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Reproductive health in developing countries in ‘chaos’ after Trump aid freeze

Donald Trump’s 90-day freeze on foreign aid has caused “absolute chaos” on the ground in developing countries, with vital reproductive health services being forced to halt treatment, charities have warned.
Immediately after his inauguration in January, US President Donald Trump announced an immediate 90-day freeze on all USAID including family planning, which, amounts annually to over $600 million, according to the Guttmacher Institute, a leading reproductive health policy organisation.
That will mean an estimated 11.7 million women and girls losing access to contraception, resulting in 4.2 million unintended pregnancies and, 8,340 maternal deaths, as well as a surge in unsafe abortions, according to Marie Stopes International, a non-governmental organisation providing contraception and safe abortion services in 37 countries around the world.
Speaking during a panel event at the London premiere of The A-Word, The Independent’s documentary about reproductive rights in America, Sarah Shaw, MSI associate director of advocacy, said in some developing countries USAID funding accounts for almost 70% of the health budget.
For every week without USAID, nearly one million women and girls worldwide are denied contraceptive care, according to analysis from the Guttmacher Institute.
Shaw describes how right now, $150 million worth of sexual and reproductive health essential medicines are sitting in warehouses in countries with extremely high needs.
“There is literally no way of getting that stock from the warehouse into the clinics because the distribution systems have all ground to a halt because the US government didn’t just fund services, it funded the health infrastructure,” she added.
Read full story
Source: The Independent. 28 February 2025
 
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Woman, 87, ‘traumatised’ after enduring 12-hour wait in A&E three times

An 87-year-old woman who waited around 12 hours at A&E on three separate occasions has been left “traumatised” by her experience of the NHS, her daughter has said.
Ann Traynor, 61, from East Lothian, said her mother Winifred Bolland found the ordeal “frightening and degrading”.
Ms Bolland, a former teacher, was taken to the Royal Infirmary of Edinburgh last September after fracturing her hip.
She was later discharged but in October was readmitted after struggling to stand on one of her legs. She waited nine hours before an ambulance arrived and was looked after by ambulance staff in a corridor, her daughter, who is a nurse, said. 
Ms Bolland was again then forced to wait in A&E for around 12 hours.
In January, Ms Bolland, who is visually impaired, fell and fractured her other hip at home. Ms Traynor said she and her mother, who was in pain, had to wait around another 12 hours in “freezing” conditions.
She said her mother was discharged from the hospital and told she did not meet the criteria for rehabilitation, but was later given access to it.
She told how she had to take nearly a month off of work to ensure her mother was safe at home.
“She doesn’t ever want to go back to the Royal Infirmary,” Ms Traynor said.
“She was traumatised there, particularly the second time. There was no dignity in that admission.
“I think she felt like a burden. It’s really sad. I think her generation is very stoic but I think she was badly let down.
“She wouldn’t survive another admission like that.
“Although she was booted out, and I think it’s appalling that she was, I think she was safer at home.”
Read full story
Source: The Scotsman, 3 March 2025
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‘We’re losing decades of our life to this illness’: Long Covid patients on the fear of being forgotten

