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Hospital told it’s ‘undoubtedly causing harm’

A major emergency department described by a national team as “undoubtedly causing patient harm and distress to staff” told HSJ it believes it has started to crack some of its problems.

The review of the Royal Sussex County Hospital in Brighton — a major trauma centre for much of the South East — found it had the lowest score in England for patient flow.

It was carried out by Getting It Right First Time, which is part of NHS England.

Only half of patients waited less than 12 hours from arrival — much worse than elsewhere in Sussex — and on average they spend more than 26 hours in the department before admission, the review said. It used data from May last year, and said there had been deterioration over the previous two years.

The review, dated July 2024 and obtained by HSJ under the Freedom of Information Act, paints a grim picture based on a visit by the GIRFT team. They saw the hospital ”stacking” patients in the ED, making “infection prevention control almost impossible”, and creating a potential fire risk.

It highlighted problems with mental health patients, who often are left in its care in short stay beds because of a shortage of mental health beds.

However, since the review was conducted last year, University Hospitals Sussex Foundation Trust says it has taken strides to improve flow. 

“We felt we needed to invest time and effort, paradoxically, outside the four walls of the hospital,” said Mae Sullivan, operational flow manager for the trust’s eastern medicines division.

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Source: HSJ, 17 March 2025

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Few may mourn NHS England's demise, but what comes next is uncertain

After Prime Minister Sir Keir Starmer's announcement this week that NHS England (NHSE) is to be disbanded, the BBC looks at whether the changes present a new opportunity to improve patient safety within the NHS.

A hospital chief executive once described NHSE as "the biggest kiss up, kick down, organisation in public life."

The comment came to mind when Health Secretary Wes Streeting on Thursday said the scrapping of NHSE would "end the infantilisation of frontline NHS leaders."

Time and again, NHS trusts have complained about the total control that NHSE, the body responsible for the day-to-day running of the health service in the country, exerted over their actions – the lack of freedom they had to either showcase their good work or respond to particular challenges.

"You won't find many who shed a tear over its demise," said one NHS official, "but there is concern as to what the re-organisation will mean for patient care."

But for many patients who have been failed by the NHS, there is a feeling that it was always more a part of the problem than the solution.

Protecting the reputation of the NHS brand often seemed to matter more than doing the right thing. Rarely has a major patient safety failure been uncovered and proactively admitted by NHSE.

Many of the patient safety scandals – the deaths of people with learning disabilities and mental health problems at Southern Health, maternity failures in Shrewsbury and Telford, East Kent and Nottingham – were only revealed after the skilled and active campaigning of grieving and committed families, who felt compelled to turn to the media when other efforts had failed.

Helen Gittos, who lost her daughter Harriet in 2014 at East Kent, is glad that NHSE is being scrapped.

"When families met with Wes Streeting to talk about maternity safety in the autumn, one of our messages was that NHSE was part of the problem, not part of the solution.

"It has been incredibly frustrating to see NHSE's response to successive reviews of maternity services. It's almost as if they haven't read the reports", she said.

The Maternity Safety Improvement Programme, led by NHSE, has not brought the kind of improvements "women and families so desperately need", she added.

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Source: BBC News, 15 March 2025

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Nottingham attacks wouldn't have happened if authorities had listened, says family of man killed months earlier

The NHS trust that failed to stop the killer behind the Nottingham attacks in June 2023 has been accused of failing other victims. 

It was a sunny morning in June 2023 as news broke that a major incident had been declared in Nottingham. As the hours went by it emerged three people had been stabbed. 

Students Barnaby Webber and Grace O'Malley-Kumar had been walking home from a night out when they were fatally attacked. School caretaker Ian Coates was heading into work when he was killed.

When he heard the news, Delvin Marriott, says he knew instinctively that the killer of Barnaby, Grace, and Ian would turn out to be a mental health patient and blames the loss of his brother on the same system that allowed paranoid schizophrenic Valdo Calocane to be out on the streets armed with a knife.

In August 2022, Delvin's brother, Rudi Marriott, stabbed his father 75 times in a frenzied attack at home in Nottingham.

The family says they had repeatedly called the police and mental health services about Rudi's violence but their warnings were ignored.

A recent NHS report found that in the four years before Calocane carried out his attacks there were 15 incidents of patients either under the current care of the Nottinghamshire Healthcare NHS Trust or who had been discharged perpetrating serious violence towards members of the community. Most of the incidents involved stabbings and three cases resulted in fatalities.

