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Hundreds of mothers diverted while in labour

Nearly 1,000 women were diverted to other NHS trusts or units while in labour within a six-month period this year, HSJ can reveal.

The information was obtained via a Freedom of Information request, but only 68 of approximately 120 trusts with maternity units provided responses – so the true figure is likely to be significantly higher.

In 528 of the 925 incidents recorded between January to June this year, patients were diverted to a different NHS trust from their chosen place of birth to either have their baby or to receive further care while they were in suspected or confirmed labour.

Of those, 402 were due to staffing, capacity issues in neonatal units, and high acuity of illness in women with a lack of diverse skill mix to support them. The remaining diverts were for clinical reasons such as premature labour.

A further 397 incidents involved diversions being made to other hospitals within the same NHS trust, bringing the overall total to 925.

HSJ’s research shines a light on a problem which is widely known but has not been properly quantified for several years.

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Source: HSJ, 17 December 2024

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Patient Safety Minister meets campaigners to discuss financial redress for mesh-injured women

Patient advocates Sling The Mesh will tomorrow (17 December) meet with Baroness Gillian Merron, the Minister for Patient Safety, to discuss financial redress options for women injured by pelvic mesh implants.

The meeting marks a significant step forward in recognising the profound harm suffered by thousands of women across the UK and the urgent need for redress to address the physical, mental, and financial toll of their injuries.

Pelvic mesh implants, including rectopexy mesh, were widely used to treat conditions such as pelvic organ prolapse and stress urinary incontinence, but have left many women with debilitating pain, organ damage, autoimmune disease and other life-altering complications.

Despite years of campaigning for justice, affected women have faced mounting medical costs, lost income, lost pensions, and faced a diminished quality of life - with little financial support.

Kath Sansom, founder of Sling The Mesh, said: “The government must act with speed to provide financial redress. Many women have their PIP applications turned down even though they are severely injured, hundreds have lost relationships, their jobs, their pensions. Some have had to sell their homes to live with family as they can’t afford mortgage payments anymore.”

She added: “We were all innocent players in this appalling story which has taken a heavy toll on women, including financially. We trusted in a medical system that should have protected us. Instead, women have lost so much. Women harmed by mesh implants deserve financial redress to help rebuild their lives and gain some measure of justice for the suffering they’ve endured.”

The meeting will focus on potential pathways for redress and hear of the urgency in addressing the issue, with many struggling to afford ongoing medical treatment and getting trapped in cycles of financial worry due to their injuries.

One of the leading voices in Parliament supporting the cause, MP Sharon Hodgson, whose mam had had her life changed forever due to mesh, underscored the importance of the financial redress initiative.

Sharon said: “It is crucial that women who have been harmed by pelvic mesh implants receive the compensation they so desperately need and deserve. These women’s lives have been shattered, through no fault of their own. It is our duty to ensure that they are not left to shoulder the burden alone. I fully support the bringing this issue to light and pushing for meaningful redress.”

Rt Hon. Sir Julian Lewis, MP for New Forest East, who supports women in his local area who have been harmed by mesh, said: “The female mesh implant scandal is an ongoing NHS disaster. Constituents have been seriously injured, left permanently in pain, and forced to spend thousands of pounds on remedial surgery, with at best only partial success. They deserve substantial compensation and a serious research effort by the NHS to find new ways of safely removing these dreadfully damaging implants."

Rt Hon. Sir Alec Shelbrooke MP, who has also supported women in Parliament for many years, added: “Medical misogyny plays a key part in this horrific scandal. Women were butchered, through no fault of their own. Most were not given fully informed consent. It is vital they are compensated financially and as soon as possible. They must not wait as the victims of the Thalidomide, infected blood and Post Office scandals have been forced to.”

