All news

A nine-year-old boy died of sepsis eight days after he was discharged from hospital with influenza and sent home with painkillers, an inquest has been told. Dylan Cope was admitted to Grange University Hospital in Cwmbran, South Wales, with abdominal pain but was discharged after a medic “dismissed any concern” about his appendix. Days later the boy had a ruptured appendix and sepsis diagnosed, and he died at the University Hospital of Wales in Cardiff on December 14, 2022. Read full story (paywalled) Source: The Times, 21 May 2024

Jersey politicians have voted to approve plans to allow assisted dying for those with a terminal illness "causing unbearable suffering". The States Assembly has been debating two routes through which people who have lived in Jersey for longer than a year, are 18 or over and have decision-making capacity could apply for assisted dying. A total of 32 members voted in favour while 14 voted against route one. The second route, for those who are not terminally ill but who have an incurable medical condition causing unbearable suffering, was rejected by a majority of 27 to 19. Plans for legalising assisted dying were voted on in principle by the assembly in 2021, but the aim of the vote was to decide how it could work in practice. With a decision now made, the process for drafting a law could take about 18 months, with a debate then taking place by the end of 2025. If a law is approved, it is expected a further 18-month implementation period would then begin, meaning the earliest for it to come into effect would be summer 2027. Speaking after the debate, Chief Minister Lyndon Farnham said "robust safeguards" would be "enshrined in law." He thanked the assembly for a "thoughtful, respectful and considered" debate. Read full story Source: BBC News, 22 May 2024

The number of people sent out of their home area for a mental health bed – in some cases hundreds of miles away – has increased to a five-year high, despite national ambitions to eliminate the practice. A 2021 date to stop “inappropriate out of area placements” was initially set by government and NHS England in 2016 but, despite initial reductions, the target was missed, with hundreds of patients still affected each month. Demand and bed pressures in the wake of covid appeared to make it more difficult and numbers have been rising. Analysis of the latest NHS Digital data this month shows 825 active inappropriate placements in February 2024 following a steady rise from December 2023, when there were 700 (see chart). The year on year increase from February last year is 15 per cent, but there has been a 46 per cent rise since a low of 565 just 14 months previously, in December 2022. Being sent out of area can disrupt the patient’s care, make it less likely patients will be visited, harder for them to return home and to community support, and is also often very expensive as places are bought at short notice from independent providers. NHSE acknowledged pressures on OAPs in 2024-25 planning guidance but asked systems to “work towards” eliminating them, saying they are “detrimental to patient safety, experience and outcomes.” National mental health director Claire Murdoch last month told HSJ they represented “poor care at relatively high costs.” Read full story (paywalled) Source: HSJ, 23 May 2024

Patients taking antidepressants are being warned to beware of side-effects that could leave them 'asexual' even after they stop using them - a problem that could affect millions of Brits. Selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressant drug in the UK, are relied upon by one in eight Brits - 8.6million in all - who are dealing with mental health issues like anxiety and depression. Common SSRIs prescribed in the UK include citalopram, fluoxetine and sertraline, sometimes known by brand names Cipramil, Prozac and Lustral - but their use has been linked to long-term and even permanent sexual dysfunction by researchers. The NHS has warned that side effects such as a loss of libido and achieving orgasm, lower sperm count and erectile dysfunction 'can persist' after taking them - and patients have described feeling 'carved out', relationships wrecked, from their use. Men and women say SSRI side-effects have hampered their sex lives, even after coming off of the medications - a condition known as Post-SSRI Sexual Dysfunction (PSSD), which is not officially recognised by UK health authorities. For millions, antidepressants can be a life-saving drug - but the authors of a US petition urging more warnings to be applied to the drugs say it can be 'impossible... to weigh the benefits of treatment against the harms'. Read full story Source: Daily Mail, 23 May 2024 Read this opinion piece on the hub by someone who suffers from post-SSRI sexual dysfunction (PSSD) after he was prescribed a selective serotonin reuptake inhibitor. The author calls for widespread recognition, improved risk communication and better support for sufferers. If you have experience of PSSD, you can also share your insights in our community discussion.

