The trust at the centre of a maternity scandal insists it has been providing immediate anaesthetic cover for obstetric emergencies, contrary to an NHS England report suggesting it had not and had been potentially breaching safety standards.
Health Education England – now part of NHSE – visited William Harvey Hospital in March and was told senior doctors in training who were covering obstetrics could also be covering the cath lab – which deals with patients who have had a heart attack, and could receive trauma, paediatric emergency and cardiac arrest calls. This suggested the trust was in conflict with Royal College guidelines which state an anaesthetist should always be “immediately available” for obstetrics.
East Kent Hospitals University Foundation Trust, which runs the hospital, originally told HSJ its rota had very recently been changed and that an anaesthetist with primary responsibility for maternity could leave any other work to attend to a maternity emergency immediately. However, it has since said it has been the case for a long time that an anaesthetist is available to return to maternity in case of an emergency.
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Source: HSJ, 17 June 2023
Staff fell asleep while on duty at a mental health trust, inspectors found.
The Care Quality Commission (CQC) said it was "very disappointed" to find patient safety being affected by the same issues it had seen previously.
It said on acute wards for adults of working age and psychiatric intensive care units, five patients described staff falling asleep at night.
Despite CCTV being available, managers told the CQC they could not always immediately prove staff had been sleeping as accessing the pictures could take up to a fortnight.
The CQC report added trust data from June to December 2022 recorded 20 incidents of staff falling asleep while on duty but no action was taken because the video evidence had not been viewed.
Rob Assall, the CQC's director of operations in London and the East of England, said: "When we inspected the trust, we were very disappointed to find people's safety being affected by many of the same issues we told the trust about at previous inspections.
"This is because leaders weren't always creating a culture of learning across all levels of the organisation, meaning they didn't ensure people's care was continuously improving or that they were learning from events to ensure they didn't happen again."
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Source: BBC News, 12 July 2023
A scheme in which ‘category 2’ 999 calls are validated by clinicians will be extended nationally after reducing journeys by 4%in a pilot, with no adverse incidents, NHS England has told HSJ.
NHSE also confirmed that one ambulance trust in the scheme, the West Midlands, has begun delaying the dispatch of ambulances for some category 2 calls by up to 23 minutes so that the validation can take place.
At three other trusts – London, South Western and the East Midlands – about 40% of category 2 calls receive clinical validation, but an ambulance is dispatched to them as soon it is available, as normal.
Officials said they believe the demand benefit could be greater if ambulance trusts are able to devote more clinical capacity to the validation process. About 40% of category 2 calls are judged suitable for validation, but not all of them complete the process before an ambulance arrives.
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Source: HSJ, 11 July 2023
An inspection of an ‘outstanding’ hospital has revealed concerns about unsafe staffing, as well as bullying and undermining behaviour.
The then Health Education England issued Frimley Health Foundation Trust 14 mandatory requirements after visiting its Frimley Park Hospital in March to look at training in medical specialties. The risk-based review followed concerns in the 2022 national training survey and previous quality interventions by HEE.
Among the problems HEE was told about were:
Junior doctors feeling staffing on some shifts was unsafe. Foundation year one doctors were sometimes the only doctors on a ward, while one foundation doctor spent their first weekend on call looking after two wards by themselves.
Concerns about bullying and undermining behaviour in an unnamed department, and consultant behaviour during weekend handover which left some staff feeling “uncomfortable”.
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Source: HSJ, 11 July 2023
Pharmaceutical giants are pouring tens of millions of pounds into struggling NHS services – including paying the salaries of medical staff and funding the redesign of patient treatment – as they seek to boost drug sales in the UK, the Observer can reveal.
The spending is revealed in an investigation that lays bare the growing role of Big Pharma in the UK’s health sector, with analysis of more than 300,000 drug company transactions since 2015 showing a surge in spending on activities other than research and development (R&D).
Payments to UK health professionals and organisations, including donations, sponsorship, consultancy fees and expenses, reached a record £200m in 2022, excluding R&D with companies seeking to promote lucrative drugs for obesity, diabetes and heart conditions among the biggest spenders.
The rise in spending raises concerns about the growing influence of pharmaceutical companies in the NHS as it reaches its 75th anniversary milestone. Amid record pressure on services, drug giants say closer collaboration can help deliver major benefits to patients.
NHS England said collaborations with industry helped patients “benefit from faster access to innovative treatments” and that it was “not unusual for industry to provide funding to support service delivery in areas such as improving cardiovascular health, tackling infectious disease or rolling out innovative cancer therapies”. It added that “strict safeguards” were in place for managing conflicts of interest.
