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

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

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

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

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

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

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

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Source: The Guardian, 5 October 2024

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

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

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

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

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

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

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

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

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Source: The Guardian, 7 October 2024

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Letby NHS trust deleted documents, tribunal told

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

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

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

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

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

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

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

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

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

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Source: BBC News, 4 October 2024

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

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

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

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

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

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Source: The Independent, 6 October 2024

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

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

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

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

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

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

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

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

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Source: The Guardian, 7 October 2024

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

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

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

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

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

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

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

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

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

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

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Source: The Guardian, 7 October 2024

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NHS maternity staff to receive mandatory training to improve patient safety

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

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

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

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

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

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

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Source: The Guardian, 7 October 2024

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Major diagnostics review kicked into long grass

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

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

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

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

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

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

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

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Source: HSJ, 4 October 2024

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RCGP sounds alarm over 'dangerously high' GP workloads

Some family doctors in the UK are opting to work part-time contracts, using their days off to catch up on admin to ensure their job is being done properly, according to a top GP.

The Royal College of General Practitioners (RCGP) is calling for action from the Government to take pressure off medics with “dangerously high workloads”.

It comes after RCGP research revealed GPs in deprived areas in England are responsible for hundreds more patients than their counterparts in more affluent districts.

RCGP chairwoman Professor Kamila Hawthorne issued the warning on workloads ahead of the college’s annual conference in Liverpool on Thursday.

In her address to an estimated 1,500 delegates, she will say: “At the heart of this is a workforce that hasn’t kept pace with workload.

“We are delivering 14% more appointments than we were five years ago, but we have fewer qualified GPs – 16% fewer than other high-income countries relative to our population.

“Less than 10% of the total NHS budget in England is spent on primary care and as the Darzi Report confirmed, that share has been falling despite an increase in workload and the movement of extra services into the community.

“What does this mean in real life? It means too many patients crying out for appointments and dangerously high workloads for our members."

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Source: Medscape, 3 October 2024

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NHS England director warns ‘we can’t surge beds and capacity’ this winter

An NHS England director has warned the health service will not be able to create the same extra capacity used to get through winter in previous years, adding to concerns about performance and safety pressures in coming months.

National director of urgent and emergency care Sarah-Jane Marsh said the NHS will not have the same ability to quickly increase the number of hospital beds or pay for extra social care support as it has had in previous years.

Ms Marsh told an NHS England board meeting on Thursday she was “very concerned” about the resilience of the service going into winter, despite it making headway with other seasonal preparations.

Ms Marsh told the meeting NHSE is also “doing additional work on our operational response” and “how we safely make choices to balance risk across systems” when waits get unacceptably long.

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Source: HSJ, 3 October 2024

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New vaccine 'could wipe out' ovarian cancer

The world's first vaccine for ovarian cancer, being developed in the UK, could wipe out the disease, researchers have said.

Scientists at the University of Oxford are creating OvarianVax, a vaccine which teaches the immune system to recognise and attack the earliest stages of ovarian cancer.

Cancer Research UK is funding the study with up to £600,000 over the next three years.

Director of the university's ovarian cancer cell laboratory Prof Ahmed Ahmed said they still had "a long way to go" but he was "very optimistic".

There are around 7,500 new ovarian cancer cases every year in the UK.

There is no screening test and it is often diagnosed late because the symptoms - such as bloating and no appetite - can be vague.

Genetic mutations put some women at a higher risk of developing the disease and, currently, women with certain genetic mutations are advised to have their ovaries removed before the age of 35.

Prof Ahmed said, if effective, the vaccine could remove the need for this.

Whilst the "full-blown timeline" for a vaccine being approved "might be many years away", Prof Ahmed said, if the vaccine was successful, it could have an impact within the next five years.

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Source: BBC News, 4 October 2024

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Delivering safe care a 'challenge' in A&Es, doctor warns

Delivering safe care continues to be a challenge in every emergency department in Scotland, according to a senior A&E doctor.

