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Sam

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  1. Sam
    Nearly half the hospitals targeted in covid-related spot checks were found to be breaching health and safety laws.
    An unpublished Health and Safety Executive report found just five out of 17 acute hospitals inspected had high levels of compliance with measures to manage the risks around covid. 
    Meanwhile, letters were sent to eight hospitals “formally requiring them to take remedial action to remedy contraventions of health and safety law”. The remaining four hospitals were given advice.
    The inspections — which involved 13 hospitals in England and two each in Scotland and Wales — focused on seven areas: risk assessment; management arrangements specific to covid; social distancing; cleaning and hygiene; ventilation; dealing with suspected covid cases; and personal protective equipment.
    The health and safety watchdog highlighted social distancing in non-clinical areas — which covered areas outside of clinical wards such as offices, rest areas, changing rooms and workshops — as needing improvement in some hospitals. 
    The inspectors — who visited between November last year and January this year — also found some hospitals needed more robust covid security measures if they were to comply with government guidance.
    HSE also noted that, although all the hospitals had adequate supplies of PPE, not all had adequate arrangements in place for ensuring it was used effectively.
    Read full story (paywalled)
    Source: HSJ, 5 May 2021
  2. Sam
    Patients are finding it increasingly hard to see their GPs, with warnings that pandemic restrictions have too often “closed the door” on NHS treatment, a report warns. 
    The Patients’ Association survey comes as an investigation reveals that almost 100 GP surgeries closed down or merged with other practices last year.
    In total, almost 2.5 million patients were forced to switch to a new surgery because of 788 such closures since 2013, the freedom of information disclosures reveal .
    Rachel Power, chief executive of the Patients’ Association, said the findings from its survey were “worrying” and show “clear dissatisfaction” from the public.
    The report said: “It is increasingly clear that many patients have found that new methods for arranging appointments do not work for them, or simply that they do not understand how to go about it. GPs are the front door to the NHS, and patients are increasingly perceiving that that door is closed to them.”
    Roughly half of those who had telephone consultations said the experience was worse than a traditional appointment, with three times as many saying they were unhappy about their experience, compared with those offering praise. 
    The report warns: “The data does not show a ringing endorsement of new or remote methods for accessing NHS care; indeed, in most cases patients rated these methods worse than traditional contact.”
    Read full story
    Source: The Telegraph, 30 April 2021
  3. Sam
    A concise training programme aimed at informing healthcare staff about diabetes has the potential to significantly improve patient safety, according to researchers.
    The programme, which was developed by the North West London Collaboration of Clinical Commissioning Groups, has been linked with a reduction in diabetes-related errors.
    The Diabetes 10 Point Training Programme was initially created with the aim of improving inpatient safety by ensuring frontline staff have access to diabetes training.
    Researchers from the CCG collaboration noted that the annual National Diabetes Inpatient Audit (NaDIA) had made for “grim reading with errors, harm, increased length of stay and mortality”.
    They highlighted that a workforce with knowledge of diabetes was “crucial to inpatient safety”, and said that complex diabetes care could be delivered by non-specialists with adequate training.
    Read full story
    Source: Nursing Times, 29 April. 2021
  4. Sam
    A private healthcare provider has been ordered to pay £20,000 after failing to disclose errors in the treatment of patients under the care of a surgeon.
    Spire Healthcare was prosecuted today in what the Care Quality Commission (CQC) said was “the first prosecution of its kind against an independent provider of healthcare”.
    The CQC said concerns around the treatment of four patients were initially raised by Leeds Clinical Commissioning Group, several physiotherapists at the hospital and another surgeon.
    The patients had surgical procedures carried out by Michael Walsh, a shoulder surgeon who held practising privileges at Spire Leeds until his suspension in April 2018. The procedures resulted in the patients suffering prolonged pain and requiring further remedial surgery.
    The CQC said it brought the prosecution after Spire failed to share details of what happened to the patients who were being treated by Mr Walsh, in line with their duty of candour responsibilities to be transparent and provide timely apologies when serious incidents occur.