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Source: The Guardian, 8 July 2023
Nearly half of all NHS hospital maternity services covered so far by a national inspection programme have been rated as substandard, the Observer can reveal.
The Care Quality Commission (CQC), which regulates health and care providers in England, began its maternity inspection programme last August after the Ockenden review into the Shropshire maternity scandal, which saw 300 babies left dead or brain damaged by inadequate NHS care.
Of the services inspected under the programme, which focuses on safety and leadership, about two-thirds have been found to have insufficient staffing, including some services that were rated as good overall. Eleven services saw their rating fall from their previous inspection.
Dr Suzanne Tyler of the Royal College of Midwives said: “Report after report has made a direct connection between staffing levels and safety, yet the midwife shortage is worsening. Midwives are desperately trying to plug the gaps – in England alone we estimate that midwives work around 100,000 extra unpaid hours a week to keep maternity services safe. This is clearly unsustainable and now is the time for the chancellor to put his hand in the Treasury pocket and give maternity services the funding that is so desperately needed.”
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Source: The Guardian, 9 July 2023
A struggling trust has been warned by regulators that it could see its junior doctors removed, after concerns about clinical supervision and safety at a hospital whose A&E closes at night.
NHS England inspectors who visited Cheltenham General Hospital found emergency patients – including potential surgical patients – became the responsibility of the overnight medical team when its accident and emergency closed in the evening.
One night, 26 patients had been handed across, the inspectors were told, and some patients were felt to be inappropriate for medical referral. A surgical registrar could be telephoned at Gloucester Royal Hospital about surgical patients.
They were told that although there were no incidents of serious harm, there had been many “near misses” and juniors felt “unsafe and unsupported in terms of consultant clinical supervision, overall clinical/nursing staffing support or logistically in managing patients in this setting or arranging transfers”.
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Source: HSJ, 7 July 2023
Daniel was about to get the fright of his life.
He was sitting in a consulting room at the Royal Free hospital in London, speaking to doctors with his limited English.
The 21-year-old street trader from Lagos, Nigeria, had come to the UK days earlier for what he had been told was a "life-changing opportunity". He thought he was going to get a better job.
But now doctors were talking to him about the risks of the operation and the need for lifelong medical care.
It was at that moment, Daniel told investigators, that he realised there was no job opportunity and he had been brought to the UK to give a kidney to a stranger.
"He was going to literally be cut up like a piece of meat, take what they wanted out of him and then stitch him back up," according to Cristina Huddleston, from the anti modern slavery group Justice and Care.
Luckily for Daniel, the doctors had become suspicious that he didn't know what was going on and feared he was being coerced. So they halted the process.
The BBC's File on 4 has learned that his ground-breaking case alerted UK authorities to other instances of organ trafficking.
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Source: BBC News, 4 July 2023
The head of NHS England has warned that July's planned strikes in the health service could be the worst yet for patients.
Amanda Pritchard said industrial action across the NHS had already caused "significant" disruption - and that patients were paying the price.
This month's consultant strike will bring a "different level of challenge" than previous strikes, she said.
Junior doctors and consultants will strike for a combined seven days.
Ms Pritchard told the BBC's Sunday with Laura Kuenssberg programme that the work of consultants - who are striking for the first time in a decade - cannot be covered "in the same way" as junior doctors.
"The hard truth is that it is patients that are paying the price for the fact that all sides have not yet managed to reach a resolution," she said.
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Source: BBC News, 2 July 2023
NHS whistleblowers need stronger legal protection to prevent hospitals using unfair disciplinary procedures to force out doctors who flag problems, the British Medical Association has said.
Doctors are being “actively vilified” for speaking out, which has resulted in threats to patient safety, including unnecessary deaths, according to the council chair of the doctors’ union, Phil Banfield.
Despite a series of scandals in recent years, it is becoming more common for hospitals to use legal tactics and “phoney investigations” to undermine or force out whistleblowers rather than address their concerns, he warned.
Banfield said: “Someone who raises concerns is automatically labelled a troublemaker. We have an NHS that operates in a culture of fear and blame. That has to stop because we should be welcoming concerns, we should be investigating when things are not right.
“Whistleblowers are pilloried because some NHS organisations believe the reputational hit is more dangerous than unsafe care,” he added. “Whereas the safety culture in aviation took off after some high-profile airplane crashes in the 70s, the difference is that the aviation industry embraced the need to put things right and understand the systems that led to the disaster – the NHS has not invested in solving the system, it’s been bogged down in blaming the individual instead of the mistake.”
