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Can interim care help ease Scotland's hospital bed shortage?

Many people who are medically ready to leave hospital are not able to go home because of pressures in social care.

Health and social care teams across Scotland are working to create more room in hospitals as we go into winter when it traditionally gets busier.

In Lothian, they are using care homes as an interim measure to help rehabilitate people before they can go back home.

Nineteen rooms at the Elsie Inglis Nursing Home in Edinburgh are being used in an effort to help people get out of hospital.

Archie McQuater, who spent seven months in The Royal Infirmary of Edinburgh after one of his big toes was removed because of an infection, has finally got out of hospital and is now staying at the Elsie Inglis.

The 94-year-old has been in the care home for two months and is trying to improve his mobility so that he can return home.

Archie is among 200 people in Edinburgh who have been moved from a hospital to a care home between November 2021 and September 2022.

NHS Lothian estimates it has saved about 13,000 bed days in hospitals during that time.

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Source: BBC News, 2 November 2022

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NHSE ‘forgot the people’ when it ‘rushed’ controversial appointment rules, Mackey admits

NHS England “forgot the people” when it published controversial guidelines last month which said patients faced being removed from the waiting list if they declined two appointment dates, a senior director has admitted.

NHSE elective recovery chief Sir Jim Mackey said the guidance was drafted to address legitimate concerns from trusts, but that the process had been “rushed”.

Following Sir Jim’s comments, NHSE told HSJ the guidance, which had sparked widespead criticism including from patient groups, would not be changing. But Sir Jim said NHSE would “spend time” better understanding patients after “reflecting” on the process which had created the controversial guidelines.

Speaking at the King’s Fund annual conference, Sir Jim said: “[The guidance] was largely a response to trusts saying to us: ‘We keep offering these patients options and they won’t take them, so what do we do?’

“We rushed through a policy to try and deal with that, and in the process, I think forgot the people…We’ve reflected on that.”

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Source: HSJ, 1 November 2022

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‘It feels very unsafe’: the NHS staff bracing for winter as cuts loom

Further funding cuts to the NHS will unavoidably endanger patient safety, an NHS leader warned last week after the chancellor’s promise of spending cuts of “eye-watering difficulty”.

Matthew Taylor, the chief executive of the NHS Confederation, said his members were issuing the “starkest warning” about “the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available”.

The warning came as figures showed that paramedics in England had been unavailable to attend almost one in six incidents in September due to being stuck outside hospitals with patients. Service leaders say wait times for A&E and other care are being exacerbated by an acute lack of nurses, with a record 46,828 nursing roles – more than one in 10 – unfilled across the NHS.

"Patients are presenting more unwell," says a GP from South Wales,

"Wait times in A&E have become unmanageable, so we’re seeing patients who have waited so long to be seen they’re bouncing back to us. Things we can’t deal with, like injuries and chest pain. We tell them they have to go back to A&E.

"Abuse of surgery reception and admin staff began last year and it’s just scaled up from there. We’ve had staff members who have been verbally and physically threatened and we’re struggling to recruit and retain staff – people are hired and quit in a couple days. A lot of people are going off sick with stress."

Five healthcare workers describe the pressures they are facing, including ambulance stacking, rising A&E wait times and difficulties discharging patients.

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Source: The Guardian, 1 November 2022

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More than a million Americans ration insulin due to the high cost of the drug

Insulin rights activists and those who live with diabetes are calling for meaningful action to address the high costs of insulin in the United States as a new study shows the widespread habit of rationing the life-saving medicine.

A study published on 18 October in the Annals of Internal Medicine by researchers at Harvard Medical School, the City University of New York’s Hunter College and Public Citizen, found that 1.3 million Americans rationed insulin due to the high costs of insulin in 2021. The staggering number represents an estimated 16.5% of the US population with diabetes.

