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Content Article
In October, the Healthcare Safety Investigation Branch will tweak its name, become independent from NHS England and the UK government, and gain new powers to strengthen investigations. With the announcement of the change in status, Health Secretary, Steven Barclay, reported it would be leading an investigation into inpatient mental health. This follows swiftly on the heels of the Strathdee rapid review into data on mental health inpatient settings, which itself was launched in response to well-documented failures in these settings. The aim of this new investigation into mental health is simple: to improve safety. In this blog, Karen West, Head of Transformation (Mental health) at Oxehealth, and Professor Dan Joyce from the University of Liverpool, discuss the importance of data in patient safety improvement and explain why inpatient mental health data is so difficult to collect and what can be done to improve this. -
Content ArticleThe report from the International Labour Organization describes the results of a special analysis of data from the Labour Force Surveys (LFS) of 56 countries which provided data about health and social care workers in sufficient detail to distinguish between different occupational groups within the workforce. The report covers analyses for 29 countries in Europe and 27 from other regions of the world. This analysis can help to highlight specific occupation groups and countries which are at heightened risk of decent work deficits and demographic imbalances.
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Content Article
I am passionate about women's health and have worked with campaigners, clinicians and patients for a number of years to look at the barriers that women face in receiving safe care and the challenges clinicians face in delivering it. We know the medical system has historically been based on the white, male patient which has led to huge gaps in knowledge and understanding around women's health. But we are not just playing catch up to address past racism and patriarchy that is embedded in the system, we are continuing to highlight and fight it where it still exists. On Saturday I attended the Women's Health Summit, organised by Five X More. It was a powerful event, designed to look at aspects of women's health throughout their life journey. Attended by mums, charity representatives, media, clinicians, patients, leaders and more, united by a desire to change things. I laughed, I talked and I cried. One of the final calls to action of the day was to find your skill, find your voice and do more. So, I start where I am most at home - in writing. -
Content ArticleThe Maternal, Newborn and Infant Clinical Outcome Review Programme, which is delivered by MBRRACE-UK, has published a report on UK Perinatal Deaths for Births from January to December 2021. Overall, it found that perinatal mortality rates increased across the UK in 2021, with 3.54 stillbirths per 1,000 total births and 1.65 neonatal deaths per 1,000 live births (3.33 and 1.53 respectively in 2020). However, there was a wide variation in stillbirth and neonatal mortality rates across organisations, though these rates increased in almost all gestational age groups. It was also found that inequalities in mortality rates by deprivation and ethnicity remain, but the most common causes of stillbirth and neonatal death are unchanged (for example, congenital anomalies continue to contribute to a significant proportion of perinatal deaths).
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Content ArticleThe Aviation Safety Reporting System (ASRS) is an important part of the continuing effort by the US government, industry and individuals to maintain and improve aviation safety. The ASRS collects voluntarily submitted aviation safety incident/situation reports from pilots, controllers and others. it analyses and responds to these incident reports to reduce the likelihood of aviation accidents. ASRS data are used to: identify deficiencies and discrepancies in the National Aviation System (NAS) so that these can be remedied by appropriate authorities. support policy formulation, planning for and improvements to the NAS. strengthen the foundation of aviation human factors safety research. This is particularly important since it is generally recognised that over two-thirds of all aviation accidents and incidents have their roots in human performance errors. The ASRS website outlines the purpose and aims of the system, provides details on how to submit reports and lists related research studies and resources.
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Content ArticleCommunity hospitals play a very important role in supporting patients but, unlike with larger hospitals, little has been known until now about how they struggle with delayed discharges. Following a freedom of information request, the Nuffield Trust reveals the number of patients experiencing delays leaving community hospitals, and highlights the capacity challenges such hospitals face.
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EventuntilDeveloping trust when it comes to the employment of AI-driven healthcare is a complex challenge, and one that’s easy to get wrong. Daniel Morris, Partner at Bevan Brittan, Mahesh Hariharan, Founder and CEO of Zupervise, and Surabhi Srivastava, Commercial VP of Qure.ai, will together explore the importance of trust in AI-driven healthcare, and how effective governance can help build trust between patients & providers. They will discuss topics such as: data provenance; algorithmic transparency; and the role of human oversight in ensuring patient safety and data security. Register
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Content ArticleThe number of under-50s worldwide being diagnosed with cancer has risen by nearly 80% in three decades, according to the largest study of its kind. Global cases of early onset cancer increased from 1.82 million in 1990 to 3.26 million in 2019, while cancer deaths of adults in their 40s, 30s or younger grew by 27%. More than a million under-50s a year are now dying of cancer, the research reveals. Experts are still in the early stages of understanding the reasons behind the rise in cases. The authors of the study, published in BMJ Oncology, say poor diets, alcohol and tobacco use, physical inactivity and obesity are likely to be among the factors. “Since 1990, the incidence and deaths of early onset cancers have substantially increased globally,” the report says. “Encouraging a healthy lifestyle, including a healthy diet, the restriction of tobacco and alcohol consumption and appropriate outdoor activity, could reduce the burden of early onset cancer.”
