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

NHS unable to treat every child with eating disorder as cases soar

The NHS can no longer treat every child with an eating disorder, a leading psychiatrist has warned, as “worrying” figures reveal hospital admissions have risen 41% in a year.
A dramatic surge in cases during the pandemic has left already struggling community services overstretched with many unable to care for everyone who requires help, experts said.
NHS Digital data for England shows a sharp rise in admissions in every area of the country. The provisional data for April to October 2021 – the most recent available – shows there were 4,238 hospital admissions for children aged 17 and under, up 41% from 3,005 in the same period the year before.
Charities said the fast rising number of hospital admissions was “only the tip of the iceberg”, with thousands more children needing support for eating disorders.
Dr Agnes Ayton, the chair of the eating disorders faculty at the Royal College of Psychiatrists, said: “The hidden epidemic of eating disorders has surged during the pandemic, with many community services now overstretched and unable to treat the sheer number of people needing help. We are at the point where we cannot afford to let this go on any longer."
“Early intervention is key to recovery and to preventing serious illness, which is why it’s crucial that the money announced by government urgently reaches the frontline. The government must also deliver a workforce plan to tackle the shortages in eating disorder services so that they have enough staff to treat everyone who needs help.”
Read full story
Source: The Guardian, 4 January 2021
 
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NHS given its 10 priorities for 2022

NHS England has set out 10 priorities for 2022-23 in its annual planning guidance.
NHSE chief executive Amanda Pritchard makes clear in an introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.”
The 10 priorities are:
Workforce investment, including “strengthening the compassionate and inclusive culture needed to deliver outstanding care”. Responding to COVID-19. Delivering “significantly more elective care to tackle the elective backlog”. Improving “the responsiveness of urgent and emergency care and community care capacity.” Increasing timely access to primary care, “maximising the impact of the investment in primary medical care and primary care networks”. Maintaining “continued growth in mental health investment to transform and expand community health services and improve access”. Using data and analytics to “redesign care pathways and measure outcomes with a focus on improving access and health equity for underserved communities”. Achieving “a core level of digitisation in every service across systems”. Returning to and better “prepandemic levels of productivity”. Establishing integrated care boards and collaborative system working, and “working together with local authorities and other partners across their ICS to develop a five-year strategic plan for their system and places”. Read full story (paywalled)
Source: HSJ, 24 December 2021
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Leak shows surge in staff absence as trusts consider letting covid positive clinicians return to wards

NHS staff absences due to covid have risen by a further 11,000 staff in a week in England, figures seen by HSJ reveal. 
At a national level, the number of absences for covid-related reasons - including isolation - rose to about 44,200 on 29 December, up from 32,800 on 22 December.
The 29 December figure has pushed up overall absence for all reasons to 103,727 - 7.8% of the total reported workforce - the leaked data shows.
Numerous senior NHS managers have said their main concern at present is about the level of staff absences, which in some cases is undermining services, with staff having to be redeployed to support others. There is concern about it rising further in the new year.
One trust is looking at whether staff who test positive could opt to work on wards dedicated to covid patients. Louise Ashley, the chief executive of Dartford and Gravesham Trust in Kent, tweeted yesterday that some nurses had asked if they could come into work while positive but asymptomatic.
Ms Ashley later confirmed to HSJ that the trust had assessed the request and “unfortunately” had to refuse it.
The two main reasons for the decision were that staff may have the more dangerous Delta strain and that it be too difficult to keep them isolated from other staff.
She added: ”I am amazed at their commitment to their patients and colleagues – very humbling after the two years they have been through. We are seeing high levels of staff absenteeism but we are hurrying through PCR tests to get staff back to work and are managing safe staffing levels currently.”
 There is also growing concern over NHS staff access to testing, which is required to enable contacts to come to work if they are negative.
Read full story (paywalled)
Source: HSJ, 31 December 2021
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Women 32% more likely to die after operation by male surgeon, study reveals

Women who are operated on by a male surgeon are much more likely to die, experience complications and be readmitted to hospital than when a woman performs the procedure, research reveals.
Women are 15% more liable to suffer a bad outcome, and 32% more likely to die, when a man rather than a woman carries out the surgery, according to a study of 1.3 million patients.
The findings have sparked a debate about the fact that surgery in the UK remains a hugely male-dominated area of medicine and claims that “implicit sex biases” among male surgeons may help explain why women are at such greater risk when they have an operation.
“In our 1.3 million patient sample involving nearly 3,000 surgeons we found that female patients treated by male surgeons had 15% greater odds of worse outcomes than female patients treated by female surgeons,” said Dr Angela Jerath, an associate professor and clinical epidemiologist at the University of Toronto in Canada and a co-author of the findings.
“This result has real-world medical consequences for female patients and manifests itself in more complications, readmissions to hospital and death for females compared with males.
“We have demonstrated in our paper that we are failing some female patients and that some are unnecessarily falling through the cracks with adverse, and sometimes fatal, consequences.”
Read full story
Source: The Guardian, 4 January 2022
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‘Get a lift to hospital,’ ambulance trust tells patients with suspected heart attacks