The study found insulin rationing was most commonly reported by those without health insurance coverage and individuals under the age of 65 not eligible for Medicare. Black insulin users were more likely to report rationing insulin, at 23.2%.

The impact of the practice can be terrible.

Janelle Lutgen of Dubuque county, Iowa, lost her 32-year-old son Jesse, a type 1 diabetic, after he started rationing his insulin because he lost his job and with it his health insurance and died in early 2018 from diabetic ketoacidosis.

Without health insurance, Lutgen said over-the-counter insulin costs more than $1,000 (£865) a month, and that her son couldn’t afford the high cost of healthcare coverage in the marketplace without a job and wasn’t eligible for Medicaid coverage because his income from when he was working was too high.

“It would probably be impossible to really know exactly all the harm that’s been done with high insulin prices,” said Lutgen, who explained that individuals who ration insulin because of the cost, if they do survive, can still experience other health impacts such as neuropathy, or losing toes or feet. “It seems like we can’t get it through legislators’ heads that we have to make sure everyone who needs insulin can get it, not just people who have insurance or people on Medicare – everybody. The only way to do that is to go to the root of the problem, big pharma.”

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Source: The Guardian, 1 November 2022

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Fertility treatment triggers suicidal thoughts in nearly half of patients

One in 10 patients undergoing fertility treatment experience suicidal thoughts “all the time”, a survey suggests.

Fertility Network UK, which carried out the poll, said the findings reveal the “far-reaching trauma” of experiencing infertility and undergoing IVF in the UK.

Four in 10 respondents - 98% of whom were women - said they had experienced suicidal feelings.

Gwenda Burns, chief executive of Fertility Network UK, said: “Fertility patients encounter a perfect storm: not being able to have the child you long for is emotionally devastating.

"But then many fertility patients face a series of other hurdles, including potentially paying financially crippling amounts of money for their necessary medical treatment, having their career damaged, not getting information from their GP, experiencing their relationships deteriorate, and being unable to access the mental support they need."

“This is unacceptable. Infertility is a disease and is as deserving of medical help and support as any other clinical condition.”

Three in four patients said their GP did not provide sufficient information about fertility problems and treatment.

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Source: The Telegraph, 31 October 2022

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Covid: Boris Johnson WhatsApp messages requested by inquiry

The Covid public inquiry has asked to see Boris Johnson's WhatsApp messages during his time as prime minister as part of its probe into decision-making.

Counsel for the inquiry, Hugo Keith KC, said the messages had been requested alongside thousands of other documents.

He said a major focus of this part of the inquiry was understanding how the "momentous" decisions to impose lockdowns and restrictions were taken.

The revelations came as he set out the details of how this module will work. The inquiry is being broken down into different sections - or modules as they are being called.

The preliminary hearing for module one, looking at how well prepared the UK was, took place last month.

Monday marked the start of the preliminary hearing for module two, which is looking at the political decision-making.

Mr Keith said this allowed the inquiry to take a "targeted approach". He said it would look at whether lives could have been saved by introducing an earlier lockdown at the start of 2020.

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Source: BBC News, 31 October 2022

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Record number of trainee doctors for ‘under pressure’ NHS

The largest expansion of medical training posts has been announced the day after Scotland’s health secretary warned that the NHS was facing up to its most challenging winter.

Humza Yousaf yesterday confirmed that 152 more places for trainee doctors would be created next year.

He hailed it as the “most significant increase in medical training places to date” and an increase on the 139 places created last year. The announcement comes after ministers were urged to fund the creation of additional training places in key specialities including general practice, core psychiatry, oncology, emergency medicine, intensive care medicine and anaesthetics.

“These additional training places highlight the Scottish government’s continued commitment to ensure that our health service is resilient and can continue delivering high quality care to those who need it,” Yousaf said. “This record expansion will support a wide range of medical specialties, many of which are under increased pressure as a result of growing demand.

“We will continue to monitor the number of available training places in collaboration with NHS Education for Scotland to help make sure the NHS is equipped to meet the country’s current and future needs.”

