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UK firm GSK to pay $2.2bn over Zantac cancer claims

UK pharmaceutical giant GSK says it will pay as much as $2.2bn (£1.68bn) to settle thousands of cases in US courts over claims that a discontinued version of its heartburn drug Zantac caused cancer.

The firm announced that it had reached agreements with 10 law firms who represent around 80,000 claimants. The settlements account for 93% of all cases.

GSK will also pay $70m to resolve a whistleblower complaint by a laboratory that alleged the drugmaker defrauded the US government by concealing Zantac's cancer risks.

GSK did not admit wrongdoing in any of the cases.

The company said in a statement to investors, external that while there is "no consistent or reliable evidence" the drug increases the risk of cancer, the settlements "remove significant financial uncertainty."

In 2020, US regulators pulled Zantac off shelves due to fears that a key ingredient, ranitidine, could turn into a substance that may cause cancer when exposed to heat.

That move led to tens of thousands of lawsuits against the drug's manufacturers.

The previous year, UK doctors were told to stop prescribing four types of Zantac as a "precautionary measure".

It followed concerns in several countries that the products may contain the impurity.

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Source: BBC News, 10 October 2024

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Inquest hears of opportunities missed in teen death

An inquest has heard opportunities were missed to "escalate" the treatment given to a 13-year-old girl who died in hospital.

Chloe Longster died a day after arriving at Kettering General Hospital in Northamptonshire on 28 November 2022.

She had been taken to the emergency department after waking up with pain in her ribs and cold-like symptoms.

An inquest into her death has heard some checks that might have alerted doctors to sepsis were not carried out.

Giving evidence on the second day of the inquest in Northampton, Katie Cockram, a nurse on duty on the day Chloe was admitted, was asked about a routine check that was due to be carried out at 22:00 GMT.

It followed evidence from a fellow nurse, Tanya Ball, who told the coroner yesterday that the check was missed.

Ms Cockram was asked whether she should have checked Chloe's condition or "re-escalated it to the doctors".

She replied: "If if hadn't been done, then yes, correct."

She agreed that this was "another opportunity to re-escalate their concerns about Chloe to the doctors", but added: "I would have faith in the doctors to do this once they had escalated in the first place."

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Source: BBC News, 9 October 2024

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The row over HRT and menopause dividing the medical world

Hormone replacement therapy (HRT), which is taken by more than two million British women to replace oestrogen and progesterone as natural production declines, is in the headlines again after a high-profile doctor was accused of overprescribing the hormones.

In a BBC Panorama documentary, which aired last Monday, Dr Louise Newson, who runs eight menopause clinics across the country, was alleged to have risked harming patients by prescribing HRT at too high a dosage. The licensed maximum is 100 micrograms, delivered via oestrogen patches, but Newson’s clinic prescribed up to 300mcg.

However, the accusations also sparked a backlash. On Saturday, Alison Perry, a patient at one of Newson’s clinics defended the doctor as “somebody who has really stuck her neck out to help women”.

This row has revealed a rift in the medical profession about the best way to use HRT.

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Source: The Times, 6 October 2024

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Families criticise redacted report into disgraced surgeon

Lawyers representing children who developed long-term pain and injury after operations at Great Ormond Street Hospital have criticised a heavily redacted report carried out for the trust.

More than 700 cases linked to the surgeon Yaser Jabbar are being reviewed including some involving leg lengthening and straightening.

Some of the cases which so far have been investigated were found to have resulted in harm, lifelong injury and even amputation.

Great Ormond Street Hospital (GOSH) commissioned a report by the Royal College of Surgeons which was handed in a year ago. But it has only been released this week to some of the families.

The report - seen by the BBC - said there were serious concerns in relation to working culture, with some staff upset about the standard of care and saying the environment was "toxic" and that some surgery done on children was "inappropriate" and "incorrect".

Georgina Wade, from Tees Law, said families were hoping that GOSH would be "open, transparent, and candid".

"The report is sadly heavily redacted and does not go far enough to providing the answers the families need to understand what has happened to their children."

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Source: BBC News, 10 October 2024

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Doctor tells woman ‘it’s not as if you’re dying’ after miscarriage pain

A woman with endometriosis was “gaslighted” by doctors over severe period pain for more than a decade and told by one doctor “It’s not as though you’re dying” after suffering a miscarriage.