    Read full story (paywalled)
    Source: HSJ, 29 April 2021
  5. Sam
    A cutting-edge child and adolescent mental health centre hopes to help prevent young people from experiencing mental health problems. 
    As we look hopefully towards a June bonfire of pandemic regulations and restrictions, many recognise that soaring rates of mental health problems and distress amongst our children and young people must be near the top of a 21st century list of challenges in “building back better”.
    School closures, uncertainty and being cut off from friends and social and sporting events have seen more children and young people referred to CAMHS — a service that was facing growing demand even before the pandemic.
    The long-term impact is obviously still unknown.
    However, a cutting-edge child and adolescent mental health centre opening in south London two years from now will play a big role in responding to the likely increased demand for ongoing support — and in developing innovative treatment responses.
    Read full story (paywalled)
    Source: HSJ, 27 April 2021
  6. Sam
    Chelsea and Westminster Hospital NHS Foundation Trust announce the successful pilot of ThermaFY Protect and the subsequent roll-out of the unique thermal screening technology across its hospitals.
    As part of its CW Innovation programme, run jointly with its charity CW+, the Trust approached ThermaFY at the beginning of the COVID-19 outbreak to codevelop and install automated temperature scanning stations at Chelsea and Westminster Hospital and West Middlesex University Hospital to help reduce the spread of infection.
    A unique project, ThermaFY Protect, was developed to provide bespoke thermal screening that combines temperature readings with staff identification. Following a successful pilot which involved six ThermaFY Protect screens being installed across the Trust’s main hospital entrances, the Trust and CW+ will now roll out the programme at all hospital entrances and off-site clinics.
    Amanda Pickford, Founder and Chief Executive of ThermaFY, explains: “It’s been fantastic working with the team at Chelsea and Westminster, who share our entrepreneurial vision and have acted quickly and collaboratively to improve patient and staff safety. During the first pilot, our systems scanned over 500,000 people; now the stations are a permanent feature, scanning over 8,000 patients and staff every day putting patient and staff safety at the centre.”
    Read full story
    Source: Digital Health, 27 April 2021
  7. Sam
    The NHS must think “very radically” about how it redesigns its elective pathways following the coronavirus pandemic, Sir Simon Stevens has told HSJ. 
    Speaking at the HSJ Leadership Congress yesterday, NHS England’s chief executive said the service should ensure as much elective work is done as possible, while covid prevalence is low, while at the same time thinking about “different ways of doing things”.
    He declined to outline how many very long-waiters the service had or would have in coming months, explaining that some predictions have been “significantly off” in the past, and that future demand is unknown.
    The NHS chief stressed that other areas of the service would also face post-covid pressures, announcing a further investment in and expansion of long-covid clinics.
    “We want to see equivalent attention paid to the increased needs we’ve seen in mental health services, including eating disorders, and we want to make sure that the health service continues to expand its offer for long covid,” he said.
    “To that end we have 69 clinics identified last year, we will have 83 long covid clinics in place by the end of this month, so a significant expansion there.” There will be at least one in each integrated care system area, he said.
    Read full story (paywalled)
    Source: HSJ, 14 April 2021
  8. Sam
    More than 80 new clinics to assess patients suffering with symptoms of Long Covid are to be opened by the NHS by the end of this month with an extra investment of £24m.
    NHS England chief executive Sir Simon Stevens said the health service must “continue to expand its offer for Long Covid” adding there will be even more funding earmarked for the problem in the future.
    Speaking at the Health Service Journal’s leadership congress on Wednesday, Sir Simon said: “We have 69 clinics identified last year and we will have 83 long Covid clinics in place by the end of this month, so a significant expansion there.
    “We will be backing that with at least £24 million revenue funding going into this New Year, up from the £10 million announced last year, and there will be more to come on the back of that as well.”
    Recent estimates by the Office for National Statistics found more than a million people could be experiencing long Covid beyond four weeks with 674,000 people saying it was affecting their day to day lives. Almost 200,000 people have said their ability to carry out normal activities has been severely limited by the condition.
