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Sam

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  1. News Article
    Plans to procure more district nursing courses to start this September have been paused because of the merger of Health Education England into NHS England, HSJ understands. An email sent last month from a commissioning officer at NHSE’s workforce, training and education directorate – the new HEE – said procurement of new district nursing courses from universities would be paused “until further notice”, due to the “ongoing merger”. Since 2009, the number of district nurses working in the English NHS has fallen drastically, from around 7,000 to around 3,900. Steph Lawrence, executive director of nursing and allied health professionals at Leeds Community Healthcare Trust, said the decision to pause the expansion of courses was a “huge concern” as numbers of district nurses need to grow “at a much faster rate”. “This is a major safety issue for safe and effective care in the community if we don’t have the appropriate numbers of nurses trained. We may also lose nurses as well who want to progress and expand their knowledge,” Ms Lawrence said. Read full story (paywalled) Source: HSJ, 5 June 2023
  2. News Article
    Children's doctors are calling for a complete ban on disposable vapes because they are likely to damage young lungs and are bad for the environment. But an anti-smoking campaign group says a ban would make it harder for some adults to give up smoking and increase the trade in illegal vapes. UK governments are planning steps to reduce vaping among under-18s. Prime Minister Rishi Sunak recently said it was "ridiculous" that vapes were designed and promoted to appeal to children when they were supposed to be used by adults giving up smoking. A BBC investigation found unsafe levels of lead, nickel and chromium in vapes confiscated from a secondary school, which could end up being inhaled into children's lungs. Scientists analysing the vapes said they were the worst lab test results of their kind they had ever seen. The Royal College of Paediatrics and Child Health (RCPCH) now says the UK government should "without a doubt" ban disposable e-cigarettes. Read full story Source: BBC News, 6 June 2023
  3. News Article
    One in five cases in which patients attend A&E needing mental healthcare are spending more than 12 hours in the department – at least double the rate of patients with physical health problems. Unpublished internal NHS data seen by HSJ also suggests the proportion of mental health patients suffering long waits in accident and emergency has almost tripled when compared to the situation before the pandemic. According to the data, the proportion of attendances by patients with a mental health problem who waited more than 12 hours in A&E before being admitted or discharged increased from 7% (34,945 breaches) in 2019-20 to 20% (88,250 breaches) in 2022-23. The situation has become so difficult, that some acute trusts are spot purchasing private sector mental health in order to discharge patients. Read full story (paywalled) Source: HSJ, 5 June 2023
  4. News Article
    Multiple problems have been highlighted with the leadership and governance of a much-vaunted integrated care system, including a lack of trust between organisations which often hide information that could weaken their position. HSJ has seen an executive summary of the review of Greater Manchester ICS, which cited widespread concerns around the allocation of resources, confusion about the role of commissioning, and “muddled” governance, including: a lack of transparency and trust between partners, with some only sharing a “partial overview” of performance and finances which drives choices likely to “bias” some organisations; complex architecture of system boards, committees and forums, with “muddled” governance, unclear paths for critical decisions to be made, and unclear delegations to localities; frustration at the quantum of meetings that take place at system, locality and provider level. Read full story (paywalled) Source: HSJ, 2 June 2023
  5. News Article
    A US organisation that supports people with eating disorders has suspended use of a chatbot after reports it shared harmful advice. The National Eating Disorder Association (Neda) recently closed its live helpline and directed people seeking help to other resources, including the chatbot. The AI bot, named "Tessa," has been taken down, the association said. It will be investigating reports about the bot's behaviour. In recent weeks, some social media users posted screenshots of their experience with the chatbot online. They said the bot continued to recommend behaviours like calorie restriction and dieting, even after it was told the user had an eating disorder. For patients already struggling with stigma around their weight, further encouragement to shed pounds can lead to disordered eating behaviours like bingeing, restricting or purging, according to the American Academy of Family Physicians. Read full story Source: BBC News, 2 June 2023