Neil Hudgell, a lawyer representing the families, says the public inquiry due to begin into the deaths of the Nottingham attack victims needs to ensure the trust is held accountable for failings.

"I think we've seen tragic story after tragic story where patients, their families, and victims have been let down," he says.

"We need to get to the bottom of why that happened, who's responsible for that and to have some genuine change."

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Source: Sky News, 17 March 2025

 

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Huge fall in NHS Long Covid clinics, study finds

New research has revealed the number of NHS clinics for people living with Long Covid has more than halved, from a peak of 120 services in 2022 to 46 today.

Services for children and young people are also affected with 13 specialists hubs reduced to eight.

The BBC also discovered the NHS in England no longer monitored the status of Long Covid clinics and stopped doing so nearly a year ago.

Spokespeople for NHS England and the Department of Health confirmed they were no longer tracking how many Long Covid clinics were still operating.

Birmingham-based charity Long Covid Support used Freedom of Information (FoI) requests to ask hospitals about what clinics they have for patients.

Margaret O'Hara, from the group, said changes in the way clinics were funded inside the NHS had led to many services being merged or stopped altogether.

She told the BBC many parts of the NHS were "struggling to cope" and the picture for patients was one of "utter confusion".

After the initial infection with coronavirus, rather than getting better, patients are instead left dealing with any number of problems including fatigue, pain and breathing difficulties.

For many, getting any sort of diagnosis let alone treatment in a specialist NHS clinic is a long and sometimes fruitless journey, according to the support group.

In a survey of patients affected by the condition, a spokesperson for Long Covid Support said they found about half of those they talked to considered themselves disabled by the condition.

A similar number of adults surveyed also said they were not followed up by a healthcare professional and still had ongoing symptoms, despite when the NHS discharged them from treatment.

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Source: BBC News, 17 March 2025

Further reading on the hub:

 

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NHS England names new executive team to lead transition

NHS England has announced the incoming team who will help lead the organisation’s transition into the Department of Health and Social Care.

The team – called the NHS Transformation Executive Team – will replace the current NHS England Executive Group and will support ongoing business priorities, statutory functions and day to day delivery.

Except for the deputy chief executive officer, all colleagues will be in post on 1 April 2025 to support this critical work.

The new team – drawn from the existing executive and the wider NHS on secondment – has been appointed following discussion with the Secretary of State, Department of Health and Social Care senior officials, incoming chair Dr Penny Dash and NHS England’s Board. All appointments are subject to the approval of the Board. Permanent recruitment and appointments will be made when the future form and structure is more clear.

The roles of chief operating officer and chief delivery officer will no longer exist in the transformation structure, and under the new team there will be two co-medical directors, alongside new posts – a financial reset and accountability director and elective care, cancer and diagnostics director.

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Source: NHS England, 17 March 2025

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USA: The fallout from David Weldon’s withdrawn CDC nomination

The abrupt withdrawal of Dr David Weldon’s nomination to lead the Centers for Disease Control and Prevention (CDC) highlights the ongoing political and financial entanglements that shape public health policy.

Weldon, a former congressman and internist, was informed just twelve hours before his scheduled Senate confirmation hearing on 13 March that his nomination was being pulled due to insufficient support.

The decision, reportedly made by the White House after realising they lacked the votes, raises critical questions about the rigidity of political gatekeeping in public health leadership.

Weldon’s nomination was doomed by concerns over his past inquiries into vaccine safety. As he explained in his statement, he was repeatedly accused of being ‘anti-vax,’ despite never claiming that vaccines cause autism.

In today’s political climate, however, even a small, measured scepticism about certain vaccines is enough to disqualify someone from holding public office.

The issue of whether vaccines cause autism is considered settled by the medical establishment. As Senator Bill Cassidy stated during Jay Bhattacharya’s confirmation hearing, conducting further studies on the matter would be “wasting” resources on research that already confirms what we know.

While this argument has some merit (since research funding is finite and often squandered), Bhattacharya countered with a crucial point: vaccines are a public health intervention, and the public must have confidence in them.

If people do not trust the data, then the government has a responsibility to present more evidence to convince them. Refusing to engage in further study only fuels scepticism and deepens public distrust.

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Source: Maryanne Demasi, 14 March 2025

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USA: At little-known health agency, DOGE ends dream ‘to make a difference’

Heather Sherman is one of the thousands of federal employees dismissed by a weekend email telling them they were “not fit for future employment.”

