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NHS billions wasted as bipolar patients left 'forgotten and failed'

Failing to properly diagnose and treat people with bipolar disorder, external is wasting billions of pounds a year in the UK, according to new data shared exclusively with the BBC. Experts say many of the estimated million people living with this condition are "ghosts in the system", whose lives are being torn apart by poorly managed extreme suicidal lows or manic, erratic highs.
Emma was diagnosed with bipolar disorder in her early 30s, after experiencing a mental health crisis.
When she was 32 weeks pregnant, her grandmother died unexpectedly, sending her into a "deep low". "I felt awful, but the perinatal team wouldn't take me on," she says. "They said my symptoms weren't that serious."
When Emma gave birth, the extreme lows of her pregnancy were replaced by an unexpected high. She felt amazing in the days after her baby was born - but she didn't sleep and her behaviour became increasingly erratic.
A few weeks later, her mood flipped again. When her baby was three weeks old, Emma took an overdose.
It took a week in hospital for her liver function to return. But even after that, she was in and out of hospital for a year before finally being diagnosed with bipolar disorder, and medicated correctly.
"If I had the correct care, and been listened to during my pregnancy or even earlier, I could have avoided taking that overdose - 100%," she says.
Experts have told the BBC how most people living with bipolar disorder in the UK are "undertreated, undiagnosed and left to try and survive in a system that has failed them".
The majority who, like Emma, are eventually diagnosed with bipolar disorder, are incorrectly prescribed antidepressants initially, which makes their symptoms worse rather than better. Experts also say there is a lack of continuity of care from GPs through to psychiatrists.
According to the Royal College of Psychiatrists (RCPsych), bipolar disorder is a manageable condition.
Dr Trudi Seneviratne, registrar at the RCPsych and a commissioner on the Bipolar Commission, says it is "completely treatable" with a combination of medication, talking therapies and lifestyle factors.
"But there are many, many people who are suffering in silence with lower levels of symptoms because there isn't a good clinical care pathway for them in the UK."
Read full story
Source; BBC News, 1 April 2025
Patient Safety Learning

The downside of young people learning about ADHD on TikTok

Less than half of the claims made about symptoms of attention deficit hyperactivity disorder (ADHD) in the most popular videos on TikTok align with clinical guidelines, a new study has found.
Two clinical psychologists with expertise in ADHD also found that the more ADHD-related TikTok content a young adult consumes, the more likely they are to overestimate both the prevalence and severity of symptoms in the general population.
People with ADHD are known to suffer inattention, hyperactivity and impulsivity – and may struggle to concentrate on a given task, or suffer extreme fidgeting.
Prescriptions for drugs for ADHD have jumped 18% year-on-year in England since the pandemic, which underscores the need for accurate and reliable information, particularly on platforms popular with young people.
In this latest study, published in the journal Plos One, the two psychologists evaluated the accuracy, nuance, and overall quality in the top 100 #ADHD videos on TikTok.
They found the videos have immense popularity (collectively amassing nearly half a billion views), but fewer than 50 per cent of the claims made were robust.
Read full story
Source: The Independent, 31 March 2025
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NHS ‘should give councils more grief’ on health

The 10-Year Plan’s focus on the NHS risks sidelining the need for more effective action by national and local government on prevention, public health directors are warning.
Association of Directors of Public Health president Greg Fell also told HSJ integrated care boards should “give us [councils] more grief” to take more action on prevention, rather than prioritising NHS upstream interventions that are not as effective as primary prevention.
Mr Fell, director of public health at Sheffield City Council, said policy makers, NHS leaders and media too often looked to growing “preventive” treatments – such as weight management treatment, and weight-loss drugs – as the solution to problems like growing obesity and falling healthy life expectancy.
He said the routine “framing” of prevention as something the NHS can solve with upstream treatments risked diverting from national and local government actions that could make a much bigger difference.
Mr Fell said such interventions – and the high-profile GLP-1 drugs for obesity – may be worthwhile, but for overcoming the big health threats were “like emptying an ocean with a teaspoon or, being kind, a soup ladle”.
He said: “The answer is way upstream of better treatment. [It] is effective regulation of junk food industries, and that isn’t primarily a Department of Health and Social Care thing, and certainly not an NHS problem. It’s a problem across the government.”
Mr Fell said he expected the 10-Year Plan “would be pretty good” but means “the bandwidth has been taken by the NHS”.
He called for government to outline its plan for preventive cross-government action as part of its health mission, beginning a “debate about the right mix of policies” across multiple government departments, local government, and others. 
“We haven’t yet seen much on the health mission,” the director of public health said, adding that it would need to cover tobacco control, alcohol, air quality, obesity, and “how does all that hang together across the totality of government?”
Read full story (paywalled)
Source: HSJ, 31 March 2025
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‘Big consolidation’ of ICBs coming, says new NHSE chief exec