MP Sarah Green, who has supported her local constituents for years,  said: "It is past time that mesh victims receive the redress they need and deserve. In February the Hughes Report by the Patient Safety Commissioner outlined how such a scheme could work. The Government now just need to deliver it"

It is hoped the meeting will conclude with a commitment to further discussions and collaboration between the government and campaign groups to explore viable financial redress models and ensure no woman is left behind.

In a recent Westminster debate about pelvic mesh held on 5 December, 2024, the Parliamentary Under Secretary of State for Health and Social Care, MP Andrew Gwynne, closed by making a commitment to move financial redress forward at pace.

He said: "The previous Government were too slow on that (redress). It is a priority for this Government. We are working at pace, and we remain focused on making meaningful progress." 

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Budget changes will leave disabled and elderly without care as providers go under, experts warn

Rachel Reeves’ Budget measures will devastate care providers, leaving vulnerable disabled and elderly people without care next year, healthcare experts are warning.

The disastrous scenario could also bankrupt local authorities, care providers say.

The rise in employers’ national insurance in April, together with increases in the minimum wage and national living wage, will threaten the future of care companies, according to the Homecare Association, a membership body for care providers.

The association says that if care providers fold, the UK risks widespread failure of care provision, which could “leave people without care, overwhelm family carers and cripple NHS services”.

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Source: The Independent, 15 December 2024

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Top A&E doctors criticise ‘dangerous’ suggestion that corridor care can be delivered safely

Top emergency doctors have criticised a new guide on how to treat patients in corridors, warning it is “normalising the dangerous”.

New guidance produced by NHS England in September on how to provide “safe and good quality care” in “temporary” spaces.

The Royal College of Emergency Medicine (RCEM) has denounced the guide as “nonsensical” and “out of touch”, saying that it is “not possible to provide safe and good quality care” in corridors and cupboards in a new position statement.

While acknowledging that corridor care is “not acceptable”, the guidance says hospitals are having to use temporary spaces more regularly - and use is no longer “in extremis”. It advises staff on how they can deliver the “safest, most effective and highest quality care possible” in such circumstances.

The RCEM’s new statement on the guidance said: “Advice from arm’s length bodies that appear out of touch with what is happening in our departments was always going to be poorly received.”

Using corridors will result in long emergency department waits which are “associated with measurable harm to patients”, it said.

Use of corridors will lead to long waits in emergency departments which is “associated with measurable harm to patients”, it added.

Patient dignity and privacy is “not maintained” when they are cared for in corridors, with sleep “difficult, if not impossible” and unfeasible circumstances for maintaining patient confidentiality.

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Source: The Independent, 16 December 2024

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One in four babies in England delivered by caesarean section, NHS data shows

One in four babies born in NHS hospitals in England last year were delivered by caesarean section, official figures show.

The gradual increase in the number of caesarean births over the past decade is due to a growing number of complex pregnancies and births, caused by factors including rising obesity rates and women waiting until they are older to have children. The proportion of spontaneous deliveries that do not involve drugs or other medical interventions has steadily declined in the last 10 years.

“Over the past decade, there has been a gradual national increase in the number of caesareans,” said Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists (RCOG).

“A major factor of this is the growing number of complex births. We are seeing national rising rates of obesity and people choosing to have children at a later stage in their life, both of which can increase the chance of complications.”

Most women seek a C-section for medical reasons, but also have the right to opt for one based on personal preference according to guidelines published by the National Institute for Health and Care Excellence. These state that if a mother does not want a vaginal birth after discussing the benefits and risks, the medic should “offer a planned caesarean birth for women requesting a caesarean birth”.

In 2022, hospitals in England were told to abandon targets aimed at limiting the number caesarean sections carried out to below 20%, over fears for the safety of mothers and babies. At the time, the chief midwife described the targets as potentially unsafe. This followed the Royal College of Midwives formally abandoned its normal birth campaign in 2017, after years of promoting vaginal births as preferable.

