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

Antidepressants: Two million taking them for five years or more

More than a quarter of patients on antidepressants in England - about two million people - have been taking them for five years, the BBC has found.
This is despite there being limited evidence of the benefits of taking the drugs for that length of time.
A doctor who runs an NHS clinic helping people off the pills says withdrawal symptoms can make it hard for some to stop taking their medication.
Withdrawal guidance was updated in 2019, but he says little has changed.
More than eight million people in England are on antidepressants - which are prescribed for depression, anxiety and obsessive compulsive disorder and other conditions. That's one million more people than five years previously, NHS prescribing figures show.
The investigation also uncovered evidence that a leading drug company attempted 27 years ago to conceal possible withdrawal effects that one drug could cause.
Read full story
Source: BBC News, 19 June 2023
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Ayrshire MSP Katy Clark wants ban on surgical mesh use in hernia ops

AN Ayrshire MSP has called for an end to surgical mesh being implanted in hernia patients in Scotland.
A Freedom of Information request by Labour's Katy Clark has revealed that one in 12 of all hernia patients in NHS Ayrshire and Arran who have been implanted with surgical mesh since 2015 have been readmitted to hospital due to complications.
And the West of Scotland MSP has backed a petition by constituents calling for the suspension of the use of surgical mesh until an independent review has been carried out.
It follows the recent public health scandal over the pain and suffering endured by many women across Scotland implanted with transvaginal mesh.
It took years of tireless campaigning by affected women before the Scottish Government took action, last year creating a mesh removal reimbursement scheme.
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Source: Irvine Times, 9 June 2023
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‘Get stuck into ICSs’, Hewitt tells local leaders

NHS leaders ‘who might be hesitating about whether or not to really commit’ to their local integrated care system should ‘put aside all of those doubts [and] get stuck in’, Patricia Hewitt has claimed.
Ms Hewitt, Norfolk and Waveney Integrated Care Board chair and former health secretary, was speaking at the NHS ConfedExpo conference, the day after government responded to her recent review of ICSs.
The Department of Health and Social Care rejected or ducked several of its most eye-catching recommendations, but did state its support for ICSs and system working; while Labour has also said it would maintain ICSs should it come to power.
Ms Hewitt said the government response was more positive than she had feared at some points, and it “would have been a complete miracle” if ministers had backed all her recommendations.
Read full story (paywalled)
Source: HSJ, 15 June 2023
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Junior doctors strikes will escalate to ‘indefinite with-drawl of labor’, union lead warns

Junior doctors could indefinitely withdraw labor, and strike for three days a month until next year, the medics’ union leaders have warned.
Hundreds of junior doctors gathered outside the largest NHS conference of the year, NHS Confedexpo, on Thursday chanting “pay us fair, pay right, we don’t want to have to strike”.
The British Medical Association’s junior doctor committee co-chair Dr Rob Laurenson warned junior doctors may next escalate strike action in an “indefinite withdrawal of labour”.
NHS England boss Amanda Pritchard said the strike is a “serious risk to patient safety” and industrial action “creates risk and upheaval”.
She said tens of thousands of appointments will be affected.
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Source: The Independent, 15 June 2023
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Forty children admitted to hospital for vaping amid rising ‘epidemic’

Forty children were hospitalised for vaping last year, prompting NHS bosses to warn we risk “sleep-walking into a crisis”.
Amanda Pritchard, NHS England boss, said it was "right" for paediatricians to call for action on vaping among young people, as the Royal College of Paediatrics and Child Health called for an outright ban on disposable vapes.
She said the 40 children admitted to hospital in England in 2022 due to “vaping-related disorders” was up from 11 two years before.
The RCPCH’s call for action comes as NHS data revealed one in five 15-year-olds said they used e-cigarettes in 2021, while charity Action on Smoking (ASH) reported the experimental use of e-cigarettes among 11 to 17-year-olds had risen by 50 per cent compared to last year.
The college warned: “Youth vaping is fast becoming an epidemic among children, and I fear that if action is not taken, we will find ourselves sleep-walking into a crisis.”
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Source: The Independent, 16 June 2023
Sam

Menopause doctor says hormone scam endangers women's health

A menopause doctor says scammers using her name to illegally sell testosterone online are damaging women's health.
Dr Louise Newson, who founded Newson Health, has warned patients a website has stolen her brand and logo and is selling the sex hormone unlawfully.
"We do not sell medication directly to anyone online," she adds.
Testosterone is illegal to sell or supply without a prescription from a health professional and currently unlicensed in the UK for use by women.
However, the National Institute for Health and Care Excellence (NICE) recommends it can be considered as a supplement for menopausal woman to treat low sexual desire if HRT alone is not effective.
Dr Newson, whose private clinics operate in Stratford-upon-Avon, London, Southampton and Bournemouth, said medication was only prescribed after a consultation with a clinician.
"As far as we are aware no Newson Health patients have fallen victim to this scam and we sincerely hope this remains the case," she said.
The practice is working with relevant organisations to have the fraudulent website taken down, she added.
Read full story
Source: BBC News, 16 June 2023
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Trust leadership accused of lack of ‘oversight’ hits out at CQC ‘algorithm’

