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Female health monitoring apps are putting women at risk by "coercing" them into disclosing - and then poorly handling - highly sensitive data, according to new research. The study examined the privacy policies and data safety labels of 20 of the most popular of these kind of apps, which are commonly used to help women conceive. It found a host of poor data-management practices, including some apps not having a delete function, even for highly personal information such as menstrual cycles and miscarriages. Its authors say it is the most extensive evaluation its kind completed to date. They say the apps are used by hundreds of millions of people. The BBC has contacted a number of app providers - none have responded to a request for comment. "While female health apps are vital to the management of women’s health worldwide, their benefits are currently being undermined by privacy and safety issues," the lead author of the study, Dr Ruba Abu-Salma, from King's College London, told the BBC. Other key findings from the study include: 35% of apps claimed not to share personal data with third parties but contradicted this in their privacy policies 50% assured users that health data would not be shared with advertisers, but were ambiguous about other data collected 45% of privacy policies denied responsibility for third-party practices, despite claiming to vet them. Female-focused technology has boomed in recent years, with the market expected to exceed $75 billion by 2025. But Lisa Malki, another of the study's authors, said the industry needed to get better at protecting the women whose data it was using. Read full article on the BBC here.

More than 30 of the most common antidepressants used in the UK are to be reviewed by the UK’s medicines regulator, as figures point to hundreds of deaths linked to suicide and self-harm among people prescribed these drugs. The medicines, which include Prozac and are prescribed to millions of patients, will all be looked at by the Medicines and Healthcare products Regulatory Agency (MHRA). It follows concerns raised by families in Britain over the adequacy of safety measures in place to protect those taking the drugs, such as warnings about potential side effects. The regulator will look into the effectiveness of the current warnings, according to a letter from mental health minister Maria Caulfield, which has been seen by The Independent. There has been a huge rise in the use of antidepressants in England, with 85 million prescriptions issued in 2022-23, up from 58 million in 2015-16, according to NHS figures. Nigel Crisp, a crossbench peer and chair of the Beyond Pills all-party parliamentary group, told The Independent: “Overprescribing of antidepressants has an enormous cost in terms of human suffering, because so many people become dependent and then struggle to get off them – and it wastes vital NHS resources.” The review comes as it emerged that: More than 515 death alerts linked to these drugs, involving suicidal ideation and self-harm, have been made to the MHRA since the year 2000 (these alerts don’t directly confirm the cause of a person’s death) Some antidepressants have been given to children as young as four, and the total cost of the medication to the NHS in 2022-23 was more than £231m Read full story Source: The Independent, 11 May 2024

Giving teenagers the HPV vaccine is cutting cases of cervical cancer by 90%, figures for England show. Scientists say it works so well that this type of cancer could be eradicated in the near future. The study shows the vaccine is most effective when offered to Year 8 students - those aged 12 to 13. The vaccine also provides protection against genital warts by preventing human papillomavirus (HPV) infections. The study, funded by Cancer Research UK and led by experts at Queen Mary University of London, shows the HPV vaccine combined with cervical screening can dramatically reduce cervical cancer incidence to the point where almost no-one develops it. More cases were prevented in the most deprived socio-economic groups in society - those often hit hardest by the disease. Prof Peter Sasieni, lead author of the work that is published in the British Medical Journal,, external said: "Our research highlights the power of HPV vaccination to benefit people across all social groups. Historically, cervical cancer has had greater health inequalities than almost any other cancer and there was concern that HPV vaccination may not reach those at greatest risk. This study captures the huge success of the school-based vaccination programme in helping to close these gaps and reach people from even the most deprived communities." Read full story Source: BBC News, 16 May 2024