On 20 March 2020, Rowan Brown started to feel a tickle at the back of her throat. Over the next few days, new symptoms began to emerge: difficulty breathing, some tiredness. By the following week, the UK had been put under lockdown in a last-minute attempt to contain the spread of SARS-CoV-2, or Covid-19. 
Brown didn’t know then she was at the beginning of a condition that did not yet have a name, but which has since become known as Long Covid. After two weeks, she had a Zoom with a friend, and at the end of the conversation it was as if all life force had drained out of her body. Her doctor advised her to stay in bed for two weeks. Those two weeks turned into three and a half months of extended Covid symptoms: nausea, fevers, night sweats, intense muscle and joint pain, allodynia (a heightened sensitivity to pain), hallucinations, visual disturbances. By the end of the three months, she had noted 32 different symptoms. “I didn’t recognise the way my body felt at all: my skin, my hair,” she remembers now. “It was like being taken over by a weird alien virus, which I guess is what happened.”
Brown, 48, is one of 2 million people in the UK thought to be experiencing long Covid symptoms; according to a study published last summer, roughly 400 million people worldwide have been affected. Often, long Covid patients experience mild primary infections, are never admitted to hospital and only realise there is a problem later, when the symptoms persist well beyond the usual two weeks. Some make a full recovery, some see improvements over time; others, like Brown, have seen little progress since being infected five years ago.
One of the main challenges in diagnosing and treating long Covid is its unpredictability: research studies have linked it to more than 200 symptoms affecting every part of the body. Many patients go on to develop complications such as postural orthostatic tachycardia syndrome (POTS) and fibromyalgia, a chronic pain disorder; 59% of patients show signs of organ damage. 
The unwillingness to discuss chronic illness is especially concerning when combined with the scepticism faced by Long Covid patients, who have to advocate for themselves so that medical professionals, employers and loved ones understand the gravity of their illness.
All of this conspires to make Long Covid patients feel invisible, voiceless and forgotten. 
Read full story
Source: The Guardian, 2 March 2025
Further reading on the hub:
Exploring the barriers that impact access to NHS care for people with ME and Long Covid Building an NHS that’s there for Long Covid and ME Top picks: 12 research papers on Long Covid It's time to confront Long Covid: An interview with Clare Rayner on why we must keep pushing for research, treatment and prevention Healthcare workers with Long Covid: Group litigation – a blog from David Osborn
Patient Safety Learning

One in three NHS doctors so tired their ability to treat patients is affected, survey finds

One in three doctors in the NHS are so tired that their ability to treat patients is impaired, according to a report that reveals medics are more sleep deprived now than during the Covid-19 pandemic.
Longer hours, staff shortages and soaring demand for care on top of the backlog that worsened during the Covid crisis are causing extreme tiredness among doctors, leading to memory blanks, problems concentrating and patient harm.
More than one-third (35%) of doctors said they were so tired that their ability to treat patients was impaired, according to the survey conducted by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, nurses, dentists and other healthcare workers across the UK.
A further third (34%) said their ability to practise medicine may have been impaired. Of the 69% who said extreme tiredness had or may have impaired their ability to treat patients, one in four (26%) said one of their patients had been harmed or a near miss had occurred as a result.
When doctors last answered confidential questions about tiredness in February 2022, nearly one in 10 (9%) said they felt sleep deprived at work on a daily basis. Three years on, the proportion affected had more than doubled to one in five (22%).
The proportion of medics saying extreme tiredness had impaired their ability to treat patients was 26% in 2022 and 35% in 2025.
Read full story
Source: The Guardian, 3 March 2025
Further reading on the hub:
Managing fatigue as part of a safety culture – a blog from Nancy Redfern, Emma Plunkett and Roopa McCrossan Why we need to manage fatigue in the NHS – a blog from Nancy Redfern and Emma Plunkett Fatigue | Association of Anaesthetists
Patient Safety Learning

Payment plan could make accessing care ‘as hard as getting an Oasis ticket’

Patients’ right to choose the provider of mental health services where waits can stretch into years could soon become an “illusion”, companies and patient groups have warned.
NHS England has proposed a new payment scheme for 2025-26 which states integrated care boards can specify a maximum amount that would be paid to any provider during one year. This could be low as £100,000. 
Last week HSJ reported warnings from private providers of physical healthcare services about the proposal. They feared it will result in funding not being available to treat NHS patients who had chosen a private provider.
Similar concerns have now emerged from private providers of ADHD and autism assessments, where waiting lists are much longer. Some people are waiting as long as 11 years in some areas for ADHD assessments.
The Right to Choose policy was enshrined in the 2018 Mental Heath Act, and allows patients to select from a range of NHS and private services via a GP referral
The impact assessment for the payment scheme insists the new rules will not damage patient choice, but it admits payment limits “could possibly impact the length of waits for a treatment option offered by that provider. This may in turn impact how patients exercise their right to choose”.
Read full story (paywalled)
Source: HSJ, 28 February 2025
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GP contract strips out key cancer and mental health targets