Mid and South Essex Foundation Trust has received a Care Quality Commission warning notice about the medical care provided by its three hospitals. 
It has been told to make urgent improvements after inspectors found a deterioration in quality across its Broomfield, Basildon and Southend hospitals. 
The overall ratings for Broomfield and Basildon hospitals have dropped to “inadequate” as a result.
The CQC carried out a focused inspection in January and February that was prompted by concerns over the safety and quality of medical care and older people’s services, including over people’s nutrition and hydration.
Hazel Roberts, CQC deputy director in the east of England, said inspectors “found a leadership team who didn’t have complete oversight of the issues they’re facing”. 
Among the concerns raised by the CQC’s report were the safety of the premises and equipment, a lack of nursing and support staff, staff not always respecting people’s dignity and privacy, and risk assessments not always being completed and updated.
Read full story (paywalled)
Source: HSJ, 16 June 2023
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Blood test to detect 50 types of cancer could be given to 1m people on NHS

A blood test which can detect 50 cancers before symptoms start to show could be offered to a million people in a pilot programme from next summer, according to the head of the NHS.
Amanda Pritchard, NHS chief executive, said the Galleri test has the potential to “transform cancer care forever”, according to reports.
The liquid biopsy detects tiny fragments of tumour DNA in the bloodstream and alerts doctors as to whether a cancer signal has been detected and predicts where in the body that signal may have originated.
If early results are successful, a pilot screening programme involving one million patients over two years is scheduled to begin next summer.
The test is expected to find 5,000 potential cases of the disease every year.
Read full story
Source: The Guardian, 15 June 2023
Patient Safety Learning

My surgeon experimented on me and ruined my life

Leann Sutherland was 21 and suffering from chronic migraines when one of Scotland's top surgeons offered to operate.
She was told she would be in hospital for a few days and had a 60% chance of improvement. Instead she was in for months while Sam Eljamel operated on her seven times.
"He had free rein on my body. He was playing god with my body and the NHS handed him the scalpel, seven times," says Leann.
When Leann tried to raise concerns with staff she was told that Mr Eljamel had saved her life. She was not told that he was under investigation, nor that he had been later forced to step down.
It was only after seeing recent BBC coverage she realised she was not alone.
The BBC can reveal her surgeon - the former head of neurosurgery at NHS Tayside - was harming patients and putting them at risk for years but the health board let him carry on regardless.
BBC Scotland has spoken to three surgeons who worked under Mr Eljamel at Tayside. All three said he was a bully who was allowed to get away with harming patients.
All three said there was a lack of accountability in the department and that Mr Eljamel was allowed to behave as if he were a "god" - partly because of the research funding he brought to the department.
Read full story
Source: BBC News, 16 June 2023
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Government dilutes public health priorities to deliver shorter NHS mandate

The government has downgraded the importance of improving public health in its annual ‘mandate’ to the NHS.
‘The government’s 2023 mandate to NHS England’ is noticeably shorter at 18 pages than the previous document from March 2022.
Speaking at the NHS ConfedExpo conference, health secretary Steve Barclay said: “For over a decade, governments have used the mandate to make asks of the system. Sometimes these asks have been excessive, with long documents with many pages full of tests and targets… But what we’ve done this year is make it short and clear… setting out our priorities: Cutting waiting lists; the three recovery plans; tech; and workforce".
All the keystone targets for recovering the elective backlog, emergency care waits and cancer care remain in place.
However, the latest mandate places significantly less emphasis on public health.
For example, one of the five objectives in the 2022 mandate called for the service to “embed a population health management approach within local systems, stepping up action to prevent ill health and tackle health disparities”. It also makes no mention of any vaccination programme.
Read full story (paywalled)
Source: HSJ, 15 June 2023
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Super-engineered vaccines created to help end polio

Scientists have "super-engineered" polio vaccines to prevent them mutating into a dangerous form that can cause outbreaks and paralysis.
The oral vaccines contain weakened live polio viruses and the genetic redesign locks them into that weakened state.
The US and UK teams have now created upgraded vaccines against all three types of polio.
However, better vaccines still need to reach every child in order to stop the disease.
Read full story
Source: BBC News, 14 June 2023
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'All pregnant women are in danger’: protests in Poland after expectant mother dies in hospital

“Stop killing us,” protesters across Poland chanted this evening, demanding the legalisation of abortion, after reports reached the media of a pregnant woman’s death in a hospital in May.
On Monday, Poland’s patients’ rights ombudsman, Bartłomiej Chmielowiec, said that the John Paul II hospital should have told 33-year-old Dorota Lalik that her life could be saved through an abortion. The hospital violated her rights by withholding the information, the ombudsman ruled.
The woman died in the hospital in Nowy Targ, in the south of the country, on 24 May, three days after her admission.
“No one told us that we had practically no chance for a healthy baby … The entire time they were giving us false hope that everything will be OK … that [in the worst case] the child will be premature,” Lalik’s husband told Polish media. “No one gave us the choice or the chance to save Dorota, because no one told us her life was at risk.”
Read full story
Source: The Guardian, 14 June 2023
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Northern Ireland Health: Waiting list patient communication 'in disarray'

