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Rise in autistic children going to A&E putting pressure on NHS

Positive Support Group said one child spent more than 120 days in hospital with ‘no medical need’ and warned that funding cuts were driving the surge

Becky, a 46-year-old charity worker. said her 14-year-old daughter Sofia first called the emergency services because she has autism and was in extreme distress during a crisis

“At the time, I had no support,” said Becky, a 46-year-old charity worker. “In a way, Sofia calling in the ambulance was a saving grace for us.”

Her called the emergency services when she was 13, not because she was in physical danger, but because she has autism and was in extreme distress during a crisis. According to her mother, Sofia has required emergency care to cope with multiple crises over the years.

NHS data analysed by the Positive Support Group (PSG) found that there were more than 20,000 episodes where children with autism were admitted to and discharged from emergency hospital care on the same day in 2023-24 — a 86% increase since 2019-20, according to the behavioural health group.

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Source: The Times, 2 April 2025

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Plan to increase access to NHS dentists in England ‘a complete failure’, MPs say

The official plan to increase access to NHS dental services in England has been a “complete failure”, and some of the government’s initiatives have worsened the crisis, a damning report warns.

Millions of patients continue to be denied dental care, forcing them to pay for private treatment, build up mountains of credit card debt, or even worse perform dangerous DIY dentistry on their own teeth, the research by MPs found.

Without immediate and significant changes to fix the “broken” system, there would be no future for population-wide access to NHS dentistry, the report by the public accounts committee (PAC) said.

“This country is now years deep in an avalanche of harrowing stories of the impact of dentistry’s system failure,” said Geoffrey Clifton-Brown, the chair of the committee. “It is utterly disgraceful that, in the 21st century, some Britons have been forced to remove their own teeth.”

He added: “Last year’s dental recovery plan was supposed to address these problems, something our report has found it has signally failed to do. Almost unbelievably, the government’s initiatives appear to have actually resulted in worsening the picture, with fewer new patients seen since the plan’s introduction.”

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Source: The Guardian, 4 April 2025

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What’s lost: Trump whacks tiny agency that works to make the nation’s healthcare safer

Sue Sheridan’s baby boy, Cal, suffered brain damage from undetected jaundice in 1995. Helen Haskell’s 15-year-old son, Lewis, died after surgery in 2000 because weekend hospital staffers didn’t realize he was in shock. The episodes turned both women into advocates for patients and spurred research that made American healthcare safer.

On 1 April, the Trump administration slashed the organisation that supported that research—the Agency for Healthcare Research and Quality, or AHRQ—and fired roughly half of its remaining employees as part of a perplexing reorganisation of the federal Health and Human Services Department.

Haskell, of Columbia, South Carolina, has done research and helped write AHRQ-published surveys and guidebooks on patient engagement for hospitals. The dissolution of AHRQ is dislodging scores of experienced patient-safety experts, a brain drain that will be impossible to rectify, she said.

Survey data gathered by AHRQ provides much of what is known about hospitalisations for motor accidents, measles, methamphetamine, and thousands of other medical issues.

“Nobody does these things except AHRQ,” she said. “They’re all we’ve got. And now the barn door’s closed.”

HHS Secretary Robert F. Kennedy Jr. posted on the social platform X on 1 April that layoffs at HHS, aimed at reducing the department’s workforce by about 20,000 employees, were the result of alleged inefficacy. “What we’ve been doing isn’t working,” he said. “Despite spending $1.9 trillion in annual costs, Americans are getting sicker every year.”

But neither Kennedy nor President Donald Trump has explained why individual agencies such as AHRQ were targeted for cuts or indicated whether any of their work would continue.

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Source: Fierce Healthcare, 3 April 2025

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USA: More Black babies are dying than white infants

Although the disparity in the number of overall deaths reported between Black and white Americans has narrowed over the course of the last 75 years, researchers say that the same does not hold true for infants.

Black infants are dying at twice the rate of white infants – and it’s largely thanks to healthcare inequality.

“This is like a red alarm,” Harvard University associated professor Dr. Soroush Saghafian explained.

“Our findings are saying: Look, we could have saved five million Black Americans if they had the same things as white Americans have,” he told The Harvard Gazette.

The authors analysed mortality data collected by the U.S. Census Bureau and the Centers for Disease Control and Prevention, calculating life expectancy, mortality rates, and years of potential life lost for both white and Black Americas. 