Jenny Ockona-Mensah, has spent decades being “fobbed off” by NHS services over “consuming” period pain and was just 20 years old when doctors suggested her only options were to get pregnant or go on the pill.

The London therapist’s story comes as the organisers of a poll warned women are being treated as “second class” citizens by the NHS.

A poll of 2,000 women found more than a third have been forced to take time off work due to gynaecological conditions. Of those, more than 41% were off work for three months.

The findings indicated 42% cent of women who suffer pain that impacts their daily lives said the NHS does not provide adequate pain management.

Praful Nargund, Labour councillor and trustee for Create Health Foundation, which carried out the survey, told The Independent: “The scale of this problem is staggering. It’s unacceptable.

“I’m both astonished and terrified at the same time, astonished that in 2024 we accept this level of problem for 51 per cent of the population and terrified because of what this means for my wife, for my two young daughters, for my mum. You know that they will have a worse experience of healthcare throughout their life, the way women’s health services are at the moment.”

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Source: The Independent, 10 October 2024

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Hospitals across US reporting IV shortages after Hurricane Helene led to plant shutdown in NC

Hospitals in the United States are cancelling and postponing elective surgeries amid a nationwide shortage of IV fluid thanks to plant closures caused by Hurricane Helene.

Virginia’s UVA Health University Medical Center told The Independent that it would postpone certain elective surgeries early this week to help conserve its supplies.

The shortage is tied to flooding at healthcare company Baxter International’s western North Carolina plant after a levee breach. The plant produces IV fluid, which is injected into a person’s veins to treat dehydration. It also makes fluids that are used by some patients on home kidney dialysis.

While some products remain at the factory, bridges to access them are mangled. The company has had to begin restricting how much customers can order. Facilities in Virginia, Massachusetts, Minnesota, and other states have reported supply problems.

The shortage has already had an impact on Americans, the American Hospitals Association said in a Monday letter to President Joe Biden.

Baxter says delays to dialysis, a treatment for kidney failure, should be considered, and Massachusetts’ Mass General Brigham told The Associated Press that some patients may receive Gatorade or water to hydrate instead of starting an IV. Although, anyone who needs an IV can still get one.

Baxter provides 60% of IV products across the country, or 1.5 million bags, with the plant’s restoration expected to take weeks.

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Source: The Independent, 7 October 2024

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Long A&E waits for hip breaks can increase odds of death

People who face long waits in A&E after fracturing a hip are at higher risk of death, a study suggests.

Patients who wait more than four hours are also more likely to have a longer stint in hospital, experts found.

Researchers examined data on hip fracture patients aged 50 and over at a trauma centre in Lothian, Scotland, between January 2019 to the end of June 2022.

Delayed disposition from our emergency department was associated with an increased mortality risk and longer length of hospital stay in patients presenting with a hip fracture

Academics found that the odds of still being alive three months after hospital admission were “significantly lower” for patients who were in A&E for more than four hours compared to those who spent less time in the emergency room.

Those who waited more than four hours had a 36% increased odds of dying within 90 days after their hip break compared to those who spent a shorter period in A&E.

The researchers said that the increased risk is the equivalent of “one additional death at 90 days for every 36 patients who waited longer than 4 hours in the emergency department”.

In light of the findings, the Royal Infirmary of Edinburgh has introduced a new “fast track” service so the majority of patients with hip fracture wait for no more than two hours in the emergency room.

Lead author Dr Nicholas Clement, from the Royal Infirmary of Edinburgh and the University of Edinburgh, said: “We’ve developed a fast track care pathway, just in the knowledge of what this study is found and as part of a quality improvement project.

“Our patients – those that don’t have to like another problem like a heart attack or a chest infection and can go straight at the ward – they go to the ward within two hours now.

“The best thing is that they spend as little time in the emergency department as possible and go to the ward, because they need to come in the hospital anyway – they’ve got a hip fracture, it’s not like any decision needs to be made, they need to come straight in the hospital to get the hip fracture fixed.”

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Source: The Independent, 8 October 2024

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More bereaved parents offered baby-loss certificate

More bereaved parents in England will now be able to apply for a certificate to formally recognise the loss of their baby.

