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Trans people in England missing out on vital cancer screening, experts warn

Thousands of transgender patients in England are missing out on vital cancer screening because of the way their GP records are drawn up, experts have warned.

Everyone registered as female with their GP is automatically invited to breast screening from the age of 50 to 70, and to regular cervical screenings from 25 to 64.

But warnings from experts at the World Cancer Congress in Geneva this week, underscored by official NHS guidance, show that many trans patients are not invited to undergo the tests.

In England, trans men who were registered female at birth and have changed the gender on their patient record to male are not offered breast or cervical screening, regardless of whether they have had chest reconstruction or a hysterectomy.

Trans women who are still registered male with their GP are also not offered routine breast screening, even if they have been on longterm hormone therapy, which puts them at added risk of breast cancer.

Experts say the problem is the way GP electronic records in England are updated when patients change their gender.

NHS England stipulates that when a patient changes their registered gender, they are given a new NHS number and must be registered as a new patient at their GP practice. All their previous medical history is transferred into their new medical record and their previous name, sex at birth, any other gender-specific terms and old NHS number are removed.

Because the breast and cervical screening programmes use patients’ current gender to generate appointment invitations, many trans patients are missing out.

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Source: The Guardian, 19 September 2024

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High-grade masks evidence weak, Covid inquiry told

There is only “weak evidence” that high-grade face masks better protected health workers than surgical ones in the pandemic, the Covid inquiry has been told.

Prof Susan Hopkins, chief medical adviser at the UK Health Security Agency (UKHSA), said respirator masks – known as FFP3s – may have performed no better than thin surgical masks in real-life situations.

She said there could be “significant harms” from wearing tight-fitting FFP3s, including blisters and breathing difficulties.

“If the evidence was strong that FFP3s really protected people, and we saw a definitive reduction [in infections], they would have been recommended,” she said.

National guidance on face masks from April 2020 was drawn up by a group of experts from across the United Kingdom known as the IP (Infection Prevention) Cell.

The inquiry was shown minutes from an IP Cell meeting on 22 December 2020, just after the new Alpha variant of Covid had been detected, which appeared to show disagreement about the use of higher-grade FFP3 masks.

The records quote Dr Colin Brown, now the deputy director of clinical and emerging infections at UKHSA but at the time with PHE, as saying: "Our understanding of aerosol transmission has changed. A precautionary approach to move to FFP3 masks [in all healthcare settings] whilst we are awaiting evidence should be advised."

However, the wider IP Cell decided that no upgrading of the guidance was warranted at the time, and NHS trusts were told to continue to supply staff with standard surgical masks in almost all cases outside intensive care.

It was not until January 2022 that the advice changed, saying that FFP3 respirators "must be worn" by all staff if they are caring for patients with a virus such as Covid, and should be offered to other staff depending on a risk assessment.

By that point, the World Health Organization, and other health bodies, had recognised Covid could be spread in tiny airborne particles over distances longer than 6.5ft (2m), something officials said was impossible at the start of the pandemic.

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Source: BBC News, 19 September 2024

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NHS consultant wins £90k after bosses ‘turned blind eye’ to 13-hour shifts

An NHS consultant has been awarded almost £90,000 in compensation after working “extremely long hours” at a mental health trust that she claimed was on its knees.

Dr Pippa Stallworthy, a consultant clinical psychologist, worked between 11 and 13 hours every day for eight months, which she described as “neither sustainable nor safe”, before her resignation in November 2019.

From 2009 she had been the clinical lead for the Traumatic Stress Service at South West London & St George’s Mental Health NHS Trust, which assessed and treated vulnerable patients with complex post-traumatic stress disorder arising from a traumatic event in adulthood.

An employment tribunal was told that referrals to the unit increased by about 35% in early 2019, putting the small team under strain.

Stallworthy felt “totally unsupported” by bosses after requesting more help and resigned after numerous warnings that patients were at risk, the hearing in Croydon was told.