Their analysis found that there was a 20.4 percent increase in life expectancy for Black Americans and a 13 percent rise for white Americans, although Black adults still have an 18 percent higher mortality rate.

The American healthcare system has long been under scrutiny for its astronomical costs and hurdles to patient care. A new study released Wednesday from the West Health Institute has found that the inability to pay for healthcare in the U.S. has reached a new high.

More than a third of Americans – or an estimated 91 million people – report that they could not access quality healthcare if they needed it, according to the latest West Health-Gallup Healthcare Affordability Index.

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Source: The Independent, 2 April 2025

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USA: NIH sued over ‘ideological purge’ of DEI, Covid and vaccine research

A group of public health experts and major labor organizations are suing the National Institutes of Health (NIH) over what they call an “ongoing ideological purge” of scientific research.

In a legal complaint filed on Wednesday, the American Public Health Association; the United Automobile, Aerospace and Agricultural Implement Workers of America (UAW); and other health experts say the NIH has abruptly canceled hundreds of grants since February 2025.

The complaint says the cuts have targeted research tied to topics like diversity, equity and inclusion (DEI), gender identity, vaccine hesitancy and even work involving collaborators in other countries. These cancellations, they argue, provide a “window into the devastation to medical and scientific research playing out across the nation right now”.

The lawsuit claims that NIH broke from its usual science-based review process and started shutting down projects based on “vague” new priorities. It alleges that the organization often justified cancellations by saying the research “no longer effectuates agency priorities”.

Researchers affected by the cuts include those studying Alzheimer’s disease, pregnancy health disparities and HIV prevention.

“Ending these NIH grants wastes taxpayer money and years of hard work to answer the world’s most pressing biomedical questions. This is an attack on scientific progress itself,” Brittany Charlton, a plaintiff and associate professor at Harvard TH Chan School of Public Health, said in a statement.

“Important discoveries and treatments will be delayed, putting lives at risk. Health issues in one community affect everyone, so this concerns us all,” Charlton added.

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Source: The Guardian, 2 April 2025

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Healthcare-related harm affects 1 in 10 NHS patients

Almost one in 10 people reported experiencing harm from NHS care in the past 3 years, according to a survey led by the University of Oxford. 

The study, published in BMJ Quality & Safety, found that 9.7% of respondents reported harm, with 6.2% attributing it to the treatment or care received and 3.5% citing lack of access to services.

Researchers noted that these findings exceed those of two previous British surveys which reported harm rates of 4.8% in 2001 and 2.5% in 2013. While acknowledging that the pandemic’s impact on healthcare access may have contributed to the higher figures, they said that the study highlights issues that “may be hidden from official data on patient safety.” 

As well as the withdrawal of medical care attributed to the pandemic, the increase could also be explained by using a broader definition of harm to include psychological as well as physical harm, the study authors suggested.

Lead author of the new study, Dr Michele Peters, medical sociologist at the University of Oxford, told Medscape News UK : “In the past, harm has usually been measured using clinical rather than patient perspectives.” She explained that this emphasis tended to highlight harm associated with clinical errors rather than harm related to system issues, such as long waits for treatment. 

The latest study is one of the first to explicitly assess actions taken following harm due to lack of access to care. Around half of those awaiting treatment experienced physical or psychological consequences, with longer waits more common in deprived areas.

“Current waiting list management approaches do recognise that some people are particularly vulnerable to deterioration during the waiting period,” Peters said. This means they may end up in poor condition when called for treatment. She noted that some interventions, such as weight management or smoking cessation support, aim to maintain patients’ health while they wait for procedures like hip replacements.

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Source: Medscape, 2 April 2025

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Doctors urge government to fight poverty after rise in patients with Victorian diseases

Doctors have reported a rise in the number of patients with Victorian diseases such as scabies, as the Royal College of Physicians urged the government to do more to fight poverty.

The survey of 882 doctors found 89% were concerned about the impact of health inequalities on their patients, while 72% had seen more patients in the past three months with illnesses related to poor-quality housing, air pollution and access to transport.

The Royal College of Physicians found 46% of respondents said that at least half of their workload involved illnesses linked to social factors.

