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Sam

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  1. Sam
    National NHS leaders are to take action over growing fears that the “unintended consequences” of focusing so heavily on tackling covid-19 could do more harm than the virus, HSJ has learned. 
    NHS England analysts have been tasked with the challenging task of identifying patients who may not have the virus but may be at risk of significant harm or death because they are missing vital appointments or not attending emergency departments, with both the service and public so focused on covid-19. 
    A senior NHS source familiar with the programme told HSJ: “There could be some very serious unintended consequences [to all the resource going into fighting coronavirus]. While there will be a lot of covid-19 fatalities, we could end up losing more ‘years of life’ because of fatalities relating to non-covid-19 health complications.
    “What we don’t want to do is take our eye off the ball in terms of all the core business and all the other healthcare issues the NHS normally attends to."

    “People will be developing symptoms of serious but treatable diseases, babies will be born which need immunising, and people will be developing breast lumps and need mammograms.”
    HSJ understands system leaders are hopeful that in the coming days they will be able to assess the scale of the problem, and the key patient groups, and then begin planning the right interventions and communications programme to tackle it.
    Read full story
    Source: HSJ, 5 April 2020
  2. Sam
    The NHS must ensure that doctors have proper protective equipment, Jeremy Hunt, the former health secretary, has urged.
    NHS chiefs say that there are no problems with national stock levels of items including masks, gowns and gloves and that local supply issues should have been resolved over the weekend.
    However, hospital staff say that they are still experiencing shortages, with nurses going to DIY shops to stock up or even refusing to work without the right equipment. One London doctor said: “Every time the government is asked they say the equipment is there, and it is just not true.”
    Read full story (paywalled)
    Source: The Times, 23 March 2020
  3. Sam
    Southampton researchers are trialling an inhaled drug that could prevent worsening of COVID19 in those most at risk.
    The trial, led by Tom Wilkinson, Professor of Respiratory Medicince in the Faculty of Medicine and a consultant in respiratory medicine at University Hospital Southampton, will involve 100 patients at Southampton and up to ten other NHS hospitals taking part.
    Those patients will receive the best current COVID19 care, whilst inhaling either a placebo or SNG001, a special formulation of the naturally occurring antiviral protein interferon beta 1a (IFN-β), for 14 days.
    The trial will be undertaken with Synairgen, a drug development company founded by University of Southampton Professors Stephen Holgate, Donna Davies and Ratko Djukanovic.
    Professor Wilkinson said, “COVID19 cis presenting a major challenge to vulnerable patients, the health service and wider society whilst a vaccine will be key, that could some time away. Right now we need effective frontline treatments to give doctors the tools to treat the most vulnerable and  to help patients recover quickly as the pressure on health systems mounts."
    Read full story
    Source: University of Southampton, 18 March 2020
  4. Sam
    NHS staff say they are being put at risk during the coronavirus outbreak because of a lack of protective gear.
    One doctor told the BBC that frontline healthcare workers felt like "cannon fodder" as they do not have access to equipment such as face masks. Health workers also expressed concerns that not enough of them were being tested for the virus.
    Prime Minister Boris Johnson said the UK had "stockpiles" of personal protective equipment (PPE). But Dr Samantha Batt-Rawden, from lobbying group the Doctors' Association, said she had heard from doctors who had not got access to PPE - or it had expired or run out.
    "All these doctors are worried that that's increasing their likelihood of contracting the virus and then ultimately spreading it to patients," she said.
    Read full story
    Source: BBC News, 18 March 2020
  5. Sam
    Prime Minister Boris Johnson has announced plans to test more people for coronavirus.
    At the moment only people in hospital are being routinely tested, so if you have symptoms and you are not sure if you have the virus, you may well never know.
    As of 18 March, 56,221 people in the UK had been tested for coronavirus. The number of tests has been rising from just over 1,000 a day at the end of February, when testing began, to more than 6,000 per day by mid-March.
    The government plans to increase this to 10,000 a day initially, with a goal of reaching 25,000 tests a day. But it has been criticised by some experts for not testing widely enough, and people have been complaining online about not having access to tests despite having symptoms.
    Public Health England says it will do some surveillance testing on a local level if clusters of cases are identified, using a network of 100 designated GP surgeries. This is to try to get a sense of how many milder cases there are in the community that do not result in hospitalisation.
    But the UK is not currently doing any mass surveillance testing or actively tracing people who have come into contact with known cases
    The Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said he had a "simple message" for all countries: "Test, test, test."
    He added: "We cannot stop this pandemic if we do not know who is infected."
    The UK's chief scientific officer Sir Patrick Vallance told a group of MPs that "we simply don't have mass testing available for the population now", and that "when you only have capacity to do a certain number of tests" you have to prioritise the most vulnerable groups.
    Read full story
    Source: BBC News, 19 March 2020
  6. Sam
    The mother of a student, who took his own life, said today she felt 'sick to her stomach' after an NHS communications manager labelled a media report on her son's suicide a 'malarkey'.
    Pippa Travis-Williams, whose son Henry was found dead days after leaving a mental health unit run by the Norfolk and Suffolk Foundation Trust (NSFT) in 2016, said an email sent by NSFT communications manager Mark Prentice to his boss was 'disgusting'.
    It comes weeks after Mr Prentice gloated in another email to his boss that the NSFT had 'got away (again)' with media coverage of the death of a dementia patient.
    In an email to his boss, explaining why NSFT chief executive, Jonathan Warren, was going on BBC Look East, Mr Prentice said the NSFT might look 'uncaring' if Mr Warren did not appear and then described the coverage of Mr Curtis-Williams' suicide as a 'malarkey'.
    Read full story
    Source: Ipswich Star, 10 March 2020
     