More than 50 NHS whistleblowers claim to have lost their jobs—with some driven to the brink of suicide—after standing up to protect patients’ lives as bosses bury their concerns. The group of doctors and nurses said that they had been targeted after raising concerns about more than 170 patient deaths and nearly 700 cases of poor care. One consultant said that it was the “biggest scandal within our country” and claimed the true number of avoidable deaths was “astronomical”. Instead of addressing the problems, the whistleblowers claim that NHS bosses are spending millions of pounds of taxpayers’ money on hiring law firms and private investigators to investigate them instead. Last year Rob Behrens, the health ombudsman, warned The Times Health Commission that patient safety was at risk due to “toxic” and hierarchical behaviour among NHS doctors. Professor Phil Banfield, the chairman of the council of the British Medical Association, which represents doctors, wrote in The Daily Telegraph that whistleblowing “is not welcomed by NHS management… NHS trusts and senior managers are more concerned with protecting personal and organisational reputations than they are with protecting patients.” In one case, the NHS spent more than £4 million on legal action against a single whistleblower, which included £3.2 million in compensation. Among the clinicians interviewed, 40 said that their employer took “no positive action” to address patient safety concerns; 36 said that patients remained at risk at their place of work; 19 said that NHS trusts covered up the problems, and ten said that their employers had denied there was a problem. Whistleblowers’ representatives are urging the government to require independent medical assessments for claims and to ban the suspension or exclusion of doctors for speaking out about patient safety. Dr Naru Narayanan, president of the hospital doctors’ union, has called for an independent national whistleblowing body outside of the NHS to register protected disclosures and protect individuals against recriminations. The Times Health Commission recommended that a no-blame compensation scheme should be introduced for medical errors, with settlements determined according to need. Backed by Jeremy Hunt, the chancellor, the scheme would help end the deadly cycle of NHS scandals and cover-ups and ensure families receive timely support. Read full story (paywalled) Source: The Times, 15 May 2024

A trust is experiencing severe problems with its electronic patient record system two years after it was installed, HSJ research has revealed. A “preliminary review” into the Oracle Cerner electronic patient record – called Surrey Safe Care – at Ashford and St Peter’s Hospitals (ASPH) Foundation Trust in Surrey found the emergency department was still spending “significant time” using the system, an electronic bed board was not updated in real-time, and there were booking and workflow errors in clinics. The review, which was released to HSJ after a Freedom of Information Act request and carried out in recent months, found problems stemming from limited system training, configuration issues and insufficient technology available on wards and in clinics. The EPR went live in May 2022. The trust also had “insufficient analysts” to provide comprehensive management information. Also, performance, utilisation and management information were described as still being “under construction.” In a statement, ASPH said, “Annual reviews will be carried out to monitor the continual progress of this project. A new working group of clinical, operational, and digital staff will agree how we use existing resources to improve staff training, add extra functionality to the EPR, invest in appropriate technology and additional analysts.” Read full story (paywalled) Source: HSJ, 15 May 2024

A mother of five died of endometrial cancer hours after being admitted to A&E following preventable delays in her diagnosis. An inquest was told that a private clinic identified the cancer by ultrasound but the report was never sent to her GP. Kerri Mothersole, 44, from Swale in Kent, had a complex medical history including decades of depression and chronic back pain. Her 21-year-old son, Jordan Dighton, said: “My mum should have been taken more seriously—if she were, maybe she’d still be alive.” In May 2020 Mothersole presented with symptoms of early menopause. Blood tests showed that she had low iron levels and her symptoms persisted. In March 2021 she told her GP at Green Porch Medical Centre that she had had vaginal bleeding for six weeks. She could not attend her ultrasound appointments because she was the family’s only driver, and was removed from the waiting list despite rescheduling two appointments. In June of that year her GP referred her for an NHS scan at HEM Clinical Ultrasound Service in Sittingbourne. A radiographer, who was new to the private clinic, found a suspected ovarian mass. However, the clinical lead deemed the scan results inaccurate so they were never returned to the GP. Instead Mothersole was asked to attend a second pelvic and abdominal scan. She was losing weight and in persistent pain. Despite her symptoms being gynaecological, she underwent what turned out to be a clear colonoscopy. According to the coroner, had the first scan report been seen this would have led to an urgent referral to gynaecology. Mothersole was eventually admitted to A&E, where she remained under the care of oncology until she was discharged home to the care of hospice nurses. Dighton told The Times, “The system was so siloed and her case was passed around from department to department. It’s only after her death that we’ve started to make sense of what pathways she should have been on.” Read full story (paywalled) Read the Prevention of Future Deaths Report for Kerri Mothersole Source: The Times, 15 May 2024

