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Sam

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  1. Sam
    GPs are failing to urgently refer patients with “red flag” signs of suspected cancer to a specialist, research suggests.
    Six out of 10 patients in England with key symptoms indicating possible cancer did not receive an urgent referral for specialist assessment within two weeks, as recommended in clinical guidelines, according to a new study.
    Nearly 4% of these patients were subsequently diagnosed with cancer within the next 12 months. The findings were published in the journal BMJ Quality & Safety.
    In the study, researchers analysed records from almost 49,000 patients who consulted their GP with one of the warning signs for cancer that should warrant referral under clinical guidelines. Of the 29,045 patients not referred, 1,047 developed cancer within a year (3.6%).
    Early diagnosis and prompt treatment is crucial to survival chances. Every four-week delay in cancer treatment increases the risk of death by 10%.
    Read full story
    Source: The Guardian, 5 October 2021
  2. Sam
    The Care Quality Commission’s (CQC) outgoing chief inspector of hospitals has called on integrated care system leaders to be ‘courageous’ in putting quality first.
    Speaking at the HSJ’s Patient Safety Congress, Ted Baker implored ICS leaders to not focus solely on financial and operational targets, although he also acknowledged “there is a lot of pressure to meet [those] targets”.
    In his speech yesterday, he said: “It’s often taken really courageous leaders to put quality first ahead of financial targets and operational targets… You have to be courageous to do that and I think some of the leaders of the ICSs, they need to be that courageous.
    “They need to focus on quality and safety within an [ICS] and not, if you like, go down the kind of NHS path of focusing on financial and operational targets.
    “If we can do that, we can have a really transformative effect on integrated care across [the] system. I suppose that’s what I’m asking for: courage from all of us to tackle some of the cultural issues in the NHS."
    Read full story (paywalled)
    Source: HSJ, 22 September 2021
  3. Sam
    The health service ombudsman has warned he will ‘be in no position to investigate’ the behaviour of another watchdog under the government’s health service reforms.
    Rob Behrens, the Parliamentary and Health Service Ombudsman, said plans to create a “closed safe space” for the information provided by clinicians to the Healthcare Safety Investigation Branch (HSIB) will mean a reduction in his powers and he will not be able to hold HSIB to account.
    Mr Behrens, speaking at HSJ’s Patient Safety Congress, said that although coroners would be able to access information gathered by HSIB investigations under the reforms, the ombudsman would not be able to access this “safe space” without the permission of the High Court.
    The reforms would see HSIB become a new statutory independent organisation, the Health Service Safety Investigations Body, and prohibit the disclosure of “protected material” such as information or documents obtained during investigations.
    However, this prohibition of disclosure would not apply to information required by coroners, ordered by the High Court or necessary to investigate an offence or address a “serious and continuing” safety risk to a patient or the public.
    Read full story (paywalled)
    Source: HSJ, 22 September 2021
  4. Sam
    A major acute trust in the East Midlands has been forced to restrict how much chemotherapy it is able to offer due to staff shortages.
    Nottingham University Hospitals Trust confirmed in a statement its chemotherapy service has been affected by long-term staff sickness and staff vacancies. 
    A trust spokeswoman said: “We continue to provide chemotherapy to patients who benefit most from the treatment and the small number of patients affected have been contacted directly by their specialist cancer team and offered support.”
    She added: “We are recruiting to posts as well as working with neighbouring NHS and private providers to ensure that any delays are minimal.”
    The trust added all its patient care decisions adhered to national guidance aimed at helping chemotherapy centres categorise and prioritise treatments when these situations arise.
    The Nottingham Post first reported the difficulties facing the trust, suggesting the restrictions would specifically affect palliative care patients who receive chemotherapy at NUH’s City Hospital site.
    Read full story (paywalled)
    Source: HSJ, 23 September 2021
  5. Sam
    Scotland's Health Secretary Humza Yousaf says the NHS is facing the "biggest crisis" of its existence.
    There's a shortage of beds, the demand for ambulances is soaring and waits in accident and emergency departments are getting longer.
    On top of that, COVID-19 admissions have been rising fast as the number of infections in Scotland spiralled at the end of the summer.
    BBC News share five charts illustrating the enormous pressures currently being felt by NHS Scotland.