Targets designed to improve mental health and cancer outcomes in primary care have been removed from the new GP contract agreed between the profession and government.
The 2025-26 general medical services contract sees core funding increased by £889m. GP leaders accepted the deal in principle following two months of intense negotiations.
However, the deal is contingent on the government confirming in writing by the middle of next month that it will negotiate a completely new contract within the current parliamentary term. 
The contract’s Quality and Outcomes Framework, which seeks to incentivise GPs to provide care in priority areas, has been radically reformed. 32 indicators which carried a total value of £298m have been removed. £198m of the total will be ”redistributed proportionately across nine CVD prevention indicators”. The remaining £101m will be reinvested into the global contract sum and in paying GPs to carry out routine childhood vaccinations instead.
Gone from the contract is the requirement for practices to hold dedicated registers of patients with cancer, chronic kidney disease, dementia, diabetes, learning disabilities, schizophrenia, asthma and COPD, as well as those receiving patient palliative care. The contract requires practices to keep accurate patient records, but no longer maintain dedicated registries.
Other abolished targets include tracking cancer care reviews, and the review of patients with depression and schizophrenia. 
Read full story (paywalled)
Source: HSJ, 28 February 2025
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Midwifery boss admits not telling Ida Lock's parents the truth amid 'grave failings'

A midwifery boss has admitted that she repeatedly failed to inform the health watchdog about issues which contributed to a newborn baby's death.
Ida Lock was born at the Royal Lancaster Infirmary (RLI) on the morning of November 9 in 2019 in a "poor condition" and with the umbilical cord wrapped around her neck.
Ida's mum Sarah Robinson, from Morecambe, had gone to the hospital's central delivery suite at 7.30am after her waters broke the previous day. Sarah, who was 40+1 weeks pregnant, had previously attended the hospital after noticing reduced foetal movements.
Despite midwife Lisa McGrow noticing that the baby's heartrate had dropped to 100bpm, below the acceptable range of 110-160bpm, Sarah was allowed to enter the birthing pool.
Less than 20 minutes later, after Ms McGrow and a more senior midwife, Amanda Sailor, called for assistance, a doctor arrived and immediately said "we need to get this baby out now".
However, after Ida was delivered, not breathing, there was a period of three and-a-half minutes when Mrs Sailor and delivery suite coordinator Celia Sykes were carrying out "ineffective" CPR. When Dr Matthew Phillips came into the room he ensured that Ida was properly resuscitated.
Ida was transferred to the neonatal intensive care unit at the Royal Preston Hospital. Her parents were informed that she had suffered a severe brain injury, due to a lack of oxygen, and she sadly died seven days later.
The inquest started earlier this month and on the 25 February heard from Carol Carlile who, in 2019, was the head of midwifery at the University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) which runs the RLI.
Ms Carlile explained that she had been appointed by the trust to oversee the implementation of the 18 recommendations made following the publication of the Kirkup Report in 2015. Dr Bill Kirkup CBE had overseen a public inquiry into maternity services at UHMBT after the deaths of 11 babies and one mother.
The inquest heard that Ms Carlile had "signed off" a Root Cause Analysis into Ida's death, carried out by the trust contrary to Care Quality Commission guidance. The report published following that analysis, and 'signed off' by Ms Carlile, concluded that "everything went well" with Ida's birth.
Just a few weeks later the independent Healthcare Safety Investigation Branch (HSIB) published its own findings which highlighted several failings which it found contributed to Ida's death.
Ms Carlile had no explanation as to why, despite there being six separate 'codes' which would have required her to report Ida's case to the Care Quality Commission, she had failed to do so and said: "I can't recall why I didn't do that. I should have done."
Read full story
Source: Lancs Live, 26 February 2025
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NHS Fife changing room tribunal: what we know so far