     
     
  7. Sam
    Complaints about NHS care cannot always be investigated properly because of medical records going missing, the public services watchdog has said.
    Ombudsman Nick Bennett said many people were left "suspicious" and thought there was a "darker motivation".
    One woman whose notes went missing said she no longer trusted what doctors said and had lost faith in NHS transparency.
    The Welsh NHS Confederation said staff were "committed to the highest standards of care".
    In a report called Justice Mislaid: Lost Records and Lost Opportunities, Mr Bennett found 70% of 17 cases he looked at in Welsh NHS hospitals and care settings could not be properly investigated because of lost documents.
    Read full story
    Source: BBC News, 10 March
  8. Sam
    A police investigation has been launched into an alleged assault against an elderly patient with Alzheimer’s by NHS staff at the troubled East Kent Hospitals University NHS Foundation Trust.
    The Independent can reveal nurses and carers at the William Harvey Hospital have been suspended after being filmed by hospital security staff for eight minutes allegedly holding down the man’s arms and legs as well as his face while they inserted a catheter.
    The trust has confirmed it has launched an investigation and alerted police after the incident on 15 December on the Cambridge J ward at the William Harvey Hospital in Ashford. A spokesperson “apologised unreservedly” for the incident and said it was being treated with the “utmost seriousness”.
    A whistleblower spoke out to The Independent about the incident, fearing it was being covered up by the trust after staff were told “don’t discuss it, don’t refer to it at all”.
    The senior clinician said they had decided to go public after the “horrific” incident because of the trust’s toxic culture and concerns for the welfare of other patients on wards.
    Read full story
    Source: The Independent, 7 February 2020
  9. Sam
    A GP has been given three life sentences for 90 sex assaults on female patients.
    Manish Shah assaulted 23 women and a 15-year-old girl while working in London - carrying out invasive examinations for his own gratification. The Old Bailey heard he used Angelina Jolie and Jade Goody as examples to frighten patients about their health.
    Judge Anne Molyneux described him as a "master of deception who abused his position of power". "You made up stories which got into heads and caused panic," she said.
    Shah, from Romford, convinced his victims to have unnecessary checks between May 2009 and June 2013.
    Read full story
    Source: BBC News, 7 February 2020
  10. Sam
    Patients were harmed at a Midlands trust because of delays in receiving outpatients and diagnostics appointments, the Care Quality Commission (CQC) has warned.
    Following the inspection at Northern Lincolnshire and Goole Foundation Trust in September and October last year, the CQC has lowered the trust’s rating in its safety domain from “requires improvement” to “inadequate”. It warned there were insufficient numbers of staff with the right skills, qualifications and experience to “keep patients safe from avoidable harm”.
    The report noted the trust had identified incidents in 2018 and 2019 where patients had come to harm due to delays in receiving appointments in outpatients, particularly in ophthalmology. Ten patients were found to have come to low harm, one patient moderate harm and two patients severe harm.
    The CQC also issued a Section 31 letter of intent to seek further clarification in relation to incidents where patients had come to harm because of delays to receiving appointments in outpatients and diagnostic imaging, although it has confirmed the trust has provided details on how it is going to manage the issues raised. The watchdog said it would continue to monitor the issue.
    Read full story (paywalled)
    Source: HSJ, 7 February 2020
  11. Sam
    Dozens of women who thought they were having a "complete mesh removal" have discovered material has been left behind, the BBC's Victoria Derbyshire programme has been told.
    Some women have been left unable to walk, work or have sex after having the initial vaginal-mesh implants.
    Specialist surgeons say in some cases total or partial mesh removal can be beneficial. But some women said their symptoms had become worse. One was left suicidal.
    Vaginal-mesh implants remain available on the NHS in England but only when certain conditions are met. In Scotland, the use of mesh was halted in 2018.
    One paitent said her surgeon had promised her a "full mesh removal", but she has now been told more than 10cm (4in) could have been left behind. She had the mesh implanted several years ago to treat urinary incontinence and said she had woken after the surgery with "chronic pain in my legs, my groin and my hips". It is believed she suffered nerve damage.