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Source: The Guardian, 2 July 2023
Nearly 170,000 workers left their jobs in the NHS in England last year, in a record exodus of staff struggling to cope with some of the worst pressures ever seen in the country’s health system, the Observer can reveal.
More than 41,000 nurses were among those who left their jobs in NHS hospitals and community health services, with the highest leaving rate for at least a decade. The number of staff leaving overall rose by more than a quarter in 2022, compared to 2019.
The figures in NHS workforce statistics of those leaving active service since 2010 analysed by the Observer show the scale of the challenge facing prime minister Rishi Sunak. He launched a new workforce plan on Friday to train and keep more staff.
Sir Julian Hartley, chief executive of NHS Providers, said: “Staff did brilliant work during the pandemic, but there has been no respite. The data on people leaving is worrying and we need to see it reversed.
“We need to focus on staff wellbeing and continued professional development, showing the employers really do care about their frontline teams.”
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Source: The Guardian, 1 July 2023
A Colorado surgeon has been convicted of manslaughter in the death of a teenage patient who went into a coma during breast augmentation surgery and died a year later.
Emmalyn Nguyen, who was 18 when she underwent the procedure 1 August 2019, at Colorado Aesthetic and Plastic Surgery in Greenfield Village, near Denver, fell into a coma and went into cardiac arrest after she received anaesthesia, officials said.
She died at a nursing home in October 2020.
Dr. Geoffrey Kim, 54, a plastic surgeon, was found guilty of attempted reckless manslaughter and obstruction of telephone service.
At Kim’s trial, a nurse anesthetist testified that he advised Kim that the patient needed immediate medical attention in a hospital setting and that 911 should be called, prosecutors said.
An investigation determined Kim failed to call for help for five hours after the patient went into cardiac arrest, prosecutors said. The obstruction charge was linked to testimony that multiple medical professionals, including two nurses, requested permission to call 911 to transfer care for Nguyen, but Kim, the owner of the surgery centre, denied the request, prosecutors said.
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Source: ABC News, 15 June 2023
An inquiry investigating deaths of mental health patients in Essex has been given extra powers, in a victory for campaigners.
Health Secretary Steve Barclay told Parliament that the probe would be placed on a statutory footing. It means the inquiry can force witnesses to give evidence, including former staff who have previously worked for services within the county.
Mr Barclay said he was committed to getting answers for the families.
He told the Commons: "I hope today's announcement will come as some comfort to the brave families who have done so much to raise awareness."
The Secretary of State added that under the new powers anyone refusing to give evidence could be fined.
Melanie Leahy, whose son Matthew died while an inpatient at the Linden Centre in Chelmsford in 2012, is among those who have long campaigned for the inquiry to be upgraded.
"Today's announcement marks the start of the next chapter in our mission to find out how our loved ones could be so badly failed by those who were meant to care for them," said Ms Leahy.
"I welcome today's long overdue government announcement and I look forward to working with the inquiry team as they look to shape their terms of reference."
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Source: BBC News, 28 June 2023
Today it was announced by the Secretary of State for Health and Social Care that the future Health Services Safety Investigations Body (HSSIB) will undertake a series of investigations focused on mental health inpatient settings.
The investigations will commence when HSSIB is formally established on 1 October 2023. The HSSIB will conduct investigations around:
How providers learn from deaths in their care and use that learning to improve their services, including post-discharge.
How young people with mental health needs are cared for in inpatient services and how their care could be improved.
How out-of-area placements are handled.
How to develop a safe, therapeutic staffing model for all mental health inpatient services.
Rosie Benneyworth, Chief Investigator at HSIB, says: “We welcome the announcement by the Secretary of State and see this as a significant opportunity to use our expertise, and the wider remit that HSSIB will have, to improve safety for those being cared for in mental health inpatient settings across England. The evidence we have gathered through HSIB investigations has helped shed light on some of the wider challenges faced by patients with mental health needs, and the expertise we will carry through from HSIB to HSSIB will help us to further understand these concerns in inpatient settings, and contribute to a system level understanding of the challenges in providing care in mental health hospitals.
“HSSIB will be able to look at inpatient mental health care in both the NHS and the independent sector and any evidence we gather during the investigations is given full protection from disclosure. It is crucial that those impacted by poor care and those working on the frontlines of the inpatient settings can share their experiences, reassured that HSSIB will use this information to improve care and not apportion blame or liability.
“At HSIB we will begin conversations with our national partners across the system, as well as talking to staff, patients and families. This will ensure that when investigations are launched in October, we have identified and will address the most serious risks to mental health inpatients within these areas and will identify recommendations and other safety learning that will lead to changes in the safety culture and how safety is managed within mental health services.”