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Source: The Times, 1 November 2022

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‘Alarming’ rise in type 2 diabetes among UK under-40s

The number of people under 40 in the UK being diagnosed with type 2 diabetes is rising at a faster pace than the over-40s, according to “shocking” and “incredibly troubling” data that experts say exposes the impact of soaring obesity levels.

The UK ranks among the worst in Europe with the most overweight and obese adults, according to the World Health Organization. On obesity rates alone, the UK is third after Turkey and Malta.

The growing numbers of overweight and obese children and young adults across the UK is now translating into an “alarming acceleration” in type 2 diabetes cases among those aged 18 to 39, analysis by Diabetes UK suggests.

There is a close association between obesity and type 2 diabetes. There is a seven times greater risk of type 2 diabetes in obese people compared with those of healthy weight, and a threefold increase in risk for those just overweight.

“This analysis confirms an incredibly troubling growing trend, underlining how serious health conditions related to obesity are becoming more and more prevalent in a younger demographic,” Chris Askew, the chief executive of Diabetes UK, said.

He added: “While it’s important to remember that type 2 diabetes is a complex condition with multiple other risk factors, such as genetics, family history and ethnicity, these statistics should serve as a serious warning to policymakers and our NHS.

“They mark a shift from what we’ve seen historically with type 2 diabetes and underline why we’ve been calling on the government to press ahead with evidence-based policies aimed at improving the health of our nation and addressing the stark health inequalities that exist in parts of the UK.”

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Source: The Guardian, 1 November 2022

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Hospital with 600 estate ‘incidents’ demands ‘urgent’ government decision

A trust has called for ministers to make an ‘urgent’ decision on funding for a new hospital, as a raft of maintenance problems such as leaking roofs and overflowing sewage pipes are hampering efforts to tackle waiting list backlogs.

There was a surge in estates’ incidents reported by Princess Alexandra Hospital Trust last year — to an average of nearly 12 each week — and the Essex trust is calling for clarity on whether it will be given the green light to build a new hospital.

The trust is one of eight given priority status under the government’s new hospitals programme, but there has been speculation in recent weeks the programme could be scaled back as departments are told to find spending cuts.

Michael Meredith, estates director at Princess Alexandra Hospital, said patients still received good care, but admitted the problems – which include sewage overflow, outdated electrics and theatre roofs leaking – were “absolutely” affecting the hospital’s ability to recover elective care.

He told HSJ: “It means you have to cancel some of your elective work. And at the moment that is critical, because we know [we’ve] got a long waiting list, we know we need to recover, we know we’ve got people waiting longer than they need to…

“That has a real impact on our staff morale, and a real impact on patients waiting to be seen.”

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Source: HSJ, 1 November 2022

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‘This cannot go on’: rise in under-18s on adult psychiatric wards in UK

A growing number of children with mental health problems are being treated on adult psychiatric wards as services struggle to cope with a surge in demand following the pandemic, the NHS watchdog has warned.

There were 249 admissions of under-18s to adult psychiatric wards in England in 2021-22, according to data provided by NHS trusts to the Care Quality Commission (CQC), up 30% on the year before.

Of the children admitted to adult wards, 58% of cases were because the child needed to be admitted immediately for their safety.

But in more than a quarter of cases, 27%, the child was admitted to the adult ward because there was no alternative child inpatient or community outreach service available.

The findings come more than 15 years after the government set a target to end inappropriate admissions of children to adult psychiatric wards. The number of admissions gradually reduced but has now risen again, the CQC figures suggest.

Dr Elaine Lockhart, chair of the Child and Adolescent Faculty at the Royal College of Psychiatrists, said the figures were “a concern but not a surprise. We’ve got a lot of children and young people who have become more unwell. Services are really struggling to meet their needs,” she said.