The government has removed a cut-off date that had meant only those who had had a pregnancy loss or miscarriage since September 2018 were eligible.

Certificates are now available, external to anyone who lost their baby before 24 weeks of pregnancy (or 28 if the loss was before October 1992).

Applicants must be aged at least 16 and live in England. More than 50,000 of the certificates, which are optional and free to receive, have been issued so far.

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Source: BBC News, 9 October 2024

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Four-year waits to register with NHS dentist revealed

People across Devon and Cornwall are often waiting around four years to register with an NHS dentist, according to information collected by an integrated care board (ICB).

A paper in Cornwall and the Isles of Scilly noted “people waiting an average of 1,441 days to register with a dentist”, which equates to about three years and 11 months.

A spokesperson for NHS Cornwall and Isles of Scilly ICB said: “We are implementing a range of measures locally to address national pressures on NHS dentistry.

“This includes commissioning additional urgent care and stabilisation services, operating an emergency dental service to deliver 20,000 appointments a year, an extensive schools’ dental education programme, free dental treatment for local fishing communities, and a pilot which is helping to retain NHS treatment for children and other vulnerable patients and is treating some of those who have been waiting the longest.”

The British Dental Association said four-year waiting periods are “not unheard of” and it estimates unmet need for NHS dentistry now stands at 13 million, or more than one in four of the adult population. NICE recommends adults should have oral health reviews every two years.

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Source: HSJ, 9 October 2024

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Women’s health being neglected worldwide, says Melinda French Gates

Women’s health is being neglected worldwide with “maternity care deserts” more common, millions denied abortions and maternal death rates surging, Melinda French Gates has warned as she launches a $250m (£190m) fund to improve women’s physical and mental health globally.

Despite advances in medicine, women experience “unacceptable” inequities across all aspects of their health, spend more years living with ill health and still face barriers to accessing basic care. Women in rich and poor nations are affected and more than 700 are dying in childbirth each day, French Gates said.

Women have also been suffering with the global consequences of the abortion bans enacted in the US after the overturning of Roe v Wade in 2022. French Gates told the Guardian the US election next month would be critical. “There is so much at stake for women and families,” she added.

Today she will launch Action for Women’s Health through her organisation, Pivotal, and direct what will total $250m in new grants to groups around the world working on improving women’s health.

“To fully exercise power over their lives, women need to be mentally and physically healthy. And yet, women’s health is being neglected everywhere,” French Gates said. “More than 1 billion women and girls suffer from malnutrition. Reproductive healthcare is being denied in the US and other countries. And globally, a woman dies in childbirth every two minutes.”

She added: “This is unacceptable, but there is reason for hope. Organisations around the world are taking innovative approaches to addressing these challenges, and this open call is about getting them the resources they need to scale up and reach as many people as possible.”

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Source: The Guardian, 9 October 2024

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Regulator steps up inspections after ‘severe’ mortuary failings

Hospital mortuaries are to face more unannounced inspections because of growing concerns over serious failings.

The Human Tissue Authority, which regulates how human tissue and organs are stored and used, said most inspections of mortuaries licensed for post-mortems will now be unannounced due to “the increased severity of shortfalls we are finding and, in some cases, a failure to take corrective and preventative action following inspection,” according to its latest newsletter.

The HTA has also increased the frequency of visits to premises and increased its scrutiny and testing of evidence on security systems, according to its board papers, to increase “protection for the dignity of the deceased”.

An independent inquiry into David Fuller, who sexually abused more than 100 women’s and girls’ bodies in a hospital mortuary, has raised awareness of the issue, the papers explain. A second report from the Fuller inquiry is due to be out later this year, which will consider whether hospitals are safeguarding the security and dignity of the deceased.

HSJ has reported on numerous mortuary failings identified in HTA inspections, including decomposing bodies and unauthorised people gaining entry.

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Source: HSJ, 8 October 2024

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First repeat prescribing guidance in 20 years urges GPs to review processes

GPs have been urged to review their repeat prescribing processes in the first guidance to be published in 20 years.

The RCGP and the Royal Pharmaceutical Society (RPS) have together produced a new ‘practical toolkit’ for repeat prescribing systems in practices in England.

Published today, the NHS England-commissioned guidance aims to efficiency for GP practices but also patient safety, for example by identifying oversupply of high-risk medication.