The trauma of that abrupt ending in mid-February — giving her just a few hours before all access was shut off — still lingers. “This was my dream job,” Sherman said.

If Sherman were an air traffic controller or nuclear materials expert, her work keeping the public safe would be obvious. But as a mid-level employee with a technical role at a little-known agency in the mammoth Department of Health and Human Services, her curt dismissal and that of an undisclosed number of AHRQ colleagues prompted not even a ripple of news coverage.

Yet what a New York Times editorial decried as a “haphazard demolition campaign” by the Elon Musk-led Department of Government Efficiency, one that is undermining “the safety and welfare of the American people,” applies to agencies like AHRQ and low-profile jobs like Sherman’s just as much as to more high-profile positions.

In complex systems, of which healthcare is surely one, carelessness has consequences.

A 2023 report by the President’s Council of Advisors on Science and Technology declared patient safety “an urgent national public health issue.” In truth, the urgency is embraced mostly by a small number of individuals determined to drastically reduce the estimated 160,000 Americans perishing each year from preventable medical errors in hospitals.

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Source: Forbes, 13 March 2025

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Hospital did not disclose DNACPR order until after grandfather’s death

The family of a man who died in hospital only discovered after his death that a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order had been put in place.

An investigation by the Parliamentary and Health Ombudsman (PHSO) found that Barts Health NHS Trust failed in its duty to tell Ali Asghar and his family about the order. 

A DNACPR order means that, if someone’s heart or breathing stops, doctors will not attempt resuscitation. The decision is made by a doctor and does not require patient consent but a patient must be informed if they have capacity. If they do not have capacity their next of kin must be informed.

The Ombudsman is urging all healthcare providers to make sure their teams are trained to have these crucial conversations about end-of-life care in a timely and sensitive manner.

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Source: PHSO, 11 March 2025

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Letby: manslaughter probe into Countess of Chester ‘widened’

The hospital where Lucy Letby murdered babies is now being investigated for gross negligence manslaughter as well as corporate manslaughter, police have announced.

Cheshire Constabulary has released a statement saying that its corporate manslaughter investigation into the Countess of Chester Hospital NHS Foundation Trust has been “widened”.

“We will not be confirming the number of people involved or their identity"

The scope of the investigation now includes gross negligence manslaughter, which is where a death is caused by an otherwise lawful but grossly negligent “act or omission” by an individual or individuals.

The corporate manslaughter investigation, which is looking into the actions of senior leaders at the hospital trust in relation to deaths at the neonatal unit, was launched in October 2023.

This happened a few months after the conviction of 35-year-old Letby for the murder of seven babies and attempted murder of six others while working as a neonatal nurse at the trust in 2015 and 2016.

Letby was later found guilty of attempting to murder a seventh baby.

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Source: Nursing Times, 14 March 2025

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Measles highest in 25 years in Europe, WHO says

The number of measles cases in the European region doubled last year to reach the highest level in 25 years, health officials say.

A joint report by the World Health Organization (WHO) and the UN children's fund, Unicef, said children under the age of five accounted for more than 40% of the cases reported in Europe and central Asia.

"Measles is back, and it's a wake-up call," Hans Henri Kluge, WHO regional director for Europe, said. "Without high vaccination rates, there is no health security."

The MMR vaccine - which immunises people against measles, mumps and rubella - is 97% effective in fighting off the dangerous virus.

Measles is a highly contagious disease which is spread by coughs and sneezes.

The measles virus can lead to pneumonia, brain swelling and death.

The WHO/Unicef joint analysis covering 53 countries said there had been 127,350 measles cases reported in the European region in 2024 - the highest since 1997.

A total of 38 deaths had been reported up to 6 March 2025.

Measles cases, they added, had been declining since 1997, but the trend reversed in 2018-19 and cases rose significantly in 2023-24 "following a backsliding in immunisation coverage during the Covid-19 pandemic".

"Vaccination rates in many countries are yet to return to pre-pandemic levels, increasing the risk of outbreaks," they warned.

The WHO/Unicef statement concluded that measles remained "a significant global threat" and urged governments where cases were occurring to take quick action - and those where the virus had not arrived to be prepared to act.

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Source: BBC News, 13 March 2025

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Two more directors exit trust where ‘poor behaviour was tolerated’

Two non-executive directors have left the board of a mental health trust just a few months after the early departure of its chair.