A “big consolidation” of integrated care boards is being planned, according to new NHS England chief executive Sir Jim Mackey.
In his first interview as NHSE’s “transition chief executive”, Sir Jim Mackey said the governnment’s decision to cut ICB running costs by 50 per cent by October had already lead to “a lot of the smaller [ICBs]… talking to each other about merger”.
As well as addressing the fate of ICBs, Sir Jim told HSJ  he “absolutely” supported the establishment of provider-led accountable care organisations in the NHS but that only parts of the NHS could successfully deliver them.
He also pledged to “stick up for the NHS” in disagreements with ministers.
Sir Jim said NHSE was “trying to resist” insisting ICBs combine or merge to cover a minimum population, but he added: “I think people are doing that naturally and the conversations at the minute look like we’re going to have quite a big consolidation.”
Read full story
Source: HSJ, 1 April 2025
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WHO proposing to cut jobs and slash budget by a fifth, memo shows

The World Health Organization (WHO) is proposing to reduce staff numbers and the scale of its work as it slashes its budget by just over one-fifth due to the impact of US funding cuts, according to an internal memo seen by Reuters.
US President Donald Trump's administration withdrew from the WHO upon taking office in January, saying the global health agency had mishandled the COVID-19 pandemic and other international health crises. The US is by far the UN health agency's biggest financial backer, contributing around 18% of its overall funding.
"The United States' announcement, combined with recent reductions in official development assistance by some countries to fund increased defence spending, has made our situation much more acute", stated the WHO memo, which was dated March 28 and signed by WHO's Director-General Tedros Adhanom Ghebreyesus.
The WHO did not immediately respond to a request for comment.
The US withdrawal has exacerbated a funding crisis due to member states reducing their development spending. Faced with an income gap of nearly $600 million this year, the WHO has proposed to slash its budget for 2026-27 by 21% from US$5.3 billion to US$4.2 billion, according to the memo.
In February, the WHO's executive board had initially reduced the proposed budget for 2026-27 from US$5.3 billion to US$4.9 billion, according to the note.
"Despite our best efforts, we are now at the point where we have no choice but to reduce the scale of our work and workforce," the memo said.
The WHO will reduce jobs at senior leadership level at its headquarters in Geneva, Switzerland, though all levels and regions will be affected, the memo added. It will decide on how to prioritise its work and resources by the end of April.
Read full story
Source: Reuters, 29 March 2025
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Hospital whistleblower wins right to protection in landmark case

Max McLean didn’t see himself as a whistleblower. As chair of the Bradford Royal Infirmary he had simply raised a number of issues including preventable deaths in newborn babies
But he was, he claims, forced out by the Board.  And when he tried to take the trust to an employment tribunal, they argued that he was not a worker and was not protected under whistleblowing law.
Now, in a landmark ruling, the tribunal said he was a worker and was protected. The tribunal ruling will have massive implications for those who sit on trust boards across England.
Too often when there have been scandals involving patient care there has been a resounding silence from those who are meant to be holding senior executives to account. Now they are being told that they can speak up and that they will be protected.
Dr McLean, a former police officer, had been trust chair for two years when he raised his concerns, which were confirmed by an independent report.
He told Channel 4 News: “There is no freedom to speak up. It is a sham.”
Read full story
Source: Channel 4 News, 26 March 2025
Related content on the hub:
Speaking up for patient safety: A new interview series about raising concerns and whistleblowing
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‘Ridiculous’ cuts to AI cancer tech funding in England could cost lives, experts warn