Dr Thakar said: “The RCOG does not promote one form of birth over another. Women should be supported to make an informed decision about how they want to give birth, including a discussion on the risks and benefits of both vaginal and caesarean births. The safety and care of the woman and baby during pregnancy, labour and birth should always be the main focus.”

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Source: The Guardian, 16 December 2024

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‘Aggressive marketing’ fuels surge in patients seeking private referrals from GPs

Growing numbers of patients are requesting NHS-funded referrals to private providers “operating outside of agreed guidelines”, fuelled by long waiting lists and “aggressive direct marketing tactics”, GPs have warned.

The GPs report the biggest problems are, increasingly, for weight management and for services to diagnose neurological disorders such as ADHD and autism — both of which have long and growing waiting lists with many NHS services. 

National NHS choice rules, known as the “right to choose”, mean all ICBs must allow and fund patients to use any provider of these services, regardless of location and as long as it has a contract with another ICB. Choice of NHS community service providers, however, is limited, partly because they are funded by block payments.

The letter from Wessex LMC to ICB medical directors calls for “ICB action to address potential patient safety and quality issues relating to the ever-expanding market of ‘right to choose’ providers”.

“It does seem that some providers are using ‘right to choose’ as a way to access the NHS market where there are long waits for local NHS services, and they sometimes use aggressive direct marketing tactics to encourage patients to choose their service.

“The public would expect that if these providers are ‘available on the NHS’ then they would be practising in line with agreed guidelines and best practice but this doesn’t always seem to be the case.”

Examples of such problems include providers diagnosing conditions based only on remote consultations and surveys and GPs being asked themselves to carry out physical assessments that should be part of the specialist work.

The LMC says NHS specialist services were refusing to recognise some diagnoses made by the independent providers for accessing follow-up services and refusing to prescribe to the patients.

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Source: HSJ, 16 December 2024

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NHS ‘ignores staff, patients and families’, says minister

Health minister Gillian Merron has declared many patients have a poor experience of NHS care as a result of a “culture that has ignored the voice of staff [and] of patients and families for too long”.

Baroness Merron, who is the patient safety minister, said “much of what is wrong with the NHS and needs to change goes back to a culture that has ignored the voices of staff [and] of patients and their families for too long”.

She said there had “been good progress in improving patient safety, but we all know there is a long way to go”.

The minister was speaking at the launch of the new National State of Patient Safety report by Imperial College London’s Institute of Global Health Innovation, for Patient Safety Watch.

She said the government planned to improve culture, including with professional regulation of managers and a professional duty of candour. Baroness Merron said the new safety report was “going to contribute massively” to the government’s 10-year health plan.

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Source: HSJ, 13 December 2024

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GMC regulation of physician associates and anaesthesia associates to begin

The General Medical Council (GMC) will begin regulating physician associates (PAs) and anaesthesia associates (AAs) from this Friday, 13 December.

Registration for PAs and AAs will open from Monday, 16 December. A small number will receive an invitation to apply for registration before the end of the month, and all PAs and AAs on existing voluntary registers will have received their invitations by the end of January 2025.

There are thought to be around 5,000 PAs and 200 AAs in the UK. From December 2026 it will be an offence to practise as a PA or AA in the UK without registration.

To join the register of PAs and AAs, individuals will need to complete an application and provide evidence, including their qualifications and, where relevant, work history and references, to show they meet the GMC’s standards.

GMC Chief Executive Charlie Massey said:

"We are looking forward to becoming the regulator of these professions and I am sure it will also be an exciting time for them. I have met many physician associates and anaesthesia associates in recent months and have seen how they work with doctors and others in teams providing excellent care for patients.

‘There have been challenges along the way, but we are about to see a step change in regulation. For the first time, patients, employers and colleagues will be assured that physician associates and anaesthesia associates have the necessary education and training, meet our standards, and can be held to account if serious concerns are raised."

Source: General Medical Council, 12 December 2024

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Americans spend more time living with diseases than rest of world, study shows

Americans spend more time living with diseases than people from other countries, according to a new study.