HSJ understands Janet Bailey, a non-executive director appointed in January 2022 and also a senior nurse and academic, was suspended by the trust and her three-year term was not renewed.

Another NED, Alison Geeson, who is a senior lecturer in mental health nursing at Wolverhampton University, resigned last week. This was described as “unexpected” by sources within the trust.

Ms Geeson has been an NED since 2020 and was Freedom to Speak Up Lead and Wellbeing Lead for the board.

In an internal email seen by HSJ, interim chair Philip Gayle announced her resignation to staff and wrote that it was with a “heavy heart” he informed staff of Ms Geeson’s decision to step down, which she felt was “the best decision for her at this time”.

The 2024 staff survey results, published on Thursday, also saw a decline at BCHFT across numerous key measures. The proportion of staff recommending the trust as a place to work fell from 58 per cent to 52 per cent, far below the 65 per cent national average. 

The trust also reported the lowest in England for staff agreeing that colleagues “are understanding and kind to one another”, with 69 per cent agreeing. 

In an internal email to staff as scores were published, BCHFT CEO Marsha Foster said: “The overall picture indicates that we still have a lot of work to do to address the challenges we face.

”We understand for some of you, your experience of working here is positive, but we also know that for others there are significant areas where things are not working as well as they should.” Ms Foster told staff the trust was “committed to making improvements”.

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Source: HSJ, 14 March 2025

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Police start manslaughter inquiry into senior individuals at Letby hospital

Police investigating the hospital where the nurse Lucy Letby worked have widened their inquiries to include gross negligence manslaughter by senior staff.

Cheshire constabulary says it has expanded its inquiry into the Countess of Chester hospital despite growing questions around Letby’s convictions.

The former nurse is serving 15 whole-life prison terms after being convicted of murdering seven babies and attempting to kill another seven.

Police launched an investigation into corporate manslaughter and the actions of senior managers at the hospital after Letby’s original trial in October 2023.

But the inquiry will now include gross negligence manslaughter by unnamed individuals. The Guardian understands this includes managers.

Det Supt Paul Hughes, the senior investigating officer, said: “As our inquiries have continued, the scope of the investigation has now widened to also include gross negligence manslaughter.

“This is a separate offence to corporate manslaughter and focuses on the grossly negligent action or inaction of individuals.

“It is important to note that this does not impact on the convictions of Lucy Letby for multiple offences of murder and attempted murder.”

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Source: The Guardian, 13 March 2025

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‘I had no voice’: black mental health patients on surviving a care system they say is racialised

It has been more than four decades since Devon Marston, a 66-year-old community organiser and musician, was taken to a psychiatric hospital where he was restrained, injected and forced to take medication. He was diagnosed with paranoid schizophrenia.

“Everything was said around me and about me, but no one asked me how I was doing,” he said. “I had no voice, and there was no one to say: ‘Don’t do that to him,’ or: ‘Listen to him, hear what he has to say.’”

The experience had a profound impact on his life and put him on a path to campaign for better care for minority ethnic people experiencing mental distress. However, progress has been painfully slow.

“Nothing has changed. Everything is still the same – only it’s more covered up now by clauses in the Mental Health Act that make it look fair but the equality and justice are not there,” he said.

The most recent data paints a frightening picture. Findings from the Care Quality Commission’s (CQC) latest report show that the number of adults sent for very urgent mental health care from crisis teams more than doubled between 2023 and 2024.

The report, published on Thursday, also raised concerns about the overrepresentation of black people being detained under the act, finding they are 3.5 times more likely to be detained than white people.

The damning report warned that people are becoming more unwell while waiting for help and are stuck in a “damaging cycle” of hospital readmission.

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Source: The Guardian, 13 March 2025

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Discrimination hits record high for second year running

Discrimination against NHS employees reached its highest level for the second year in a row, while one in seven experienced physical violence from the public, according to the 2024 annual staff survey.

Results published for England showed the percentage of staff who had faced discrimination from the public in the past 12 months had risen from 8.5% in 2023 to 9.3% cent in 2024.

The figure has reached its highest level since the question was first asked in 2019, when it was 7.2%, and has risen year-on-year post-pandemic. This has also increased among managers, team leaders and colleagues, from 8.4% in 2020 to 9.2% in 2024.

More than half of respondents (54%) said the discrimination was due to their ethnic background.

