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‘I acted in good faith’ says Letby trust CEO

A former trust chief executive at the centre of the Lucy Letby scandal has defended his actions, stating both he and other executives were “acting in good faith”.

Tony Chambers, who led The Countess of Chester Foundation Trust from December 2012 until September 2018, spoke publicly for the first time since Letby’s conviction last year, giving evidence to the public inquiry into the events.

Neonatal nurse Letby was convicted last year of murdering seven babies, and attempting to murder seven more, from 2015-16, while working in the hospital.

Mr Chambers told the inquiry on Wednesday: “I stand by the decisions that we made. We were acting in good faith. I was acting in good faith. I listened to the doctors when they raised their concerns. I also listened to the nurses when they raised their support [for Letby].”

Since her conviction, Chester paediatricians have accused the executives of pushing back on concerns they raised, rather than taking them seriously. Part of their response was to commission several internal and external reviews.

Mr Chambers defended his actions. “I was being presented with things that, at times, felt quite binary. I never took a binary view. I listened to both. 

“Therefore, Letby was removed from frontline duties and therefore we also focused on the safety of the unit, redesignated [downgraded it so it did not take high-risk cases] and so forth, and all the inquiries that went through were done all in good faith.

“The biggest cause of unnatural, unexplained deaths in maternity and neonatal units is not deliberate harm, but failure in systems of care. There are many examples. The Kirkup report, the Ockenden report, many, many examples.”

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Source: HSJ, 27 November 2024

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‘Heroic leadership’ has prevented action on staff violence, says CEO

A “heroic” model of leadership has meant the NHS hasn’t made enough progress in tackling violence and aggression against staff and promoting sexual safety, a trust chief has said.

Sam Higginson, chief executive of Royal Devon University Healthcare Foundation Trust, said NHS leaders “probably haven’t done as much as we could have done in the past” to reduce violence and aggression and promote sexual safety.

In an interview with HSJ, Mr Higginson said these safety issues have been raised consistently in the RDUH’s staff surveys, and leaders need to talk about them “a lot more.”

In the latest NHS staff survey, the number of staff reporting physical violence from patients or members of the public was at 13.5 per cent nationally, and 12 per cent at RDUH. This proportion has been falling slightly in recent years but widespread concerns about staff safety remain.

A union has warned recently that NHS England is cutting several national initiatives aimed at reducing violence against staff.

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Source: HSJ, 27 November 2024

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Dallas anaesthesiologist convicted of tampering with IV bags sentenced to 190 years in prison

A Dallas anaesthesiologist who injected dangerous drugs into patient IV bags, leading to one death and numerous cardiac emergencies, was sentenced today to 190 years in prison.

Raynaldo Riviera Ortiz Jr., 60, was charged by criminal complaint in September 2022 and indicted the following month on charges related to tampering with IV bags used at a local surgical centre.

In April, following an eight-day trial, a jury convicted him of four counts of tampering with consumer products resulting in serious bodily injury, one count of tampering with a consumer product and five counts of intentional adulteration of a drug. He was sentenced today by Chief U.S. District Judge David Godbey for the Northern District of Texas, who found that Dr. Ortiz caused the death of his colleague and called his other conduct “tantamount to attempted murder.”

“The defendant betrayed the trust of patients by tampering with critical medical supplies, and the result was serious bodily injury,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s sentence reflects the seriousness of these offenses and should make clear that the department will work tirelessly to investigate and prosecute anyone who endangers patients by tampering with drugs.”

“This disgraced doctor acted no better than an armed assailant spraying bullets indiscriminately into a crowd. Dr. Ortiz tampered with random IV bags, apparently unconcerned with who he hurt. But he wielded an invisible weapon, a cocktail of heart-stopping drugs, concealed inside an IV bag designed to help patients heal,” said U.S. Attorney Leigha Simonton for the Northern District of Texas. “On at least nine separate occasions, he essentially attacked unconscious patients lying on an operating table, and even killed a colleague.  I am so proud of our office’s work in bringing Dr. Ortiz to justice and bringing a measure of solace to his victims and their families.”

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Source: Office of Public Affairs, 20 November 2024

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Bone-on-bone agony: the cruel reality of facing a three-year waiting list for a new knee

When Alexandra McTeare was told she might have to wait three years for knee replacement surgery, she felt desperate. “Because of how miserable your life is, how small it has become,” she says.