One doctor said that they had seen patients with two Victorian skin diseases, erysipelas and scabies, over the past three months. Another said they were seeing more people “with poor nutritional status due to poverty”, eventually leading to “prolonged and impaired recovery from acute illnesses”.

Several patients had contracted hypothermia. One doctor said it was due to the patient not being able to afford heating at home.

The Royal College of Physicians has called on the government to set out how its health mission will address these illnesses.

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Source: The Guardian, 3 April 2025

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Trump officials to cut Planned Parenthood family planning funds

The reproductive health provider Planned Parenthood said the Trump administration would cut federal family planning funding as of Tuesday, affecting birth control, cancer screenings and other services for low-income people.

Planned Parenthood said that nine of its affiliates received notice that funding would be withheld under a programme known as Title X, which has supported healthcare services for the poor since 1970.

The Wall Street Journal reported last week the US Department of Health and Human Services planned an immediate freeze of $27.5m in family planning grants for groups including Planned Parenthood.

Alexis McGill Johnson, president and CEO of Planned Parenthood, predicted that cancers would go undetected, access to birth control would be severely reduced, and sexually transmitted infections would increase as a result.

“President Trump and Elon Musk are pushing their dangerous political agenda, stripping health care access from people nationwide, and not giving a second thought to the devastation they will cause,” McGill Johnson said in a statement.

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Source: The Guardian, 1 April 2025

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States sue HHS over $12B in cancelled health funds

Twenty-three states and the District of Columbia have filed a lawsuit against HHS over the Trump administration’s abrupt cancellation of billions in public health grants to state health departments. 

The suit, filed April 1 in the U.S. District Court for the District of Rhode Island, alleges HHS’ discontinuation of more than $11 billion in funding to state health departments violates federal law and jeopardises public health. The eliminated funds supported efforts to track infectious diseases, improve pandemic preparedness, expand mental health services and modernize outdated systems. If funding is not restored, states allege key public health programs will be disbanded and thousands of employees could lose their jobs. 

State health departments began receiving notices late March 25 that $11.4 billion in grants from the CDC and roughly $1 billion in funds from the Substance Abuse and Mental Health Services Administration were being rescinded immediately. 

“Slashing this funding now will reverse our progress on the opioid crisis, throw our mental health systems into chaos, and leave hospitals struggling to care for patients,” New York Attorney General Letitia James said in a news release, adding that the state is set to lose nearly $400 million as part of the cuts. 

The plaintiffs are seeking a temporary restraining order to immediately prevent the funds from being rescinded, as well longer-term injunctions. 

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Source: Becker's Hospital Review, 1 April 2025

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Almost 1.7 million hernia mesh implanted in NHS in 20 years

Almost 1.7 million people have had hernia mesh surgery in the NHS since 2004, figures released by the NHS have revealed.

The statistics do not include people who’ve had hernia mesh in private hospitals.

Nobody can say how many are now suffering complications – because patients are not tracked for their lifetime.

Yet campaigners and academics globally say it can take many years for mesh to cause problems- so the scale of suffering falls into a black hole of missing data.

Moreover, support groups show that patients are being implanted with hernia mesh in their thousands ever year – but nobody is being given fully informed consent of the potential risks such as pain, loss of mobility, loss of sex life and losing the ability to have children. Also autoimmune diseases and allergies caused by the plastic mesh material.

The figures came to light thanks to a Written Parliamentary Question asked by MP Sharon Hodgson, chair of the All Party Parliamentary Group for First Do No Harm.

In its response, The Department of Health say: “Clinicians are expected to inform patients about risks associated with recommended treatments, including reasonable alternatives, to enable informed consent and a balanced patient decision.”

But campaign group Sling The Mesh says that the majority of people are told hernia mesh is ‘not the mesh in the media’, or it is a new mesh, or that this is a gold standard treatment and that mesh receives undeserved negative attention.

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Source: Sling the Mesh, 25 March 2025

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NHS trust apologises as man’s tumour death investigated for manslaughter

A troubled NHS trust has apologised to the family of a man who died after a series of potentially fatal delays to treat a tumour, in a case that is being investigated by police as possible corporate manslaughter.

Richard Harris, 71, died last July after a series of errors in the neurosurgery department at the Royal Sussex County hospital in Brighton, which is part of University Hospitals Sussex NHS foundation trust (UHSussex).

