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Warning for parents after rise in hospitalisations for flu in children under 5

Parents are being told to urgently bring their children forward for flu vaccinations as new data reveals the rate of hospitalisation and ICU admission for people with the virus is rising fastest among those under five years old.

New figures published in the UK Health Security Agency’s (UKHSA) National flu and Covid-19 surveillance report show that cases of flu have climbed quickly in the past week, indicating that the season has begun earlier than normal.

According to the UKHSA, vaccination for flu is currently behind last season for pre-schoolers (12.1% from 17.4% in all two-year-olds and 12.8% from 18.6% in all three-year-olds).

It has also fallen behind in pregnant women (12.4% from 15.7%) and under 65s in a clinical risk group (18.2% from 20.7%).

Dr Mary Ramsay, director of public health programmes at the UK Health Security Agency, said: “Our latest data shows early signs of the anticipated threat we expected to face from flu this season.

“We’re urging parents in particular not to be caught out as rates of hospitalisations and ICU admissions are currently rising fastest in children under 5.

“This will be a concern for many parents and carers of young children, and we urge them to take up the offer of vaccination for eligible children as soon as possible.”

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Source: The Independent, 20 October 2022

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CQC taking ‘enforcement action’ against every fourth service it inspects

A quarter of services the Care Quality Commission has recently inspected required enforcement action from the regulator, its chief executive has revealed. 

Speaking at the launch of the regulator’s annual State of Care report, Ian Trenholm called for a “long-term, sustainable funding solution” from the government to aid a service that was ”genuinely struggling to cope”.

Mr Trenholm said “about a quarter of the services” the CQC has inspected in 2022 had resulted in it having to take “enforcement action”.

Examples of action taken against NHS trusts in the last year included enforcement measures placed on Nottingham University Hospitals, University Hospitals Sussex, and Princess Alexandra Hospital.

In response to a question from HSJ about the robustness of the CQC’s inspection regime following further care quality and safety scandals, Mr Trenholm said observers should not focus solely on the ratings given to trusts by the CQC as there was a lot ”work going on in the background, whether that’s enforcement or otherwise”.

He added the CQC had significantly increased the amount of information it was gathering in relation to concerns about services.

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Source: HSJ, 21 October 2022

 

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Prescribing art and gardening for patients may be a waste of money

The “social prescribing” of gardening, singing and art classes is a waste of NHS money, a study suggests.

Experts found that sending patients to community activity groups had “little to no impact” on improving health or reducing demand on GP services.

The research calls into question a major drive from the NHS and Department of Health to increase social prescribing as a solution to the shortage of doctors and medical staff.

In 2019 the NHS set a target of referring 900,000 patients for such activities via their GP surgeries within five years.

Projects receiving government funding include football to support mental health, art for dementia, community gardening and singing classes to help patients to recover from Covid.

However, the study, published in the journal BMJ Open, said there was “scant evidence” to support the mass rollout of so-called “social prescribing link workers”.

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Source: The Times, 18 October 2022

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Statement from East Kent Hospitals' chief executive Tracey Fletcher

Tracey Fletcher, chief executive of East Kent Hospitals, said: "I want to say sorry and apologise unreservedly for the harm and suffering that has been experienced by the women and babies who were within our care, together with their families, as described in today’s report.

"These families came to us expecting that we would care for them safely, and we failed them.

"We must now learn from and act on this report; for those who have taken part in the investigation, for those who we will care for in the future, and for our local communities. I know that everyone at the Trust is committed to doing that.

"In the last few years we have worked hard to improve our services and have invested to increase the numbers of midwives and doctors, in staff training, and in listening to and acting on feedback from the people who receive our care.

"While we have made progress, we know there is more for us to do and we absolutely accept that. Now that we have received the report, we will read it in full and the Board will use its recommendations to continue to make improvements so that we are providing the safe, high-quality care our patients expect and deserve.

"I want every family – whether they contributed to the investigation or not – to know I am here to listen to them, to learn and to lead our Trust in acting on this report. 

"I would like to thank Dr Bill Kirkup and the investigation team for their work. Today, our thoughts remain with those who have shared their experiences. We are grateful to them.”