  6. News Article
    Researchers have completed the first successful in-patient trial of liver dialysis. The DIALIVE device, invented by researchers at UCL’s Institute for Liver and Digestive Health, was found to be safe and effective, research suggests. According to a new study, the device is associated with substantial improvement in the severity of symptoms and organ function in a greater proportion of patients with acute-on-chronic liver failure (ACLF), when compared with patients receiving standard of care. The next step would be a larger clinical trial, which if successful could see DIALIVE approved for clinical use within the next three years. Read full story Source: The Independent, 1 June 2023
  7. News Article
    Women are waiting too long for abortions, according to a major review into a leading UK provider. The Care Quality Commission (CQC) review of the leadership at the abortion provider the British Pregnancy Advisory Service found there were “delays” in “investigating incidents”. The remains of some pregnancies were sometimes not stored properly and there were issues were record keeping, patient monitoring and safe care, the review found. The watchdog also noted “women did not always receive care in a timely way to meet their needs”. The health watchdog said: “In August 2021 we found significant concerns in we found that safe care was not being provided; ineffective safeguarding processes; incomplete risk assessments were not fully completed; observations were not monitored or recorded; records were not fully completed, clear or up to date.” Read full story Source: The Independent, 2 June 2023
  8. News Article
    An integrated care board (ICB) has advised its GP practices not to give patients automatic access to their records, contradicting NHS England national requirements. Instead, North East London ICB has suggested practices only allow access where patients request it, and subject to conditions. The national go-live date for patients to be allowed automatic access to future entries in their records has been repeatedly delayed since initially being set at December 2021. GPs have argued they needed more time to redact sensitive information, ensure records are not inappropriately shared, and train staff. They have cited workload and safeguarding concerns. The ICB’s chief clinical information officer Osman Bhatti, who is a GP, told HSJ the ICB instead “wanted a process where patients could access both prospective and retrospective records safely, with less workload for GPs and so patients who actually want access can have it”. Read full story (paywalled) Source: HSJ. 1 June 2023
  9. News Article
    Patients diagnosed with cancer in 2020 had “significantly lower” survival rates in Scotland a year after having their cases confirmed compared with the previous year, a report has found. The increase in deaths was an indirect result of the pandemic as coronavirus dissuaded people from getting check-ups or visiting physicians. Many cancer screening programmes were also paused and infection control measures in healthcare settings caused delays in both diagnosis and treatment. Andrew Elder, president of the Royal College of Physicians, said the government’s decision to pause screening programmes was “understandable in the extreme circumstances”, but added that the figures were “concerning”. He said: “Fewer and later presentations by patients who may have had more advanced disease clearly have had sometimes tragic consequences that are now being identified in the data.” Read full story (paywalled) Source: The Times, 31 May 2023
  10. News Article
    The Royal College of Midwives says the need for a maternity strategy in Northern Ireland has gone beyond urgent and is now critical. The warning comes as the RCM is publishing a report on Northern Ireland's maternity services at Stormont on Tuesday. The report will highlight growing challenges as more women across the country with additional health needs are being cared for by maternity services. The RCM report will outline three steps to deliver high quality and safe services for women and families. Develop, publish and fund the implementation of a new maternity and neonatal strategy for Northern Ireland. Sustain the number of places for new student midwives at their recent, higher level. Focus on retaining the midwives in the HSC. Read full story Source: ITV News, 30 May 2023
  11. Event
