Clive Flashman

Many feared that the UK leaving the EU would cause shortages and limitations to the medicine supply throughout England, Scotland, Wales and Northern Ireland. Now ten months on from Brexit are we finally seeing the short fallings? Ninety percent of the UK's medicines are imported from abroad meaning disruptions caused by the outcomes of Brexit and a lack of HGV drivers has caused a significant problem in transporting drugs into the country. Leaked Department of Health and Social Care documents revealed two hundred and nine medicines had supply “issues” in 2019, more than half of these remained in short supply for over three months. Drugs such as hepatitis vaccines and anti-epileptic drugs, faced “extended” problems. A document published by the NHS Nottinghamshire Shared Medicines Management Team compiled a list of shortages and disruptions to supply due to COVID. The following 5 products had long-term manufacturing issues: AstraZeneca’s Zyban (bupropion, anti-smoking drug) Par’s Questran (colestyramine, a bile acid sequestrant) Diamorphine (a painkiller, used for cancer patients) Metoprolol (used for high blood pressure) Co-Careldopa (given to people with Parkinson’s disease) A further thirty medicines had short-term manufacturing issues, including end of life medicines such as morphine and anti-vomiting drug, levomepromazine. NHS Scotland and NHS Wales have published lists of drugs in low supply which are available to view on their NHS websites. NHS England consider this to be ‘sensitive information’ and have not published any shortfalls. An amendment to The Human Medicines Regulations 2019 legislation has added a ‘Serious Shortage Protocol’ (SSP). This allows for pharmacists and contractors to supply patients with a ‘reasonable and appropriate substitute’ if their prescription has an active SSP. Currently, shortages on Fluxoetine, (anti-depressive drug) and Estradot patches, (hormonal replacement therapy) have active SSP’s according to the NHS Business Service Authority. Original source: National Health Executive

Health Education England (HEE) has announced that its new £10 million training programme, intended to ‘boost’ the critical care workforce, will be rolled out this autumn. According to HEE, the funds it secured earlier this year will provide nurses and Allied Health Professionals with a ‘nationally recognised pathway’ to further their careers in Adult Intensive Care Units (ICUs). Specialist training, delivered through a ‘blended learning package’ could help to strengthen the ICU workforce across England and will offer around 10,500 nursing staff the chance to undertake courses and ‘further their careers’. There will be a focus on flexible training – enabling participants to balance family and caring commitments, as well as taking into account those who are unable to travel, when the roll-out of the programme begins. The learning will be delivered by higher education institutions, Critical Care Skills Networks and acute trusts, and it is expected to take participants up to 12 months to receive the standardised qualification. It’s hoped that the programme could lead staff to career opportunities such as becoming a shift leader or clinical educator, or to lead on research. Read full article here Original source: Leading Healthcare News

The agency is now showing disease incidence among unvaccinated people, as well as those who received Johnson & Johnson, Pfizer, and Moderna vaccines. The U.S. Centers for Disease Control and Prevention has published information on its COVID Data Tracker about rates of cases and deaths among fully vaccinated and unvaccinated people. In August, according to the data, unvaccinated people had a 6.1 times greater risk of testing positive for COVID-19, and an 11.3 times greater risk of dying from the disease. Interestingly, the agency also breaks out case and death rates by vaccine product. In mid-August, at the peak of the latest wave, unvaccinated people made up the greatest percentage of COVID-19 cases, at an incident rate of 736.72 cases per 100,000 people. Johnson & Johnson had the second-highest incidence rate, at 171.92 cases per 100,000. Pfizer had the third-highest, at 135.64. And Moderna had the lowest rate, at 86.28 cases per 100,000 people. The death rate mirrored the breakdown in terms of vaccine product and frequency, although the numbers were far lower across the board. Again, at the peak in mid-August, the death rate among unvaccinated people was 13.23 in 100,000 people. Rates for vaccinated people were dramatically reduced, at 3.14, 1.43 and 0.73 for Johnson & Johnson, Pfizer, and Moderna, respectively. When it came to age groups, peak case rates were highest among unvaccinated 12-17 year olds, followed by unvaccinated 30- to 49-year-olds. And 30- to 49-year-olds also had the highest case incidence among vaccinated people when broken down by age group, followed by fully vaccinated 18- to 29-year-olds. Those older than 80 had the highest death rates among both unvaccinated and vaccinated individuals. The COVID Data Tracker site also includes integrated county views, forecasting and hospitalizations by vaccination status. Read the full article here Original source: Healthcare IT News

