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News Article
Major trust records fifth never event at troubled department
Patient Safety Learning posted a news article in News
A fifth patient has been given the wrong blood at a major teaching hospital’s haematology department where patient safety concerns were raised by clinicians last year. The incident, at University Hospitals Birmingham Foundation Trust, is the fifth never event involving patients being transfused with the wrong blood at the trust since April 2020. Only 15 such never events have been recorded in England in the last two financial years, which means UHB accounted for a third of the total in 2020-21 and 2021-22. HSJ revealed last year that several clinicians had raised safety concerns at the trust’s haematology specialty after most of its services at Heartlands Hospital were moved to Queen Elizabeth Hospital as part of the trust’s pandemic response. The latest never event, which occurred in March, saw a patient being given an “unintentional transfusion of ABO-incompatible blood components” – according to papers provided to the trust’s council of governors. Read full story (paywalled) Source: HSJ, 14 June 2022 -
News Article
Infected blood inquiry: Five things we have learned
Patient Safety Learning posted a news article in News
A long-running public inquiry into what has been called the worst treatment disaster in the history of the NHS will hear its final evidence on Friday. It is thought tens of thousands were infected with HIV and hepatitis between 1970 and 1991 after being given a contaminated drug or blood transfusion. The inquiry, which started in 2018, has reviewed thousands of documents and heard testimony from 370 witnesses. A total of 1,250 people with haemophilia and other bleeding disorders contracted HIV after being given a protein made from blood plasma known as Factor VIII. About half of that group later died of an Aids-related illness. Researchers found that 380 of those infected with HIV - about one in three - were children, including some very young toddlers. One of the key questions the inquiry will now have to answer is whether more could and should have been done to prevent those infections and deaths. Hundreds of victims of the scandal have received annual support payments but - before this inquiry - no formal compensation had ever been awarded for loss of earnings, care costs and other lifetime losses Further recommendations on compensation are expected when the inquiry publishes its final report, which is likely to be around the middle of the year. Read full story Source: BBC News, 3 February 2023 -
News ArticleVictims and family members affected by the contaminated blood scandal are calling for criminal charges to be considered as the public inquiry into the tragedy draws to a close. While the inquiry, which will begin to hear closing submissions on Tuesday, cannot determine civil or criminal liability, people affected by the scandal are keen for the mass of documents and evidence accumulated over more than four years to be handed over to prosecutors to see whether charges can be brought. About 3,000 people are believed to have died and thousands more were infected in what has been described as the biggest treatment disaster in the history of the NHS. The inquiry has heard evidence that civil servants, the government and senior doctors knew of the problem long before action was taken to address it and that the scandal was avoidable. But no one has ever faced prosecution. Eileen Burkert, whose father, Edward, died aged 54 in 1992 after – like thousands of others – contracting HIV and hepatitis C through factor VIII blood products used to treat his haemophilia, said the inquiry had shown there was a “massive cover-up”. She said: “In my eyes it’s corporate manslaughter. You can’t go giving people something that you know is dangerous, and they just carried on doing it. As far as my family’s concerned, they killed our dad and they killed thousands of other people and there’s been no recognition for him since he died, there’s been nothing. Read full story Source: The Guardian, 16 January 2023 See UK Infected Blood Inquiry website for further details on the inquiry.