Ministers have cut millions of pounds of funding for potentially life saving AI cancer technology in England, which cancer experts warn will increase waiting times and could cause more patients to die.
Contouring is used in radiotherapy to ensure treatment is as effective and safe as possible. The tumour and normal tissue is “mapped” or contoured on to medical scans, to ensure the radiation targets the cancer while minimising damage to healthy tissues and organs.
Normally, this is a slow, manual process that can take doctors between 20 and 150 minutes to complete. AI auto-contouring takes less than five minutes and costs around £10-£15 per patient.
Research shows that AI contouring can cut waits for radiotherapy by more than five days for breast cancer patients, up to nine days for prostate cancer patients and three days for lung cancer patients.
In May 2024, the Conservative government announced £15.5m over three years to fund AI auto-contouring for all hospitals providing radiotherapy. Work continued on the scheme after the general election, with online webinars and follow-up calls for radiotherapy departments held in September.
The 51 trusts offering radiotherapy continued to work on installing the cloud-based technology, with a number using it early, in the belief the funding was secured.
But in February, in an email seen by the Guardian, Nicola McCulloch, the deputy director of specialised commissioning at NHS England, said the funding had been cancelled “due to a need to further prioritise limited investment”. There would no longer be a centrally funded programme to support implementation of the technology, she said.
The decision means many radiotherapy departments face a return to manual contouring, prompting accusations that the government is ditching digital and going back to analogue cancer care.
Analysis by Radiotherapy UK has calculated that removing funding for AI contouring in England will add up to 500,000 extra days to waiting lists for breast, prostate and lung cancer alone and leave each of the 51 trusts with a £300,000 shortfall.
The chair of Radiotherapy UK, Prof Pat Price, said: “The government cannot laud the advent of AI in one breath, and allow this to happen. Far from moving from an analogue to digital NHS, when it comes to radiotherapy it feels like the opposite is happening. This wrong-footed decision will exacerbate the impact of severe staff shortages.”
The leading oncologist urged ministers to intervene. “Some departments are so short-handed that they’re shutting machines down because no one is there to operate them and nationally, radiotherapy vacancy rates are running at 8%. This investment in AI could have alleviated some of these pressures. Without it, cancer patients will wait longer than necessary for treatment, potentially costing their lives.”
Read full story
Source: The Guardian, 31 March 2025
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Morning-after pill to be offered without charge at pharmacies in England

The morning-after pill will be available without charge on the NHS at pharmacies in England, the government has announced in an effort to reduce the “postcode lottery” of free access to the emergency contraception.
The morning-after pill is one of two forms of emergency contraception that women can use after having unprotected sex, or where other forms of contraception have failed. The sooner that emergency contraception is used, the more effective it is.
The new announcement aims to increase access to the morning-after pill; while it is already available for nothing from most GP surgeries, most sexual health clinics and some NHS walk-in centres, not all pharmacies offer it for nothing, with some women paying up to £30 for the medication.
The health minister Stephen Kinnock said: “Equal access to safe and effective contraception is crucial to women’s healthcare and a cornerstone of a fair society.
“Women across England face an unfair postcode lottery when seeking emergency contraception, with access varying dramatically depending on where they live. By making this available at community pharmacies, we will ensure all women can access this essential healthcare when they need it, regardless of where they live or their ability to pay.”
Read full story
Source: The Guardian, 30 March 2025-
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Cancer patients missed chance for treatment due to 100-day waits, trust admits

Lung cancer patients at a major trust were on waiting lists for so long that their disease progressed to a stage where it was no longer treatable.
Following a harm review, Newcastle Hospitals Foundation Trust discovered two dozen patients whose cancer had progressed to a stage where it was more serious and difficult to treat.
Within this group of 24 patients, six were moved straight to end of life care when doctors finally decided on their treatment plan.
Between 1 January 2024 and 31 January 2025, a total of 160 lung cancer patients at Newcastle FT waited longer than 104 days for treatment after an urgent or suspected cancer referral. The national target is for 85% of cancer patients to receive their first treatment within 62 days, although it has not been met since 2015. 
“Stage migration” was the biggest concern in those cases, meaning the patient’s cancer progressed while they waited for treatment, making it harder to treat.
In papers submitted to a board meeting on Friday, the trust accepted its performance on cancer was still “clearly below” the standard required. The data on lung cancer in particular “underscored” the need for a “specific and continued” focus on treatment for the disease, the trust said.
Naser Turabi, Cancer Research UK’s director of evidence and implementation, said the trust’s disclosure has drawn attention to the issue of the impact of missing waiting times standards on patients.
“Delays to treatment negatively impact patients, but it’s hard to know just how badly,” he told HSJ.
“One study suggests that for many cancers, a four-week delay to surgery increases the risk of dying by 6-8 per cent, but we know that long waits can reduce the treatment options that are available, and have significant psychological impacts too.”
Read full story (paywalled)
Source: HSJ, 31 March 2025
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Zero tolerance ‘won’t fix sexual harassment of staff’

