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

Rubella warning to pregnant women amid MMR jab decline

Diminishing rates of measles, mumps, and rubella (MMR) jabs have prompted a Royal College warning over the risks to pregnant women, as the NHS raises concerns over London “lagging” behind the national uptake.
The Royal College of Paediatrics and Child Health’s immunisations lead, Dr Helen Bradford, said the falling uptake of the MMR vaccine could present a serious risk to pregnant women and their unborn children.
The warning comes as London health authorities are planning a major summer drive to improve uptake in the capital, The Independent has learned.
Documents seen by The Independent setting out NHS plans for a summer MMR campaign put the focus on social media, including approaching “influencers” to spread messages. The plans also rely on free publicity, with proposals to approach broadcast media.
Risks to increasing uptake, according to the document, included anti-vaxx sentiment towards MMR, apathy towards the vaccine, controversy meaning influencers won’t work with the NHS, and a lack of internal data.
Read full story
Source: The Independent, 27 June 2022
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UK’s biggest GP chain replacing doctors with less qualified staff

The UK's biggest chain of GP practices lets less qualified staff see patients without adequate supervision, an undercover BBC Panorama investigation has found.
Operose Health is putting patients at risk by prioritising profit, says a senior GP.
The company, with almost 600,000 NHS patients, is owned by US healthcare giant Centene Corporation. 
BBC Panorama sent undercover reporter Jacqui Wakefield to work as a receptionist at one of the UK company's 51 London surgeries. 
A GP working at the practice said they were short of eight doctors. The practice manager said they hired less qualified medical staff called physician associates (PAs), because they were "cheaper" than GPs.
Physician associates were first introduced by the NHS in 2003, so that doctors could deal with more complex patient needs. PAs are healthcare professionals who have completed two years of post-graduate studies on top of a science degree, as opposed to 10 years education and training for GPs. They support GPs in the diagnosis and management of patients, but should have oversight from a doctor.
Panorama gathered evidence that PAs were not being properly supervised at the Operose practice. The PAs told the undercover reporter they saw all sorts of patients, sometimes without any clinical supervision. They said the practice treated them as equivalent to GPs.
Prof Sir Sam Everington, a senior practising GP at an unconnected partner-run practice, reviewed BBC Panorama's undercover footage and said he was concerned for patient safety.
During the undercover investigation at the London practice, administrative workers also revealed a backlog of thousands of medical test results and hospital letters on Operose computer systems. 
One worker said they were tasked with getting through 200 documents a day, deciding which were important enough to be seen by a GP or pharmacist and which would be filed to the patient's records. One member of staff, worried about making mistakes said they sometimes used Google to help them work out what to do with the documents.
Read full story
Source: BBC News, 11 June 2022
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World faces ‘perfect storm’ for measles outbreak affecting children, WHO warns

A spike in the number of measles cases around the world has sparked concerns over the potential for serious outbreaks this year.
Almost 17,338 measles cases were reported worldwide in January and February 2022, compared to 9,665 during the first two months of last year – which represents a rise of 79%.
Unicef and the World Health Organisation (WHO) warned that there is a “perfect storm” for serious outbreaks of the vaccine-preventable illnesses such as measles.
As of this month, the agencies report 21 large and disruptive measles outbreaks around the world in the last 12 months.
The five countries with the largest measles outbreaks since the past year include Somalia, Yemen, Nigeria, Afghanistan, and Ethiopia.
The coronavirus pandemic has seen much of health funding and resources diverted to deal with the spread of the virus since 2020.
In 2020, the first year of the pandemic, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.
These pandemic-related disruptions – as well as increasing inequalities in access to vaccines – has left many children without protection against contagious diseases while Covid restrictions are eased in most countries, the two organisations said.
Read full story
Source: The Independent, 28 April 2022
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Australia: National cosmetic surgery standards needed for patient safety

More than 100,000 doctors in Australia hold the right to call themselves cosmetic surgeons, without having undergone the specific training to be competent and safe.
President of the Australasian College of Cosmetic Surgery and Medicine Dr Patrick Tansley says cosmetic surgery does not form part of the traditional medical training undertaken in Australia, due to the practice being relatively new.
“Society has moved faster than legislation has followed it,” he told Sky News Australia.
Dr Tansley said he is advocating for the introduction of a national standard to endorse this area of practice in Australia, where doctors would be placed on a public register for patients to review their accreditation.
“Once they had met those standards and then were endorsed, they could be placed on a public register, independently administered by the regulator AHPRA.
“And the public would then be able to see, with clarity and transparency, which of those doctors have been trained and accredited in cosmetic surgery.”
Read full story
Source: Sky News, 23 April 2022
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Pandemic disrupted routine vaccinations of US kindergarteners