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News Article
No timetable for infected blood victims' compensation
Patient Safety Learning posted a news article in News
There is a "moral case" for compensation to be paid to people affected by the contaminated blood scandal, the government has said. But Paymaster General Jeremy Quin told MPs he could not commit to a timetable. In August, the government announced that 4,000 UK victims would receive interim payments of £100,000. Tens of thousands of people contracted HIV or hepatitis C in the 1970s and 80s after being given infected blood. In September, modelling by a group of academics commissioned by the public inquiry estimated that 26,800 people were infected after being given contaminated transfusions between 1970 and 1991. The study calculated that 1,820 of those died as a result, but that the number could be as high as 3,320. The inquiry, chaired by retired High Court judge Sir Brian Langstaff, began taking evidence in 2018. The interim compensation announcement in August came after Sir Brian argued there was a compelling case to make payments quickly - saying victims were on borrowed time because of their failing health. Payments have been made to those whose health is failing after developing hepatitis C and HIV, and partners of people who have died. But families have complained that many people affected, such as bereaved parents, missed out. Read full story Source: BBC News, 15 December 2022 -
News ArticleThe 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." Read full story Source: BBC News, 22 June 2023
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News Article
'Hidden' rise in blood clot deaths 'breaking families' warns charity
Patient Safety Learning posted a news article in News
Thrombosis UK has warned that deaths involving blood clots are higher than expected as it called for more transparency over the work hospitals are doing to reduce the risk for patients. Before the pandemic hit, hospitals were regularly publishing data on the number of patients who had been risk assessed for blood clots. In March 2020, the NHS in England took the decision to suspend the data collection on venous thromboembolism (also known as VTE) risk assessments to “release capacity in providers and commissioners to manage the Covid-19 pandemic”. But the data collection and publication is yet to resume. The charity said the data shows how many VTE cases are missed in hospitals. One bereaved man described how his mother died last year after the condition was missed. Tim Edwards, 42, said healthcare workers missed signs of the condition while Jennifer Edwards, 74, was in hospital on the south coast. Despite having many symptoms of a pulmonary embolism she was discharged home and died three days later. Mr Edwards said: ““My mother’s symptoms were missed from her admission to hospital right up to her time in the cardiology department. “She was discharged and passed away three days after phoning the NHS with shortness of breath. She should not have died. I took it upon myself to enquire about the circumstances surrounding her death and was overwhelmed by the lack of care taken. “Sadly, I know this is not an isolated case.” Read full story Source: Wales Online, 12 May 2023 Further reading on the hub: Pulmonary embolism misdiagnosis – a systemic problem (a blog from Tim Edwards) Independent review of pulmonary embolism fatalities in England & Wales – recent trends, excess deaths, their causes and risk management concerns (Tim Edwards) Jenny, and why we must learn from her misdiagnosis of pulmonary embolism National Voices: Pulmonary embolism misdiagnosis - a blog by Helen Hughes. -
News Article
Elective recovery drive at risk from product shortages, warns NHS Supply Chain
Patient Safety Learning posted a news article in News
Long-running supply issues with blood collection equipment risk delaying the elective recovery, according to an internal NHS Supply Chain communication seen by HSJ. Global supply and manufacturing delays have caused the delivery of blood collection sets, apparatus used to draw intravenous blood into vacuum tubes, by months. The problems are affecting multiple products and suppliers. An NHS Supply Chain procurement advisory cell communication warned trusts: “There is a risk that the continued supply disruption of blood collection sets is delaying elective recovery, with providers restricting blood collection to continue to prioritise urgent procedures.” This is the second “important customer notice” relating to supply problems with blood collection equipment issued by the national procurement agency. Read full story (paywalled) Source: HSJ, 9 May 2023 -
News Article
Practices eradicate racial inequalities in blood pressure control
Patient Safety Learning posted a news article in News
GPs in South London have eradicated a large gap in blood pressure control between white patients and those from a Black or minority ethnic background, after a year-long project. AT Medics Streatham PCN in Lambeth found that among their patients under 80 diagnosed with hypertension, there was a 12% inequality gap in blood pressure control, with 67% of white patients and 55% of black patients treated to target. The two practices in the PCN have 45,000 patients, with around 3,100 diagnosed with hypertension. They set up a centralised recall system and made use of practice pharmacists and healthcare assistants to provide guidance, education around self-care, lifestyle and medicines. Dr Tarek Radwan, GP director said: ‘This project has delivered incredible results, and this is all down to the dedication of our amazing team, especially our administrators, healthcare assistants and pharmacists. "The last 12 months have proved that we can not just reduce but actually eradicate health inequalities and raise the quality of care for everyone at the same time. "I know the difference this will make to our local communities, and it really shows what is possible with a highly motivated multidisciplinary team." Read full story Source: Pulse, 3 May 2023 -