The problems with her knee started in 2017. “It was painful and would swell up, particularly in the heat.” She would take painkillers and keep her leg elevated when she was sitting down, and did stretching exercises for her muscles. But over the next few years, “it gradually got worse, the intervals between swelling episodes reduced and the pain increased”. It reached a point where it was no longer bearable.

Ten years ago, McTeare could get a GP appointment within a week. “Now, you phone up and you’re lucky if you get an appointment within a month, and nine times out of 10 it’ll be a nurse practitioner.” McTeare has nothing against nurse practitioners; she used to be a nurse herself and she was working for the NHS when they were introduced to GP practices. “But they’re not appropriate for everything,” she says. “People do need to be able to see a GP.”

Her knee didn’t get better. The opposite happened. “I didn’t believe it was a torn meniscus, it was going on and on, so I decided: to hell with it, I’ll pay and see somebody privately.” In March 2023, she saw an orthopaedic consultant, got an X-ray, was told she had arthritis in her knee and needed a total knee replacement. It took no more than half an hour and cost her £400. McTeare says she is lucky she could raise the money for a private consultation. But she wants to make something clear: “I have always despised private medicine.”

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Source: The Guardian, 27 November 2024

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NHSE board members face regulation under government proposals

A major consultation on introducing professional regulation of NHS managers and leaders proposes applying the measures to NHS England board members.

One of the questions in the Department of Health and Social Care’s consultation on regulating NHS managers, published this afternoon, asks participants whether “appropriate board members at arms-length bodies (for example, NHS England)” should face a system of regulation.

However, the consultation does not ask participants whether NHSE employees should be included in plans for an individual statutory duty of candour, which could see managers face legal penalties for failing to report safety concerns.

Instead, it only asks if managers at Care Quality Commission-regulated organisations should face tougher legal accountability, and at which level this should be considered.

The consultation, set to run for 12 weeks, will consider the type of regulatory system that would be deemed appropriate, which managers should be in scope, what kind of body should be responsible for its regulation, and what types of standards managers should be required to demonstrate.

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Source: HSJ, 27 November 2024

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Plans to end NHS dental care crisis not working, warns spending watchdog

Plans to end the deepening crisis in access to NHS dental care are failing, leaving patients unable to get treatment, according to a warning from the government’s spending watchdog.

The National Audit Office’s (NAO) damning verdict on the “dental recovery plan” prompted patient groups to voice alarm that people’s struggles with decayed teeth represents “a serious public health concern”.

A pledge to provide an extra 1.5m treatments in England this year is in disarray amid falls in both the number of dentists doing NHS work and people receiving help from them.

There is “significant uncertainty” as to whether that ambition will be fulfilled because two key elements of the plan have not been achieved, an NAO investigation found. None of the promised new fleet of mobile dental vans has appeared and £20,000 “golden hellos”, to entice 240 dentists to work in areas of acute shortage, have only produced one extra dentist.

The plan, launched in February by the then Conservative government, promised that “everyone who needs to see a dentist will be able to do so” during 2024-25.

However, “based on initial analysis to date, the plan is not on track to deliver the additional courses of treatment,” the NAO concluded.

Even if the plan did provide what was promised, the NHS would still be offering 2.6m fewer treatments this year than before Covid hit in early 2020, it added.

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Source: The Guardian, 27 November 2024

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Trust recalls 1,500 patients over potential misdiagnosis

Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. 

Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. 

But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. 

The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. 

One affected trust is Maidstone and Tunbridge Wells FT, which said around 1,500 patients had been identified for a retest following a technical issue affecting results in July.

A spokesman said the problem was escalated to the supplier as soon as possible, and that affected patients would be contacted by GPs. 

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Source: HSJ, 27 November 2024

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UK falls “well below” EU average on doctors per population, report finds

The UK had a shortage of around 176 000 doctors, nurses, and midwives in 2022 and has become over-reliant on international recruitment, warns a report by the Organisation for Economic Co-operation and Development (OECD).

The report, which looked at the state of health in the EU, found that in total EU countries had an estimated shortage of 1.2 million doctors, nurses, and midwives. It cited multiple factors, including ageing populations, difficult working conditions, staff burnout, and challenges presented by the covid pandemic.

Significant inequalities also continue to exist between EU member states.

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Source: BMJ, 21 November 2024

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Major incident declared at hospital over cyber issue

A major incident has been declared at a hospital "for cyber security reasons".

