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Keep up to date with the latest news, research and activity in patient safety.
A woman who has been waiting three years for a hysterectomy says she feels she and other women have been pushed to the bottom of the list.
Jessica Ricketts, from Barry, is one of 164,000 patients who have been on various NHS waiting lists for more than a year, compared to less than 7,000 two-years-ago. But it will take another three years to tackle the backlog.
Welsh government's plan to tackle long waits is due to be published later.
But for Jessica, she remains in pain with endometriosis despite six gynaecological surgeries over the past 10 years and is now waiting for the hysterectomy.
"Every day there's some sort of pain and I'm in pain right now," she told BBC Radio Wales Breakfast.
"My fear is that the endometriosis - because obviously I'm just waiting - is now in my diaphragm, and so I get pain on my left side.
"With every day almost, which used to just be cyclical and now it's gone a lot worse."
Jessica is keen to see what the Welsh government's plan to cut waiting times is, but she believes women's health "seems to be at the very bottom of the pile".
She added: "I think it's even more important now than ever, to really push the women's health side of things. We have it takes on average 10 years for a diagnosis of endometriosis.
"As women we have to fight to even get past the GP who is severely under-trained in this department.
"And it's just seems to be that because we're women. We're told that you know, just suck it up really and carry on and it needs to be a fairer system, particularly for the women of Wales and we need to stop pushing it to the bottom of the pile."
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Source: BBC News, 26 April 2022
The UK’s Health Security Agency (UKHSA) says it is investigating after finding more than 100 cases of sudden hepatitis in children.
Doctors said they had seen "increasing" evidence the problem is linked to adenoviruses - a group of viruses that can cause illnesses such as the common cold and flu.
The HSA said it cannot rule out other possible causes such as Covid, which it is also investigating, but that an adenovirus has been identified in 40 out of the 53 cases so far tested.
In Britain, cases have reached 81 in England, 14 in Scotland, 11 in Wales and five in Northern Ireland, with the majority of patients under five years old.
No children in the UK have died, it was confirmed, after the World Health Organization said there had been 169 cases globally with at least one child who had died from the illness.
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Source: The Independent, 26 April 2022
Relatives of intensive care Covid patients were left traumatised by being banned from visiting their seriously ill loved ones during the pandemic, a study has found. 
Researchers found two-thirds of family members of patients in intensive care were still suffering high levels of symptoms of post traumatic stress disorder (PTSD) three months after their relative was admitted. 
Symptoms of PTSD include flashbacks, nightmares and physical sensations such as pain, sweating, feeling sick or trembling. 
Before the Covid pandemic, symptoms of PTSD in family members of intensive care patients were between 15 and 30 per cent, depending on the condition. 
The team from the University of Colorado School of Medicine said visitation restrictions may have inadvertently generated a secondary public health crisis of stress-related disorders in family members of Covid patients. 
At the height of the pandemic, hospitals across Britain restricted access to patients, with many people forced to say goodbye to dying loved ones over Skype, or behind screens or windows. 
Even as late as last winter, a Telegraph investigation showed that a quarter of trusts were still imposing restrictions on visitors. 
The findings suggest that the rates of PTSD may be higher in relatives than in patients. A previous study by Imperial College and the University of Southampton found that only one-third of patients on ventilators suffer symptoms. 
Read full story (paywalled)
Source: The Telegraph, 25 April 2022
Women with asthma are twice as likely to die from an asthma attack compared with men in the UK, new figures show as health experts called for urgent research into the condition’s sex-related differences.
They are more likely to have the condition, more likely to need hospital treatment for it and more likely to die from an attack, Asthma + Lung UK said. Over the past five years women have accounted for more than two-thirds of asthma deaths in the UK.
The charity said the current “one size fits all” approach to asthma treatment is “not working” because it does not take into account the impact that female sex hormones during puberty, periods, pregnancy and menopause can have on asthma symptoms and attacks. More must be done to tackle the “stark health inequality”, it added.
Between 2014-15 and 2019-20 more than 5,100 women in the UK died from an asthma attack compared with fewer than 2,300 men. Meanwhile, emergency hospital admissions in England show that, among those aged 20 to 49, women were 2.5 times more likely to be admitted to hospital for asthma treatment compared with men.
Asthma + Lung UK said many people were unaware that fluctuations in female sex hormones can cause asthma symptoms to flare up or even trigger life-threatening attacks. It is calling for more research to examine the sex-related differences in asthma.
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Source: The Guardian, 27 April 2022
A trust has discovered 1,800 patients who were removed by mistake from its elective waiting list.