Ambulance trusts have begun asking patients with heart attacks and strokes to get a lift to hospital with family or friends instead of waiting for an ambulance, because of high covid absences and ‘unprecedented’ surges in demand, HSJ has learned.
An internal note at North East Ambulance Service Foundation Trust said that where there was likely to be a risk from the delay in an ambulance reaching a patient, call handlers should “consider asking the patient to be transported by friends or family”.
This applies to calls including category two, which covers suspected strokes and heart attacks, according to the note seen by HSJ.
It said call handlers should “consider all forms of alternative transport” for patients. 
The note from medical director Mathew Beattie gives the example of a person with chest pain who would normally get a category 2 response – with a target of reaching them within 18 minutes – but where the ambulance response time would be two hours.
In the message to staff, Dr Mathew Beattie said: “To manage [current] unprecedented demand, we have no other option than to try and work differently which I am aware will not sit comfortably but is absolutely essential if we are to sustain a service to those who need it most."
“We need to weigh up the risk of delays for ambulances against alternative disposition or transport options. Where such risks are considered, I want you to be aware that the trust will fully support you in your decision-making under these circumstances.”
Read full story (paywalled)
Source: HSJ, 4 January 2022
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More than 90 care home operators in England declare red alert over staffing

Care operators are facing acute staffing shortages caused by Omicron with more than 90 declaring a “red” alert, which means staffing ratios have been breached.
Over 11,000 care home workers are off for Covid reasons, according to internal health system staffing data seen by the Guardian. One of the UK’s largest private operators, Barchester, is dealing with outbreaks in 105 of its 250 homes. It said that rules meaning homes with Covid cannot accept hospital discharges will cause backlogs in the already struggling NHS.
Across England, 9.4% of care home staff are off work, according to government live data, with close to 3% absent because of Covid. The figures, which may be an underestimate because of the festive break, are drawn from submissions by thousands of care providers.
“The spread of Omicron across the country will bring more care homes into outbreak, put huge pressure on the already compromised staff group and mean those who need care do not get it,” said Vic Rayner, chief executive of the National Care Forum. Many care operators said delays in getting PCR test results back were a key frustration, meaning workers who may not be infected were isolating longer than necessary."
Stephen Chandler, president of the Association of Directors of Social Services, said councils were braced for calls for help from care operators and said “the care that people experience will be affected”.
Read full story
Source: The Guardian, 5 January 2022
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Pilot scheme has 'changed critical care forever'

A specialist service to transport critically ill and injured patients is being copied around England after the success of a trial in the South West.
More than 700 patients have been transported since the pilot scheme began a year ago.
Retrieve was set-up to transport the most seriously ill patients between intensive care units to take pressure off ambulance and hospital staff.
Six other regions around England are now developing a similar service.
"Everyone will have a service that looks similar to Retrieve by the end of next year which is amazing in the short period of time that we've been talking about it," said Dr Scott Grier, lead consultant for Retrieve.
Dr Grier said critically unwell patients need to be transported between hospitals for various reasons, though frequently to be treated in a hospital specialising in the care they require.
The service, which operates in Bristol, Gloucestershire, Wiltshire, Somerset, Devon and Cornwall, is funded by NHS England and Improvement South West and costs £3.2m a year.
"It sounds expensive but it's an efficient service and every time we make a transfer we save the hospital and staff time and those hospitals can care for other people while we care for their patients on the move.
"It's incredibly exciting because we have changed this area of critical care forever," added Dr Grier.
Read full story
Source: BBC News, 5 January 2021
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Government to review number of healthcare regulators

The government has ordered an external review of whether the number of professional healthcare regulators should be reduced to ‘simplify’ the system.
Newly published procurement documents reveal the Department of Health and Social Care has hired KPMG to make recommendations on whether the number of regulators “should be reduced and how this might be achieved”.
The scope of the review covers the eight independent healthcare regulators – which include the General Medical Council, the Nursing and Midwifery Council and the Professional Standards Authority for Health and Social Care. It does not cover other healthcare regulators such as the Care Quality Commission, NHS England/Improvement, or the Medicines and Healthcare Products Regulatory Agency. 
According to DHSC there is ongoing work to “reform the healthcare regulators’ legislation” which has created an “opportunity to consider” if the regulatory landscape could be “simplified to provide better public protection in a more efficient way”.
A spokeswoman for the DHSC told HSJ that “stakeholders” accepted that having nine separate professional regulatory bodies “can be confusing for the public”.
She said: “We know health regulators play an integral role in our commitment to making sure everyone has access to safe and effective healthcare, and we will continue to identify opportunities to improve the professional regulation system.” 
In 2014, Sir Robert Francis, who chaired the inquiry into failings at Mid Staffordshire Foundation Trust, said there were too many healthcare regulators in the NHS.
Read full story (paywalled)
Source: HSJ, 5 January 2022
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Ministers order review into Covid-hit ambulance chiefs telling people to get a lift to A&E