Source: NHS East Kent Hospitals, 19 October 2021

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Further cuts will kill off NHS dental services, chancellor told

Jeremy Hunt has been told that any cuts to the health budget will in effect “kill” dental services across the UK and deny millions of patients access to a dentist on the NHS.

The chancellor has told members of the cabinet that “everything is on the table” as he seeks to find tens of billions of pounds in savings after ditching the economic plan of Liz Truss, who said on Thursday she was standing down as prime minister. Health is one key area expected to be hit.

But in an email to Hunt seen by the Guardian, the head of the British Dental Association (BDA) said in plain terms that because NHS dentistry had already “faced cuts with no parallel anywhere in the health service” over the last decade, any further reduction in funding could trigger its collapse.

“In blunt terms, NHS dentistry is approaching the end of the road,” Martin Woodrow, the BDA chief executive, wrote in the memo. “There is simply no more fat to trim, short of denying access to an even greater proportion of the population.”

In the memo to Hunt, Woodrow wrote: “Recent NHS England board papers confirm officials are euphemistically ‘taking steps to maximise access from existing resources’. We know what that means. Yes, we recognise the unparalleled pressures on public spending. Equally, we cannot escape the hard fact that a service millions depend on materially lacks the resources to underpin any rebuild.

“You have also spoken of the need for all departments to seek ‘efficiency savings’. Since the financial crash, NHS dentistry has faced cuts with no parallel anywhere in the health service, going into the pandemic with lower government contributions – in cash terms – than it saw a decade ago.

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Source: The Guardian, 21 October 2022

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Care substandard at 39% of maternity units in England, NHS watchdog finds

Two out of five maternity units in England are providing substandard care to mothers and babies, the NHS watchdog has warned.

“The quality of maternity care is not good enough,” the Care Quality Commission (CQC) said in its annual assessment of how health and social care services are performing.

It published new figures showing it rated 39% of maternity units it inspected in the year to 31 July to “require improvement” or be “inadequate” – the highest proportion on record.

Ian Trenholm, the CQC’s chief executive, said maternity services were deteriorating, substandard care was unacceptably common and failings were “systemic” across the NHS.

Its latest state of care report said: “Our ratings as of 31 July 2022 show that the quality of maternity services is getting worse, with 6% of NHS services (nine out of 139) now rated as inadequate and 32% (45 services) rated as require improvement.

“This means that the care in almost two out of every five maternity units is not good enough.”

The report said: “The findings of recent reviews and reports … show the same concerns emerging again and again. The quality of staff training, poor working relationships between obstetric and midwifery teams and a lack of robust risk assessment all continue to affect the safety of maternity services. These issues pose a barrier to good care.”

Staff not listening to women during pregnancy and childbirth is a recurring problem, Trenholm said. Their concerns “are not being heard” by midwives and obstetricians “in the way that they should”.

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Source: The Guardian, 21 October 2022

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Breast cancer patients in England face delays to reconstruction surgery

Women waiting for breast reconstruction surgery on the NHS in England face a “postcode lottery” of care, with some forced to wait more than three years, a damning report warns.

Two in five women (40%) waiting for breast reconstruction during the pandemic after having their breasts removed due to cancer faced a delay of 24 months or longer, according to research involving 1,246 women who either underwent reconstruction surgery or were waiting for it.

The report by charity Breast Cancer Now also warned that some breast reconstruction services are still not operating at full capacity after temporarily pausing at the start of the Covid-19 pandemic.

It says there was a 34% drop in breast reconstruction activity in England in 2021-22 compared with 2018-19. The charity added that on top of the delays, women face a “postcode lottery” of care, with some women offered certain types of reconstruction while others are denied the same operation.

Breast Cancer Now called on NHS England to develop a plan to address the backlog of breast reconstruction services.

One woman told the authors of the report she waited for three and a half years for breast reconstruction surgery, while another said she “wants to move on with my life” but has no idea when her surgery will go ahead.

Baroness Delyth Morgan, the chief executive of Breast Cancer Now, said: “For women who choose breast reconstruction, it is a core component of their recovery – far from a solely aesthetic choice, this is the reconstruction of their body and indeed their identity after they have been unravelled by breast cancer treatment and surgery.

