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News Article
Retired consultant is struck off over treatment of young transgender patients
Patient Safety Learning posted a news article in News
A retired consultant gastroenterologist has been struck off the UK medical register for “wide ranging failings” in treating young transgender patients and in prescribing testosterone for men. Michael Webberley, who was charged with failing to provide good care to 24 patients, acted outside the limits of his expertise, a medical practitioners tribunal concluded. Through the private online clinic GenderGP, which he ran with his wife Helen, a GP, Webberley prescribed puberty blockers to a child of nine and cross sex hormones to a teenager who died by suicide a few months later. He faced charges over his care of seven transgender patients, and the tribunal found that he had provided treatment that was not clinically indicated or that had been prescribed without adequate tests, assessments, or examinations. Read full story (paywalled) Source: BMJ, 30 May 2022 -
News ArticleA staffing crisis in children’s dentistry has prompted the urgent removal of junior doctors from Great Ormond Street Hospital NHS Foundation Trust (GOSH. GOSH has struggled to recruit consultants for its paediatric dentistry services for at least two years, which has led to trainee doctors going unsupervised, according to a new report by regulator Health Education England. A report seen by The Independent said the service was running with just one part-time consultant but needed at least two. The news comes amid a national “crisis” in dentistry, with the latest data from the government showing that half of all children’s tooth extractions in 2021-22 were due to “preventable tooth decay”. GOSH told The Independent it was struggling with a “limited pool” of paediatric dentists and, as a result of shortages, many patients were waiting longer than the 18-week standard. Read full story Source: The Independent, 8 February 2023
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News ArticleNearly three-quarters of children detained under the mental health act are girls, a new report has found, amid warnings youngsters face a “postcode lottery” in their wait for treatment. Average waiting times between children being referred to mental health services and starting treatment have increased for the first time since 2017 with the children’s commissioner describing support across the country as “patchy”. In the annual report on children’s mental health services, the watchdog warned that, although the average wait is 40 days, some children are waiting as long as 80 days for treatment after being referred in 2021-22. The analysis, published on International Women’s day, also says young girls represented the highest proportion of children detained under the mental health act last year, highlighting “stark and worrying” gender inequalities. Read full story Source: The Independent, 7 March 2023 Further reading on the hub: Top picks: Women's health inequity
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News Article
Nursing shortages are delaying spinal operations
Patient Safety Learning posted a news article in News
Nursing shortages are contributing to children waiting up to three times longer for spinal surgery than pre-pandemic, a top surgeon has claimed. Chris Adams says up to one in four operations are cancelled at NHS Lothian, with staffing the main reason. Mr Adams also claims that some children are not being put on waiting lists as early as they should be. NHS Lothian disputes some of Mr Adams' statements but says "significant pressures" are affecting waiting times. The senior clinician, one of Scotland's three paediatric spinal surgeons, said he was speaking out of behalf of spinal patients and their families The surgeon's claims appear in a new BBC Disclosure investigation into Scotland's NHS, which reveals that some children are waiting up to three times longer than pre-pandemic for spinal surgery, with some waiting more than a year. At least 51 out of a possible 190 planned spinal surgeries at RHCYP were cancelled at short notice in 2022, with nursing shortages understood to be the main cause Read full story Source: BBC News, 7 March 2023 -
News Article
Misplaced tube contributed to first UK child Covid death, coroner rules
Patient Safety Learning posted a news article in News
A misplaced medical tube contributed to the death of the first child in the UK to die after contracting Covid, a coroner has found. Ismail Mohamed Abdulwahab, 13, of Brixton, south London, died of acute respiratory distress syndrome, caused by Covid-19 pneumonia, on 30 March 2020, three days after testing positive for coronavirus. He had a cardiac arrest before he died. Ismail’s death prompted widespread alarm about the potentially lethal impact of Covid on children. Hours before Ismail died, an endotracheal tube (ET) used to help patients breathe was found to be in the wrong position. A consultant in paediatric intensive care decided to leave it and monitor him. Giving his judgment on Thursday, senior coroner Andrew Harris said: “I am satisfied that he [Ismail] would not have died when he did were it not for the tube misplacement.” On Wednesday, the inquest at London Inner South London coroner’s court heard evidence from Dr Tushar Vince, a consultant in paediatric intensive care at King’s College hospital who treated Ismail on 29 March after he had been intubated. Asked by Harris if it would be reasonable to put the positioning of the ET on the death certificate as one of the causes, Dr Vince said: “I think it would be reasonable to consider it, yes.” She said: “I was so focused on the lungs I just didn’t see how high this tube was and I’m so sorry that I didn’t see it.” Read full story Source: The Guardian, 2 March 2023 -