The trust admitted that Harris was “lost to follow-up” when the hospital repeatedly failed to monitor a tumour in his nervous system, or operate on it, as doctors recommended.

An internal review of Harris’s care found that doctors failed to arrange a routine MRI scan for him when he was first urgently referred to neurosurgery in 2017. Harris, who was fit and a regular swimmer, only received a scan when he contacted the department again in 2019.

The scan picked up a benign schwannoma tumour, which a multidisciplinary team concluded would require regular monitoring, every six months. They also said “surgical intervention should be advised”, the review found.

But no surgery was arranged. And the required follow-up scans were postponed and cancelled at a time when internal whistleblowers expressed alarm about high cancellation rates, and repeated and allegedly dangerous failures to follow up patients under the trust’s care.

Eventually Harris was referred to neurosurgery early last year suffering with acute pain. He had to wait weeks to be seen, despite repeatedly pleading with his consultant in emails complaining of “red-hot poker pain” that was “scaring me to death”. There were yet further delays in arranging MRI scans, the review found.

Months later, the tumour was assessed to be cancerous and inoperable. Harris was discharged to hospice care and died a few weeks later.

Sussex police have confirmed to Harris’s family that his death is being investigated as possible corporate manslaughter, as part of its expanding Operation Bramber investigation.

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Source: The Guardian, 1 April 2025

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Patient satisfaction with NHS has hit record low of 21%, survey finds

Public satisfaction with the NHS is at a record low and dissatisfaction is at its highest, with the deepest discontent about A&E, GP and dental care.

Just 21% of adults in Britain are satisfied with how the health service runs, down from 24% a year before, while 59% are dissatisfied, up from 52%, the latest annual survey of patients found.

Satisfaction has fallen dramatically from the 70% recorded in 2010, the year the last Labour government left office, and the 60% found in 2019, the year before the Covid-19 pandemic.

Mark Dayan, a policy analyst at the Nuffield Trust thinktank, which analysed the data alongside the King’s Fund, said the years since 2019 have seen “a startling collapse in NHS satisfaction.

“It is by far the most dramatic loss of confidence in how the NHS runs that we have seen in 40 years of this survey.”

A&E is the NHS service the public is least happy about. Satisfaction fell from 31% in 2023 to just 19% last year – the lowest proportion in the 41 years the British Social Attitudes (BSA) survey of the views of patients in England, Scotland and Wales has been carried out.

Satisfaction with NHS dentistry has collapsed, too, from 60% as recently as 2019 to just 20% last year. More people (55%) are dissatisfied with dental care than with any other service.

Similarly, fewer than a third (31%) of adults are satisfied with GP services.

“The latest results lay bare the extent of the problems faced by the NHS and the size of the challenge for the government”, said Dan Wellings, a senior fellow at the King’s Fund. “For too many people, the NHS has become too difficult to access. How can you be satisfied with a service you can’t get into?”

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Source: The Guardian, 2 April 2025

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CQC tells trust to move care of sick babies

A trust has moved the care of some sick babies out of one of its neonatal units at the Care Quality Commission’s request.

Leeds Teaching Hospitals Trust said babies requiring more than 24 hours of neonatal intensive or high dependency care would now be moved from St James’ University Hospital to the Leeds General Infirmary, which has a neonatal intensive care unit, or alternative hospitals.

The trust confirmed this followed a request from the Care Quality Commission, which carried out unannounced inspections of its maternity and neonatal services in December and January.

Previously St James’ had been providing “less complex elements of intensive care and high dependency care”, despite only having a “special care baby unit” (SCBU), which typically provides care for less seriously ill babies than a NICU.

This unusual position had been agreed with the Yorkshire and Humber neonatal operational delivery unit. The trust said its neonatal doctors and nurses worked across the units in both hospitals, and were qualified and trained to treat babies requiring the highest level of care.

The trust’s maternity services have recently been criticised by a group of parents, and HSJ last week highlighted how they have been rated “red” for high perinatal mortality in the national maternity services audit four times in the past seven years.

Chief nurse Rabina Tindale said: “Individuals are still able to give birth at St James’ Hospital and babies will receive the appropriate level of care in our SCBU, but this [change] does mean that if babies need more than 24 hours of intensive care or high dependency care, they must be transferred to Leeds General Infirmary or another unit.”