As the service gears up for winter, the Royal College of Emergency Medicine (RCEM) is warning that the government's winter planning is not doing enough to support A&E departments as they approach their busiest time of year.

The warning comes after the figure for August's emergency department waiting times was the worst ever recorded for that month, with just under a third of patients waiting longer than four hours to be seen.

The government target that 95% of patients should be admitted, transferred or discharged from an emergency department within four hours has not been met since summer 2021.

Dr John Paul Loughrey, vice president for Scotland of the RCEM, told BBC Scotland News that the Scottish government’s plans for the NHS this winter would not improve the experience of staff or patients.

He accused the Scottish government of "continuing to disregard" the urgent need to keep patients moving through the hospital system to stop them getting stuck in A&E.

We are seeing lots of discussion, but we haven’t seen any useful measures so far that will make it any better for people working in A&Es this winter," he said.

Dr Loughrey added that every day recently had been like "the winter crisis of winters before, but every day".

"Sometimes giving safe care can be a challenge in every A&E in Scotland," he said.

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Source: BBC News, 3 October 2024

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Work-to-rule punishes patients, Streeting tells GPs

The health secretary has urged GPs in England to end collective action and warn it will "only punish patients" in a speech on Friday.

Addressing the Royal College of GPs conference in Liverpool, Wes Streeting said he understands why doctors "wanted to give the previous government a kicking".

But he asked them not to "shut your doors to patients" and instead "work with us to rebuild the NHS together".

GPs voted to work-to-rule in a ballot conducted by the British Medical Association (BMA) in August, with 98.3% of the 8,500 GPS who took part in favour of taking collective action.

Following the ballot, the BMA recommended 10 protocols for surgeries to action, including limiting the number of patients seen by a doctor each day to 25 and being able to stop work when they are not contracted to do so.

NHS England warned the action could not only disrupt GP services, but also affect A&E waits and delay referrals for treatments such as knee and hip operations.

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Source: BBC News, 4 October 2024

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ICBs told to fix ‘substantial gaps’ in whistleblowing support

Integrated care boards have been told to rectify the “substantial gaps” in reporting through Freedom to Speak Up in primary care.

While numbers of “freedom to speak up” whistleblowing reports from staff in primary care are “improving”, they remain “relatively low”, NHS England said.

This is largely because “routes to escalate concerns are more limited than in secondary care, with risks to individual confidentiality due to the size of some providers,” Sir Andrew Morris, deputy chair of NHSE, said in a letter to ICBs this week.

He asked ICBs to ensure primary care workers are aware of and have access to “speaking up routes”, in order to support the primary care patient safety strategy published last week.

Primary care staff should be able to reach an FTSU guardian, the letter said. NHSE said there are “relatively very few trained and registered Freedom to Speak Up guardians that support primary care workers” and that even where guardians are in place, levels of speaking up “remain extremely low”.

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Source: HSJ, 3 October 2024

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Trust to limit ‘non-essential’ CT scans as deficit rises

A Yorkshire acute trust is reviewing its use of diagnostic scans with a view to “limiting non-essential procedures” as it tries to bring down its deficit, according to internal messages sent to staff.

The message, sent to staff and seen by HSJ, says: “The trust should identify ways to reduce spending on clinical supplies. Reviewing diagnostic usage and limiting non-essential procedures, such as CT scans, would significantly cut costs.”

A spokesman stressed the message also said “financial targets should never come at the expense of patient safety and quality care”.

Katharine Halliday, president of the Royal College of Radiologists, told HSJ that scans were “certainly not the area to target for cost savings.”

She added that demand for diagnostics was being pushed up by the introduction of new tests and treatments, patient and staff expectations, and anxieties over litigation.

Dr Halliday said: “For instance, in the case of strokes, options were once limited, but now effective management begins with accurate imaging.

“Early diagnostic tests are essential in identifying patients who can be safely discharged, benefiting both patients and alleviating pressure on hospital beds.