News Article
Trust ‘missed opportunities’ to prevent sex offender working as locum
Patient Safety Learning posted a news article in News
A trust has admitted it ‘missed opportunities’ to identify that a locum doctor – who was arrested on hospital premises for two sexual offences — had already been cautioned for indecent exposure. Salman Siddiqi admitted two offences – attempting to engage in sexual communication with a child and attempting to arrange or facilitate a meeting with a child for sexual offences – last month. East Kent Hospitals University Foundation Trust, where he was working as a locum paediatric registrar at the time of the January offences, has now said there had been “missed opportunities” to identify his previous caution. Chief medical officer Rebecca Martin told HSJ the trust had taken steps to ensure that these missed opportunities could not happen again. She said in a statement: “This includes standardising DBS checks for temporary workers booked through an agency and escalating all DBS and General Medical Council checks that feature conditions, cautions or warnings.” Read full story (paywalled) Source: HSJ, 23 February 2023 -
News Article
Laughing gas users risk spine damage, say doctors
Patient Safety Learning posted a news article in News
Doctors at an east London hospital say they are seeing so many risky cases of laughing gas misuse that they have drawn up treatment guidelines for colleagues in the UK. Nitrous oxide, sold in metal canisters, is one of the most commonly used drugs by 16 to 24-year-olds. Heavy use can lead to a vitamin deficiency that damages nerves in the spinal cord. The Royal London Hospital team say medics need to be on alert. They have been seeing a new case almost every week. The guidelines, endorsed by the Association of British Neurologists and written with experts from Manchester, Birmingham, Nottingham and the Queen Mary University of London, warn doctors what to look for and how to treat. Read full story Source: BBC News, 23 February 2023 -
News Article
Children’s surgery backlog grows as NHS prioritises adult waiting lists
Patient Safety Learning posted a news article in News
Hundreds of thousands of children are waiting for surgery as new figures show the backlog has spiralled by almost 50 per cent in two years. The latest NHS data for December lays bare the parlous state of paediatric medicine, with NHS leaders and doctors warning that adult care is being prioritised over children’s. In December 2022, 364,000 children were waiting for treatment, from neurosurgery to ear, nose and throat operations, while a further 200,000 needed community services such as speech and language therapy. The surgery figure is up by 48%t since April 2021 – a far bigger increase than was seen in the overall NHS waiting list, which grew by 36% over the same period. Mike McKean, vice-president of policy at the Royal College of Paediatrics and Child Health, said “Lengthy waits are unacceptable for any patient, but for children and young people, waits can be catastrophic, as many treatments need to be given by a specific age or developmental stage. It is not the same as for adults. If you miss the right window to treat a child, or wait too long, the consequences can be irrevocable.” Read full story Source: The Independent, 19 February 2023 -
News ArticleChildren's services could be forced to close at a hospital that is accused of leaving young patients traumatised and sick through poor care. The care regulator said it had taken action to "ensure people are safe" on Skylark ward at Kettering General Hospital (KGH) in Northamptonshire. Thirteen parents with serious concerns after their children died or became seriously ill have spoken to the BBC. A BBC Look East investigation has heard allegations spanning more than 20 years about the treatment of patients on Skylark ward, a 26-bed children's unit. The BBC discovered: An independent report found staff left a 12-year-old boy - who died at KGH in December 2019 - for four hours suffering seizures, and suggests little effort was made to obtain critical care support. In April 2019, nurses allegedly dragged a "traumatised" four-year-old girl down a corridor in agony, insisting that she could walk. Medics are accused of refusing to carry out an MRI scan, which would have detected a dangerous cyst on her spine. Mothers claim to have been threatened with safeguarding referrals, with one stating a referral was made against her after she complained her son was struggling to breathe, while another likened it to blackmail. Read full story Source: BBC News, 20 February 2023