A trust has announced it is scrapping a major suicides review, prompting concerns about the “devastating” impact the surprise move could have on some grieving families. The concerns from a whistleblower—and a family member who has reportedly expressed their “upset and shock”—come despite the provider’s insistence they had taken relatives’ views into account when reaching their decision. Cambridgeshire and Peterborough Foundation Trust originally announced plans for the review of over 60 cases in July last year—a move which followed allegations that a patient’s record was tampered with after they had died by suicide in the trust’s care. A chair was appointed to lead the review just last month. But in a short statement on its website, the trust said it had now taken the decision “not to proceed with [the review] as originally intended [after] speaking with several families and loved ones with lived experience” of the suicide cases, which date back to 2017. The review had been “planned with the best of intentions [but] it has become clear… that the review would not answer the individual and highly personal questions some families might have,” the trust said. Read full story (paywalled) Source: HSJ, 13 May 2024

Hospital surgical teams that include more female doctors improve patient outcomes, lower the risk of serious complications and could in turn reduce healthcare costs, according to the world’s largest study of its kind. Studies show diversity is important in business, finance, tech, education and the law not only for equity but for output. However, evidence supporting the value of sex diversity in healthcare teams has been limited. Now researchers who examined more than 700,000 operations spanning a decade report that hospitals with more women in their surgical teams provide better outcomes for patients. The findings were published in the British Journal of Surgery. “Care in hospitals with greater anaesthesia-surgery team sex diversity was associated with better postoperative outcomes,” the researchers concluded. “The main takeaway for clinical practice and health policy is that increasing operating room teams’ sex diversity is not a question of representation or social justice, but an important part of optimising performance." Dr Julie Hallet, the lead author of the study at the University of Toronto, said, “These results are the start of an important shift in understanding the way in which diversity contributes to quality in perioperative care.” Read full story Source: Guardian, 15 May 2024

The last acute trust deemed “inadequate” by the Care Quality Commission has had its rating improved to “requires improvement”, the regulator has announced today. Shrewsbury and Telford Hospitals Trust has been rated “inadequate” since November 2021. Until today, it was the only acute trust in England to have the lowest possible combined CQC rating. Inspectors said leaders were visible and approachable, but kept the trust’s leadership rating as “requires improvement.” This was unchanged from the previous inspection. Meanwhile, maternity services at Princess Royal Hospital in Telford, which for years have been under intense scrutiny over multiple instances of poor care and scores of baby deaths, have also been upgraded, this time from “requires improvement” to “good”. Inspectors visiting in October and November 2023 said there had been a “positive shift” in culture with staff saying they felt safer to speak up. The CQC’s report said that overall, people were receiving a higher standard of care with “staff now proud to work for the trust” and SaTH was “working hard to help rebuild people’s confidence” in its services. Read full story (paywalled) Source: HSJ, 15 May 2024

The Patient-Centered Outcomes Research Institute (PCORI) awarded Patients for Patient Safety US (PFPS US) a $100,000 Eugene Washington PCORI Engagement Award for a new project called “Patients Involved in deVeloping Outcomes Together” or “Project PIVOT.” Project PIVOT is a novel patient-led initiative to advance the integration of patient-centred patient-reported outcomes (PROs) and patient-reported experiences (PREs) into Patient-Centered Outcome Research (PCOR), Comparative Clinical Effectiveness Research (CER) and quality assessment measurement tools to improve patient safety, diagnostic quality, and equity. “This award will allow us to identify opportunities to capture—directly from patients and families—their care experiences and challenges, filling key gaps in the traditional data sources used to evaluate healthcare quality and safety,” stated Sue Sheridan, co-founder of PFPS US. In contrast to traditional tools, such as clinical outcome measures and hospital readmission rates, Project PIVOT’s long-term goal is to make healthcare safer and more equitable by capturing and learning from patients’ experiences related to patient safety, diagnostic quality and bias. Project PIVOT will have a special focus on historically underserved communities to help define which questions and outcomes are most important to capture. Priority areas of focus include maternal/newborn health in communities of colour, the physical, intellectual and developmental disability communities and older adults. Read full story Source: Newswire, 13 May 2024