News Article
Judge says parents and children should receive infected blood payments
Patient-Safety-Learning posted a news article in News
The parents and children of victims of the contaminated blood scandal should receive government compensation, a judge has said. The chairman of the infected blood public inquiry, Sir Brian Langstaff, said it was time to "recognise deaths which have so far gone unrecognised". More than 3,000 people died after contracting HIV or hepatitis C via NHS treatments in the 1970s and 80s. The government must now respond to the recommendations. In August 2022, the government agreed to make the first interim compensation payments of £100,000 each to about 4,000 surviving victims, and bereaved widows. Sir Brian said, "It is a fact that around 380 children with bleeding disorders were infected with HIV. Some of them died in childhood. But their parents have never received compensation. Children who were orphaned as a result of infections transmitted by blood transfusions and blood products have never had their losses recognised. It's time to put that right." Read full story Source: BBC News -
News Article
‘Deliberate attempts’ to conceal racism at NHS agency, says leaked report
Patient Safety Learning posted a news article in News
Deliberate attempts were made to “conceal the extent of racial discrimination” at a national NHS agency, according to a report leaked to HSJ. A highly critical internal report at NHS Blood and Transplant (NHSBT) also said fewer than half the recommendations made in 2020 by external mediation experts, around issues of racism, had so far been actioned. A review conducted by Globis Mediation Group in 2020 found “systemic racism” among management at the agency’s large Colindale site in north London, with ethnic minority staff being “ignored, being viewed as ineligible for promotion and enduring low levels of empathy”. It made nine recommendations, including exploring whether similar issues existed at the other 15 NHSBT sites. Read full story Source: HSJ, 16 March 2023 -
Content ArticleExtravasation is the unintentional leakage of vesicant fluids or medications from the vein into the surrounding tissue. This can cause harm and lead to complications for the patient. This guide, produced by the Royal Children's Hospital Melbourne, includes: Introduction Aim Definition of terms Risk factors Assessment Management Irrigation Procedure Follow-up/Review Special considerations Evidence Table Companion documents References
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News Article
Home blood test kits ‘piling work on NHS’
Patient Safety Learning posted a news article in News
Private companies are offering “misleading” home blood-testing kits that fuel health anxieties and pile pressure on the NHS, a report has suggested. There has been a boom in sales of the kits, which promise to reveal everything from cancer risk to how long patients can expect to live. But an investigation by the BMJ found these “unnecessary and potentially invasive tests” can be misleading and generate false alarms. The NHS is then left to “clear up the mess” as worried patients see GPs for reassurance or extra tests, piling more pressure on the overstretched service. One GP described patients coming in “clutching the results of private screening tests”, with doctors asked to review the results. The companies have been criticised for not providing sufficient follow-ups after the “poor quality and overhyped” tests, and for misleading results such as wrongly telling people their test levels are outside the “normal” range. Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, said: “Most of the online [tests] will send the results to the patient with at best a sort of asterisk next to the ones that are abnormal, with advice to either pay some more money to get some sort of health professional to speak about it or go and see your own GP.” Doctors are calling for the tests to be more tightly regulated by the health watchdog, the Care Quality Commission. Read full story (paywalled) Source: The Times, 27 October 2022 -
News ArticleAbout 4,000 UK victims of the infected blood scandal are to receive interim compensation payments of £100,000 by the end of this month. It is being paid to those whose health is failing after developing blood borne viruses like hepatitis and HIV. It is also being paid to partners of people who have died. Conan McIlwrath, from Larne in County Antrim, who is among the 100 or so victims affected in Northern Ireland said it was "very much welcomed". "This is the first compensation that's ever been paid - anything prior has been support," he told BBC News NI. All victims have campaigned for actual 'compensation' as they have said only this would acknowledge decades of physical and social injury, as well as loss of earnings and the cost of care. Read full story Source: BBC News, 22 October 2022
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News Article
