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

High levels of microplastics found in operating theatres

High levels of microplastics have been found in operating theatres by researchers who highlighted the “astoundingly high” amounts of single-use plastic used in modern surgical procedures.
A team from the University of Hull found the amount of microplastics in a cardiothoracic operating theatre was almost three times that found in homes, and said this identifies another route through which the tiny particles can enter the human body, with unknown consequences.
The study, published in the journal Environment International, is the first to examine the prevalence of microplastics in surgical environments.
The team analysed levels in the operating theatre and the anaesthetic room in cardiothoracic surgeries and discovered an average of 5,000 microplastics per metre squared when the theatre was in use.
Jeanette Rotchell, professor of environmental toxicology at the university, said the types of microplastic particles identified relate to common plastic wrapping materials and could also come from blister packs, surgical gowns, hairnets and drapes for patients.
Prof Rotchell said: “Although we know microplastics are in the air in a variety of settings, we can’t yet say what the consequences are or whether microplastics are harmful to health. Researchers have yet to establish this.
Read full story
Source: The Independent, 27 January 2023
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Political will to tackle health security ‘melting away’, warns Tony Blair

The impetus to tackle health security has started to “melt away”, despite the devastation wrought by the Covid pandemic, Tony Blair has warned.
In the foreword to a new book, ‘Disease X’, the former British prime minister said that while there are “concurrent crises jostling for the attention of governments”, leaders should not miss the opportunity to implement the “hard-won lessons” of the past three years.
“Covid-19 was an unprecedented global crisis and should mark a turning point in global health policy and preparedness,” Mr Blair wrote. 
“Our governments need to demonstrate the same level of political will, ambition and international cooperation that leaders demonstrated in the wake of World War II, when they coalesced around the objective of a sustainable peace. 
“This must be applied to the post pandemic order because, at its heart, health security is national security,” he added. “It is clear this will not be the last pandemic threat of our lifetimes … there is no excuse to be unprepared, again.” 
Read full story (paywalled)
Source: The Telegraph, 25 January 2023
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NHS in England will have one strategy for all major conditions, including cancer

The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing numbers of people in England with complex and often multiple long-term conditions.
Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia, mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer have its own dedicated 10 year strategy.
England’s health and social care secretary, Steve Barclay, told the House of Commons on 24 January that the strategy would build on measures in the NHS long term plan.
Read full story (paywalled)
Source: BMJ, 25 January 2023
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Trust receives record fine for maternity care failure

An acute trust has been fined a record sum by the Care Quality Commission for failing to provide safe maternity care, which resulted in the death of a baby after 23 minutes.
Nottingham University Hospitals must pay a fine of £800,000 within two years. It is only the second time the regulator has brought a case against a NHS maternity service, and the highest fine ever given for failings of this nature.
The trust pleaded guilty earlier this week to two charges of failing to provide safe care and treatment to Sarah Andrews and her baby daughter Wynter Andrews at Queen’s Medical Centre in 2019, a short time after her birth by Caesarean section. This guilty plea saw the fine reduced from £1.2m. 
An inquest in 2020 found the death was a “clear and obvious case of neglect”. It was also found there was “an unsafe culture prevailing within maternity services”, including a “failure to listen and respond to staff safety concerns”.
Read full story (paywalled)
Source: HSJ, 27 January 2023
Sam

Whistleblowers claim children ‘seriously harmed’ at scandal-hit mental health hospitals

Children came to “significant” harm due to chronically low staffing levels at scandal-hit mental health hospitals, whistleblowers have said.
In a third exposé into allegations of poor care at private hospitals run by The Huntercombe Group, former employees have claimed that staffing levels were so low “every day” that patients were neglected, resulting in:
Patients as young as 13 being force-fed while restrained. Left alone to self-harm instead of being supervised. Left to “wet themselves” because staff couldn’t supervise toilet visits. One staff member, Rebecca Smith, said she was left in tears after having to restrain and force-feed a patient.
Following a series of investigations by The Independent and Sky News, 50 patients came forward with allegations of “systemic abuse” and poor care, spanning two decades at children’s mental health hospitals run by the organisation.
The government has since launched a “rapid review” into inpatient mental health units across the country following the newspaper’s reporting.
Read full story
Source: The Independent, 28 January 2023
 
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Nearly £15bn wasted on Covid PPE, says UK spending watchdog

