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How to fix the NHS? Free waffles and a maximum BMI for nurses

A website launched by Sir Keir Starmer to hear the public’s ideas on how to change the NHS has been flooded with unusual responses, including a maximum BMI for nurses and free waffles for every patient.

Before the launch of the website on Monday, the prime minister said it was time to “roll up our sleeves and fix” the NHS, and asked the public for suggestions on how to do it. “We have a clear plan to fix the health service but it’s only right that we hear from the people who rely on the NHS every day to have their say and shape our plan as we deliver it,” he said.

In a video launching the website, Wes Streeting, the health secretary, said: “We all owe the NHS a debt of gratitude … I’m calling on you to help us fix it. This government is launching a ten-year plan to turn the NHS around but we can’t do this alone.

“We want patients and NHS staff to have your fingerprints all over it. Whether you work in the NHS or use it as a patient, you see firsthand what’s great but what isn’t working and we need to hear your experiences of the NHS to get your ideas about how to change it.

“So please add your voice today by following the options below. It’s quick, easy and it’ll be worth it. Because if we get this right then together we can take the NHS from the worst crisis in its history, get it back on its feet and make it fit for the future. So get involved.”

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Source: The Times, 21 October 2024

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AI to help doctors spot broken bones on X-rays

Artificial intelligence (AI) has the potential to reduce the number of broken bones missed when doctors analyse X-rays, according to the National Institute for Health and Care Excellence (NICE).

The health assessment body says research suggests the technology is safe and could speed up diagnosis, relieving pressure on clinicians and reducing the need for some follow-up appointments.

AI will not be working alone - each image will be reviewed by a healthcare professional.

NICE says broken bones are missed in 3-10% of cases - it is the most common diagnostic error in emergency departments.

And the trained experts who perform and analyse thousands of X-ray images every day in the NHS are in short supply, with a huge workload.

Vacancy rates are 12.5% for radiologists and 15% for radiographers, according to the long-term plan for the NHS in England, external.

The solution, according to NICE, is to harness the power of AI to work alongside clinicians.

Mark Chapman, director of health technology at NICE, said it would make their job easier.

“These AI technologies are safe to use and could spot fractures which humans might miss, given the pressure and demands these professional groups work under," he said.

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Source: BBC News, 22 October 2024

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NHS delays mean ‘death sentence’ for some patients, says Wes Streeting

Some NHS patients have received a “death sentence” due to delays within the health service, Wes Streeting has said, as Keir Starmer stressed the need for more use of AI and technology.

The health secretary was speaking alongside the prime minister at the launch of what they described as the “biggest national conversation about the future of the NHS since it was founded 76 years ago”.

But while Keir Starmer tried to take an optimistic tone, alluding to the benefits and opportunities that could arise from a public conversation, Streeting warned the NHS is in “such a poor state, I’m amazed we’re not still using carrier pigeons”.

Streeting said: “The NHS is going through what is objectively the worst crisis in its history, whether it’s people struggling to get access to their GP, dialling 999 and an ambulance not arriving in time, turning up to A&E departments and waiting far too long, sometimes on trolleys in corridors, or going through the ordeal of knowing that you’re waiting for a diagnosis that could be the difference between life and death.

“Worse still, receiving a prognosis that amounts to a death sentence that could have been avoided, because the NHS didn’t reach you in time.

“That is, I’m afraid, the daily reality in the NHS today.”

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Source: The Guardian, 21 October 2024

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AI does not necessarily lead to more efficiency in clinical practice

The use of artificial intelligence (AI) in hospitals and patient care is steadily increasing. Especially in specialist areas with a high proportion of imaging, such as radiology, AI has long been part of everyday clinical practice.

However, the question of the extent to which AI actually influences workflows in a clinical setting remains largely unanswered. Researchers at the University Hospital Bonn (UKB) and the University of Bonn have therefore conducted a comprehensive analysis of existing studies on the effect of AI. They were able to show that AI does not automatically lead to an acceleration of work processes. Their results have now been published in the journal npj Digital Medicine.