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Content ArticleHealthcare is where the "most exciting" opportunities for artificial intelligence (AI) lie, an influential MP has said, but is also an area where the technology's major risks are illustrated. Greg Clark, chairman of the Commons Science, Innovation and Technology Committee (SITC), said the wider adoption of AI in healthcare would have a "positive impact", but urged policy makers to "consider the risks to safety". He said: "If we're to gain all the advantages, we have to anticipate the risks and put in place measures to safeguard against that." An interim report published by the Science, Innovation and Technology Committee sets out the Committee’s findings from its inquiry so far, and the twelve essential challenges that AI governance must meet if public safety and confidence in AI are to be secured.
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News Article
UK Long Covid cases hit record high of 2 million
Patient Safety Learning posted a news article in News
The number of people suspected to be living with Long Covid has risen to a record high of two million, new figures show. Estimates from the Office for National Statistics (ONS) suggest that, as of 1 May, around 3.1% of the population were suffering from persistent symptoms after becoming infected with coronavirus. This includes 826,000 who have had Long Covid for at least one year – up from 791,000 in April. Some 376,000 people have meanwhile lived with the condition for at least two years, the figures show. The prevalence of Long Covid in the UK has jumped sharply since the end of the Omicron wave, which infected millions of people over winter. Since the beginning of the year, 700,000 people have developed the condition – more than one-third of the overall total. Lingering symptoms adversely affected the day-to-day activities of 1.4 million people, the ONS said, with 398,000 reporting that their ability undertake day-to-day activities had been “limited a lot”. Long Covid was found to be most prevalent in people aged 35 to 69 years, women, people living in more deprived areas, those working in healthcare, social care, or teaching and education, and those with another activity-limiting health condition or disability, the ONS said. Read full story Source: The Independent, 1 June 2022 -
News Article
NHS will not hit virtual wards target, internal data suggests
Patient Safety Learning posted a news article in News
The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022 -
News Article
Wrong surgery and jabs among hundreds of NHS ‘never events’
Patient Safety Learning posted a news article in News
A woman who had her ovaries removed by mistake was one victim of the hundreds of “never events” that occurred in the NHS over the past year. Between April 2021 and March 2022 more than 400 patients in England’s hospitals suffered errors so serious that they should never have happened according to data released by NHS England. They include the wrong hips, legs, eyes and knees being operated on, and diabetic patients being given too much insulin. Foreign objects were left inside 98 patients after operations, including gauzes, swabs, drill guides, scalpel blades and needles. Vaginal swabs were left in patients 32 times and surgical swabs were left 21 times. Other objects left inside patients included part of a pair of wire cutters, part of a scalpel blade, and the bolt from surgical forceps. On three separate occasions part of a drill bit was left in a patient. “Wrong-site surgery” was carried out on 171 patients and six patients had injections to the wrong eye. The wrong hip implant was put in 12 times, a wrong knee implant was performed 11 times, and patients were connected to air instead of oxygen 13 times. Seven patients were given the wrong type of blood during a transfusion. Some patients were given doses of drugs that were far too high, including the immunosuppressant methotrexate, which is used for severe arthritis, psoriasis and leukaemia. There were 11 overdoses of insulin. Read full story (paywalled) Source: The Times, 19 May 2022 -
News ArticleObese adults in Britain are on course to outnumber those who are a healthy weight within five years, a stark report has revealed. Experts have warned there will be a “tipping point” in 2027 when one third of adults will be obese if current trends continue. By 2040, they predict there will 21 million people classed as obese in the UK, and 19 million deemed to be overweight. The analysis by Cancer Research UK shows seven in 10 (71%) people will be overweight or obese by 2040. Of this, almost four in 10 (36%) adults will be obese. At present, 64% of adults are overweight or obese, with figures rising every year. Being overweight or obese increases the risk of at least 13 different types of cancer and also causes other conditions such as high blood pressure and Type 2 diabetes. The new data comes after former Conservative leader William Hague attacked the government for postponing a ban on “buy one get one free” deals for foods high in fat, salt and sugar for a year because of the cost-of-living crisis. Read full story Source: The Independent, 19 May 2022
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News ArticleNew figures leaked to HSJ show the true volume of 12-hour waiters in emergency departments is more than four times higher than official statistics suggest. Internal NHS England figures for February and March show around one in five admissions through ED waited more than 12 hours from arriving until being admitted to a ward – equating to around 158,000 cases. The official stats published by NHSE record a slightly different, and shorter, time period, from ‘decision to admit’ to admission. There were around 39,000 of these cases in the same two months, which equates to 4 per cent of admissions through ED, and 5.4 per cent of total emergency admissions. The Royal College of Emergency Medicine has long called for the official stats to reflect the total time spent from arrival in ED (as per the internal data), and for trusts to be measured and regulated on this. Senior medics have for some time been warning about the patient safety risks of long waiting in EDs and have appealed to NHS England and the government for plans to tackle the crisis. Adrian Boyle, vice president of RCEM, said: “This data show the scale of long waiting times in emergency departments and the scale of the patient safety crisis. Performance continues to deteriorate across multiple metrics meaning we are documenting a failing urgent and emergency care system without any system transformation or improvement." Read full story (paywalled) Source: HSJ, 13 May 2022
