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Campaign success as new NHS England programme launches to get medication delivered on time in hospital

Following years of relentless campaigning by Parkinson's UK, charities and their community, NHS England has committed to ensuring that time critical medication is delivered on time in hospitals as part of an exciting three-year Medicines Safety Improvement Programme.

People living with Parkinson’s need their medication on time. A delay of as little as 30 minutes can mean the difference between functioning well and being unable to move, walk, talk or swallow.

And it’s not just Parkinson’s. People living with conditions such as epilepsy and diabetes also need their medication on time. Otherwise, there could be severe implications for their health and wellbeing.

Last year, as part of the Get It On Time campaign, Parkinson's UK published Every Minute Counts report, which found that only 42% of people with Parkinson’s admitted to hospitals in England received their medication on time every time. 

At the same time as releasing the ‘Every Minute Counts’ report, Parkinson's UK released a joint statement with other charities whose communities rely on time critical medication and health professional bodies calling on the government to take action on this issue.

Following meetings with the National Medical Director of NHS England, an emergency summit on time critical medication, and tireless campaigning by the Parkinson’s community, Parkinson's UK are pleased to announce that NHS England has committed to a national improvement programme to tackle this problem.

The programme will run from 2024-2027 and is part of the National Patient Safety Strategy. It will address the most important causes of severe harm to patients. A key ambition of the programme will be to improve care for people by ensuring they receive the critical medication they need on time.

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Source: Parkinson's UK, 27 November 2024

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Structural racism leading to stark health inequalities in London, report shows

Structural racism is leading to stark health inequalities among people from some ethnic backgrounds in London, according to a review by one of the UK’s top public health experts.

More than half (52%) of black children and almost three-quarters (70%) of Bangladeshi and Pakistani children are growing up in relative poverty after housing costs in London, compared with a quarter (26%) of white children.

And unemployment among young black people aged between 16 and 24 is more than double that of white people the same age, the paper states. Gypsy, Roma and Irish Traveller young people have the highest rate, at 40%.

The review, conducted by the UCL Institute of Health Equity (IHE) led by Prof Sir Michael Marmot, found that people who are repeatedly exposed to structural racism during their daily lives experience worse physical and mental health as a direct consequence. It also says the ethnic inequalities in poverty, housing and employment result in poorer health outcomes for these ethnic groups.

It concluded that these economic inequalities, which can be attributed to structural racism, lead to poorer health outcomes for minority groups in London, as they are less likely to have access to decent housing, nutritious meals and other factors that affect a person’s health outcomes.

Marmot, the director of the IHE and author of a seminal review into health inequalities in the UK in 2010, said structural racism “is a scar on society” and public health institutions are failing by not directly addressing the effects racism has on a person’s health.

He added: “Focusing on disease and healthcare services fails to address three impacts of racism on health. First, how racism directly damages health and wellbeing. Second, the reasons why some ethnic groups are more likely to be in poverty, experience poor housing, suffer in the educational and criminal justice system, be low paid and experience racism and poor employment prospects – all of which harm health. Third, it does not deal with racism that leads to worse experiences of healthcare and other services and worse outcomes as a result.”

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Source: The Guardian, 1 October 2024

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Streeting considers reviving dedicated cancer strategy

Wes Streeting may revive the use of a dedicated cancer strategy to tackle the UK’s second biggest killer after experts warned the Conservatives’ scrapping of it was “a disaster” for patients.

The health secretary is considering publishing a new comprehensive plan for England, amid record numbers of people being diagnosed with the disease and NHS cancer services struggling to meet demand.

Previous Labour and Tory government published four cancer-specific action plans between 2000 and 2015 and they helped to bring about improvements in treatment, waiting times and survival.

However, in January last year Steve Barclay, then the health secretary, caused consternation among specialists in the disease and charities such as Cancer Research UK when he announced that plans to boost cancer care were being subsumed into a much wider-ranging major conditions strategy.

They warned that a disease that kills 167,000 people a year in the UK would not get the focus it merits when it was part of a document that also covered heart disease, mental illness, dementia, lung health and joint problems.

But Streeting – himself a kidney cancer survivor – is examining the case for once again publishing a specific plan that would address issues such as long waiting times for care, frontline cancer services’ lack of staff and how best to ensure patients can access emerging treatments.