Although AI is often seen as a solution for handling routine tasks such as monitoring patients, documenting care tasks and supporting clinical decisions, the actual effects on work processes are unclear. Particularly in data-intensive specialties such as genomics, pathology and radiology, where AI is already being used to recognise patterns in large amounts of data and prioritise cases, there is a lack of reliable data on efficiency gains.

"We wanted to find out to what extent AI solutions actually improve efficiency in medical imaging," explains Katharina Wenderott, lead author of the study and a doctoral student at the University of Bonn at the UKB's Institute for Patient Safety (IfPS). "The widespread assumption that AI automatically speeds up work processes often falls short."

"Our results make it clear that the use of AI in everyday clinical practice must be considered in a differentiated way," emphasises Prof. Matthias Weigl, Director of the IfPS at the UKB, who also conducts research at the University of Bonn. "Local conditions and individual work processes have a major influence on the success of implementation."

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Source: Digital Health News, 18 October 2024

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Wes Streeting unveils plans for ‘patient passports’ to hold all medical records

Wes Streeting is to unveil plans for portable medical records giving every NHS patient all their information stored digitally in one place on Monday, despite fears over breaching privacy and creating a target for hackers.

The health secretary is launching a major consultation on the government’s plans to transform the NHS from “analogue to digital” over the next decade. It will offer “patient passports” containing health data that can be swiftly accessed by GPs, hospitals and ambulance services.

New laws are also set to be introduced on Wednesday to make patient health records available across all NHS trusts in England. It will speed up patient care, reduce repeat medical tests and minimise medication errors, he said.

The digital data bill will standardise information systems across the NHS, making it possible to share electronic records across all parts of the service, and bringing them together in a single patient record on the NHS app.

Streeting moved to allay patients’ fears over “big brother” oversight of private records, telling the Guardian that they would be “protected and anonymised” as the government pursued new technological opportunities.

He also defended the government’s plan to transform healthcare in England by working with big tech and pharma companies to develop new treatments, saying he would get the “best possible deal” for the NHS.

The health secretary told the Guardian the development “will mean the NHS can work hand in hand with the life sciences sector, offering access to our large and diverse set of data”.

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Source: The Guardian, 21 October 2024

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White women most likely to get HRT prescriptions in England, study finds

Menopausal women of Chinese and black African backgrounds are about 80% less likely to receive hormone replacement therapy than white women, according to a large-scale study.

HRT is one of the most common treatments for menopausal symptoms such as hot flushes, mood swings, poor sleep and vaginal dryness. It can also help maintain muscle strength and prevent osteoporosis.

But a 10-year study of nearly 2 million women in England has found worrying inequalities in women’s access to HRT.

Academics at the University of Oxford examined HRT prescriptions issued in England to 1,978,348 women aged 40 to 60 over a 10-year period.

Findings presented at the World Congress on Menopause in Melbourne on Monday revealed that between 2013 and 2023, almost six times as many white women were prescribed HRT than black women, and more than twice as many women in affluent areas were offered HRT than those living in socially deprived areas.

While previous studies have identified unequal access to HRT, the academics believe this is the first study to quantify the likelihood of receiving it, having adjusted for age, deprivation and ethnicity.

Over the 10 years they found that, compared with their white counterparts, women of Chinese backgrounds were 82% less likely, and those of black African backgrounds 79% less likely, to receive HRT. Women from Pakistani, Bangladeshi and Indian backgrounds were respectively 70%, 64% and 61% less likely to be on HRT.

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Source: The Guardian, 21 October 2024

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Ambulance staff told to leave patients in hospital corridors

A health minister has defended plans for ambulances to leave patients in hospital corridors after 45 minutes to be able to respond faster to 999 calls.

While emergency doctors have criticised the move, Stephen Kinnock, the care minister, said the policy had “worked very well” in London.

The Times revealed that NHS England has told ambulance services to think about adopting the “drop and go” system used in London, which is credited with cutting response times for heart attacks and strokes.

Ambulance bosses argue it is safer to leave patients in hospital — even if they have not yet been admitted — rather than risk delays in reaching life-threatening emergencies.

However, A&E doctors insist that it is “not acceptable” to abandon patients without a proper handover and assessment by hospital staff and warn of rows between staff as the health service anticipates a tough winter.