A nurse is taking legal action against a Scottish health board after she was suspended for complaining about sharing a changing room with a transgender colleague.
Sandie Peggie, a nurse at NHS Fife, has claimed she was subjected to unlawful harassment under the Equality Act 2010 by being made to share a changing room with Dr Beth Upton, who is a transgender woman.
At the time of the incidents, Ms Peggie, a nurse, and Dr Upton, a medic, were both employed at Victoria Hospital, Kirkcaldy and worked in the A&E department.
According to Ms Peggie, in late August 2023, she entered a changing room in the A&E department and saw Dr Upton getting dressed, which made her feel embarrassed to get changed and led her to leave the room.
Then, in late October or early November 2023, Ms Peggie was getting changed in the changing room, dressed in her bra and trousers, when Dr Upton came in.
Again, the nurse said she felt embarrassed at changing in front of Dr Upton, so replaced her top and left the room.
Ms Peggie said she then entered the changing room on 24 December 2023 to take care of a personal hygiene need and ended up being left alone with Dr Upton after two members of staff left.
Following the third incident, Dr Upton refused to leave the changing room and later made a complaint of bullying against Ms Peggie.
On 30 December 2023, NHS Fife placed Ms Peggie on special leave and then, on 4 January 2024, the health board suspended her.
At the time the incident took place, it was NHS policy to allow transgender people to use the changing rooms that align with their gender identity.
This is not the first time nurses have threatened legal action in an NHS changing room row.
Read full story (paywalled)
Source: Nursing Times, 20 February 2025
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Trump administration cancels meeting on flu shots, fueling anti-vax concerns

The Trump administration has cancelled a meeting of scientific experts called to discuss next winter’s flu shots in a move that has underscored fears of emerging anti-vaccine polices under the new health secretary, Robert F Kennedy Jr.
The Food and Drug Administration (FDA), which Kennedy oversees, notified members of its vaccines and related biological products advisory committee on Thursday that the next meeting scheduled for 13 March was cancelled without providing an explanation.
No new date was set for a meeting and scientists warned that the cancellation risked undermining the development of flu vaccines for next year.
The committee was due to discuss the development of appropriate vaccine for combatting expected prevalent influenza strains next year, using data provided by the World Health Organization, from which the US recently withdrew, and the Centers for Disease Control and Prevention (CDC).
Committee members were given no advance notice that the meeting, which is held in late February or late March every year, was to be called off.
“We’re all left trying to understand what is going on. Why was this meeting cancelled? It’s an important meeting. What’s the plan for flu vaccines this year,” Paul Offit, a committee member and director of the vaccine education centre at Children’s Hospital of Philadelphia, told CBS.
Read full story
Source: The Guardian, 27 February 2025
Patient Safety Learning

Cancer patients 'may starve' without vital drug

Cancer patients and others with debilitating conditions have highlighted shortages of a vital drug they say have had a "devastating" impact on their lives.
Creon, a pancreatic enzyme replacement therapy (Pert), helps digestion, but has been hard to obtain for the last year and shortages are predicted to last until 2026.
It is thought more than 61,000 patients in the UK need it, including those with pancreatic cancer, cystic fibrosis and chronic pancreatitis.
Some patients said through Your Voice, Your BBC News that they have had to cover long distances to find a pharmacist with supplies.
The Department of Health and Social care says it is working closely with the NHS, manufacturers and others in the supply chain to try to resolve the issues.
Without the drug, patients lose weight and strength, which means their ability to cope with treatment such as chemotherapy is reduced.
Diana Gibb, who is 74, and her husband Mick, 78, live in Tonbridge, Kent.
Mick had a major operation to treat pancreatic cancer in 2023. Diana wrote to BBC News explaining that it is impossible for Mick to digest food without creon. She says he was prescribed a high dose to enable him to regain weight after losing four stone in hospital, but it became increasingly difficult to get hold of the medicine.
"We started to have trouble getting them in the higher dosage, involving me traipsing round pharmacies to find one who could get them. Pharmacies cannot get hold of that dosage. He now has to take a lower dose doubling up on the number of tablets taken, one box now lasts less than a week.
"Pharmacies cannot get hold of lower dosage either and there is no alternative medication. I was worried that my husband would starve to death without them."
Read full story
Source: BBC News, 28 February 2025
Related reading on the hub:
Medicines shortages: minimising the impact on patients Medication supply issues: A pharmacist’s perspective Medication supply issues: Mast cell activation syndrome (MCAS)
Patient Safety Learning