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Source: The Guardian, 30 September 2024

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Call for independent review into physician associates

There needs to be an independent review of physician and anaesthesia associates (PAs and AAs) in England, the Academy of Medical Royal Colleges says.

The group, which brings together leading doctors and surgeons, has been broadly supportive of the rollout of these roles which assist health care teams.

But it said given the “increasingly acrimonious and destructive debate”, fuelled by some unsubstantiated comments on social media, it was important to look into claims around safety as the campaign against them was damaging teamwork.

The British Medical Association has voiced concerns PAs and AAs are being asked to do tasks they are not meant to and the lines with doctors are getting blurred.

The number of PAs and AAs have been gradually increasing since 2016. There are now more than 3,000 in England, but the NHS workforce plan has called for them to be increased to 12,000 by 2036.

The academy, which represents 24 medical royal colleges, said there has been a growing campaign against their use “potentially fuelled by unsubstantiated claims of social media”.

Chair Dr Jeanette Dickson said: “We want an independent, evidence-based, rapid review to help us make a decision about how best to delineate their roles and where they might best fit into the system.

“What’s important is that we can objectively assess the data around safety, efficiency and cost effectiveness and make a judgement about what precise roles in healthcare may be suitable for them and what levels of responsibility they might be safely given based on the actual evidence.”

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Source: BBC News, 30 September 2024

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DHSC to review clinical risk standards for digital health tech

The Department of Health and Social Care will launch a consultation on the clinical risk standards for the use of digital health technologies in 2024/2025, the minister for patient safety has confirmed.

In a letter to Patient Safety Learning, Baroness Gillian Merron said there will be a review of standards DCB0129 and DCB0160, which provide guidelines to help healthcare providers manage and mitigate risks associated with healthcare IT systems.

She wrote to the charity in response its report, ‘Electronic patient record systems: Putting patient safety at the heart of implementation’, published on 31 July 2024, which sets out “significant patient safety risks” relating to EPR rollouts in the NHS.

In a letter dated 17 September 2024, seen by Digital Health News, Baroness Merron said that clinical risk standards play a “crucial role” in patient safety when using EPRs.

“The standards, published in 2012, require organisations to ensure that clinical risk management is embedded in the deployment of EPRs and throughout the life cycle of the technology, including version upgrades.

“NHS England is responsible for ensuring the continued effectiveness of the clinical risk standards.

“A comprehensive review of both standards is planned for 2024/2025, which will involve a public consultation and wide stakeholder engagement,” Baroness Merron said.

Helen Hughes, chief executive of Patient Safety Learning, welcomed the forthcoming consultation, adding that it is “vital” that patient safety is at the core of EPR implementation.

“We welcome proposed steps by NHSE to undertake further analysis aimed at identifying new and under-recognised patient safety issues relating to EPR systems.

“Patient Safety Learning believes there must be transparency in reporting of unintended harm and that such insights lead to learning from EPR implementations, with action taken to directly support front line clinicians in their work and the delivery of safe care.

“It is also important that there are robust safety standards in digital health to keep apace with new technologies as they evolve.

“These standards should be accompanied by strong quality assurance and accountability mechanisms with patient safety at their core,” Hughes said.

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Source: Digital Health, 30 September 2024

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Lucy Letby: Experts tell BBC about medical evidence concerns

Senior doctors and scientists have told the BBC they have concerns about how crucial evidence was presented to the jury at Lucy Letby's trials.

The BBC’s File on 4 has examined how expert witnesses helped to build the case against the former nurse.

The programme raises concerns about how courts grapple with cases of significant medical complexity - with the juries in Letby’s two trials presented with huge amounts of complicated medical evidence relating to each child.

The experts who spoke to the BBC raise questions about the amount of insulin she needed to harm babies in her care, the health condition of one of the babies she was convicted of murdering, and pathology findings presented to the jury.

A public inquiry is under way to establish how Letby was able to murder and injure babies. At its opening Lady Justice Thirlwall was scathing about those who have questioned the verdicts, saying this was causing “enormous additional distress to the parents”.

Last month some of the families of the babies gave evidence at the inquiry.

