Health leaders have written to Boris Johnson issuing new warnings on the impact of a no-deal Brexit. In a letter to the Prime Minister, the heads of 17 royal colleges and health charities across the UK say clinicians are "unable to reassure patients" their health and care will not be affected.
They go on to say they have "significant concerns about shortages of medical supplies". Government said it was working with the health sector on "robust preparations".
The letter, co-ordinated by the Royal College of Physicians, is signed by the heads of organisations including the British Dental Association, the Royal Pharmaceutical Society, Kidney Care UK and the Royal College of Emergency Medicine. It calls for the Health and Social Care Secretary Matt Hancock to be put on the EU exit strategy committee chaired by Michael Gove, who is in charge of no-deal planning.
The signatories argue that - given the scale of the NHS - without sufficient planning, even the smallest of problems could have "huge consequences on the lives of millions of people".
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Source: BBC News, 21 August 2019
Two million pensioners are taking at least seven types of prescription drugs - putting them at risk of potentially lethal side-effects, a major report warns.
Age UK said the rise of “polypharmacy” was putting lives at risk, with three quarters likely to suffer adverse reactions to at least one of their drugs. The research found that the number of emergency hospital admissions linked to such side-effects has risen by 53 per cent in seven years, with some cases proving fatal.
Experts said GPs were doling out too many drugs because they were too busy to properly consider complex health problems, and the risk of side-effects, and interactions between different drugs.
Caroline Abrahams, Charity Director at Age UK, said: "We are incredibly fortunate to live at a time when there are so many effective drugs available to treat older people’s health conditions, but it’s a big potential problem if singly or in combination these drugs produce side effects that ultimately do an older person more harm than good.”
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Source: The Telegraph, 22 August 2019
After two decades of keeping the public in the dark about millions of medical device malfunctions and injuries, the US Food and Drug Administration (FDA) has published the once hidden database online, revealing 5.7 million incidents publicly for the first time.
The newfound transparency follows a Kaiser Health News investigation that revealed device manufacturers, for the past two decades, had been sending reports of injuries or malfunctions to the little-known database, bypassing the public FDA database that’s pored over by doctors, researchers and patients. Millions of reports, related to everything from breast implants to surgical staplers, were sent to the agency as “alternative summary” reports instead.
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Source: Kaiser Health News, June 27 2019
NHS England has declared a national emergency over shortage of feed for babies and disabled patients, with some patients being told to go to Accident & Emergency (A&E) departments. Hundreds of NHS patients, including children, who depend on intravenous (IV) nutrition, have been experiencing delays in deliveries.
It follows an inspection by watchdogs which found manufacturers were failing to meet safety standards, and the presence of potentially fatal bacteria. The NHS National Patient Safety Director, Aiden Fowler, has written to all NHS hospital trusts, and affected patients, warning that the incident has been designated as an emergency incident, under the Civil Contingencies Act, at the highest level.
British manufacturer Calea had already said the shortages could last up to four weeks. But the letter warns that the crisis could last far longer, outlining plans to ration the product to those most in need.
Parents said the situation was “terrifying” with some told to go to A&E if vulnerable children were left too long without being fed.
Hospitals have now been asked to review all patients receiving such IV feed to ensure only those deemed at high-risk are allocated the supplies, which are tailored to meet specific individual needs. Others will be allocated standard bags of nutrition, with extra supplements.
In the letters from Dr Fowler, disclosed by the Health Service Journal, he warns that the NHS is facing a “difficult balance” between the risks caused by the shortages, and the dangers of allowing production to continue, without safety improvements.
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Source: The Telegraph, 13 August 2019
Registrars at an Australian hospital have launched legal action against its management amid claims that they are being worked beyond exhaustion while being denied their mandatory clinical training.
The alleged plight of the doctors at Melbourne’s Sunshine Hospital has become the latest instalment in a growing list of complaints among doctors in training over excessive workload pressures, exploitation, harassment, and bullying across the country’s public hospital system.
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Source: BMJ, 12 August 2019
Medical leaders need to prevent and tackle “problematic subcultures”, which can include groups of “divas” who are viewed as “untouchable”, new General Medical Council research has concluded.