    Read full story
    Source: BBC News, 23 September 2021
  6. Sam
    Record numbers of children and young people are seeking access to NHS mental health services, figures show, as the devastating toll of the pandemic is revealed in a new analysis.
    In just three months, nearly 200,000 young people have been referred to mental health services – almost double pre-pandemic levels, according to the report by the Royal College of Psychiatrists.
    Experts say the figures show the true scale of the impact of the last 18 months on children and young people across the country.
    “These alarming figures reflect what I and many other frontline psychiatrists are seeing in our clinics on a daily basis,” said Dr Elaine Lockhart, the college’s child and adolescent faculty chair. “The pandemic has had a devastating effect on the nation’s mental health, but it’s becoming increasingly clear that children and young people are suffering terribly.”
    Read full story
    Source: The Guardian, 23 September 2021
  7. Sam
    A woman with stage 4 endometriosis said she was told she needed to "be more positive" before her diagnosis - despite heavy blood loss and pain.
    Anna Cooper, from Newbridge, Wrexham, started her periods at 11 and by the time she turned 14, her mother was pushing for a referral.
    Since then she has had 13 surgeries, with a 14th due in the coming months.
    She said: "It is not taken seriously enough. It seems to be that we are just not being heard at the minute."
    Watch video
    Source: BBC News, 9 September 2021
  8. Sam
    A catalogue of failures among prison and health professionals has been highlighted in an investigation report into the death of a teenager’s baby after she gave birth alone in her cell at the largest women’s prison in Europe.
    The Prisons and Probation Ombudsman published the devastating report into the events in September 2019 at HMP Bronzefield in Ashford, Middlesex on Wednesday. The case was first revealed by the Guardian and the baby’s death triggered 11 separate inquiries.
    The report details a disturbing series of events that culminated with the young woman, who cannot be named, being in “constant pain” on the night of 26 September and eventually passing out while giving birth.
    According to the report the teenager "appeared to have been regarded as difficult and having a ‘bad attitude’ rather than as a vulnerable 18-year-old, frightened that her baby would be taken away”. Failings included:
    There was confusion among different health professionals about her due date. The day before her baby was born she told a prison nurse she would kill herself or someone else if the baby was taken away from her, but this information was not adequately shared. On 26 September she was put on extended observation, meaning she should have been regularly checked but this did not happen. She rang the bell twice at 8.07pm and 8.32pm that day. A call was connected then immediately disconnected at 8.45pm. She did not press the bell again. Checks by prison officers at 9.27pm and 4.19am revealed “nothing untoward”. It was left to two prisoners to alert staff to the fact that there was blood in her cell at 8.21am on 27 September. Prisons and Probation ombudsman Sue McAllister said: “Ms A gave birth alone in her cell overnight without medical assistance. This should never have happened. Overall, the healthcare offered to Ms A in Bronzefield was not equivalent to that she could have expected in the community.”
    The publication of the report has triggered multiple calls for an end to the imprisonment of pregnant women from the Royal College of Midwives, NGOs and academics in the field. 
    Read full story
    Source: The Guardian, 22 September 2021
  9. Sam
    Consultants at a major tertiary centre have written to their chief executive, warning services are in ‘an extremely unsafe situation’ and calling for elective work to be diverted elsewhere.
    Surgeons and anaesthetists at the former Brighton and Sussex University Hospitals Trust — now part of University Hospitals Sussex Foundation Trust — said: “We are devastated to report that the care we aspire to is not being provided at UHS… we are forced to contemplate that it is not safe to be open as a trauma tertiary centre and we feel elective activity must be proactively diverted elsewhere.”
    The letter from BSUH’s anaesthetist and surgical consultant body is dated yesterday and was sent to UHSussex chief executive Dame Marianne Griffiths. The Royal Sussex County Hospital in Brighton — part of the trust — is the major trauma centre for the South East coast, from Chichester to parts of Kent.
    In the letter, seen by HSJ, the consultants claimed a shortage of theatre staff is leading to “clinical safety issues, gross operational inefficiencies and burnout within our remaining depleted staff groups”. 
    Read full story (paywalled)
    Source: HSJ, 21 September 2021
  10. Sam
    It was "regrettable" that the government said there was "no conclusive proof" AIDS could be transmitted by blood products in 1983, a public inquiry has heard.