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News ArticleA high court judge has expressed her “deep frustration” at NHS delays and bureaucracy that mean a suicidal 12-year-old girl has been held on her own, in a locked, windowless room with no access to the outdoors for three weeks. In a hearing on Thursday, Mrs Justice Lieven told North Staffordshire combined healthcare NHS trust “you are testing my patience”, after she heard that a proposal to move Becky (not her real name), could not progress until a planning meeting that would not be held until next week, and that a move was not anticipated until 2 March. Three sets of doctors at the hospital trust have disagreed as to Becky’s diagnosis; at her most recent assessment doctors said she was not eligible to be sectioned, which would trigger the protections provided by the Mental Health Act, because her mental disorder was not of the “nature and degree” as to warrant her detention. In a robust exchange, the judge demanded: “Where’s the urgency in this … I cannot believe that the life and health of a 12-year-old girl is hanging on an issue of NHS procurement, when you cannot tell me what it is you’re trying to procure. “If the delay is procurement, I’m not having it,” Lieven continued. “I will use the inherent jurisdiction to make an order. We have a 12-year-old child in a completely inappropriate NHS unit for about three weeks, and it’s suddenly dawned on your client that ‘actually we’ll put her in a Tier 4 unit and we might have to do some [building] work.’” Sometimes, the judge said, “public bodies have to move faster”. Read full story Source: The Guardian, 17 February 2023
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News Article
Ambulance waits putting disabled children's lives at risk, doctors warn
Patient Safety Learning posted a news article in News
Thousands of severely disabled children's lives are at risk because of long waits for ambulances, doctors and other experts have warned. Emergency care is a vital part of their everyday lives, the British Academy of Childhood Disability says. Almost 100,000 children have life-limiting conditions or need regular ventilator support in the UK. They often rely on ambulances as part of their healthcare plan, because their condition can become life-threatening in an instant. Dr Toni Wolff, who chairs the British Academy of Childhood Disability, told BBC News some families with severely disabled children had "what are essentially high-dependency units" of medical equipment at home. "As part of their healthcare plan, we would normally say, 'If the child starts to deteriorate, call for an ambulance and it will be there within 10 or 20 minutes,'" she said. "Now, we can't give that reassurance." Despite their child being classed as a priority, parents have told BBC News they face the difficult decision to wait for an ambulance or take them, often in a life-threatening condition, to hospital themselves - a risk because of the huge amounts of equipment needed to keep them alive, Read full story Source: BBC News, 16 February 2023 -
News Article
The moment I knew something was wrong at the Tavistock
Patient Safety Learning posted a news article in News
A damning report last year from Dr Hilary Cass into the Tavistock Gender Identity Development Service (GIDS) found that it was putting children at “considerable risk”. Her full report is due to be published later this year. Whistleblower Dr Anna Hutchinson, a senior clinical psychologist at GIDS, describes when she realised something was very wrong. “I just couldn’t comfortably keep being part of a process that was, I felt, putting children — but also my colleagues — at risk,” Hutchinson explains. Faced with no discernible action from the executive, staff began to look for other ways to raise their concerns, to other people who might listen — and act. Hutchinson approached the Tavistock’s Freedom to Speak Up guardian. At least four other colleagues did the same in 2017. That same year, another four clinicians took their concerns outside GIDS to the children’s safeguarding lead for the Tavistock trust." Read full story (paywalled) Source: The Times, 13 February 2023 -
News Article
Children in mental health crisis spent more than 900,000 hours in A&E in England
Patient Safety Learning posted a news article in News
Children suffering mental health crises spent more than 900,000 hours in A&E in England last year seeking urgent and potentially life-saving help, NHS figures reveal. Experts said the huge amount of time under-18s with mental health issues were spending in A&E was “simply astounding” and showed that NHS services for that vulnerable age group were inadequate. Children as young as three and four years old are among those ending up in emergency departments because of mental health problems, according to data obtained by Labour. Dr Rosena Allin-Khan, the shadow mental health minister, who is also an A&E doctor, said: “With nowhere to turn, children with a mental illness are left to deteriorate and reach crisis point – at which time A&E is the only place left for them to go. Emergency departments are incredibly unsuitable settings for children in crisis, yet we’re witnessing increasingly younger children having to present to A&E in desperation.” Young people who endured long A&E waits included those with depression, psychosis and eating disorders as well as some who had self-harmed or tried to kill themselves, doctors said. Read full story Source: The Guardian, 9 February 2023 -