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Source: HSJ, 14 August 2019
Nearly 2 million NHS patients are to be given access to video consultations with doctors employed by a digital healthcare supplier as a result of a series of deals signed with NHS commissioners.Nearly 2 million NHS patients are to be given access to video consultations with doctors employed by a digital healthcare supplier as a result of a series of deals signed with NHS commissioners.
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Source: HSJ, 12 August 2019
Whitehall investigators have launched an inquiry into allegations of serious misconduct during the official review of the Gosport hospital scandal. They are examining claims that civil servants working on the £13m inquiry bullied staff, buried evidence and went on taxpayer-funded “working retreats” to Spain.
An independent panel last year linked Dr Jane Barton to the premature deaths of up to 656 elderly people given opiate overdoses at Gosport War Memorial Hospital between 1989 and 2000.
Whistleblowers have alleged that the panel ignored concerns about the hospital’s culture and use of faulty medical equipment to deliver a “clean hit” and “draw a line under it all”.
The Department of Health said last night: “We take all and any allegations of wrongdoing very seriously. An investigation is being undertaken and it would be inappropriate to comment further until it is concluded.”
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Source: The Sunday Times, 11 August 2019
Documents released in an Ohio court case last month, in a landmark, multi-district opioid lawsuit, gave new insight into an unparalleled opioid epidemic in the United States. It revealed that between 2006 and 2012, some 76 billion opioid pills were distributed in the United States — more than 200 pills for every man, woman and child.
It paints a damning picture of the tension between drug company profits and patient safety during the time opioid sales were climbing dramatically. In one 2009 exchange, a pharmaceutical company representative emailed a colleague at another company to alert him to a pill shipment. “Keep ’em comin’!” was the response. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are.”
According to Charles L. Bennett et al. in an editorial published in the Los Angeles Times, the failings are at every point in the system, starting with drug approvals. But the authors believe there is a particularly serious problem with the mechanisms for identifying, monitoring and disseminating information about issues with a drug after its release.
They suggest a good starting point for reforming the system would be increased transparency about drugs already recognised as particularly dangerous. These drugs, currently numbering about 70 (including opioids), carry the FDA’s so-called 'black box warning,' intended to alert patients and their doctors to the high risks associated with the drugs. But that is not enough. The authors propose a 'black box' database or 'registry,' publicly available and simple to use, that would contain extensive information about where, by whom and for what purpose black box drugs are prescribed, as well as where and in what quantities such drugs are being distributed and sold. Information about adverse side effects, culled from the myriad of government databases that now collect them, would also be consolidated in an open form and format.
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Source: Los Angeles Times, 8 August 2019
Appropriate methods and standards around artificial intelligence (AI) need to be created to protect patient safety, experts have said. Responding to the Government’s pledge of £250 million for a National Artificial Intelligence (AI) Lab, Matthew Honeyman, researcher at The Kings Fund, said the NHS workforce needs to be equipped with digital skills for the benefits of new technologies to be realised.
“AI applications are in development for many different use cases – from screening, to treatment, to admin work – there needs to be appropriate methods and standards developed for safe deployment and evaluation of these solutions as they enter the health system,” he told Digital Health.
Adam Steventon, Director of Data Analytics at the Health Foundation, said the commitment was a “positive step” but that technology needs to be driven by patient need and “not just for technology’s sake”. “Robust evaluation therefore needs to be at the heart of any drive towards greater use of technology in the NHS, so that technologies that are shown to be effective can be spread further, and patients protected from any potential harm,” he said.
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Source: Digital Health, 9 August 2019
A judge has backed a decision by the Care Quality Commission to block the opening of an “institutional” care home for people with learning disabilities, concluding that the setting would have created “unacceptable and serious risks” for residents.
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Source: Nursing Times, 9 August 2019
The past year has seen wide concern about the safety of medical implants. Some of the worst scandals have involved devices for women, such as textured breast implants with links to cancer, and transvaginal mesh implants, which were the subject of the asenate inquiry. But women are harmed not only by 'women's devices' such as breast implants and vaginal mesh. Women are also more likely to be harmed by apparently gender-neutral devices, like joint replacements and heart implants according to Katrina Hutchison in a recent MENAFN article.