With over one billion prescriptions dispensed annually, 77% of which are repeat prescriptions, the need for efficiency and safety ‘is paramount’, the organisations stressed.

Repeat prescriptions also account for nearly 80% of NHS medicine costs for primary care, and the ‘significant’ workload for GP practices related to this ‘necessitates streamlining and improvement’, they added.

The toolkit, which was commissioned by NHS England, takes the form of a ‘self-assessment process’, to help practices and PCNs to assess their local arrangements.

The guidance recommends practices undertake a full ‘process-mapping exercise’ of their repeat prescribing system, with input from the local patient participation group and community pharmacies.

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Source: Pulse, 8 October 2024

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We were not treated as parents, Covid inquiry told

A mother of premature twins has told the Covid inquiry she did not feel like she was treated as a parent after giving birth in the early stages of the pandemic.

Tamsin Mullen said she was kept in a side room for 27 hours after giving birth by caesarean section while her sons were taken to neonatal intensive care.

She said “rigid” visiting restrictions meant that, for the next month, only one parent was allowed to visit her newborn babies at a time.

"We needed the hospital to understand we were a family," she told the inquiry.

“We didn’t feel like a mother and father to our children in the way we should have done.”

The Covid inquiry has been taking evidence about the impact on maternity services as part of its third section, or module, which is investigating the impact on the NHS and healthcare.

Ms Mullen, a mother of three, was giving first-hand "impact" evidence on behalf of 13 pregnancy, baby and parent organisations.

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Source: BBC News, 7 October 2024

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Coroner highlights lack of specialist ME care

A coroner has highlighted the lack of specialist care for patients with myalgic encephalomyelitis (ME) after the death of a 27-year-old woman.

Deborah Archer has spoken out following the death of Maeve Boothby-O’Neill, who had suffered with ME for a decade before she died at home in Exeter in October 2021 from severe malnutrition.

The coroner said there was no current available funding for research into and treatment for the chronic fatigue syndrome and there was “extremely limited” training for doctors treating patients.

The 10-day hearing focused on the final few months of her life, by which time she was confined to bed, unable to chew food and had difficulty drinking because she was not able to sit up.

The coroner said the evidence showed there were no specialist hospitals or hospices, beds, wards or other healthcare provision in England for patients with severe ME.

Maeve's father, Sean O’Neill, described the coroner’s report as "short, stark and shocking".

He said: "She has found that NHS care for people with severe ME is ‘non-existent’, that medical training is ‘extremely limited’ and research budgets inadequate. She warns there will be further deaths from ME unless action is taken."

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Source: BBC News, 7 October 2023

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Blood pressure warning over small change that can have huge impact on readings

Researchers have warned that people may be misdiagnosed with high blood pressure simply because their arm is in the wrong position when a reading is taken.

In the new study, researchers at Johns Hopkins Medicine in the US looked at blood pressure readings when arms were supported on a desk, arms were supported on a lap, and when arms were unsupported and hung at the patient’s side.

Experts found that some arm positions – such as resting the arm on the lap – can substantially overestimate blood pressure readings.

The NHS advises that correct positioning is to sit on an upright chair with a back, placing both feet flat on the floor and resting the arm on a table or desk.

People should also rest for five minutes before taking a reading and then take another reading several minutes later to check it is accurate.

Published in the journal JAMA Internal Medicine, the study found that putting an arm on the lap overestimated systolic pressure (the top number in a blood pressure reading) by 3.9mmHg and diastolic blood pressure — the bottom number – by 4mmHg.

Dr Tammy Brady, from the Johns Hopkins University School of Medicine, said arm position makes a “huge difference” when it comes to an accurate blood pressure measurement and people should always have their arm on firm support such as a desk or table.

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Source: The Independent, 7 October 2024

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‘Angry’ families to launch their own maternity inquiry after losing faith in NHS probe

Dozens of families say they have been forced to launch their own inquiry into a troubled maternity care service after being shut out by an NHS review.

More than 70 families who claim they were harmed by maternity care in Swansea are set to launch a “family-led” maternity review after they lost faith in an inquiry commissioned by Swansea Bay Health Board.

Leading maternity safety expert, Donna Ockenden warned the Health Board had “failed” families and that the current review would be “worthless and meaningless” without their engagement.