News ArticleA mother who has seen her suicidal 12-year-old daughter shuttled between placements and then held in a locked and windowless hospital room says she is frightened for her child’s life. Since going into care in Staffordshire nine months ago, Becky (not her real name) has attempted to take her own life on several occasions. Her case throws fresh light on the chronic nationwide shortage of secure accommodation for vulnerable children. “I am constantly told there is nowhere for her,” said her mother, who cannot be identified for legal reasons. “I fear I’ll soon be arranging her funeral due to the systemic failings in health and social care.” Becky has been alone in a locked hospital room since 27 January. The room has no window or access to the outdoors, no furniture except for a bed, and she is permitted no belongings. All human contact is conducted through a hatch. The child’s court-appointed guardian told the high court at a hearing to discuss Becky’s case that she considered “the risk to Becky’s life to be catastrophic”. Read full story Source: The Guardian, 7 February 2023
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News ArticleA little boy whose headaches turned out to be a brain tumour died in his parent’s arms just four months after his diagnosis. Rayhan Majid, aged four, died after doctors discovered an aggressive grade three medulloblastoma tumour touching his brainstem. His mother Nadia, 45, took Rayhan to see four different GPs on six separate occasions after he started having bad headaches and being sick in October 2017. No one thought anything was seriously wrong, but when his headaches didn’t clear up Nadia rushed him to A&E at the Queen Elizabeth University Hospital in Glasgow. An MRI scan revealed a 3cm x 4cm mass in Rayhan’s brain. Rayhan underwent surgery to remove as much of the tumour as possible and was told he would need six weeks of radiotherapy and four months of chemotherapy. But before the treatment even started another MRI scan revealed the devastating news that the cancer has spread. Read full story Source: The Independent, 30 January 2023
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News ArticleChildren came to “significant” harm due to chronically low staffing levels at scandal-hit mental health hospitals, whistleblowers have said. In a third exposé into allegations of poor care at private hospitals run by The Huntercombe Group, former employees have claimed that staffing levels were so low “every day” that patients were neglected, resulting in: Patients as young as 13 being force-fed while restrained. Left alone to self-harm instead of being supervised. Left to “wet themselves” because staff couldn’t supervise toilet visits. One staff member, Rebecca Smith, said she was left in tears after having to restrain and force-feed a patient. Following a series of investigations by The Independent and Sky News, 50 patients came forward with allegations of “systemic abuse” and poor care, spanning two decades at children’s mental health hospitals run by the organisation. The government has since launched a “rapid review” into inpatient mental health units across the country following the newspaper’s reporting. Read full story Source: The Independent, 28 January 2023
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News Article
Manchester to open two homes for vulnerable children stuck in hospital
Patient Safety Learning posted a news article in News
Manchester city council is setting up two special children’s homes to house the increasing number of vulnerable young people who end up stuck in hospital because no residential providers will take them. The homes, believed to be the first of their kind, aim to undercut private operators which sometimes demand tens of thousands of pounds each week to look after children with the most complex needs. Five Manchester children with complex emotional needs spent many weeks in hospital in 2022 because no children’s homes would take them because of their challenging behaviour, according to the city council’s director of children’s services. Manchester council has developed what it calls the Take a Breath model. Two houses are being renovated to house up to four children in total, with the first hopefully moving in by March. The idea is that when children first turn up at hospital – often at accident and emergency after a suicide attempt or self-harming incidents – once their injuries have been treated they can be discharged straight into the new homes rather than occupying a paediatric bed they do not need. Jointly commissioned by the council and the NHS, the two homes will cost £1.4m a year. Of that, MCC expects to spend £5,500 a week for each child. It represents a huge cost saving compared with some external placements. Last year the council was charged £16,550 a week by one private provider to look after a young profoundly autistic person with learning difficulties deemed a danger to themselves and to others. Read full story Source: The Guardian, 22 January 2023 -