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Source: The Guardian, 30 October 2022

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NHS Scotland in a perilous situation, says doctors' union

Scotland's NHS is in "a perilous situation" amid a staffing and funding crisis, according to the chairman of the doctors' union.

Dr Iain Kennedy said urgent action was needed to tackle workload pressures ahead of a potentially "terrifying" winter period.

It comes after Scotland's health secretary Humza Yousaf admitted NHS Scotland was not performing well. Mr Yousaf told BBC Scotland it would take at least five years to fix.

Dr Kennedy, who is chairman of the industry body BMA Scotland, said it was good to hear Mr Yousaf being honest about the scale of the problems, but added that "frankly we cannot wait five years" for things to improve.

He told BBC Radio's Good Morning Scotland programme: "The NHS in Scotland is in a perilous situation and we have a particular crisis around the workforce - we simply do not have enough doctors in general practice and in hospitals.

"We need more urgent action because the pressures and the workload have really shot up."

Dr Kennedy has called on the government to publish a "heat map" showing where NHS vacancies are unfilled across Scotland.

He said: "The public need to see transparency on where the vacancies are. We think that there are probably 15% vacancies across hospital consultant posts across Scotland.

"Even the government admits to 7% and that we are at least 800 GPs short in Scotland - and I, and others, suspect we are probably well over that figure now."

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Source: BBC News, 31 October 2022

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MRSA reported at Manston in migrant who tested positive for diphtheria

A case of MRSA has been reported at the congested asylum processing centre at Manston in Kent, the Guardian has learned, after it emerged that Suella Braverman ignored advice that people were being kept at the centre unlawfully.

The antibiotic-resistant bacteria was identified in an asylum seeker who initially tested positive for diphtheria. But the asylum seeker was moved out of the site in Ramsgate to a hotel hundreds of miles away before the positive test result was received, raising concerns about the spread of the infection.

The Manston site is understood to now have at least eight confirmed cases of diphtheria, a highly contagious and potentially serious bacterial infection.

Migrants are meant to be held at the short-term holding facility, which opened in January, for 24 hours while they undergo checks before being moved into immigration detention centres or asylum accommodation such as a hotel.

But giving evidence to a committee of MPs last week, David Neal, the independent chief inspector of borders and immigration, said he had spoken to a family from Afghanistan living in a marquee for 32 days, and two families from Iraq and Syria sleeping on mats with blankets for two weeks. Conditions at the site left him “speechless”, he said.

On a visit to the site on 24 October, Neal was told there were four confirmed cases of diphtheria. 

Protective medical equipment for staff has now been brought on to the site. Although diphtheria is a notifiable disease, meaning cases must be reported to authorities, those at Manston have not appeared on weekly public health reports.

A Home Office spokesperson said it was “aware of a very small number of cases of diphtheria reported at Manston”, and that proper medical guidance and protocols were being followed.

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Source: The Guardian, 30 October 2022

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Access to mental health services worsening, according to survey findings

Results from the recently published Community Mental Health Survey highlight that issues with access to services and support, as evidenced in the 2020 and 2021 surveys, continue to persist. 

The 2022 Community Mental Health Survey – coordinated by Picker for the Care Quality Commission – collected feedback from more than 13,400 people in contact with services between September and November 2021. The survey is an important source of information to help us understand the quality of person-centred care provided to mental health service users.

A key feature of a high-quality person centred mental health service is timely access to care. The survey shows that there is more to be done here to ensure that service users have a good experience as nearly a third (31%) reported not being told who was in charge of organising their care and services – up from 28% in 2021. In parallel with this, 30% of service users said that they had not seen NHS mental health services enough in the last 12 months (compared to 27% in 2021 and 24% in 2020) and only 55% said they were given enough time to discuss their needs and treatment.