Bias starts with design and then lab testing: biological and social factors can affect how women present when injured or ill, and how well treatments work. Often, device designers do not take these differences into account. The lab tests used to make sure implants are safe often ignore the possibility women could have different reactions to materials, or their activities could place different loads on implants.
Bias continues with clinical trials. And then there's the doctor-patient relationship; the gender of the doctor and patient can make a difference to what women learn about their implant.
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Source: MENAFN, 11 August 2019
Researchers at Queen Alexandra Hospital in Cosham carried out a study on 8,585 patients and staff using the Lifelight app. Using a selfie taken on a smartphone, and the ambient light that bounces off the skin, the app carries out calculations and tells the user the resulting rates. Among the hundreds of people who took part in the Vision-D project, 1,295 were diagnosed with previously unidentified high blood pressure during what was the largest digital physiological study in history.
Developer Xim has brought the technology’s accuracy in line with current NHS equipment. It also measures a person’s respiratory rate. Hopes are high it will win approval from the National Institute for Health and Care Excellence (NICE) - paving the way for it to be used by health care providers and patients.
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Source: Portsmouth News, 30 July 2019
Palliative and end-of-life care must become a priority in healthcare, a cancer charity has said. Macmillan Cancer Support said emergency departments were not the right places to care for terminally ill people. Their comments come after new research conducted by Macmillan and the NI Cancer Registry at Queen's University.
The report highlights the need for planning and communication around end-of-life care. It also found late diagnosis of cancer to be a problem. Among the research's findings is that three quarters of cancer patients who died in Northern Ireland in 2015 were admitted to A&E at least once in the last year of their lives.
"Emergency departments cannot provide the very specialist care needed by cancer patients", said Heather Monteverde, Macmillan's Head of Service.
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Source: BBC News, 8 August 2019
The NHS in England is setting up a national artificial intelligence (AI) laboratory to enhance care of patients and research. The Health Secretary, Matt Hancock, said AI had "enormous power" to improve care, save lives and ensure doctors had more time to spend with patients. He has announced £250m will be spent on boosting the role of AI within the health service.
Clinical trials have proven AIs are as good as leading doctors at spotting lung cancer, skin cancer, and more than 50 eye conditions from scans. This has the potential to let doctors focus on the most urgent cases and rule out those that do not need treatment. Other tools have been developed that can predict ovarian cancer survival rates and help choose which treatment should be given. However, AI will pose new challenges, including protecting patient data.
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Source: BBC News, 8 August 2019
A bullying culture still “persists” at Wirral University Teaching Hospital FT 18 months after a major governance scandal was exposed, a senior Parliamentarian has told health ministers.
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Source: HSJ, 8 August 2019
New research released by Jo's Cervical Cancer Trust has revealed the extent to which women who have physical disabilities are discriminated against when attempting to undergo cervical screenings. The charity surveyed 335 women for the investigation who have health conditions including spinal muscular atrophy, Ehlers-Danlos syndrome, paraplegia and cerebral palsy. According to the study's findings, 88% of the participants felt that it is more difficult for a women with a physical disability to attend a cervical screening and just under half of the participants said that they had purposely chosen not to attend a smear test because of a negative, past experience they'd had due to their disability.
Robert Music, Chief Executive of Jo's Cervical Cancer Trust, said: ""It is not acceptable that women with a physical disability are often faced with additional hurdles or even being denied access to this potentially lifesaving test."
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Source: Independent, 8 August 2019
The Department of Health and Social Care (DHSC) indicates that more than a million machines are still on the decade-old operating system with less than six months until Microsoft ceases support for Windows 7.
In answer to a written parliamentary question from shadow Cabinet Office Minister Jo Platt, former Department of Health and Social Care Minister Jackie Doyle-Price said that the NHS operates about 1.37 million PCs. As of the end of last month, some 1.05 million of these, equating to 76% of the overall total, still run on Windows 7, she added.
Platt – whose parliamentary question recently revealed that there are still 2,300 computers across the NHS running Windows XP, for which support ended five years ago – claimed that the widespread use of Windows 7 is “deeply concerning”. She added: “The WannaCry cyberattack two years ago starkly proved the dangers of operating outdated software. Unless the government swiftly acts and learns from their past mistakes, they are risking a repeat of WannaCry. Protecting public data and computer systems should be a highest priority of government...".