A mental health trust ‘scapegoated’ a psychiatrist over the death of a patient amid systemic issues, an employment tribunal has found. Judges called the conduct of two senior directors — one of whom is a current NHS trust medical director — into question after ruling they had colluded to scapegoat Bernadette McInerney for issues that would have damaged the trust’s reputation. Nottinghamshire Healthcare Foundation Trust was found unanimously to have unfairly sacked and victimised Dr McInerney, a former consultant forensic psychiatrist at Rampton secure hospital, in a decision published last week. The judgement was critical of both Chris Packham, a GP at Rampton hospital, and NHFT’s then-executive medical director Julie Hankin, but it also strongly condemned the trust’s former executive director for forensic services Peter Wright. Dr Hankin is now medical director at Cambridgeshire and Peterborough FT. Read full article here (paywalled) Original source: Health Service Journal

The BMA has advised practices to immediately start offering consultations of 15 minutes or more; and apply to close their patient list, as part of the fightback against the Government’s new GP access plan. It set out a range of measures GPs should take to protect their staff and patients and ‘prioritise’ core work amid pressure to return to pre-pandemic ways of working. In an email bulletin sent to GPs on Friday, the BMA’s GP Committee said that practices ‘should not feel pressured to return to a traditional 10-minute treadmill of face-to-face consultations that are neither good for patients nor clinicians’. It said: ‘Instead, they should offer patients consultations that are 15 minutes or more [and] apply to close the practice list to focus on the needs of existing patients.’ Read full article here Original source: Pulse

Over-55s are not being recommended useful health technology as GPs presume they cannot use a smartphone, say researchers Older patients are being excluded from beneficial health technology because “ageist” doctors presume they cannot work a smartphone, research has suggested. Experts have accused doctors of “stereotyping” older people as being incapable of using technology and warned patient safety was being put at risk by a failure to support them in using appropriate online health tools. GPs typically recommend NHS-approved health apps to about one in 10 patients aged under 35 to help them manage their conditions between appointments, such as by reminding them to take medications or monitoring their symptoms. However, doctors recommend the same apps to just one in 25 patients over 55 and one in 50 patients over 65, according to research by the Organisation for the Review of Care and Health Apps (ORCHA), which assesses apps for the health service. The same research found 55 per cent of over-55s would be happy to try using a health app if it was recommended, while nine in 10 over-55s and eight in 10 over-65s who have used a health app felt satisfied or very satisfied with the experience. The NHS Long Term Plan states that patients should have access to “digital tools” to manage their health and studies have shown NHS-approved health apps can have clinical benefits. Older people ‘will benefit from digital products’ However, Helen Hughes, the chief executive of the charity Patient Safety Learning, suggested ageist assumptions about older people’s technological ability meant they were missing out. “The data suggests that older people maybe being stereotyped, with assumptions they won’t be computer literate,” she said. “Plenty of older people are tech savvy – or at least willing to learn – and will really benefit from being able to manage their health from home, using digital products. Older patients need to be offered technology solutions with support on how best to use them, if this is needed.” She warned there was also “a significant patient safety issue” with the failure to advise patients about NHS-approved apps, as it left older patients at risk of inadvertently downloading one of the thousands of unreliable health apps available. To read the full article (paywalled), click here Original Source: The Telegraph