    Giving evidence, former secretary of state Lord Fowler said it would have been better to add that it was likely NHS treatment could be contaminated. But he said he didn't think the change would have made a crucial difference.
    Survivors have accused ministers of playing down the risks at the time.
    It's thought around 3,000 haemophiliacs died of AIDS and hepatitis C after being treated with a blood-clotting product called Factor VIII in the 1970s and 1980s.
    Groups representing families of those affected by the scandal claim the use of the phase "no conclusive proof" minimised the danger from blood products at the time.
    Read full story
    Source: BBC News, 22 September 2021
  11. Sam
    Leaked results from a national survey of NHS staff has revealed a sharp drop in those who believe their health and wellbeing is being supported by their employer.
    The People Pulse is a national, monthly survey launched in 2020. It enables provider and commissioner organisations to monitor the NHS workforce’s health and wellbeing.
    According to a snapshot of the results recorded between May and August seen by HSJ, there was a drop of 9.6 percentage points in “perceptions of wellbeing support”, with “positivity” sitting at 57.3%.
    Almost a quarter of the survey respondents reported a “negative” experience of health and wellbeing support.
    The survey results also revealed almost a third of respondents said they wanted to speak up about a specific issue during the pandemic, especially on issues of staff safety, health and wellbeing, but they did not because they feared repercussions or believed nothing would happen.
    Read full story (paywalled)
    Source: HSJ, 21 September 2021
  12. Sam
    Life expectancy in England has fallen to its lowest level since 2011, a Public Health England (PHE) report has said. Deaths were 1.4 times higher than expected between 21 March 2020 and 2 July 2021, according to the report’s findings.
    The increase, largely driven by the pandemic the report said, resulted in a life expectancy decrease of 1.3 years in males, to 78.7, and a 0.9 year decrease in females, to 82.7 years - the lowest life expectancy since 2011.
    Life expectancy inequality is also widening between people in the most and least deprived areas. The gap in male life expectancy between the most and least deprived areas in England is 10.3 years in 2020, which is a year higher than the 2019 level. Similarly for females, this same gap was 8.3 years in 2020, 0.6 years greater than in 2019.
    The PHE report said the inequality gap reached its highest since it began recording data on deprivation linked life expectancy over two decades ago.
    Its report stated: “This demonstrates that the pandemic has exacerbated existing inequalities in life expectancy by deprivation.
    Read full story
    Source: The Independent, 16 September 2021
     
  13. Sam
    The Scottish government has asked the MoD for military assistance for the country's ambulance service.
    Nicola Sturgeon said health services were dealing with the most challenging combination of circumstances in their history due to the COVID-19 pandemic.
    Opposition politicians have highlighted a series of serious ambulance delays, including one where a man died after a 40-hour wait. They said this should not be happening in Scotland in 2021.
    Ms Sturgeon said her government was looking at a range of plans to deal with the significant challenges facing the health services, with the detail of a request for military assistance being considered.
    Investigations are ongoing into several cases reported in the media on Thursday, including one where a Glasgow pensioner died after a 40-hour wait for an ambulance.
    The Herald newspaper reported that the family of 65-year-old Gerard Brown were told that he could have survived had help arrived sooner.
    Mr Brown's GP - who is said to have repeatedly warned 999 call handlers that the patient's status was critical - was quoted as describing the crisis engulfing the Scottish Ambulance Service as being like "third world medicine".
    The Scottish Ambulance Service is investigating the circumstances of the case, and said it will be "in contact with Mr Brown's family directly to apologise for the delay".
    Read full story
    Source: BBC News, 16 September 2021
  14. Sam
    One in 40 people with coronavirus has symptoms lasting at least three months, Office for National Statistics figures suggest.
    In April, an ONS report put the proportion at about one in every 10. The latest, large and comprehensive analysis suggests long Covid may be less common than previously thought.
    But the condition is not fully understood and still has no universally agreed definition, leading to different studies producing different figures.
    However, like many other reports, the analysis suggests women, 50- to 69-year-olds and people with other long-term health conditions are the most likely to have symptoms of long Covid 12 weeks after a Covid infection.
    People with high levels of virus in their body when testing positive are also more likely to have long Covid, the analysis suggests.