The system for communicating with patients on healthcare waiting lists in Northern Ireland is in disarray, the Public Services Ombudsman has found.
Its year-long investigation found that significant and repeated failures in updating patients amounted to "systematic maladministration".
The ombudsman urged the Department of Health (DoH) to work with trusts, GPs and others to address the failings.
DoH said it appreciated the distress and frustration of patients on lists.
The investigation found that failures by trusts across Northern Ireland to follow guidance meant that patients were given little or no information once a referral had been made. 
Commenting on the findings, Ombudsman Margaret Kelly said the investigation found a waiting list system "which is in disarray and sometimes even chaos".
"There is a lack of coherence between the different parts of the system, a lack of clear communication, and a lack of an overall agreed plan for improvement."
Read full story
Source: BBC News,15 June 2023
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NHS 'corrected mistakes' after son's suicide

An NHS trust has been accused of adding to the records of a man the day after he took his own life to "correct their mistakes".
The patient, a man aged 33, died under the care of Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) in 2017.
The patient, who was diagnosed with paranoid schizophrenia and substance misuse, had been under CPFT's care two months when he died.
He had been transferred from a neighbouring trust after moving to Ely and then been taken off a community treatment order.
His mother, Angelina Pattison, told the BBC that despite being heavily involved in her son's care, she was "shocked that they transferred him without even telling me".
A trust serious untoward incident (SUI) review acknowledged that when he was transferred no-one from CPFT had asked about whether his family had been involved in his care.
Ms Pattison said: "They didn't have any address of [my home] in his care plan and the care plan was done when he died - when they were running around to correct their mistakes, which they have done"
The BBC has separately spoken to consultant nurse and psychotherapist Des McVey, who was asked by the trust to investigate a complaint in July 2021, understood to be the one from Ms Pattison.
Mr McVey said: "I noticed that the deceased did have care plans, but they were written the day after his death and they were also evaluated the day after his death and I was concerned that this wasn't picked up by the SUI."
He said this "really alarmed me", adding: "Surprisingly, there was no care plan to address his suicidal ideation and he had... an extensive history of trying to kill himself."
Read full story
Source: BBC News, 15 June 2023
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Retired specialists set to help with tackling Covid backlog

Retired doctors will have an option to “keep caring” and re-join the NHS to carry out outpatient appointments in a new initiative to help reduce waiting lists.

From autumn, newly-retired doctors will be able to sign up to a new digital platform where they will be able to offer their availability to trusts across England to perform outpatient appointments, either virtually or in person.
NHS hospitals will choose the consultant whose skillset and availability best matches the appointments they need covered, which are scheduled and arranged with patients in the normal way.
More than four-fifths of people on the waiting list require an outpatient appointment such as a follow-up for cardiology or rheumatology – rather than a surgical procedure.
Consultants carrying out remote appointments could be based anywhere in England, which can help those hospitals in areas with higher demand.
Those requiring a face-to-face appointment or follow-up will be seen in the usual way.
Speaking at NHS Confed Expo, Amanda Pritchard, NHS Chief Executive, said: “Ahead of the NHS 75th birthday in July, this new platform is an innovative example of how we are constantly adapting the way we work to benefit patients by helping to reduce waiting times as well as supporting staff.
“Using this digital tool will help us to match patients with retired doctors who we know are keen to stay working in a flexible way so they can keep caring for patients, as well as allowing us to expand capacity to see even more patients – and faster.
“NHS staff have already made excellent progress against our Elective Recovery Plan – and this platform will not only help us continue to reduce the longest waits but it will also help us slash agency spend, using the existing capacity of experienced doctors who still have so much to offer the NHS”.
Read full story
Source: NHS England, 14 June 2023
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GP referrals system may be creating a 'hidden' patient backlog of patients needing treatment

A reduction in the number of GP referrals to hospitals could be creating a "hidden backlog" of patients needing help, according to a new report.
The study by the Institute for Government (IFG) and Public First says that not enough data is published about the "advice and guidance" referral system.
Family doctors have been told to reduce the number of people they refer for hospital care by using the 'advice and guidance' route – whereby a GP will call or email a hospital doctor to ask for advice on whether or not a referral is required.
The method has been used since 2015 but NHS England introduced a target for GPs to have 12 "advice and guidance" patients for every 100 outpatient appointments in October 2021 in an attempt to reduce the backlog of hospital care. This has now increased to 16 but it has been reported that as many as 22 out of 100 potential hospital appointments are being handled this way.
The IFG and Public First report states: "There is a risk that GPs making fewer referrals – in part to address hospital capacity concerns – is creating a 'hidden backlog' by allowing treatable conditions to deteriorate and possibly leading to more unplanned admissions."
Read full story
Source: Medscape, 14 June 2023
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