Each of the experts interviewed by File on 4 acknowledge how difficult it must be for the families to hear doubts raised about the trials. However, they say they feel so strongly about the evidence they felt compelled to speak out.

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Source: BBC News, 1 October 2024

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NHS hearing units misdiagnosed thousands of children and ‘did nothing’

Watching from the side of the school playing field, Amy and Noel Denman were worried about Scarlet, their three-year-old daughter.

While other children ran around laughing, enjoying their first sports day at the Lincolnshire nursery school, Scarlet seemed vacant. When the teachers told her to run she stood still … then burst into tears.

Amy Denman now knows why her daughter was acting so strangely. Recalling that day six years ago, she is furious over how the NHS has failed her family.

Scarlet, she has learnt, is partially deaf. She could not understand what was happening or what was expected of her. She is one of thousands of children misdiagnosed by NHS audiology units across England.

Leaked internal documents from NHS England reveal a nationwide failure in child hearing services. They suggest that 1,540 children have been misdiagnosed since 2019. Some, like Scarlet, were given the all-clear when they had significant problems. Others were told they were deaf — but hearing aids could have helped them.

Some 480 children suffered moderate or severe harm, the papers say. For some infants this will mean permanent delays in speech and language development as well as their educational abilities.

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Source: The Times, 28 September 2024

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Man who killed himself in Blackpool hospital was badly failed, says mother

A 27-year-old man who killed himself in a hospital toilet after waiting nearly 24 hours to see a mental health professional was badly failed by the NHS, his mother has said.

Jamie Pearson was admitted to Blackpool Victoria hospital’s A&E department after taking an overdose of high-strength painkillers on 17 August.

His mother, Julie Knowles, said her son was left for hours in a “depressing” side room along with other patients, including one who was also suffering a mental health crisis.

Pearson, a self-employed joiner, had been experiencing paranoid delusions and was receiving treatment for acute psychosis when he was admitted to the hospital at about 7pm, Knowles said.

Knowles said “no one seemed to be doing anything” for her son, so she pleaded for him to be seen urgently by a mental health professional.

A nurse then “marched” over to Pearson and told him that he needed to finish his drip before he would be assessed, she said.

After nearly 24 hours in A&E, Pearson became more agitated and went to the toilet a number of times, his mother and the fellow patient said.

Then at about 6pm he went to the disabled toilet for a final time. He was found unresponsive by staff after Knowles called for help.

“If someone would’ve come to see him and say everything’s going to be alright that would’ve meant a lot to my son. But at no time did anyone come from the mental health team,” she said.

“He was in the right place. He wanted help. I know if he had been given some help he would’ve got better.”

Knowles said she was speaking out so that people suffering a mental health crisis would be treated with more urgency in A&E.

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Source: The Guardian, 29 September 2024

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Social workers in England begin using AI system to assist their work

Hundreds of social workers in England have begun using an artificial intelligence system that records conversations, drafts letters to doctors and proposes actions that human workers might not have considered.

Councils in Swindon, Barnet and Kingston are among seven now using the AI tool that sits on social workers’ phones to record and analyse face-to-face meetings. The Magic Notes AI tool writes almost instant summaries and suggests follow-up actions, including drafting letters to GPs. Two dozen more councils have or are piloting it.

By cutting the time social workers spend taking notes and filling out reports, the tool has the potential to save up to £2bn a year, claims Beam, the company behind the system that has recruited staff from Meta and Microsoft.

But the technology is also likely to raise concerns about how busy social workers weigh up actions proposed by the AI system, and how they decide whether to ignore a proposed action.

The British Association of Social Workers welcomed AI systems that free up time for face-to-face work, but said they “must never replace relationship-based social work practice and decision-making”.

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Source: The Guardian, 28 September 2024

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NHSE commissions rapid review of acute trusts’ EPR plans

Beverley Bryant, former director of digital transformation at NHS England, and joint chief digital information officer at Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS FT, is undertaking a rapid review of electronic patient record (EPR) plans at nine acute NHS trusts.

The eight-week review, commissioned by John Quinn, chief information officer at NHSE, is intended to share lessons to help the trusts, which are at various stages of EPR journeys, ranging from business case development to planning for implementation.

The review started in September 2024, with a letter sent to the chief executives of the respective trusts by Quinn and Vin Diwakar, director of the NHSE Transformation Directorate.