Survey results also found 14.4% of staff had faced violence from patients, their relatives or other members of the public in 2024. This figure has increased slightly from 13.9% in 2023 but is below levels seen during covid.

More than 774,000 staff in England responded to 2024 survey between September and November 2024, the highest in its 20-year history, at a response rate of 50 per cent. This is up from 707,000 the previous year and 636,000 the edition before, out of a 1.5 million workforce.

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Source: HSJ, 13 March 2025

Read Patient Safety Learning's response to the NHS Staff Survey

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World’s largest quango scrapped under reforms to put patients first

Reforms to reduce bureaucracy, make savings and empower NHS staff to deliver better care for patients have been set out today (Thursday 13 March) by the Prime Minister, Keir Starmer. 

NHS England will be brought back into the Department of Health and Social Care (DHSC) to put an end to the duplication resulting from 2 organisations doing the same job in a system currently holding staff back from delivering for patients. By stripping back layers of red tape and bureaucracy, more resources will be put back into the front line rather than being spent on unnecessary admin.  

The reforms will reverse the 2012 top-down reorganisation of the NHS which created burdensome layers of bureaucracy without any clear lines of accountability. As Lord Darzi’s independent investigation into the state of the NHS found, the effects of this are still felt today and have left patients worse off under a convoluted and broken system.

The current system also penalises hardworking staff at NHS England and DHSC who desperately want to improve the lives of patients but who are being held back by the current overly bureaucratic and fragmented system.

Health and Social Care Secretary, Wes Streeting, said:

"This is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction and most expensive NHS in history.

"When money is so tight, we cannot justify such a complex bureaucracy with 2 organisations doing the same jobs. We need more doers and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.

"NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers. 

"Just because reform is difficult does not mean it should not be done. This government will never duck the hard work of reform. We will take on vested interests and change the status quo, so the NHS can once again be there for you when you need it."

The reforms to deliver a more efficient, leaner centre will also free up capacity and help deliver significant savings of hundreds of millions of pounds a year, which will be reinvested in frontline services to cut waiting times through the government’s Plan for Change.

The changes will crucially also give more power and autonomy to local leaders and systems - instead of weighing them down in increasing mountains of red tape, they will be given the tools and trust they need to deliver health services for the local communities they serve with more freedom to tailor provision to meet local needs.  

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Source: GOV.UK, 13 March 2025

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Australia: Two women face court charged with manslaughter after home-birth death of NSW baby

Two women who police allege practised as unregistered midwives have been charged with manslaughter after a baby died after a home birth on the New South Wales mid north coast.

The women, aged 41 and 51, appeared in Coffs Harbour local court on Wednesday in relation to the newborn boy’s death in 2022.

Emergency services were called to a home in Karangi, north-west of Coffs Harbour, when the baby was unresponsive after the home birth on 11 September 2022, NSW police said in a statement.

Paramedics treated the baby before he was airlifted to Coffs Harbour base hospital where he died.

Police allege the younger woman was an unregistered midwife at the time of the birth while the older woman held no medical qualifications and had been practising unregistered home-birth midwifery.

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Source: The Guardian, 13 March 2025

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Starmer to scrap NHS England and bring health service back under 'democratic control'

Prime Minister Keir Starmer has announced that NHS England will be abolished to "cut bureaucracy" and bring management of the health service "back into democratic control".

Starmer says it will put the NHS "back at the heart of government, where it belongs, freeing it to focus on patients, less bureaucracy, with more money for nurses," adding that it would also help cut waiting times, which he said had been falling for five months in a row.

NHS England was established in 2013 to give the health service greater independence and autonomy; it employs around 13,500 staff - three times more than the Department of Health.

Outlining his decision to ditch NHS England, Starmer said the move would reduce "duplication" and save money for the frontline services.

Starmer stresses that employees of NHS England are hugely qualified and says the government will not be abandoning anybody as it moves to scrap the body.

But, the PM says, we can't look people who want quicker appointments in the eye and say that we're fearful of taking big decisions.

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Source: BBC News, 13 March 2025

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ICBs ordered to cut costs by 50%

Integrated care boards have been told to cut their running costs in half by December.

ICBs had already been ordered to cut running costs by 20% over the past two years.

Sir Jim told the ICB CEOs the Treasury would cover the cost of redundancies, which are likely to be necessary, and that cuts must be made by the third quarter of 2025-26. HSJ understands they were also informed that trusts would be required to cut managerial costs.