The changes will allow pharmacists to spend more time with patients, levelling the playing field between smaller pharmacies and larger chains. The government has confirmed plans to make ‘hub and spoke’ dispensing models available to all local pharmacies. The change aims to make local pharmacies more efficient and free up time for more complex elements of dispensing and clinical care. The move is part of government’s drive to make patient access to medicines and treatment more efficient across the NHS. Patients stand to benefit thanks to an efficiency drive that will allow all local pharmacies to dispense medicines more efficiently. Currently, larger pharmacy chains can take advantage of the efficiencies and cost-savings that come with centralising the dispensing of medicines at a larger ‘hub’. But smaller independent pharmacies are unable to operate the same model due to legal restrictions on dispensing for pharmacies under different ownership, meaning they can face additional costs and workload. Under the changes announced today, the government will progress in making the ‘hub and spoke’ model universally available, allowing pharmacies belonging to different legal entities to use hubs belonging to other companies. This will level the playing field between smaller pharmacies and larger chains. The changes will enable pharmacists to dispense medicines more efficiently and spend more time dealing face to face with patients. Primary Care Minister, Andrea Leadsom said, “We’re continuing our drive to make access to medicines and care faster, simpler and fairer for all patients, including at local pharmacies. These proposals will level the playing field and enable our hard-working community pharmacies to benefit from centralised dispensing. It will also free up highly skilled pharmacists from back-office duties to deliver patient-facing services, including Pharmacy First and contraception consultations, supply medicines and provide advice.” Read full story Source: WiredGov, 13 May 2024

NHS England will begin monitoring and benchmarking systems on the extent to which patients are given the option to be treated by a private provider. The move follows the government today endorsing the recommendations of a review by the chair of the newly created Independent Patient Choice and Procurement Panel, which has highlighted how some local areas are restricting patient choice. It highlighted significant variation in choice between some systems, which it said was driven by factors including messaging from commissioners to GPs that discourages choice and/or encourages referrals to local NHS trusts, financial incentives for referrals to particular providers and difficulties in securing accreditation from commissioners. It cited one example where the operator of an independent sector hospital that is co-located with an NHS hospital was contractually prevented by the NHS trust from accepting certain referrals. Health and social care secretary Victoria Atkins said: “Empowering patients to take control of their own healthcare decisions is a key part of my missions to make the NHS faster, simpler and fairer for everyone that uses it.” Read full story (paywalled) Source: HSJ, 15 May 2024

A recent analysis found poor survival rates after bone fractures in older adults, with fewer than a third of men and half of women surviving five years after a fracture. Published in JBMR Plus, the study looked at a cohort of 98,474 Ontario residents age 66 and older who suffered fractures to parts of the body associated with osteoporosis between January 2011 and March 2015. The patients were grouped into sets based on the fracture site and matched to patients with a similar demographic profile but no bone breaks during the study period. The fracture cohort was mostly female (73 percent), and the median age at fracture was 80. In the year before the fracture, up to 45 percent of the women and 14 percent of the men had been treated for osteoporosis. The analysis revealed that those within a year of a hip, vertebral or proximal non-hip, non-vertebral fracture were at the highest risk of death. The survival probability was lower for the oldest patients. “Survival most dramatically declined within one month after most types of fracture, with a five-year survival being similar to or worse than some common cancers,” the paper’s lead author, Laval University department of medicine professor Jacques Brown, said Read full story (paywalled) Source: Washington Post, 12 May 2024

