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Keep up to date with the latest news, research and activity in patient safety.

Eight in ten trusts more likely to appoint white staff to jobs

Eight in 10 trusts are significantly more likely to appoint White applicants than Black and minority ethnic applicants after shortlisting, new NHS England data has revealed.
The latest data, from the 2024 NHS Workforce Race Equality Standard (WRES) report, which covers the 12 months to March 2024, reveals this metric applied at 80% of trusts.  
It has worsened from the previous year (76%) and the year before that (71%). 
While the London region has seen year-on-year improvement in this area, NHS England said it has “progressively deteriorated in the Midlands,” while there has been a “marked deterioration” in the North West .
The report said: “Recruitment from interview remains the most difficult to change metric, with the national likelihood ratio remaining broadly unchanged since the inception of the WRES in 2016.”
The relative likelihood of staff from minority ethnic backgrounds entering formal disciplinary processes compared to White staff has also worsened.
According to NHSE, just over half (51%) of trusts reported that these staff were 1.25 times more likely to enter these processes than their White colleagues.
Patient Safety Learning

Starmer outlines plan to shift NHS care from hospitals to new health centres

The NHS will shift a huge amount of care from hospitals into new community health centres to bring treatment closer to people’s homes and cut waiting times, Keir Starmer will pledge on Thursday.
The prime minister will outline radical plans to give patients in England much easier access to GPs, scans and mental health support in facilities that are open 12 hours a day, six days a week.
The health service must “reform or die”, he will say, when he unveils his 10-year health plan.
Experts, however, said the planned revolution in the way the NHS operates risked being undermined by staff shortages, tight public finances, a lack of premises in which to host one-stop shop-style “neighbourhood health services” and a public backlash at hospitals being downgraded.
“Our 10-year health plan will fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps, harnesses game-changing tech and prevents illness in the first place,” Starmer is expected to say at a launch event in London with the health secretary, Wes Streeting.
“That means giving everyone access to GPs, nurses and wider support all under one roof in their neighbourhood – rebalancing our health system so that it fits around patients’ lives, not the other way round.”
Read full story
Source: The Guardian, 3 July 2025
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NICE to remove approval from scores of drugs for first time

The National Institute for Health and Care Excellence will withdraw its backing for a large number of drugs and other interventions which now offer poor value for money in an unprecedented move set to be revealed in tomorrow’s 10-Year Health Plan, HSJ has learned.
Such a move would end the NHS’s statutory mandate to supply the “retired” medicines, treatments, medical devices and procedures.
At present, NICE does not remove its approval for interventions which have successfully completed its appraisal process, even when they are no longer recommended in guidelines as being clinically and/or cost-effective. This new policy will see those interventions not recommended having their NICE approval withdrawn.
Hundreds of technologies have been approved by NICE since its formation in 1999. HSJ understands scores could be retired following re-evaluation over the next few years.
The NICE business plan adds that technologies which remain recommended will be prioritised by ability to “maximise population health…expand access to treatments [and release] cost savings”.
The 10-Year Health Plan will also seek to address variation in prescribing practice across the country by proposing the creation of a “single national formulary” (SNF) by 2028. This is intended to replace the local formularies which the plan says “do not make sense” in the context of ensuring patients receive consistent, high-quality care across the country, HSJ understands.
The plan, due to be published tomorrow, will also confirm that some digital technologies approved by NICE will be nationally reimbursed.
Read full story (paywalled)
Source: HSJ, 2 July 2025
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US Joint Commission to cut more than 700 hospital standards in accreditation overhaul

The Joint Commission has unveiled an overhaul to its healthcare accreditation and certification process that will cut hundreds of requirements for hospitals, streamline patient safety practices and give stakeholders as well as the public a clearer look into what’s expected of an accredited facility.
Called “Accreditation 360: The New Standard,” the changes are described by the organization as “the most significant, comprehensive evolution of Joint Commission’s accreditation process since 1965.”
Headlining the effort is the removal of 714 standing requirements from the hospital accreditation programme, which builds upon the 2023 initiative to cut 400 other requirements. And, starting in July, the Joint Commission said it will have its standards available online for public access and search. 
“Accreditation 360 directly responds to what this moment demands,” Joint Commission President and CEO Jonathan Perlin, M.D., Ph.D., said in the announcement. “Designed by a team of operationally experienced healthcare leaders, this new model removes standards whose time has passed, and we are introducing a suite of novel tools for benchmarking and performance support. Reducing burden helps busy clinicians and healthcare organizations focus on what matters most: delivering the safest, highest-quality and most compassionate healthcare possible.”
Read full story
Source: Fierce Healthcare, 30 June 2025
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Almost one in five NHS operations now carried out in private hospitals