“We hear of patients affected by delays to reconstruction surgery and the significant emotional impact this has on them, including altered body confidence, loss of self-esteem and identity, anxiety and depression, and hindering their ability to move forward with their lives, knowing their treatment is incomplete."

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Source: The Guardian, 19 October 2022

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New research collaboration to improve patient safety

University College London Hospitals (UCLH) is to host to a new collaboration researching patient safety, after being awarded £3 million in funding from the National Institute for Health and Care Research.

The NIHR Central London Patient Safety Research Collaboration (PSRC) aims to improve safety in Surgical, Perioperative, Acute and Critical care (SPACE) services, which treat more than 25 million NHS patients annually. Perioperative care is care given at and around the time of surgery.

Amongst the highest risk clinical settings are SPACE services because of the seriousness of the patients’ conditions and the complex nature of clinical decision making.

Further risks arise at the transitions of care between SPACE services and other parts of the health and social care system. 

The research team led by UCLH and UCL will develop and evaluate new treatments and care pathways for SPACE services.  This will include new interventions such as surgical and anaesthetic techniques, and new approaches to predicting and detecting patient deterioration. They will also help the NHS become safer for patients through the development of innovative approaches to organisational learning, and to how clinical evidence is generated. The PSRC’s learning academy will support the next generation of patient safety researchers through a comprehensive programme of funding, mentoring and peer support.

The team includes frontline clinicians, policy makers and world-leading academics across a range of scientific disciplines including social and data science, mechanical and software engineering. Patients and the public representing diverse backgrounds are key partners in the collaboration.

Professor Moonesinghe said: “We have a great multidisciplinary, multiprofessional team ready to deliver a truly innovative programme to improve patient safety in these high-risk clinical areas. As a uniquely rich research environment, UCLH and UCL are well placed to lead this work, and we are looking forward to collaborating with clinicians and patients across the country to ensure impact for the whole population which the NHS serves.”

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NHSE’s ‘institutionalised’ firing of CEOs contributed to ‘major service failure’

An “institutionalised” and “counterproductive” system of hiring and firing trust leaders was a contributory factor to care failings which caused the death of at least 45 babies an inquiry has concluded. 

The inquiry into maternity care at East Kent Hospitals University Foundation Trust, chaired by Bill Kirkup, discovered what it described as the latest ”major service failure” in NHS maternity care. It concluded that successive chairs and chief executives were “wrong” to believe the trust had provided adequate care for more than a decade and urged they be held accountable. But he added the churn of senior management had been “wholly counterproductive” for the trust.

His report said: “We have found at chief executive, chair and other levels a pattern of hiring and firing, initiated by NHS England. The practice may never have been an explicit policy, but it has become institutionalised. In response to difficult problems, pressure is placed on a trust’s chair to replace the chief executive, and/or to stand down themself."

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Source: HSJ, 20 October 2022 (paywalled)

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New national incident reporting system delayed amid fears of patient safety ‘disaster’

The deadline for the NHS to move to a new system for safety incident reporting has been delayed after widespread concerns the rollout could be a ‘disaster’.

A memo from NHS England to local teams yesterday, seen by HSJ, says the deadline to transition to the new “learning from patient safety events” database has been pushed back by six months to September 2023.

The creation of LFPSE is a key strand of NHSE’s safety strategy, along with the overhaul of how serious incidents are investigated. It aims to make it easier for staff across all healthcare settings to record safety events, as the service will be expanded to include primary care.

It will replace the current national reporting and learning system, a central database created in 2003 to help identify trends and maximise learning from mistakes. The new system is part of a national strategy that pledges to save 1,000 extra lives and £100m in care costs each year from 2023-24.

Multiple patient safety managers at local trusts had raised concerns to HSJ about the previous March deadline, with one patient safety lead saying it would have been a “disaster” if enforced.