In her resignation letter, she said she had lost all “trust and confidence” in managers, accusing them of failing to address her safety concerns and “neglect” in making sure there were enough doctors.

“In my opinion the fact that both I and the service are on our knees is largely due to systematic management failure,” she wrote.

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Source: The Times, 18 September 2024

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Sepsis errors caused 'preventable' death of girl

The death of a three-year-old girl could have been prevented if hospital staff had followed sepsis guidelines, a coroner ruled.

Zadie Ajetunmobi was taken to Broomfield Hospital, Essex, with a temperature of 40 degrees (104F) on 10 November 2022.

She died less than 10 hours later after suffering a cardiac arrest, with post-mortem tests showing her death was from complications associated with sepsis.

Senior coroner Lincoln Brookes said if staff had adhered to the sepsis pathway immediately, "her death would likely have been prevented".

In a later report provided to the family by the Mid and South Essex NHS Foundation Trust, it was disclosed that staff had failed to update local sepsis guidance since 2017.

Zadie's parents, Theo and Rhiannon, said that if the correct procedure had been followed, she would have had a potentially life-saving dose of intravenous antibiotics.

Instead, the medicine was not administered for more than seven hours following her arrival, an inquest at Essex Coroner's Court heard.

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Source: BBC News, 19 September 2024

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'Like ripping my insides' - fears hysteroscopy guidelines not enough

Wendy McLean was due to start her seventh round of IVF when her doctor said she needed a hysteroscopy – a procedure to examine the inside of her uterus.

“It was sold to me as a smear test, basically. A thin narrow camera up through your cervix.

"It’ll take minutes. You won’t need pain relief. You’ll be absolutely fine,” she said.

Wendy, 38, took over-the-counter pain killers before the outpatient procedure at Aberdeen Royal Infirmary in case it was uncomfortable, but this did not prepare her for what happened.

“It felt like getting a hot poker, like getting my insides ripped out. I think I described it to somebody before as like being clawed, like sharp nails, just ripping at my insides.”

Wendy said she lost consciousness twice, vomited and asked for the procedure to be stopped.

It was only when searching online she discovered thousands of other women had had similar experiences of painful hysteroscopies without anaesthetic.

According to the Royal College of Obstetricians and Gynaecologists (RCOG), a third of those undergoing a hysteroscopy report pain levels of seven or above out of 10.

It says patients should be offered local or general anaesthesia for the procedure and their medical history should be taken into account, including trauma or difficulty with smear tests.

But despite RCOG producing new clinical guidelines promoting pain relief and choice, many women say they are not being offered it.

Dr Geeta Kumar, consultant gynaecologist and vice president of RCOG, said they had listened to patients’ concerns.

“Clear accurate written and verbal information must be provided, both at the time of referral, and at the procedure appointment,” she said.

“This will support a woman to make an informed choice, including whether they want to proceed with the procedure and if so, their preferences for treatment setting and pain relief options.”

Katharine Tylko, from the Campaign Against Painful Hysteroscopy, said: “It will have no impact whatsoever, apart from a few very conscientious and compassionate fighting-types of gynaecologist - young women who will say – ‘We want decent care for our patients.’

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Source: BBC News, 18 September 2024

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Poor NHS maternity care in danger of becoming normalised, regulator warns

Maternity services in England are so inadequate that cases of women receiving poor care and being harmed in childbirth are in danger of becoming “normalised”, the NHS regulator has said.

A Care Quality Commission (CQC) report based on inspections of 131 maternity units sets out an array of problems, adding to the sense of crisis that has enveloped an NHS service that cares for the 600,000 women a year who give birth and their babies.

The watchdog’s grim findings came as Wes Streeting, the health secretary, admitted he felt acute anxiety about “the risk of disaster greeting women in labour tomorrow”.