    Read full story
    Source: The Independent, 14 April 2021
  9. Sam
    New victims of rogue breast surgeon Ian Paterson are being blocked from using lawyers with experience of the scandal to bring fresh compensation claims against the private hospital where he worked, The Independent has learned.
    Under the terms of a legal settlement for £37m in 2017, 40 law firms are barred from bringing any new claims against Spire Healthcare for 20 years – meaning that former patients who have learned since then that they were victims of the surgeon, who was jailed for carrying out needless surgeries on women, face having to find lawyers with no prior knowledge of the case.
    When the deal was signed, it was thought that most of Paterson’s victims had been contacted by the hospital company, but an inquiry published in 2020 heavily criticised its failure to reach affected patients and accused the company of seeking to protect its reputation rather than the interests of patients.
    In response, Spire Healthcare launched a mass recall of 5,500 former patients, with independent clinicians reviewing their medical records. Some are learning for the first time that they had needless surgery at the hands of the surgeon.
    Read full story
    Source: The Independent, 11 April 2021
  10. Sam
    The NHS is currently considering implementing standardised uniforms for nursing staff and other healthcare workers.
    Staff working in clinical roles across the health service in England are now being asked to take part in a seven week consultation on the proposals.
    With significant variation in the styles and colours used by each individual profession between different NHS trusts, the 2013 Francis Report recommended concluded that a standardised approach could improve patient safety.
    The consultation document reveals that a blue “smart scrub tunic” was shown to be favoured by nurses in recent workshops, moving from pale blue for junior staff to dark blue for the most senior.
    Other colours have been suggested for matrons, specialist nurses, advanced clinical practitioners and heads of nursing.
    Ruth May, Chief Nursing Officer for England said: “Patients have told us that, for them, contact with several NHS professionals in a hospital setting can sometimes feel confusing, frequently due to not knowing who does which role."
    “We want patients and the public to be able to easily identify which nursing, midwifery or care professional is providing their care. Keeping patients and staff safe is fundamental to this consultation so please have your say.”
    Read full story
    Source: Nursing Notes, 14 April 2021
  11. Sam
    A 23-year-old woman who begged doctors to remove her womb to relieve chronic pain says the surgery is being refused due to her age and childless status.
    Hannah Lockhart has endometriosis, a condition that can cause debilitating pain, heavy periods and infertility.
    Although she has always wanted her own children, Hannah says her daily pain is now so severe she wants a hysterectomy.
    "It's heartbreaking that just because I'm so young I have to keep suffering," she told the BBC's Evening Extra.
    Ms Lockhart, from Bangor in County Down, has been in hospital seven times in the past year because of crippling pain from endometriosis.
    "Every single day I'm taking morphine, I'm taking different tablets for nerves to try and stop the pain and nothing works," she said.
    Read full story
    Source: BBC News, 14 April 2021
  12. Sam
    Long Covid patients have voiced growing frustration at a “postcode lottery” in clinical support for debilitating symptoms, with some areas of the UK offering no specialist clinics more than a year after coronavirus took hold.
    Other sufferers said they were disappointed by long Covid clinics investigating certain symptoms only, with no comprehensive treatment plan.
    Official figures suggest there are almost 700,000 Britons with Covid symptoms lasting over three months. In October, NHS England announced more than £10m for a network of clinics bringing together doctors, nurses, therapists and other NHS staff to conduct physical and psychological assessments and recommend treatments for long Covid patients.
    Additional local funding would also be available to help establish a clinic in every area, the NHS England chief executive, Simon Stevens, said. By December, 69 clinics had been set up in England with a further 12 sites earmarked to launch in January.
    But Louise Barnes, founder of the Post Acute Covid Syndrome 19 (Pacs19) patient advocacy group, said a survey of 200 British members revealed about 90% had not been able to access a clinic because there wasn’t one available, their GP could not refer them or they were declined without explanation. Others were disappointed by the type of services on offer.