GPs strike deal to help end '8am scramble' for appointments

Patients will be able to book more appointments online and request to see their usual doctor under a new contract agreed with England's GPs, the government has said.
The deal gives an extra £889m a year to general practices, as well as a reduction in red tape and targets that ministers hope will mean doctors are freed up to see more patients.
The Labour government made manifesto promises to bring back "family" doctors and end the early morning phone "scramble" for appointments.
The doctors' union, the BMA, says the deal is an important first step in restoring general practices.
However, doctors also want the government to commit to talks about a completely new national contract for GPs within this Parliament.
GP surgeries are seen as the front door to the NHS, but for years now, doctors have been warning about the pressure their service is under.
Patients have felt it too, with some people facing long waits for appointments.
Now it is hoped extra money agreed in the new contract for GP surgeries will kick-start improvements.
Read full story
Source: BBC News, 28 February 2025
Patient Safety Learning

Consultants express no confidence in trust chair and board

Consultants at a prestigious teaching hospital have written a letter of no confidence in its chair and board, and have made a string of serious allegations against members of the trust’s leadership team.
The senior medics at Moorfields Eye Hospital Foundation Trust sent the letter, obtained by HSJ, to the organisation’s governors on 26 February.
Allegations in the letter include: there was a bullying culture at the organisation, including “coercive behaviour” by the trust’s chair; the trust’s reputation as a research institution was being damaged; and there was “a lack of corporate integrity”.
The letter, from consultants’ committee chair Hari Jayaram, said more than half of the senior doctors — more than 80 consultants — at the trust had contacted him to “voice a lack of confidence in the organisation by the current chair and board”.
It also said morale among these senior doctors was “at a significant nadir, which most colleagues do not ever recall experiencing in their consultant careers” and that senior staff have lost confidence in the trust’s Freedom to Speak Up process.
Read full story (paywalled)
Source: HSJ, 27 February 2025
Patient Safety Learning

Coroner warns about NHS physician associates after misdiagnosis and death of woman

A coroner has issued a warning about the role of physician associates in NHS hospitals after a woman with severe abdominal problems was wrongly diagnosed as having a nosebleed and died four days later.
The family of Pamela Marking, 77, were under the mistaken impression she had been seen by a doctor when she was examined in an emergency department, rather than a physician associate (PA) with far less training.
Surrey assistant coroner Karen Henderson has written to 12 health leaders or bodies including the UK health secretary, Wes Streeting, and NHS England expressing concerns about the “limited training” PAs have and the lack of public understanding about their roles.
In a prevention of future deaths report, Henderson said Marking was taken to East Surrey hospital in Redhill on 16 February last year after she vomited blood-stained fluid and had a tender abdomen.
The coroner said the PA who saw her had “a lack of understanding of the significance of abdominal pain” and sent her home the same day. Marking deteriorated, returning to the hospital two days later. She underwent surgery for complications arising from a femoral hernia but died on 20 February 2024.
Henderson said the PA had acted independently in the diagnosis, treatment, management and discharge of Marking without independent oversight by a medical practitioner.
The coroner said: “Given their limited training and in the absence of any national or local recognised hospital training for physician associates once appointed, this gives rise to a concern they are working outside of their capabilities.”
Read full story
Source: The Guardian, 27 February 2025
Related reading on the hub:
Physician associates: What are the patient safety issues? An interview with Asif Qasim Partha Kar: We need a pause to assess safety concerns surrounding Physician Associates Prevention of future deaths report: Susan Pollitt (8 August 2024)
Patient Safety Learning