In its report, the CQC says problems in maternity care are so ingrained that:

  • Some women, frustrated at facing such long delays in being assessed at triage, discharge themselves before they are seen.
  • 65% of units are not safe for women to give birth in, 47% of trusts are rated as requiring improvement on safety and another 18% are rated as inadequate.
  • Some hospitals do not record incidents that have resulted in serious harm.
  • There is a widespread lack of staff and in some places a lack of potentially life-saving equipment.
  • Hospitals do not always consider women’s suffering after receiving poor care.

Nicola Wise, the CQC’s director of secondary and specialist care, said: “We cannot allow an acceptance of shortfalls that are not tolerated in other services.”

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Source: The Guardian, 19 September 2024

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NHS junior doctors to be known as resident doctors after job title change

Junior doctors working across the NHS will now be called resident doctors instead - in a change intended to better reflect their expertise.

The doctors union, the British Medical Association (BMA), which called for the change, called the term junior "infantilising and demeaning".

"Resident doctor" will refer to more than 50,000 qualified doctors working in GP practices and hospitals - some recently out of medical school and others with a decade of experience.

Health ministers say they have accepted the new name as part of a drive to "reset the relationship" between NHS doctors and the government.

The BMA says many of its members said the term "junior" was confusing and wrongly implied doctors were unqualified.

BMA member Dr Lily Huang, who works in London and specialises in ear, nose and throat surgery, has been a qualified doctor working in NHS hospitals for seven years.

"When I say, 'junior doctor', my friends and family interpret that to mean I am still at medical school.

"It takes a lot of explaining to say I'm still in training to be a consultant but am not a student."

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Source: BBC News, 18 September 2024

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Communication, resolution and apology programs gain momentum

A new patient safety measure from the Centers for Medicare and Medicaid Services brings renewed attention to the value of using a communication and resolution approach to meet the needs of patients and families after harm events. 

Acceptance of this approach has reached a “tipping point,” according to Melinda Van Niel, M.B.A., Betsy Lehman Center’s Program Director for CARe, which stands for Communication, Apology and Resolution. 

Communication and resolution programs (CRPs) such as CARe are expected to draw additional interest in Massachusetts and across the country, Van Niel says, after new expectations were set in a patient safety structural measure from CMS asking hospitals to attest to their investment in an “evidence-based communication and resolution program.”

CARe includes the elements CMS says should be part of a CRP: open and ongoing communication with patients and families; harm event investigation, prevention, and learning; clinician support; and appropriate resolution (financial and non-financial) for patients and families, she notes.

“In Massachusetts, CARe has reached a tipping point,” says Van Niel. “Most organizations know and accept that this is what they should do when something has gone wrong in a patient’s care,” she says.  “The next question is, ‘How do we do it?’” 

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Source: Betsy Lehman Center, 18 September 2024

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I’ll reject ‘status quo’ proposals, Streeting warns officials

Wes Streeting has warned NHS England and departmental officials he will reject any proposals “that suggest sticking with the status quo, or bids for more money without reform”.

The health and social care secretary was speaking alongside NHSE chief executive Amanda Pritchard at a joint briefing of NHSE and Department of Health and Social Care staff yesterday.

They both spoke about last week’s Darzi review findings and, in comments shared with HSJ, Mr Streeting said: “I want this report taken as gospel. Our response must be: to take it on the chin, pull up our sleeves, and begin the hard work of reform.”

It would be “major surgery, not sticking plasters”, he said, and told officials he wanted “bold, radical reform proposals”, warning he would “reject anything that suggests sticking with the status quo, or bids for more money without reform”.

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Source: HSJ, 17 September 2024

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Nurses bore the brunt of Covid, ex-chief nurse says

Nurses bore the brunt of the pandemic, with low staffing levels and difficulties accessing protective equipment, according to England’s former chief nurse.

Dame Ruth May told the Covid inquiry the NHS had been understaffed in 2020, in part because of the “catastrophic decision” to cut financial support for student nurses in 2015.

Resources had been "stretched", particularly in intensive care, she said, with a knock-on effect on the care some Covid patients received.