In a statement on their website, Wirral University Teaching Hospital said the ongoing incident at the Trust is likely to impact performance at Arrowe Park Hospital in Wirral.

The hospital has asked people to only attend the hospital if they have "a genuine emergency".

“The Trust business continuity processes are in place and our focus remains on maintaining patient safety," a hospital spokesperson said.

The statement added: “However, this issue is likely to result in longer waits in the emergency department and assessment areas.

“Please only attend the emergency department if you have a genuine emergency.

“If it’s not an emergency, please visit 111, use a walk-in centre, an urgent treatment centre, a GP or pharmacist."

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Source: BBC News, 26 November 2024

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Texas woman dies after receiving inadequate treatment for a miscarriage

A Texas woman has died after receiving inadequate medical treatment for a miscarriage, according to a new report from ProPublica – the fifth pregnant woman the publication has found to have died since the fall of Roe v Wade after receiving inadequate care or being denied a legal abortion.

Porsha Ngumezi, a 35-year-old mother of two, died in June 2023 after experiencing a miscarriage in Texas, where nearly all abortions are banned, ProPublica reported on Monday. Ten weeks into her pregnancy, Ngumezi started to bleed and went to Houston Methodist Sugar Land, which is part of the Houston Methodist hospital chain and located in the Houston metropolitan area. While at the hospital, Ngumezi continued to bleed for several hours. She underwent multiple blood transfusions.

Doctors who reviewed Ngumezi’s case told ProPublica that she should have been offered a dilation and curettage, or D&C, a common procedure that can be used for miscarriages and abortions to clear tissue from the uterus. However, some doctors in states with abortion bans have become hesitant to offer D&Cs, doctors said, because they are afraid of being punished for violating abortion bans – even in situations where women’s pregnancies have ended, as in Ngumezi’s case.

Rather than being offered a D&C, a doctor gave Ngumezi misoprostol, ProPublica reported. Although misoprostol is frequently used in miscarriages and abortions, it can be dangerous to give to women who are – like Ngumezi – bleeding heavily.

However, in states with abortion bans, doctors may feel more comfortable giving patients misoprostol than giving them D&Cs, because D&Cs can attract too much attention.

“You have to convince everyone that it is legal and won’t put them at risk,” Dr Alison Goulding, a Houston OB-GYN, told ProPublica of D&Cs. “Many people may be afraid and misinformed and refuse to participate – even if it’s for a miscarriage.”

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Source: The Guardian, 25 November 2024

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Thousands of children affected by ADHD medication shortage

Thousands of children with attention deficit hyperactivity disorder (ADHD) are having to go without medication as a result of shortages, with some missing school as a result.

There has been a national shortage of ADHD medications for more than a year, with the worst affected drug currently methylphenidate, which is commonly used for children and sold under the brand names Concerta and Ritalin.

Two thirds of parents said they faced problems getting their child’s medication at the beginning of this school year, according to a survey by the charity ADHD UK, with some saying their children are unable to concentrate in lessons or having to take days off.

Campaigners and pharmacists have urged the Department of Health and NHS to loosen bureaucracy that means patients cannot switch to alternative drugs that are in stock.

Henry Shelford, chief executive of ADHD UK, said: “We were under the impression it would be solved by now but it’s absolutely not. There are huge challenges across the country. The problem in the UK is much worse than almost anywhere else in the world.

“It is absolutely destroying lives. It is devastating for children. Removing medication from a child with ADHD is akin to removing a wheelchair from a disabled person. They can’t live their normal lives.

“I know people whose entire careers are being unravelled because of problems with their medication. For many people medication is life-changing, and so to have it removed is equally life-changing.”

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Source: The Times, 24 November 2024

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Hospital covered up baby’s death, says senior coroner

A senior coroner has accused Chelsea and Westminster Hospital of a cover-up over the death of a baby who died when midwives failed to act on clear signs that his mother was in distress.

Elton Deutekom was pronounced dead 37 minutes after his birth in January 2022. During labour his mother had a placental abruption — when some or all of the placenta separates from the wall of the womb. This was not picked up by her care team, and Elton was starved of oxygen.

Doctors at the west London hospital did not refer the incident to the coroner and wrongly told the NHS’s healthcare safety investigation branch (HSIB) that Elton had been stillborn and no investigation was required, an inquest into his death was told.