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Source: HSJ, 1 April 2025

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Departing NHSE boss ‘calls out’ A&E variation

NHS England’s outgoing chief operating officer has claimed there is too much unwarranted variation in the service’s emergency care performance.

Dame Emily Lawson made the comment at last week’s NHSE board meeting ahead of her departure from the organisation yesterday.

She told the board that she “wanted to call out variability” in the spread of 12-hour A&E waits across the county.

Dame Emily said: “If we look at the last six months of data, 17.6 per cent of trusts have deteriorated in 12-hour breaches, 25.8 per cent have improved, and the rest have sustained their 12-hour performance.

“When we look at headline numbers, we often miss both the improvement that’s going on, but also some of the tensions that are happening and needing to be managed locally.”

Dame Emily added that emergency care “still has some opportunity” to improve its productivity, adding that long A&E waits for people in mental health crisis “remain too common”.

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Source: HSJ, 1 April 2025

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India trains thousands of medics to promote vaccine in huge push to end cervical cancer

Tens of thousands of doctors across India are being trained to promote the HPV vaccine, in a push to eliminate cervical cancer in the country.

They will check with mothers attending medical appointments that they intend to vaccinate their daughters, and visit schools and community centres armed with facts and slideshows to counter vaccine disinformation.

One in five cervical cancer cases worldwide occur in India – and the overwhelming majority of those are caused by the human papillomavirus, or HPV.

HPV vaccination has become routine practice in many countries and has been available in India privately since 2008, but with low take-up.

Sutapa Biswas, co-founder of the Cancer Foundation of India, said imported vaccines were expensive and people were reluctant to spend money on prevention. Misinformation surrounding deaths during, but unrelated to, an HPV vaccine trial in the country had left it with “baggage”, she said.

However, India has recently started manufacturing its own cervical cancer vaccine, and the government is expected to make it part of the national vaccination programme later this year or early next year.

Last year about 11,000 members of the Federation of Obstetric and Gynaecological Societies of India (Fogsi) underwent virtual training. About 100 of those trainees have now become the National HPV Faculty and will each train 500 general physicians from the Indian Medical Association over the next six months.

The idea, Biswas said, “is to build confidence”. Training includes practical information on dosages, details of the World Health Organization’s push to eliminate cervical cancer, and advice on how to answer common questions.

The implementation of India’s cervical screening programme had been sluggish, she said. Most cancers are diagnosed late, and most people’s experiences of the disease relate to death.

Many non-specialist doctors “didn’t even know that a cancer could be eliminated and vaccination could be such a gamechanger”, Biswas said.

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Source: The Guardian, 1 April 2025

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Trump makes sweeping HIV research and grant cuts: ‘Setting us back decades’

The federal government has cancelled dozens of grants to study how to prevent new HIV infections and expand access to care, decimating progress toward eliminating the epidemic in the United States, scientists say.

The National Institutes of Health (NIH) terminated at least 145 grants related to researching advancements in HIV care that had been awarded nearly $450m in federal funds. The cuts have been made in phases over the last month.

“The loss of this research could very well result in a resurgence of HIV that becomes more generalized in this country,” said Julia Marcus, a professor at Harvard Medical School who recently had two of her grants cancelled. “These drastic cuts are rapidly destroying the infrastructure of scientific research in this country and we are going to lose a generation of scientists.”

In 2012, the FDA approved pre-exposure prophylaxis (PrEP), an antiviral drug taken once a day that is highly successful at preventing new HIV infections. While the drug has been a powerful tool to contain the virus, inequities remain in accessing those drugs and sustaining a daily treatment. Despite major progress, there are still 30,000 new infections each year in the US.

Many of the terminated HIV-related studies focused on improving access to drugs like PrEP in communities that have higher rates of infections – including trans women and Black men. One of Marcus’s projects was examining whether making PrEP available over the counter would increase the use of the drug in vulnerable communities.

“The research has to focus on the populations that are most affected in order to have an impact and be relevant,” said Marcus.

Yet, this may be the justification for defunding so many HIV-related studies. A termination letter reviewed by the Guardian dated 20 March cited that “so-called diversity, equity and inclusion (DEI) studies are often used to support unlawful discrimination on the basis of race and other protected characteristics, which harms the health of Americans.”