    ANNOUNCEMENT: Due to the upcoming junior doctors industrial action, this event was originally 14 July but has been postponed to 10 October. Meeting the NHS' net zero emission targets requires carbon reductions across patient pathways. Achieving this means delivering high quality, evidence based, low carbon care to our patients. Clinicians are a vital part of the innovation, adoption, and embedding of low carbon practices which prioritise high quality patient care. The BMJ and the UK Health Alliance on Climate Change are hosting a new one-day conference which will focus on reducing the carbon impact of services across the health and care system, and the role that every healthcare professional can play in delivering a net zero NHS. Due to popular demand the event will be both an in-person and virtual event. You can attend virtually, via a live feed, or add your name to the waiting list to attend in-person on 14 July at BMA House, London. Register
  12. News Article
    One of the first studies to examine the full lifespan of people living with Down syndrome (DS) has provided evidence in support of health guidelines specifically for people with the condition. Life expectancy for people with DS had increased dramatically over the last 80 years or so, yet people with the condition still died at an earlier age than people in the general population or those with other intellectual disabilities, said the authors of a new study, published in The Lancet. This meant that there was an "opportunity to improve health outcomes for this minority", they said. There continued to be disparities in surveillance, diagnosis, and treatment of common health conditions in people with intellectual disabilities, including those with DS, highlighted the authors, with ongoing premature mortality and excess morbidity identified in these groups. In April 2022, the Down Syndrome Act was introduced in England, which stipulated that the Government must provide information to the NHS and local councils on how to provide the most appropriate care and support for people with DS. Read full story Source: Medscape, 26 May 2023
  13. News Article
    Patients are being urged to shop around on the NHS app and website to cut their waiting time for treatment in England. IT systems have been updated to allow patients to more easily exercise their right to choose where they go for planned care, such as knee operations. They will now be able to view up to five providers - filtered by distance, waiting times and quality of care. But hospitals warned staffing shortages still needed to be tackled to make the biggest impact on waits. The idea of choosing where to go for treatment has been in place since the early 2000s, but few use it. Currently only1 in 10 exercises their right to choose, with patients reporting they are not always offered a choice of where to go or that it is hard to select different venues. Ministers believe that by searching the list of different hospitals, patients will be able to reduce their waits - potentially by up to three months, research suggests. Read full story Source: BBC News, 25 May 2023
  14. News Article
    The health secretary is set to signal a major delay to one of the headline promises in the last Conservative manifesto by suggesting the delivery of 40 new hospitals in England is likely to be pushed back until after 2030. In a move that will spark anger among MPs who wanted “spades in the ground” before the next election, government sources said Steve Barclay would make the announcement today. The pledge to build and fund “40 new hospitals over the next 10 years” was one of the major headlines of Boris Johnson’s pitch to the electorate in 2019. Sources indicated the government had been ready to make the announcement about the probable delay for some time, but it was repeatedly pushed back because of fears about a backlash from Tory MPs. Rundown NHS hospitals have become a danger to patients, warn health chiefs Read full story Source: The Guardian, 25 May 2023
  15. News Article
    Extra beds squeezed into hospitals as part of winter planning are crowding out space for rehab, pushing up length of stay and knock-on costs, and increasing the chance of readmission, NHS leaders have been warned. Systems and trusts were encouraged to staff thousands of additional ward beds in the run-up to last winter to try to ease emergency care pressures, and government and NHS England have since asked for many of them to be kept open through the year. However, many of the additional beds are not in proper ward spaces, instead being located in gyms and other areas used for physiotherapy and other rehab. This followed on from some rehab areas already being lost during the pandemic, to be used for beds or storage. NHSE has sent out a warning about the issue, following a commitment by ministers earlier this year. However, senior figures in physio and older people’s care remain concerned the spaces will not be restored without checks and enforcement, especially as acute trusts remain under pressure to increase general bed space.