News Article
WHO urges action after cough syrups linked to more than 300 child deaths
Patient Safety Learning posted a news article in News
The World Health Organization (WHO) has called for “immediate and concerted action” to protect children from contaminated medicines after a spate of child deaths linked to cough syrups last year. In 2022, more than 300 children - mainly aged under 5 - in the Gambia, Indonesia and Uzbekistan died of acute kidney injury, in deaths that were associated with contaminated medicines, the WHO said in a statement on Monday. The medicines, over-the-counter cough syrups, had high levels of diethylene glycol and ethylene glycol. “These contaminants are toxic chemicals used as industrial solvents and antifreeze agents that can be fatal even taken in small amounts, and should never be found in medicines,” the WHO said. As well as the countries above, the WHO told Reuters on Monday that the Philippines, Timor Leste, Senegal and Cambodia may be affected because they may have the medicines on sale. It called for action across its 194 member states to prevent more deaths. “Since these are not isolated incidents, WHO calls on various key stakeholders engaged in the medical supply chain to take immediate and coordinated action,” WHO said. Read full story Source: The Guardian, 24 January 2023 -
News Article
Children in England at clear risk ‘cannot get mental health bed’
Patient Safety Learning posted a news article in News
Young people in the midst of a mental health crisis need to have attempted suicide several times before they get a bed in an inpatient unit in England, a report has revealed. Admission criteria for beds in child and adolescent mental health units are now so tight that even very vulnerable under-18s who pose a clear risk to themselves cannot get one. The practice – caused by the NHS’s lack of mental health beds – leaves young people at risk of further harm, their parents confused, exhausted and worried, and the police and ambulance services potentially having to step in. The high thresholds for admission to a child and adolescent mental health services (Camhs) unit are detailed in a report on NHS mental health care for under-18s in England based on interviews with patients, their parents and specialist staff who look after them. The report says a young person has to “have attempted suicide multiple times to be offered inpatient support”. Olly Parker, the head of external affairs at the charity Young Minds, said: “It is shameful that children and young people are reaching crisis point before they get any support for their mental health. We know from our own research that thousands have waited so long for mental health support or treatment that they have attempted to take their own life. “Those who end up in A&E are often there because they don’t know where else to turn. But A&E can be a crowded and stressful environment, and is usually not the best place to get appropriate help.” Read full story Source: The Guardian, 18 January 2023 -
News Article
Sudden unexplained death in childhood debated in Parliament
Patient Safety Learning posted a news article in News
The issue of children dying unexpectedly and without any known cause has been debated in Parliament for the first time. Sudden unexplained death in childhood (SUDC) is a rare category of death in which the cause remains unknown even after thorough investigation. Former Chancellor Kwasi Kwarteng, who led the debate, said SUDC had not had the attention it deserved. In his first speech as a backbencher for six years, he said it was important to not shy away from discussing "something that is incredibly difficult to deal with, emotionally very taxing, and one of the most serious medical phenomena". He said: "Imagine a death of a child, who has all his or her life in front of them, suddenly ended. If you can imagine that and if you can imagine that for one of your own children you can get a sense of how tragic and how difficult that occurrence is." He added: "It's such an uncomfortable issue but it is important to grasp uncomfortable issues to honour those who had died and prevent future deaths." He added: "It's such an uncomfortable issue but it is important to grasp uncomfortable issues to honour those who had died and prevent future deaths." The MPs were united in their call for more research to be carried out. They also called for the NHS website to be updated to include information about SUDC and for there to be more training for medical practitioners. Read full story Source: BBC News, 17 January 2023 -
News Article
Transgender people lose NHS waiting times High Court case
Patient Safety Learning posted a news article in News