The American Medical Association has published its latest findings, revealing that Americans live with diseases for an average of 12.4 years. Mental and substance-use disorders, as well as musculoskeletal diseases, are main contributors to the years lived with disability in the US, per the study.

Women in the US exhibited a 2.6-year higher so-called healthspan-lifespan gap (representing the number of years spent sick) than men, increasing from 12.2 to 13.7 years or 32% beyond the global mean for women.

The latest overall healthspan-lifespan gap in the US marks an increase from 10.9 years in 2000 to 12.4 years in 2024, resulting in a 29% higher gap than the global mean.

Globally, the healthspan-lifespan gap has widened over the last 20 years, extending to 9.6 years from 8.5 years in 2000 – a 13% increase.

Following the US in the largest healthspan-lifespan gaps were Australia at 12.1 years, New Zealand at 11.8 years, the UK and Northern Ireland at 11.3 years and Norway at 11.2 years. By contrast, the smallest healthspan-lifespan gaps were seen in Lesotho at 6.5 years, Central African Republic at 6.7 years, Somalia and Kiribati at 6.8 years and and Micronesia at 7 years.

Describing the results, the study’s authors, Armin Garmany and Andre Terzic, said: “These results underscore that around the world, while people live longer, they live a greater number of years burdened by disease.”

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Source: The Guardian, 11 December 2024

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GPs ‘should perform minor surgery’ to cut waiting lists

GPs should be empowered to perform minor surgery to help the thousands of Scottish patients who are waiting years for treatment, one of the country’s leading family doctors has said.

Despite pledges by SNP ministers to tackle the backlog of patients waiting for care, the latest data shows more than 10,000 Scots have been waiting for at least two years for treatment — 100 times higher than the equivalent figure in England.

Doctors have suggested that GPs could perform more services within local surgeries, removing the need for a hospital referral and cutting down waiting times.

Minor treatments which GPs could perform include cutting out skin lesions and cryotherapy (which includes freezing skin lesions with liquid nitrogen), contraceptive coil fittings and joint injections, it has been suggested.

Dr Chris Williams, deputy chairman of the Royal College of General Practitioners in Scotland, said that the Scottish government’s announcement of £13.6 million in extra funding this financial year for general practice “should allow some practices to offer these services should they choose to do so”.

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Source: The Times, 11 December 2024

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Irish medical regulator says regulating physician associates is outside its remit

The Medical Council, the medical regulator for Ireland, has announced that it believes it is not the appropriate body to regulate physician associates (PAs)—in sharp contrast to the position in the UK where the General Medical Council takes on this role from 13 December.

The role of PA was introduced in Ireland in 2016 by the Royal College of Surgeons in Ireland’s School of Medicine which offers the only masters in physician associate studies in the Republic of Ireland.

To date, 76 PAs have graduated from the two year programme with 60% working in public hospitals and 40% employed by the private sector. The GMC estimates that there are around 5000 PAs and 200 anaesthetic associates (AAs) in the UK.

PAs are not yet subject to statutory regulation in Ireland but there is a managed voluntary register, which lists all fully qualified PAs who successfully fit the criteria to practise as a PA in the Republic. The register is designed to provide public protection and safety and is managed by the Irish Society of Physician Associates.

In a position statement2 published on 3 December, the Medical Council said it was not the appropriate regulatory body for PAs.

“The Medical Practitioners Act 2007 has no provision to regulate health professionals other than doctors,” said the statement. “The Medical Council’s primary purpose is to protect the public by setting high standards of professional conduct, education, training, and competence among doctors.”

The council also said there was potential for emerging patient safety risks arising from confusion for patients, as observed recently in the UK.

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Source: The BMJ, 12 December 2024

Further reading on the hub:

Physician associates: What are the patient safety issues? An interview with Asif Qasim

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NHS warns of 'tidal wave' of flu as hospital cases rise 70% in England

The number of hospital beds in England occupied by patients with flu has increased by 70% in a week, NHS England said, as it warned of a “tidal wave of flu hitting hospitals”.