Nearly one in five NHS operations are now being carried out in private hospitals or clinics, new analysis reveals.
Data from the Independent Healthcare Providers Network (IHPN) revealed that private facilities delivered the equivalent of 2,859 NHS procedures every working day in April.
The figure is an increase of over 60% compared to the same month in 2019, and a record high.
Overall, the independent sector is delivering 10% of all NHS planned care, up from 8% before the Covid-19 pandemic.
The IHPN also said that the number of referrals it had received also reached a new high, with private providers receiving 7,162 referrals each working day in April.
David Hare, chief executive of the IHPN, said that this latest data “shows the independent sector’s increasingly pivotal role in delivering frontline NHS care”.
Read full story
Source: The Independent, 2 July 2025
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Women over 65 still at risk from cancer from HPV and should be offered cervical screening

Routine cervical screening should be offered to women aged 65 and over as they are still at heightened risk of cancer from human papillomavirus (HPV), according to research.
Despite it being a preventable disease, there were about 660,000 cases of cervical cancer and 350,000 deaths from it worldwide in 2022, according to the World Health Organization (WHO).
HPV is responsible for about 95% of cervical cancer, which occurs when abnormal cells develop in the lining of the cervix and grow, eventually forming a tumour.
WHO’s global strategy on cervical cancer states that by 2030, all countries should vaccinate 90% of girls with the HPV vaccine by 15, screen 70% of women and treat 90% of those with cervical disease. Modelling suggests this would prevent 62m deaths and a cumulative 74m new cases of cervical cancer by 2120.
Screening programmes vary from country to country, but most guidelines recommend stopping cervical screening after the age of 65 if previous test results have been normal.
Yet global cases of cervical cancer among people over 65 have been rising: in 2022, worldwide there were 157,182 new cases and 124,269 deaths from the disease among women aged 65 or older.
Read full story
Source: The Guardian, 1 July 2025
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Thousands of cancer patients denied key drug due to ‘unfair’ NHS rulings, says charity

Thousands of women battling advanced breast cancer could be denied access to crucial life-extending medication due to an "unfair" assessment process for NHS drug approval.
Charity Breast Cancer Now has issued an urgent plea to Health Secretary Wes Streeting, demanding "immediate action" to dismantle current spending restraints.
The organisation is also calling for the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), to lower its threshold for what it classifies as a "very severe health condition."
NICE's severity modifier, introduced in 2022, is designed to give greater weight to treatments for more severe illnesses, increasing the likelihood of their recommendation for NHS use.
However, Breast Cancer Now argues that the current criteria are too stringent, potentially preventing thousands of women from accessing vital therapies.
According to NICE, the process raises the threshold for what it considers to be a cost-effective treatment, meaning it can give more expensive drugs the green light.
However, a new report from Breast Cancer Now claims the system means women with incurable breast cancer with months to live may be told their condition does not qualify for the most severe rating.
The call comes after it emerged that the life-extending drug Enhertu will not be made available for women with incurable breast cancer on the NHS in England and Wales.
Read full story
Source: The Independent, 2 July 2025
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Cass review: how has report affected care for transgender young people?

At the heart of the controversy about how to meet the needs of young people questioning their gender has been the huge rise in referrals to the Tavistock – previously the only dedicated clinic in England and Wales treating children with gender dysphoria.
The clinic was closed one month before the Cass review into youth gender identity services, commissioned by NHS England and led by the British paediatrician Hilary Cass, which found that children had been “let down” by the NHS amid a “toxic” public discourse.
Her report recommended a significant shift in treatment away from medical intervention towards a more holistic approach to care, including therapy and treatment for coexisting mental ill health, neurodivergence or family issues, and to be provided by a network of regional hubs rather than concentrated in one location.
Fourteen months later and the exponential rise in referrals for NHS care has halted, with figures showing a sharp reduction from up to 280 referrals a month at the Tavistock to between 20 and 30 a month this year, a 10th of the earlier rate.
James Palmer, the medical director for specialised services at NHS England, who is responsible for implementing the recommendations of Cass, suggests a number of factors are behind the decrease. Young people can now only be referred for the youth gender service through mental health or paediatric specialists, rather than by a GP.
Palmer also believes the reduction is partly because of the “change in philosophy” brought in by Cass about hormone treatments. Her review concluded there was “remarkably weak evidence” that puberty blockers (prescribed to give young people experiencing distress and dysphoria about their bodies time to consider their next move) and cross-sex hormones (which masculinise or feminise people’s appearances) improve young people’s wellbeing and there was concern they may harm health.
Cass prompted a temporary ban on the use of puberty-blocking drugs, which was extended indefinitely by the health secretary, Wes Streeting, last December. Cross-sex hormones may be prescribed to 16- to 18-year-olds in rare cases but in practice none have been since the review.
“There’s also an impact – completely immeasurable – of the change in stance in this country and around the world,” Palmer adds. The Cass review was clear, he argues, that even social transition is “not a neutral act” and better information is needed about the outcomes for children who do so, as well as support for parents and schools. “But there is also an impact from the global political environment which has become less accepting of trans people and gender-questioning young people.”
Read full story
Source: The Guardian, 2 July 2025
Patient Safety Learning