Just over half of service users (51%) said that they did not receive any help or advice with finding support for financial advice or benefits – a 3% point increase from last year’s survey. When asked a similar question regarding support for finding or keeping work, 50% said they did not receive help or advice but would have liked it. With the financial worries that the increased cost of living is causing for many people, signposting support and advice for employment, managing money, and claiming benefits are vital for helping people maintain good mental health.

Commenting on the results, Jenny King, Picker’s Chief Research Officer, said:

“On the 22nd September 2022, the Secretary of State for Health and Social Care and Deputy Prime Minister at the time, Thérèse Coffey, announced the UK government’s Our plan for patients. Whilst it notes that work will continue to improve the availability of mental health support through expansion of services, there was little detail on how this would be achieved and how backlogs of care in mental health services would be resolved.

With the backdrop of the cost of living crisis and its impact on people’s mental health, the findings from this survey highlight the urgent need for more to be done to address accessibility issues. And not just in mental health services but across health and social care where, as highlighted by CQC’s 2021/22 State of Care report, people are waiting too long for appointments, assessments, and treatment. Without a plan for tackling the NHS’s workforce crisis, the ability to make sustainable service improvements to address the unmet need is severely restricted.”

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Source: Picker, 27 October 2022

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London surgeons complete record week’s worth of operations in one day

Surgeons in a London hospital have performed a week’s worth of operations in a single day, pioneering a technique that could be used to help reduce the NHS backlog.

The team at Guy’s and St Thomas’ hospital performed eight robot assisted radical prostatectomy operations in under ten hours, the highest number performed in a single day in the UK in one hospital.

High Intensity Theatre lists (HIT) focus on one procedure at a time and seek to minimise the turnaround time between operations. Using two theatres, the surgeon can go between cases without having to wait for a patient to come in. This helps to cut the significant amount of time it takes for medics to anaesthetise a patient, set up equipment in the theatre and help them to recover – a process which sometimes takes longer than the operation itself.

The team at Guy’s assembled a large team for the HIT list, which took place on 8 October. Each theatre had a team of around 1.5 times its usual size and staff were given very specific roles.

By the time the list had reached the third patient, the turnaround time between operations had dropped as low as 32 seconds. Behind the scenes, staff in the control room used Proximie software to monitor activity in the theatre in real time.

Dr Ben Challacombe, a consultant urological surgeon who performed the operations with his surgical consultant colleagues Paul Cathcart, Christian Brown, and Prokar Dasgupta, told the Standard that the success of the HIT list had given staff a “huge” morale boost.

“Everyone pulled together to do the job, it really helped to energise the team. Morale has been hit by Covid and other issues, but people feel galvanised by doing something different.”

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Source: Evening Standard, 29 October 2022

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Fears Covid surge will force care homes to impose harsh visiting restrictions this winter

A surge in Covid cases over winter could lead to harsh visiting restrictions being reimposed in care homes and hospitals, MPs and campaigners have warned.

Families are still facing a “postcode lottery” of Covid restrictions in care homes, with visiting times restricted and personal protective equipment (PPE) obligatory.

However MPs are worried that some will reimpose even harsher measures if Covid cases rise this winter.

Daily global Covid infections are projected to rise slowly to around 18.7 million by February, up from the current 16.7 million average daily cases this October.

MPs are calling for the government to enact legislation that would enshrine the right for an essential care giver to be present with their loved ones in care settings.

Liberal Democrat MP Daisy Cooper said that one of her constituents, Lynn, was not allowed into a hospital A&E ward to see her husband Andy when his dementia deteriorated over Christmas last year.

The hospital refused to let Andy have any visitors for two weeks until Ms Cooper intervened. When she was allowed in, Lynn was distraught to find that Andy had lost a significant amount of weight in the weeks he was isolated.

Ms Cooper continued: “We have come a long way since last Christmas, and since the start of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in Covid cases.

“It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.”

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Source: Independent, 30 October 2022

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Eighteen deaths following Tees health trusts' safety lapses

Eighteen people died at two Teesside hospital trusts following patient safety lapses over a 12-month period.