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Source: HSIB, 28 June 2023
NHS trusts across England are scrambling to trace thousands of children for urgent hearing tests amid fears that cases of infant deafness may have been missed for years.
An internal NHS report has exposed poor-quality testing within paediatric audiology departments at five hospitals and warned of systemic failings. At another NHS trust, almost 1,500 children were found to have missed out on appointments dating back to 2012.
Vital quality inspections of departments checking infants for hearing loss were stopped ten years ago. Whistleblowers who previously worked for the NHS’s newborn hearing screening programme have revealed that concerns were raised shortly before they were told to stop carrying out checks.
They say that thousands of children may have been mistreated for deafness and hearing loss in the past decade.
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Source: The Times, 25 June 2023
The Home Office has been accused of abandoning 55 asylum seekers with a range of severe disabilities and life-limiting conditions at a former care home in an Essex seaside town.
The asylum seekers, who fled various conflict zones including Sudan and Afghanistan, are struggling with a range of health conditions they have suffered from since childhood or life-changing injuries suffered in war zones.
One told the Guardian: “Everybody is suffering in this place. It used to be a care home but now there is no care. We are free to come and go but to me, this place feels like an open prison. We have just been left here and abandoned.”
Those living in the former care home are struggling with health conditions including loss of limbs, blindness, deafness and mobility issues requiring a wheelchair – although not all have been able to access one. At least eight are paraplegic.
They were placed in the former care home, which opened in November, by Home Office officials. It is staffed like a standard Home Office asylum seeker hotel with security guards and reception staff but does not have trained care workers or nurses there as part of the contract.
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Source: The Guardian, 23 June 2023
Shrewsbury and Telford Hospital Trust temporarily suspended admissions to the women’s and children’s centre at Princess Royal Hospital – which houses the provider’s consultant-led maternity services – earlier this week due to an issue with a generator.
HSJ understands a power cut occurred and estates chiefs were concerned about running solely on battery power, hence suspending admissions while the problem was fixed.
Five inductions of labour were diverted to neighbouring trusts, while fewer than five caesarean sections were rescheduled during the outage.
Meanwhile, 56 patients accessing the trust’s telephone triage service were advised by medical chiefs to attend nearby hospitals.
Following the incident, a learning review is taking place, and HSJ understands this will investigate whether any women came to harm. HSJ has also been told the generator has been fixed “as good as permanently”.
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Source: HSJ, 23 June 2023
Junior doctors will take part in what is “thought to be the longest single period of industrial action in the history of the health service” for five days next month.
The British Medical Association junior doctor committee announced this morning there would be a walkout from 7am on Thursday 13 July and 7am on Tuesday 18 July in its ongoing pay dispute with government.
It comes amid growing expectation that a Royal College of Nursing ballot on further strike action over the Agenda for Change pay award, which ends this week, is likely to fail to secure a mandate.
But junior doctors’ strikes are continuing to hit elective recovery, and strain relationships, with workload on other groups increased as they are asked to provide cover.
Junior doctors have allowed no “derogations” (exemptions) from the action, as they say other staff groups can cover emergency care, and one move to call them in to a busy hospital in the south west, in an earlier round, was abandoned.
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Source: HSJ, 23 June 2023
A Swedish appeals court on Wednesday increased a prison sentence for an Italian surgeon over experimental stem cell windpipe transplants on three patients who died.
Dr Paolo Macchiarini made headlines in 2011 for carrying out the world’s first stem cell windpipe transplants at Sweden’s leading hospital and had been sentenced to no prison time by a lower court.
But the Svea Court of Appeal concluded that there were no emergency situations among two of the three patients who later died, while the procedure on the third could not be justified. The appeals court sentenced the Italian scientist to 2 1/2 years in jail for causing the death of three people between 2011 and 2014.
“The patients have been caused bodily harm and suffering,” the appeals court said of the two men and one woman. The patients, it concluded, “could have lived for a not insignificant amount of time without the interventions.”
Macchiarini denied any criminal wrongdoing. Once considered a leading figure in regenerative medicine, Macchiarini has been credited with creating the world’s first windpipe partially made from a patient’s own stem cells.
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Source: ABC News, 21 June 2023
The UK had one of the worst increases in death rates of major European economies during the Covid pandemic, BBC analysis has found.
Death rates in the UK were more than 5% higher on average each year of the pandemic than in the years just before it, largely driven by a huge death toll in the first year.
That was above the increase seen in France, Spain or Germany, but below Italy and significantly lower than the US.
It would take many inquiries to tease apart the effect of all the possible reasons behind every nation's pandemic outcomes: preparedness, population health, lockdown timing and severity, social support, vaccine rollout and health care provision and others.