Covid inquiry hears of care home 'slaughter'

A civil servant's assertion that there was a "generational slaughter within care homes" in the early days of the pandemic is a phrase that "chimes with the experience of thousands of our families", the Covid inquiry has heard.
Pete Weatherby, barrister for the campaign group Covid-19 Bereaved Families for Justice UK, said the phrase might seem an exaggeration but it highlighted issues the inquiry must address.
His opening statement came on the first day of the sixth part of the Covid inquiry which will focus on the impact of the pandemic on care services for elderly and disabled people.
The government has said it is committed to learning lessons from the inquiry.
Mr Donaldson's evidence also describes "complete chaos" in the Department of Health and Social Care when he started working there in April 2020, soon after the start of the pandemic.
Nearly 46,000 care home residents died with Covid in England and Wales between March 2020 and January 2022, many of them in the early weeks of the pandemic.
Key questions the families hope the inquiry will answer include why the decision was made in March 2020 to rapidly discharge some hospital patients into care homes.
Read full story
Source: BBC News, 30 June 2025
Patient Safety Learning

Why girls are less likely to be put on transplant waiting lists than boys

Academics have found that some children in need of a kidney transplant are facing inequalities in their care.
Researchers set out to examine whether inequalities exist in access to kidney transplantation among children in the UK by analysing the UK Renal Registry and NHS Blood and Transplant data between 1996 and 2020.
The team at the University of Bristol found that Black children were less likely to be put on the transplant waiting list, as were those from more deprived backgrounds.
Dr Alice James, lead author of the study, said the gender disparity in wait-listing may reflect “implicit gender biases in clinical decision-making, differences in parental advocacy, or variation in disease presentation and severity between sexes.”
“There may also be social factors influencing clinicians’ assumptions about transplant suitability or family engagement in the transplantation process,” she said.
“While evidence is limited in paediatric populations, adult studies suggest that women are often perceived as less suitable candidates due to comorbidities or psychosocial factors— perceptions that may inadvertently extend to female children.”
Read full story
Source: The Independent, 30 June 2025
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ICBs exempt from performance regime

Integrated care boards will not be put into performance “segments” in 2025-26, while they go through major reorganisation and job cuts, NHS England has decided.
Its NHS Oversight Framework for 2025-26, finalised on Thursday after more than a year of development, says integrated care boards should this year focus on cutting their running costs by 50 per cent alongside delivery, and changing their role to match the model ICB blueprint.
ICBs already subject to the “recovery support programme” intervention will stay in it, and be monitored by NHS England.
But while trusts will be given a one (best) to five (worst) performance segment, ICBs will this year not be segmented.
This NOF will apply for one year, the document says, and be changed for 2026-27 based on the 10-Year Health Plan and the new “operating model” it will propose. It suggests it will be applied to ICBs again in the future, but other documents suggest they may be subject to a separate commissioning capability regime.
Read full story (paywalled)
Source: HSJ, 30 June 2025
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Ex-leaders of Letby trust arrested