Sixteen such deaths were recorded at the South Tees Hospitals NHS Foundation Trust, with two at the North Tees and Hartlepool NHS Foundation Trust.

Examples of patient safety lapses include a failure to provide or monitor care, a breakdown in communication, an out-of-control infection in a hospital, insufficient staffing or a missed diagnosis.

NHS England figures show that, between April 2021 and March this year, there were 16,557 incidents at the South Tees Trust, which operates James Cook University Hospital in Middlesbrough, and Northallerton's Friarage Hospital. Thirty-four resulted in "severe" harm.

Middlesbrough MP Andy McDonald told the Local Democracy Reporting Service the figures were a concern and that he planned to take them up with the South Tees Trust's chief executive.

He said NHS staff worked under "the most demanding of conditions" but added: "Every person going into hospital rightly expects to receive the best treatment. Patient safety is paramount and no family wants to see a loved one suffer."

Dr Mike Stewart, the trust's chief medical officer, said: "We encourage an open and transparent culture and promote the reporting of all patient safety incidents, even when there is uncertainty over a direct link between any problems in care and incidents of severe harm or death.

"In the last year there were no deaths graded as definitely preventable due to a problem in the care delivered by the trust.

"While our reporting has increased consistently over the last three years, the number of serious incidents has not risen, which is strong evidence of a positive safety culture."

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Source: BBC News, 30 October 2022

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NHS yet to see ‘a single penny’ of promised £500m emergency fund

Hospitals and care homes have not received a single penny of a £500m emergency fund promised by the government to prevent the NHS becoming overwhelmed this winter, the Guardian has learned.

Ministers announced they were injecting the cash into the health and social care system last month, to help get thousands of medically fit patients out of hospital into either their own home or a care home as soon as possible in an effort to better prepare the NHS for the coming months.

“At the moment, one of the key challenges is discharging patients from hospital into more appropriate care settings to free up beds and help improve ambulance response times,” Thérèse Coffey, the then health and social care secretary, said on 22 September. “To tackle that, I can announce today that we are launching a £500m adult social care discharge fund for this winter.”

However, the Guardian has been told that none of the funding has materialised. Senior health and social care sources described the government’s failure to release the promised cash as “inexplicable” and “outrageous”.

More than 13,000 of the 100,000 NHS hospital beds in England currently contain “delayed discharge” patients, which has led to A&E units becoming heavily congested and long delays in ambulance handovers. As a direct result, thousands of 999 patients are suffering potential “severe harm” every month because ambulances are stuck outside hospitals.

“Leaders across the NHS and local authorities are yet to see a single penny of this investment or any official detail on how it will be allocated,” said Matthew Taylor, the chief executive of the NHS Confederation.

“Currently, only two-fifths of patients in hospital are able to leave when they are ready to do so, including due to problems accessing social care, yet health leaders still do not know how and when the £500m will be released to the system. So close to winter, this is unbelievable.

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Source: The Guardian, 31 October 2022

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Ministers urged to launch inquiry into inpatient mental health services after ‘systemic abuse’ allegations

Ministers have been urged to launch a public inquiry into the care of mental health patients after The Independent revealed allegations that patients had suffered “systemic abuse” in inpatient units.

A joint investigation with Sky News found that teenagers at facilities run by The Huntercombe Group had been left with post-traumatic stress disorder by their treatment despite hundreds of warnings to regulators and the NHS.

Now the government is facing calls to review all mental health care services over fears that these cases are “the tip of the iceberg”.

Labour’s shadow mental health minister Dr Rosena Allin-Khan has called for a “rapid review” by the government into inpatient mental health services, while Deborah Coles, the chief executive of charity Inquest, has called on the new health secretary Steve Barclay to launch a statutory public inquiry.

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Source: The Independent, 28 October 2022

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Plea to vaccinate children against flu as hospitalisations rise in England

Parents are being urged to get their young children vaccinated against flu as data suggests hospitalisation rates among under-fives have almost doubled in England in the space of two weeks.

