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Sam

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  1. Sam
    A trust has warned it may reach a ‘tipping point’ where it is ‘impossible’ to separate covid positive and negative patients.
    Surrey and Sussex Healthcare Trust also revealed in papers published ahead of its Thursday board meeting that it planned to distribute a “duty of candour” leaflet for patients, warning them of the risk of contracting covid in hospital.
    The papers noted covid patients at the trust increased from 80 pre-Christmas to 230 by January, filling half its beds. HSJ’s figures suggest covid patients at the trust continued to rise until around 14 January before dropping back slightly. 
    The report from the trust’s safety and quality committee — which met on 7 January — said: “It is becoming more difficult to separate the covid+ and covid- patients. In an increasing number of instances, patients are admitted to cold areas for non-covid treatment and without symptoms but then test positive. These patients then need to be admitted to hot areas and any contacts (including patients from the same bay) isolated.
    “At some point a tipping point could be reached where it may be impossible to retain hot and cold areas.”
    Read full story (paywalled)
    Source: HSJ, 27 January 2021
  2. Sam
    The government is being “wilfully negligent” by not introducing measures to suppress the recent rise in coronavirus cases, the chair of the British Medical Association (BMA) has said.
    Dr Chaand Nagpaul made the comments after the health secretary ignored NHS leaders’ pleas for the implementation of ‘Plan B’, which could see the return of mandatory mask wearing in indoor spaces and the need to work from home where possible.
    Speaking at a No 10 press conference on Wednesday afternoon, Sajid Javid said the current pressure on the NHS was not “unsustainable”, noting that the contingency plan would only be introduced if hospitals were at risk of being “overwhelmed”.
    However, Dr Nagpaul disagreed with the minister’s assessment, suggesting that the NHS was already reaching breaking point and that the government should follow through on its promise to protect the health service.
    “By the health secretary’s own admission we could soon see 100,000 cases a day and we now have the same number of weekly Covid deaths as we had during March, when the country was in lockdown,” he said.
    Dr Nagpaul described the government’s decision not to take further preventative action as “wilfully negligent”, branding the current rate of coronavirus infections and deaths as “unacceptable”.
    Read full story
    Source: The Independent, 21 October 2021
  3. Sam
    Challenging the NHS’ workplace culture is key to improving patient safety says NHS Resolution in their latest guidance: Being fair: supporting a just and learning culture for staff and patients following incidents in the NHS. The paper draws on NHS Resolution’s unique dataset to explore best practice in response to incidents resulting from claims from across the system. The guidance aims to help the NHS to create an environment to better support staff when things go wrong and to encourage learning from incidents.
     
     
  4. Sam
    A GP commissioning leader has publicly criticised hospital visiting rules at local hospitals, after hearing that a stroke patient was denied seeing family or friends for six weeks.
    Philip Stevens, a locality chair at Northamptonshire Clinical Commissioning Group (CCG), described the situation reported to him by one of his patients as “heartbreaking”, and has challenged visiting policies at Northampton General Hospital and Kettering General Hospital trusts. 
    During a CCG governing body meeting, Dr Stevens called for explanation from the county’s director of public health, Lucy Wightman, who said trusts could choose their own rules.
    Dr Stevens, who is also a GP at Brackley Medical Centre, argued that visitors were permitted in neighbouring counties, where he claimed there were similar covid case rates to Northamptonshire, which remains in tier 1 restrictions under the government’s framework.
    He said: “I’ve been dealing this week with a family who, the wife’s husband, has been in Northampton General for six weeks now and has had no visitors at all during that time. He’s had a profound stroke and when he comes home he’ll need considerable community support which ordinarily the family would have been trained in but discharge is planned without any of that training.”
    Mr Stevens said in an “adjacent county” hospital policy was that each patient would have ”one hour, one visitor each day” with 30-minutes in between visiting slots. While not named, trusts in neighbouring Cambridge and Lincolnshire both have policies that permit pre-booked visitors.
    He added: “When I heard this story it seemed heartbreaking to me for this woman and her husband and I just wonder whether that this is a situation we should be challenging, particularly since it appears that the public health advice in an adjacent county may be different to that which is being offered within Northamptonshire.”
    Read full story (paywalled)
    Source: HSJ, 27 October 2020
  5. Sam
    A nurse from scandal-hit Shrewsbury and Telford Hospital ordered a pregnant woman to take medication she was allergic to.
    Christine Speake, who had worked in the NHS for almost 40 years as a midwife and nurse, has been struck-off the Nursing and Midwifery Council (NMC) register after a tribunal heard she told the mother to “just take it” and then tried to cover-up her mistake after the woman suffered a reaction.