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Source: The Times, 21 October 2024

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Woman died of sepsis after being ‘abandoned in hospital corridor’

A woman died of sepsis after being “abandoned” for ten hours on a hospital trolley in a busy A&E corridor, an inquest was told.

Tamara Davis, 31, was left to “fend for herself” as she coughed up blood in the corridor of the A&E department at the Royal Sussex County Hospital in Brighton in December 2022.

She had been taken to hospital after complaining of breathing difficulties and collapsing at home. Davis was diagnosed with a respiratory infection and initially placed in a resuscitation room and given oxygen. However, she was moved into the corridor when another patient needed the room and left on a trolley, even as her condition became progressively worse.

At one stage there were 20 patients being treated in the hospital corridor as there was “nowhere else to put patients”, the inquest at West Sussex coroner’s court was told on Monday.

When her condition deteriorated further she was moved back to a resuscitation cubicle and from there she was transferred to intensive care. She died the following day from sepsis, a life-threatening condition that occurs when the body’s immune system overreacts to an infection or injury.

Joanne Andrews, the West Sussex coroner, said she would write to the Department of Health and NHS England to voice her concerns over the use of corridors to treat patients.

Recording a conclusion of death by natural causes, she said: “In relation to the use of corridors, this does to me create a substantial concern.”

However, she added: “There is no evidence of the patient having been placed in a corridor caused or contributed to her death in these circumstances.”

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Source: The Times, 15 October 2024

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More babies harmed in Letby’s care, files suggest

New evidence seen by the BBC suggests more babies in Lucy Letby’s care were harmed – and in one case poisoned with insulin.

The former nurse was found guilty of murdering seven babies and attempting to murder seven others - including trying to kill two with insulin at the Countess of Chester Hospital neonatal unit between June 2015 and June 2016.

BBC One's Panorama has seen documents which suggest a third baby may have also been poisoned within hours of Letby taking over the boy’s care.

Medical records reveal the infant’s blood sugar level plummeted and lab results indicated he had suspiciously high levels of insulin.

Panorama has also discovered that potentially life-threatening incidents involving infants occurred on almost a third of Letby’s 33 shifts while she was training at Liverpool Women's Hospital in 2012 and 2015.

The programme’s revelations follow months of criticism of the prosecution’s case in her first trial. A number of experts have challenged the medical evidence used to convict Letby, as well as the way statistics were put forward in court.

In August 2023, the 33-year-old was sentenced to life in prison, with no chance of parole. Letby was then found guilty of attempting to murder a seventh baby at a second trial in July this year, and sentenced to a 15th whole-life prison term.

Panorama has examined mounting questions from leading statisticians and medical experts about the safety of her convictions.

But as part of the programme, new evidence has also emerged of other sick and premature babies potentially being harmed while in Letby’s care.

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Source: BBC News, 21 October 2024

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Only a third of NHSE staff think it has a ‘clear vision’

A survey showing only a third of NHS England staff believe it has a “clear vision” for the future has been described as ”not as challenging as could be expected” by the organisation. 

It is NHSE’s first full staff survey since its major restructuring and merger with Health Education England and NHS Digital, which has seen around 7,000 posts cut, and widespread irritation with how how the changes were handled.

The summary report from the 2024 staff survey (attached below), obtained by HSJ, highlights particular problems with morale, and failures to develop staff.  

Among NHSE’s worst scores were whether staff felt it had a “clear vision for the future” (33 per cent agreed), while only 26% “feel like I am part of my organisation’s vision for the future”, and just 36% agreed the organisation would address staff concerns if they spoke up.

However, an NHSE executive team presentation report on the results said: “This year’s results should be considered against the backdrop of ongoing organisational change, which can significantly impact staff engagement levels and decreased morale. 

“Independent feedback from our survey providers indicates that the results are not as challenging as could be expected, given the scale and complexity of NHSE’s change programme.”

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Source: HSJ, 16 October 2024

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'Rules not followed' at home where 7 people died

Measures to protect residents from Covid at a care home where seven elderly people died were not “effectively or consistently” followed by staff, a coroner has ruled.