Barking, Havering and Redbridge University Hospitals Trust chief executive Matthew Trainer wrote to colleagues in the east London health system today to “apologise for the stress this will have caused those experiencing a delay”.
Of the 1,800 patients involved, 600 have been waiting more than a year and roughly 200 have been waiting for more than two years.
Mr Trainer’s note explained: “The patients have been waiting to see our specialists in routine clinics in gynaecology, neurology, neurosurgery and ophthalmology.”
It continued: “As we have been working through our waiting lists, we have discovered a problem with one of them that was used to deal with the backlog created by the pandemic.
“It contained routine referrals that were submitted by GPs who wanted their patients to be seen by a specialist, but for whom there were no appointments available due to covid-19. Unfortunately, these patients were removed automatically from this list before they had been seen.”
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Source: HSJ, 26 April 2022
Major differences in the rate of foot amputations for people with diabetes in England are incredibly concerning, patient groups say.
Such amputations are a sign patients have not received adequate care, as poorly controlled diabetes increases the risk of foot ulcers and infections.
One in 10 areas had "significantly higher rates", government data shows. There was nearly a five-fold difference between the best and worst when taking into account risk factors such as age.
The government data - published by the Office for Health Improvement and Disparities - looked at the three years leading up to the pandemic.
It is believed up to 80% of foot amputations could be avoided with better care.
Diabetes UK said the figures "shined a light on the scale of the crisis facing diabetes care" and it warned access to support was likely to have become worse during the pandemic.
A report produced by the charity earlier this month said lives would be needlessly lost because of disruption to services over the past two years.
Diabetes UK chief executive Chris Askew said the latest figures were "incredibly concerning".
"The majority of these major amputations are preventable, but many people living with diabetes are struggling to access the care they need - and in areas of higher deprivation, people are experiencing worse outcomes. These inequalities must be addressed."
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Source: BBC News, 27 April 2022
Fewer than one in three people who have been hospitalised with Covid-19 have fully recovered a year after they succumbed to infection.
That is the shock finding of a survey into the impact of long Covid in the UK. The team of scientists and doctors at Leicester University also found that women had poorer recovery rates than men after hospitalisation, while obesity was also likely to hinder a person’s prospects of health improvements.
Among the symptoms reported by patients a year after their initial infection were fatigue, muscle pain, poor sleep and breathlessness.
“Given that more than 750,000 people have been hospitalised in the UK with Covid-19 over the past two years, it is clear from our research that the legacy of this disease is going to be huge,” said Rachael Evans, one of the study’s authors.
The team stressed their results show there is now an urgent need to develop ways to tackle Long Covid. “Without effective treatments, Long Covid could become a highly prevalent long-term condition,” said Professor Chris Brightling, another author.
A critical factor in these poor rates of recovery was the lack of treatments that exist for Long Covid, added Professor Louise Wain, who was also involved in the study. “No specific therapeutics exist for long Covid and our data highlights that effective interventions are urgently required.”
The researchers also found that many of those reporting impairment in the wake of their hospitalisation were suffering from persistent inflammation. “That suggests these groups might respond to anti-inflammatory strategies,” added Wain.
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Source: The Guardian, 24 April 2022
Three in four GPs have reported facing increasing patient abuse last year, according to a major survey by a medical defence organisation.
The Medical and Dental Defence Union of Scotland (MDDUS) surveyed almost 2,000 members across the UK, including 668 GPs, about their experiences last year compared with 2020.
It revealed that 76% of GPs reported an increase in verbal abuse from patients towards them and their practice staff. Half of these (38%) said this had ‘significantly increased’ and the other half that it had ‘somewhat increased’ throughout 2021.
Female GPs were more likely to face verbal abuse or aggression than their male counterparts, with 81% reporting an increase in this compared with 72% of their male colleagues.
The survey found that this has led to a ‘huge increase in work-related stress’, MDDUS said.
Among GPs who experienced verbal abuse or aggression in the workplace, 83% said they felt ‘more stressed’ than they did in 2020.
MDDUS chief executive Chris Kenny said: ‘The pandemic has stretched our healthcare professionals to the limit. For those at the very frontline, it is clear now that the levels of stress have reached an almost unsustainable point.
‘GPs urgently need recognition, reassurance and realism to support them so they can reset their relationship with patients.’
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Source: Pulse, 22 April 2022
In an unprecedented murder case in the United States about end-of-life care, a physician accused of killing 14 critically ill patients with opioid overdoses in a Columbus, Ohio hospital ICU over a period of 4 years was found not guilty by a jury Wednesday.
The jury, after a 7-week trial featuring more than 50 witnesses in the Franklin County Court of Common Pleas, declared William Huse not guilty on 14 counts of murder and attempted murder.