    The NMC hearing was told the 11-week pregnant patient and her unborn child could have died after being prescribed the Buscopan by a junior doctor to treat severe nausea and vomiting in January 2019.
    The woman – named only as 'Patient A' – was given the drug by Speake despite her allergy being included in her medical records. Speake was employed as a sister on the gynaecology ward at the Princess Royal Hospital.
    When the mother questioned what she was being given, Speake, who has worked as a midwife and nurse since 1985, snapped "just take it".
    The panel heard Patient A then had a violent reaction and broke out in a rash and started vomiting.
    But Speake, who realised her mistake, then failed to tell her colleagues in a bid to “cover up” what she had done and later resigned, the NMC tribunal heard.
    Read full story
    Source: The Independent, 26 October 2021
  6. Sam
    Poorer mothers are three times more likely to have stillborn children than those from more affluent backgrounds, according to a new study.
    The wide-ranging research, conducted by pregnancy charity Tommy’s, also found that high levels of stress doubled the likelihood of stillbirth, irrespective of other social factors and pregnancy complications. Unemployed mothers were almost three times more at risk.
    The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity.
    Researchers said getting more antenatal care can stop women from having a stillbirth — with mothers who went to more appointments than national rules stipulate having a 72% lower risk.
    Ros Bragg, director of Maternity Action said, “If the government is serious about combatting stillbirths, it must address the social determinants of health as well as clinical care. Women need safe, secure employment during their pregnancy and the certainty of a decent income if they find themselves out of work. It is not right that increasing numbers of pregnant women are dealing with the stress of financial insecurity, putting them at increased risk of serious health problems, including stillbirth.”
    Read full story
    Source: The Independent, 29 October 2020
  7. Sam
    London-based HealthUnlocked has been acquired by worldwide leader Corrona. 
    HealthUnlocked is a social network of 1.3 million patients across hundreds of condition-specific communities. Moderated by over 500 patient advocacy groups, it captures insights to better understand what matters most to these patients.  
    Corrona, based in Massachusetts, US, describes itself as a built-for-purpose source of gold-standard real-world evidence. 
    “By combining with HealthUnlocked, we are expanding our broad set of capabilities–ranging from highly granular and longitudinal structured data across our eight registries, to broader patient insights from HealthUnlocked,” said Abbe Steel, Chief Patient Officer of Corrona.  
    “The HealthUnlocked communities provide access to engaged patients across the globe, allowing us to better understand the patient experience and what matters most to patients."
    Read full story
    Source: Business Cloud, 22 October 2020
  8. Sam
    ‘Very heavy-handed, laborious and expensive’ inspections ‘have not been the right way’ of regulating hospitals, according to the Care Quality Commission’s (CQC) former chair.
    Speaking at a Royal Society of Medicine event on Wednesday, Lord David Prior, who is now the chair of NHS England, said “very few” physicians will have improved their work after reading a report from the regulator.
    He added that there is a role for the CQC to move in when “things are going wrong” although he is “sceptical” the regulator can actually drive improvement in hospitals.
    Lord Prior said: “I am highly sceptical as to whether or not CQC or any regulator can really drive improvement and drive the top hospitals to make them better.
    “And certainly I think there’ll be very few physicians who will say that their clinical work has improved as a result of reading a CQC report.
    “I think the sadness I have about CQC is that we have not been able, or it has not been able, to develop a series of predictive metrics that could replace these very heavy handed, very laborious and very expensive visits that we used to do.”
    Read full story (paywalled)
    Source: HSJ, 9 September 2021
  9. Sam
    Availability of inpatient child and adolescent mental health services beds — particularly for eating disorders — has reached ‘crisis point’, with young people left waiting on a standard paediatric ward or at home as demand surged during the covid pandemic.
    A report to Surrey Heartlands Clinical Commissioning Group (CCG) in January read: “Availability of tier four beds [inpatient mental health beds for children and adolescents, commissioned centrally by NHS England] in the South East and across the country is at crisis point and providers have to compete for the small pool of beds."
    “Waits for beds or being placed far from home is a distressing and unacceptable experience for children and young people and families and places an additional burden on other parts of the system such as paediatric wards.”
    The report noted a “demand upsurge to the highest levels in the last three years” since the pandemic. It stated, in mid-January, the CCG had two patients awaiting eating disorder beds being managed on paediatric wards as they had become “physically too unwell to be managed at home”. Four others also waiting for a CAMHS bed were being managed at home. 
    Read full story
    Source: 16 February 2021
  10. Sam
    London’s largest acute trust has been accused of ‘emotional blackmail’ by suggesting junior doctors could do voluntary shifts in its ‘really short staffed’ critical care unit.