But some argue that there are lessons for the UK that need to be learned even before we think about future pandemics.
The UK's heavy pandemic death toll "built on a decade of lacklustre performance on life expectancy" says Veena Raleigh, of the King's Fund, a health think tank. She argues that government action to improve population health and turn that around has "never been more urgent.
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Source: BBC News, 22 June 2023
The family of a man who died after being given infected blood have called on the UK government to pay their compensation immediately.
Randolph Peter Gordon-Smith, who had haemophilia, learned in 1994 that he had been infected with hepatitis C.
His daughter said the family were "abandoned" to care for him without support before his death in 2018.
The chairman of the UK infected blood inquiry has said parents and children of victims should receive compensation.
Sir Brian Langstaff wants to see a final compensation framework set up by the end of the year.
Ms Gordon-Smith, who lives in Edinburgh, says compensation would provide an acknowledgement of "what they did to our family" as his daughters cared for him when he was dying.
"I think the government needs to get their chequebook out, do the right thing and pay [the compensation]," she added. "Not when the inquiry rules, but now."
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Source: BBC News, 22 June 2023
At least 100,000 people across the UK have had their lives put at risk over the last decade because of delays to them getting tested or treated for cancer, a new report claims.
In some cases, patients’ treatment options narrowed or their cancer spread or became incurable as a direct result of their long waits for NHS care, according to Macmillan Cancer Support.
The “inhumane” impact of delays on patients is “shameful”, it said, blaming ministers across the four home nations for underfunding and not tackling staff shortages in cancer services.
“I’ve had patients arrive for their radical chemotherapy appointment, who wait three hours only to be told that because of staff shortages we can’t deliver their treatment today. It’s inhumane”, said Naman Julka-Anderson, an advanced practice therapeutic radiographer who is also an allied health professional clinical adviser for Macmillan.
Many waited longer than 62 days to start treatment – surgery, chemotherapy or radiotherapy – after a GP referred them as an urgent case, the charity’s analysis of official NHS data found.
At least 100,000 of those 180,000 people have seen their symptoms worsen, or their cancer progress or their chances reduce of successfully being treated because they have had to wait.
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Source: The Guardian, 20 June 2023
The current GP funding model ‘does not sit comfortably’ with NHS England’s plans for primary and community care integration, according to a senior NHS England director.
In a Lords Committee hearing today, NHS England’s national director of primary and community care services Dr Amanda Doyle said a ‘rethink’ was required with regards to the primary care estate, with Integrated Care Boards (ICBs) tasked to draw up local plans.
Asked whether the GP partnership model was compatible with integration, Dr Doyle told the committee that this was ‘one of the challenges’ they are facing.
She said: "One of the challenges that the current predominant ownership model in general practice gives us is that both investment and revenue flows support that model [of] an individual, practice-sized building.
"And lots of the things we want to do as we move forward into co-located primary care services and scaled-up primary care delivery drive the need for bigger premises with a wider range of capacity, and those two models don’t sit comfortably together."
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Source: Pulse, 19 June 2023
The government should ‘relieve’ GP practices of being the sole controller for their patients’ data, a senior NHS England director has said.
Tim Ferris, NHSE director of transformation, said it was a “challenge” that GP practices acted as the sole controllers of their patients’ data.
Dr Ferris, whose background is as a primary care doctor in the US, was giving evidence to a Lords committee on integration of primary and community care today. He was asked whether it was time to revisit legislation on the control of GP patient data.
He said: “Thirty years ago when the law was created, it made more sense. But I think it might no longer be fit for purpose… The idea that if I were a GP in this country, if I had legal liability for the exchange of data, I would be worried about that.”
Dr Ferris agreed there would be merit to the committee recommending the government “relieve” GPs of the sole responsibility for data protection, and their data controller status.
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Source: HSJ, 20 June 2023
A trust has been told to not “shut down” staff who raise concerns by a former employee whom a tribunal found was racially discriminated against.
Moorfields Eye Hospital Foundation Trust racially discriminated, victimised and harassed Samiriah Shaikh, who worked at the trust as an ophthalmic technician, according to a recent judgment.
Judges said Ms Shaikh was described as “aggressive” by her boss Peter Holm, and stereotyped by managers as a “loud ethnic female” after she and fellow colleagues raised allegations of racism in the promotion of in-house staff.
Mr Holm, who is listed as a chief ophthalmic and vision science practitioner at the trust, is said to have responded to staff members’ concerns by making jokes during a team meeting. It is unclear whether he is still at the trust.
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Source: HSJ, 20 June 2023