    A year later – after being told by one expert a mesh removal would be unlikely to resolve her pain – she found a surgeon who told her the implant could be completely removed. She had two operations, each taking her half a year to recover from, and was told there had been a full removal. But "within a few months" the pain began to return and her health deteriorated and she found out that only 5–8cm had been removed.
    "My whole world turned upside down," she said, breaking into tears.
    She has since been told by a separate specialist her form of mesh was one of the most difficult to remove and could cause significant nerve damage if not removed properly. She said she had never been told this by her surgeon.
    The number of women affected is unknown but the Victoria Derbyshire programme understands there are at least dozens of such cases.
    The Royal College of Obstetricians and Gynaecologists said in a statement that it took "each and every complication caused by mesh very seriously". It said: "Women must be informed of all options available and the benefits and risks of each so they can make the best decision about their care."
    Read full story
    Source: BBC News, 6 February 2020
  12. Sam
    A shortage of contraception is causing chaos and risks unplanned pregnancies and abortions, doctors are warning.
    Leading sexual health experts have written to ministers warning that the supply shortage of contraceptives is beginning to lead to serious problems across the UK.
    A number of daily pills and a long-acting injectable contraceptive are thought to be affected, including Noriday, Norimin and Synphase. The problem follows a shortage of hormone replacement therapy for menopausal women last year.
    It is unclear how many women use these types of contraception - overall around three million women take daily pills, and more than 500,000 use long-acting contraception, such as coils, implants and injections.
    The Royal College of GPs said its members were doing their best to help women find alternatives - there are many different types of daily pill available.
    Faculty president Dr Asha Kasliwal said; "We are aware that women are sent away with prescriptions for unavailable products and end up lost in a system. This is causing utter chaos."
    The faculty has teamed up with the Royal College of Obstetricians and Gynaecologists and the British Menopause Society to write to ministers, asking them to set up a working group to address the problems. The letter warns women are becoming distressed by having to find alternative products that might not necessarily suit them or go without contraception altogether.
    It said this was affecting the "physical and mental wellbeing of girls and women" and could lead to a "rise in unplanned pregnancies and abortions".
    Read full story
    Source: BBC News, 7 February 2020
  13. Sam
    The toxicity of a commonly prescribed beta blocker needs better recognition across the NHS to prevent deaths from overdose, a new report warns today.
    The Healthcare and Safety Investigation Branch (HSIB) report focuses on propranolol, a cardiac drug that is now predominately used to treat migraine and anxiety symptoms. It is highly toxic when taken in large quantities and patients deteriorate quickly, making it difficult to treat. The investigation highlighted that these risks aren’t known widely enough by medical staff across the health service, whether issuing prescriptions to at risk patients, responding to overdose calls or carrying out emergency treatment.
    Dr Stephen Drage, ICU consultant and HSIB’s Director of Investigations, said: “Propranolol is a powerful and safe drug, benefitting patients across the country. However, what our investigation has highlighted is just how potent it can be in overdose. This safety risk spans every area of healthcare – from the GPs that initially prescribe the drug, to ambulance staff who respond to those urgent calls and the clinicians that administer emergency treatment."
    The report also emphasises that there is a link between anxiety, depression and migraine, and that more research is needed to understand the interactions between antidepressants and propranolol in overdose.
    Read full story
    Source: HSIB, 6 February 2020
  14. Sam
    The former police chief who investigated mental health services in a crisis-hit health board was “shocked” by the poor working relationships and “blame shifting” he uncovered.