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Source: Public Technology.net, 30 July 2019
In a recent BMJ 'Head to head', the authors argue whether the World Health Organization's (WHO) surgery safety checklist saves lives.
Studies show that the WHO's surgery checklist saves lives around the world, say Alex Haynes and Atul Gawande. But David Urbach and Justin Dimick argue that there’s not enough evidence to say for sure.
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Source: BMJ, 5 August 2019
A leading expert on learning disability services will work with the NHS to review the circumstances and lessons of the death of Oliver McGowan, a young teenager with learning disabilities. NHS England has announced that Dr Celia Ingham Clark, England’s Medical Director for Professional Leadership and Clinical Effectiveness, will oversee the completion of the learning disability mortality review (LeDeR) of Oliver’s death.
Fiona Ritchie, an independent consultant, will chair the review which aims to ensure there is the necessary learning from deaths of people with a learning disability, working with the McGowan family. Ms Ritchie, the independent chair, will now take forward – with the family and Dr. Ingham Clark – finalising the terms of reference for review and overseeing the completion. Following agreement with Oliver’s family, further experts will join an oversight group, which will provide specialist clinical input and advice as needed to Ms Ritchie ensuring that the review process is thorough and the final findings are robust.
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Source: NHS England, 7 August 2019
More than 4,000 women in the Republic of Ireland were not told the results of cervical cancer smear tests due to an IT problem, a report has revealed.
It found in about 870 of the cases, results letters were not issued to the women or their GP. In the other 3,200 cases the results were issued to GPs, but not the women. The report concluded there was not proper due diligence and risk assessment in appointing a new lab as a cervical check test facility.
Quest Diagnostics Chantilly Laboratory was appointed in an effort to help clear a major backlog of cervical cancer test samples. This, the review said, was well intentioned but no testing took place to see if it could be seamlessly integrated into the way the system operated.
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Source: BBC News, 6 August 2019
The Healthcare Safety Investigation Branch (HSIB) has launched a new online feedback form so that anyone involved or interested in HSIB's healthcare safety investigations can "tell us what they think".
There are options to give feedback on national investigations in general, specific national investigations, maternity investigations and HSIB in general.
The feedback form is available from the HSIB website
Source: HSIB, 1 August 2019
Twenty hospitals in England due to receive an extra £850m funding for upgrades to outdated facilities and new equipment have been revealed. Prime Minister Boris Johnson will formally announce the plans – part of NHS spending pledges totalling £1.8bn – at a Lincolnshire hospital today. Ahead of his visit to Lincolnshire, Mr Johnson said the new money – less than 1% of the annual NHS budget – would mean "more beds, new wards, and extra life-saving equipment".
But responding to the funding announcement, the Health Foundation said "years of under-investment in the NHS's infrastructure means this extra money risks being little more than a drop in the ocean". Ben Gershlick, from the charity, added that NHS facilities in England were "in major disrepair", with a £6bn maintenance backlog.
GPs say they are misdiagnosing patients because appointment slots are too short. A survey of family doctors found more than one in three said they had failed to properly diagnose cases because they did not have enough time to fully assess them. Typically, the time slot to see a patient is around 10 minutes. The poll of 200 GPs found that 95 per cent of those surveyed said such slots were too short to do their jobs safely.
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Source: The Telegraph, 25 July 2019
Nurses from Northwest Pennsylvania convened at a billboard calling for greater limitations on the number of patients a nurse can attend to during a shift. The advertisement, located on state Route 8 outside of Centerville, is one of two billboards that Nurses of Pennsylvania, a non-profit advocacy group in the US for nurses and patients, crowd funded in order to raise awareness about the issue of safe staffing and possible legislation.
Registered nurse Kimberly Aldrich, said: “What gets me is that this is not an unprecedented idea in Pennsylvania... When we drop our kids off at daycare, we can rest assured that the facility is legally required to adhere to limits on the number of kids a childcare worker can be assigned. Why should we accept less if our kids are in the hospital?”
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Source: The Titusville Herald, USA, 24 July 2019