Five serious incidents, including the deaths of two children, spark “urgent” investigations at specialist trust Great Ormond Street Hospital FT has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery Supplier says it followed the correct recall processes for the product Five serious incidents, including the deaths of two children, have sparked ‘urgent’ investigations into the processes through which clinicians are alerted to potential safety concerns over medical products used on patients. Great Ormond Street Hospital Foundation Trust has been investigating the incidents which happened between December 2020 and April 2021. The trust has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery. The glue, called Histoacryl, is produced by B. Braun Medical Ltd, and the company issued three separate “field safety notices”, relating to different batches of the product, in March and April this year. The company has stressed that it followed the correct recall processes throughout. According to a report to GOSH’s public board meeting on 29 September, Histoacryl has been used for the endovascular treatment of brain arteriovenous malformations for more than 30 years, but earlier this year batches of the product were identified as hardening less rapidly than expected. The trust told HSJ in a statement: “A comprehensive serious incident investigation has been carried out to determine the impact of the faulty glue on all patients treated with it. “The investigation found that whilst the passage of glue through the intended vessel may have been contributory in some instances of harm, it was unlikely to be the sole or main factor. “Both patients who died had serious and complex medical conditions and the procedure to correct these always carries a high degree of risk which is discussed extensively with the families before any treatment takes place.” Read full article here (paywalled) Original source: Health Service Journal

The Care Quality Commission (CQC) has published State of Care. The report, which draws on the experiences of care people have shared with Healthwatch England, has found that health and social care services face some highly concerning challenges, including: A workforce drained in terms of resilience and capacity, especially in social care, where the staff vacancy rate has risen; A rising number of people seeking emergency care, leading to unacceptable waiting times; and Tackling the health inequalities that the COVID-19 pandemic has exacerbated. The report welcomes the additional funding that the Government has allocated to help the NHS and social care address their challenges. However, CQC has called for the extra investment to be used to: Develop new ways of working and don’t just prop up existing approaches and plug demand in acute care; and Improve the training, career development and terms and conditions of social care workers to help attract and retain more staff. CQC has also recommended that the short-term funding - currently in place to help discharge patients who are no longer in need of hospital care but may still require care services - be extended. The HealthWatch response Responding, Sir Robert Francis QC, Chair of Healthwatch England said: “During the pandemic, people have told us about the challenges they have faced. Whether this not being able to access dental care, problems using online GP services or being discharged from the hospital without the proper support. It’s great to see this report drawing so much on the experiences people have shared with us. “We urge Government to act on this report. The health and care system upon which we all depend is facing a hard winter, but, as this report makes clear, the longer-term picture is also challenging. “The steps the CQC are recommending, like extending the extra funding to help people leave hospital safely and ensuring there is enough dental capacity, will help give services the breathing space they need to get through this winter. “However, come spring we need to grasp the opportunity to build a better NHS and social care system. A system that tackles heath inequalities head-on, ensuring that no matter who you are or where you live, you can access high-quality care that meets your needs. A system that is sustainable, is designed round the needs of people and breaks perennial cycle of winter crises.” Original source: HealthWatch CQC report here

NHS England has said that there is no ‘widespread issue’ with the national booking system for Covid vaccinations, despite eligible patients claiming they have been unable to book their booster jabs. It comes as Sajid Javid yesterday urged people to ‘come forward’ for their Covid vaccines if they are eligible and have not had an invite six months after their second jab, and the Government launched a new campaign to promote boosters and flu vaccines. Daisy Cooper, liberal democrat MP for St Albans, said yesterday in the House of Commons: ‘Many of my constituents are desperate to get their third jabs and their boosters. The Minister said that if their invitation has not arrived, they can book on the national booking service or 119, but that is simply not working. ‘When they get on to the national booking service, it says they are not eligible if they have not received an invitation letter. If they call 119, it is telling them it cannot override the system.’ Vaccines minister Maggie Throup assured Ms Cooper: ‘I will definitely look into that. If there is a problem in the system, we will get it fixed.’ But NHS England told Pulse: ‘There isn’t a widespread issue with the system not recognising people who are eligible.’ The NHS website currently says: ‘If you haven’t received an invite by 6 months and 1 week, you can try to book your appointment online without an invite.’ Patients have also taken to Twitter to complain about not being able to book Covid boosters, despite receiving invitations to do so. Read full article here Original source: Pulse Today