It was not until his parents learnt of this anomaly in the records that an investigation was carried out by the HSIB, which uncovered serious failings in his care.

Professor Fiona Wilcox, the senior coroner, said: “I need to say this on the record and in public — this feels like there has been an attempt at a cover-up.” She later repeated: “I am concerned there is an element of cover-up in this death. I will say it categorically.”

Concluding that Elton had died from natural causes to which neglect contributed, the coroner said there had been “gross” failings in his care. She said that if the midwives had adequately monitored his heart rate, acknowledged his mother’s pain and recognised hypoxia — oxygen deficiency — he would have been delivered earlier and would have survived.

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Source: The Times, 21 November 2024

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Give me prescription or I'll kill you, nurse told

Staff at a GP surgery were left in tears and forced to call police after incidents in which angry patients threatened them and acted violently.

Nurse consultant Dr Jennifer Loke, who works at the practice in East Yorkshire, said she was forced to press a panic button when one patient started moving towards her, saying, "If you don't give me that prescription, I'm going to kill you".

Humberside Police has received 411 reports of abuse towards GP staff in the region since 2019. Although most were verbal, the force investigated assaults, a kidnapping and six death threats.

The British Medical Association (BMA) said it knew current pressures could make it harder for patients to get care, but no one should go to work fearing abuse.

Among the death threats was one made towards Dr Loke – an academic doctor who works as a nurse consultant.

Dr Loke said she was not frightened by the incident, but abuse took its toll.

"It's stressful enough to work in a surgery because you have to cope with a lot of complex issues and you need to maintain your cool with patients who are anxious and depressed," she said.

"And yet you have all this in the background, so it's quite distressing."

Most of the patients she saw were "good", but attitudes had changed because of an "on-demand" and consumer culture.

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Source: BBC News, 25 November 2024

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About 20 terminally ill people in UK die in unrelieved pain each day, research finds

An estimated 20 terminally ill people in the UK die in unrelieved pain each day, according to a study by the independent Office of Health Economics (OHE).

According to its research, to be presented to MPs on Tuesday, one in four people receiving palliative care in England have “unmet pain needs”. The OHE said it used “the most conservative of estimates [suggesting] the true number is likely to be much larger”.

It calculated that, even with the “highest possible standards of hospice-level palliative care”, more than 7,300 people across the UK died with unrelieved pain in the last three months of their lives in 2023. In 2019, the comparable figure was nearly 6,400 people a year – a 15% increase over four years.

It also said that fewer than 5% of terminally ill people in England who needed hospice care in 2023 received it.

The OHE’s findings will feed into an intensifying debate over the legalisation of assisted dying ahead of a historic vote by MPs on Friday. 

The OHE said that irrespective of the outcome of Friday’s vote, investment in high-quality end-of-life care should be a “crucial component of the conversation around assisted dying”.

Prof Graham Cookson, the organisation’s chief executive, said: “Our research finds that even assuming the highest standards of care, there remains a group for whom no amount of pain relief will ease their suffering in the last few months of their life.

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Source: The Guardian, 25 November 2024

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A toxic staffing row is splitting the NHS

Julia’s first four years as a physician associate were everything she hoped they would be. After working in the NHS for the best part of a decade in a non-patient facing role, she was delighted to be on the wards supporting doctors and the wider healthcare teams.

“I loved the contact I had with patients, assessing them and playing a part in their care. I felt supported and part of a team.”

That all changed about a year ago.

“Suddenly we came under attack. Doctors in the radiology department started refusing to talk to me about scans and others have been saying we don’t deserve to get paid what we do.

“The atmosphere has totally changed. We’ve even stopped going into the canteen as we were being made to feel uncomfortable.”

Julia is far from alone. United Medical Associate Professionals (UMAPs), a body which represents physician (PAs) and anaesthesia associate (AAs), says there are countless examples like this with staff facing bullying and being sidelined.

The Academy of Medical Royal Colleges, which represents senior doctors in the NHS, has warned the whole situation has become so “destructive” that it is damaging teamwork across hospitals and GP surgeries where PAs and AAs work.

Dr Emma Runswick, of the British Medical Association, is worried about patient safety. She says: “We’re seeing PAs doing things, such as ordering scans they are not qualified to order and prescribing drugs that they aren't qualified to prescribe.

"And when they see patients it’s not always clear to the patient that they are not being seen by a doctor. It’s dangerous and has got to stop.”