Helen Hughes, chief executive of charity Patient Safety Learning, said NHSE also needs to change its way of working, as well as the deadline extension. She said:

“We believe that NHS England needs to seriously reconsider their approach to engaging with trust leaders and staff on this issue, so that improvements can be made to the new LFPSE service to ensure it has the best possible chance of success, and to enable patient safety improvement.”

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Source: HSJ, 20 October 2022

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General practice is like calling an Uber, MPs say

Patients in England are being put at risk because of the unacceptably poor service they receive from GPs, MPs say.

The House of Commons' Health Committee blamed the failure to tackle doctor shortages, which had led to a decline in the GP-patient relationship.

Seeing a GP should not be like booking an Uber with a driver you are unlikely to see again, the MPs said. The warning comes just weeks after ministers launched a drive to improve access to GP services. But the cross-party group of MPs said more needed to be done.

Louise Ansari, from the patient group Healthwatch England, said, "The impacts of poor access can be huge, with people feeling abandoned and suffering in silence and not getting referred to hospitals for more specialised treatment."

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Source: BBC News, 20 October 2022

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Expert advisers urge FDA to pull pregnancy drug from market

An expert panel convened by the US Food and Drug Administration voted 14-1 on Wednesday to recommend withdrawing a preterm pregnancy treatment from the market, saying it does not work.

During the sometimes contentious three days of hearings, the drugmaker Covis Pharma, backed by some clinicians and patient groups, had argued there is evidence to suggest the drug, called Makena, might work in a narrower population that includes Black women at high risk of giving birth too soon.

But FDA experts and others said the data does not support such a view. In closing arguments, Peter Stein, director of the Office of New Drugs at the FDA’s Center for Drug Evaluation and Research, agreed on the urgent need for a drug to reduce the incidence of preterm birth — a leading cause of infant mortality in the United States. But he said the data indicates that Makena is not that drug.

Stein said, “Hope is a reason to keep looking for options that are effective,” he said. “Hope is not a reason to take a drug that is not shown to be effective, or keep it on the market.”

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Source: The Washington Post, 19 October 2022

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Main hospital corridor turned into ‘makeshift ward’

The main corridor of an acute hospital has been closed to patients and staff and turned into a ‘makeshift ward’, in what sources describe as an ‘absolutely unprecedented’ situation.

The move by Aintree Hospital comes after staff clashed with paramedics last week about whether ambulance patients could be brought into the crowded emergency department.

One staff member, who wished to remain anonymous, said: “It’s exceptional for this to happen, but I can see it happening more over winter. It’s a rock and a hard place… either you wait in the ambulance if the queue is too long, or you wait in the main hospital corridor. Neither option is ideal.”

Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: “Across the country, the urgent and emergency care system is in unprecedented crisis. Emergency medicine teams and our paramedic colleagues are doing their very best to deliver effective care in exceptionally difficult circumstances. Circumstances like these require ICB leaders to engage, take control of the situation and accept their responsibility. This will both help to de-escalate the situation and ensure the right decision is made for the patients, the ED teams and ambulance crews."

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Source: HSJ, 19 October 2022 (paywalled)

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Trust CEOs and chairs to blame for care failings which saw death of over 40 babies

A series of chairs and chief executives at an acute trust were ‘wrong’ to believe the organisation was providing acceptable care over an 11-year period and should be held accountable for one of NHS’s largest maternity care scandals, an inquiry concluded today.

Bill Kirkup’s inquiry into East Kent Hospitals University Foundation Trust found 45 of the 65 deaths of babies examined could have been prevented. It also concluded the overall outcome of 48% of 202 cases investigated could have been different, if care had matched nationally recognised standards. 

It also warned that the unjustified belief that things “would get better” as a result of management changes still continued at the trust.

The report added that problems in the service were visible to senior managers and the board through a succession of reports, dating back to 2009. 

The report stated: “We have concluded that accountability lies with the successive trust boards and the successive chief executives and chairs. They had the information that there were serious failings, and they were in a position to act; but they ignored the warning signs and strenuously challenged repeated attempts to point out problems. This encouraged the belief that all was well, or at least near enough to be acceptable. They were wrong.”