The measures are part of a “financial reset” package due to be outlined by Sir Jim to NHS CEOs in London on Thursday. 

The cuts to integrated care board budgets will make it next to impossible for some individual ICBs to operate as a standalone organisations, or to carry out the full range of responsibilities originally given to them by the 2022 Health and Care Act.

One leader told HSJ the size and speed of the cut was “terrifying” and would throw management of the NHS “into chaos”. Another director briefed on the plan said it felt “like full panic mode and blunt cost cutting without clarity on purpose”.

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Source: HSJ, 12 March 2025

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India's frontline health workers fight for better pay and recognition

Thousands of frontline healthcare workers in southern India's Kerala state, who have been holding demonstrations for the past month seeking better pay and recognition, have vowed to continue their protest.

Kerala's 26,225 female workers, known as Accredited Social Health Activists or Ashas (Hindi for hope), have been holding protests near the state government headquarters in the capital city of Thiruvananthapuram.

The protesters, who provide crucial medical support in the country's rural areas, say they plan to "lay siege" to the state secretariat in the coming week, if authorities continue to ignore their demands.

The Ashas, who number more than a million across the country, are fighting for better salaries and for official "worker" status.

The women are currently categorised as volunteers, which means they are not guaranteed any benefits from the government, despite playing a crucial role in delivering healthcare in rural and underserved areas.

In a country where millions of Indians, especially in the remote areas, do not have access to quality healthcare, the Asha workers have played a vital role over the years.

Their job involves going door-to-door to raise awareness about nutrition, sanitation, immunisation and providing neonatal and antenatal care, among other things.

They played a crucial role during the Covid pandemic, especially in Kerala which was first to report a Covid case, and have been credited for successfully containing outbreaks of Zika and Nipah viruses.

Dr Joe Thomas, a Melbourne-based public health policy analyst, believes India should change its perception of these community health workers whose contribution to primary health is universally recognised.

These workers are doing the job of midwives in Kerala after the state's health authorities froze recruitment of midwives, he told the BBC. "The maternity care support has slowly been shifted to Ashas."

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Source: BBC News, 13 March 2025

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‘First-of-a-kind’ daily pill for endometriosis treatment approved for NHS in England

A new daily pill that could transform the way endometriosis is treated has been approved for use on the NHS across England, the medicines watchdog has announced.

About 1,000 women a year living with endometriosis will be able to access relugolix-estradiol-norethisterone. The “first-of-a-kind” treatment, which was initially rejected by the National Institute for Health and Care Excellence (Nice), works by blocking the specific hormones that contribute to endometriosis while providing necessary hormone replacement.

The medication eliminates the need for multiple medications and regular trips to clinics for injections.

Unlike current injectable treatments which can initially worsen symptoms, the pill can be taken at home, works more quickly and combines hormones in one pill.

Endometriosis care has also long been recognised as substandard, with a previous report finding that on average women are waiting nearly nine years for a diagnosis in the UK.

A spokesperson for Endometriosis UK welcomed the decision by Nice, adding: “Endometriosis UK believes that women and those assigned female at birth in the UK should be able to choose the right treatment and management options for them.

“We recommend that treatment decisions are always made in partnership with the individual and their medical practitioner. There are far too few options available due to the historic lack of research into endometriosis.”

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Source: The Guardian, 13 March 2025

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Poor support ‘driving rise in deaths after discharge’

The rate of patients dying by suicide shortly after discharge from mental health units has increased in recent years, with researchers calling for better post-discharge support.

According to the National Confidential Inquiry into Suicide and Safety in Mental Health annual report – an audit published by the Health Quality Improvement Partnership – the number and rate of deaths after discharge from a ward have been gradually increasing since 2017, after falling from 2013-17.

The rate in 2022, the most recent figures reported, was 14.1 per 10,000 discharges.

Isabelle Hunt, senior research fellow at the Manchester University and report co-author, told HSJ  the most recent figures should be “treated with caution”, but added that the rise in post-discharge suicides could be attributed to the case mix of patients. A “reduction in inpatient beds” could mean “a higher-risk group of patients are being managed by services” and being discharged when more unwell.

Dr Hunt said the increases could also be associated with changes in the circumstances patients are being discharged to.

“Around a quarter of patients who died by suicide within three months of discharge were known to have been discharged to housing, financial or employment problems and a fifth were discharged to poor social support,” Dr Hunt said.