Data suggests the UK could face a triple whammy of respiratory illness this winter. While experts are concerned there could be another Covid wave, levels of both flu and respiratory syncytial virus (RSV) are increasing. The latter is a common winter virus that typically affects young children and can cause bronchiolitis.

Dr Conall Watson, consultant epidemiologist for the UK Health Security Agency (UKHSA), said hospital admission rates for flu had risen in recent weeks and were highest in children under five.

“Already this year a small number of young children have needed intensive care. Please book your preschooler in for flu vaccine at your GP surgery as soon as you can,” he said. “Flu nasal spray vaccine is also currently being offered to all primary school children and will be available for some secondary school years later this season.”

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Source: The Guardian, 28 October 2022

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New rules will discourage trusts from consuming more than their ‘fair share of NHS resources’

NHS England has launched the first substantive consultation on changes to the NHS provider licence since 2013. 

Licences set out the requirements providers must meet and are the legal mechanism NHS England can use to take enforcement action. Having a licence has long been mandatory for foundation trusts and independent providers, and will become so for trusts. The intention is for the proposals to take effect from next year.  

Most of the changes to the licence regime have been made to bring it into line with this year’s Health and Care Act and accompanying policy changes. For example, trusts will be required to collaborate with other providers and work effectively as part of their integrated care system. 

This extends to trusts delivering agreed financial plans decided at a system level. The aim is to provide “mutual accountability” and ensure each provider does not use “more than their fair share of NHS resources”.'

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Source: HSJ, 28 October 2022

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'I wouldn't bring a member of my family to this hospital,' says medic

Steve Barclay is back as England's health secretary, just as the NHS prepares for what its chief executive Amanda Pritchard says could be a "very, very challenging winter".

The government has said "intensive work" is under way in the 15 most under-pressure hospital trusts in England, to speed up ambulance delays, free up beds and reduce waiting times in A&E.

Emergency departments across the UK are struggling to quickly treat patients.

Only 57% of people who turned up at major A&E departments in England last month were seen, admitted or discharged within four hours, well below the 95% national target.

The latest figures from Gloucestershire Royal show it performs slightly worse than average, with 55% dealt with in four hours.

One medic, speaking anonymously to the BBC, said: "I wouldn't bring a member of my family to this hospital. And winter is going to be worse unless something changes fast."

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Source: BBC News, 28 October 2022

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NICE recommends NHS collects real-world evidence on devices that monitor people with Parkinson’s disease

Five promising technologies that could help improve symptoms and quality of life for people with Parkinson’s disease have been conditionally recommended by NICE.

The wearable devices have sensors that monitor the symptoms of people with Parkinson’s disease while they go about their day-to-day life. This information may more accurately record a person’s symptoms than a clinical assessment during in-person appointments and help inform medication decisions and follow up treatment such as physiotherapy.

Parkinson's disease is an incurable condition that affects the brain, resulting in progressive loss of coordination and movement problems. It is caused by loss of the cells in the brain that are responsible for producing dopamine, which helps to control and coordinate body movements.

Mark Chapman, interim director of Medical Technology at NICE, said: “Providing wearable technology to people with Parkinson’s disease could have a transformative effect on their care and lead to changes in their treatment taking place more quickly.

“However there is uncertainty in the evidence at present on these five promising technologies which is why the committee has conditionally recommended their use by the NHS while data is collected to eliminate these evidence gaps.

“We are committed to balancing the best care with value for money, delivering both for individuals and society as a whole, while at the same time driving innovation into the hands of health and care professionals to enable best practice.”

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Source: NICE, 27 October 2022

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Pinned down, force-fed and drugged into ‘zombie-like’ state: ‘Systemic abuse’ at children’s hospitals revealed

Children say they were "treated like animals" and left traumatised as part of a decade of “systemic abuse” by a group of mental health hospitals, an investigation by The Independent and Sky News has found.