    In an email cascaded to all junior doctors at Whipps Cross Hospital, run by Barts Health Trust, hospital medical director Heather Noble said day and night shifts at another trust site, the Royal London Hospital, “really need cover”.
    She said doctors could work overtime through a “voluntary or paid shift”, and that if they made contact, should “state whether or not they want to be paid”.
    Doctors working at the trust who received the email, who wished to remain anonymous, described the email as “tone deaf” and “not the right way to incentivise anyone to do what they want”.
    One medic said: “There has been a lot of anger generated by this correspondence amongst junior doctors. People already working antisocial and demanding rotas are very unhappy about being asked to work more hours for free.”
    Read full story (paywalled)
    Source: HSJ, 26 January 2021 
  11. Sam
    Tens of thousands of people may require kidney dialysis or transplants because of coronavirus, according to experts who warn the long-term effects of Covid are causing an “epidemic in primary care”.
    Up to 90% of coronavirus patients admitted to hospital may still experience symptoms two to three months later – from breathlessness to joint pain, fatigue and chest pain – scientists told the Lords science and technology committee on Tuesday.
    Donal O’Donoghue, a consultant renal physician at Salford Royal NHS trust, said damage to the kidneys was of major concern. It is believed the virus may attack the organ directly, he said, while the kidneys could also be injured by body-wide inflammation caused by the virus.
    “Normally we see maybe 20% of people that go on to intensive care unit need to have a form of dialysis. During Covid it was up to 40% – and 85% of people had some degree of kidney injury,” he said. “No doubt that is happening out in the community as well, probably to a lesser extent.”
    Tom Solomon, professor of neurology at the University of Liverpool, told the committee more needed to be done to support Covid survivors. “[GPs] are seeing lots of patients who are left over with problems from their Covid and they need to be able to refer them to get help in understanding what is going on,” he said, adding: “This is really the current epidemic in primary care.”
    Read full story
    Source: The Guardian, 15 September 2020
  12. 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
     
     
     
  13. 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
  14. Sam
    A major London trust’s critical care staff have urged leaders to review elective work targets amid serious concerns over workload, safe staffing and burnout, HSJ  has learned.
    In a letter to Guy’s and St Thomas’ Foundation Trust’s board, staff represented by trade union Unite said they had “repeatedly” raised concerns about the provider’s approach to elective work, as well as winter pressures and second wave planning, and the implications this has had for “the health, safety and wellbeing of both staff and patients”. 
    The letter — which was also addressed to the trust’s health and safety committee and has been seen by HSJ —  said: “Our primary concern is that the trust’s endeavours, and understandable need to square these circles, may be unrealistic given the current pressures on staffing and the high rates of sickness and burnout the trust is continuing to experience.
    “This is especially in critical care, where we are concerned this may compromise patient safety and is already damaging staff wellbeing and morale.”
    Read full story (paywalled)
    Source: HSJ, 18 December 2020
  15. Sam
    Cases of psychosis have risen significantly in England during the pandemic, according to new NHS data.
    The number of people referred to mental health services for their first suspected episode of psychosis increased by 75% between April 2019 and April 2021, figures showed.
    The data, which has been analysed by the charity Rethink Mental Illness, showed that much of the increase in referrals has happened over the last year, after the first national lockdown.
    The charity, Rethink Mental Illness, said that the data offers some of the first concrete evidence of the impact of the pandemic on the mental health of the population.
    It is calling on the government to invest more in early intervention for psychosis to halt the further deterioration in people’s conditions.
    The NHS defines psychosis as “when people lose some contact with reality”. This could involve seeing or hearing things that other people cannot see or believing things that are not actually true.
    People experiencing symptoms of psychosis need to seek medical help very quickly and charity Rethink Mental Illness is campaigning to get people faster access to vital treatment.
    Read full story
    Source: The Independent, 18 October 2021
  16. Sam
    A UK oncologist with a world reputation is facing allegations by the General Medical Council that he provided medication inappropriately in an attempt to keep terminally ill patients alive.
    Justin Stebbing, professor of cancer medicine and oncology at Imperial College London, who has a private practice in Harley Street, faces allegations at a medical practitioners tribunal of failing to provide good clinical care to 11 patients between March 2014 and March 2017.
    Read full story (paywalled)
    Source: BMJ, 15 September 2020
  17. Sam
    Which trusts receive the highest recommendations from staff as a place to work? HSJ has analysed the full results of today’s 2022 NHS Staff Survey for general acute and acute/community trusts.
    HSJ has also analysed the results for mental health trusts and ambulance and community trusts.