A group of transgender people have lost their legal case against NHS England over waiting times to get seen by a gender specialist. The two trans adults and two trans children had tried to get the wait times - more than four years in one of their cases - deemed illegal. But a High Court judge ruled on Monday the waiting times are lawful. The Good Law Project - which helped to bring the legal action - said it would seek permission to appeal. The four people brought the legal action against NHS England (NHSE) over the waiting time to get a first appointment with a gender dysphoria specialist. The claimants argued that NHS England was failing to meet a duty to ensure 92% of patients referred for non-urgent care start treatment within 18 weeks. They said the waiting times were discriminatory, arguing the delays faced by trans people were longer than for other types of NHS treatment. But the judge dismissed the claim on several grounds. Read full story Source: BBC News, 16 January 2023 -
News Article
Five million children worldwide die before fifth birthday, says UN
Patient-Safety-Learning posted a news article in News
Five million children worldwide died before their fifth birthday in 2021, with almost half (47%) dying during their first month, according to new UN figures. Most of the deaths could have been prevented with better healthcare, say campaigners, adding that deaths among newborn babies haven’t reduced significantly since 2017. Children born in sub-Saharan Africa are 15 times more likely to die in childhood than children in Europe and North America. UN figures also show that 1.9 million babies were stillborn during 2021, more than three-quarters (77%) in sub-Saharan Africa and in south Asia. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times greater than for women in Europe and North America. Read full story Source: The Guardian, 10 January 2022 -
News ArticlePupils should learn what health problems they must not bother the NHS with, doctors and pharmacists have said. In a new strategy paper they call for a “wholesale cultural shift” towards more self-care, insisting this could both empower patients and reduce demand. Conditions like lower back pain, the common cold and acute sinusitis can generally be treated without the need for GPs or hospital visits, experts said. They called for the national curriculum to include requirements for both primary and secondary pupils to be taught to treat and manage common health problems at home. Medical students or pharmacists could go into school to offer lessons on “self-care techniques and signposting to appropriate use of NHS services”, they said. The paper is from the Self-Care Strategy Group, a coalition of pharmacy bodies and GP and patient groups. Read full story (paywalled) Source: The Times, 9 January 2023
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News Article
Children’s oral health is “national disgrace,” says head of royal college
Patient Safety Learning posted a news article in News
The poor state of children’s teeth is a damning indictment of widening inequalities in child health in England, the president of the Royal College of Paediatrics and Child Health has said. In an interview with The BMJ Camilla Kingdon said that paediatricians were seeing the effects of longstanding health inequalities widening as the cost of living crisis affects the types of ill health that children are presenting with. She further told The BMJ, “There are lots of examples. One that we often forget about is oral health and the state of children’s teeth, which is actually a national disgrace. The commonest reason for a child having a general anaesthetic in this country is dental clearance. That’s a terrible admission of failure.” In her interview with The BMJ, Kingdon identified asthma and nutrition as other major areas of child health where the UK was failing. She said that these trends were partly being driven by social factors and expressed concern at the lack of focus in policy on fixing them. She warned, “Our worry, with the health disparities white paper being kicked into the long grass, is that without that intention, without a clear signal from the government that this is a priority, all these ideas [for tackling child health inequalities] just won’t be prioritised and we will miss an opportunity to really intervene.” Read full story Source: BMJ, 4 January 2023 -
News Article
Child referrals for mental health care in England up 39% in a year
Patient Safety Learning posted a news article in News
The number of children in England needing treatment for serious mental health problems has risen by 39% in a year, official data shows. Experts say the pandemic, social inequality, austerity and online harm are all fuelling a crisis in which NHS mental health treatment referrals for under-18s have increased to more than 1.1m in 2021-22. In 2020-21 – the first year of the pandemic – the figure was 839,570, while in 2019-20 there were 850,741 referrals, according to analysis of official figures by the PA Media. The figures include children who are suicidal, self-harming, suffering serious depression or anxiety, and those with eating disorders. Dr Elaine Lockhart, chair of the child and adolescent psychiatry faculty at the Royal College of Psychiatrists, said the rise in referrals reflected a “whole range” of illnesses. She said “specialist services are needing to respond to the most urgent and the most unwell”, including young people suffering from psychosis, suicidal thoughts and severe anxiety disorder. Lockhart said targets for seeing children urgently with eating disorders were sliding “completely” and that more staff were needed. Read full story Source: The Guardian, 3 January 2023