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Source: The Guardian, 1 April 2025

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Obsolete imaging equipment raises concerns in NI hospitals

A report from the Northern Ireland Audit Office has found that 16% of imaging equipment used in healthcare settings is “effectively obsolete”. 

Comptroller and Auditor General Dorinnia Carville has raised concerns over the “substantial proportion of out-of-date equipment” and a growing gap between demand and capacity.

Northern Ireland’s Department of Health said that while some of the equipment base “would ideally be replaced at a quicker rate”, it remains “safe and fit for purpose”.

The report noted that around 90% of all hospital patients have images taken and interpreted. It said that increasing recognition of the benefits of imaging services has resulted in a “growing demand for them”.

The report added: “Combined with changing patient demographics, and an absence of sustainable funding and resources, capacity has been unable to keep pace.”

The report found that between 2018 and 2024, the health service delivered a total of 350,000 fewer scans (MRI, CT, and non-obstetric ultrasound scans) than what was required to meet demand. Similarly, waiting lists and waiting times for imaging services have risen in that period.

The report said that timely replacement of imaging equipment is one of the “key components to service delivery and quality”.

It said: “Currently 16% of all HSC imaging equipment is over 10 years old and is effectively obsolete. Older equipment can result in increased downtime and maintenance costs. It can also be potentially slower, reducing the number of patients which can be scanned, and may produce lower quality images meaning an increased risk of missed disease.”

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Source: Medscape, 31 March 2025

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NHS billions wasted as bipolar patients left 'forgotten and failed'

Failing to properly diagnose and treat people with bipolar disorder, external is wasting billions of pounds a year in the UK, according to new data shared exclusively with the BBC. Experts say many of the estimated million people living with this condition are "ghosts in the system", whose lives are being torn apart by poorly managed extreme suicidal lows or manic, erratic highs.

Emma was diagnosed with bipolar disorder in her early 30s, after experiencing a mental health crisis.

When she was 32 weeks pregnant, her grandmother died unexpectedly, sending her into a "deep low". "I felt awful, but the perinatal team wouldn't take me on," she says. "They said my symptoms weren't that serious."

When Emma gave birth, the extreme lows of her pregnancy were replaced by an unexpected high. She felt amazing in the days after her baby was born - but she didn't sleep and her behaviour became increasingly erratic.

A few weeks later, her mood flipped again. When her baby was three weeks old, Emma took an overdose.

It took a week in hospital for her liver function to return. But even after that, she was in and out of hospital for a year before finally being diagnosed with bipolar disorder, and medicated correctly.

"If I had the correct care, and been listened to during my pregnancy or even earlier, I could have avoided taking that overdose - 100%," she says.

Experts have told the BBC how most people living with bipolar disorder in the UK are "undertreated, undiagnosed and left to try and survive in a system that has failed them".

The majority who, like Emma, are eventually diagnosed with bipolar disorder, are incorrectly prescribed antidepressants initially, which makes their symptoms worse rather than better. Experts also say there is a lack of continuity of care from GPs through to psychiatrists.

According to the Royal College of Psychiatrists (RCPsych), bipolar disorder is a manageable condition.

Dr Trudi Seneviratne, registrar at the RCPsych and a commissioner on the Bipolar Commission, says it is "completely treatable" with a combination of medication, talking therapies and lifestyle factors.

"But there are many, many people who are suffering in silence with lower levels of symptoms because there isn't a good clinical care pathway for them in the UK."

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Source; BBC News, 1 April 2025

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The downside of young people learning about ADHD on TikTok

Less than half of the claims made about symptoms of attention deficit hyperactivity disorder (ADHD) in the most popular videos on TikTok align with clinical guidelines, a new study has found.

Two clinical psychologists with expertise in ADHD also found that the more ADHD-related TikTok content a young adult consumes, the more likely they are to overestimate both the prevalence and severity of symptoms in the general population.

People with ADHD are known to suffer inattention, hyperactivity and impulsivity – and may struggle to concentrate on a given task, or suffer extreme fidgeting.

Prescriptions for drugs for ADHD have jumped 18% year-on-year in England since the pandemic, which underscores the need for accurate and reliable information, particularly on platforms popular with young people.

In this latest study, published in the journal Plos One, the two psychologists evaluated the accuracy, nuance, and overall quality in the top 100 #ADHD videos on TikTok.