  16. News Article
    Pregnant women and new mothers are facing wide variation in access to mental health support, new figures suggest, as NHS England admits national performance on a key long-term plan goal to expand services is ‘over a year behind trajectory’. Analysis of access rates for perinatal mental health services from NHS Digital shows the rates of women accessing support within the past 12 months range from 3.7 per cent in Humber and North Yorkshire to 15 per cent in Shropshire, Telford and Wrekin ICS. The long-term plan target is for 66,000 women per year to be accessing specialist perinatal services, which can help with conditions such as post-partum psychosis, by March 2024. NHSE admitted in its papers that “although access is increasing, performance remains over a year behind trajectory”. Read full story (paywalled) Source: HSJ, 25 May 2023
  17. News Article
    Some mental health patients in England are still having to travel more than 300 miles for hospital treatment two years after the government pledged to end the “completely unacceptable” practice. The number of patients in crisis forced to move potentially hundreds of miles for NHS help is rising again after falling during the pandemic, separating them from family and support networks and potentially delaying their recuperation. According to official data seen by the Observer, 420 so-called “out of area” treatments started in February because no local beds were available – up from 240 in February last year. The most recent NHS England records show there are 720 out of area placements deemed “inappropriate”, risking the patient’s recovery. Dr Mayura Deshpande, an associate registrar for policy at the Royal College of Psychiatrists, said targets for eliminating the practice had been “widely missed” and called for an urgent plan for the proper funding of mental health services. “It’s completely unacceptable that some mental health patients are having to travel hundreds of miles for care at a time when they are at their most vulnerable,” she said. Read full story Source: The Guardian, 20 May 2023
  18. News Article
    Britain’s reliance on foreign nurses has reached “unsustainable” levels, the government has been warned as new analysis reveals that international recruits has accounted for two thirds of the rise in numbers since 2019. Ministers have repeatedly promised to boost the domestic supply of health staff amid warnings that reliance on international workers leaves the NHS at the mercy of global labour markets. Overall, a fifth of the UK’s nursing, midwifery and nursing associate workforce originally trained overseas. The figures will reignite concerns that nations such as the Philippines, traditionally a key source for the NHS, are being increasingly targeted by countries including Germany and Canada. Senior NHS leaders fear the health service could be left in a precarious position if increased competition results in nurses choosing alternative destinations, resulting in a shortfall for the UK. The health service in England already has one post in ten vacant. Read full story (paywalled) Source: The Times, 18 May 2023
  19. News Article
    Healthcare leaders are rolling out new NHS training to help speed up dementia diagnoses among Black and Asian people following criticism about a lack of support for patients from minoritised communities, The Independent has revealed. An awareness campaign is being launched in England to help those from ethnic minority communities receive a prompt diagnosis and get the support they need at the earliest opportunity. The announcement follows a critical report which found that thousands of south Asian people with dementia are being failed by “outdated health services designed for white British patients”. Dr Bola Owolabi, director of the Healthcare Inequalities Improvement programme at NHS England, said: “The pandemic put a greater spotlight on longstanding health inequalities experienced by different groups across the country. “While there are many factors involved, the NHS is playing its part in narrowing the gap and ensuring equitable access to services through taking targeted action where needed to improve outcomes." Read full story Source: The Independent, 21 May 2023
  20. News Article
    Ambulance chiefs have warned a controversial piece of legislation could lead to legal action against their trusts by patients denied an ambulance. The Strikes (Minimum Service Levels) Bill, which is currently going through Parliament, would enable the health and social care secretary to set minimum levels of staffing for ambulance call centres and crews. Employers would be able to issue “work notices” compelling staff to provide cover during any strike. But, in its response to the government consultation on how the system would work, the Association of Ambulance Chief Executives has said it does not support the legislation in its current form as it does not believe it will deliver an improvement for patients, or offer a practical means of delivering minimum service levels. It said the proposed legislation appears to pass responsibility for the service levels to employers, which could leave them “exposed to patient liability risks to a greater extent than before”. Read full story (paywalled) Source: HSJ, 22 May 2023
  21. News Article