But UMAPs chief Stephen Nash says: “It’s not about patient safety, but about protecting their interests. They want us to be subservient.”

He says the deaths like those reported are “absolute tragedies”, but he has concerns about how they are being used to attack a whole profession.

“There is meant to be a no-blame approach to learning the lessons from failures.”

He says when mistakes are made there are often multiple factors at play, but the campaign against PAs and AAs has meant their role has been singled out. “It misleads the public," he adds.

In the end it will be up to the independent review, which is being led by Royal Society of Medicine president Prof Gillian Leng, to establish the truth on this.

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Source: BBC News, 23 November 2024

Read our recent interview on the hub: Physician associates: What are the patient safety issues? An interview with Asif Qasim

 

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One in seven A&E patients are repeat visitors with unmet needs, study finds

One in seven A&E patients are repeat visitors with unmet medical needs who feel they have nowhere else to go, according to research that found most are over 70 with multiple conditions or under 50 with mental ill health.

Less than 2% of the population account for almost 14% of all A&E attendances, the British Red Cross study suggests. Across the UK, patients are turning to emergency departments five or more times a year due to “unresolved medical issues”, the charity said.

“Many of those frequently attending A&E had often tried to get other help but this had not met their needs,” its report says. “This meant that when they reached A&E, they were often in need of more urgent care.”

The research comes as NHS England’s top A&E doctor urged people to use 111 services this winter and suggested that as many as two in five people arriving at A&E could be better treated elsewhere.

Frontline emergency doctors have sounded the alarm over an approaching winter crisis that they say is already putting patients in overstretched A&E departments at risk.

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Source: The Guardian, 25 November 2024

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NHS bosses who silence whistleblowers face sack under government plans

NHS managers who silence whistleblowers or endanger patients through misconduct face being sacked and barred from working in the health service for life under radical government plans to regulate thousands of bosses for the first time.

Ministers will begin a public consultation on Tuesday seeking views on the proposals, which they say are designed to eradicate a “culture of cover-up” in the NHS. It follows a series of scandals over the last decade at trusts including Morecambe Bay, East Kent and Shrewsbury and Telford.

A statutory duty of candour making NHS managers legally accountable for responding to concerns about patient safety could also be introduced as part of the government’s plans.

Measures being considered include “statutory barring mechanisms”, similar to systems used for teachers, which could see health bosses who have been deemed to be unfit to practise appearing on a centrally held list.

Karin Smyth, a minister in the Department of Health and Social Care, said the proposals formed part of the government’s plans to end the “revolving door” that allows failing bosses to continue working in the NHS.

“To turn around our NHS we need the best and brightest managing the health service, a culture of transparency that keeps patients safe, and an end to the revolving door that allows failed managers to pick up in a new NHS organisation,” she said.

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Source: The Guardian, 24 November 2024

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‘Deeply flawed’ watchdog fails to act in 182 cases

Bereaved parents have described maternity investigations carried out by a watchdog as “deeply flawed” after it failed to make recommendations to trusts in 182 cases of deaths and harm. 

The Maternity and Newborn Safety Investigations programme investigates certain cases of early neonatal deaths, stillbirths and severe brain injury in babies born at term following labour, alongside maternal deaths. Last year, it moved to the Care Quality Commission having previously been hosted by the Health Services Safety Investigation Branch.

Now a Freedom of Information request has revealed a third (182) of 556 MNSI reports completed between April 2023 and March 2024 did not contain recommendations.

Officials said in the 182 reports, none of the findings of the investigation contributed to the outcome for the mother or baby, and therefore no recommendations were made.

However, Emily Barley, whose daughter Beatrice died during labour in 2022, said it was “very concerning” to see that so many investigations result in no safety recommendations at all.

She added: “It is hard to believe that when a full-term baby dies or suffers a serious brain injury there is nothing for providers to learn. 

“I do not have any confidence in the MNSI, its investigations, or its conclusions. Having been through an MNSI investigation following the death of my daughter… it is clear to me the entire process is deeply flawed.”

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Source: HSJ, 25 November 2024

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New AI tool offers insights to improve safety for mothers and babies in maternity care

Loughborough University researchers have developed an artificial intelligence (AI) tool that identifies the key human factors influencing maternity care outcomes, supporting ongoing efforts to improve safety for mothers and babies.