A LACK of capacity is meaning vulnerable kids in England are being put into foster care and children’s homes in Scotland, a new report has revealed. An investigation by the Competition and Markets Authority (CMA) into social care in the UK found that stakeholders are raising concerns about the practice. They warned that young people are facing disruption at school after being placed into different legal and educational systems – all due to a lack of spaces near their home area. It could mean some kids from as far away as London are being placed into care in Scotland. The investigation also revealed difficulties in Scotland placing children with disabilities or complex needs. And it found Scottish children in the care system were more likely to be separated from their siblings than their counterparts in England. The CMA reported that in England in 2019/20, 1400 (13% of all siblings in care) siblings were not placed according to their plan. In Scotland, there were 200 sibling groups separated after being placed into foster care - more than 20% of all sibling groups in foster care. For the full article, click here Original source: The National

This survey looks at the experiences of people who stayed at least one night in hospital as an inpatient. The results show that, generally, people’s experiences of inpatient care were positive and overall differences between COVID-19 and non-COVID-19 patients were small, suggesting that care provided was consistent. Most people said they were treated with respect and dignity, had confidence and trust in the doctors and nurses that treated them and observed high levels of cleanliness. Survey findings were less positive, however, for areas of care including people’s experiences of receiving emotional support, information sharing and hospital discharge. For the detailed findings, click here Original source: Care Quality Commission

As part of the UK Government’s efforts to tackle health problems, including mental health, earlier in the cycle, the newly-created Office for Health Improvement and Disparities (OHID) has launched the latest Better Health – Every Mind Matters campaign to improve the general public’s mental wellbeing. The new campaign aims to empower members of the general public to look after their mental health through tips and practical advice, helping to find what works for them in reducing stress and anxiety, boosting their mood, sleeping better, and feeling in greater control of their lives. New research commissioned by OHID revealed nearly half of adults (49%) in England said the Covid-19 pandemic had a negative impact on their mental wellbeing. In the same research, more than a third of all adults in England (34%) said they did not know what to do to improve their mental wellbeing. That equated to 15.1 million people. Younger adults were the most significantly affected group with their mental health, with 57% of 18-34 year olds suggesting the pandemic had negatively impacted their mental health. Just under half (44%) reported not knowing what to do to help improve it. This is the first campaign delivered by OHID since being officially launched on October 1, 2021. They have been set up with the aim of tackling health inequalities across the country. Minister for Care and Mental Health, Gillian Keegan, said: “The public showed great resilience throughout the pandemic, but it has served as a stark reminder that we all need to look after ourselves not only physically, but mentally. “There are simple steps we can all be taking to improve our mental wellbeing and reduce feelings of stress and anxiety. For anyone who is unsure what they can do, I urge you to visit Every Mind Matters and take advantage of the expert advice and practical tips available to you.” Claire Murdoch, NHS National Director for Mental Health, added: “The last year has taken its toll on people’s mental health but NHS staff have responded rapidly to treat more people with mental health issues than ever before – rolling out 24/7 crisis lines across the country and mental health support teams in schools during the pandemic. “The NHS is here for you, so if you’re struggling with anxiety and depression our rapidly expanding talking therapy services are available, while anyone who needs urgent help can access our 24/7 NHS crisis lines – available to people of all ages. “I would encourage everyone to look after their mental health, and by answering 5 simple questions, get a tailored ‘mind plan’ which will give you tips to help boost your mood, sleep better and deal with stress and anxiety.” Over 3.4 million individual Mind Plans have already been created since the campaign was first launched in October 2019. Original source: National Health Executive

I think that sounds about right, especially if you factor in social media videos as well. I do really worry about people's personal information management capabilities with this much data (and information governance too). There is definitely a gap in the market for smart tech to help people manage all of their personal digital assets.