Having an epidural during labour can reduce the risk of serious childbirth complications by 35%, according to research that suggests expanding access to the treatment may improve maternal health. An epidural is an injection in the back to stop someone feeling pain in part of their body. Making them more widely available and providing more information to those who would benefit from one was even more important than previously thought, researchers said. The study by the University of Glasgow and the University of Bristol involved 567,216 women who were in labour in Scottish NHS hospitals from 2007 and 2019, and went on to give birth vaginally or by an unplanned caesarean section. Of the total, 125,024 of the women had an epidural. Researchers analysed the rate of serious complications, including heart attacks, eclampsia, and hysterectomies during childbirth. Having an epidural cut the risk of these events by 35%, the study found. The lead author, Prof Rachel Kearns, of the University of Glasgow, said: “This finding underscores the need to ensure access to epidurals, particularly for those who are most vulnerable – women facing higher medical risks or delivering prematurely. “By broadening access and improving awareness, we can significantly reduce the risk of serious health outcomes and ensure safer childbirth experiences.” Read full story Source: The Guardian, 22 May 2024

Patients could be put at risk by plans to allow local NHS bodies to oversee the quality of health screening programmes for diseases such as breast and bowel cancer, experts have suggested. At the moment, NHS England runs the Screening Quality Assurance Service (SQAS) to make sure local organisations comply with national standards, are safe and can be subject to inspections. There are 11 national screening programmes in England, including those for breast, cervical and bowel cancer, plus antenatal and newborn screening, abdominal aortic aneurysm and diabetic eye screening. At the moment, screening programmes must report all safety incidents to the SQAS and the SQAS inspectors visit local sites to pick up urgent issues and make recommendations. Now, a report in the British Medical Journal questions plans by NHS England to allow local bodies to have more control. Sue Cohen, former national lead of screening quality assurance at Public Health England, told the BMJ that devolving responsibility for SQAS to local organisations would be a “retrograde” step. She pointed to previous issues, such as in Kent where a lack of oversight of a cervical screening programme led to women with cancer not being picked up. She said: “If you don’t have a quality assurance service that is properly resourced and has that ability to keep a national view, you will simply not have the oversight of the system and there is a bigger risk of incidents going undetected.” Read full story Source: Medscape News, 22 May 2024

Children with mental health illnesses are forced to stay in wards not fit to care for them with patients warning these hospital stays are like a “form of torture”, an NHS safety watchdog has found. Children with mental health conditions were admitted to general hospital wards, not intended for mental health care, nearly 44,000 times in 2021 and 2022, the Health Services Safety Investigation Body has warned. These wards which are “noisy, busy and brightly lit” are not often appropriate for these children who require mental healthcare and are unable to keep them safe, HSSIB said in a report on Thursday. The watchdog is calling for new guidance for hospitals on how to adapt their general paediatric wards for children who have mental health support needs. In a new investigation, the watchdog said it found in some hospitals patients were placed in rooms with “little or no consideration of therapeutic elements” which are “stripped of everything” including window blinds and shower curtains. In one hospital, staff said even the mattresses are removed. Between 2021 and 2022 11.7 per cent, or 39,926 admissions to paediatric wards, for physical health, were for children who had a mental health condition. Read full story Read HSSIB investigation report – Keeping children and young people with mental health needs safe: the design of the paediatric ward (23 May 2024) Source: The Independent, 23 May 2024

Dental graduates in England could be forced to work in the NHS to help tackle the crisis in access that has left millions struggling to get their teeth repaired. Under the government’s plan they would have to undertake NHS work for “several years” after leaving university or face paying back some of the £200,000 cost of training them. A fall in the number of dentists doing NHS work has helped create “dental deserts”, where patients cannot get treatment, and prompt some people to turn to “DIY dentistry”, including pulling their own teeth out. However, the British Dental Association (BDA), which represents dentists, claimed ministers were seeking to “shackle graduates to a service facing collapse” and said the plan would do little to improve access to NHS care. Victoria Atkins, the health secretary, said: “Taxpayers make a significant investment in training dentists, so it is only right to expect dental graduates to work in the NHS once they’ve completed their training.” Read full story Source: The Guardian, 23 May 2024

An artificial intelligence (AI) system that sends text messages to alert hospital physicians about the high risk for mortality in their patients reduces the number of deaths, according to a study published in Nature Medicine. Chin-Sheng Lin, PhD, associate professor of cardiology at the Tri-Service General Hospital of the National Defense Medical Center in Taipei, Taiwan, and his colleagues have developed an AI system that identifies patients with a high risk for mortality on the basis of a 12-lead ECG. The system is intended to identify patients who would benefit from intensified care. "It is widely acknowledged that providing intensive care to critically ill patients reduces mortality. Delays in providing intensive care for critically ill patients result in catastrophic outcomes. Most in-hospital cardiac arrests are potentially preventable; however, the early signs of deterioration might be difficult to identify," wrote the researchers. The authors emphasized that exactly how the AI warning messages lead to a decrease in overall mortality must still be clarified. But the results suggest that they help in detecting high-risk patients, triggering timely clinical care, and reducing mortality, they wrote. Read full story Source: Medscape, 21 May 2024