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'No-one joined the dots' - grandad who exposed an NHS scandal

More than 200 families in south-east England will learn today the results of a major inquiry into the maternity care they received from a hospital trust. The investigation into East Kent Hospitals NHS Trust follows dogged campaigning by one determined bereaved grandfather.

Derek Richford's grandson Harry died at East Kent Hospitals after his life support system was withdrawn.

Sixty one-year-old Derek had never campaigned for anything in his life. His initial approach was to wait for East Kent Hospitals Trust to investigate the death, as it had promised.

However, one nagging issue that was to become central to Derek's view of the trust, was the hospital's continual refusal to inform the coroner of Harry's death. The family repeatedly requested it, but the trust said it was unnecessary as it knew the cause, namely the removal of the life support system.

The hospital also recorded Harry's death as "expected" - again because his life support system had been withdrawn. On both points, the family were left confused and increasingly angry.

In early March 2018, some four months after Harry's death, the family finally received the outcome of the trust's internal investigation - known as the Root Cause Analysis (RCA). The RCA indicated multiple errors had been made in Harry and Sarah's care and treatment, and his death was "potentially avoidable".

Prior to the meeting, Derek wrote to the Kent coroner's office outlining in general the circumstances of Harry's case, asking if that was the type they would expect to be notified of. The email response from the coroner's office was clear. It said: "Based on the facts you have presented, this death should have been reported to the coroner."

Despite this, at the meeting with the trust, the lead investigator into Harry's death told the family: "If we have a clear cause of death by and large we do not involve the coroner."

The family's insistence eventually paid off - five weeks after that meeting, the trust informed the coroner of Harry's death.

While his son and daughter-in-law started trying to recover from the trauma of losing Harry, Derek turned his attention to investigating East Kent, one of the largest hospital trusts in England.

"When I started investigating what was going on with Harry, it was very much like peeling back an onion. 'Hang on a minute, that can't be right, that doesn't add up.' Ever since I was a small kid, justice has been so important to me.

"What I found was that, up to that point, no-one had ever joined the dots. And that's so important. I think this had to happen, someone had to do it. There will be families before us that wish they did it. We will be saving a level of families after us."

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Source: BBC News, 19 October 2022

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Former trust CEO and medical director cleared over surgery scandal

A major trust’s former chief executive and medical director have been cleared, after being accused of failing to protect breast patients from a rogue surgeon.

The Medical Practitioners Tribunal Service has ruled neither Mark Goldman nor Ian Cunliffe’s fitness to practise was impaired, in a case brought by the General Medical Council. 

Mr Goldman was chief executive of the Heart of England Foundation Trust from 2001 until 2010, while Dr Cunliffe served as HEFT medical director between 2006 and 2010. Both held roles at HEFT while Ian Paterson was there.

Mr Paterson was jailed for 20 years in 2017 after being convicted of 17 offences of wounding with intent while being employed at HEFT, while a later inquiry concluded he may have conducted up to 1,000 botched and unnecessary operations over a 14-year period.

Mr Goldman and Dr Cunliffe are now pursuing the GMC for the costs of the case, which is expected to be heard over five days in January 2023.

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Source: HSJ, 18 October 2022

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More than a third of US counties lack obstetric care as services are deemed unprofitable

More than a third of the 3143 counties in the US are maternity “deserts” without a hospital or birth centre that offers obstetric care and without any obstetric providers—and the situation is getting worse, says a report from the March of Dimes organisation.

Maternity deserts have increased by 2% since the 2020 report, said the organisation which seeks to improve the health of women and babies. Care is diminishing where it is needed most—especially in rural areas. It affects nearly seven million women of childbearing age and about half a million babies.

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Source: BMJ, 17 October 2022

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East Kent Hospitals accused of ‘cancer at the top of the organisation’ by governor

The former lead governor of East Kent Hospitals University Foundation Trust has resigned this morning, claiming there is “a cancer at the top of the organisation” and that its services won’t be safe until the government provides funding for critical estates work.

His resignation as a governor came hours before the publication of what is expected to be a “harrowing” report into maternity services at the trust from an independent review led by Sir Bill Kirkup. He is also expected to raise concerns about national progress on maternity services safety in recent years.

