Visiting times have been extended at Dorset's hospitals during strike action so relatives and friends of patients can help.
Times at general inpatient wards have been altered to be between 10:00 and 20:00 GMT on Wednesday and Thursday.
Hospital bosses said help at mealtimes, for example, would allow nursing staff to focus on clinical care.
All wards "will be safely staffed during the industrial action", the hospitals said.
The UHD trust said: "If you wish to help your loved one at mealtimes or with any personal care, please do so - just let a member of the ward team know."
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Source: BBC News, 18 January 2023
A series of concerns about serious incidents at a mental health trust are being investigated by the Care Quality Commission, with a referral also made to the police, HSJ has learned.
HSJ understands that various incidents at Black Country Healthcare Foundation Trust have been raised with the Care Quality Commission by whistleblowers.
According to a well-placed source, one of the alleged incidents involved alleged inappropriate sexual behaviour, and this has been referred to West Midlands police.
Other complaints are understood to include staff using mental health inpatients’ rooms to sleep in, and an information governance breach in which patient information was shared with members of staff who did not need to receive them. It is understood this was in an email raising patient safety concerns.
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Source: HSJ, 17 January 2023
An acute trust chief executive has criticised the lack of communication during last month’s nursing strike, warning that he and other accountable officers could face manslaughter charges if patients are put in danger by decisions made by senior colleagues elsewhere in the system.
Matthew Hopkins told a board meeting that Worcestershire Royal Hospital’s emergency department was “pushed to the extreme” on 20 December, with 176 people squeezed into a facility originally built for 50.
He said that without warning from regional colleagues, an additional 18 people were brought in to the hospital by the ambulance service and ended up in corridors, at which point the trust declared a critical incident.
The chief executive officer said he wanted to put on record an apology to staff for the incident, adding that he was “not aware” of the situation until it unfolded.
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Source: HSJ, 17 January 2023
Patients will suffer if ministers bow to nurses’ demands for pay rises, the health secretary has warned as tens of thousands of NHS staff walk out on today.
Steve Barclay told the Independent said any boost to wages would “take billions of pounds away from where we need it most”.
He wrote: “Unaffordable pay hikes will mean cutting patient care and stoking the inflation that would make us all poorer.”
Today tens of thousands of nurses will strike across 55 trusts. NHS data shows 4,567 operations and 25,009 outpatient appointments were cancelled during the nurse’s strikes on 15 and 20 December.
The NHS also faces further ambulance strikes next Monday, which sources indicate will go ahead, and new strikes are to be announced for February by union GMB.
The Royal College of Nursing (RCN) criticised Mr Barclay for “pitting nurses against patients”, branding the comments “a new low for the health secretary”.
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Source: The Guardian, 18 January 2023
Young people in the midst of a mental health crisis need to have attempted suicide several times before they get a bed in an inpatient unit in England, a report has revealed.
Admission criteria for beds in child and adolescent mental health units are now so tight that even very vulnerable under-18s who pose a clear risk to themselves cannot get one.
The practice – caused by the NHS’s lack of mental health beds – leaves young people at risk of further harm, their parents confused, exhausted and worried, and the police and ambulance services potentially having to step in.
The high thresholds for admission to a child and adolescent mental health services (Camhs) unit are detailed in a report on NHS mental health care for under-18s in England based on interviews with patients, their parents and specialist staff who look after them.
The report says a young person has to “have attempted suicide multiple times to be offered inpatient support”.
Olly Parker, the head of external affairs at the charity Young Minds, said: “It is shameful that children and young people are reaching crisis point before they get any support for their mental health. We know from our own research that thousands have waited so long for mental health support or treatment that they have attempted to take their own life.
“Those who end up in A&E are often there because they don’t know where else to turn. But A&E can be a crowded and stressful environment, and is usually not the best place to get appropriate help.”
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Source: The Guardian, 18 January 2023
The fact that the NHS is under enormous pressure is undisputed. Almost everything else is debated, including the question of how many patients are dying as a result of the chaos in hospitals.
The proportion of patients who wait more than 12 hours in A&E departments to be admitted to a ward has risen from 2% to 7% over the past year.
The Royal College of Emergency Medicine has estimated that delays in A&E are leading to 300-500 additional deaths per week. However, officials at NHS England do not accept this figure.
The data suggest that something is very awry.
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Source: The Economist, 11 January 2023
Hospital inspectors have raised safety concerns over maternity care at an NHS trust where dozens of babies died unnecessarily.
The Care Quality Commission (CQC) is threatening the East Kent Hospitals trust with enforcement action to ensure patients are protected.
An independent review in October found that at least 45 babies might have survived with better care at the trust.
