needed, however problems began early last year when companies complained their expertise was not being used, while others who had no relevant experience of building ventilators, were asked to do so. 

A government spokesperson has said: “Throughout the pandemic, we have done whatever it takes to protect the NHS and save lives. This included launching the ventilator challenge, which saw more than 15,000 new machines delivered to the NHS, meaning every patient who needs a ventilator has been able to access one". 

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Source: The Guardian, 18 July 2021

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NHS England plans dental ‘treatment blitz’ to tackle appointments backlog

Hundreds of thousands of dental patients in England are to be offered weekend and evening appointments under NHS plans to tackle the backlog exacerbated by the pandemic.

More than 350,000 extra dental appointments are to be made available in February and March, NHS England said, with a new £50m funding pot aimed at fuelling a dentistry “treatment blitz”.

However, senior dentistry sources said the cash was a “drop in the ocean”, with tens of millions of NHS appointments cancelled as a result of Covid-19 and the resulting backlog set to take years to clear.

Some also expressed doubts about whether there would be enough staff to offer the additional appointments, since hundreds of dentists have quit the profession in the last year amid warnings that NHS dentistry is increasingly “hanging by a thread”.

Millions of patients have struggled to access dental care since 2019. Some have spent weeks or months in pain as a result, and others believed they had no option but to conduct “DIY dentistry” while waiting for treatment, or felt coerced into “going private”.

Under the new plans to tackle the backlog, NHS England said dentists involved in the scheme would “be paid more than a third on top of their normal sessional fee” for delivering care outside their core hours.

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Source: The Guardian, 25 January 2022

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Trust branded ‘inadequate’ for leadership and maternity

One of the trusts worst affected by coronavirus has been issued with two warning notices and rated ‘inadequate’ for leadership, following a Care Quality Commission inspection.

The regulator raised serious concerns about the safety of Countess of Chester Hospital Foundation Trust’s maternity services, as well as the oversight and learning from incidents.

It also found staff were experiencing multiple problems with a newly installed electronic patient record, while systems for managing the elective waiting list were said to be unsuitable.

In maternity services, the inspectors flagged severe staff shortages and a failure to properly investigate safety incidents.

They said there were three occasions during the inspections when the antenatal and post-natal ward was served by only one midwife, despite the interim head of midwifery saying this would never happen. 

Inspectors also highlighted five incidents last year where women had suffered a major post-partum haemorrhage, involving the loss of more than two litres of blood and which resulted in an unplanned hysterectomy. The CQC said two were not reported as serious incidents, and where learning had been identified from the others, action plans were not being completed on time.

The CQC said it was only made aware of the incidents by a whistleblower, while internal actions agreed in December 2021 had still not been implemented two months later.

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Source: HSJ, 15 June 2022

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NHS England’s list of trusts with worst elective and cancer problems

Almost a third of acute trusts have been identified by NHS England as being ‘at risk’ of missing key targets for electives and cancer recovery, with some facing “periodic calls between ministers and CEOs”, HSJ can reveal.

NHS England has identified 39 acute trusts at the most risk of missing the targets of having no patients waiting 78 weeks or more for elective treatment by April 2023, and returning the 62-day cancer waiting list to pre-pandemic levels by March 2023.

HSJ can reveal the full lists of 19 trusts placed in “tier one” – the most at-risk category – and 20 in “tier two” (see lists below). 

The “at risk” trusts represent 31% of the acute providers in England, with many of them among the lowest performers in the country for elective and cancer recovery.

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Source: HSJ, 19 August 2022

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Europe faces ‘cancer epidemic’ after estimated 1m cases missed during Covid

Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic.

The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say.

A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe.

One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said.

“To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.

“These issues will ultimately compromise survival and contribute to inferior quality of life for many European patients with cancer.”

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Source: The Guardian, 15 November 2022

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Patients die after multiple warnings about national 999 IT system dismissed

Patients have died after the government overruled multiple safety concerns raised about an IT system used to triage 16 million NHS patients a year. An HSJ investigation has uncovered at least three instances where patients triaged by the NHS Pathways software died months, sometimes years, after central agencies were alerted to safety concerns by ambulance trusts, but declined to make changes requested.

NHS Digital, the organisation that oversees NHS Pathways, told HSJ it had assessed the complaints but made changes only where “clinically necessary”. It has repeatedly asked coroners to “strike from the record” concerns raised about the safety of NHS Pathways’ advice.

Since 2015, coroners investigating 11 patient deaths have called for changes to the NHS Pathways software, used by NHS 111 and 999 services to triage patient calls, to prevent future deaths. Coroners have raised these concerns with health and social care secretary Matt Hancock, his predecessor Jeremy Hunt, NHS England, NHS Digital, the Care Quality Commission and service providers. Although NHS Pathways is run by NHS Digital, overall responsibility rests with NHS England.

Read full story (paywalled)

Source: HSJ, 15 July 2019

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