Yet another hidden cost of Covid-19 was revealed on Thursday as the Centers for Disease Control and Prevention presented new data showing how the pandemic has dramatically impeded the US effort to vaccinate kids for other diseases.
According to the CDC’s report, national vaccine coverage among American children in kindergarten dropped from 95% to below 94% in the past year – which may seem like a small amount but meant 350,000 fewer children were vaccinated against common diseases.
“Overall, today’s findings support previous data showing a concerning decline in childhood immunizations that began in March 2020,” Shannon Stokley, the CDC’s immunization services deputy division director, said in a press conference on Thursday.
Some of the reasons for the lower vaccination rates included reluctance to schedule appointments, reduced access to them, so-called “provisional” school enrollment, the easing of vaccination requirements for remote learners, fewer parents submitting documents and less time for school nurses to follow up with unvaccinated students.
States and schools also told the CDC that there were fewer staff members to assess kindergarten vaccination coverage, and a lower response rate from schools, both due to Covid-19.
“The CDC provides vaccines for nearly half of America’s children through the Vaccines for Children program,” Stokley said. “And over the last two years, orders for distribution of routine vaccines are down more than 10% compared to before the Covid-19 pandemic.
“We are concerned that missed routine vaccinations could leave children vulnerable to preventable diseases like measles and whooping cough which are extremely dangerous and can be very serious, especially for babies and young children.”
Read full story
Source: The Guardian, 21 April 2022
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Hyponatraemia: How documentary lifted the lid on a scandal that shocked parents to the core

In October 2004, UTV broadcast a documentary called When Hospitals Kill, which examined the deaths of Raychel Ferguson, Adam Strain and Lucy Crawford.
The programme claimed the children died from hyponatraemia because they had been given too much of the wrong type of fluid while in hospitals in Northern Ireland.
The following month, the then minister with responsibility for health in Northern Ireland, Angela Smith, announced a public inquiry into the allegations made in the UTV documentary and appointed Mr John O’Hara QC as chair of the inquiry.
Claire Roberts was then added to the remit of the inquiry after her parents viewed When Hospitals Kill and raised concerns over the circumstances of her death.
Following Claire’s death, her parents were told she had died as a result of a viral infection which spread to her brain, but they never fully understood what had happened to their only daughter.
Mr O’Hara then made a decision to also examine the death of 15-year-old Conor Mitchell.
Publishing his findings in January 2018, Mr Justice O’Hara said that four of the five deaths he had examined were preventable.
In a scathing assessment of the health service, he said that “doctors and managers cannot be relied upon to do the right thing at the right time” and that some witnesses to the inquiry “had to have the truth dragged out of them”.
Read full story
Source: Belfast Telegraph, 29 March 2022
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UK to bring in licensing scheme for Botox and filler procedures

People administering Botox or fillers will be required to have a licence under new laws after an “unacceptable” rise in reports of botched cosmetic procedures in the UK.
The legislation to protect against rogue practitioners will make it an offence to perform such non-surgical work without a licence after Sajid Javid said “far too many people have been left emotionally and physically scarred” when things have gone wrong.
The health secretary recognised that most of those in the aesthetics industry “follow good practice” when it comes to patient safety but said it was time to think about the harm botched cosmetic procedures can have.
“We’re doing all we can to protect patients from potential harm, but I urge anyone considering a cosmetic procedure to take the time to think about the impact on both their physical and mental health and ensure they are using a reputable, safe and qualified practitioner,” he said.
Maria Caulfield, the minister for patient safety, said the spread of images online via social media has led to a rise in demand for Botox and fillers and there had been a subsequent increase in people suffering the consequences of badly performed procedures.
She said: “While these can be administered safely, we are seeing an unacceptable rise in people being left physically and mentally scarred from poorly performed procedures.”
Read full story
Source: The Guardian, 28 February 2022
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‘Black market’ Botox scars women for life