The East Kent Hospitals trust has been approached for comment.
Inspectors carried out an unannounced inspection of the trust's maternity services over two days last week.
Following the visit, the CQC has now written to the trust "to request evidence of the steps it is taking to ensure people are safe and protected from risk."
In a statement to the BBC, Deanna Westwood, a director of operations with the CQC, said they would "review the trust's response to determine whether the use of our enforcement powers is required."
The warning comes just four months after the trust was severely criticised for its maternity care between 2009 and 2020.
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Source: BBC News, 18 January 2023
Further reading:
Patient Safety Learning - Mind the implementation gap: The persistence of avoidable harm in the NHS
Ambulance workers are to join nurses in taking strike action on 6 February in England and Wales in what will be the biggest NHS walkout in this dispute.
The GMB announced four new stoppages for ambulance staff - one of which coincides with a nurses' strike date.
It is the first time both ambulance staff and the Royal College of Nursing (RCN) have acted on the same day.
GMB national secretary Rachel Harrison said: "Ambulance workers are angry. Our message to the government is clear - talk pay now."
The walkouts by staff including paramedics, call handlers and support workers in seven of the 10 English ambulance services along with the national Welsh service will take place on 6 and 20 February, and 6 and 20 March.
Under trade union laws, both unions will have to provide emergency cover.
But it raises the prospect of urgent 999 calls for falls not being responded to, and a huge chunk of pre-planned hospital care such as hernia repair, hip replacements or outpatient clinics not being done.
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Source: BBC News, 18 January 2023
An artificial pancreas has been successfully trialled in patients with type 2 diabetes, a university said.
Scientists at the University of Cambridge developed the device which combines a glucose monitor and insulin pump with an app.
The app uses an algorithm that predicts how much insulin is required to keep glucose levels in the target range.
Average glucose levels fell while patients trialled the device, the university said.
The researchers have previously shown that an artificial pancreas run by a similar algorithm is effective for patients living with type 1 diabetes, where the body's immune system attacks and destroys the cells that produce insulin.
Dr Charlotte Boughton from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge, who co-led the study, said: "Many people with type 2 diabetes struggle to manage their blood sugar levels using the currently available treatments, such as insulin injections.
"The artificial pancreas can provide a safe and effective approach to help them, and the technology is simple to use and can be implemented safely at home."
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Source: BBC News, 19 January 2023
You may also be interested in:
Top picks: 5 key resources about diabetes
Diabetes technology is life-changing, but we need to be prepared when it fails
How safe are closed loop artificial pancreas systems?
Consultants who blew the whistle at a major teaching trust have raised “grave concerns” about the impartiality of three reviews into the safety and bullying allegations they made.
Last month, Birmingham and Solihull Integrated Care Board announced three investigations into University Hospitals Birmingham, following worries about bullying and poor workplace culture.
Former trust consultants Manos Nikolousis, John Watkinson and Tristan Reuser have now written to the cross-party reference group holding the investigations to account. Their letter, seen by HSJ, outlines their concerns about potential conflicts of interest.
The first investigation is reviewing the trusts’ handling of 12 never events, staff deaths including a recent suicide, and 26 GMC referrals. It is being run by former NHS England deputy medical director Mike Bewick and may report as early as next week.
The second and third reveiws will assess trust leadership and broader cultural issues respectively, and will be carried out with UHB and NHSE.
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Source: HSJ, 18 January 2023
Ministers must use legislation to address an “unacceptable and inexcusable” failure to address racial disparity in the use of the Mental Health Act (MHA), MPs and peers have said.
The joint committee on the draft mental health bill says the bill does not go far enough to tackle failures that were identified in a landmark independent review five years ago, but which still persist and may even be getting worse.
The committee says the landmark 2018 review of the MHA by Prof Simon Wessely – which the bill is a response to – was intended to address racial and ethnic inequalities, but that those problems have not improved since then “and, on some key metrics, are getting rapidly worse”.
Lady Buscombe, the committee chair, said: “We believe stronger measures are needed to bring about change, in particular to tackle racial disparity in the use of the MHA. The failure to date is unacceptable and inexcusable.
“The government should strengthen its proposal on advanced choice and give patients a statutory right to request an advance choice document setting out their preferences for future care and treatment, thereby strengthening both patient choice and their voice.”
A Department of Health and Social Care spokesperson said: “We are taking action to address the unequal treatment of people from Black and other ethnic minority backgrounds with mental illness – including by tightening the criteria under which people can be detained and subject to community treatment orders.
“The government will now review the committee’s recommendations and respond in due course.”