“Cultural transformation” rather than “zero tolerance” is required to overcome widespread sexual harassment by ambulance service staff and patients, according to the person leading national efforts to make improvements.
The comments to HSJ from Bron Biddle, the lead for reducing misogyny and improving sexual safety at the Association of Ambulance Chief Executives, follow the publication of the 2024 NHS staff survey results.
These found 1 in 12 reported unwanted sexual behaviour from colleagues or other staff in the past year – more than double the figure across all sectors and a slight increase on 2023.
When reporting unwanted sexual behaviour at work from patients, relatives or the public, the figure totals a huge 29% of ambulance staff nationally — slightly higher than 2023 and massively above the national average for all NHS staff of under 9%.
Despite the huge issue, HR specialist Ms Biddle, who has been running a programmme to tackle the problem for several years, said rooting it out required a “reset” of cultural norms, as well as social change.
“If we just reinforce things like zero tolerance and stamping it out, we are missing the nuance of why this is happening in the first place,” she told HSJ. “It is easy for us to think of someone as a bad apple, but are they bad apples, or are we complicit in the environment they are operating in? And this is why wider culture transformation is so important if we want to prevent sexualised behaviours in the first place.”
It means action taken against perpetrators should be “proportionate” rather than always hard-line, she said, and drew a distinction between predatory and exploitative behaviour, and that exhibited by someone who is capable of adapting their behaviour.
Read full story (paywalled)
Source: HSJ, 28 March 2025
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Patients routinely smoking in hospitals, despite ban

Mental health patients are routinely smoking on trust premises, and do not have enough support to stop, despite the threat of tightening rules.
Public health charity Action on Smoking and Health (ASH) surveyed mental health trusts at the end of last year and found  that although the vast majority of had smoke-free policies, fewer than half were able to support their patients to stop smoking.
ASH found mental health patients still routinely smoked on trust sites, often with the support of staff, and with “patchy” tobacco dependence treatment.
The charity warned implementation of “tobacco dependence treatment services” had been inhibited by “staff attitudes and beliefs, lack of capacity and resources, lack of leadership, and inadequate or poorly enforced policy”.
Read full story (paywalled)
Source: HSJ, 18 March 2025
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Almost 1.7 million hernia mesh implanted in NHS in 20 years

Almost 1.7 million people have had hernia mesh surgery in the NHS since 2004, figures released by the NHS have revealed.
The statistics do not include people who’ve had hernia mesh in private hospitals.
Nobody can say how many are now suffering complications – because patients are not tracked for their lifetime.
Yet campaigners and academics globally say it can take many years for mesh to cause problems- so the scale of suffering falls into a black hole of missing data.
Moreover, support groups show that patients are being implanted with hernia mesh in their thousands ever year – but nobody is being given fully informed consent of the potential risks such as pain, loss of mobility, loss of sex life and losing the ability to have children. Also autoimmune diseases and allergies caused by the plastic mesh material.
The figures came to light thanks to a Written Parliamentary Question asked by MP Sharon Hodgson, chair of the All Party Parliamentary Group for First Do No Harm.
In its response, The Department of Health say: “Clinicians are expected to inform patients about risks associated with recommended treatments, including reasonable alternatives, to enable informed consent and a balanced patient decision.”
Read full story
Source: Sling the Mesh, 25 March 2025
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NHSE vows to end ‘bombardment’ of trusts

NHS England has vowed to “reduce duplication and prevent providers from being bombarded with conflicting instructions”, including by removing integrated care boards’ performance management role.
A new draft NHS Performance Assessment Framework, published today, promises to “streamline oversight” by “providing consistent and co-ordinated oversight to reduce duplication and prevent providers from being bombarded with conflicting instructions”.
The document attempts to set out how integrated care boards and trusts will be regulated by NHS England, starting from July. 
It confirms that NHSE, not ICBs, will be responsible for provider performance management – a move announced late last year but met with anger from many ICBs.
The new paper says: “Discussions about performance will be led by colleagues at NHS England, who are experienced in addressing delivery challenges.”
The proposal that NHSE performance management will be carried out “with and through” ICBs — included in earlier versions of the framework — has gone.
In addition, trusts’ performance “segments” will no longer take into account wider system performance, nor a proposed judgement of their “capability”, as they will “solely [be] linked to delivery metrics”.
ICBs will still have to “hold their partners to account using the system levers that bind them together, such as their joint system plans, partnership agreements, joint committees and collaboratives”, however.
The framework is subject to consultation, and new NHSE CEO Sir Jim Mackey told its board today it was likely to be changed. There will “absolutely be some things we need to change and adjust”, he said. “This isn’t something that can be perfect at the first go.”
Read full story (paywalled)
Source: HSJ, 27 March 2025
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Baby deaths trust claimed £2m 'good care' payments