William Wilkinson, 102, Doris Lockett, 92, Roy Gilliam, 96, Jean Hartley, 81, Susan Skinner, 70, Ronald Bampfylde, 92, and Stanislawa Koch, 93, all died in March or April 2021 after contracting coronavirus at the Holmesley Care Home in Sidford, Devon.

The deaths all came at the height of the Covid pandemic when rules were in place intended to protect residents from infection.

After the inquest on Thursday, Mick Koch - son of Ms Koch - said he wanted to take the matter further and see it scrutinised at the national Covid inquiry.

Alison Longhorn, area coroner for Devon, Plymouth and Torbay, said that while there were proper processes at the home these “were not effectively or consistently followed” by all the staff working there.

Earlier in the inquest, it was heard two staff members - manager Joanne Burchell and nurse Christos Provistallis - had been arrested on suspicion of ill-treatment or wilful neglect in connection with the deaths. CPS officials decided there was not a realistic prospect of conviction.

Allegations were heard during the inquest that Mr Provistallis refused to wear a face mask after claiming "Covid was a conspiracy".

Others alleged Ms Burchell had not sent sick staff home due to shortages and had ignored positive lateral flow test results.

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Source: BBC News, 18 October 2024

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'World-first' study examines period pain in teens

A new study will seek to identify changes in the brain when teenagers experience period pain and whether it is linked to developing chronic pain in later life.

In what is described as a world first, researchers at the University of Oxford will conduct a trial of 11 to 20-year-olds using a range of tests including MRI scans.

Half of the 120 volunteers recruited into the RoADPain, external project will suffer from period pain and half will not.

Dr Katy Vincent, Professor of Gynaecological Pain, said not enough was known about severe period pain despite it being "incredibly common".

"I think it's really important that we take period pain seriously," she said.

"About 30% to 40% of teenagers and young women will have periods that are so painful that they can't go to work, can't go to school, can't do their normal activities.

"If we can reduce the risk of people developing chronic pain in the future, that would be so much easier than trying to treat it once it's developed."

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Source: BBC News, 17 October 2024

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Repair bill for crumbling NHS buildings in England soars to almost £14bn

The cost of repairing crumbling NHS buildings in England has soared to almost £14bn, prompting warnings that patients and staff are at risk from falling roofs and faulty equipment.

The repair bill faced by the health service to make its estate fit for purpose has more than trebled from £4.5bn in 2012-13 to £13.8bn last year, according to NHS England data.

The latest bill means that, for the first time since records began, it would cost the NHS more to eradicate its maintenance backlog than the £13.6bn it spends on running its entire estate.

“Vital bits of the NHS are literally falling apart after years of underinvestment nationally. The safety of patients and staff is at risk,” said Saffron Cordery, the deputy chief executive of NHS Providers.

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Source: The Guardian, 17 October 2024

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Trust eliminated year-long waits ‘by employing an administrator’

A community trust cut waiting times for one of its children’s services from a year to seven weeks, in large part by employing a dedicated administrator, it has said.

A Kent Community Health Foundation Trust board report said it had employed what it initially described as a “business manager” to take burden off clinicians in its East Sussex children’s therapies service.

CEO Mairead McCormick’s report said this had “resulted in a fall in waiting lists from an average of one year to seven weeks”.

She said: ”This freed up time in the initial assessment and ongoing sessions for the therapist to deliver best practice and concentrate on working with the child, rather than discussing wait times and when the next appointment may be.

“It also gave families peace of mind and managed their expectations as a schedule of sessions was provided immediately.”

The claim generated huge interest on X (formerly Twitter) yesterday when shared by HSJ, with many of the posts highlighting the importance of investing in non-clinical staff and management.

However, some clinicians suggested the reduction had probably involved the trust removing people from the wating list.

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Source: HSJ, 16 October 2024

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A mother blamed herself for her baby’s death for a decade. Now the hospital has admitted it made fatal errors

For a decade after her baby Kaiden was stillborn, Hayley Brunt blamed herself for the child’s death.

The “deep grief” in believing she had been to blame for her baby’s death sent Hayley’s mental health into a spiral so bad she made multiple attempts to take her life, and caused her extreme anxiety during later pregnancies.