And she had been aware of widespread reports of problems supplying personal protective equipment (PPE) in March 2020, including a shortage of plastic gowns that had left front-line nurses living "in fear".

And she criticised a “catastrophic decision”, in 2015, to replace the grant or bursary paid to student midwives and nurses with loans.

It had led to reduction of about 5,700 trainees in England by 2020, Dame Ruth said, which “would have made a difference” in the pandemic.

“There would have been less burnout - there would have been less psychological impact,” she said.

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Source: BBC News, 17 September 2024

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One in five GPs use AI such as ChatGPT for daily tasks, survey finds

A fifth of GPs are using artificial intelligence (AI) tools such as ChatGPT to help with tasks such as writing letters for their patients after appointments, according to a survey.

The survey, published in the journal BMJ Health and Care Informatics, spoke to 1,006 GPs. They were asked whether they had ever used any form of AI chatbot in their clinical practice, such as ChatGPT, Bing AI or Google’s Gemini, and were then asked what they used these tools for.

One in five of the respondents said that they had used generative AI tools in their clinical practice and, of these, almost a third (29%) said that they had used them to generate documentation after patient appointments, while 28% said that they had used the tools to suggest a different diagnosis.

A quarter of respondents said they had used the AI tools to suggest treatment options for their patients. These AI tools, such as ChatGPT, work by generating a written answer to a question posed to the software.

The researchers said that the findings showed that “GPs may derive value from these tools, particularly with administrative tasks and to support clinical reasoning”.

However, the researchers went on to question whether these AI tools being used could risk harming and undermining patient privacy “since it is not clear how the internet companies behind generative AI use the information they gather”.

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Source: The Guardian, 17 September 2024

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UK facing ‘tsunami of missed cancers’ in wake of pandemic, experts say

The UK can expect a “tsunami of missed cancers”, leading experts have said, after an international study found that diagnoses fell sharply during the pandemic.

Preliminary figures from the International Cancer Benchmarking Partnership, presented to delegates at the World Cancer Congress in Geneva, compared data on the instance and stage of cancer diagnosis in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK, before and during the pandemic.

The results showed that UK nations had the biggest and most sustained falls in the diagnosis of lung, breast, colorectal and skin cancers during 2020. Particular data for Northern Ireland and Wales showed how badly they did compared with other countries studied.

While all countries reported a drop in cases diagnosed at the peak of the pandemic, most had caught up again within the year. In contrast, Wales and Northern Ireland still had not recovered their diagnosis rates by the end of 2020.

The study calculated that between April and July 2020, breast diagnoses dropped by 35% in Northern Ireland and Wales, compared with 24% in Norway and 14% in Denmark. For lung cancer, over the same time period the decline was 16% in Northern Ireland and Wales, compared with 10% in Norway or 1% in New Zealand.

For the most affected month, 44% of breast cancer cases and 30% of lung cancer cases were missed in Northern Ireland and Wales. There were also sharp declines in colorectal cancer diagnoses.

Cancer experts said that as a result of such large drops in diagnoses, they are expecting to see many more patients presenting with more advanced, late stage cancers.

“These data are a shocking wake-up call, providing the key evidence that the UK can expect a tsunami of missed cancers and a potential shift in stage that may lead to more aggressive cancers that are more difficult to treat,” said Mark Lawler, professor of digital health at Queen’s University Belfast and chair of the International Cancer Benchmarking Partnership. “And the fact we are still way off meeting the 62-day target to treat cancer can only compound the issue.”

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Source: The Guardian, 17 September 2024

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Letby managers: We weren’t slow to act

Former senior managers at the Countess of Chester Hospital have told the public inquiry into murders of babies that “given the information with which we were provided, we acted appropriately at the time”.

A joint written statement from the former chief executive, medical, nursing and HR directors at the Cheshire Hospital was published on Friday by the Thirwall Inquiry into the circumstances surrounding the deaths of seven newborn babies between 2015 and 2016.

Neonatal nurse Lucy Letby was convicted of seven counts of murder and seven of attempted murder in August 2023.