    More than 630,000 staff responded to the NHS staff survey between September and December 2022 – a 46% response rate, down from 48% in 2021.
    Nationally, across all trust types, 57.4% said they would recommend their organisation as a place to work in 2022. That was down from 59.4% in 2021, and from 63.4% in 2019.
    Read full story (paywalled)
    Source: HSJ, 9 March 2023
  18. Sam
    Shortfalls in mental health services and staffing have been flagged as concerns in dozens of inquests since 2015, the Observer has revealed, with coroners issuing repeated warnings over patients facing long waiting lists or falling through gaps in service provision.
    The Observer has identified 56 mental health-related deaths in England and Wales from the start of 2015 to the end of 2020 where coroners identified a lack of staffing or service provision as a “matter of concern”, meaning they believed “there is a risk that future deaths could occur unless action is taken”.
    Coroners issue Reports to Prevent Future Deaths (PFD) when they believe action should be taken to prevent deaths occurring in future, and send them to relevant individuals or organisations, who are expected to respond. In one case, a woman referred to psychotherapy services had still not received any psychotherapy by the time she died 11 months later. In another, someone had endured a seven-month wait for a psychological assessment.
    Alison Cobb, senior policy and campaigns officer at the mental health charity Mind, said: “It’s shocking that so many should lose their lives because there isn’t enough capacity in mental health services to provide adequate care. These prevention of future deaths notices are meant to inform better ways of working, and it’s especially concerning that similar stories are repeating over and over again.”
    Read full story
    Source: The Guardian, 5 September 2021
    Coroner's reports on the hub
  19. Sam
    A trust which accounted for one in eight of covid deaths in hospital during part of the summer has been criticised by the Care Quality Commission for its infection control.
    Staff did not follow social distancing rules in a staff room at East Kent Hospitals University Foundation Trust, did not always practise hand hygiene, and the trust had used incorrect PPE, the CQC said.
    In addition, two hourly cleans were not always carried out, soap and hand sanitiser were missing, and the emergency department at the William Harvey Hospital in Ashford did not have enough sinks for staff and visitors to wash their hands in. There was also a lack of hand hygiene guidance on display.
    Inspectors added that not all staff understood what needed to be done when a walk-in patient presented with covid symptoms, and the emergency department did not have an escalation plan if areas were crowded and patients could not socially distance.
    The CQC inspected the William Harvey Hospital on 11 August and took enforcement action after the visit. It has yet to publish the report but the initial feedback was summarised in the trust’s latest board papers, together with the trust’s response. 
    Read full story (paywalled)
    Source: HSJ, 14 September 2020
  20. Sam
    Pfizer’s oral antiviral drug paxlovid significantly reduces hospital admissions and deaths among people with COVID-19 who are at high risk of severe illness, when compared with placebo, the company has reported.
    The interim analysis of the phase II-III data, outlined in a press release, included 1219 adults who were enrolled by 29 September 2021. It found that, among participants who received treatments within three days of COVID-19 symptoms starting, the risk of covid related hospital admission or death from any cause was 89% lower in the paxlovid group than the placebo group.
    Commenting on the announcement, England’s health and social care secretary, Sajid Javid, said, “If approved, this could be another significant weapon in our armoury to fight the virus alongside our vaccines and other treatments, including molnupiravir, which the UK was the first country in the world to approve this week.”
    Read full story
    Source: BMJ, 8 November 2021
  21. Sam
    A lack of coronavirus tests for NHS staff is leading to staff absences and services being put at risk, hospital bosses have warned.
    NHS Providers, which represents hospital trusts in England, said staff are having to self-isolate rather than work because they cannot get tests for themselves or family members. It comes after widespread reports of people struggling to get tested.
    The home secretary defended the system, saying capacity was increasing.
    The government's testing system - part of its test, track and trace operation which Prime Minister Boris Johnson promised would be "world-beating" - has faced criticism in recent weeks. An increase in demand for coronavirus tests has led to local shortages - with some people being directed to test sites hundreds of miles from their homes.
    One doctor working in a coronavirus hotspot said she applied for a test for herself and her partner after they developed coughs and fevers. After refreshing the website for five hours, she managed to get an appointment but on arrival was told no booking had been made.
    She had taken screenshots of a confirmation code but was not sent a QR code to scan. "I showed the screenshots but I was told that the appointments weren't happening," she said.
    "I have to say I burst into tears. I was meant to be seeing patients and I feel guilty."
    Dr Rachel Ward, a GP in Newbury, told BBC Breakfast she was seeing a lot of patients who were struggling to get tests, saying a lot of families were "at the end of their tether" as it was "very stressful when you are faced with two weeks off work".