Alex Lister, who is chair of the council of governors’ membership engagement and communications committee, said in the letter: “I believe officials on six-figure salaries continue to mislead, obfuscate, bully and conceal vital information. I consider the way the trust communicates internally and externally to be completely unacceptable and utterly untrustworthy.

“Without the valiant efforts of the brave families caught up in a tragedy of the trust’s making, the world may never have found out about the disastrous health failings at our trust.”

In the letter to chair Niall Dickson, Mr Lister says he has seen a continuation “of the same apparent policy of manipulation and discrediting dissenting voices that existed prior to the scandal”.

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Source: HSJ, 19 October 2022

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NHS England to set up ‘war rooms’ for ‘tough winter ahead’

The NHS is setting up “war rooms” as it prepares for one of the toughest winters in its history, officials have announced.

In a letter to staff, health leaders in England set out “winter resilience plans”, which include new system control centres that are expected to be created in every local area.

These centres will be expected to manage demand and capacity across the entire country by constantly tracking beds and attendances.

They will be operated by clinicians and experts who can make quick decisions about emerging challenges in the health service, NHS England said.

The data-driven centres will be able to spot when hospitals are near capacity and could benefit from mutual aid. Where A&Es are especially busy, ambulances will be diverted to nearby hospitals with more space.

Meanwhile, NHS England announced plans to expand falls response services so people are treated in their homes, avoiding unnecessary trips to hospital where possible.

NHS England’s chief executive, Amanda Pritchard, said: “Winter comes hot on the heels of an extremely busy summer – and with the combined impact of flu, Covid and record NHS staff vacancies – in many ways, we are facing more than the threat of a ‘twindemic’ this year.

“So it is right that we prepare as much as possible – the NHS is going further than it ever has before in anticipation of a busy winter, and today we have set out further plans to step up these preparations – building on our existing plans to boost capacity set out in August this year."

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Source: The Guardian, 19 October 2022

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Northern Ireland: Community pharmacists warn of medicine shortages amidst rising costs

Shortages and rising costs of medicines could result in patients not receiving important prescriptions, community pharmacists have warned.

Commonly prescribed drugs used to treat conditions such as osteoporosis, high blood pressure and mental health are among those affected.

The Department of Health (DoH) said a support package worth £5.3m for the sector is being finalised. But Community Pharmacy NI said this "falls way short of what is needed".

David McCrea from Dundela Pharmacy said the price of some medicines had been raised "fiftyfold".

"As a community pharmacist for over 30 years, I have never witnessed the price of medicines rise this sharply," Mr McCrea said.

"It is becoming increasingly hard for us to afford to buy the medicines from wholesalers because we are not being paid the full cost of these drugs by the department."

Mr McCrea added the current situation was causing "financial stress" and was becoming unsustainable.

"The bottom line is that we are now facing the situation where we will not be able to afford to supply our patients with essential medicines, within weeks."

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Source: BBC News, 18 October 2022

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NHS faces £90bn bill for ‘staggering’ maternity blunders

The NHS faces a record £90 billion maternity bill, The Telegraph can reveal ahead of a “harrowing” report into failings at East Kent Hospitals Trust.

Official figures show the number of claims have risen by almost one quarter in just two years following a series of scandals. 

The data show 1,243 maternity negligence claims in 2021/22 - up from 1,015 in 2019/20. 

Safety campaigners said the figures were “staggering” - with £90 billion now set aside to cover the costs of claims.

It means that in total, 70% of total liability provision for NHS negligence is associated with failings in pregnancy and childbirth, amid rising claims. 

The figure - equivalent to two-thirds of the NHS annual budget - represents an estimate for the total costs if all claims it expects to settle were paid out, at today’s prices.

An NHS spokesperson said: “Despite improvements to maternity services over the last decade – with significantly fewer stillbirths and neonatal deaths – we know that further action is needed to ensure safe care for all women, babies and their families.

“The NHS is ensuring that work is already underway to make these improvements, including a £127 million investment this year to boost the maternity workforce, strengthen leadership and increase neonatal cot capacity – which is on top of an annual boost of £95 million for staff recruitment and training announced last year.”