Public responds to NHS amber alert over donor blood stocks
Patient Safety Learning posted a news article in News
The blood-donation service has been inundated with offers of help after putting out an alert, on Wednesday, warning NHS stocks were running critically low in England. More than 10,000 appointments to donate blood over the next few weeks have been booked in the past 24 hours. The NHS usually has six days' worth of blood to use for operations and transfusions but levels are currently due to fall below two. Type-O blood is in particular demand. O positive is the most common and anyone can receive O negative in an emergency or if their blood type is unknown. Blood supplies have been challenging since the Covid pandemic, because of staff shortages and sickness, and a change in people's behaviour means they are less likely to visit donation centres in towns and cities, according to NHSBT. Individual hospitals must decide how to manage the shortage - for example, by postponing some non-urgent operations. "This is an amazing response from the public and we have been reminded in the last 24 hours of the incredible goodwill and spirit of the public towards helping patients in times of great difficulty," an NHSBT official said. Read full story Source: BBC News, 13 October 2022 -
News Article
NHS declares first-ever ‘amber alert’ over critically low blood supplies
Patient Safety Learning posted a news article in News
The NHS has declared its first-ever amber alert over blood supplies, which have fallen to critically low levels. The alert means some non-urgent operations that require blood are likely to be impacted, with hospitals advised to swap in other surgeries which do not require blood. A letter is due to go out to hospitals on Wednesday, The Independent was told. Hospitals will be asked to make individual decisions over whether to postpone surgeries such as hip replacements but will continue to carry out urgent surgeries and blood transfusions for those with long term conditions. The “amber-alert” will last for four weeks initially, NHS Blood and Transplant has said. Wendy Clark, interim chief of NHS Blood and Transplant said: “Asking hospitals to limit their use of blood is not a step we take lightly. This is a vital measure to protect patients who need blood the most. “Patients are our focus. I sincerely apologise to those patients who may see their surgery postponed because of this." “With the support of hospitals and the measures we are taking to scale up collection capacity, we hope to be able to build stocks back to a more sustainable footing." Read full story Source: The Independent, 12 October 2022 -
News Article
How 175 British children were infected with HIV
Patient Safety Learning posted a news article in News
At least 175 children with the blood disorder haemophilia were infected with HIV in the 1980s, according to documents from the national archives seen by BBC News. Some of the families affected are giving evidence at a public inquiry into what has been called the worst treatment disaster in the history of the NHS. It was almost 36 years ago - in late October 1986 - but Linda will never forget the day she was told her son had been infected. She had been called into a consulting room in Birmingham Children's Hospital, with 16-year-old Michael. As a toddler, he had been diagnosed with haemophilia, a genetic disorder that stopped his blood clotting properly. Linda assumed the meeting was to discuss moving his care to the main Queen Elizabeth Hospital in the city. "It was so routine that my husband stayed in the car outside," she says. "Then, all of a sudden, the doctor said, 'Of course, Michael is HIV positive,' and he came out with it like he was talking about the weather outside. My stomach just fell." Between 1970 and 1991, 1,250 people with blood disorders were infected with HIV in the UK after taking Factor VIII - a new treatment that replaced the clotting protein missing from their blood. About half of those infected with HIV died of an Aids-related illness before life-saving antiretroviral drugs became available. Almost three decades later, Linda is giving evidence to the long-running public inquiry into the treatment disaster. She will appear alongside other parents, in a special session about the experiences of families whose children were infected in the 1970s and 80s. "I felt as though I needed to do it because I want to help get to the bottom of it," she says. "We all want to know why it was allowed to happen and to keep on happening as well." Read full story Source: BBC News, 6 October 2022 -
News Article
Tribunal told of 'failure' over girl's blood tests
Patient Safety Learning posted a news article in News