The number of women in the UK who have not had vital NHS breast screening, which can stop people dying from breast cancer, has risen by an estimated 50% - to nearly 1.5 million women - since services resumed, the leading UK breast cancer charity warns during Breast Cancer Awareness Month. Breast Cancer Now reveals an alarming increase of around half a million women who haven’t been screened since services restarted in summer 2020, estimating that around 1,480,000 fewer women in the UK had breast screening between March 2020 and May 2021, compared to pre-pandemic levels. This comes a year after the charity reported that almost one million women had missed breast screening due to COVID-19 seeing services paused. According to the charity, nearly 12,000 people in the UK could have been living with undiagnosed breast cancer at the end of May 2021, due to the impact of the pandemic on breast screening services and fewer women being referred to specialists with possible symptoms of the disease since March 2020 – a frightening prospect when early detection can stop people dying from the disease. Full article here Source: Breast Cancer Now Also covered in the Independent

Bristol Children’s hospital tried to ‘deceive’ Ben Condon’s parents about his death, NHS ombudsman says An eight-week-old baby died after “a catalogue of failings” in his treatment at a children’s hospital, which then tried to “deceive” his parents about his death, an official inquiry has found. Doctors failed to spot that Ben Condon was suffering from a deadly bacterial infection and did not give him antibiotics until an hour before he died, the NHS ombudsman said. “We found that Ben and his family suffered serious injustice in consequence of the failings we found in his care and treatment,” the parliamentary and health service ombudsman said in a report that contained damning criticisms of Bristol Children’s hospital. The errors were all “lost opportunities” to help Ben recover from his illness and so increased the risk of him dying. Read the full article here Source: The Guardian Also covered in the Independent

Where Healthcare Is Improving and Where It Needs More Work While the public discourse on health equity has increased in recent years, there are still many problems in health disparities research and in care delivery. Health systems are struggling to tackle health equity issues as highlighted by a recent study that evaluated online consumer reviews of hospitals and experiences of racism. However, organizations are making a positive impact toward health equity in a variety of areas. Walmart is partnering with virtual care company Grand Rounds Health and Doctor On Demand on a digital health program aimed at tackling health disparities among African American workers. Women's health company Tia is looking to welcome female-identifying patients in an effort to improve inclusivity in health tech. For more content on companies that are addressing health equity gaps, including specialized care for women and individuals with female biologies, check out the recent blog post where we collaborated with Rock Health: Building comprehensive women+ digital health: Eight sectors serving women+ needs.

The Office for Health Improvement and Disparities (OHID) has been officially launched by the UK Government, aimed at preventing health disparities across the country and supporting people to live longer, healthier, and happier lives. OHID will focus on stopping debilitating health conditions before they develop and represents a distinct step-change in focus from the Government towards a more preventative, rather than reactionary, approach to health. One of the key intentions of this is to reduce the backlog and also put social care on a long-term sustainable footing, tackling health issues much earlier in their presentation, tackling the underlying causes of many of these, or preventing them altogether. The new government office will see Professor Chris Whitty, Chief Medical Officer, provide professional leadership to the organisation. Announcing the official launch of OHID, the Government pointed to some of the clear trends shown in recent figures, which highlight how geographical location can play a significant role in a person’s life expectancy and the years that they can expect to live a healthy life. For example: men in the most deprived areas in England are expected to live nearly 10 years fewer than those in the least deprived. Women in the same areas can expect to live 7 years fewer smoking is more prevalent in more deprived areas and one of the leading causes of inequalities in life expectancy; an international study found it accounts for half the difference in mortality between the least and most deprived men aged 35 to 69 obesity is widespread but more prevalent among the most deprived areas; prevalence is almost 8% higher among those living in the most deprived decile of local authorities (66.6%) compared to those in the least deprived areas (58.8%) Under its new remit, OHID will work to coordinate across local and central government, the NHS and wider society – utilising expert advice, analysis, and evidence – to drive improvements in the public’s health which may be able to have preventative roles and level up health across the UK. Preventative approaches to health can, it is intended, reduce the pressure on existing healthcare services, saving significant resource and money, and ensure that record investments into health and social care services can go further. Source: National Health Executive Health and Social Care Secretary, Sajid Javid said: “The pandemic has laid bare the health disparities we face not only as a country, but as communities and individuals. “This must change, and this body marks a new era of preventative healthcare to help people live healthier, happier and longer lives. “The Office for Health Improvement and Disparities will be the driving force across government, supported by communities, academics, industry and employers, to level up the health of our nation, which will reduce the pressure on our NHS and care services.”