The UK health department was forced to write down £14.9bn worth of personal protective equipment and other medical items, according to a report by the independent public spending watchdog, which also issued a scathing criticism of the UK Health Security Agency.
The National Audit Office said that the Department for Health and Social Care did not complete an “effective programme of year-end stock counts” to assess the quality and quantity of coronavirus-related items, such as lateral flow tests.
During the last two financial years, the DHSC reported nearly £15bn of write down costs associated with PPE and other health items. The department estimated that the continuing cost of storage and disposal of excess and unusable equipment stands at £319mn.
The watchdog found a “lack of adequate governance, oversight and control” at the UKHSA. It noted that due to a “lack of sufficient, appropriate audit evidence and significant shortcomings in financial control” the NAO was unable to provide an audit opinion on the 2021-22 accounts of the agency.
Read full story (paywalled)
Source: Financial Times, 27 January 2023
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‘Risk of future deaths’: coroner issues rare warning to health secretary over hospitals crisis

A coroner has urged the health secretary to take action to prevent needless deaths after a woman died of heart failure following a four-hour wait in the back of an ambulance.
Lyn Brind, 61, was taken to the Queen Elizabeth Hospital (QEH) in King’s Lynn, Norfolk, with chest pains and low blood oxygen levels but could not be admitted because the hospital had “no space”. Instead she remained in a queue of ambulances outside A&E without a timely diagnosis or treatment and where warning signs about her condition were missed.
It was only after four hours and 25 minutes of waiting that she was transferred to a ward, by which time she was “agitated and short of breath”. She was placed on life support but died 22 minutes later.
Brind’s family believe the grandmother of four, a former dinner lady from the town, “might still be alive today” had she been admitted more swiftly. “She wasn’t given a chance,” her partner of 38 years, Richard Bunton, said.
After an inquest earlier this month into Brind’s death in May 2022, the senior coroner for Norfolk, Jacqueline Lake, took the unusual step of writing to England’s health secretary, Steve Barclay, to raise concerns about the NHS and social care.
She warned that others could die in similar circumstances unless action was taken. “I believe you have the power to take such action,” Lake wrote in a prevention of future deaths report.
Read full story
Source: The Guardian, 29 January 2023
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NHS plan: £1bn for hospital beds and ambulance fleet

Thousands of extra hospital beds and hundreds of ambulances will be rolled out in England this year in a bid to tackle the long emergency care delays.
The 5,000 new beds will boost capacity by 5%, while the ambulance fleet will increase by 10% with 800 new vehicles.
Details of the £1bn investment will be set out later in a joint government and NHS England two-year blueprint.
Questions have also been raised about how the extra resources will be staffed - 1 in 10 posts in the NHS is vacant.
The government believes the measures, which will be introduced from April, will help the NHS to start getting closer to its waiting time targets.
It has set goals that by March 2024:
76% of A&E patients will be dealt with in four hours. Currently fewer than 70% are. The official target is 95% An average response time of 30 minutes for emergency calls such as heart attacks and strokes. In December patients waited over 90. The official target is 18. Prime Minister Rishi Sunak said cutting NHS waiting times was one of his five main priorities.
Read full story
Source: BBC News, 30 January 2023
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NHSE launches new intervention regime for worst A&E performers

NHS England has revealed a new intervention regime, as it seeks to deliver on its new urgent and emergency care recovery plan.
Systems will be placed in three “tiers of intervention”, with those systems deemed “off-target on delivery” being given “tier three intensive support” from NHSE, which will include on-the-ground planning, analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”.
The approach follows that which has been taken over the past year for elective and cancer care recovery. 
The urgent care plan, published by NHSE and the Department of Health and Social Care today, says: “NHS England will identify and share good practice so that all can learn from the best. For those systems that are struggling, we will offer support to ensure that they have the best opportunities to drive improvement locally.”
Read full story (paywalled)
Source: HSJ, 30 January 2023
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Toxic slimming pill drug DNP to be declared poison

A highly toxic chemical compound sold illegally in diet pills is to be reclassified as a poison, a government minister has said.
Pills containing DNP, or 2,4-dinitrophenol, were responsible for the deaths of 32 young vulnerable adults, said campaigner Doug Shipsey.
His daughter Bethany, from Worcester, died in 2017 after taking tablets containing the chemical.
The deaths were down to a "collective failure of the UK government", he said.
DNP is highly toxic and not intended for human consumption. An industrial chemical, it is sold illegally in diet pills as a fat-burning substance.
Experts say buying drugs online is risky as medicines may be fake, out of date or extremely harmful.
Mr Shipsey said he had targeted the minister following the death of another young man who had taken the drug sold as a slimming aid.
Prior to this, following the inquests of dozens of young people who had suddenly and unexpectedly died from DNP toxicity, the government had "ignored numerous coroners reports" to prevent future deaths, he said.
"So, at last after 32 deaths and almost six years of campaigning, the Home Office (HO) finally accept responsibility to control DNP under the Poisons ACT 1972," he added.
Read full story
Source: BBC News, 28 January 2023
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Thousands of NHS staff with long Covid risk losing their pay