More and more UK hospitals are leaving patients in corridors due to a lack of bed space. NHS bosses say so-called corridor care is freeing up ambulances and saving lives, but BBC Newsnight has spoken to patients who say the growing practice is humiliating and degrading. Gregory Knowles counted 13 other patients alongside him on a corridor at the Norfolk and Norwich University Hospital (NNUH) in March. Complications after an operation put him back in hospital and on to a ward but at 04:00 one morning he was moved. The 68-year-old was wheeled in his bed to reception. "I was waking up with people around me. It was horrendous," he told the BBC. "I had no screens and no facilities for water or for really getting changed. My possessions were on the bottom of the bed. My daughter and partner were as horrified as I was," he said. His partner Alicia Goulty described how staff had been too rushed to attend to him. "One day when we got there his catheter had leaked in the bed when he was on the corridor. He was wet with no covers or any screens and I had to take him to the bathroom to get him cleaned". Ms Goulty said her partner's medication had been missed. "We had to ask for water for him. We had to ask sometimes for his meals because he got forgotten." Read full story Source: BBC News, 15 May 2024 You can read a nurse's first-hand account of a corridor care shift in this blog on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift

An NHS trust has lost an employment tribunal case against a nurse who had his shifts cancelled after whistleblowing when a patient was put in seclusion because of staff shortages. A judgment published last week found that Mark Temperton, a mental health nurse, was “subjected to detriment” after having made a “protected disclosure” during his agency shift at Greater Manchester Mental Health Foundation Trust’s (GMMH) Atherleigh Park Hospital. Mr Temperton, who is also employed by the Priory Group as a regulatory inspector as well as doing ad-hoc work for the Care Quality Commission, worked as an agency mental health nurse for Blackstone Recruitment and was booked to work a night shift in a psychiatric intensive care unit (Priestners Unit) at Atherleigh Park on 14 October 2022. He raised concerns after a patient, brought in by the police, was put “immediately” into seclusion because of staff shortages. Mr Temperton subsequently raised it with the nurse in charge and with a locum consultant psychiatrist but the patient was kept in seclusion. According to the Mental Health Act’s Code of Practice, seclusion “should not be used as a punishment or a threat, or because of a shortage of staff”. Serious concerns were also raised about the trust’s Edenfield Centre in September 2022 by BBC Panorama, one of them being use of inappropriate seclusion. Paul Lewis-Grundy, associate director of corporate governance at GMMH, said: “It is absolutely vital that staff feel confident and safe to speak up, with no detrimental impact to themselves or their career and prospects. Over the past two years, we have invested significantly, and taken a number of steps, to support this across GMMH.” Read full story (paywalled) Source: HSJ, 15 May 2024

A weight loss injection could reduce the risk of heart attacks and benefit the cardiovascular health of millions of adults across the UK, in what could be the largest medical breakthrough since statins, according to a study. It found that participants taking the medication semaglutide, the active ingredient in brands including Wegovy and Ozempic, had a 20% lower risk of heart attack, stroke, or death due to cardiovascular disease. Read full story Source: Guardian, 14 May 2024

The government is spending £5.5bn less on health in England than it suggested it would be at this stage, the Institute for Fiscal Studies says. Plans set out in the 2019 election campaign indicated the budget would increase by 3.3% a year above inflation during this Parliament, the IFS said. But despite extra being put in to cover the high inflation seen, spending had risen by only 2.7% a year on average. Read full story Source. BBC News, 14 May 2024

An NHS England review has found the proportion of ‘low acuity’ patients attending emergency departments is far smaller than expected. During a trial of new acuity measures at 17 accident and emergency sites, NHSE found the proportion of patients with low acuity was just 4 per cent, when it had expected the figure to be between 20 and 40 per cent. Low acuity cases are those which could often be seen by less specialist services, such as urgent treatment centres. Read full story (paywalled) Source: HSJ, 13 May 2024

Patients in part of the East of England are choosing to begin palliative care over cancer treatment because of prohibitive travel times and costs to get to the nearest specialist centre, a local system leader has warned. The Bedfordshire, Luton and Milton Keynes Integrated Care Board CEO said delays to a proposed £400m project, which includes creating “satellite” treatment centres on its patch, was therefore putting lives at risk and widening inequalities. Read full story (paywalled) Source: HSJ, 13 May 2024