Health leaders said that people eligible for their free flu jab should get vaccinated as soon as possible to avoid “festive flu”.

An average of 1,861 flu patients were in hospitals in England each day last week, including 66 in critical care beds, NHS figures show. This is up from 1,099 patients the previous week, when 39 were in critical care. It is also more than four times the figure at this point last year.

NHS England said cases of norovirus and respiratory syncytial virus (RSV) were also on the rise.

Prof Sir Stephen Powis, the national medical director for NHS England, said on Thursday: “The tidal wave of flu cases and other seasonal viruses hitting hospitals is really concerning for patients and for the NHS – the figures are adding to our ‘quad-demic’ worries.

“While the NHS has plans in place to manage additional demand over the busy winter period, with one week left to book your vaccine, I cannot stress enough the importance of getting booked in to protect yourself against serious illness and to avoid ‘festive flu’.”

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Source: The Guardian, 12 December 2024

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‘Safety concerns’ over provider with £500m new contracts

A patient transport company which is taking over contracts worth hundreds of millions of pounds is grappling with concerns about service performance and risk to patients.

EMED has been delivering the non-emergency patient transport service in the Surrey Heartlands area since April.

HSJ has learned that several trusts have repeatedly highlighted problems with missed and late appointments, including those for renal patients attending for dialysis.

One trust – Ashford and St Peter’s – said in a board paper the contract “continues to generate significant patient safety and patient experience concerns across the whole system”.

The Royal Surrey County Hospital Foundation Trust’s board papers said challenges had “a knock-on effect with patient experience, particularly in end of life care transfers, and longer waits for patients being discharged”.

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Source: HSJ, 13 December 2024

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Eight women developed cancer after smear test misread, says report

Eight women whose smear tests were misread by screeners went on to develop cancer, a major review into cervical screening at the Southern Health Trust has found.

A further 11 women's slides were found to have pre-cancerous changes in the cells when they were reviewed and had to receive treatment.

All these women had either pre-cancerous changes to their cervix or were diagnosed with another significant gynaecological condition when their smears were reviewed.

The review was triggered when the diagnoses of three women were investigated as a Serious Adverse Incident.

Two of the women, Lynsey Courtney and Erin Harbinson, have since died.

More than 17,000 were approached to have their smear tests rechecked.

The examination of cancer screening at the Southern Health Trust over 13 years found that many women were failed after some screeners underperformed and went unchecked by management for years.

Stella McLoughlin from the campaign group Ladies with Letters described what had happened as unforgivable and called for a public inquiry.

"This has been an absolute scandal from start to finish and was allowed to go on for 10 years," she added.

"Smears being misread, people not being held to account, screeners not being managed properly - all of this is affecting real people."

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Source: BBC News, 11 December 2024

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Puberty blockers for under-18s banned indefinitely

The ban on giving puberty blockers to under-18s questioning their gender identify is to be made permanent, Health Secretary Wes Streeting has announced.

Streeting told MPs he was making the temporary ban introduced in May indefinite across the UK, following a consultation and advice from the Commission on Human Medicines - calling the way the drugs had been used a "scandal".

The expert group said prescribing the drugs to children for gender dysphoria was an "unacceptable safety risk".

Campaigners on both sides have reacted to the news, with those in support of the ban commending Streeting's "integrity" and those against calling it "discrimination".

A temporary ban was put in place by the last Conservative government, and had been renewed twice by Streeting.

He said on Monday that the review identified cases where children had been prescribed the treatment after filling out an online form and only having one online consultation with a healthcare provider.

The health secretary said it was essential for the government to be evidence-led when it came to healthcare.

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Source: BBC News, 11 December 2024

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National probe into deaths of NHS heart patients as scale of cardiology crisis revealed

A national probe has been launched into the deaths and harm of thousands of NHS patients waiting for cardiac surgery, as doctors and experts warn of a “crisis in heart care”, an investigation by The Independent has revealed.