Swansea Bay University Health Board in Wales announced it would commission an independent review into its maternity and neonatal services following concerns raised by families over deaths and injuries to babies during birth and by women who have suffered traumatic births due to alleged poor care.

However, nine months on from the review announcement, families now feel they have been ignored by the review’s key staff and believe the process is not independent of the health board.

Rob and Sian Channon lead the Swansea Bay Maternity Campaign Group. Their son, Gethin, was born in March 2019 at Singleton Hospital, and due to multiple failings by the maternity service, he now suffers from quadriplegic cerebral palsy, a severe disability that requires care 24 hours a day.

An independent review by Dr Bill Kirkup in 2022 into Gethin’s care, found several failings and revealed the hospital tried to “downplay” the mistakes it made.

Mr Channon told The Independent: “We lost faith months ago.”

This came after families felt ignored by those directing the review including the former chair who declined to meet with families directly.

He said: “We’ve just become really angry that we’re having to do this now. We can’t let what happened to Gethin happen to others. I’m furious, I’m sickened about this, I’ve been dealing with this since December, we didn’t want it it’s not our job to fix that maternity unit.”

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Source: The Independent, 8 October 2024

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Senior manager who made offensive comments leaves trust

A senior manager who apparently made sexist and racist remarks on a work video call with colleagues has left the trust involved after an investigation.

But Medway Foundation Trust will not say whether the senior manager resigned or was disciplined for the remarks, which were condemned by leading campaigners. HSJ has been unable to contact the manager concerned.

HSJ reported in August on two short videos which appear to come from the same work call, where the manager is chatting with colleagues while waiting to begin a meeting.

At one point a colleague says she has just eaten a KitKat. The senior manager then introduces a new colleague — who appears to be of South Asian heritage — saying: “While we are all talking chocolate, can we just introduce…” before naming the member of staff and their role. 

In the other video, the participants are joking about people’s character, and when someone asks about how “nice girls” are regarded, the senior manager says: “If you are a nice girl, you are frigid.”

Professor Partha Kar, who received a copy of the videos, said at the time the remarks were “astonishing examples of sexism and racism”. Professor Kar, who has a South Asian background and is a medical consultant in a different trust, also contacted the trust.

He said: “It’s good to hear this matter has been looked into and dealt with. The trust needs to reflect why it has needed external focus and flagging for this to be dealt with, and hopefully such behaviour will be taken into account for said individual looking into other jobs in the NHS.”

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Source: HSJ, 7 October 2024

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Mother repeatedly ‘kept in dark’ about reason for baby’s death, inquest told

A grieving mother has told an inquest how secretive, evasive and “patronising” behaviour by NHS staff was “traumatic” and led to her spending years seeking the truth about her daughter’s death.

Jedidajah Otte told how she encountered a “stubborn refusal” by doctors and nurses at St Thomas’ hospital in London to tell her what was happening with three-month-old Aviva’s health.

The hospital insisted for 10 years that Aviva died of natural causes. However, last month it admitted that her death in January 2014 occurred as a result of contaminated feed given to her by staff, which led to her developing a deadly infection.

Otte, who is a Guardian journalist, also accused Guy’s and St Thomas’ NHS trust (GSTT), which runs the hospital, of “dishonesty”, a “lack of transparency” and “misleading” her about the outbreak of Bacillus cereus, a food-borne bacteria in the baby feed, which caused Aviva’s death.

Otte also alleged that she was “repeatedly kept in the dark” about why her daughter’s health suddenly collapsed, “discouraged” from making inquiries and “told off” for looking at Aviva’s medical notes in her desire to understand her condition.

GSTT has denied being “dishonest” towards Otte. Two senior doctors from St Thomas’ who treated Aviva have told the inquest there was no “cover-up” of the reasons why she lost her life.

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Source: The Guardian, 5 October 2024

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Baby boomers living longer but are in worse health than previous generations

Baby boomers are living longer but are in worse health than previous generations were at the same age, despite advances in medicine and greater awareness of healthy lifestyles, a global study shows.

Researchers found people in their 50s and 60s were more likely to have serious health problems than people who were born before or during the second world war when they reached that age.