Unvaccinated child dies of measles in west Texas as outbreak worsens

The unfolding crisis over the spread of measles in the US among communities where scepticism towards vaccines is running high has taken a turn for the worse after a person who was hospitalized with the disease died in west Texas, the first fatality in the outbreak that began late last month.
A Texas Tech University Health Sciences Center spokesperson, Melissa Whitfield, confirmed the death on Wednesday. It is the first death from measles in the US since 2015.
The school-aged child who died was not vaccinated, the Texas department of state health services said, and was hospitalised in Lubbock last week after testing positive for measles, per the Texas department of state health services.
The measles outbreak in rural west Texas has grown to 124 cases across nine counties, the state health department said on Tuesday. There are also nine cases across the border in eastern New Mexico.
Cases are concentrated in the “close-knit, undervaccinated” community, state health department spokesperson Lara Anton said. Gaines county, which has reported 80 cases so far, has a strong homeschooling and private school community.
The crisis is in Texas is hitting just as the US Health and Human Services Department (HHS) falls into the hands of the notorious vaccine skeptic Robert F Kennedy Jr. Donald Trump’s pick as health secretary has promoted the debunked theory that childhood vaccinations are linked to autism, and in one of his first acts in his new job has postponed a public meeting on immunization.
Kennedy on Wednesday said that the HHS is “watching” cases, though he did not provide specifics on how the federal agency is assisting. He dismissed Texas’s outbreak as “not unusual” during the first meeting of Trump’s cabinet members in the president’s second administration.
Read full story
Source: The Guardian, 26 February 2025
Patient Safety Learning

Why popular blood sugar monitors could actually be harming your health

Popular glucose monitors used to take regular blood sugar readings could be driving poor diets and food restrictions due to inaccurate measurements, according to a new study.
Continuous Glucose Monitors (CGMs) take blood sugar readings every five minutes and were originally designed for people with diabetes to assess how their body responds to different foods.
But they are growing in popularity and in recent years have increasingly been used by the health-conscious to track their diet and avoid glucose spikes.
Carried out in healthy, non-diabetic volunteers, the research compared results from a CGM to the gold standard finger-prick test for blood sugar levels.
Scientists found that the CGMs consistently reported higher levels than the finger-prick test. The monitors overestimated the time spent above the Diabetes UK’s recommended blood sugar level threshold by nearly 400 per cent, causing unnecessary concern for people whose blood sugar was actually well-controlled.
Professor Javier Gonzalez, from the university’s department of health, warned people should stick with the finger-prick test if they are looking for accurate readings.
“Continuous glucose monitors (CGMs) are fantastic tools for people with diabetes because even if a measurement isn’t perfectly accurate, it’s still better than not having a measurement at all,” he said.
“However, for someone with good glucose control, they can be misleading based on their current performance."
Read full story
Source: The Independent, 26 February 2025
Patient Safety Learning

Social media influencers are ‘fearmongering’ to promote health tests with limited evidence, study finds

Influencers are appealing to emotional narratives around health and often “fearmongering” to promote controversial medical tests on social media, a new study has found, in ways that are overwhelmingly misleading and fail to mention potential harms.
The research, led by the University of Sydney, published in the journal JAMA Network Open, investigated five tests being discussed on social media despite limited evidence of their benefits for generally healthy people and concerns about overdiagnosis.
These were full-body magnetic resonance imaging (MRI) scans; genetic testing claiming to identify early signs of 50 cancers; blood tests for testosterone levels; the anti-Mullerian hormone (AMH) or “egg-timer” test, which surveys a woman’s egg count; and the gut microbiome test.
The study’s lead author, Dr Brooke Nickel, said posts about these tests came from a “wide range” of account holders, from major influencers to “everyday girl-next-door” accounts, as well as news outlets, doctors and the companies making the tests. “Across the board, they were being promoted misleadingly,” she said.
Nickel said the tests were being promoted under the guise of empowerment: early screening as a way for people to take control of their own health. However, as Nickel noted: “These tests carry the potential for healthy people to receive unnecessary diagnoses, which could lead to unnecessary medical treatments or impact mental health.”
Read full story
Source: The Guardian, 26 February 2025
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