    Barnes said: “Patients in the UK have waited going on a year to get support for the multitude of symptoms they’ve been experiencing. To finally think you are going to get referred to a clinic but your GP tells you they don’t have any information, or you get there to find it’s a ‘respiratory-only clinic’ or only staffed by physiotherapists leaves them feeling despondent. For the most part, sadly, patients are coming away massively feeling let down and with no viable treatment plan offered – even a rudimentary one, whilst a treatment is found."
    Read full story
    Source: The Guardian, 6 April 2021
  13. Sam
    People suffering from chronic pain that has no known cause should not be prescribed painkillers, the medicines watchdog has announced, recommending such patients be offered exercise, talking therapies and acupuncture instead.
    In a major change of pain treatment policy, the National Institute for health and Care Excellence (NICE) say that in future, doctors should advise sufferers to use physical and psychological therapies rather than analgesics to manage their pain.
    Painkillers such as aspirin 'do more harm than good' for chronic primary pain
    Medical teams can also consider prescribing antidepressants, the government health advisers suggest.
    NICE’s new guidance potentially affects the way many hundreds of thousands of people in England and Wales tackle their condition because between 1% and 6% of the population of England is estimated to have chronic primary pain.
    Read full story
    Source: The Guardian, 7 April 2021
  14. Sam
    One in three people who were severely ill with coronavirus were subsequently diagnosed with a neurological or psychiatric condition within six months of infection, a study has found.
    The observational research, which is the largest of its kind, used electronic health records of 236,379 patients mostly from the US and found 34% experienced mental health and neurological conditions afterwards. The most common being anxiety, with 17% of people developing this.
    Experts warned that healthcare systems need to be resourced to deal with patients affected by this, which could be “substantial” given the scale of the pandemic. They anticipate that the impact could be felt on health services for many years.
    Neurological diagnoses such as stroke and dementia were rarer, but not uncommon in those who had been seriously ill during infection. Of those who had been admitted to intensive care, 7% had a stroke and almost 2% were diagnosed with dementia.
    The study, which was published in the Lancet Psychiatry, found that these diagnoses were more common in COVID-19 patients than among those who had the flu or respiratory tract infections over the same time period.
    Read full story
    Source: The Guardian, 7 April 2021
  15. Sam
    Nearly 30 patients suffered severe or moderate harm due to quality issues with ultrasounds carried out by an independent provider, a review has found. 
    Scans of 1,800 patients carried out by two sonographers employed by Bestcare Diagnostics were examined as part of a clinical harm review initiated by Coastal West Sussex Clinical Commissioning Group in 2019.
    Papers for next week’s governing body meeting of West Sussex CCG — which has absorbed Coastal West Sussex CCG — reveal the review found 29 cases of severe or moderate harm. 
    According to the NHS’ National Recording and Learning System, moderate harm is that where a patient needs further treatment or procedures but the harm is short-term. Severe harm results in permanent or long-term harm. Both require NHS bodies to exercise the duty of candour.
    Read full story (paywalled) 
    Source: HSJ, 6 April 2021
  16. Sam
    Deep-rooted relationship problems between consultants in a major trust’s neurosurgery department distracted from patient care, according to a review leaked to HSJ.
    A review by the Royal College of Surgeons (RCS) into neurosurgery services at University Hospitals Birmingham FT last year found serious concerns over consultant “cliques” and relationship problems across the department.
    It comes as a new review has been launched into the care of 23 patients in the deep brain stimulation service, which is a sub-speciality in the department.
    According to the RCS report, which was completed in May last year, there have been wide-ranging problems within the department for several years.
    The report said: “Poor team working and inter-relational difficulties, which had been deep-rooted and recognised to have existed for some time, have had the potential to compromise patient care and will be likely to continue to do so if these issues remain unresolved.”
    It suggested some consultant neurosurgeons had prioritised their personal or professional differences over patient care, with the relationship issues being “amplified” within the wider surgical workforce.
    Read full story (paywalled)
    Source: HSJ, 7 April 2021
  17. Sam
    An NHS trust has been charged over the deaths of two patients.