The results cannot be explained by people living longer, experts at the University of Oxford and University College London (UCL) said. Obesity, type 2 diabetes, cancer, heart disease and other diseases were all affecting people at younger ages.

Rates of illness and disability increased across successive generations during the last century, according to the findings published in the Journals of Gerontology.

The lead author, Laura Gimeno, of UCL, said there was a “generational health drift”, with younger generations tending to have worse health than previous generations at the same age.

“Even with advances in medicine and greater public awareness about healthy living, people born since 1945 are at greater risk of chronic illness and disability than their predecessors.

“With up to a fifth of the population in high-income western nations now over 65, increasing demands for health and social care will have huge implications on government spending.”

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Source: The Guardian, 7 October 2024

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Letby NHS trust deleted documents, tribunal told

A judge has said he was "troubled" after the Countess of Chester Hospital NHS Trust deleted potentially important evidence ahead of an employment tribunal, including documents relevant to the Thirlwall Inquiry into the crimes of Lucy Letby.

Former chief executive Dr Susan Gilby is suing the trust and its chairman, Ian Haythornthwaite, claiming constructive unfair dismissal.

The tribunal was also told documents relevant to the Thirlwall Inquiry into the crimes of Letby had also been deleted from Dr Gilby's email account by her former employers - although these were later recovered.

In a ruling on a preliminary application, employment judge David Franey said the failure to preserve certain emails, messages and documents was "unexplained".

Dr Gilby was appointed medical director of the Countess of Chester Hospital NHS Foundation Trust in August 2018, a month after Letby was first arrested, and became chief executive in 2019.

She was suspended in December 2022 and gave notice of her resignation a few days later, although her contract ran until June 2023.

Dr Gilby said she had made a series of "protected disclosures" about the chairman of the board, Mr Haythornthwaite, who is named as a joint respondent in the claim.

After she accused him of inappropriate and bullying behaviour, she claimed he became "hostile" and "aggressive" and "co-ordinated" her suspension, the tribunal heard.

Both the trust and Mr Haythornthwaite deny the accusations and claim Dr Gilby's treatment was a "consequence of genuine and substantial performance concerns".

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Source: BBC News, 4 October 2024

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Health chiefs launch review to tackle ‘poor care’ faced by many young sickle cell disease sufferers

Health bosses are aiming to tackle “poor care” faced by many children and young people living with sickle cell disease when they move to adult healthcare providers.

NHS Race and Health Observatory, an independent body which examines inequality in healthcare, will work with the Sickle Cell Society charity with the aim of improving the transition for patients into adult care.

It is estimated around 300 babies are born with sickle cell disease each year in the UK and young people with the illness “often experience poor care in non-specialist settings” when moving to adult care, the body said.

Professor Habib Naqvi, chief executive of NHS Race and Health Observatory, said: “By improving trust within the care pathway we can tackle gaps in care, learn from successful outcomes in transition from other disorders and initiatives, and ensure excellent patient-centred care is provided."

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Source: The Independent, 6 October 2024

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Inquest to open over deaths of patients treated by breast surgeon Ian Paterson

When Stuart Coyne received a letter to say his wife’s death, now 16 years ago, was being investigated to see if she had died unnecessarily after being operated on by the disgraced surgeon Ian Paterson, he was taken aback.

“It was a shock; it came out of the blue. When Catherine died, we all thought that she’d had the best treatment for the breast cancer that she had,” said Coyne, 70, who lives in Solihull. “Now, of course, it raises that question – would she still be here today?”

On Monday, an inquest into the deaths of 62 of Paterson’s former patients, thought to be one of the largest inquests ever held in the UK, will commence at Birmingham and Solihull coroner’s court.

A team of doctors reviewed hundreds of cases to identify patients they believed might have “died an unnatural death as a result of Ian Paterson’s actions”.

Paterson, who is serving a 20-year prison sentence after being found guilty of 17 counts of wounding with intent, is due to give evidence. The first day of the inquest hearing will consider his application for legal aid, which is being opposed by lawyers representing the victims.

A report published in 2020 found that Paterson subjected more than 1,000 NHS and private healthcare patients in the West Midlands to unnecessary and damaging operations over 14 years before he was stopped.

This included convincing patients to undergo surgery by exaggerating the risk of breast cancer, and performing unrecognised cleavage-sparing operations that left patients at risk of their cancer returning.