    Read full story
    Source: BBC News, 17 September 2021
  15. Sam
    Surgical hubs, new technology and innovative ways of working will help tackle waiting lists and treat around 30% more elective care patients by 2023 to 2024.
    Backed by a new £36 billion investment in health and social care over the next 3 years, ‘doing things differently’ and embracing innovation will be the driving force to get the NHS back on track.
    The funding will see the NHS deliver an extra 9 million checks, scans and operations for patients across the country, but it’s not enough to simply plug the elective gaps. The NHS will push forward with faster and more streamlined methods of treatments.
    Surgical hubs already being piloted in a number of locations, including London, are helping fast-track the number of planned operations, including cataract removal, hysterectomies and hip and knee replacements, and will be expanded across the country. Located on existing hospital sites, surgical hubs bring together the skills and resource under one roof while limiting infection risk and providing a COVID-secure environment, with more planned to open in the coming year.
    The NHS has been trialling a range of new ways of working in 12 areas, backed by £160 million, to accelerate the recovery of services. This includes setting up pop-up clinics so patients can be treated quickly, in person, and discharged closer to home, as well as virtual wards and home assessments to allow patients to receive medical support from the comfort of their home, freeing up beds in hospitals.
    GP surgeries are using artificial intelligence to help prioritise patients most in need and identify the right level of care and support needed for patients on waiting lists.
    The latest cancer tests being deployed across the NHS are also helping speed up diagnosis and spot cancer early on. Thanks to the hard work of staff, a quarter of a million people were checked for cancer in June – the second highest number on record – and more than 27,000 people started treatment for cancer in the same period.
    Professor Steve Powis, NHS England medical director, said:
    "Although the pandemic is still with us and we will have to live with the impact of COVID for some time, the NHS has already made effective use of additional resources to recover services. From adopting the latest technologies to more evening and weekend working, NHS staff are going to great lengths to increase the number of operations carried out.
    The further funding announced this week will support staff to deliver millions more vital checks, tests and operations, so if you have a health concern, please do come forward to receive the care and treatment you may need."
    Read full story
    Source: 8 September, Department of Health and Social Care
  16. Sam
    Failures by a health board led to eight cancer patients not being appropriately monitored or included in treatment targets after being referred to England, the ombudsman has found.
    Of the 16 patients on Wale's Betsi Cadwaladr health board's prostatectomy waiting list in August 2019, eight were referred to England for treatment. None of those treated in England met the health board's targets.
    The health board, which covers north Wales, has apologised to the patients. It said it had accepted the findings of the report and agreed to implement its recommendations.
    The investigation was launched after a report into the case of a prostate cancer patient raised suspicion there were further incidents.
    Public Services Ombudsman for Wales Nick Bennett said: "Clearly there's consequences for any type of cancer treatment, where people who are treated in England do not receive the same monitoring, do not receive the same harm reviews...
    "Going forward, this must never happen again."
    Read full story
    Source: BBC News, 9 September 2021
  17. Sam
    NHS leaders are being urged to tackle racist abuse of staff as new figures reveal that a third of black, Asian or minority ethnic workers in mental health trusts in England have experienced harassment, bullying or attacks by patients, relatives or members of the public.
    One in three (32.7%) BAME staff in mental health settings have experienced abuse, according to analysis by the Royal College of Psychiatrists. For BAME workers across the NHS, the rate is more than one in four (28.9%).
    One medical director told the Guardian that hot tea had been thrown at them “because of the colour of my skin”. A psychiatrist told how they were left traumatised after they were racially abused – then threatened with a knife.
    The college is calling on health leaders to take a stand against discrimination by setting up better processes in NHS trusts to record and understand data about bullying and harassment.
    Dr Adrian James, president of the Royal College of Psychiatrists, said the findings were deeply concerning. He said: “NHS leaders and local health bosses must tackle this head-on.”
    Read full story
    Source: The Guardian, 9 September 2021
  18. Sam
    The father of a man who took his own life said the mental health unit where he was staying "failed him completely".
    Joshua Sahota, 25, died as a result of asphyxia and psychosis at the Wedgewood Unit in Bury St Edmunds, Suffolk, on 9 September 2019.
    Insufficient staffing levels at the unit contributed to his death, an inquest jury found.