Practitioners with no professional medical qualifications use social media to target women and girls, an investigation by undercover Times reporters has found.
The medicines regulator has begun an investigation after undercover Times reporters found beauticians offering to inject women with “black market” Botox, putting them at risk of being disfigured for life.
Practitioners with no professional medical qualifications used social media to target women and girls, suggesting the treatments were safe and would enhance their looks. Many used products that have not gone through safety checks in Britain. Reporters confirmed that at least three practitioners advertising facial injections on social media sites were using cheap versions of Botox that are not licensed in the UK.
Campaigners say they are receiving increasing reports of disfigurements such as permanent facial scarring and large sores caused by injections with unlicensed versions of Botox, often carried out in people’s homes and at beauty salons.
The Medicines and Healthcare products Regulatory Agency (MHRA) said it was reviewing the findings and would “take appropriate regulatory action where any non-compliance is identified”.
Sajid Javid, the health secretary, said the practices uncovered were “totally unacceptable” and officials were looking into whether legal changes were needed “to ensure no one is harmed”.
Read full story (paywalled)
Source: The Times, 2 February 2022
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Measles warning for young children as MMR jab rate drops in England

More than 1 in 10 school entry-age children in England are at risk of measles because they have not had their vaccine jabs, data reveals.
Coverage for the two doses of MMR that helps protect five-year-olds against measles, mumps and rubella is currently at 85.5%.
That is the lowest for a decade, and well below the 95% target recommended to stop a resurgence of measles.
Measles is highly contagious, more than Covid, and can cause serious illness. Nine in every 10 people can catch it if they are unjabbed and exposed.
As well as a distinctive rash, measles can lead to severe complications, such as pneumonia and brain inflammation, and sometimes can be fatal.
Vaccination can remove almost all of these risks.
Two doses of the MMR vaccine give 99% protection against measles and rubella and about 88% protection against mumps.
When a high percentage of the population is protected through vaccination, it becomes harder for the disease to pass between people.
But since the start of the Covid pandemic, there has been a concerning drop in the number of children receiving these vaccines on time.
Experts say some parents may not have realised doctors were still offering appointments, or did not want to burden the NHS.
Coverage of the first dose of the MMR vaccine in two-year-olds has now fallen below 90%. This means that more than one in 10 children under the age of five are not fully protected from measles and are at risk of catching it.
Among all five-year-olds in England, 93.7% have had one dose and 85.5% have had the recommended two doses.
Read full story
Source: BBC News, 1 February 2022
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Scots mum considered ending her life due to mesh hell after suffering hernia

A mum says her life has been destroyed following a hernia repaired with a mesh implant – with pain so severe she considered ending her life.
Roseanna Clarkin, 38, has suffered excruciating pain since medics used mesh products to repair the issue.
Now she wants the use of mesh in hernia operations to be suspended, as it has for vaginal mesh following years of suffering by thousands of women.
Revealing her own hell, Roseanna told how she was in so much pain she asked for ­guidance about how to legally end her own life.
She said: "It sent me to a very dark place. I contacted Euthanasia UK. I asked how I could legally do this is Scotland."
Roseanna tearfully admitted: "I said to my husband, 'I have had enough of fighting'."
She added: "When I was going to the doctor's after my op, I wasn't believed.
Read full story
Source: Daily Record, 31 January 2022
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Measles could see a deadly comeback after pandemic saw millions of children miss vaccines

A global threat in the form of a measles outbreak is mounting as more than 22 million infants missed their first vaccine dose for the disease in 2020, warned the world’s top health agencies.
The World Health Organization (WHO) and the US Centres for Disease Control (CDC), in a joint statement on Wednesday, said the number represents the largest increase in missed vaccinations in two decades.
The 22-million figure is three million more than in 2019, “creating dangerous conditions for outbreaks to occur,” according to the agencies.
The surveillance of measles cases deteriorated because of the coronavirus pandemic, which resulted in a reported dip in cases by more than 80%t in 2020, the statement said.
Measles is one of the most contagious viruses to date. It kills more than 60,000 people a year, mostly young children. But at the same time, the disease is entirely preventable through vaccinations, which have averted more than 30 million deaths from the disease globally.
“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support Covid-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, the CDC’s global immunisation director.
Read full story
Source: The Independent, 11 November 2021
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Stillbirth rate high for black and Asian babies in UK