A health minister has asked NHS England to look into a stricken ambulance trust that is asking patients to get a lift to A&E.
The North East Ambulance Service (NEAS) said staff should “consider asking the patient to be transported by friends or family.” See previous news story.
NEAS medical director Dr Mathew Beattie said the service had “no option than to try to work differently” amid Covid staff shortages.
However, Health Minister Gillian Keegan said she would ask NHS England to look into the situation.
She told Sky News: "That is not what we have put in place at all. We have more ambulance crews in operation than we have ever had."
“We also gave £55 million extra just for this period to cover staff and make sure we had increases in staff and staffing levels.
"I've actually asked NHS England to look at that particular case because that doesn't sound to me like that's an acceptable approach.
“People should be able to get an ambulance if they have a heart attack and that's why we've put that extra funding in place, and why we've been building up our ambulance service over the last couple of years."
Read full story
Source: Mirror, 5 January 2022
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Fix NHS staffing crisis to tackle waiting lists backlog, warn MPs

A long-term plan to fix the staffing crisis in the NHS is needed to cut record waiting lists for treatment, the government is being warned.
Currently, nearly six million people in England are waiting for routine operations and procedures - many of whom are in pain.
A report from MPs says the government needs to address staff shortages - or NHS workers will quit. 
There have been repeated warnings over the length of hospital waiting lists in England. As of September 2021, a record 5.8 million patients were waiting for surgery - such as hip or knee replacements - with 300,000 waiting more than a year compared with just 1,600 before the pandemic.
In the autumn Budget, the government announced an extra £5.9bn for the NHS in England to help clear the backlog. This was on top of another funding package in September to create an extra nine million checks, scans and operations.
But in its report published today, the Commons health and social care select committee said the health service was hugely understaffed and was facing an "unquantifiable challenge" in tackling the backlog.
Jeremy Hunt, the former health secretary who now chairs the committee, said the NHS was short of 93,000 workers and there was "no sign of any plan to address this".
He described the staffing crisis as "entirely predictable", adding: "The current wave of Omicron is exacerbating the problem, but we already had a serious staffing crisis, with a burnt-out workforce."
"Far from tackling the backlog, the NHS will be able to deliver little more than day-to-day firefighting unless the government wakes up to the scale of the staffing crisis facing the NHS."
Read full story
Source: BBC News, 6 January 2022
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Hundreds of babies born addicted to drugs and alcohol

Scottish Liberal Democrat leader Alex Cole-Hamilton is calling for more cash to be invested in drug and alcohol services after “utterly heart-breaking” figures showed at least 852 babies have been born addicted since April 2017.
A total of 173 such births were recorded in both 2019-20 and 2020-21, down from 205 in 2018-19 and 249 in 2017-18.
In addition to this, a further 52 babies were born addicted in the first part of 2021-22, according to the figures, which were compiled by the Scottish Lib Dems using data obtained under Freedom of Information.
Mr Cole-Hamilton described the figures as being “utterly heart-breaking”, adding: “It is hard to think of a worse possible start in life for a newborn baby to have to endure.”
He criticised SNP ministers, saying: “In 2016, the Scottish Government slashed funding to drug and alcohol partnerships by more than 20 per cent. Valuable local facilities shut their doors and expertise was lost which has proved hard to replace."
“Scotland now has its highest-ever number of drug-related deaths. The Scottish Government has belatedly begun to repair that damage but there is so much more to do."
Read full story
Source: The Independent, 6 January 2022
 
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A quarter of inpatients at mental health trust have Covid