The audit was ordered by NHS England after concerns were raised about the impact on patients left waiting too long for specialist surgery, according to a leaked memo. Waiting times for all types of cardiac surgery are also under review.

Senior doctors have described how the NHS is struggling to provide life-saving care to those suffering heart attacks and strokes, with worsening ambulance delays meaning patients are being deprioritised.

The latest figures show waiting lists for cardiology services have doubled since the onset of the pandemic in March 2020 with 412,164 patients waiting for routine care in October 2024 – up from 397,956 the year before.

As of October this year, just 58 per cent of heart patients were seen within the NHS target of 18 weeks.

An NHS spokesperson said: “Patients who come to emergency departments with heart attacks and strokes should be transferred as quickly as possible to units that are able to offer this care and prioritised accordingly. Despite significant pressure on services and thanks to staff across the country, the NHS is making good progress with the overall waiting list coming down, however, we know boosting capacity for cardiovascular care remains crucial to improving outcomes. We’re committed to using innovations like surgical hubs and implementing the “right procedure, right place model” to help release capacity and speed up access for patients.”

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Source: The Independent, 9 December 2024

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Woman who died after ‘butt lift’ surgery did not give informed consent, Bolton coroner rules

A 26-year-old woman died after she was subjected to a “frankly barbaric” Brazilian butt lift procedure without giving informed consent, a coroner has ruled.

Demi Agoglia travelled to Turkey for the operation after seeing celebrity endorsements for Istanbul-based Comfort Zone Surgery on social media.

Her partner, Bradley Jones, said he had not wanted Agoglia to have the surgery but she had booked the trip months earlier after seeing “some celebrity” endorse it online.

Immediately after the operation she was “shaking” and appeared “very, very cold”, he told Bolton coroner’s court.

Staff from Comfort Zone were called to the villa where she was staying after Agoglia complained of a tight chest, and they checked her blood pressure, but did not inspect the area of the operation or check her heart rate and pulse, the inquest heard.

Agoglia then collapsed at the villa and was taken back to a hospital in Istanbul where she died on 8 January, three days after the operation.

It later emerged that the Comfort Zone staff who were called out to the villa were not qualified nurses. The inquest heard that their “completely bizarre” actions included trying to feed pieces of cucumber to Agoglia after she collapsed.

Dr Omar Tillo, a Harley Street consultant plastic surgeon, told the inquest: “The lack of proper care and response, particularly the failure to address post-operative complications, are likely to have played a significant role in Demi’s tragic outcome.”

The Bolton coroner, John Pollard, ruled that the medical cause of death was a microscopic fat embolism in which tissue leaks into the bloodstream. Concluding that Agoglia had died as a result of misadventure contributed to by neglect, he said: “I find there was no proper informed consent in this matter, there was no proper pre-operative care and advice, and no proper post-operative care.

“All of this meant the care in total fell well below the standard expected of this type of treatment and the lack of care contributed significantly to Demi’s death.”

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Source: The Guardian, 11 December 2024

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Pay deal could extend waiting list and ‘make day job even harder’, says NHSE

A pay rise of more than the 2.8% budgeted for next year would slow down the NHS’s waiting list recovery, and make ”the day-to-day job of NHS staff even harder”, NHS England has claimed.

The national body said the 2025-26 NHS funding envelope was “extremely tight” and any pay rises above 2.8 per cent would mean “further tough re-prioritisation, significantly impacting patient care and in turn making the day-to-day job of NHS staff even harder”.

In evidence to the NHS Pay Review Body panel published on Monday, NHS England said it would have to meet extra costs from its own budget, and every half percentage point above 2.8 per cent would cost around £700m. This was the equivalent of reducing the elective waiting list by at least 300,000, it said.