Quinn told Digital Health News: “Beverley Bryant is supporting NHS England’s frontline digitisation programme to help a number of acute trusts, who are at varying stages of their EPR journey, to overcome any barriers to the successful delivery of their EPR strategies".

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Source: Digital Health, 26 September 2024

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‘NHS is letting sickle cell patients down’ say parents of 22-year-old who died after hospital failings

Life will never be the same for Leila and Errol after the death of their 22-year-old son Darnell, who lived with disabilities including sickle cell disease.

Darnell Smith died on 23 November 2022 after medics took his vital signs just once in 12 hours instead of the prescribed hourly checks.

Earlier this year, a coroner called on health bosses at Royal Hallamshire Hospital in Sheffield to take action to prevent future deaths.

Darnell, from Sheffield, received regular treatment for cerebral palsy and sickle cell disease, which is an inherited, long-term and potentially life-threatening condition, most common among Black people. It affects about 15,000 in England.

As the UK observes Sickle Cell Awareness month in September, Leila and Errol say they do not feel the inquest’s ruling went far enough.

“What we would like is more accountability from the NHS and the members of staff who were working that day,” Errol said.

They say his case reflects the failures of care experienced by patients with sickle cell.

“I feel like there’s still a lot of injustice still being done, not just because of what happened to Darnell but also to other sickle cell patients within hospital settings all over England. It’s not just in Sheffield,” Leila said.

“There’s a lot of systematic racism, a lot of discrimination, whether it’s blatant, it’s there. We felt it, we saw it and I said that in the inquest.”

A 2021 all-party parliamentary group (APPG) on sickle cell and thalassaemia inquiry into sickle cell care found “serious care failings” in acute services and evidence of attitudes underpinned by racism.

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Source: The Independent, 28 September 2024

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Surgeons urge Wes Streeting to act on medical schools’ failure to tackle sexual assault

A group of surgeons have urged Wes Streeting to intervene over claims medical schools are failing to tackle sexual assault and harassment of students.

Surviving in Scrubs, a campaign group representing doctors who’ve faced sexual violence in medicine, has called on the health secretary to force dozens of medical schools to commit to new NHS standards for tackling sexual assault and harassment.

In a letter to the health secretary, Surviving in Scrubs co-founders Dr Becky Cox & Dr Chelcie Jewitt warned medical students were particularly vulnerable to suffering sexual violence but that medical schools had not committed to the NHS’ sexual safety charter.

Last year NHS England published a new charter on how to handle sexual assault concerns and how to better protect staff. Hospitals nationwide were told by the NHS England chief executive Amanda Pritchard that they must sign up for this charter earlier this year.

In July The Independent revealed a warning from Surviving in Scrubs that just three out of 36 medical schools had signed up.

In their letter to the Mr Streeting the campaign group said: “Medical students are particularly vulnerable to sexual misconduct. Their lower professional status places them at the lower end of a power imbalance that facilitates sexual misconduct and discourages victims from reporting. The testimonies we receive detail students being sexually harassed and sexually assaulted whilst on clinical placement by senior doctors...

“We urgently ask for your support to engage medical schools to address sexism and sexual violence affecting their students. We request to meet with you to discuss this issue and hope we can work collaboratively to find meaningful solutions.”

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Source: The Independent, 30 September 2024

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NHS warns of 18,000 flu deaths since 2022 as it urges vaccination uptake

At least 18,000 deaths in England were associated with flu over the past two winters, figures have revealed, as health experts urge those eligible to take up a free vaccination on the NHS.

The figures from the UK Health Security Agency (UKHSA) cover the period from October to May in 2022-2023 and 2023-2024. Over the same timeframe UKHSA estimates a little more than 19,500 deaths were associated with Covid.

Steve Russell, the NHS national director for vaccinations and screening, said:

“Today’s data showing there were almost 20,000 deaths associated to flu over the past two winters is a shocking reminder that this is a seriously dangerous virus, and I urge those who are eligible to book their vaccine appointment as soon as they can as it is our best way of protecting those who are vulnerable as winter approaches.”