In a news conference after the verdict was announced, lead defense attorney Jose Baez said Husel, whom he called a "great doctor," hopes to practice medicine again in the future. The verdict, he argued, offers an encouraging sign that physicians and other providers won't face prosecution for providing "comfort care" to patients suffering pain. "They don't need to be looking over their shoulders worrying about whether they'll get charged with crimes," he said.
The trial raised the specific issue of what constitutes a medically justifiable dose of opioid painkillers during the end-of-life procedure known as palliative extubation, in which critically ill patients are withdrawn from the ventilator when they are expected to die. Under medicine's so-called double-effect principle, physicians must weigh the benefits and risks of ordering potentially lethal doses of painkillers and sedatives to provide comfort care for critically ill patients.
To many observers, however, the case really centered on the largely hidden debate over whether it's acceptable to hasten the deaths of dying patients who haven't chosen that path. That's called euthanasia, which is illegal in the United States. In contrast, 10 states plus the District of Columbia allow physicians to prescribe lethal drugs to terminally ill, mentally competent adults who can self-administer them. That's called medical aid in dying, or physician-assisted dying or suicide.
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Source: Medscape, 27 April 2022
NHS management and leadership are overly ‘task focused’, according to briefings by the senior military leader who has carried out a major review of health and care for the government. 
General Sir Gordon Messenger has nearly completed the work, which had been due to be published shortly before Easter but was delayed by the government, and has briefed several senior leaders on several of his main observations.
According to several senior figures, he has said NHS management and leadership are heavily “task focused” — a management term referring to an approach devoted to completing certain tasks or meeting certain short-term objectives; in contrast to an approach which focuses on people, relationships or skills.
HSJ has spoken to several senior sources who have been briefed on Sir Gordon’s findings so far.
One said the former military figure had observed that “NHS leadership is… very focused on getting things done, and not focused enough on how things get done – which I think is very fair if you think particularly what the last 10, 15 years have been like”.
Another finding, according to those briefed, is the need for better support for NHS leaders running the most difficult local organisations, including providing what has been described as “support packages”.
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Source: HSJ, 26 April 2022
Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic have been ruled unlawful by the High Court.
The ruling comes after two women took former Health Secretary Matt Hancock and Public Health England to court.
Dr Cathy Gardner and Fay Harris said it had caused a "shocking death toll".
Prime Minister Boris Johnson renewed his apologies for all those who lost loved ones during the pandemic.
Dr Gardner and Ms Harris partially succeeded in claims against Mr Hancock and Public Health England.
The women claimed key policies of discharging patients from hospitals into care homes were implemented with no testing and no suitable isolation arrangements in the homes.
A barrister representing Dr Gardner and Ms Harris told the court at a hearing in March that more than 20,000 elderly or disabled care home residents died from Covid between March and June 2020 in England and Wales.
Jason Coppel QC also said in a written case outline for the judicial review that the care home population was known to be "uniquely vulnerable" to Covid.
"The government's failure to protect it, and positive steps taken by the government which introduced Covid-19 infection into care homes, represent one of the most egregious and devastating policy failures in the modern era," he added.
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Source: BBC News, 27 April 2022
A major reform of the way NHS clinical negligence claims are handled in England is needed, MPs say.
The House of Commons' Health and Social Care Committee said the current system was too adversarial, leading to bitter and long legal fights for patients.
More than £2bn a year is paid out on claims, but 25% goes to legal fees.
An independent body should be set up to adjudicate on cases and the need to prove individual fault should be scrapped, the cross-party group said.
Instead, the focus should be whether the system failed, which the MPs believe would create a better culture for learning from mistakes.
The committee heard from families who had lost children or whose babies had been left with brain injuries from mistakes made during birth.
Parents described how they had to fight for years to get recognition for the harm that had been caused.
One woman criticised the "complacent attitude" of the hospital involved, saying they just wanted to put it down to one mistake and carry on as normal.
Another woman whose daughter died aged 20 months after errors in her care said she felt lessons had not been learnt despite a settlement in her favour. She said the whole process had left her feeling devastated.
The average length of time for these settlements was over 11 years, the committee was told.
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Source: BBC News, 27 April 2022
An NHS mental health trust that has been the worst performing in England has been warned it must improve after failing another inspection.
Norfolk and Suffolk NHS Foundation Trust (NSFT) has been rated "inadequate" in the latest Care Quality Commission (CQC) report.
The CQC said it had served the trust with a warning notice that it had to act on to improve patient care.
The trust has been rated "inadequate" on three previous occasions by the health watchdog, as well as being the only one currently within the NHS's improvement regime for not meeting standards.