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Source: The Guardian, 7 October 2024

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‘No care left in the system’: patients on use of locum psychiatrists in Scotland

Scotland’s health boards have paid up to £837 an hour for locum psychiatrists to help cope with a deepening staff shortage crisis in mental health services.

The Royal College of Psychiatrists and NHS executives said mental health services in Scotland were now at breaking point because of severe staff shortages, which was damaging patient care and causing experienced consultants to quit.

Vox Scotland surveyed patients after hearing of repeated cases of poor experiences with locums, the agency psychiatrists on whom Scotland’s mental health services increasingly depend.

The complaints about locum psychiatrists have a clear pattern. Patients say they routinely experience inconsistent care or get contradictory advice. Some describe an indifference that borders on box-ticking.

“I had 14 locums [and] they all had different views and opinions on my care,” said one respondent to a survey of 469 patients by the advocacy group Vox Scotland. “The last locum did not bother to call me back. That was four months ago. I’ve had no contact from my mental health team since then.”

For some, the anger is palpable. “There is no care left in people or the system and it’s criminal what they have been allowed to do, especially over these last few years taking everything online,” one respondent said. “Online appointments are not accessible to many neurodivergent people like me. Suicidal? Nothing says care like a five-minute Zoom and a prescription 20 miles away with nobody to collect it.”

Nearly a third said all or most of their care came from locums, of whom half were dissatisfied or very dissatisfied with the overall quality of care. A fifth of those polled said they did not know whether they were seen by locums or NHS psychiatrists.

“Every new locum has new ideas, medication changes, but are never here long enough to see the medication work or not. Then the cycle begins with the new one,” another said.

“Each time you see someone different you have to pour your heart and soul out,” said another. “There is no rapport or relationship with locum psychiatrists for vulnerable people – it is impossible to do from receiving notes from the last person.”

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Source: The Guardian, 7 October 2024

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NHS maternity staff to receive mandatory training to improve patient safety

NHS maternity staff will take part in a mandatory training programme to improve patient safety after a damning report by the health regulator said that poor care and harm in childbirth was in danger of becoming “normalised”.

Obstetricians, midwives and obstetric anaesthetists at nine maternity units across England will all have to do extra training from Monday under government plans to raise care standards for women and babies. The scheme will be rolled out to every maternity unit in the country if the pilots are successful.

The move comes just weeks after a Care Quality Commission (CQC) report based on inspections of 131 maternity units exposed a slew of problems, adding to the sense of crisis that has engulfed a service responsible for the 600,000 women a year who give birth and their babies.

The programme will teach maternity staff how to better identify signs a baby is showing distress during labour so they can act more quickly. It will also help staff deal with obstetric emergencies that occur when a baby’s head is lodged deep in the mother’s pelvis during a caesarean section.

Gillian Merron, the minister for patient safety, women’s health and mental health, said: “This government is working with the NHS to urgently improve maternity care, giving staff the support they need to improve safety and ensure women’s voices are properly heard.

“This is a critical step toward avoiding preventable brain injuries in babies, as we work to make sure all women and babies receive safe, personalised and compassionate care.”

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Source: The Guardian, 7 October 2024

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Major diagnostics review kicked into long grass

There are “no plans to publish” a much-anticipated NHS England review of diagnostic services that had been expected this month, a government source has told HSJ.

The review on diagnostics and community diagnostic centres, a follow-up to Sir Mike Richards’ report in 2020, was due this month ahead of the budget on 30 October, senior figures familiar with the report said.

The original report prompted ministers to pledge £2.3bn worth of funding which involved the development of over 160 CDCs – a key recommendation from the report. But cash for the programme runs out in March 2025.

Diagnostic leaders had been hopeful the follow-up report, which was being overseen by NHSE, would provide fresh funding and focus for the CDCs programme.

However, HSJ understands the review is now unlikely to be published in full and will instead be subsumed into the government’s “10-year health plan”.

A government source told HSJ this week: “There are no plans to publish a second report into diagnostics by [Sir Mike].”

“To develop the 10-year health plan we are going to listen to the public and the people who work in the NHS, because patients and staff must feel the difference in their daily lives. We will announce further details later this year.”

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Source: HSJ, 4 October 2024

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