They found the videos have immense popularity (collectively amassing nearly half a billion views), but fewer than 50 per cent of the claims made were robust.

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Source: The Independent, 31 March 2025

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NHS ‘should give councils more grief’ on health

The 10-Year Plan’s focus on the NHS risks sidelining the need for more effective action by national and local government on prevention, public health directors are warning.

Association of Directors of Public Health president Greg Fell also told HSJ integrated care boards should “give us [councils] more grief” to take more action on prevention, rather than prioritising NHS upstream interventions that are not as effective as primary prevention.

Mr Fell, director of public health at Sheffield City Council, said policy makers, NHS leaders and media too often looked to growing “preventive” treatments – such as weight management treatment, and weight-loss drugs – as the solution to problems like growing obesity and falling healthy life expectancy.

He said the routine “framing” of prevention as something the NHS can solve with upstream treatments risked diverting from national and local government actions that could make a much bigger difference.

Mr Fell said such interventions – and the high-profile GLP-1 drugs for obesity – may be worthwhile, but for overcoming the big health threats were “like emptying an ocean with a teaspoon or, being kind, a soup ladle”.

He said: “The answer is way upstream of better treatment. [It] is effective regulation of junk food industries, and that isn’t primarily a Department of Health and Social Care thing, and certainly not an NHS problem. It’s a problem across the government.”

Mr Fell said he expected the 10-Year Plan “would be pretty good” but means “the bandwidth has been taken by the NHS”.

He called for government to outline its plan for preventive cross-government action as part of its health mission, beginning a “debate about the right mix of policies” across multiple government departments, local government, and others. 

“We haven’t yet seen much on the health mission,” the director of public health said, adding that it would need to cover tobacco control, alcohol, air quality, obesity, and “how does all that hang together across the totality of government?”

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Source: HSJ, 31 March 2025

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‘Big consolidation’ of ICBs coming, says new NHSE chief exec

A “big consolidation” of integrated care boards is being planned, according to new NHS England chief executive Sir Jim Mackey.

In his first interview as NHSE’s “transition chief executive”, Sir Jim Mackey said the governnment’s decision to cut ICB running costs by 50 per cent by October had already lead to “a lot of the smaller [ICBs]… talking to each other about merger”.

As well as addressing the fate of ICBs, Sir Jim told HSJ  he “absolutely” supported the establishment of provider-led accountable care organisations in the NHS but that only parts of the NHS could successfully deliver them.

He also pledged to “stick up for the NHS” in disagreements with ministers.

Sir Jim said NHSE was “trying to resist” insisting ICBs combine or merge to cover a minimum population, but he added: “I think people are doing that naturally and the conversations at the minute look like we’re going to have quite a big consolidation.”

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Source: HSJ, 1 April 2025

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WHO proposing to cut jobs and slash budget by a fifth, memo shows

The World Health Organization (WHO) is proposing to reduce staff numbers and the scale of its work as it slashes its budget by just over one-fifth due to the impact of US funding cuts, according to an internal memo seen by Reuters.

US President Donald Trump's administration withdrew from the WHO upon taking office in January, saying the global health agency had mishandled the COVID-19 pandemic and other international health crises. The US is by far the UN health agency's biggest financial backer, contributing around 18% of its overall funding.

"The United States' announcement, combined with recent reductions in official development assistance by some countries to fund increased defence spending, has made our situation much more acute", stated the WHO memo, which was dated March 28 and signed by WHO's Director-General Tedros Adhanom Ghebreyesus.

The WHO did not immediately respond to a request for comment.

The US withdrawal has exacerbated a funding crisis due to member states reducing their development spending. Faced with an income gap of nearly $600 million this year, the WHO has proposed to slash its budget for 2026-27 by 21% from US$5.3 billion to US$4.2 billion, according to the memo.

In February, the WHO's executive board had initially reduced the proposed budget for 2026-27 from US$5.3 billion to US$4.9 billion, according to the note.

"Despite our best efforts, we are now at the point where we have no choice but to reduce the scale of our work and workforce," the memo said.

The WHO will reduce jobs at senior leadership level at its headquarters in Geneva, Switzerland, though all levels and regions will be affected, the memo added. It will decide on how to prioritise its work and resources by the end of April.