Following the latest inspection, its overall rating was downgraded from "requires improvement" - and three out of five measures assessed by the CQC, for safety, leadership and effectiveness, met its lowest grading.
The report said two wards were immediately closed to new patients following a CQC visit in November, after the trust was threatened with enforcement action if urgent measures were not taken.
Significant staffing problems, including an annual nurse vacancy rate of more than 17%, were also highlighted.
Staff at an adult long stay ward did not complete regular checks on patients supposed to happen every 30 to 60 minutes, which meant they were unaware if somebody needed help for periods of up to seven hours.
Inspectors also said there had been a severe deterioration on the trust's inpatient ward for children and young people - the Dragonfly Unit in Carlton Colville, Suffolk.
They found it was reliant on agency workers and lacked a permanent doctor.
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Source: BBC News, 27 April 2022
New responsibilities for doctors regarding their use of social media and tackling toxic workplace behaviours and sexual harassment are among key proposals in the General Medical Council’s (GMC) planned update to its core ethical guidance.
The regulator has launched a 12-week consultation on the draft new content of 'Good medical practice', which outlines the professional values, knowledge and behaviours expected of doctors working in the UK. This represents the first major update of the guidance since it first came into effect in April 2013, with the review process launched last year.
The GMC said the draft new update follows months of working with doctor, employer, and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces.
Included for the first time in the draft new guidance is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment, or discrimination, as well as zero tolerance of sexual harassment.
For the first time, the GMC's ethical guidance proposes 12 commitments, including:
Make the care of patients my first concern. Demonstrate leadership within my role, and work with others to make healthcare environments more supportive, inclusive, and fair. Provide a good standard of practice and care, and be honest and open when things go wrong. Ensure my conduct justifies my patients’ trust in me and the public's trust in my profession. Read full story
Source: Medscape, 27 April 2022
At least 200,000 people missed out on essential surgery as a result of the Covid-19 pandemic, with many enduring “misery and daily pain” as a result, a conference has heard.
Both scheduled and emergency surgery levels dropped by 20% during the pandemic, suggesting there is now significant pent-up demand for treatment, according to the national clinical lead in surgery, Prof Deborah McNamara.
Almost 343,000 people are waiting to see a surgeon for the first time, 100,000 of whom have been on a waiting list for more than 18 months, she told the conference on outcomes from the pandemic at the Royal College of Surgeons in Ireland (RCSI).
This was only the start of delays for patients, she pointed out, as they have to wait again for their procedure to be carried out. Currently, more than 71,000 patients are waiting for surgery, a fifth of whom have been on the list for more than a year.
Long-waiting patients needing complex surgery have been disproportionately affected, she said, as the system focused on treating “quick-win” procedures such as endoscopies. The amount of day-case work carried out by hospitals is back to 84 per cent of 2017 levels, yet complex care remains at only 67 per cent, she pointed out. Patients waiting for surgery were enduring a “huge amount of misery” that remains unquantified, according to Prof McNamara.
The pandemic resulted in some positive changes, she said, including shorter hospital stays, a greater role for physician associates and a generational change in the use of IT. However, it also led to greater constriction in the capacity for scheduled surgery, and greater seasonal variations in demand.
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Source: The Irish Times, 26 April 2022
Nearly a third of community pharmacies in Wales should be able to prescribe medicines for NHS patients, including antibiotics, by the end of this year, health officials say.
It is the first new service of its kind in the UK. The aim is to take the pressure off GPs at a time of increasing strain on the NHS.
Scotland has adopted a similar approach but England and Northern Ireland have not so far.
Community pharmacies in Wales are allowed to offer prescriptions of medicines for acute illnesses such as urinary tract and respiratory infections, gout and chronic pain, as well as emergency contraception - if they have a pharmacist who has had extra training for prescribing.
For most patients, that will be more convenient and avoid waits for GP appointments.
The plan is to roll out the service progressively across Wales, building on local schemes already in place.
Local doctors in general practice have welcomed the new policy.
Dr Penny Coyle said each week about 25 patients with minor ailments were referred to the pharmacist, saving 100 GP appointments a month and giving doctors more time to visit seriously ill patients in their homes.
"We are finding that demand is outweighing capacity and so anything that relieves some of the pressure on general practice is very welcome," she said.
Association of Independent Multiple Pharmacies chief executive Dr Leyla Hannbeck said: "Pharmacist prescribers can help massively when you think about the shortages and the HRT issues, for example, that we are currently facing - having a pharmacist prescriber being able to prescribe alternative medicines without the patient having to wait to see the GP." 
Read full story
Source: BBC News, 27 April 2022
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