    About 23,000 people died in accident and emergency departments last year, according to an estimate by Labour based on Freedom of Information requests to every NHS trust in England. Half of the trusts responded to the party’s requests and, based on that information, it calculated that just over 23,000 people had died – an increase of more than 20% on 2021, and nearly 40% on 2020. The increase in deaths corresponds with a sharp rise in NHS waiting times, as hospitals struggle with high demand and a lack of resources after the Covid-19 pandemic. Wes Streeting, the shadow health secretary, said: “People turning to the NHS in an emergency should know they will be seen and treated before it’s too late. The Conservatives’ failure over 13 years to properly staff or reform the NHS has a cost in lives.” Maria Caulfield, the health minister, defended the government’s record, however, saying: “We are delivering a record number of tests, speeding up discharge from hospitals, and cutting waiting lists as we also work to halve inflation, grow the economy, reduce debt, and stop the boats.” Read full story Source: The Guardian, 19 May 2023
  22. News Article
    An ‘outstanding’ trust’s Care Quality Commission rating has been dropped to ‘requires improvement’, after inspectors found potential safety risks and a disconnect between board and ward. A highly critical report on University Hospitals Sussex Foundation Trust also downgraded its well-led rating to “inadequate” and recommended the trust be placed in segment four – the bottom tier – of NHS England’s system oversight framework. Its main tertiary centre – the Royal Sussex County Hospital – was also rated “inadequate”, including for safety. Deanna Westwood, Care Quality Commission’s director of operations in the South, said “staff and patients were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment”. Read full story (paywalled) Source: HSJ,12 May 2023
  23. News Article
    The boss of a private healthcare company exposed by the Guardian for putting seriously ill children and adults at risk was warned it was failing patients three years ago. Darryn Gibson, the chief executive of Sciensus, Britain’s biggest medicines courier, was told in November 2020 that patients with bleeding disorders were being left dangerously exposed to internal bleeding with little or no treatment at home as a result of botched, delayed or missed deliveries. Gibson received the written warning from Kate Burt, the chief executive of the Haemophilia Society, a leading health charity, after she had become outraged at how vulnerable patients were being let down. Sciensus blamed IT issues and promised action. However, three years later, patients remain at “very serious” risk of harm because of “recurring” problems with the company, Burt said. “We continue to receive complaints about missing, incomplete or inaccurate deliveries and are very concerned to see the same issues recurring, indicating that far more needs to be done to improve Sciensus’s ordering and delivery systems,” she said. Read full story Source: The Guardian, 12 May 2023
  24. News Article
    A breakthrough AI model can determine a person's risk of developing pancreatic cancer with staggering accuracy, research suggests. Using medical records and information from previous scans, the AI was able to flag patients at a high risk of developing pancreatic cancer within the next three years with great accuracy. There are currently no full-proof scans for pancreatic cancer, with doctors using a combination of CT scans, MRIs and other invasive procedures to diagnose it. This keeps many doctors away from recommending these screenings. Over time, they also hope these AI models will help them develop a reliable way to screen for pancreatic cancer — which already exists for other types of the diseases. "One of the most important decisions clinicians face day to day is who is at high risk for a disease, and who would benefit from further testing, which can also mean more invasive and more expensive procedures that carry their own risks," Dr Chris Sander, a biologist at Harvard who contributed to the study, said. "An AI tool that can zero in on those at highest risk for pancreatic cancer who stand to benefit most from further tests could go a long way toward improving clinical decision-making." Read full story Source: Mail Online, 9 May 2023
  25. News Article
    A key government pledge to reduce the size of the NHS’s record-breaking care backlog has been broken, the health secretary has admitted. Steve Barclay slipped out the news in a Commons statement on Tuesday about a totally unrelated area of NHS policy – his new plan to improve access to GP care. He disclosed to MPs that the NHS in England had missed its target to ensure that all patients who had been waiting 18 months for an operation in hospital would be treated by April. It is thought that about 10,000 people who had been waiting for at least 78 weeks were still languishing on the 7.2 million-strong waiting list at the end of April. The failure to eradicate 18-month waits for care is embarrassing for Rishi Sunak, who made “cut waiting lists” one of his five key pledges and insisted as recently as January that the promise, which NHS England and the then health secretary Sajid Javid first made in the elective surgery recovery plan last year, would be honoured. Read full story Source: The Guardian, 9 May 2023
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