Stillbirth rates remain "exceptionally high" for black and Asian babies in the UK, a report examining baby loss in 2019 has found.
The figures come despite improving numbers overall, with some 610 fewer stillbirths in 2019 than in 2013.
The MBRRACE-UK report found babies of mothers living in deprived areas are at higher risk of stillbirths and neonatal deaths than those in other places.
Charities say there is an urgent need to tackle inequalities around birth.
There were some 2,399 stillbirths (a death occurring before or during birth once a pregnancy has reached 24 weeks) and 1,158 neonatal deaths (babies who die in the first 28 days of life) in the UK in 2019.
The report, by the Universities of Leicester and Oxford, found:
Overall stillbirth rates fell from 4.2 per 1,000 births in 2013 to 3.35 per 1,000 births in 2019 For babies of black and black British ethnicity, stillbirth rates were 7.23 per 1,000 births For babies of Asian and Asian British ethnicity, stillbirth rates were 5.05 per 1,000 births For babies of white ethnicity, stillbirth rates were 3.22 per 1,000 births. Read full story
Source: BBC News, 15 October 2021
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Thousands fewer children immunised against common diseases because of lockdown

Lockdown measures in England led to thousands fewer children receiving vital immunisations for a range of diseases include measles, diphtheria and whooping cough, Public Health England (PHE) has warned.
PHE has warned parents they should continue to get their children immunised regardless of lockdown and restrictions brought on by coronavirus.
During the first wave of coronavirus the government advised that children should continue to receive vaccinations as scheduled but despite these some appointments were delayed and the numbers of children vaccinated against common diseases fell compared to 2019.
PHE looked at data from almost 40% of GP surgeries for use of the common 6-in-1 vaccination for diseases including diphtheria, tetanus, whooping cough, and polio as well as uptake of the measles, mumps and rubella (MMR) vaccine to 19 October. 
In total 167,322 children had the 6-in-1 vaccine, a drop of 6,600 on the same period in 2019, a fall of almost 4%. A total of 167,670 children had the MMR jab, 4,700 fewer than in 2019, a drop of 2.8%.  Although the vaccinations recovered after lockdown the rates are still lower overall than 2019.
Dr Mary Ramsay, head of immunisations at Public Health England, said: “Vaccines remain the best defence against infection. It’s essential we maintain the highest possible uptake to prevent a resurgence of serious and sometimes life-threatening diseases.
“Routine vaccinations are still available throughout the pandemic – it’s vital that we continue to make it as easy and safe as possible for parents to take their children to appointments.”
Read full story
Source: The Independent, 11 November 2020
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Cosmetic surgeon struck off after botched ops

A cosmetic surgeon who did not have adequate insurance for operations that went wrong has been struck off.
Dr Arnaldo Paganelli worked privately for The Hospital Group in Birmingham. The Medical Practitioners' Tribunal Service ruled his actions constituted misconduct.
Four women took their case to the body and the tribunal heard evidence about his time at Birmingham's Dolan Park Hospital where he made regular trips from Italy to work.
Lead campaigner Dawn Knight, from Stanley, County Durham, said too much skin was removed from her eyes during an eyelift in 2012 and they became "constantly sore".
She told BBC Radio 4's You and Yours programme she felt relieved Dr Paganelli "cannot injure anyone else on UK soil" and called for the government to tighten regulation around cosmetic procedures to protect the public.
"The process has been long, emotional and exhausting. This situation must never be repeated. After all, when are you more vulnerable than when under aesthetic at the hands of a surgeon who has no insurance?"
Read full story
Source: BBC News, 12 August 2020
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Bolsin: Maverick or martyr?

Dr Stephen Bolsin is the man widely credited with blowing the whistle on Bristol - endangering his own future in the process.
He claims he was virtually driven out of medicine in this country after proving the catalyst for the ensuing scandal.
But what drives a relatively junior consultant anaesthetist to take the extreme step of risking everything in this way?
Dr Bolsin's own words sum it up: "In the end I just couldn't go on putting those children to sleep, with their parents present in the anaesthetic room, knowing that it was almost certain to be the last time they would see their sons or daughters alive."
Read full story
Source: BBC News
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Missed vaccinations could lead to other fatal outbreaks, doctors warn

Senior doctors fear that thousands of routine vaccination appointments may be missed or delayed because of the coronavirus lockdown, raising the risk of sudden and potentially fatal outbreaks of other diseases when restrictions on movement are finally eased.
GPs and accident and emergency departments have witnessed unprecedented falls in the numbers of people seeking medical care in recent weeks, prompting concerns that vital routine immunisations for infections such as measles, mumps, rubella, tetanus and whooping cough are falling by the wayside.
“We are very concerned. There are no data yet because we have only been in lockdown for a month, but there are plenty of anecdotes from practice nurses and others saying they have noticed a decline in vaccine uptake,” said Helen Bedford, a professor of children’s health at the UCL Great Ormond Street Institute of Child Health and member of the Royal College of Paediatrics and Child Health’s health promotion committee.
Read full story
Source: The Guardian, 26 April 2020
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