The statement set out the various steps the directors had taken after the spate of deaths came to light, including commissioning experts from the Royal College of Paediatrics and Child Health.

The management team has faced criticism that it was too slow to act in response to deaths on the unit, as it pushed back on concerns raised by clinicians about Letby.

But the four directors – former chief executive Tony Chambers, medical director Ian Harvey, nursing director Alison Kelly and HR director Susan Hodkinson – argued the RCPCH team had failed to pass on concerns.

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Source: HSJ, 18 September 2024

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Children’s hospital where staff ‘dragged patients across floor’ to close as parents warn of ‘brutal’ treatment

A hospital where staff allegedly physically abused patients is set to close as parents come forward describing the “brutal” treatment of their children, The Independent can reveal.

Joyce Parker Hospital, a children’s mental health unit run by Cygnet Health Care in Coventry, will shut following allegations by the national care watchdog, first highlighted by The Independent, that staff were found dragging patients across the floor.

Parents of children who are in the unit, whose care is NHS-funded, have been told this week that Cygnet Health Care intends to shut and reopen the hospital for adults just weeks later.

“From day one, it’s been really brutal,” said the mother of a teenage girl still in the hospital. “She [daughter] was covered in bruises. She was really distressed. I keep thinking this is my child, who is really unwell, and you trust people will look after her. She’s been pushed against walls, had her arms put around the back, she’s been put on the floor. My daughter is so much worse than she was when she got there.”

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Source: The Independent, 18 September 2024

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Man, 27, dies weeks after receiving Covid vaccine he was wrongly invited to take by NHS

A man who died three weeks after receiving the AstraZeneca Covid-19 jab was given the vaccine despite not being eligible, an independent investigation has found.

A probe into failings linked to the death of Jack Last, a young man who died in April 2021 from a blood clot linked to the Oxford-AstraZeneca jab, revealed the 27-year-old was wrongly called up early for the vaccine by his GP - and so, did not receive a jab deemed safer for under 30s.

The report found his death was “a consequence of a combination of system shortcomings, human error, and tragic unfortunate timing”.

His family have accused the NHS of a “litany of errors” that cost a “fit and healthy” young man his life.

They said: “Sharing the horrific ordeal that Jack was put through is something that must be done to highlight the litany of errors that have cost Jack his life…Jack died following days of agony, with immense internal damage throughout his body, bleeding and clots in his brain.”

These failures, according to the report, also included a “lack of urgency” in getting him a CT head scan treatment for possible blood clots and a misdiagnosis of his scan once it had been done.

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Source: The Independent, 18 September 2024

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IHI marks World Patient Safety Day with patient safety certification milestone and commitment to diagnostic excellence

For World Patient Safety Day, the Institute for Healthcare Improvement (IHI) is celebrating the milestone of 7,000 healthcare professionals who have earned the Certified Professional in Patient SafetyTM (CPPS) credential. Certification requires a combination of education, experience, and successful completion of the evidence-based certification exam. This includes more than 1,000 students, staff, and faculty from the University of North Texas Health Science Center’s Texas College of Osteopathic Medicine, which is the first medical education program in the world to incorporate the CPPS review course and exam as a required part of the curriculum.

“These are 7,000 health care professionals across the world who are changemakers in safety, and their expertise and commitment to safer care for all is saving lives each and every day,” said Patricia McGaffigan, RN, MS, CPPS, IHI Senior Advisor, Safety, and President of the Certification Board of Professionals in Patient Safety (CBPPS). “The impressive growth of the CPPS program in recent years has resulted in a larger, more diverse health care workforce with competencies in safety. This is concurrent with the call to action for health care leaders to use the National Action Plan to Advance Patient Safety Organizational Assessment Tool to identify opportunities to improve foundational areas for safety across many elements that are aligned with the new CMS Patient Safety Structure Measure that will take effect next year.”