    She said if the staff at her practice were unable to get tests and had to self-isolate it would have a "huge impact" on patients as some of their healthcare workers are booked in to administer 100 flu jabs in a day.
    Read full story
    Source: BBC News, 14 September 2020
  22. Sam
    Detainees held in an immigration centre in the US have been subjected to potentially unnecessary hysterectomies performed without informed consent, a nurse whistleblower has alleged.
    Dawn Wooten, who filed a whistleblower complaint with the inspector general of the Department of Homeland Security, says she was demoted and her hours slashed after she complained about substandard medical care, questionable surgeries on women, and failure to protect detainees and staff from COVID-19.
    A report of the charges1 was filed by four non-profit rights and welfare groups on behalf of the detained immigrants at the Irwin County Detention Center in Georgia, which is operated by the private prison company, LaSalle Corrections.
    Read full story (paywalled)
    Source: BMJ, 16 September 2020
  23. Sam
    A hospital trust has been fined for failing to be open and transparent with the bereaved family of a 91-year-old woman in the first prosecution of its kind.
    Elsie Woodfield died at Derriford hospital in Plymouth after suffering a perforated oesophagus during an endoscopy.
    The Care Quality Commission (CQC) took University Hospitals Plymouth NHS trust to court under duty of candour regulations, accusing it of not being open with Woodfield’s family about her death and not apologising in a timely way.
    Judge Joanna Matson was told Woodfield’s daughter Anna Davidson eventually received a letter apologising over her mother’s death, which happened in December 2017, but she felt it lacked remorse.
    Davidson said she still had many unanswered questions and found it “impossible to grieve”.
    The judge said: “This offence is a very good example of why these regulatory offences are very important. Not only have [the family] had to come to terms with their tragic death, but their loss has been compounded by the trust’s lack of candour.”
    Speaking afterwards, Nigel Acheson, the CQC’s deputy chief inspector of hospitals, said: “All care providers have a duty to be open and transparent with patients and their loved ones, particularly when something goes wrong, and this case sends a clear message that we will not hesitate to take action when that does not happen."
    Lenny Byrne, the trust’s chief nurse, issued a “wholehearted apology” to Woodfield’s family. “We pleaded guilty to failure to comply with the duty of candour and fully accept the court’s decision. We have made significant changes in our processes.”
    Read full story
    Source: The Guardian, 23 September 2020
  24. Sam
    A framework has been developed by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and the Society and College of Radiographers, in partnership with NHS England and NHS Improvement, to support maternity services with the local reintroduction of hospital visitors and individuals accompanying women to appointments.
    During the pandemic, some Trusts in England have allowed partners to attend antenatal appointments and pregnancy scans, but there has not been a consistent approach across the country, leading to frustration and confusion among pregnant women and their partners.
    In a recent hub blog, Jules Mckoy, a Specialist Perinatal Mental Health Midwife at University Hospital Southampton, highlighted the huge rise in pregnant women reporting feelings of anxiety because of being isolated from friends and relatives and their concerns for the safety of their baby, themselves and their families. 
    Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: “We welcome the publication of this framework to support Trusts in England safely re-introduce measures enabling partners to attend to antenatal and postnatal appointments, including pregnancy scans. This is an important step for the health and wellbeing of pregnant women and their partners, who have understandably found it difficult not to share the experience of a pregnancy scan, attend important appointments, support women in early labour or spend time with their newborn babies on the postnatal ward."
    “With the re-introduction of partners in maternity settings, it’s important that anyone attending hospitals and clinics for appointments and scans wears a face covering and ensures they practice social distancing and regular hand washing. These measures are in place to keep pregnant women, partners and staff safe.”
    Gill Walton, Chief Executive of the Royal College of Midwives, said: “Visiting restrictions during the pandemic have been challenging for everybody, particularly for pregnant women and their families at an incredibly important and transformative time in their lives. These new guidelines are good news for them and for staff. They set out clearly the rules around visiting, providing much needed clarity about who can visit and the precautions they need to take to ensure visits can be done safely for themselves, for the people they are visiting, and for staff."
    “The guidance will also be welcome by maternity staff who have experienced some aggression from a small minority of visitors, unhappy and confused with varying and changing guidance.”
    Source: Royal College of Obstetricians and Gynaecologists, 8 September 2020
  25. Sam
    NHSX has just completed a major review of NHS tech spending. They have agreed to reducing the burden on clinicians and staff, so they can focus on patients; giving people the tools to access information and services directly; ensuring clinical information can be safely accessed, wherever it is needed; aiding the improvement of patient safety across the NHS; and improving NHS productivity with digital technology.
    Read full story
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