If doctors had tested a nine-year-old girl's blood sooner they may have changed the treatment she received before her death, an expert witness has confirmed to a medical tribunal. The hearing was told this was a "significant failure" in the care of Claire Roberts. Claire died at the Royal Belfast Hospital for Sick Children in 1996. In 2018 a public inquiry concluded she died from an overdose of fluids and medication caused by negligent care. At the time, her parents were told a viral infection had spread from her stomach to her brain. The General Medical Council (GMC) said one of the doctors involved in Claire's care, Dr Heather Steen, acted dishonestly in trying to conceal the circumstances of her death. Dr Steen denied allegations that she acted dishonestly and engaged in a cover-up. The Medical Practitioners Tribunal Service (MPTS) heard from a defence expert witness on Monday who said doctors not checking the sodium levels in Claire's blood earlier was a "significant failure" in her care. Dr Nicholas Mann told the tribunal he would have ordered more blood tests on Claire on the morning after she was admitted to hospital but he said he did not know if this would have prevented her death. "There should have been more attention to her fluids and electrolytes on the day after admission. Whether that would have altered the final outcome I don't know but certainly it would have been sensible to do that," he said. The tribunal also heard that Claire's death was not referred to a coroner, despite this being something all of the doctors caring for her would have had a duty to do. It was also told that a letter sent to Claire's parents from the hospital in 2005 contained inaccuracies. During questioning of Dr Mann, a barrister for the GMC highlighted the involvement of Dr Steen in compiling the letter which was signed by another doctor. Tom Forster KC said it was the GMC's case that Claire's family were given incorrect information about potential causes of her death despite these not being definitively diagnosed. Read full story Source: BBC News, 3 October 2022 -
News Article
Infected blood transfusions killed 1,820 in UK, study estimates
Patient Safety Learning posted a news article in News
An estimated 1,820 people died in the UK after being given contaminated blood transfusions between 1970 and 1991, a report has found. The findings were published by the public inquiry into the scandal. The long period between infection and symptoms appearing makes it difficult to know how many people were infected through a transfusion in the 1970s and 1980s, before it became possible to screen blood donations for the virus. New modelling for the public inquiry estimated that between 21,300 and 38,800 people were infected after being given a transfusion between 1970 and 1991, with a central estimate of 26,800. The study, by a group of 10 academics commissioned by the public inquiry, calculated that 1,820 of those died as a result, although the number could be as high as 3,320. Its findings were based on the rate of hepatitis C infection in the population, the number of blood donations made over that time, the survival rate of the disease and other factors. It found at least 79 and possibly up to 100 people also contracted HIV through donated blood, based on data provided by the UK Health Security Agency (UKHSA), with most infections between 1985 and 1987. It said 67 people in that group had now died, although there was no data confirming the causes of death. The public inquiry into the infected blood scandal began taking evidence in 2019 and is expected to publish its final report in 2023. Read full story Source: BBC News, 17 September 2022 -
Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation aims to improve patient safety by supporting healthcare staff in the safe use of central venous catheters to access a patient’s blood supply. Specifically, it looks into the use of tunnelled haemodialysis central venous catheters, which are a type of central line. The reference event involved Joan, who had a cardiac arrest caused by an air embolus after her haemodialysis catheter was uncapped, unclamped, and left open to air. This took place during a procedure to take blood culture samples to test for a possible line infection (where bacteria or viruses enter the bloodstream). This investigation’s findings, safety recommendations and safety observations aim to prevent the future occurrence of an air embolus following uncapped and unclamped haemodialysis catheters, and to improve care for patients across the NHS.
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Content ArticleTension pneumothorax can occur following chest trauma, respiratory disease and infection, or during resuscitation requiring invasive or non-invasive ventilation. It is a life-threatening condition resulting from a collapsed lung when air trapped in the pleural cavity compromises cardiopulmonary function. Immediate temporary decompression is required to prevent cardiac arrest. This is commonly done by inserting a needle and cannula, usually used for intravenous access, through the chest wall into the pleural cavity (needle thoracostomy). The needle is withdrawn, and the cannula left in place to allow the trapped air to flow out. New blood control (closed system) intravenous cannulas are increasingly used in the NHS; at least 130 trusts bought a total of three million of them in the last year. They look very similar to both traditional and standard safety cannula (with needle guard or shield) but have an extra integral septum which closes when the needle is withdrawn and stops free flow in or out of the cannula. Flow is only possible once an intravenous line or Luer-lock syringe is attached to the hub, which opens the septum. Blood control (closed system) cannulas help prevent blood spillage, exposure and contamination, when used for their intended intravenous purpose, but they cannot be used to decompress a pneumothorax without additional equipment. The main patient safety risks are: staff may select a blood control (closed system) cannula not realising its limitations for this procedure a blood control (closed system) cannula may wrongly be assumed to be functioning in a patient who is deteriorating rapidly a second needle might be introduced risking very significant damage to the lung as it reinflates.