The Department of Health and Social Care has now launched a probe into the allegations of 22 young women who were patients in units run by The Huntercombe Group, which has run at least six children’s mental health hospitals, between 2012 and this year.

They say they suffered treatment including the use of “painful” restraints and being held down for hours by male nurses, being stopped from going outside for months and living in wards with blood-stained walls. They also allege they were given so much medication they had become “zombies” and were force-fed.

But despite reports to police and regulators dating back seven years, and findings by the Care Quality Commission (CQC) that the units were inadequate, the NHS has still handed Huntercombe nearly £190m since 2015-16 to admit children to its mental health beds.

Through witness testimony, documents obtained by Freedom of Information request and leaked reports, the investigation has uncovered:

  • The CQC has received more than 700 whistleblowing and safeguarding reports, including “incidents of concern” and several “sexual safety” concerns.
  • NHS England was notified of 195 safeguarding reports between 2020 and 2021.
  • A 2018 internal report at Meadow Lodge hospital in Newton Abbot (now closed) found staff members using sexually inappropriate language in front of patients.
  • 160 reports investigated by Staffordshire police about Huntercombe Staffordshire between 2015 and 2022.
  • Between March 2021 and 2022, the CQC gave permission for 29 patients to be admitted to Maidenhead hospital after it was placed in special measures.

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Source: The Independent, 27 October 2022

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CQC inspection approach helping fuel emergency care crisis, says trust chief

A trust chief executive says the Care Quality Commission’s (CQC) inspection regime is still overly focussed on individual organisations, rather than systems, and this is driving the “risk aversion” which is partly responsible for the emergency care crisis.

Mid Yorkshire Hospitals Trust CEO Len Richards acknowledged the CQC has started to scrutinise system-wide issues but suggested the “heat” of its regulation is still on individual providers.

Mr Richards told the House of Lords’ public services committee on Wednesday that care homes and nursing homes in his area have declined to take patients ready to be discharged from hospital, due to concerns it would put their CQC accreditation at risk.

He said: “[Last winter] we asked nursing homes and care homes to take patients and they couldn’t take them beyond a certain limit because it would put their accreditation at risk.

“We went to the CQC to try and create some flexibility. Their perspective was very much of an independent regulatory body that would look at the organisation and not look at the system. I think we’ve got an awful long way to go there.

“I think regulation does drive risk aversion… [and] the heat of regulation right at the moment is on individual organisations.

“Therefore, when the CQC come and look at my organisation, they will talk about congestion in the A&E department. They won’t talk about the assessment that we made around there being a greater risk in the community if we didn’t offload ambulances.”

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Source: HSJ, 28 October 2022

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Nurses are working the equivalent of one day a week for nothing, research says

Nurses are working the equivalent of one day a week for nothing, according to a study.

Researchers from London Economics were commissioned by the Royal College of Nursing (RCN) to look at pay in England, Wales, Scotland and Northern Ireland since 2010.

They found that the salary of an experienced nurse had fallen by 20% in real terms, based on a five-day week.

Experienced nurses in England, Wales, and Northern Ireland would need a nominal pay rise of 45% by 2024-25 just to return their salaries to levels seen in 2010-11 in real terms, the research said.

And such a pay rise would actually help the NHS save money in the long term, as it would be cheaper than hiring staff from overseas, according to the study.

Dr Gavan Conlon, who oversaw the research, said that bringing staff in from overseas costs approximately £16,900 more annually than retaining a nurse, while using agency workers costs around £21,300 more per year.

He said that about 32,000 nurses leave the NHS every year, many due to the failure of their pay to keep up with the rising cost of living.

The RCN is balloting its 300,000 members for strike action, calling for higher pay and an effort by government to fill the hundreds of thousands of nursing vacancies across the country.

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Source: Sky News, 28 October 2022

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