Before Sara Smythe began to disappear, she was thriving. The youngest of four sisters, Sara was born with Down syndrome and lived the life of an active teen. At 13, the Toledo student was heading to middle school and loved soccer and swim practice, took dance and karate classes, and was a Girl Scout. But in 2011, everything changed in a matter of weeks. Sara morphed from a sociable teen to a person who stopped talking and engaging with other people, and, at her worst, had full-blown catatonia. Sara’s doctors were at a loss, but her mother, Eileen Quinn, wasn’t giving up. She embarked on what would become a 13-year quest, harnessing the power of a mother’s love to push the scientific community to pay attention to the mysterious regressions that some young people with Down syndrome were experiencing. Read full story (paywalled) Source: Washington Post, 12 May 2024

An inquiry into traumatic childbirths has called for an overhaul of the UK's maternity and postnatal care after hearing "harrowing" stories from parents. The Birth Trauma Inquiry heard evidence from more than 1,300 women - some said they were left in blood-soaked sheets while others said their children had suffered life-changing injuries due to medical negligence. A new maternity commissioner who would report directly to the prime minister is a key recommendation in the group's report, along with ensuring safe levels of staffing. Read full story Source: BBC News, 13 May 2024

Dementia could cost the UK almost £91bn a year by 2040, as the number of people affected rises inexorably, a study has found. The “colossal” costs of the disease are likely to more than double from an already “staggering” £42.5bn today to £90.6bn, according to research undertaken for the Alzheimer’s Society. That projected rise will happen in line with an expected increase in the number of diagnosed cases from 981,575 to 1,402,010, related to an ageing and growing population. Read full story Source: Guardian, 13 May 2024

The chair of the major inquiry into rogue surgeon Ian Paterson has raised concerns over a separate patient recall process conducted by Salford Royal Hospital, and suggested NHS England should intervene. Leaders in Salford have been resisting pressure to expand a review of patients treated by the former head of its spinal division, John Williamson, over his 23-year career at the hospital. A review of his last five years established clear problems with his surgical techniques and found multiple cases of avoidable harm. Read full story Source: HSJ, 7 May 2024

A new vaccine could be effective against coronaviruses which have yet to emerge, with hopes it could be used to battle future pandemics, research suggests. Scientists at the University of Cambridge, the University of Oxford, and Caltech in the US are developing a novel approach called “proactive vaccinology”, which aims to train the body’s immune system to recognise several different coronaviruses. The vaccine used antigens – a substance that triggers an immune response in the body – found in eight different coronaviruses, including those circulating in bats. This trains the immune system to go after the parts of the antigens that are shared across the viruses and other similar ones, including those not included in the vaccine. “Our focus is to create a vaccine that will protect us against the next coronavirus pandemic, and have it ready before the pandemic has even started,” said Rory Hills, a graduate researcher in the University of Cambridge’s Department of Pharmacology and first author of the report. He added: “We’ve created a vaccine that provides protection against a broad range of different coronaviruses – including ones we don’t even know about yet.” Read full story Source: Independent, 7 May 2024

Integrated care boards and local authorities are cutting their voluntary contributions to the better care fund by more than £500m compared to a high point in 2021-22. It appears to be caused by the funding squeeze in both the NHS and local government; extra pressure on ICBs to focus on hospital admissions and discharge; a shift away from pooled budgets as a method of integration; and restructure, with ICBs taking over from clinical commissioning groups in 2022. Local BCF pooled budgets are made up of mandatory “minimum” funds from ICBs and local government – the largest share, which the government has generally ordered to grow steadily each year – and from the “additional” voluntary contributions. In the past government has said it wants the sum pooled across the NHS and councils to grow and to ultimately account for most NHS and adult social care spending, to help join up services and decision making. But figures published on Tuesday by NHS England show the voluntary income going backwards. At its high point in 2021-22, ICBs and councils planned a discretionary ”additional” contribution of £3bn, and the actual spend turned out to be £3.2bn – £2bn from the NHS and £1.2bn from councils. The newly published figures show the total was planned to fall to £2.8bn in 2023-24 and £2.7bn in 2024-25 – £500m less than the 2021-22 peak spend. Read full story (paywalled) Source: HSJ, 8 May 2024