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Content Article
Infiltration is when fluid or intravenous drugs administered to a patient (which are given to patients into a vein through a cannula or other device) inadvertently leak into the tissue surrounding a vein by mistake. Extravasation is when infiltration occurs but the drugs involved are called vesicants which can damage the tissue and cause serious harm to the patient. The National Infusion and Vascular Access Society (NIVAS) are leading a campaign to improve awareness of infiltration and extravasation and reduce avoidable harm. In this interview Andrew Barton, Chair of NIVAS, explains why this is such an important issue and what needs to happen to improve patient safety. -
News Article
1 in 3 infected with HIV in blood scandal was a child
Patient Safety Learning posted a news article in News
Almost one out of every three people infected with HIV through contaminated NHS blood products in the 1970s and 80s was a child, research has found. About 380 children with haemophilia and other blood disorders are now thought to have contracted the virus. The new estimate was produced by the public inquiry into the disaster, after a BBC News report into the scandal. In August, the government agreed to pay survivors and the partners of those who died compensation. The first interim payments of £100,000 per person were made last month. The initial agreement does not cover bereaved parents or the children of those who have died. A wider announcement on compensation is expected when the inquiry concludes, next year. Read full story Source: BBC News, 9 November 2022 -
News ArticleInquest finds Susan Warby, 57, received insulin she did not need after blood test mistakes. Hospital errors contributed to her death five weeks after bowel surgery, an inquest into her death has concluded. Susan Warby, 57, who died at West Suffolk hospital in Bury St Edmunds, was incorrectly given glucose instead of saline through an arterial line that remained in place for 36 hours and resulted in inaccurate blood test readings. She was subsequently given insulin she did not need, causing bouts of extremely low blood sugar (hypoglycemia) and the development of “a brain injury of uncertain severity”, recorded Suffolk’s senior coroner, Nigel Parsley. Speaking after the inquest was adjourned in January, Susan's husband, Jon Warby, said he was “knocked sideways completely” when he received an anonymous letter two months after her death highlighting blunders in her treatment. Doctors at the hospital were reportedly asked for fingerprints as part of the hospital’s investigation into the letter, a move described by a Unison trade union official as a “witch-hunt” designed to identify the whistleblower. Following January’s adjournment, Parsley instructed an independent expert to review the care that Warby received. Warby’s medical cause of death was recorded as multi-organ failure, with contributory causes including septicaemia, pneumonia and perforated diverticular disease, affecting the bowel. Recording a narrative conclusion, Parsley wrote: “Susan Warby died as the result of the progression of a naturally occurring illness, contributed to by unnecessary insulin treatment caused by erroneous blood test results. This, in combination with her other comorbidities, reduced her physiological reserves to fight her naturally occurring illness.” Jon Warby said in a statement: “The past two years have been incredibly difficult since losing Sue, and it is still a real struggle to come to terms with her no longer being here. The inquest has been a highly distressing time for our family, having to relive how Sue died, but we are grateful that it is over and we now have some answers as to what happened." “After learning of the errors in Sue’s care, I wanted to know how these occurred and what action was being taken to prevent any similar incidents in the future. The trust has now made a number of changes which I am pleased about.” Read full story Source: The Guardian, 7 September 2020
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News Article
Patient bleeds to death in hospital run by scandal-hit trust
Clive Flashman posted a news article in News
Inspectors raise ‘serious concerns’ about medical wards and emergency care at Shropshire NHS trust A patient bled to death on a ward at Shrewsbury and Telford Hospitals Trust after a device used to access his bloodstream became inexplicably disconnected, The Independent has learnt. The incident came to light as new concerns arose about quality of care at the Shropshire trust, with the Care Quality Commission (CQC) warning of “serious concerns” about its medical wards and emergency department following an inspection last month. Although the report from the inspection has not yet been published, it is understood that the trust has been served with a legal notice by the regulator to comply with more than a dozen conditions. It remains in special measures following the inspection and is rated inadequate overall. See full article in The Independent here -
News Article
Infected Blood Enquiry: Timetable and factsheet for expert hearings
Clive Flashman posted a news article in News
This is the independent public statutory inquiry into the use of infected blood. The timetable and factsheet to provide information for those attending the hearings in London on 24-28 February have just been published. Go to this link for more information >> https://www.infectedbloodinquiry.org.uk/news