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Source: HSJ, 11 December 2024

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NHS spends £14.7bn a year treating patients in England hurt by care mistakes, says report

The NHS is forced to spend a “staggering” £14.7bn a year treating people who have been harmed by mistakes made during their care, a report reveals.

And a stark north/south divide on patient safety has opened up across England, with double the amount of death and disability caused by medical negligence in the north-east than in London.

The report, by experts at Imperial College London, found that the safety of the care patients receive had declined over the past two years.

The authors include Prof Lord Ara Darzi, the surgeon and former health minister who produced a major NHS report for the Labour government, which highlighted avoidable patient deaths.

Darzi said there had been “alarming declines” in 12 key metrics of patient safety in England since 2022. They include maternity care, in which there are growing rates of stillbirth, babies dying during or soon after they are born and also women dying while giving birth.

“Our analysis highlights a troubling increase in neonatal and maternal deaths, with Black women disproportionately affected,” said Darzi, the co-director of Imperial’s Institute of Global Health Innovation, which drew up the report.

He urged ministers and NHS bosses to take “immediate action” to improve maternity care. The Royal College of Midwives said staff shortages, including of specialist midwives, were a key reason for the recent deterioration in women’s experiences during pregnancy, labour and afterwards – a decline which reviews by other organisations have also identified.

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Source: The Guardian, 12 December 2024

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Malaria cases rise for fifth year as disasters and resistance hamper control efforts

Malaria killed almost 600,000 people in 2023, as cases rose for the fifth consecutive year, according to a new report from the World Health Organization (WHO).

Biological threats such as rising resistance to drugs and insecticides, and climate and humanitarian disasters continue to hamper control efforts, world health leaders warned.

Globally, there were 263m cases last year, 11m more than the previous year; the vast majority (94%) occurred in Africa.

Officials said a $4.3bn (£3.4bn) annual funding shortfall was among further challenges, which also include the spread of a new insecticide-resistant species of mosquito, genetic mutations in the malaria parasite that stop tests working, and the emergence of a new type of malaria parasite in south-east Asia.

Dr Tedros Adhanom Ghebreyesus, WHO director general, said: “No one should die of malaria; yet the disease continues to disproportionately harm people living in the African region, especially young children and pregnant women.”

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Source: The Guardian, 11 December 2024

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Mothers came to harm at maternity unit says report

Mothers and newborn babies came to harm because of staffing shortages and a "toxic" culture at Edinburgh's maternity unit, according to a whistleblowing investigation seen by BBC News.

NHS Lothian commissioned a report into the obstetrics triage and assessment unit at Edinburgh Royal Infirmary after a member of staff raised concerns in February this year.

The investigation upheld or partially upheld 17 concerns about safety.

NHS Lothian said an "improvement plan" designed to enhance patient safety and improve the working environment for staff was already under way as a result of the report.

The health board said a detailed review was taking place into the death in a bid to give the family much-needed answers.

But staff say they fear the risks to patients remain.

"We are afraid we can't provide safe patient care and that women and babies are being harmed," one staff member said, speaking to the BBC anonymously.

"The situation has been getting worse over the past five years and it is at its worst now."

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Source: BBC News, 10 December 2024

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Cost and safety concerns hamper crisis care

Most integrated care boards report a lack of funding is hampering the NHS’s efforts to respond better to mental health crisis incidents, rather than requiring a police response.

The Department of Health and Social Care has published an evaluation of the Right Care, Right Person model, which was introduced nationally last year in response to the police arguing they were spending huge resources on these cases, and would stop answering them.

The NHS said it would move to RCRP, based on a pilot in Humberside in which the health service had dealt with more crises without police input. 

However, mental health service leaders have consistently raised concerns about funding, and the speed of rollout.

The concerns have now been confirmed in the DHSC evaluation, which includes a survey of integrated care boards and councils.