UKHSA said uptake of the flu vaccine fell last winter compared with the year before across all eligible groups, including the very young, elderly people and pregnant women. Among people aged six months to 65 years with one or more long-term health condition uptake declined from 49.1% in the winter of 2022-2023 to 41.4% in the winter of 2023-2024.

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Source: The Guardian, 30 September 2024

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Staff ‘rebuked’ for raising safety concerns despite patient deaths

Staff were ‘rebuked’ for raising safety concerns at a trust where the incorrect use of chemotherapy has been linked to patient deaths, HSJ has discovered.

In 2020, East and North Hertfordshire Trust identified higher-than-expected mortality rates among its ovarian cancer patients. An external review, obtained by HSJ, found chemotherapy may have contributed to the deaths of four patients in 2019 and 2020 whose comorbidities had not been adequately considered.

The serious incident investigation was undertaken by a team from specialist cancer trust The Christie. This identified issues including a “reluctance of staff to escalate safety concerns” and “poor consideration” of patient fitness levels in pre-treatment assessments.

The review said: “Many clinical decisions were driven from a senior individual member of the team, rather than a team-based decision-making model.”

“Some members of the MDT [multidisciplinary team] did not feel empowered to escalate issues around SACT [systemic anticancer therapy] assessments, with some staff stating that they felt that they were rebuked for escalating out-of-range blood test results.”

The review said decisions over treatment were not driven by protocol or multidisciplinary team input as part of general practice.

It added: “In the absence of a psychologically safe working environment, over time the above described behaviours became embedded in practice and were therefore less likely to be challenged.”

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Source: HSJ, 27 September 2024

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I won't back down on broken NHS claims - Streeting

Wes Streeting says he will not back down in his criticism of the NHS, after the BBC revealed there was growing unease in the service about the "broken" NHS messaging from government.

England's health secretary told the Labour Party conference that not acknowledging the problems in the NHS would result in "killing it with kindness".

His comments came after senior sources in the health service said they believe some of the claims have gone too far - and may result in patients being put off seeking help and causing lasting damage to staff morale.

In recent weeks, the government has claimed cancer is a "death sentence" because of NHS failings, while maternity services "shame" the nation.

Streeting told delegates in Liverpool: "I know the doctor's diagnosis can sometimes be hard to hear.

"But if you don't have an accurate diagnosis, you won't provide the correct prescription.

"And when you put protecting the reputation of the NHS above protecting patients, you're not helping the NHS, you're killing it with kindness.

"I won't back down. The NHS is broken, but it's not beaten, and together we will turn it around," Mr Streeting said.

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Source: BBC News, 25 September 2024

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NHS bosses reject calls for specialist ME care

NHS bosses have rejected pleas for specialist care for people with severe myalgic encephalomyelitis despite promises from a health minister to tackle the lack of provision.

The recent inquest into the death of Maeve Boothby-O’Neill, 27, whose case exposed failings in the treatment of patients with severe ME, led to a minister’s declaration she had fallen through the cracks.

Andrew Gwynne, the minister for public health and prevention, pledged in August to boost research, improve attitudes and “better the lives of people with this debilitating disease”.

However, The Times has been told that a national service for ME patients is not on the agenda despite acknowledgement that patients are not receiving the expert care they need.

Karen Hargrave, the co-founder of #ThereForME, said that the government had made encouraging commitments to improving the care for ME and long Covid patients. However she warned that there did not seem to be a sense of urgency, even though lives were at risk.

The government has committed to publishing its ME delivery plan, the long-delayed strategy to improve treatment and understanding of ME, but not until the late winter and then it will have to be implemented. “We need action now,” Hargrave said. “Patients are being failed, but healthcare workers are being failed just as badly. They need proper structures and clear guidance to provide people with ME-safe care and save lives when needed.”

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Source: The Times, 27 September 2024

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Politicians are failing to prepare for next pandemic, warns head of European health agency

Politicians throughout Europe are gambling on the next pandemic not happening for the next five years and as result are failing to invest in preparedness, warns a doctor in charge of protecting 500 million people in Europe from infectious diseases.

Pamela Rendi-Wagner, director of the European Centre for Disease Prevention and Control (ECDC), told the European Health Forum Gastein on 25 September, “Every politician now in parliament hopes [the next pandemic] will not be within the next five years of his or her period—that’s why they aren’t investing too much in preparedness."