    The Care Quality Commission alleges Natalie Billingham, 33, and Kaysie-Jane Bland were exposed to "significant risk of avoidable harm" at Dudley's Russells Hall Hospital.
    The regulator has brought the charges against Dudley Group NHS Foundation Trust over two alleged breaches of the Health and Social Care Act.
    This relates to the trust's duty to ensure safe care and treatment.
    Read full story
    Source: BBC News, 6 April 2021
  18. Sam
    Growing numbers of women and men in England with eating disorders are being denied support because they are not considered to be thin enough to warrant it, a leading psychiatrist and other experts have warned in a briefing shared with ministers.
    Against the backdrop of a fourfold rise in people admitted to hospital with eating disorders during the Covid pandemic, doctors said body mass index (BMI) was too often used as a blunt measure to decide whether someone should get treatment.
    In some cases, women have not received an eating disorder diagnosis despite their periods stopping due to overexercising or restrictive eating.
    BMI uses height and weight to calculate a healthy weight score. A normal body weight is considered to be between 18.5 and 24.9, and some doctors consider anything below this a signifier of an eating disorder.
    Dr Agnes Ayton, the chair of the Royal College of Psychiatrists eating disorders faculty, and the mental health campaigner Hope Virgo shared a briefing paper with the Department of Health and Social Care (DHSC) urging funding to meet demand and “as a direct result of an increase in the number and severity” of patients during the pandemic. The paper, seen by the Guardian, said there had been a significant increase in eating disorders among ethnic minorities and men.
    Concern has been raised about “a state of emergency” for eating disorders, the briefing paper said. Hospital admissions have seen a fourfold increase in the last year without extra investment in specialist eating disorder inpatient services during this time, it added.
    Read full story
    Source: The Guardian, 5 April 2021
  19. Sam
    Patients could be waiting as much as two years for vital operations by the time of the next election due to a “truly frightening” backlog of care caused by the pandemic, the NHS’s former boss has said.
    Lengthening delays in getting treatment in England are will become a major political problem for Boris Johnson and pose a risk to patients’ health, Sir David Nicholson told the Guardian.
    “The backlog is truly frightening. We can very easily get to the next election with people waiting over two years. It’s easy to do that,” said Nicholson, citing an explosion in the number of people waiting at least a year since the start of the COVID-19 crisis.
    “The whole issue of access [to care] is a greater threat to the NHS than privatisation because poor access undermines confidence amongst those people who fund the service – taxpayers,” he added.
    The widespread suspension of normal NHS diagnostic tests and surgery during the pandemic as hospitals prioritised Covid care has left the service in England with a record 4.59 million people waiting for hospital treatment.
    That number is set to rise to what the NHS Confederation believes could be as much as 6.9m cases by the end of the year as people on a “hidden waiting list” – who put off seeking help after discovering symptoms of illness – finally visit a GP.
    According to the most recent figures, the number of people who have been waiting for at least a year has rocketed from 1,613 before the pandemic struck to 304,044.
    Under the NHS Constitution, 92% of people waiting are meant to be treated within 18 weeks. However, a third of the 4.59 million people have already waited longer than that.
    Read full story
    Source: The Guardian, 2 April 2021
  20. Sam
    Mental health "hubs" for new, expectant or bereaved mothers are to be set up around England.
    The 26 sites, due to be opened by next April, will offer physical health checks and psychological therapy in one building. NHS England said these centres would provide treatment for about 6,000 new parents in the first year.
    Five years ago, 40% of areas in England had no dedicated maternal mental health services.
    Things have improved since then with some specialist services available in each of the 44 local NHS areas in England. But in the NHS's Long Term Plan, published in 2019, the health service pledged to offer more "evidence-based" support, including to partners and families through these hubs or "outreach clinics".
    The NHS hopes to offer services to people with moderate-to-severe difficulties, whereas earlier investment focused on the most acutely unwell mothers.
    These clinics will "integrate maternity, reproductive health and psychological therapy for women experiencing mental health difficulties directly arising from, or related to, the maternity experience," NHS England said.