“… Although not every diagnostic test is necessary, using CT scans where appropriate leads to faster, improved treatments and more efficient hospital operations. This is certainly not the area to target for cost savings.”

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Source: HSJ, 3 October 2024

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Sickle cell drug is withdrawn over safety concerns just months after rollout

The sickle cell treatment voxelotor (Oxbryta) has been withdrawn from all markets by the manufacturer Pfizer after a “higher than anticipated” number of deaths were reported and clinical evidence showed that the drug’s benefits no longer outweighed the risks.

In a recall notice issued on 30 September the UK Medicines and Healthcare Products Regulatory Agency (MHRA) told clinicians and patients that “emerging data” suggested an “unfavourable imbalance in vaso-occlusive crises (acute painful crises) and fatal events (deaths)” in patients treated with the drug.

The agency shared a letter from Pfizer with UK healthcare professionals, which said that all patients currently having voxelotor prescribed must be contacted and advised to discontinue treatment and, where appropriate, discuss alternative treatment options. Patients should be instructed to return the product to the hospital pharmacy or homecare company that dispensed it.

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Source: BMJ, 1 October 2024

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Grieving mothers who have lost babies have to wait six weeks for mental health help to start, says report

Women experiencing trauma after birth and baby loss are waiting an average of six weeks – four weeks longer than they should – to be assessed by specialist mental health teams according to a new survey by the Maternal Mental Health Alliance.

More broadly, mothers are facing year-long waits for general mental health care as a lack of funding leaves “patchy” services throughout the country, the study said.

The charity has published a report highlighting the postcode lottery facing women who need maternal mental health support.

Data from 41 maternal mental health teams in England also found the average waiting time for one-to-one therapy following an assessment is 16 weeks. However, waits across the country varied from 0 to 12 months.

Providing maternal mental health services to all areas of the country was a core target within the NHS’s long-term plan, published in 2019. These services offer a range of help to women including those who have suffered trauma after birth.

Although most areas of the country have a team, access to services is varied according to the MMHA.

Dr Camilla Rosan, Chair of the Faculty of Perinatal Psychology at the British Psychological Society, said while there has been progress, “women and birthing people are still left waiting for months and months, still jumping through hoops and leaping over mountains to get to the evidence-based care they need and deserve. All the while their symptoms are worsening.

“This is time they don’t have – parents and babies simply can’t wait...”

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Source: The Independent, 2 October 2024

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NHS England to screen 100,000 babies for more than 200 genetic conditions

The NHS in England is to screen 100,000 newborn babies for more than 200 genetic conditions in a world-first scheme aimed at bolstering early diagnosis and treatment.

All new parents are currently offered a blood spot test for their babies, normally when the child is five days old, to check whether they have any of nine rare but serious conditions. The newborn’s heel is pricked to collect a few drops of blood on a card that is sent away to be tested.

Now, as part of a large-scale research study, 100,000 newborns will be offered much more advanced tests of the whole genome sequencing using blood samples typically taken from the umbilical cord shortly after birth.

“Diagnosing rare conditions in newborn babies at the earliest opportunity through genomic testing could be truly life-changing for families,” said Amanda Pritchard, the chief executive of NHS England.

“It has the potential to give thousands of children the chance to access the right treatment at the right time, giving them the best possible start to life, and for families to better plan for their care.”

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Source: The Guardian, 3 October 2024

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The places with the worst GP shortages revealed

Shortages of doctors mean the average GP in England has to care for 17% more patients than nine years ago, a BBC analysis shows.

It means for every permanent GP there are more than 2,300 patients - a jump of nearly 350 since 2015, helping explain why access to general practice has been worsening and patient satisfaction declining.

The analysis of NHS data also shows the areas struggling the most have list sizes exceeding 3,000 patients, nearly double those with the most doctors. Experts said the variation was "unwarranted" and put patients' health at risk.

The government said it was developing plans to train more doctors and relieve some of the pressure by giving pharmacists more responsibilities.