Developed by AI and data scientist Professor Georgina Cosma and human factors and complex systems expert Professor Patrick Waterson, the tool analyses maternity incident reports to highlight key human factors – such as communication, teamwork, and decision-making – that may have impacted care outcomes, providing insights into areas that could benefit from additional support.

When an adverse maternity incident occurs in England, detailed investigation reports are produced to identify opportunities for learning and enhancing safety.

Currently, experts must carry out manual reviews to extract human factor insights from incident reports. This process is resource-intensive, time-consuming, and relies on individual interpretation and expertise, which can lead to varying conclusions.

The AI tool addresses these challenges by identifying and categorising human factors in reports quickly and consistently. Its standardised approach allows it to analyse multiple reports and identify recurring factors, helping pinpoint areas that would benefit most from additional support.

The AI model was trained and tested on data from 188 real maternity incident reports. It successfully identified human factors in each report and analysed them collectively, providing insights into where extra support could improve outcomes.

"AI has transformed our analysis of maternity safety reports. We've uncovered crucial insights far quicker than manual methods," said Professor Cosma.

“This has enabled us to gather a comprehensive understanding of where there are areas for improvement in maternity care, and these insights can help identify ways to enhance patient safety and improve outcomes for mothers and babies."

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Source: Loughborough University, 20 November 2024

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Worst trusts on A&E experience revealed by CQC

A Care Quality Commission (CQC) survey has identified the trusts where the most patients report a bad experience in A&E.

The CQC surveyed more than 45,500 people who used NHS urgent and emergency care services in 2024.

It found that while many were broadly positive about their interactions with staff, there were often complaints of long waits for assessment, and some patients were not given enough help to manage their pain or control symptoms.

The survey, published this week, identified six acute providers that achieved “worse” or “much worse than expected” results when compared with all other trusts across the full range of survey questions. Even these did have more areas where patients were “positive” than those which were negative, however.

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Source: HSJ, 22 November 2024

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USA: Georgia axes maternal health panel after leak about abortion deaths

Georgia officials have dissolved a committee responsible for investigating deaths of pregnant women in the state, after one or more members leaked confidential information about deaths linked to the state's strict abortion laws.

In a letter sent to members of the Maternal Mortality Review Committee (MMRC), Georgia health commissioner Kathleen Toomey said an investigation failed to identify those responsible for the leak, so all current members would be removed.

The news comes two months after the outlet published stories on the deaths of two women, external the panel ruled were preventable and linked to the state's strict abortion ban.

The women's stories became a rallying call for reproductive rights advocates and was cited often by Democrats during the US election.

Since June 2022, Georgia has prohibited all abortions after six weeks of pregnancy, when many women might not know they are pregnant, except in cases of rape, incest or when necessary to prevent "irreversible physical impairment" or death of the mother.

Amber Thurman, 28, and Candi Miller, 41, both died that same year, following rare complications involving the FDA-approved abortion medications mifepristone and misoprostol prescribed from out of state.

Thurman waited 19 hours at a Georgia hospital before doctors performed a rare procedure - prohibited by the state abortion ban with few exceptions - needed to expel fetal tissue from the uterus that had not been fully cleared by the abortion pills.

By the time she was taken into surgery, Thurman had developed acute sepsis. She died on the surgery table.

Tasked with examining pregnancy-related deaths to improve maternal health, the panel of experts, which includes 10 doctors, deemed her death “preventable” and said the hospital’s delay in performing the critical procedure had a “large” impact on her fatal outcome.

“The fact that she felt that she had to make these decisions, that she didn’t have adequate choices here in Georgia, we felt that definitely influenced her case,” one committee member told ProPublica in September. “She’s absolutely responding to this legislation.”

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Source: BBC News, 22 November 2024

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UK Covid-19 Inquiry: Evidence shows a leadership culture that cares even less for science than it does for healthcare worker’s lives

A consortium of healthcare professional bodies, representing 65,000 healthcare workers, has drawn depressing conclusions from the evidence given during Module 3 of the UK Covid-19 Inquiry. 

The COVID-19 Airborne Transmission Alliance or CATA came together early in the pandemic to provide scientific evidence which challenge officials’ stated view that the virus was not capable of being spread by the airborne route, which would have required employers to provide respiratory protective equipment such as FFP3 masks. CATA has been a core participant in the Module 3 Inquiry and provided substantial evidence about the science, but also the bizarre behaviour of healthcare bureaucrats.