    David Strang, who led the independent inquiry into the issues in NHS Tayside, said staff felt isolated and unsupported and people complained about each other’s practices without coming together to sort the issues out.
    He described asking staff questions based on information he had received and being met with the response: “Who told you?” He added: “A lot of staff felt there was a real blame culture and that risk and blame fell to the front line.”
    Read full story (paywalled)
    Source: 6 February 2020, The Times
  15. Sam
    The new executive must act urgently if it is to "divert the current mental health epidemic among young people", Northern Ireland's children's commissioner has said.
    Koulla Yiasouma said progress in implementing recommendations in a report on children and young people's mental health services, produced 12 months ago, had been "too slow". 
    The stark read captured the scale of youth mental health problems in Northern Ireland. The report found that young people are waiting too long to ask for help and even longer to access the right support.
    Health Minister Robin Swann said his aim was that young people do not wait longer than nine weeks to see a CAMHS (child and adolescent mental health services) professional."I take the mental health and wellbeing of our children and young people very seriously and I am committed to working with my colleagues in a new executive working group on mental well-being, resilience and suicide prevention," he said.
    Read full story
    Source: 6 February 2020
  16. Sam
    A whistleblower raised the alarm over patient safety at West Suffolk Hospital because of concerns about the behaviour of a doctor who had been seen injecting himself with drugs, the Guardian has revealed.
    The incident had already prompted internal complaints from senior staff at West Suffolk hospital, but the whistleblower decided to take matters a step further when the same doctor was later involved in a potentially botched operation. The whistleblower then wrote to relatives of a dead patient and urged them to ask questions about the conduct of the doctor and his background.
    When they did this, the hospital launched a widely criticised “witch-hunt” in an attempt to find out the identity of the leaker.
    The doctor’s drug use, which the trust has never acknowledged until now, helps explain why it demanded fingerprint and handwriting samples from staff – tactics which the NHS regulator roundly condemned in a hard-hitting report last week.
    Read full story
    Source: Guardian, 5 February 2020
  17. Sam
    All NHS hospitals in England have been ordered to create secure areas for coronavirus testing to “avoid a surge in emergency departments”, according to a leaked NHS letter.
    Hospitals have been told to create “coronavirus priority assessment pods”, where people will be checked for the virus, which will need to be decontaminated each time they are used.
    The letter, seen by The Independent and dated 31 January, instructs all chief executives and medical directors to have the pods up and running no later than Friday 7 February.
    It comes as the global death toll from the virus has reached 565 with around 28,000 infected.
    One hospital chief executive told The Independent he believed the requirement was “an overreaction”, adding: “I think we should be sending teams out to swab in patients homes as the advice is to stay at home and self-manage as with any other flu".
    In the letter, Professor Keith Willett, who is leading the NHS’s response to coronavirus, told NHS bosses: “Plans have been developed to avoid a surge in emergency departments due to coronavirus. “Although the risk level in this country remains moderate, and so far there have been only two confirmed cases, the NHS is putting in place appropriate measures to ensure business as usual services remain unaffected by any further cases or tests of coronavirus.”
    Read full story
    Source: 5 February 2020
  18. Sam
    Heart attack, stroke and burns victims are among the seriously ill and injured patients waiting over an hour for an ambulance to arrive in England and Wales, a BBC investigation shows.
    The delays for these 999 calls - meant to be reached in 18 minutes on average - put lives at risk, experts say.
    The problems affect one in 16 "emergency" cases in England - with significant delays reported in Wales.
    NHS bosses blamed rising demand and delays handing over patients at A&E.
    Rachel Power, Chief Executive of the Patients Association, said patients were being "let down badly at their moment of greatest need" and getting a quick response could be "a matter of life or death".
    She said the delays were "undoubtedly" related to the sustained underfunding of the NHS.
    Read full story
    Source: BBC News, 29 January 2020
     