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Source: BBC News, 2 October 2024

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NHS boss calls out ‘predator’ surgeon who harassed junior female medics

A top NHS boss has called out a “predatory” surgeon who was sanctioned by regulators for sexually harassing colleagues and trainees.

Amanda Pritchard, NHS England chief executive, has condemned the “appalling behaviour” of Oxford University Hospital-based surgeon Mr James Gilbert, who was found to have sexually harassed four female colleagues.

She also announced the NHS is working on a national sexual misconduct policy which will provide workers with a route to report anonymous incidents and gain access to independent investigators.

Mr Gilbert was sanctioned by a medical practitioners tribunal service (MPTS) panel this year with an eight-month suspension. Since then the General Medical Council (GMC), which regulates doctors in the UK, has launched an appeal against the MPTS decision, calling for a harsher sanction.

In a tweet on Sunday night, Ms Pritchard quoted a story detailing Mr Gilbert’s wrongdoing and said: “Appalling predatory behaviour should never happen in our NHS – in settings that are supposed to be compassionate, caring and safe.

“To put it simply, sexual predators should never be allowed to work in the NHS. People who treat our colleagues that way should not be allowed to treat patients.”

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Source: The Independent, 1 October 2024

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Hospital staff broke man’s arm while restraining him and then left him ‘untreated for 24 hours’

A private healthcare provider has agreed to pay damages to a patient with learning disabilities after staff broke his arm, The Independent can reveal.

Cygnet Health Care, one of the largest providers of mental health inpatient care in the UK, has settled a claim with the former patient of a hospital it now owns.

Jamie Newcombe, a 29-year-old young autistic man with learning disabilities, took action against the healthcare giant after he allegedly suffered “significant physical and psychological harm” at Bostall House assessment and treatment unit in London.

He claimed he had been “violently restrained by staff and pushed out into the hospital garden” in 2014, at the age of 19. At the time, the hospital was owned by another private company The Danshell Group.

As a result of this restraint, he says he sustained a fracture in his right arm and staff allegedly left his injuries untreated for 24 hours.

He said he suffered further physical assaults in December 2014 and January 2015, that he was subjected to “degrading treatment” such as personal care being ignored, and was denied access to hot running water for three weeks.

Following his experience, his mother Julie Newcombe launched an autism and learning disability rights campaign group, called Rightful Lives, which now has hundreds of members.

She told The Independent: “What happened to Jamie was horrific and is still happening to so many others 10 years later. I co-founded Rightful Lives 6 years ago to shine a light on the human rights of autistic people and people with learning disabilities. Yet the fact remains that if Jamie were to go into one of these units again, the same things could happen. That is our fear.”

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Source: The Independent, 2 October 2024

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Targeted support could reduce infant mortality gap across England, study finds

A study published in The Lancet Regional Health Europe has identified four key factors that together account for more than one-third of the inequalities in infant deaths between the most and least deprived areas of England.

Researchers say targeted interventions to address these factors – teenage pregnancy, maternal depression, preterm birth and smoking during pregnancy – could go a significant way to reduce inequalities, although higher-level structural changes to address socioeconomic inequality will also be necessary.

The UK currently ranks 10th out of 38 OECD countries for infant mortality (deaths in children under the age of one), with four deaths recorded per 1,000 live births.

Children born to mothers who are poor, black or young are known to be at increased risk, but where children are born also matters: according to ONS data for 2022, the mortality rate for infants in the most deprived 10% of England was almost three times higher than for infants living in the least deprived 10%.

“The inequality in infant mortality is at an alarming level,” said Dr Frederick Ho at the University of Glasgow’s School of Health, who led the study. “We also know that infant mortality is an indicator of more general effectiveness in the healthcare system. We wanted to understand the reasons for this inequality, as this could have policy implications for whether we could use the healthcare system to reduce or to eliminate it.”

The study, published in The Lancet Regional Health Europe, found that infants in the most deprived areas had double the mortality rate of those in the least deprived areas during the study period, and identified four factors – preterm birth, smoking during pregnancy, teenage pregnancy, and maternal depression – which collectively accounted for 38% of this inequality.