Now Nottingham University Hospitals NHS Trust (NUH) has admitted that its own mistakes led to the death of Kaiden in 2013.

Ms Brunt, 27, is one of almost 2,000 families whose maternity care will be scrutinised by an inquiry led by Donna Ockenden. The probe was launched by Sajid Javid, then the secretary of state for health and social care, after The Independent revealed in 2021 that dozens of babies and mothers had been harmed as a result of poor care by NUH services.

The trust is also facing a criminal investigation into alleged failings in its maternity care.

Speaking with The Independent, Hayley—who has since had three more children—said that shortly after Kaiden’s funeral she was told by a hospital doctor that his death had been due to her placenta “not working”.

“This led to me blaming myself and my body for what happened to him. The inconsolable grief for Kaiden’s loss and the blame I felt caused my mental health to spiral. I began suffering awful nightmares about Kaiden and his delivery, which continue today. I became so depressed and low that it led to me making a number of attempts to end my life. I have had more children since Kaiden’s death, and each of the pregnancies has been plagued with anxiety and fear that history will repeat itself,” Hayley said.

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Source: The Independent, 16 October 2024

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Covid XEC: What are the symptoms of new virus strain?

A new strain of Covid emerging in the UK is spreading as cases increase at a high rate, the UK Health Security Agency (UKHSA) has said.at a high rate, the UK Health Security Agency (UKHSA) has said.

Called XEC, the strain is a combination of the KS.1.1 and KP.3.3 variants. Figures from the UKHSA show that the admission rate for patients testing positive for the new strain rose to 4.5 per 100,000 people in the week to October 6. This was up from 3.7 a week earlier.

It is thought the XEC strain is more transmissible due to its numerous mutations, and presents symptoms similar to those of other Covid variants including tiredness, headaches, a sore throat and high temperatures.

Although self-isolation is no longer a legal requirement in the UK, the NHS has advised anyone who tests positive for Covid to avoid contact with others for at least five days. It is also recommended that contact with more vulnerable people be avoided for 10 days, to reduce the risk to them. As a general rule, it is advised anyone with symptoms at least wait for them to subside before returning to normal activities.

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Source: The Independent, 17 October 2024

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British BAME and foreign doctors ‘suffer discrimination throughout careers’

British doctors of BAME origin and overseas-trained medics working in the UK experience “persistent and pernicious” inequality throughout their careers, the medical regulator has warned.

The General Medical Council (GMC) said too many doctors are still being reported by their employers for alleged misconduct compared with white British-trained medics.

Doctors also experience “discrimination and disadvantage” in their efforts to progress medical careers because of a hostile “culture” in too many parts of the NHS, it said.

The report, by the GMC’s chief executive, Charlie Massey, is intended to stamp out discrimination.

Massey said, "For too many doctors, medicine is a story of discrimination and disadvantage. From the early days of education and training, to the leadership positions of latter years, issues of inequality are persistent and pernicious. This unfairness is deep-rooted and longstanding. It undermines doctors’ morale and ability to perform at their best. And it shames our health services. Fair treatment is not the preserve of a select few – it is the right of all doctors, regardless of who they are.”

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Source: The Guardian, 17 October 2024

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Letby gave baby overdose two years before murders

Lucy Letby gave a baby 10 times the prescribed dose of morphine "in error" two years before her killing spree began, a public inquiry has heard.

The nurse was then unhappy at being told she could no longer administer controlled drugs at the Countess of Chester Hospital after the incident in July 2013.

The Thirlwall Inquiry, which is examining how she was able to kill and attack babies between June 2015 and June 2016, heard Letby received extra training after the incident. Yvonne Farmer, who was practice development nurse at the time, told the inquiry at Liverpool Town Hall it was a "very serious error".

The mistake was spotted quickly and the baby suffered no ill-effects, the inquiry heard. Ms Farmer said Letby was not far into her nursing career at the time, but was outside the period of supervision required by the Nursing and Midwifery Council.

Letby, of Hereford, was convicted of murdering seven babies and attempting to murder seven others, including one she tried to kill twice, and is serving 15 whole life prison sentences.

The inquiry continues.