    Mr Sahota, from Kennett in Cambridgeshire, was taken to the unit three weeks before his death as his mental health had declined.
    There was no psychologist in post and the jury at Suffolk Coroner's Court recorded this as having contributed to his death.
    It also found that a plastic bag which contributed to his death was on a restricted items list, but this was "unclear" and there were "inconsistencies of understanding this" by staff and visitors.
    Other factors that the jury said contributed to his death included insufficient observations and one-to-one processes, no clear and concise risk assessments, being slow to develop a care plan and the absence of a documented crisis plan.
    Read full story
    Source: BBC News, 10 September 2021
  19. Sam
    ‘Very heavy-handed, laborious and expensive’ inspections ‘have not been the right way’ of regulating hospitals, according to the Care Quality Commission’s (CQC) former chair.
    Speaking at a Royal Society of Medicine event on Wednesday, Lord David Prior, who is now the chair of NHS England, said “very few” physicians will have improved their work after reading a report from the regulator.
    He added that there is a role for the CQC to move in when “things are going wrong” although he is “sceptical” the regulator can actually drive improvement in hospitals.
    Lord Prior said: “I am highly sceptical as to whether or not CQC or any regulator can really drive improvement and drive the top hospitals to make them better.
    “And certainly I think there’ll be very few physicians who will say that their clinical work has improved as a result of reading a CQC report.
    “I think the sadness I have about CQC is that we have not been able, or it has not been able, to develop a series of predictive metrics that could replace these very heavy handed, very laborious and very expensive visits that we used to do.”
    Read full story (paywalled)
    Source: HSJ, 9 September 2021
  20. Sam
    The deaths of three adults with learning disabilities at a failed hospital should prompt a review to prevent further "lethal outcomes" at similar facilities, a report said.
    The report looked at the deaths of Joanna Bailey, 36, and Nicholas Briant, 33, and Ben King, 32, between April 2018 and July 2020. It found here were significant failures in the care of the patients at Jeesal Cawston Park, Norfolk.
    Ms Bailey, who had a learning disability, autism, epilepsy and sleep apnoea, was found unresponsive in her bed and staff did not attempt resuscitation, while the mother of Mr King said he was "gasping and couldn't talk" when she last saw him. Mr Briant's inquest heard he died following cardiac arrest and obstruction of his airway after swallowing a piece of plastic cup.
    The report found:
    "Excessive" use of restraint and seclusion by unqualified staff. Concerns over "unsafe grouping" of patients. Overmedication of patients. High levels of inactivity and days of "abject boredom". Relatives described "indifferent and harmful hospital practices" and said their questions and "distress" were ignored
    Joan Maughan, who commissioned the report as chairwoman of the Norfolk Safeguarding Adults Board, said: "This is not the first tragedy of its kind and, unless things change dramatically, it will not be the last."
    Read full story
    Source: BBC News, 9 September 2021
  21. Sam
    Becton Dickinson (BD), which manufactures most of the blood tubes used by the NHS, has alerted NHS England and NHS Improvement (NHSE/I) to a global shortage of some of its products, including two types of blood tubes: those with a yellow or purple top.
    BD says that the COVID-19 pandemic created the most unpredictable demand it has seen in the past 70 years. The company says that it has also been difficult for customers to predict the types and quantities of blood tubes they will be using from month to month, which affects manufacturers’ abilities to meet demand. “Adding to the issue are global transportation delays that have resulted in more products being tied up in transportation than is normal, creating additional delays in deliveries,” BD said in a statement. “Raw material suppliers are also challenged to keep up with demand for materials and components.”
    In the UK, BD has been authorised to import blood tubes that are approved for use in other regions of the world, including the United States. It plans to deliver nine million of these additional blood tubes to the NHS for immediate distribution. 
    Read full story (paywalled)
    Source: BMJ, 3 September 2021
  22. Sam
    A child safeguarding expert who faced vilification after raising concerns about the safety of children undergoing treatment at a London NHS gender identity clinic has won an employment tribunal case against the hospital trust.
    Sonia Appleby, 62, was awarded £20,000 after an employment tribunal ruled the NHS’s Tavistock and Portman trust’s treatment of her damaged her professional reputation and “prevented her from proper work on safeguarding”.