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Source: Reuters, 29 March 2025

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Hospital whistleblower wins right to protection in landmark case

Max McLean didn’t see himself as a whistleblower. As chair of the Bradford Royal Infirmary he had simply raised a number of issues including preventable deaths in newborn babies

But he was, he claims, forced out by the Board.  And when he tried to take the trust to an employment tribunal, they argued that he was not a worker and was not protected under whistleblowing law.

Now, in a landmark ruling, the tribunal said he was a worker and was protected. The tribunal ruling will have massive implications for those who sit on trust boards across England.

Too often when there have been scandals involving patient care there has been a resounding silence from those who are meant to be holding senior executives to account. Now they are being told that they can speak up and that they will be protected.

Dr McLean, a former police officer, had been trust chair for two years when he raised his concerns, which were confirmed by an independent report.

He told Channel 4 News: “There is no freedom to speak up. It is a sham.”

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Source: Channel 4 News, 26 March 2025

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‘Ridiculous’ cuts to AI cancer tech funding in England could cost lives, experts warn

Ministers have cut millions of pounds of funding for potentially life saving AI cancer technology in England, which cancer experts warn will increase waiting times and could cause more patients to die.

Contouring is used in radiotherapy to ensure treatment is as effective and safe as possible. The tumour and normal tissue is “mapped” or contoured on to medical scans, to ensure the radiation targets the cancer while minimising damage to healthy tissues and organs.

Normally, this is a slow, manual process that can take doctors between 20 and 150 minutes to complete. AI auto-contouring takes less than five minutes and costs around £10-£15 per patient.

Research shows that AI contouring can cut waits for radiotherapy by more than five days for breast cancer patients, up to nine days for prostate cancer patients and three days for lung cancer patients.

In May 2024, the Conservative government announced £15.5m over three years to fund AI auto-contouring for all hospitals providing radiotherapy. Work continued on the scheme after the general election, with online webinars and follow-up calls for radiotherapy departments held in September.

The 51 trusts offering radiotherapy continued to work on installing the cloud-based technology, with a number using it early, in the belief the funding was secured.

But in February, in an email seen by the Guardian, Nicola McCulloch, the deputy director of specialised commissioning at NHS England, said the funding had been cancelled “due to a need to further prioritise limited investment”. There would no longer be a centrally funded programme to support implementation of the technology, she said.

The decision means many radiotherapy departments face a return to manual contouring, prompting accusations that the government is ditching digital and going back to analogue cancer care.

Analysis by Radiotherapy UK has calculated that removing funding for AI contouring in England will add up to 500,000 extra days to waiting lists for breast, prostate and lung cancer alone and leave each of the 51 trusts with a £300,000 shortfall.

The chair of Radiotherapy UK, Prof Pat Price, said: “The government cannot laud the advent of AI in one breath, and allow this to happen. Far from moving from an analogue to digital NHS, when it comes to radiotherapy it feels like the opposite is happening. This wrong-footed decision will exacerbate the impact of severe staff shortages.”

The leading oncologist urged ministers to intervene. “Some departments are so short-handed that they’re shutting machines down because no one is there to operate them and nationally, radiotherapy vacancy rates are running at 8%. This investment in AI could have alleviated some of these pressures. Without it, cancer patients will wait longer than necessary for treatment, potentially costing their lives.”

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Source: The Guardian, 31 March 2025

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Morning-after pill to be offered without charge at pharmacies in England

The morning-after pill will be available without charge on the NHS at pharmacies in England, the government has announced in an effort to reduce the “postcode lottery” of free access to the emergency contraception.

The morning-after pill is one of two forms of emergency contraception that women can use after having unprotected sex, or where other forms of contraception have failed. The sooner that emergency contraception is used, the more effective it is.

The new announcement aims to increase access to the morning-after pill; while it is already available for nothing from most GP surgeries, most sexual health clinics and some NHS walk-in centres, not all pharmacies offer it for nothing, with some women paying up to £30 for the medication.

The health minister Stephen Kinnock said: “Equal access to safe and effective contraception is crucial to women’s healthcare and a cornerstone of a fair society.

“Women across England face an unfair postcode lottery when seeking emergency contraception, with access varying dramatically depending on where they live. By making this available at community pharmacies, we will ensure all women can access this essential healthcare when they need it, regardless of where they live or their ability to pay.”

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Source: The Guardian, 30 March 2025-

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