England's patient safety commissioner says her calls for changes following failings highlighted in three health scandals are "falling on deaf ears". Dr Henrietta Hughes made the comments at a meeting in Westminster on Tuesday of MPs and campaigners of medical scandals. It comes after Sir Brian Langstaff's highlighted a decades-long "subtle, pervasive, chilling" cover-up by successive governments and the NHS in the conclusion of his report on the infected blood scandal. Like the victims of that scandal, those affected by epilepsy drug Valproate, as well as vaginal mesh implants, and the hormone pregnancy test Primodos, are also waiting on the government to implement a redress scheme. The three campaign groups have already had a combined review. In July 2020, the Cumberlege review found similar failings to the blood scandal: damaging products, poor regulatory decisions, and one government after another refusing to accept wrong had been done. In February this year, the patient safety commissioner set out her "blueprint" of a redress scheme for victims. However, Ms Hughes, who attended the First Do No Harm All Parliamentary group meeting, said on Tuesday: "I'm itching to get the changes that are needed, but I feel my words are falling on deaf ears." Read full story Source: Sky News, 21 May 2024

Attacks on health workers, hospitals and clinics in conflict zones jumped 25% last year to their highest level on record, a new report has found. While the increase was largely driven by new wars in Gaza and Sudan, continuing conflicts such as Ukraine and Myanmar also saw such attacks continue “at a relentless pace,” the Safeguarding Health in Conflict coalition said. Researchers recorded more than 2,500 incidents of “violence against or obstruction of healthcare” in 2023, including the killing or kidnapping of health workers and the bombing, looting and occupation of hospitals. The coalition called for national and international prosecutions of “war crimes and crimes against humanity involving attacks on the wounded and sick, health facilities and health workers.” Its report highlighted cases of attacks on children’s hospitals and sites running immunisation campaigns, leaving people vulnerable to infectious diseases. It also warned of a new trend in which drones armed with explosive weapons are used to target health facilities. Leonard Rubenstein, of the Johns Hopkins school of public health, who chairs the coalition, said violence inflicted on healthcare workers and facilities had “reached appalling levels”. The report included examples where workers had been deliberately targeted, and others where combatants were reckless or indifferent to the harm caused, he said. “The lack of restraint we are seeing, from the beginning of conflicts, suggests to me that the law on protecting healthcare has had no meaning to combatants.” Read full story Source: The Guardian, 22 May 2024

A former Team GB rower claims a treatment she underwent for long Covid leaves participants feeling "blamed" for being ill. Oonagh Cousins was offered a free place on a course run by the Lightning Process, which teaches people they can rewire their brains to stop or improve long Covid symptoms quickly. Ms Cousins, who contracted Covid in March 2020, said it "exploits" people. However, the programme's founder denied it blames patients for their illness, saying that was completely at odds with the concepts of the programme Ms Cousins had reached a career goal many athletes can only dream of - being selected for the Olympics - when she developed long Covid. By the time the cancelled 2020 Olympic Games in Tokyo were rescheduled for 2021, Ms Cousins was too ill to take part. When she went public with her struggles, she was approached by the Lightning Process. It offered her a free place on a three-day course, which usually costs around £1,000. "They were trying to suggest that I could think my way out of the symptoms, basically. And I disputed that entirely," the former rower said. "I had a very clearly physical illness. And I felt that they were blaming my negative thought processes for why I was ill." She added: "They tried to point out that I had depression or anxiety. And I said 'I'm not, I'm just very sick'." Prof Danny Altmann, a leading long Covid researcher, says such behavioural approaches disregard the "mass" of underlying damage in patients that can be measured in tests. Read full story Source: BBC News, 21 May 2024

The chief executive of an acute trust operating in one of the country’s most troubled healthcare economies has admitted his organisation is struggling to get the most from its top of the range electronic patient record system three years after rollout. Royal Devon University Healthcare Foundation Trust implemented the Epic EPR in October 2020, but the system is still causing problems with reporting performance. In an interview with HSJ, chief executive Sam Higginson described Epic as a “Rolls-Royce of an EPR”, but he added: “For lots of different reasons we’re still driving it a little bit like it’s a Ford Focus. He added: “We assumed by installing an EPR that basically it would have a sufficient level of functionality that we could switch off pretty much everything else. But then you find actually it doesn’t quite have the functionality you thought it did, or you don’t quite know how to use it.” However, Mr Higginson said the trust’s use of the EPR was improving “every month”, and the trust is testing a new cancer reporting module which it hopes will resolve the reporting problems. Read full story (paywalled) Source: HSJ, 21 May 2024