There is a mental health crisis in England, with rates of depression doubling since the COVID pandemic began. Strategies of “speaking up”, mindfulness sessions at work, and national “happiness” campaigns have been touted as an effective approach to tackling mental health at work, but therapists are unconvinced. But what of mental health services offered by the state? This has been equally unconvincing. Over the past decade or so, mental health services in England have been undergoing a process of “Uberisation”. This refers to how services are effectively treated as commodities marketed through online platforms, changing the way they are delivered as well as making the jobs of the people delivering them more precarious – similar to the effect of ride-hailing apps on taxi drivers. Specifically, this has happened through the introduction of a standardised and digitalised model of therapy called Increased Access to Psychological Therapies (IAPT). This Uberisation appears to be contributing to a mental health crisis within the therapy profession itself. IAPT, which was introduced in 2008, provides psychotherapy for depression and anxiety to over a million people each year – the largest NHS programme in England. It uses a model of cognitive behavioural therapy – made up of short-term interventions of four to 12 sessions – that use techniques, such as relaxation exercises, to encourage positive mood and behaviour. With extremely high levels of depression and anxiety among therapists, there is a genuine question about patient safety that is being overlooked. If the mental health model itself is broken, are services deepening the mental health crisis, rather than solving it? Read the full article here Source: The Conversation

A team of world-leading medical experts have collaborated to improve patient safety and outcomes following high-risk surgery. The endeavour, which includes industry specialists such as anaesthetists, surgeons, and patient representatives, is called the Improving Patient Outcomes (ImPrOve) Think Tank. The ImPrOve team has recently published its European report that highlights and looks to address a severe patient safety and health issue in which death and serious complication rates in the 30-days following high-risk surgery are alarmingly high. The insightful report outlines an array of practices and innovations in the health sector that can improve patient safety and outcomes. These include calling for better physician training on the latest guidelines, funding for modern digital monitoring, utilisation of data from current technologies in health policies, and the right for patients to be involved in the discussion of the management of their procedure. Perils of high-risk surgery Around 2.4 million patients undergo high-risk surgery annually in Europe alone, with UK evidence indicating that 80% of postoperative deaths occur in a 10% sub-population of high-risk patients. If this startling trend continues throughout Europe, it is estimated that a staggering 192,000 people will die within the 30-day period following their surgery, demonstrating the immense dangers posed to patient safety and outcomes. There is an array of challenges during high-risk surgery; however, the ImPrOve Think Tank believes that potentially the most alarming complication is haemodynamic instability, which manifests as drops in blood pressure (known as IOH). Mitigating risks and increasing patient safety Professor Olivier Huet, the ImPrOve Chair and Professor of Anaesthesia and Intensive Care Medicine, said: “Our mission is to work collaboratively with patient representatives, clinicians and policymakers to improve perioperative patient safety and experience with the help of advanced haemodynamic monitoring technologies. Full article here Source: Health Europa

The latest edition of the Wolters Kluwer Journal of Patient Safety has just been published. Original studies include: Is There a Mismatch Between the Perspectives of Patients and Regulators on Healthcare Quality? A Survey Study The Ideal Hospital Discharge Summary: A Survey of U.S. Physicians Impact of an Original Methodological Tool on the Identification of Corrective and Preventive Actions After Root Cause Analysis of Adverse Events in Health Care Facilities: Results of a Randomized Controlled Trial Detach Yourself: The Positive Effect of Psychological Detachment on Patient Safety in Long-Term Care Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles Prescribing Errors With Low-Molecular-Weight Heparins Development and Psychometric Evaluation of the Speaking Up About Patient Safety Questionnaire Descriptive Analysis of Patient Misidentification From Incident Report System Data in a Large Academic Hospital Federation Medication Errors at Hospital Admission and Discharge: Risk Factors and Impact of Medication Reconciliation Process to Improve Healthcare Reducing and Sustaining Duplicate Medical Record Creation by Usability Testing and System Redesign Full articles are payalled but the abstracts may be viewed free of charge. Access the Journal here