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Source: BBC News, 16 October 2024

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Woman died after taking medicine from husband’s ‘identical’ dosette box

A Berkshire woman with cognitive impairment died after taking medicines from her husband’s dosette box rather than her own “for several days,” a coroner has found. 

A report by assistant coroner for Berkshire Katy Thorne found that Sewa Kaur Chaddha died on May 10 2023, five days after she was found collapsed at home in Slough. 

Both she and her husbands were taking “multiple prescribed conditions” as well as “cognitive impairment due to their age” according to the report. 

The coroner wrote: “It was discovered that she had been taking her husband’s medication instead of her own for several days, including diabetes medication. Her blood sugar levels were found to be extremely low.” 

The cause of death was principally attributed to hyponatraemia “caused by the necessary treatment for hypoglycaemia which was in turn caused by the accidental ingestion of hypoglycaemic medication”.

In her report – which was written in July but made public yesterday (October 15) – the coroner said that both Mrs Chaddha and her husband received separate multi-compartment compliance aids (MCAs) from their local pharmacy, which was then a branch of LloydsPharmacy, adding: “The two patients’ dosette boxes were identical to each other except for a small pharmacist’s label with small type with the relevant patient’s name.”

The inquest found both that there was no “well disseminated” guidance for pharmacies around issuing medicines to patients with dementia and that “dosette boxes of different colours or labels with different colours were not routinely given to elderly or cognitively impaired patients living at the same address”.

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Source: Pharmacy Magazine, 16 October 2024

 

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UK women who suffer cardiac arrest in public less likely to get CPR, study finds

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”, according to a study.

The research by St John Ambulance said nearly a quarter of the 1,000 Britons surveyed admitted they were less likely to perform cardiopulmonary resuscitation (CPR) on a woman in public, with a third of men worrying they would be accused of “inappropriate” touching when giving CPR to a woman compared with 13% of females.

The survey suggests the “taboo” surrounding women’s chests creates an “alarming gender disparity” in access to emergency medical care as only 68% of women are likely to receive CPR from bystanders compared with 73% of men.

Previous research has shown that more than 8,200 women in England and Wales could have survived a heart attack if they had been given the same treatment as men, according to an analysis of data from between 2003 and 2013.

Jordan Davison, a community experience manager at St John Ambulance, which teaches first aid and emergency medical services, said: “Our message to people is that it is always better to do something than nothing in these circumstances.

“Regardless of gender, when it comes to CPR, every ‘body’ is the same, the technique is the same, and everyone deserves the best possible chance of survival.”

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Source: The Guardian, 16 October 2024

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Vulnerable people not at risk from proposed assisted dying law, says MP

The lives of disabled and vulnerable people will not be at risk from a proposed assisted dying law because it will only apply to terminally ill adults, and each case is likely to be ruled on by two doctors and a judge, the MP sponsoring it has said.

Kim Leadbeater said her historic “choice at the end of life” bill will include “stringent” criteria and a cooling-off period in what is likely to be one of the most controversial pieces of legislation to go before parliament in years.

But people who are facing intolerable suffering but are not dying will still be denied medical assistance to end their lives, under the likely terms of the bill to be introduced on Wednesday.

That decision will prompt debate over whether the threshold for medical assistance to die should relate to suffering rather than time left to live.

Some campaigners argue people whose conditions mean they can be trapped and suffering in their bodies long before they meet a narrow definition of terminal illness will be left out.

A major poll has suggested most of the public support an assisted dying law in every constituency of Great Britain apart from Bradford West.

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Source: The Guardian, 16 October 2024

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NHS needs better plan around weight loss jabs, warn experts

An urgent review is needed to make sure people in England can get weight loss jabs such as Wegovy and Mounjaro on the NHS, top experts warn.

It comes a day after the prime minister said such injections could boost Britain's economy by getting obese unemployed people "back into work".

More than 200 doctors and specialists have now written to the health secretary to say how stretched NHS obesity treatment services face unprecedented demand from patients wanting these drugs.

They warn the injections are only part of what should be a wider package of non-stigmatising care.

They say the government must fix some fundamentals issues in NHS obesity services - chronic underfunding, workforce challenges and unequal access to care.