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Source: The Guardian, 19 January 2023
Pressures on emergency health services are so bad that the UK government should declare a “national emergency” and call a meeting of the Civil Contingencies Committee (COBRA)—the body summoned periodically to deal with matters of major disruption—peers have said.
The cross party House of Lords Public Services Committee said in a report that the government needed to respond with an emergency approach and steps to remedy the situation in the longer term.
A recurring theme of the report is the substantial delays highlighted by the media in recent months, which peers said were caused by a “broken” model of primary and community care. This was driving unmet need in directing patients to hospitals where many remained longer than clinically necessary because of inadequate social care.
The report recommended that the Department of Health and Social Care should mandate a greater presence of clinical staff in NHS 111 control centres to help boost numbers of clinicians in the 999 and 111 services. This would mean that patients were directed to the right services more quickly thanks to better triaging of calls, which could mean fewer patients being passed to emergency or urgent care services.
Another suggestion was for the government to introduce more incentives for faster safe discharges from hospitals, with more capacity in hospitals and social care to help people move through the health system more quickly.
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Source: BMJ, 19 January 2023
Further reading on the hub:
Patient safety impact of hospital bed shortages – A Patient Safety Learning blog
High risks relating to the ordering, prescribing, storing and administration of medicines have been found by the Mental Health Commission in a series of inspections of mental health centres in Dublin.
The commission emphasised the need to have appropriate practices including the recording of the minimum dose interval information; where medication has been stopped, the stop date to be recorded; and the need to always have the prescriber’s signature recorded.
The inspector of mental health services Dr Susan Finnerty said it was positive to see centres maintaining high compliance rating, but spoke of concerns around the administration of medication.
“We know that medication is an important tool in treatment of mental illness. In order to reduce the risk of medication errors, we need to be sure that medication prescription and administration records are completed correctly,” Dr Finnerty said.
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Source: Independent Ireland, 18 January 2023
An invitation to a cervical screening test upon your 25th birthday has become a necessary but often unwanted coming-of-age present. Despite years of education and advocacy about the benefits of screening, many women still do not attend. About 16 million women in the UK aged 25-64 are eligible for testing, but only 11.2 million took a test in 2022, the lowest level in a decade.
There unfortunately remains a false narrative that there are good reasons to be nervous about cervical screening tests. In reality, the test is not physically painful for the vast majority of women, although it can be a bit uncomfortable. However, the test can be needlessly emotionally painful, and for no good reason. This is in part because some women go through the experience of sitting with legs spread apart and “private parts” out, and then hear the nurse call for “the virgin speculum” to be used.
This is the archaic and unnecessarily sexualised term for the extra-small speculum. It should have no place being used in 2023, and it clearly creates feelings of vulnerability.
Next week it is Cervical Cancer Awareness week, and campaigners are hoping to shine a light on barriers to cervical screening testing that must be removed.
By creating feelings of vulnerability around testing, we are allowing cervical cancer to continue to go undetected. All women should be aware of the importance of attending their cervical screening test and do so with confidence, regardless of their sexual status. This will play a valuable role in reducing the mortality rate.
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Source: The Guardian, 19 January 2023
Further hub reading:
Doctors’ shocking comments reveal institutional misogyny towards women harmed by pelvic mesh
Misogyny is a safety issue: a blog by Saira Sundar
Gender bias: A threat to women’s health (August 2020)
Ask any MP or local Healthwatch what health issue sits at the top of their inbox, and there is a good chance it will be the public’s access to NHS dentists. The launch of a Health and Social Care Committee inquiry into dentistry is therefore welcome news.
The inquiry is well timed, coming after a recent BBC investigation showing that 90% of practices across England were not accepting new adult NHS patients.
The severe access problems stem from several factors. Longstanding issues relating to the dental contract not offering high enough rates for dentists to provide NHS care, for example, have contributed to a decline in the availability of NHS dentistry. This has led to thousands of people across the country going private or, very concerningly, turning to self-care.
Accident and emergency departments are over-flowing with people in severe dental distress, with tooth decay being the most common reason for hospital admission among children aged five to nine in recent years.
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Source: HSJ, 19 January 2023
Inspectors raised serious concerns around leadership and safety at Lister Hospital in Stevenage, run by East and North Hertfordshire Trust, when they visited in October. The maternity service was also rated inadequate for leadership.
The CQC also raised concerns about staffing shortages, infection prevention control, care records, cleanliness, waiting times and training.
The inspection did, however, find staff worked well together, managers monitored the effectiveness of the service and findings were used to make improvements.
Carolyn Jenkinson, the CQC’s head of hospital inspection, said: “This drop in quality and safety was down to insufficient management from leaders to ensure staff understood their roles, and to ensure the service was available to people when they needed it.”
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Source: HSJ, 20 January 2023
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