An NHS trust criticised over the avoidable death of a newborn baby was paid £2m for providing good maternity care, the BBC can reveal.
A senior coroner ruled on Friday that University Hospitals of Morecambe Bay (UHMB) NHS trust contributed to Ida Lock's death and had failed to learn lessons from previous maternity failures.
Despite this, the trust claimed it had met all 10 standards under an NHS scheme aimed at promoting safe treatment.
Ida's mother Sarah Robinson said it was "another kick in the teeth" while her father Ryan Lock labelled it "disgusting". The trust, which has previously apologised for its failings in Ida's care, declined to comment about the NHS payment scheme.
Senior coroner for Lancashire James Adeley concluded that Ida had died due to the gross failure of three midwives to provide basic medical care.
Ida, who was born at the Royal Lancaster Infirmary (RLI) on 9 November 2019, died a week later after suffering a serious brain injury due to a lack of oxygen.
Dr Adeley ruled her death had been caused by the midwives' failure to deliver the infant "urgently when it was apparent she was in distress" and contributed to by the lead midwife's "wholly incompetent failure to provide basic neonatal resuscitation".
He said eight opportunities had been missed "to alter Ida's clinical course".
Read full story
Source: BBC News, 26 March 2025
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NHS hospital too slow to treat doctor’s son who died of sepsis, coroner rules

A hospital failed to treat the son of one of its consultants with antibiotics and fluids with the required urgency hours before he died of sepsis, a coroner has ruled.
It was unclear whether mistakes and delays in the treatment of William Hewes, 22, on 21 January contributed to his death, the coroner, Mary Hassell, said.
The death of Hewes raised similar issues to the death of 13-year-old Martha Mills in 2021, Hassell said. Martha’s death led to the adoption of Martha’s rule, which gives families the right to a second opinion on medical treatment.
Hewes, who was studying politics and history at Leeds University, died of meningococcal septicaemia at Homerton hospital in east London, where his mother, Dr Deborah Burns, was a consultant paediatrician.
Burns told the inquest she had been unable to work at the hospital since her son’s death because of feelings of “betrayal” towards colleagues who ignored her warnings about his treatment.
Burns repeatedly asked medics to administer lifesaving antibiotics in the vital first hour of his treatment. But antibiotics were not given until 1.25am due to a misunderstanding between a doctor and nurses, the inquest at Bow coroner’s court heard. There was also a delay of about 90 minutes in transferring Hewes from the resuscitation area of A&E to the intensive care unit amid a disagreement between medics about escalating his care.
The hospital admitted these mistakes were “suboptimal”. Hassell said Hewes was not treated “with the urgency he should have been” but added: “It is unclear whether, if he had been administered all appropriate treatment promptly, his life would have been saved.”
She said she would issue a prevention of future deaths report to Homerton hospital on the basis that the work it had done since Hewes’s death should be shared nationally.
Read full story
Source: The Guardian, 27 March 2025
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AI pregnancy scans twice as fast and just as accurate as traditional sonograms, study finds

Artificial intelligence is being hailed as a potential game-changer in prenatal care, cutting down the time it takes to identify fetal abnormalities by almost half, according to a groundbreaking new study.
Researchers at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust found as well as being faster, AI is just as accurate as traditional methods, offering the potential to revolutionise the 20-week scan.
The technology, tested in the first trial of its kind, could significantly reduce scan times, easing anxiety for expectant parents and freeing up sonographers to focus on potential problem areas.
The AI also proved more reliable than human sonographers in taking crucial measurements.
This improved accuracy offers the potential for earlier detection of potential issues, allowing medical professionals to intervene sooner if required.
The AI tool was also found to alter the way in which the scan is performed, as sonographers no longer needed to pause, save images or measure during the scan.
Read full story
Source: The Independent, 27 March 2025
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