“Having followed the evidence in detail, it seems that those who had leadership roles during the pandemic, many of whom have been promoted to even more senior positions and rewarded with national honours, care less for science than they did for the lives of healthcare workers,” says Dr Barry Jones, Chair of CATA and an eminent medic. “They have taken the stand and asked the Inquiry to believe ideas that offend against common sense, let alone science.”

CATA has consistently pointed out the mass of scientific evidence that shows while diseases can be spread by a combination of inhaling airborne particles and being infected by droplets or contact with infected surfaces, Covid-19 has a significant dominant airborne component. CATA’s contentions have been supported by the experts commissioned by the Inquiry, are now no longer denied by the majority of healthcare leaders in the UK and are supported by international organisations including WHO and CDC.

Shockingly, evidence from the most senior health officials and experts in infection prevention and control confirm that they deem that protecting against droplets and aerosols is an either/or choice.

“It’s a bit like saying that your house can be damaged by fire or flood, but your insurance company saying that you can only pick one to be protected against,” commented Dr Barry Jones.

Rather than accepting that difficult decisions needed to be made because of lack of supply of PPE, senior healthcare leaders have taken the view that specially designed PPE might not have worked anyway, so it was not needed.

The Inquiry has heard evidence that there is no plan to stockpile PPE for future pandemics or to have a national supply, despite a global shortage costing the UK millions and resulting in illness and deaths for hundreds of healthcare workers, not to mention almost a quarter of a million UK citizens

The Inquiry has heard of continuing confusion about who was responsible for making critical decisions about how the scientific evidence was used to inform guidance for protecting healthcare workers and patients. 

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Source: British Occupational Hygiene Society, 21 November 2024

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Learning CPR on manikins without breasts puts women’s lives at risk, study finds

Most CPR manikins don’t have breasts, which contributes towards women being less likely to receive life-saving first aid from bystanders, a study has found.

The study led by Dr Rebecca Szabo, the lead of the Gandel Simulation Service at the Royal Women’s hospital in Melbourne, analysed all manikin models on the global market designed for adult cardiopulmonary resuscitation training.

Of the 20 different manikins, the researchers found all them had flat torsos, with only one model having a breast overlay. Eight were identified as male and seven had no gender specified.

The study, published in the journal Health Promotion International, highlights the findings as an equity issue with implications for the human right to health.

Australian research published in June found women are less likely to receive life-saving CPR after cardiac arrest and less likely to survive.

A survey by St John Ambulance in the UK, published in October, found women who go into cardiac arrest in public are less likely than men to receive chest compressions from bystanders as people “worry about touching their breasts”. The study suggested “unequal outcomes for women after cardiac arrest may start in CPR training and CPR manikin design related to implicit bias.”

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Source: The Guardian, 21 November 2024

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Streeting names and shames trust for ‘really poor’ care

The health and care secretary has singled out a trust for “really poor-quality care,” just moments after he said he was “not in the business of public humiliation.”

Wes Streeting said North East London Foundation Trust “continues to appear in the headlines for providing really poor quality care.”

Mr Streeting was responding to a question from the trust’s chair, Eileen Taylor, who had called on the minister to highlight the work being done by NELFT, which covers his Ilford North constituency.

NELFT is currently being prosecuted for manslaughter by gross negligence in the death of mental health inpatient Alice Figueiredo, for not removing suicide risks from the wards.

The organisation has also been criticised by a coroner for a “culture of impunity” and the falsification of patient records.

NELFT chair Eileen Taylor asked if Mr Streeting “could also reinforce that it’s not just the acute trust, but it’s the community and mental health care as well” after he had paid tribute to leadership at Barking, Havering and Redbridge University Hospitals Trust, which serves the same patch, prompting applause from the audience.

The health and care secretary responded: “I’m very aware of NELFT, not least because NELFT has and continues to appear in the headlines for providing really poor-quality care.

“So, if we want to name and shame, I’ll do the name and shame before the naming and praising… 

“I really don’t need lectures from NELFT about recognising the challenges and pressures there, because I read about them in the newspapers on a regular basis.”

Mr Streeting did say he agreed with Ms Taylor ”about the need for the left shift” which is “exactly what we want to deliver”.

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Source: HSJ, 13 November 2024

Related reading:

There are many better things Wes Streeting could focus on than picking rows with NHS managers, writes HSJ editor Alastair McLellan in Not having a row about failing managers

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