    Read full story
    Source: 5 April 2021
  22. Sam
    Intense pressures on the already overstretched NHS are being exacerbated by the tens of thousands of health staff who are sick with Long Covid, doctors and hospital bosses say.
    At least 122,000 NHS personnel have the condition, the Office for National Statistics disclosed in a detailed report that showed 1.1 million people in the UK were affected by the condition. That is more than any other occupational group and ahead of teachers, of whom 114,000 have it.
    Patient care is being hit because many of those struggling with Long Covid are only able to work part-time, are too unwell to perform their usual duties, or often need time off because they are in pain, exhausted or have “brain fog”.
    “Ongoing illness can have a devastating impact on individual doctors, both physically and by leaving them unable to work. Furthermore, it puts a huge strain on the health service, which was already vastly understaffed before the pandemic hit,” said Dr Helena McKeown, the workforce lead at the British Medical Association, which represents doctors.
    “With around 30,000 sickness absences currently linked to Covid in the NHS in England, we cannot afford to let any more staff become ill. Simply put, if they are off sick, they’re unable to provide care and patients will not get the care and treatment they need.
    “In the longer term, if more staff face ongoing illness from past COVID-19 infection, the implications for overall workforce numbers will be disastrous.”
    Read full story
    Source: The Guardian, 3 April 2021
  23. Sam
    Campaigners have started legal action against the government over guidance that bans care home residents in England aged 65 and over from taking trips outside the home.
    John's Campaign, of residents and their loved ones, says the ban is unlawful. They are also challenging the requirement for residents to self-isolate for 14 days after such visits.
    The government said its guidance provides a "range of opportunities" for visitors to spend time with loved ones.
    Nearly all residents have now had at least one dose of the vaccine, and care homes have been cautiously reopening, allowing indoor visits with designated family or friends.
    But the government guidance, updated on 8 March, says trips to see family or friends "should only be considered" for under-65s while national Covid restrictions apply because they increase the risk of bringing Covid into a home.
    Visits out for residents, whatever their age, "should be supported in exceptional circumstances such as a visit to a friend or relative at the end of their life", it adds - but on returning to the home, the resident must self-isolate for two weeks.
    The legal letter sent to the Department of Health and Social Care by John's Campaign says the decision whether someone can go on a visit outside a care home should be based on individual risk assessments.
    Read full story
    Source: BBC News, 2 April 2021
  24. Sam
    Maternity services are at risk because demoralised midwives are planning to quit the NHS, healthcare leaders have warned.
    A new report, carried out by the Institute for Public Policy Research, suggests 8,000 midwives may depart due to the “unprecedented pressure” of the coronavirus pandemic.
    Researchers, who surveyed about 1,000 healthcare professionals from around the country in mid-February, discovered that two-thirds reported being mentally exhausted once a week or more.
    Read full story (paywalled)
    Source: The Independent, 31 March 2021
  25. Sam
    An estimated 10% to 30% of people who get COVID-19 suffer from lingering symptoms of the disease, or what's known as "long COVID."
    Judy Dodd, who lives in New York City, is one of them. She spent nearly a year plagued by headaches, shortness of breath, extreme fatigue and problems with smell, among other symptoms.
    She says she worried that this "slog through life" was going to be her new normal.
    Everything changed after she got her COVID-19 vaccine.
    "I was like a new person, it was the craziest thing ever," says Dodd, referring to how many of her health problems subsided significantly after her second shot.
    And she's not alone. As the U.S. pushes to get people vaccinated, a curious benefit is emerging for those with this post-illness syndrome: Their symptoms are easing and, in some cases, fully resolving after they get vaccinated.
    Judy Dodd suffered lingering symptoms of COVID-19 for nearly a year, until she got her vaccine.
    It's the latest clue in the immunological puzzle of long COVID, a still poorly understood condition that leaves some who get infected with wide-ranging symptoms months after the initial illness.
    The notion that a vaccine aimed at preventing the disease may also be a treatment has sparked optimism among patients, and scientists who study the post-illness syndrome are taking a close look at these stories.
    Read full story
    Source: NPR, 31 March 2021

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