“Awareness of the stressors patients may face after leaving hospital is a key element when judging the appropriateness of discharge, and greater involvement of families and carers is likely to provide a clearer picture of the circumstances a patient is returning to.”

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Source: HSJ, 12 March 2025

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New DHSC delivery unit to 'bring a laser-like focus on reform'

The Department of Health and Social Care is launching a delivery unit that promises to tackle some of the NHS’s most pressing problems.

The secretary of state's delivery unit will sit within DHSC and act as a mechanism through which the health secretary can hold NHS England and other relevant organisations to account for delivering on the government’s priorities, according to a job advert for the unit’s director.

It will “bring a laser-like focus on delivering the reform needed to drive improvement generally across health and care and specifically on the three things that surveys show matter most to the public”, the ad says – namely elective waiting times; urgent and emergency care waiting times and performance; and GP access.

The department is offering £125,000 a year for a director to lead the unit’s “small, multidisciplinary team”, who will be tasked with “tracking and challenging” delivery of the health secretary’s priorities, including manifesto commitments.

The unit will work to “raise the profile of delivery” throughout the department and will “operate in lockstep with departmental strategy functions”, according to the candidate pack for the role.

It will “share responsibility for ensuring that the delivery issues of the day are tackled in ways that do not defer problems for the long term and do not make implementation of the long-term strategy emerging from the 10-year plan more difficult”.

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Source: Civil Service World, 7 March 2025

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Antisemitic abuse rises within NHS and staff are the ‘worst culprits’

NHS staff are more likely than members of the public to perpetrate antisemitic abuse in hospitals and doctors’ surgeries since the October 7 Hamas attacks, according to complaints compiled by an influential charity.

The file includes a Jewish doctor being given a hijab as a secret santa present and a patient having pro-Palestine stickers plastered across his room as he lay fighting for his life.

Meanwhile, a group of therapists who complained about a colleague posting messages supporting Hamas online were subject to a countercomplaint for “micro-aggressions”. A patient waiting to be discharged from hospital was told: “Get your Jewish ambulance to come and get you.”

Dave Rich, policy director at the Community Security Trust, said: “It is essential that hospitals and NHS trusts deal with this trend of rising antisemitism quickly and firmly and set a clear example that anti-Jewish prejudice has no place in the NHS.”

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Source: The Times, 6 March 2025

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USA: Patient Safety Awareness Week

This week in the USA is Patient Safety Awareness Week (PSAW). Now in its 23rd year, this annual recognition event aims to encourage everyone to learn more about healthcare safety.

The Institute for Healthcare Improvement (IHI)'s theme for this year’s PSAW is “The Power of A: Awareness, Assessment and Action.” IHI Vice President Patricia McGaffigan, said: “It’s time for everyone in health care, in partnership with patients, families, and the communities we serve to leverage the power of ‘A’ [Awareness] and operationalize what matters for safety.”

Check out the full article via AORN: https://go.ihi.org/4i7Z5t3

Join IHI for a PSAW webinar on Thursday 13 March at 11:00 am.

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How systems are managing the radiologist shortage

A radiology shortage has been plaguing health systems in the US for a few years and is expected to get worse in coming years — but systems are making changes to reduce its impact.

A shortage of up to 42,000 radiologists is expected by 2033. Currently, the radiology technologist vacancy rates are up to 18.1%, compared to 6.2% three years ago. Further complicating the matter, the number of imaging studies has increased by up to 5% per year, but the number of radiology residency positions has increased by only 2%. If current imaging rates remain standard, there will be an estimated 16.9% to 26.9% increase in imaging utilization by 2055.

"We (the industry) waited too long to start discussing the shortage," leaders from Evanston, Ill.-based Endeavor Health told Becker's. "Had we been proactive in understanding this phenomenon, we could have avoided some of the deficit. Now we are in reaction mode and trying to catch up." 

With America's aging population, many radiologists are also going to be retiring in coming years, with fewer radiologists coming up to replace them.

And the challenges for health systems do not end there.

"The relatively higher fixed costs smaller private groups bear for billing services, malpractice insurance, benefits, etc. make it increasingly difficult to offer competitive wages, so recruitment and retention in a competitive market become challenging," they said. "We have also experienced unplanned increases in teleradiology pricing over the last year, resulting in a negative margin for this volume subset as the reimbursement for most interpretations outweigh the professional fee collections."

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Source: Becker's Hospital Review, 5 March 2025

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