Three former senior leaders of the trust where babies were murdered by Lucy Letby have been arrested on suspicion of gross negligence manslaughter.
Cheshire police confirmed the three, who were part of the leadership team at the Countess of Chester Hospital Foundation Trust in 2015 and 2016, were arrested on 30 June.
All three have subsequently been bailed pending further enquiries, the police confirmed in a statement.
Letby was convicted in 2023 of murdering seven babies, and attempting to murder others, in 2015 and 2016, while working in the neonatal unit at the hospital.
Detective superintendent Paul Hughes, senior investigating officer at Cheshire police, said in a statement today: “In October 2023, following the lengthy trial and subsequent conviction of Lucy Letby, Cheshire Constabulary launched an investigation into corporate manslaughter at the Countess of Chester Hospital.
“This focuses on senior leadership and their decision making to determine whether any criminality has taken place concerning the response to the increased levels of fatalities.
“In March 2025, the scope of the investigation widened to also include gross negligence manslaughter.
“This is a separate offence to corporate manslaughter and focuses on the grossly negligent action or inaction of individuals.
“It is important to note that this does not impact on the convictions of Lucy Letby for multiple offences of murder and attempted murder.”
Read full story (paywalled)
Source: HSJ, 1 July 2025
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New DHSC-NHSE top team structure revealed

The top-team structure of the Department of Health and Social Care – as it takes over directly running the NHS – is being revealed to staff today.
The new arrangements will be introduced over the next few months, in preparation for NHS England being formally abolished in coming years.
There will be 13 director generals, plus five “national priority programmme” leads, and seven regional directors, who will have the status of DGs.
Several will report jointly to the DHSC permanent secretary, Samantha Jones, and to the NHS chief executive, Jim Mackey, who will take on the status of a permanent secretary in the department.

Read full story (paywalled)
Source: HSJ, 26 June 2025
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Parents face hurdles vaccinating children

Parents are being prevented from vaccinating their children because of obstacles such as difficulty booking appointments and a lack of reminders on what jabs are needed and when, a report suggests.
Child health experts say "practical or logistical reasons" are discouraging families more often than fears over the vaccines.
Vaccine uptake in the UK has fallen over the last decade, leading to outbreaks of measles and whooping cough.
UK health officials say they are committed to working with the NHS to improve vaccine uptake among children.
Since 2022, no childhood vaccine in the UK has met the World Health Organisation target of 95% of children vaccinated, which ensures protection of vulnerable people. As a result, measles and other preventable diseases have made a comeback.
A commission of experts from the Royal College of Paediatrics and Child Health (RCPCH) spent a year looking at why.
Dr Helen Stewart, officer for health improvement at RCPCH, said the steady decline in vaccination rates in a wealthy country like the UK was "extremely concerning".
But she said vaccine hesitancy, when parents waver over getting their children vaccinated, "is only part of a very complex picture".
"The reality is that there are many who simply need better support and easier access to appointments," Dr Stewart said.
Read full story
Source: BBC News, 1 July 2025
Patient Safety Learning

UK-trained doctors ‘to get priority for jobs’ in Streeting’s 10-year NHS plan

British doctors are set to be prioritised for NHS roles under new plans to make the health service “self-sufficient” in staffing, according to reports.
Labour’s 10-year plan for the NHS is due to be announced this week, with ministers vowing to deliver a service “fit for the future”.
The government says the plan will help rebuild the health system and tackle widening inequalities across the country.
The plan will pledge to limit overseas recruitment to no more than one in 10 NHS hires, aiming to overhaul a system where two-thirds of new doctors currently come from abroad, according to The Times.
Doctors will be directed to make returning to work a key focus of treatment, as ministers try to reduce the growing benefits bill, according to leaked documents seen by the publication.
Work coaches will be placed in GP surgeries, and local NHS leaders will be set targets to support patients back into employment.
Last month, health secretary Wes Streeting admitted the NHS treats doctors “like crap” but urged medics not to strike in the latest row about pay.
Read full story
Source: The Independent, 1 July 2025
Patient Safety Learning

Staff will have to ‘see more patients’ to justify tech funding

Services will have to change clinicians’ job plans to increase productivity, in order to receive national tech funding, an NHS England director has suggested.
Alex Crossley, NHS England director of transformation strategy, finance and delivery, said he would like the NHS to move to a model “where we are not going to invest nationally unless there is an implementation business change plan to partner the technology investment”.
Speaking at the HSJ Health and Care Intelligence Forum last week, Mr Crossley said that historically, the NHS has invested too much in technology that is “insufficiently well implemented” and “not embedded enough into operational reality on the ground”. “We need to focus much, much more heavily on getting the implementation right,” he said.
Mr Crossley said: “At the end of the day, we can put in all the [electronic patient record systems] we like, we can put in all the patient engagement portals we like, but if a clinician does not change their way of working to see more patients because they have had some time freed up, if their job plan is not adjusted and if we do not make all the other operational changes that you need to make, we have not achieved anything.”
Read full story (paywalled)
Source: HSJ, 30 June 2025
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