Of the 34 ICBs asked between autumn 2023 and spring 2024, 62% said they had experienced “barriers”. The majority of these ICBs said “cost/funding pressure” was the biggest barrier (86%), followed by “lack of clarity regarding responsibilities of agencies when responding to incidents” (71%), then “lack of workforce to cope with demands” (67%).

Sixty per cent of ICBs reported their “health-based place of safety” — where patients are meant to be taken after being detained under section 136 of the Mental Health Act — did not ”meet demand”. This was mostly because of a lack of adult inpatient beds, followed by a rising number of detentions, ICBs said. 

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Source: HSJ, 11 December 2024

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‘Medical misogyny’ condemns women to years of gynaecological pain, MPs told

Women and girls are enduring years of pain because their reproductive conditions are being dismissed due to “medical misogyny”, according to a damning parliamentary report.

The report, by the Women and Equalities committee, found that gynaecological conditions such as endometriosis and adenomyosis are treated with inadequate care due to a “pervasive stigma”, a lack of education by healthcare professionals and “medical misogyny”.

The Commons select committee, which set out to examine the experiences of care women with reproductive conditions get in England, found that symptoms are often “normalised” and it can take years for women to get a diagnosis and treatment.

The substandard gynaecological care cited by the report also includes routine IUD contraceptive fittings, cervical screenings, and hysteroscopies.

The report said women were being left in pain and discomfort that “interferes with every aspect of their daily lives”, including their education, careers, relationships and fertility, while their conditions worsen.

It also found there to be a “clear lack of awareness and understanding of women’s reproductive health conditions among primary healthcare practitioners” and concluded that gynaecological care is not being treated as a priority.

Pervasive stigma associated with gynaecological and urogynaecological health, a lack of education and “medical misogyny” has contributed to poor awareness of these conditions.

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Source: The Guardian, 11 December 2024

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New leaders bring ‘energy, focus and grit’ to troubled trusts, says NHSE

Changing chairs, CEOs and finance chiefs has helped turn around several poorly performing trusts and systems, NHS England has said, but it plans to do more to “strengthen” leadership at troubled organisations.

Dame Emily Lawson made the comments in an update to NHSE’s board on its “recovery support programme”, which is the current name of its intervention regime for the most poorly performing trusts and systems.

The NHSE chief operating officer said: “We know we have got more to do… to strengthen leaders at the most challenged places. We are developing a more systematic way of identifying and developing talented leaders and matching them to roles where they can make the biggest impact when in post.

“That means we need to give leaders the right flexibilities, incentives and support to turn things around.”

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Source: HSJ, 6 December 2024

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USA: Price stops 1 in 6 adults with asthma from taking their life-saving medications as prescribed

The cost of medication to treat asthma, the chronic lung disease, is stopping one in six US adults from taking their medication as it has been prescribed, researchers have warned.

Furthermore, failure to stick to drug treatment was associated with nearly doubling the risk of an asthma attack and a more than 60 percent heightened risk of visiting an emergency department, they said.

“Adults with asthma who reported experiencing cost-related medication non-adherence had a higher likelihood of experiencing asthma exacerbations,” Emily Graul and Dr. Christer Janson — of the Emory University School of Medicine and Sweden’s Uppsala University, respectively — explained in an editorial article linked to the research.

Asthma can be treated using medications, lifestyle treatments, and inhalers. Inhalers are handheld devices that get medicine directly into peoples’ lungs. While Americans with asthma are more likely to have health insurance, the agency says most adults aged 18 to 64 report cost barriers.

The prices of inhaled medicines have increased by an average of 50 percent since 2009, according to the Asthma and Allergy Foundation of America. The cost of inhalers ranges between tens and hundreds of dollars, with some companies agreeing to a $35 cap earlier this year.

On average, 10 people in the US die from asthma each day and more than 3,200 people died in 2022, the foundation said. An estimated 22 million American adults had asthma in the US that year, according to the Centers for Disease Control and Prevention.

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Source: The Independent, 10 December 2024

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