The letter to Wes Streeting is being sent by the Obesity Health Alliance, external (OHA), which represents health charities and medical royal colleges, and has compiled a report.

It says some patients can wait up to five years for specialist support, and that some services are so overstretched they have closed their waiting lists entirely.

The OHA wants to see equitable access for obesity treatments, including weight loss injections.

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Source: BBC News, 16 October 2024

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Overhauling CQC ratings ‘could bring greater clarity’, ministers told

Changes to the Care Quality Commission’s one-word ratings “could be beneficial”, Penny Dash has concluded in the final version of her review.

Much of its contents, which is highly critical of the CQC, had already been published in an interim version in July, which prompted health secretary Wes Streeting to declare the regulator “not fit for purpose”.

But the final version of the review, which includes seven recommendations, addresses some areas not covered in the scathing interim report, including on the much-debated issue of the CQC’s single-word ratings.

It notes “the government recently announced that Ofsted would end the use of one-word ratings and so it would be reasonable to similarly consider their use in health and social care

The review adds: ”Changes to one-word ratings could be beneficial in allowing greater clarity to be brought to the different key questions of quality, allowing a ‘balanced scorecard’ approach across [the key CQC inspection domains] ‘safe’, ‘effective’, ‘responsive’/’caring’ and ‘well led’.

However, “all this needs to be set against the need for a straightforward narrative that is accessible for users and patients”.

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Source: HSJ, 15 October 2024

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Families 'left in lurch' on child autism diagnoses

Hundreds of thousands of children with suspected neurodevelopmental conditions in England, including autism and ADHD, face unacceptably long waits to be diagnosed, the Children's Commissioner, external has warned.

Dame Rachel de Souza's report into the issue said the system has failed to keep up with rising demand, leaving families "in the lurch" and expected to cope by themselves while they wait.

Parents are having to "jump through multiple hoops" to get support, while their children can end up in crisis and robbed of their potential, she said.

The report calls for urgent change to a needs-led, not a diagnosis-led, system of support - something the government insists it is tackling head-on.

Dame Rachel said she was shocked by how many providers had published apology messages and videos about the long waits.

"At such a crucial time developmentally, every day a child waits for support could permanently alter their life course," she warned.

She said, tragically, some children's unmet needs escalate to crisis point, citing the example of a 14-year-old autistic girl who ended up being admitted to hospital multiple times and required police involvement after health, social care and education had "failed to put in place the interventions she needed".

"Children and their families should never have to 'beg' or 'fight' for help," she said. "Yet, sadly, these are the words I hear most often when asking about seeking support for a child's neurodivergence."

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Source: BBC News, 15 October 2024

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Unemployed could be given weight-loss jabs to get back to work, says Wes Streeting

New weight-loss jabs could be given to unemployed people to help them get back into work, Wes Streeting has suggested.

The health secretary said “widening waistbands” were placing a burden on the NHS.

The latest generation of weight-loss medicine, such as Ozempic or Zepbound, could be administered to people in order to get them back into employment, and to ease costs to the health service, he added.

The plans announced at the summit will include real-world trials of weight-loss jabs’ impact on worklessness, according to the Telegraph.

The health secretary wrote: “Our widening waistbands are also placing significant burden on our health service, costing the NHS £11bn a year – even more than smoking. And it’s holding back our economy.

“Illness caused by obesity causes people to take an extra four sick days a year on average, while many others are forced out of work altogether.”

Dr Dolly van Tulleken, who specialises in obesity policy and is a visiting researcher at the MRC epidemiology unit at the University of Cambridge, told BBC Radio 4’s Today programme there were “some serious ethical, financial and efficacy considerations with such an approach … Such as looking at people, or measuring people based on their potential economic value, rather than primarily based on their needs and their health needs.”

She went on: “It’s incredibly important that people in the UK access healthcare based on their health need rather than their potential economic value.”

But despite scepticism, Van Tulleken said Streeting was on “the side of the population”, adding: “We know from across so much research … how popular these interventions are. People want the government to act. They want to live in a healthy environment; he is absolutely on the side of public.”

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Source: The Guardian, 15 October 2024

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