  19. Sam
    Health products powered by artificial intelligence, or AI, are streaming into our lives, from virtual doctor apps to wearable sensors and drugstore chatbots.

    IBM boasted that its AI could “outthink cancer.” Others say computer systems that read X-rays will make radiologists obsolete.
    Yet many health industry experts fear AI-based products won’t be able to match the hype. Many doctors and consumer advocates fear that the tech industry, which lives by the mantra “fail fast and fix it later,” is putting patients at risk and that regulators aren’t doing enough to keep consumers safe.
    Early experiments in AI provide reason for caution, said Mildred Cho, a professor of pediatrics at Stanford’s Center for Biomedical Ethics.

    Systems developed in one hospital often flop when deployed in a different facility, Cho said. Software used in the care of millions of Americans has been shown to discriminate against minorities. And AI systems sometimes learn to make predictions based on factors that have less to do with disease than the brand of MRI machine used, the time a blood test is taken or whether a patient was visited by a chaplain. In one case, AI software incorrectly concluded that people with pneumonia were less likely to die if they had asthma an error that could have led doctors to deprive asthma patients of the extra care they need.

    “It’s only a matter of time before something like this leads to a serious health problem,” said Steven Nissen, chairman of cardiology at the Cleveland Clinic.
    Read full story
    Source: Scientific American, 24 December 2019
  21. Sam
    China has introduced a new law with the aim of preventing violence against medical workers.
    The announcement comes days after a female doctor was stabbed to death at a Beijing hospital.
    The law bans any organisation or individual from threatening or harming the personal safety or dignity of medical workers, according to state media.
    It will take effect on 1 June next year.
    Under the new law, those "disturbing the medical environment, or harming medical workers' safety and dignity" will be given administrative punishments such as detention or a fine. It will also punish people found illegally obtaining, using or disclosing people's private healthcare information.
    Read full story
    Source: BBC News, 29 December 2019
  22. Sam
    Machine learning algorithms can accurately assess the capabilities of neurosurgeons during virtual surgery before they step into an actual operating room, a new study shows.
    Researchers recruited 50 participants from four stages of neurosurgical training: neurosurgeons, fellows and senior residents, junior residents and medical students. The participants performed 250 complex tumour resections using NeuroVR, a virtual reality surgical simulator. Using the raw data, the machine learning algorithm developed performance measures that could predict the level of expertise of each participant with 90% accuracy. The top performing algorithm could classify participants using just six performance measures.
    As reported in the Journal of the American Medical Association, the findings show that the fusion of artificial intelligence (AI) and virtual reality neurosurgical simulators can accurately and efficiently assess the performance of surgeon trainees. This means that scientists can develop AI-assisted mentoring systems that focus on improving patient safety by guiding trainees through complex surgical procedures. These systems can determine areas that need improvement and how the trainee can develop these important skills before they operate on real patients.
    “Our study proves that we can design systems that deliver on-demand surgical assessments at the convenience of the learner and with less input from instructors. It may also lead to better patient safety by reducing the chance for human error both while assessing surgeons and in the operating room,” said leading author, Rolando Del Maestro of McGill University.
    Read full story
    Source: FUTURITY, 5 August 2019
     
  24. Sam
    Latest National Medical Examiner update on national and regional infrastructure, funding the medical examiner system, medical examiners and referrals to coroners, working with registrars, and face to face training.
    Read update
     
     
     
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