The 7,000 certificants span clinical settings and include safety, quality, and risk managers and leaders, nurses, physicians, pharmacists, health care executives, medical students and residents, academic faculty, and many more clinical and non-clinical professionals. IHI offers scholarships that cover the full cost of the CPPS review course, practice exam, and CPPS exam. A full day CPPS review course will be held December 8 at the 2024 IHI Forum. Learn more about the full Forum agenda and how to register here.

In addition to the CPPS review course, the Forum’s Patient and Workforce Safety track offers nearly 20 unique sessions for onsite learners, including multiple workshops that align with the theme for this year’s World Patient Safety Day: “Improving diagnosis for patient safety.” IHI is steadfastly committed to diagnostic excellence and continues to advance this critical component of safe and effective care through educational offerings, fellowships, projects, and tools, including the Safer Dx Checklist: 10 High-Priority Practices for Diagnostic Excellence. 

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Junior doctors bring dispute to end by voting to accept Streeting’s pay offer

Junior doctors in England have voted to accept the government’s pay offer, bringing to an end one of the longest and bitterest disputes in recent NHS history.

Just under two-thirds (66%) of the 45,830 junior doctors who voted backed the deal, which will see them receiving an average salary increase of 22.3% over two years.

It ends 18 months of strikes during which junior doctors stopped work on 44 days – sometimes for five days at a time – causing huge disruption to the NHS.

The 22.3% increase was less than the 35% rise the British Medical Association’s junior doctors committee (JDC) had been seeking for the last two years as “full pay restoration” for the fall in their earnings they have experienced since 2008. But it proved enough to persuade a sizeable majority of that branch of the medical profession to call off their campaign of stoppages.

Danny Mortimer, the chief executive of NHS Employers, welcomed the news. “Health leaders will breathe a massive sigh of relief to know that the ongoing pay dispute between resident doctors and government has come to a successful resolution. The last thing our members wanted was the threat of more strikes over what is expected to be a very difficult winter,” he said.

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Source: Guardian, 16 September 2024

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Long Covid sufferer's call for better support

A doctor from Leeds who developed Long Covid and the debilitating effects of ME has said NHS patients like her have been “left to rot”.

Becky Williams, 34, first caught Covid in March 2020 and has been left house-bound ever since, with her symptoms including extreme fatigue, brain fog and pain.

Dr Williams, who said she had "lost my job, lost friends, lost my independence", has joined about 200 other healthcare workers who have signed a letter calling on the government to provide better support for patients with these conditions.

The Department of Health and Social Care said the government would “ensure patients receive the care they deserve”.

Dr Williams initially developed Long Covid, but for the past two years has also met the criteria for ME (myalgic encephalomyelitis), also known as chronic fatigue syndrome (CFS).

Often developing after an acute viral or bacterial infection from which people are unable to fully recover, ME has many overlapping features with Long Covid.

It is estimated at least 250,000 people in the UK have ME, which affects multiple systems within the body and which can lead to symptoms like fatigue and a flu-like malaise.

Dr Williams said she had signed a letter organised by campaign group #ThereforME calling on Health Secretary Wes Streeting to improve care.

The letter asked Mr Streeting and the government to acknowledge that gaps in NHS care for ME patients were leading to "serious patient safety concerns".

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Source: BBC News, 17 September 2024

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Cutting hospital staff won’t help productivity, says ICB chief

The leader of an integrated care board has dismissed a “narrative” that the NHS can become more productive by cutting hospital staff numbers.

West Yorkshire Integrated Care Board CEO Rob Webster said a whole “system response” was required to improve productivity. 

Mr Webster made his comments at HSJ’s Patient Safety Congress in Manchester after being asked what his message was to organisations facing increasing demands to cut spending and staffing numbers safely.

He said: “This narrative about ‘the NHS is not productive, there’s too many staff in hospitals, [and] therefore cut staff in hospitals, you’re more productive’, it’s not true.”

After the session on Monday, he told HSJ: “Just cutting staff in hospitals will not in itself make us more productive. There needs to be a system response that improves flow and has a strong focus on safety and quality.