For the past 16 years, I have run a small community pharmacy in rural west Dorset. My business is older than me – the little yellow-brick building I own is about to turn 235. Right now, I am really concerned about it getting through the next 12 months. In my years as a pharmacist, I have never seen things as bad as they are at the moment. We are going through a period of rampant drug shortages in England, caused by global shortages, the NHS’s insistence on paying unsustainably low prices for medicines and Brexit, among other things, and people are on the brink. Long gone are the days when customers could place a prescription order safe in the knowledge their life-saving medication would arrive the next day. Read full story Source: Guardian, 17 May 2024

The NHS’s leading wheelchair provider has been told to urgently improve its complaints system by the health service ombudsman amid concerns disabled people are waiting up to two years for chairs. The parliamentary and health service ombudsman (PHSO) took the unusual step of writing to AJM Healthcare after a sharp rise in complaints from wheelchair users. Most related to people not receiving new wheelchairs or the correct parts. The waits range from a month to two years, the ombudsman said. Read full story Source: Guardian 21 May 2024

Rishi Sunak has promised to pay "comprehensive compensation" to people affected by the infected blood scandal. The prime minister said the government would pay "whatever it costs" following a damning report on the scandal, external, which saw 30,000 people infected. A public inquiry found authorities had exposed victims to unacceptable risks and covered up the NHS's biggest treatment disaster. The government will set out compensation details on Tuesday. Ministers have reportedly earmarked around £10bn for a compensation package. Read full story Source: BBC News, 21 May 2024

Prime Minister Rishi Sunak has apologised for the infection of around 30,000 people with contaminated blood products, and the failure to address the problem. Mr Sunak accepted the findings of Sir Brian Langstaff's inquiry report: "Was there a cover-up? Let me directly quote him - there has been". Watch the recording Source: BBC News, 20 May 2024

Pharmacists are calling for fresh powers to provide patients with alternative prescriptions as they warned that drugs shortages are hampering their ability to tackle whooping cough. More than 2,700 cases have been reported across England so far in 2024 – more than three times the number recorded in the whole of last year. But some pharmacies have been forced to turn away families seeking help for their children because they have run out of clarithromycin, a key antibiotic used to treat the condition. Read full story Source: Guardian, 20 May 2024

Hundreds of senior doctors have been driven out of their jobs in the NHS after raising concerns about patient safety, a campaign group has claimed. The senior consultants say managers of NHS trusts employ a playbook of “dirty tricks” to sack whistleblowers or force them to move trusts or take early retirement. Justice for Doctors (JFD), which represents 140 whistleblowing doctors, claims some have been forced to sell their homes to pay legal fees, had their careers destroyed and had been pushed to the brink of suicide. Read full story (paywalled) Source: The Times, 16 May 2024

Hospitals are struggling to treat more people despite higher funding and extra staff because thousands more patients are stranded on wards with nowhere to go, an internal review has concluded. Read full story (paywalled) Source: The Times, 16 May 2024

'There are literally thousands of us out there who have suffered just for trying to do the right thing.' Former Consultant Urological Surgeon, Peter Duffy, explains the extent NHS bosses are going to, to silence whistleblowers who are standing up for patient safety. Watch full story Source: GB News Related reading: NHS bosses destroy careers of whistleblowers who stand up to protect patients’ lives - News - Patient Safety Learning - the hub (pslhub.org)

NHS managers are destroying the careers of whistleblowers who raise concerns about patient safety, a group of medics warns. More than 50 doctors and nurses have told The Telegraph they have been targeted after raising concerns about upwards of 170 patient deaths and nearly 700 cases of poor care. One consultant described it as “the biggest scandal within our country” and said the true number of avoidable deaths was “astronomical”. Read full story (paywalled) Source: Telegraph, 18 May

Jeremy Hunt will approve final compensation for the victims of the contaminated blood scandal this week after a Sunday Times campaign for justice was backed across the political divide. The chancellor is preparing to unveil a package worth at least £10 billion for those affected by the deadliest man-made disaster in postwar Britain. Tens of thousands of people were treated with disease-ridden blood products from the United States in the 1970s and 80s. Read full story (paywalled) Source: The Times, 19 May

Some of the country’s largest trusts could be left without a safety incident reporting system when NHS England removes the existing solution next month, HSJ has learned. NHSE has put around 37 trusts on a “red list” for failing to move to the new learning from patient safety events service. They remain on the historic national reporting and learning system, which national leaders describe as ” liable to irretrievable failure at any time” and plan to shut down in June. NHSE has warned those providers – including University Hospitals Birmingham and University College London Hospitals foundation trusts – that they will be in breach of their licence if they fail to make the switch. Read full story (paywalled) Source: HSJ, 20 May

Matthew Sayed argues that, as other nations offered compensation, we dithered and delayed for decades in yet another very British travesty. Read full story Source: The Times, 18 May 2024