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Source: BMJ, 26 September 2024

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NHS 'corrected mistakes' after son's suicide

An NHS trust has been accused of adding to the records of a man the day after he took his own life to "correct their mistakes".

The patient, a man aged 33, died under the care of Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) in 2017.

The patient, who was diagnosed with paranoid schizophrenia and substance misuse, had been under CPFT's care two months when he died.

He had been transferred from a neighbouring trust after moving to Ely and then been taken off a community treatment order.

His mother, Angelina Pattison, told the BBC that despite being heavily involved in her son's care, she was "shocked that they transferred him without even telling me".

A trust serious untoward incident (SUI) review acknowledged that when he was transferred no-one from CPFT had asked about whether his family had been involved in his care.

Ms Pattison said: "They didn't have any address of [my home] in his care plan and the care plan was done when he died - when they were running around to correct their mistakes, which they have done"

The BBC has separately spoken to consultant nurse and psychotherapist Des McVey, who was asked by the trust to investigate a complaint in July 2021, understood to be the one from Ms Pattison.

Mr McVey said: "I noticed that the deceased did have care plans, but they were written the day after his death and they were also evaluated the day after his death and I was concerned that this wasn't picked up by the SUI."

He said this "really alarmed me", adding: "Surprisingly, there was no care plan to address his suicidal ideation and he had... an extensive history of trying to kill himself."

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Source: BBC News, 15 June 2023

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NHS trust to review all suicides since 2017

The deaths of dozens of people who took their own lives while patients of an NHS trust will be reviewed after concerns were raised.

Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) will review all 63 suicides since 2017.

It comes after the trust was accused of adding to the records of a patient the day after he took his own life to "correct their mistakes".

The patient, who was diagnosed with paranoid schizophrenia and substance misuse, had been under CPFT's care for two months when he died in Ely in 2017.

Last month, his mother Angelina Pattison, from Newmarket, Suffolk, told the BBC his care plan "was done when he died - when they were running around to correct their mistakes, which they have done".

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Source: BBC News, 25 July 2023

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Mum fears NHS trust cover-up over Cambridgeshire suicides review

The mother of a woman who took her own life weeks after being discharged from a mental health ward fears a "culture of cover up" within the NHS trust.

Hannah Roberts, 22, died by suicide in 2018 and her mother Sally said there were "discrepancies" in the accounts of the talented musician's discharge. She feels an ongoing internal review into all Cambridgeshire & Peterborough NHS Foundation Trust (CPFT) suicides since 2017 should be independent.

CPFT did not respond to her comments.

The trust's chief executive Anna Hills previously said the internal review into 63 suicides would "be an important piece of work".

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Source: BBC News, 15 August 2023

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Trust told it ‘lacks skills or integrity’ to carry out suicides review

A senior clinician has raised fundamental concerns about a trust’s probe into dozens of suicide cases, which was sparked by his allegations that staff had tampered with the notes of a patient.

Cambridgeshire and Peterborough Foundation Trust announced in July there would be an internal review of 60 suicide cases dating back to 2017.

But a key whistleblower told HSJ he fears it could be a “whitewash” and it should be carried by an external, independent investigator rather than led by the trust.

The suicides review was prompted by allegations staff had added a care plan into the patient record of a patient a day after the 33-year-old had died by suicide in 2017.

The allegations, not contested by the trust, were based on the findings of an internal investigation in 2021 of the trust’s conduct around the patient's case.

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Source: HSJ, 6 September 2023

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Trust appoints chair to lead independent suicides review

A trust has appointed a chair to lead an independent review into dozens of suicides that was sparked by allegations of record tampering.

Following questions from HSJ about the review’s chair and terms of reference, Cambridgeshire and Peterborough Foundation Trust said Ellen Wilkinson, a former medical director at Cornwall Partnership FT and its current chief clinical information officer, would chair the review. 

The trust, which is looking for a substantive CEO following Anna Hills’ departure earlier this year, said the review “will not examine individual patient deaths but will take a thematic approach and look at the learnings we can take from these tragic incidents”.

The trust told HSJ the terms of reference for the review of more than 60 cases of patients who died by suicide since 2017 were still being finalised.