“We also need a much more sophisticated plan for the future, with an eye on the medium term, where our hospitals are supported by all partners to be productive and where people themselves are much better supported in communities.”

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Source: HSJ, 17 September 2024

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Trusts told to report harm from ‘unacceptable’ corridor care

NHS England has told trusts to monitor patient harm caused by corridor care this winter – admitting it is happening regularly in some areas despite being “unacceptable”.

NHSE today issued new guidance for the use of “temporary escalation spaces”, including corridors and other “unplanned settings”, even though it says the practice “is not acceptable and should not be considered as standard”.

Last winter trusts were sometimes tacitly encouraged to use corridor space, and to squeeze additional patients onto already-full wards, in order to reduce crowding in emergency departments, and release queuing ambulances — which in turn often leads to very long waits for emergency ambulances.

But in June, a Channel 4 documentary showed scenes of patients being neglected in corridors in the Royal Shrewsbury Hospital, bringing a lot of attention to the issue, and NHSE subsequently said corridor care “must not be considered the norm”. The Royal College of Nursing said it should be a “never event”.

Today’s NHSE guidance warns some trusts are using such spaces more regularly than they should be due to “the current healthcare landscape”, and admitted “this use is no longer in extremis”.

The guidance – setting out “principles for providing safe and good quality care” in corridors and other “unplanned” spaces – has been published along with NHSE’s annual letter setting priorities for the coming winter.

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Source: HSJ, 16 September 2024

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£10bn NHS medtech spend undermined by ‘lack of data’, warns DHSC director

The lack of information about the performance and value for money of medtech products is leading to ineffective procurement and wasting scarce NHS funding, a senior government official has told HSJ.

The Department of Health and Social Care’s MedTech director David Lawson told a roundtable organised by HSJ this month that “unwarranted variation” in the procurement process was “tying up funding that could otherwise be deployed to adopt and accelerate the use of the most effective medtech”.

The NHS spends around £10bn each year on medical technology according to government estimates.

Mr Lawson blamed the “variation” on the “lack of information” about the medtech products that would let “decision makers at a local level… make informed, evidence-based decisions.”

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Source: HSJ, 16 September 2024

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Inside an NHS ‘barn theatre’ with four operations done at once

Music from the Spice Girls is blaring out from speakers as the surgeon Paddy Subramanian grabs a bone saw and gets to work on Jacqueline Carby’s left knee. The 78-year-old is one of four patients being operated on side by side in the same room at an NHS hospital in north London.

Each of the four operating zones in the vast “barn theatre” is a hive of activity; with half a dozen staff in scrubs buzzing around the foot of each bed, hovering over trays holding an array of surgical tools required to perform routine knee and hip replacements. The surgeons’ soundtrack of choice — jaunty Nineties pop tunes — is punctuated only by the noise of drills, saws and of metal hammering away at bone.

The pioneering barn theatre complex at Chase Farm Hospital, part of the Royal Free London NHS Foundation Trust, has been designed to ensure doctors get through as many operations as possible, as quickly and safely as possible. In a week when a report by Lord Darzi criticised the lack of productivity in crumbling hospitals, it provides an example of the NHS at its most ruthlessly slick and efficient.

The large open-plan theatre equipped with cutting-edge air canopies that ensure infection cannot spread between the four beds. Compared with traditional single operating theatres it offers the crucial advantage of allowing consultant surgeons to supervise numerous operations at once.

Subramanian, a consultant orthopaedic surgeon at the hospital, said: “It is super efficient. There is no bed wasted, and no time wasted. We can do four hip replacements in the same room. One consultant can supervise two parallel operating tables. Communication and the sharing of expertise is key in surgery. Registrars [trainee surgeons] can stick their hand up and ask for help or a second opinion. It is much safer and better for patients and staff.”

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Source: The Times, 16 September 2024

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Trust claims ‘stressed’ staff are quitting over faulty IT system

An acute trust has claimed “experienced and dedicated staff” have quit their roles because of “the stress and anxiety caused by the instability” of its imaging IT system as its row with a private provider intensifies.