Queen Elizabeth Hospital Kings Lynn carried out a transparent review of 389 Covid infections An NHS trust has apologised to hundreds of families whose relatives caught Covid-19 in hospital and died, after a review found a lack of private rooms contributed to the spread of the virus. The Queen Elizabeth Hospital (QEH) in Kings Lynn, Norfolk, has carried out a review of all 389 cases of patients who either definitely or probably contracted Covid while in the hospital between March 2020 and February this year. Of those, 151 patients died. The trust is the only NHS trust to have carried out a full and transparent review of hospital acquired infections of Covid-19 with staff speaking with each family to understand their concerns and views. Read full article here Source: Independent

The country’s largest clinical study is being launched in Greater Manchester to investigate the best gap between first and second Covid-19 vaccine doses for pregnant women. Led by St George’s, University of London, the Preg-CoV study will provide vital clinical trial data on the immune response to vaccination at different dose intervals – either four to six weeks or eight to 12 weeks. This data will help determine the best dosage interval and reveal more about how the vaccine works to protect pregnant mothers and their babies against Covid-19. Pregnant women are more likely to develop severe Covid-19 or die from the disease but are excluded from clinical trials with new vaccines. This means there are currently very limited clinical trial data on the immune response and side effects caused by the vaccines for these women. Read the full story here Source: National Health Executive

Patients are starting to suffer because health and care workers are unable to purchase fuel. The fuel crisis is starting to have an effect on the care of vulnerable patients, community and mental health service providers have warned. Many petrol stations are running short of fuel as a result of panic buying, after the oil firm BP warned that it would have to close some of its petrol stations because of the lack of lorry drivers. Currently there is a shortage of about 100,000 HGV drivers. Crystal Oldman, chief executive for the Queen’s Nursing Institute, which represents community nurses, told the journal HSJ that the fuel shortage was already affecting them: “This potentially means nurses cannot get to the patients they need to if they are unable to access fuel. At the very least, it will mean more time searching for petrol stations that have a supply, taking valuable time from their working day and more unpaid overtime will be undertaken as nurses will always prioritise their patient care.” Patient transport has also been affected. A source at a patient transport provider in the West Midlands told HSJ that it had been “a bit of a nightmare”. The provider had had to turn down a request for a patient going to London because of the fuel shortage and because of climate protesters disrupting motorway transport: “Ultimately those patients are either at home and distressed carrying a big risk in the community or [accident and emergency] departments which [are not] the right settings.” Read the full article here Source: Future Care Capital

Mental health patients who were discharged from or admitted to acute mental health services during the first Covid-19 lockdown experienced loneliness and social isolation, according to a new study. Published in the British Journal of Psychiatry Open the 34 patients, carers and clinical staff were interviewed by a team of researchers from The University of Manchester. Mental health service users also reported ‘working harder’ to avoid admission due to fears around environmental safety as a result of COVID-19. “Even before the pandemic, there are lots of safety concerns associated with recent discharge from inpatient mental health services, for example suicide and self-harm,“ said lead author Dr Natasha Tyler, researcher at the GM PSTRC and The University of Manchester. Dr Tyler added: ‘Our patients and carers felt that because of the national need to free-up hospital beds, the quality of discharge and admission planning was compromised at times. “That meant discharging patients from hospitals who were not ready to cope in the community or not admitting patients who needed in-patient care. “The closure of most community support services meant patients had minimal opportunities for accessing care via alternative routes. This worsened their feelings of helplessness and loneliness.” Full article here Source: Greater Manchester Patient Safety Translational Research Centre