The decision not to investigate individual cases has been criticised by the whistleblower whose concerns prompted the review in the first place, as HSJ reported in October.

While an employee of the trust, Des McVey, a consultant nurse and psychotherapist, carried out an investigation in July 2021 into the case of a 33-year-old man, who died by suicide in 2017.

Mr McVey told HSJ his review found the patient record had been tampered with and “his care plans were created on the day after his death” – a conclusion he stands by.

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Source: HSJ, 3 April 2024

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Basic security measure would have prevented disastrous cyber attack

A major cyber attack which caused months of disruption across NHS services in south London would have been thwarted if the affected system had been protected by a basic IT security process, HSJ has learned.

Synnovis, which provides pathology services for more than 2 million people in the capital, was hit by a ransonware attack in June.

The attack locked staff working for the pathology provider to Guy’s and St Thomas’ and King’s College Hospital foundation trusts out of their systems for months. This resulted in widespread delays to care, including cancer treatment. Clinical teams in hospital had to revert to pen and paper, while GPs in the area were left “flying blind” without the ability to order tests.

Senior sources who worked on the response to the attack have now confirmed to HSJ that the system was not protected by multi-factor authentication (commonly known as “two-factor authentication”). MFA involves a user who has entered their password verifying their identity via another method, typically a call or text to their mobile.

After the attack, NHS England’s chief information security officer Phil Huggins wrote to all NHS providers saying two-factor authentication was now mandatory for all NHS systems and those used by their suppliers.

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Source: HSJ, 26 September 2024

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‘Aggressive’ ministers legitimising bullying in trusts, Letby inquiry told

Bullying, aggressive behaviour, and other forms of inappropriate pressure from ministers and the leaders of central bodies can significantly contribute to the development of an unhealthy workplace culture at local level, an expert witness has warned the inquiry into Lucy Letby’s crimes.

THIS Institute director Mary Dixon-Woods has been instructed by the Thirlwall inquiry to report on NHS cultural issues.

She said in evidence on Thursday: “The outer context more broadly, from ministerial level down, is highly impactful for culture and behaviour in NHS organisations.

“Pressures and behaviours (including bullying or aggressive behaviour) from those at the centre may be implicated in poor cultures at the level of NHS provider organisations.

“As well as being an unpleasant experience for those on the receiving end, they will tend to indicate that these are legitimate ways to behave that can be reproduced within organisations themselves.”

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Source: HSJ, 27 September 2024

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ADHD: ‘We’re sharing and rationing meds to get by’

A year ago, life for many people in the UK with attention deficit hyperactivity disorder (ADHD) became unpredictable and disorientating as their medications suddenly became scarce. They were told the shortages would be over within months - but people with the condition tell the BBC it is still a problem.

Spending two hours on hold to her pharmacy or GP each day has become the norm for Lorelei Mathias, 44, who has struggled to get a consistent supply of her prescription ADHD drugs since the shortages began last September.

The Brighton-based author and comedian, who created the web series Life in ADHD, says she has gone "against advice" and started rationing, hoarding and sharing pills with friends on similar prescriptions to make sure they all have enough.

"I have many friends who are also really struggling and splitting pills or shutting down from work as they can't function without it," she says.

When the UK government issued a patient safety alert, external warning last September about a shortage of many ADHD medications, it said it expected the disruption to end by December 2023.

Dr Ulrich Müller-Sedgwick, a consultant psychiatrist for adult neurodevelopmental pathways at the Royal College of Psychiatrists, says production and manufacturing issues are a factor.

He says: "There’s only a limited number of factories where these medicines are actually produced. They're stimulants, so there’s also quite a high security standard in these factories and they’re not easy operations to run."

The Department of Health and Social Care (DHSC) says most supply issues have been resolved and it is working with manufacturers on the remaining problems.

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Source BBC News, 27 September 2024

Related reading on the hub:

Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? 

  • Was there an impact on your health (physical and mental)? 
  • Were you told the reason for it not being available? 
  • Was the issue resolved? If so, how long did it take?
  • If you are still impacted by medication supply issues, have you been told when you will be able to access them again?

To help us understand how these issues impact the lives of patients and families, please share your experience and insights on the hub here. You'll need to register with the hub first, its free and easy to do. 

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