Gloucestershire Hospitals Foundation Trust said the picture archiving and communication system imaging software, provided by Philips, had caused “significant disruption” since its deployment in May 2023.

Trust CEO Kevin McNamara wrote in a highly critical report to the trust’s September board meeting that “the improvements we would reasonably expect from [the] supplier have not been delivered”.

As well as alleging the system’s failings were having a “serious impact” on care quality, the CEO claimed in the report that the disruption had meant “experienced and dedicated staff leaving the service and the trust due to the stress and anxiety caused by the instability of the system”.

He also alleged the trust had incurred “significant costs” due to additional staffing and outsourcing for its radiology service “to mitigate the impact of an unstable PACS system”.

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Source: HSJ, 16 September 2024

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Girl, 8, died of sepsis after GP sent her home due to ‘full hospital’

An eight-year-old girl died of sepsis hours after she was sent home by a GP who said that the local hospital was full and advised her mother to give her fluids and ibuprofen.

Mia Glynn visited a GP surgery twice in four days but her parents Soron, 39, and Katie, 37, were told to take her home, even though she displayed symptoms of group A strep.

Her parents, from Biddulph, Staffordshire, first took Mia to the doctor on 5 December 2022, after she had begun vomiting, had a severe headache and complained of a sore throat.

They returned to the surgery on 8 December after Mia, who hadn’t eaten properly for the past three days, had a raised heart rate, reduced urine output and was feeling sleepy.

The Glynns were told to take their daughter home because the hospital was full and they would have to wait in a corridor.

Mia slept in her parents’ bed that night but woke up in the early hours of 9 December, disorientated, with blue lips and rashes on her arms and legs. She complained of feeling hot but was cold to touch.

After being rushed to the hospital by an ambulance, she was given intravenous fluids and antibiotics, but went into suspected septic shock and suffered a cardiac arrest about 15 minutes after arriving. Despite attempts to resuscitate her, she died 20 minutes later. Her cause of death was given as sepsis caused by a group A strep infection.

Victoria Zinzan, a specialist medical negligence lawyer at Irwin Mitchell who is representing the couple, said: “Sadly through our work we see too many families affected by sepsis; with Mia’s death vividly highlighting the dangers of the condition. Early diagnosis and treatment is key to beating sepsis, therefore it’s vital people know what signs to look out for when it comes to detecting this incredibly dangerous and life-threatening condition.”

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Source: The Times, 15 September 2024

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Woman told she had blood cancer on eve of wedding as report reveals Black and Asian patients' diagnosis delays

Black and Asian blood cancer patients are four times more likely to face delays in diagnosis, an “alarming” new report has revealed.

Research from Blood Cancer UK, shared exclusively with The Independent, found 45% of people from ethnic minority communities said they have had to visit their GP three or more times before referral for testing.

Bansri Dhokia, 32, was diagnosed with T-cell acute lymphoblastic leukaemia in July 2020, on the eve of her wedding and during the height of the Covid-19 pandemic. But she only received the diagnosis after a number of false starts.

Speaking to The Independent, the former business analyst, whose illness has left her disabled, said she feels she wasn’t listened to enough and initially felt that her symptoms were dismissed.

“The delay in my diagnosis may have been because it was at the start of the Covid pandemic, so maybe my symptoms were harder to explain over the phone and it was difficult to get an in-person appointment,” Ms Dhokia said. “My heavy bleeding - which is a symptom of blood cancer - was explained by a heavy period, while the fatigue was explained by possible anaemia.”

Researchers are therefore calling for the NHS to launch a targeted monitoring programme for people at higher risk of developing blood cancer.

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Source: The Independent, 15 September 2024

The theme of this year's World Patient Safety Day is 'Improving diagnosis for patient safety'. Read some of the blogs we have published on the hub on safe diagnosis and the impact of delayed diagnosis:

 

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