    Appleby, an experienced psychoanalytical psychotherapist, was responsible for protecting children at risk from maltreatment.
    The tribunal heard evidence she raised concerns about the treatment of increasing numbers of children being referred to the trust’s Gender Identity Development Service (Gids). The service in Hampstead has been at the heart of a controversy over its treatments, including the provision of drugs known as puberty blockers to children as young as 10.
    The tribunal heard evidence that after she raised the concerns, instead of addressing them, the trust management ostracised her and attempted to prevent her from carrying out her safeguarding role, by sidelining her. Appleby said the management’s action amounted to a “full-blown organisational assault”.
    Read full story
    Source: The Guardian, 4 September 2021
  23. Sam
    More than one in five ‘covid deaths’ were both probably hospital-acquired, and caused at least in part by the virus, at several trusts, according to analysis released to HSJ.
    HSJ obtained figures from more than 30 trusts which have looked in detail at cases where patients died after definitely, or probably, catching covid in hospital. 
    Thirty-two acute trusts provided HSJ with robust data, out of the total 120 in England. Across all 32, they had recorded 3,223 covid hospital deaths which were either “definitely” or ‘probably’ nosocomial — making up around 17% of their total reported 19,020 hospital deaths.
    The trusts said 2,776 of the 3,223 deaths also had covid listed on their death certificate, either as an “immediate cause” or as a contributory factor. That constitutes about 15% of all the hospitals’ covid deaths, and 86% of the nosocomial deaths.
    When approached by HSJ, these trusts said they followed robust infection control practices, and that high community covid prevalence, and covid admissions, were the main cause of hospital-acquired infection. Some trusts also cited their ageing infrastructure.
    Read full story (paywalled)
    Source: HSJ, 6 September 2021
     
  24. Sam
    Shortfalls in mental health services and staffing have been flagged as concerns in dozens of inquests since 2015, the Observer has revealed, with coroners issuing repeated warnings over patients facing long waiting lists or falling through gaps in service provision.
    The Observer has identified 56 mental health-related deaths in England and Wales from the start of 2015 to the end of 2020 where coroners identified a lack of staffing or service provision as a “matter of concern”, meaning they believed “there is a risk that future deaths could occur unless action is taken”.
    Coroners issue Reports to Prevent Future Deaths (PFD) when they believe action should be taken to prevent deaths occurring in future, and send them to relevant individuals or organisations, who are expected to respond. In one case, a woman referred to psychotherapy services had still not received any psychotherapy by the time she died 11 months later. In another, someone had endured a seven-month wait for a psychological assessment.
    Alison Cobb, senior policy and campaigns officer at the mental health charity Mind, said: “It’s shocking that so many should lose their lives because there isn’t enough capacity in mental health services to provide adequate care. These prevention of future deaths notices are meant to inform better ways of working, and it’s especially concerning that similar stories are repeating over and over again.”
    Read full story
    Source: The Guardian, 5 September 2021
    Coroner's reports on the hub
  25. Sam
    The family of a senior medic and lifelong NHS campaigner have called for an investigation into his death as it took paramedics more than half an hour to arrive at his home after operators were told he was suffering a cardiac arrest.
    Professor Kailash Chand, a former British Medical Association deputy chair, had complained of chest pains before one of his neighbours, a consultant anaesthetist at Manchester Royal Infirmary, called 111 for help before telling the call handler within three minutes that he believed his friend was having a cardiac arrest.
    “I was answering their questions when Kailash’s eyes began rolling and he slipped into unconsciousness. That’s when I said ‘this looks like a cardiac arrest’ and to upgrade the call. They kept asking questions as I started CPR and asked for an urgent ambulance. That was two or two and a half minutes into the call."
    Evidence seen by i News shows that it took another 30 minutes after the neighbour told the operator about the cardiac arrest for the paramedics to arrive at Professor Chand’s flat in Didsbury, Greater Manchester.
    National standards for ambulance trusts show that ambulance trusts must respond to category 1 calls – those that are classified as life-threatening and needing immediate intervention and/or resuscitation, such as cardiac or respiratory arrest – in 7 minutes on average, and respond to 90% of Category 1 calls in 15 minutes.
    Read full story
    Source: iNews, 3 September 2021
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