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Covid inquiry told how putting on PPE delayed treatment of dying patients

Dying patients experienced vital delays in being treated by paramedics because of the time it took ambulance crews to put on protective personal equipment, the Covid inquiry has been told.

An ambulance technician, Mark Tilley, came close to tears on Tuesday as he described how the experience still “played on his mind”.

Ambulance crews had been told they could not put on PPE before arriving at the scene and had to wait to put on plastic Tyvek suits and protective hoods or masks.

Tilley told the inquiry that the delays could cost crews vital minutes before they were able to start treatment. “We could have actually been at the patient’s side a minute, minute and a half quicker in those really most serious cases,” he said.

“Turning up at people’s houses where someone was unfortunately dead inside the front window or just on the pathway up to their property … I would have normally gone over and started bouncing up and down on their chest [to perform CPR], but we went and got our masks and suits on, and all of that – that plays on my mind all the time.”

Tilley, an ambulance technician at South East Coast ambulance service who was giving evidence as a representative of the GMB union, also described how the inadequate PPE made him consider making his own protective equipment.

Aprons were so poorly made and in such short supply, he said, that “we seriously considered using bin bags and literally cutting a hole in them, because that way they wouldn’t blow up in front of your face” when outside.

In addition to flimsy aprons, protective gloves were out of date, “really cheap and nasty”, and ripped and tore easily.

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Source: The Guardian, 1 October 2024

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The trusts struggling most with delayed discharge ‘interface’ problems

The trusts struggling most on the number of delayed discharges caused by so-called “interface issues” between acute and other care services – mostly negotiations over care packages – are revealed by a new dataset.

HSJ has analysed the first three months’ worth of data from a new NHS England dataset which for the first time breaks down the causes of delayed discharges for patients in acute hospitals for 14 days or more.

At more than 20 trusts the majority of delayed discharges were caused by “interface issues”, referring to NHS trusts and system partners spending too long “brokering or discussing” patients’ onward care.

King’s Fund assistant policy director Alex Baylis said interactions between acute hospitals, other trusts and councils on discharges can vary by area and warned the relationships between some providers “lacks depth”.

Mr Baylis, who co-authored research on delayed discharges last year, added: “In some places they create this narrative that they are working together but when you scratch the surface there’s not the depth that’s needed.

“In research, our perception was some people had learned an acceptable vocabulary about working together but don’t necessarily have the same shared commitment behind that.”

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Source: HSJ, 2 October 2024

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USA: How Mass General Brigham built the largest 'hospital at home'

Mass General Brigham in the USA has built the biggest hospital-at-home programme in the country by getting buy-in from leadership and clinicians and through tech partnerships, executives said at a recent conference.

The health system now has a capacity for acute hospital care at home of 70 patients, and is currently treating about 50 to 60 a day. The goal is to move to 10% of Mass General Brigham's overall capacity, or about 200 to 300 patients.

"I'm really thrilled we are the largest home hospital in the country," Mass General Brigham President and CEO Anne Klibanski, MD, said at the health system's World Medical Innovation Forum in Everett, Mass.

She cited the programme as a way the health system could stay afloat and thrive amid financial challenges affecting the industry, with lower costs and better outcomes for patients at home. She also said it's a benefit of partnering with tech companies; Best Buy Health provides the in-home technology. "That's what they do. They bring technology into the home," she said. "That's what they're known for."

The programme, which Mass General Brigham calls Home Hospital, typically treats patients with conditions like COPD flare-ups, heart failure exacerbations, acute infections and complex cellulitis.

"It's not typically comfortable to be cared for in the emergency room," Dr. Britton said at the conference.

Heather O'Sullivan, APRN, president of Mass General Brigham Healthcare at Home, said it's been estimated that 30% of inpatient care will move to the home in the next five years, representing $82 billion in revenue. "This is a tremendous opportunity," she said at the panel.

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Source: Becker's Health IT, 27 September 2024

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