Thousands of NHS staff across the UK are facing pay cuts because of a change in Covid sickness policy.
Analysis by BBC Panorama suggests that between 5,000 and 10,000 NHS workers could be off sick with Long Covid.
Unions are accusing the government of failing to support health staff who worked during the coronavirus pandemic.
The government says the Covid-19 public inquiry will examine these issues when it begins taking evidence in May.
Changes to special sick pay rules introduced during the pandemic mean that some NHS staff unable to work due to Long Covid may soon no longer receive full pay.
Enhanced provision ended last year. Many had a six-month transition, so expect their wages to go down soon.
Some face losing their jobs.
Professor David Strain is the chair of the Board of Science at the British Medical Association (BMA) and says this makes him "genuinely angry".
He explains: "We've got a group of people that have put themselves forward to look after the population, they've been left with an illness and they're not being supported.
"They're just in a no man's land."
He believes that health workers with long Covid should be allowed to focus on their recovery without money worries.
Read full story
Source: BBC News, 30 January 2023
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NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn

The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures.
Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK.
In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”.
Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone.
NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay.
Read full story
Source: The Guardian, 29 January 2023
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Medicines blackout threatens ICS prevention target

The government’s target for England to become smoke-free by 2030 – which integrated care systems are expected to pursue – is being undermined by the unavailability of two smoking cessation medicines.
The objective, set by government in 2019, is being taken forward by many ICSs, as they seek to prevent premature illness and death, and narrow health inequalities, with smoking rates normally higher in more deprived populations.
However HSJ analysis of drug shortages revealed that the two cessation medicines are both currently unavailable for an extended period.
Champix (varenicline) has been unavailable since October 2021, a situation exacerbated by the absence of Zyban (bupropion), since December 2022.
Both drugs were withdrawn because of concerns about the presence of nitrosamines, which may increase risk of cancer if people are exposed to them above acceptable levels, and will be subject to further tests and regulatory checks if they are to return.
Matthew Evison, a lung cancer and tobacco dependency specialist at Manchester University Foundation Trust, said Champix was clinicians’ “most powerful weapon” against smoking. He said the treatment gap would make the target harder because “smoking prevalence declines will be slower without varenicline”.
Read full story
Source: HSJ, 30 January 2023
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A mysterious Adderall shortage reveals how America fails ADHD patients

Erik, a 26-year-old Seattle grocery clerk, who also has attention-deficit hyperactivity disorder (ADHD), has been unable to get his medications filled for months now – and he’s worried he’ll lose the first full-time job he’s ever had.
For people like Erik, ADHD medication is a prerequisite for basic functioning – and over the last year it’s become dramatically harder for patients like them to access care. Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD.
In recent months, patients have reported problems filling nearly every type of ADHD medication. What’s stranger is that no one seems to know why. Is it some kind of supply chain issue? A pandemic-era surge in demand? A government crackdown?
Official explanations have offered little clarity. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation.
The situation has left patients in turmoil.
Read full story
Source: The Guardian, 30 January 2023
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Hospital doctor accused of sexual assaults on patients

The National Crime Agency and Interpol has been drafted in by detectives investigating a junior doctor accused of multiple sexual assaults on children and adults in A&E departments. 
Last year, Staffordshire police began an investigation into a 35-year-old medic's work at two hospitals, the Royal Stoke University Hospital in Staffordshire and the Russells Hall Hospital in Dudley, West Midlands.

Source: Sunday Times
Shared by Shaun Lintern Tweet, 29 January 2023
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‘Hospitals at home’ plan to save NHS

More than half a million patients a year will be treated in “hospitals at home” in an attempt to relieve pressure on A&E departments.
Under the plans, elderly and frail patients who fall will be treated by video link, with ministers saying that a fifth of emergency admissions could be avoided with the right care.
Health officials said the “virtual wards” would be backed up by £14 billion in extra spending on health and care services over the next two years, as the NHS tackles record backlogs, with seven million people on waiting lists.
Rishi Sunak said the Urgent & Emergency Care Recovery Plan showed that the NHS was one of his “top priorities”.
Read full story (paywalled)
Source: The Telegraph, 29 January 2023
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