More than one in four inpatients at one of England’s largest mental health trusts were reported as covid-positive this week, according to data seen by HSJ.
Around 160 inpatients across South London and Maudsley (SLAM) Foundation Trust’s sites, or 28% of its total open beds, were reported as positive at the beginning of the week. 
Several other London mental health trusts have seen high rates of covid cases in recent weeks, as there has been enormous spread of the omicron variant in the capital, although rates have not been as high as at SLAM.
SLAM told HSJ that infection rates rose and fell in a reflection of community transmission, with covid-positive people being admitted, and there being spread within inpatient units.
While no wards have been closed and all of the trust’s services are open, visiting was suspended in mid-December due to what the organisation described on its website as a “high number of [covid] outbreaks”.
Several sources in the sector told HSJ there had been widespread omicron outbreaks in mental health units across England. They said the nature of psychiatric wards and use of restraints meant adhering to stringent social distancing measures, in the face of a highly infectious variant, was more difficult than in other settings.
Read full story (paywalled)
Source: HSJ, 6 January 2022
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Omicron blocks thousands of overseas doctors joining NHS

Thousands of overseas-qualified doctors wanting to work in the UK will be delayed after the General Medical Council cancelled exams due to the surge in Covid cases.
The regulator said its decision to pause professional and linguistic assessment board tests, scheduled for January and February, was made “in direct response” to the current omicron wave. Up to 54 doctors would have been needed each per day as examiners, it said, alongside a “large number of role players and staff”.
It comes as overseas recruitment is seen by government and national officials as a crucial way to boost NHS staffing, including GPs.
Director of registration Una Lane said: “We are deeply disappointed to have to cancel exams at this time, but given the pressures on the NHS and the impact on examiner availability, it was the only viable option.”
Read full story (paywalled)
Source: HSJ, 6 January 2022
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Deadly Omicron should not be called mild, warns WHO

The World Health Organization (WHO) has warned against describing the Omicron variant as mild, saying it is killing people across the world.
Recent studies suggest that Omicron is less likely to make people seriously ill than previous Covid variants.
But the record number of people catching it has left health systems under severe pressure, said WHO chief Dr Tedros Adhanom Ghebreyesus.
On Monday, the US recorded more than one million Covid cases in 24 hours.
The WHO - the UN's health agency - said the number of global cases has increased by 71% in the last week, and in the Americas by 100%. It said that among severe cases worldwide, 90% were unvaccinated.
"While Omicron does appear to be less severe compared to Delta, especially in those vaccinated, it does not mean it should be categorised as mild," Dr Tedros told a press conference on Thursday.
"Just like previous variants, Omicron is hospitalising people and it is killing people.
"In fact, the tsunami of cases is so huge and quick, that it is overwhelming health systems around the world."
Read full story
Source: BBC News, 6 January 2022
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Number of adults with dementia to exceed 150m by 2050, study finds

The number of adults living with dementia worldwide is on course to nearly triple to 153 million by 2050, according to the first study of its kind.
Experts described the data as shocking and said it was clear that dementia presented “a major and rapidly growing threat to future health and social care systems” in every community, country and continent.
US researchers said the dramatic rise from an estimated 57 million cases in 2019 would be primarily due to population growth and ageing. However, several risk factors for dementia – including obesity, smoking and high blood sugar – would also fuel the increase, they said.
Improvements in global education access are projected to reduce global dementia prevalence by 6.2 million cases by 2050. But this will be countered by anticipated trends in obesity, high blood sugar and smoking, which are expected to result in an extra 6.8 million dementia cases.
Hilary Evans, the chief executive of Alzheimer’s Research UK, who was not involved in the study, said the figures “lay bare the shocking scale of dementia across the world”.
She said: “We need to see concerted global action to avoid this number tripling. Dementia doesn’t just affect individuals, it can devastate whole families and networks of friends and loved ones. The heartbreaking personal cost of dementia goes hand in hand with huge economic and societal impacts, strengthening the case to governments across the world to do more to protect lives now and in the future.”
Read full story
Source: The Guardian, 6 January 2022
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UK survey suggests 1.3 million have Long Covid

About 1.3 million people in the UK have Long Covid symptoms lasting more than four weeks after an initial infection, an Office for National Statistics survey suggests. Of those, 892,000 (70%) first caught the virus at least 12 weeks ago and 506,000 (40%) at least a year ago.
The survey asked nearly 352,000 people to record their own symptoms. There is no universally agreed definition of long Covid and different studies use varying definitions.
The ONS survey, over four weeks in November and December 2021, suggests, of those with Long Covid:
51% have fatigue 37% have loss of smell 36% have shortness of breath 28% have difficulty concentrating. University of Exeter senior clinical lecturer Dr David Strain said: "The stark warning here is that, based on this, in the previous waves, over 800,000 people have their day-to-day activities significantly affected over three months after catching Covid and nearly a quarter of a million report this has a dramatic impact on their quality of life.
"As we continue to see case numbers of Omicron rise, we must be wary that our reliance purely on hospitalisations and death as a measure of the risk from Covid could grossly underestimate the public-health impact of our current Covid strategy."
Read full story
Source: BBC News, 6 January 2022
 
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