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Source: The Telegraph, 18 October 2022

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Coffey’s ‘ultra-libertarian’ health stance risks lives, Tory ex-minister warns

People could die because of Thérèse Coffey’s “ultra-libertarian ideological” reluctance to crack down on smoking and obesity, a Conservative ex-health minister has warned.

The strongly worded criticism of the health secretary came from Dr Dan Poulter, a Tory MP and NHS doctor who served as a health minister in the coalition government from 2012 to 2015.

Poulter claims Coffey’s “hostility to what the extreme right call ‘nanny statism’” is stopping her from taking firm action against the “major killers” of tobacco and bad diet.

His intervention – in an opinion piece for the Guardian – was prompted by Coffey making clear that she opposed banning adults from smoking in cars containing children, even though the practice was outlawed in 2015 and is credited with reducing young people’s exposure to secondhand smoke.

The government’s widely anticipated scrapping of measures to curb obesity such as the sugar tax and ditching of the tobacco control plan and health inequalities white paper – both of which previous health ministers had promised to publish – have led Poulter to brand Coffey’s stance “deeply alarming”.

He writes: “More smoking and more obesity means more illness, more pressure on the NHS and shorter lives, particularly amongst the poorest in society.

“I am acutely concerned that the health secretary’s ideological hostility to what history shows is government’s potentially very positive role in protecting us against these grave threats to our health will exacerbate the problems they already pose.

“At its worst such a radically different approach to public health could cost lives, as it will inevitably lead to more people smoking and becoming dangerously overweight.”

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Source: The Guardian, 18 October 2022

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Urgent safety measure took three years to implement

A key national policy change recommended by the inquest which led to the East Kent maternity inquiry will not be implemented until next February – more than three years after it was called for by a coroner.

The recommendation – that obstetric locum doctors be required to demonstrate more experience before working – was made in a prevention of future deaths report following the inquest into the death of seven-day-old Harry Richford at East Kent Hospitals University Foundation Trust.

The remaining 18 recommendations from the PFD report were requiring specific actions by the trust, rather than national policy makers. The trust says they have been implemented. 

However, NHS England and the Royal College of Obstetricians and Gynaecologists have only in recent months produced guidance on using short-term locums in these services, and it will not come into effect until February.

When it does, it will require them to complete a certification of eligibility, demonstrating they have had recent experience in a number of clinical situations, including complex Caesarean sections. Middle-grade locums have until next February to gain the certificate.

The independent inquiry into maternity at the trust – prompted by Harry’s death – will report tomorrrow, Wednesday 19 October, and is expected to be highly critical of the trust, and of national efforts to make services safe over recent years. 

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Source: 18 October 2022

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‘Mothballed beds’ must be brought back into service to boost elective activity says NHSE

NHS England has warned trusts that it is “essential” that elective procedures go ahead over winter, despite acknowledging hospital occupancy is running at an “all time high”.

New winter planning guidance from NHS England, published today, says electives should go ahead “unless there are clear patient safety reasons for postponing activity,” and trusts considering cancelling significant levels of elective activity should escalate to their regional directors to mobilise mutual aid where possible.

NHSE has said bed occupancy “continues to be at all-time highs” and encouraged systems to “take all opportunities” to maximise physical and virtual bed capacity, including the use of “previously mothballed beds”.

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Source: HSJ, 18 October 2022

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Leadership review launched at ‘outstanding’ trust

The Care Quality Commission has launched a review of leadership at an “outstanding”-rated specialist trust, after receiving multiple concerns from whistleblowers.

The regulator is understood to have made an unannounced visit to The Christie Foundation Trust within the last week to inspect its medical services. The review will also cover the trust’s overall leadership.

HSJ understands the review is, at least, partly in response to the regulator receiving a number of concerns from whistleblowers about the trust’s leadership culture and behaviour of senior staff.

It comes after the trust came under scrutiny from NHS England last year, with independent reviews finding there had been multiple failings around the handling of a major research project.

The reviews also criticised the trust’s reaction to staff who had raised concerns, but failed to answer a key accusation that was made about the detriment suffered by whistleblowers.

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Source: HSJ, 19 October 2022

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