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News Article
Hundreds of organisations breached patient data rules, reveals BMJ
Patient Safety Learning posted a news article in News
Hundreds of organisations, including drug companies, private healthcare providers and universities, have breached patient data sharing agreements but not had their access to patient data withdrawn, a report reveals. “High risk” breaches were revealed to have occurred at healthcare groups, pharmaceutical giants and educational institutions including Virgin Care, GlaxoSmithKline (GSK) and Imperial College London, during audits by NHS Digital, according to an investigation by the BMJ. This means these organisations were handling information outside the remit agreed in data contracts and may be failing to protect confidentiality, the journal said. In one instance, local NHS commissioners allowed sensitive, identifiable patient data to be released to Virgin Care without permission from NHS Digital. When auditors tried to get access to Virgin Care to check their compliance, they were denied access for several weeks and the company refused to delete the patient data, the BMJ reported. Records about mental health, including children and young people, those with learning disabilities, diagnostic imaging and other confidential patient data was being processed outside the scope of objectives agreed with NHS Digital, at an address that had not been agreed, and without a data sharing contract. A spokesperson for Virgin Care said it had “robust data protection in place”. “It is outrageous that private companies and university research teams are failing to comply,” said Kingsley Manning, the former chair of NHS Digital. “How is it that these organisations can be so lax with data?” Read full story Source: The Guardian, 11 May 2022 -
News Article
Trusts failing on waiting list ask told to ‘get act together’
Patient Safety Learning posted a news article in News
Trusts have been told to ‘get their act together’ on health inequalities, after HSJ research suggested only a small minority have so far published data on disparities in waiting times between different patient groups. Planning guidance issued by NHS England in September 2021 said trusts’ board performance reports should include a disaggregation of waiting lists by ethnicity and deprivation group. Through freedom of information and media requests, HSJ attempted to obtain such data from the 20 trusts with the largest waiting lists, but only three currently appear to have met the requirement in full. The remainder either said they were still undertaking the work, were thinking about how to publish it, or failed to respond. Roger Kline, an academic researcher and former director of NHSE’s workforce race equality standard, said trusts should have been collecting and publishing the data for years. He said: “We know there are issues around health and healthcare of some groups of people, most notably in poor working class communities and black and minority ethnic communities. It shouldn’t be seen as an optional extra, this should be part of good public health work and good equitable healthcare provision." “This data should be on the trust website. It should be an active part of the conversations with local communities. Well done to the trusts that are pushing this forward. The ones that are not need to get their act together.” Read full story (paywalled) Source: HSJ, 3 May 2022 -
News ArticleThe number of notified “extreme” and “major” incidents involving serious harm to patients and others in hospital has risen significantly in the Republic of Ireland in recent years, new figures reveal. Reported “extreme” incidents, which can involve death or permanent incapacity, rose from 373 in 2017 to 579 last year. The number of cases classified as “major”, where there is long-term disability or incapacity, climbed from 46 to 82 in the same period. “Moderate” incidents, when there is a patient injury involving medical treatment, also increased from 9,219 in 2017 to 13,563 last year. Minor incidents, involving injury or illness needing first aid, also increased over the same time from 9,210 to 15,483. The figures, involving patients, staff, visitors, contractors and the public, were released by the HSE in response to a parliamentary question from Aontú leader Peadar Tóibín. A spokewoman for the HSE said: “It is HSE policy that all incidents are identified, reported and reviewed so that learning from events can be shared to improve the quality and safety of services.” “The number of reported incidents has increased year on year since 2004 with a significant increase noted since 2015, with the introduction of the National Incident Management System.” Read full story Source: Independent.ie, 3 May 2022
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News Article
Lack of Covid testing leaves researchers blind to evolution patterns, WHO warns
Patient Safety Learning posted a news article in News
A dramatic drop in testing for Covid-19 has left the world blind to the virus’s continuing rampage and its potentially dangerous mutations, the head of the World Health Organization has warned. The UN health agency said that reported Covid cases and deaths had been dropping dramatically. “Last week, just over 15,000 deaths were reported to WHO – the lowest weekly total since March 2020,” WHO chief Tedros Adhanom Ghebreyesus told reporters. While saying this was “a very welcome trend”, he warned that the declining numbers could also be a result of significant cuts in testing for the virus. “As many countries reduce testing, WHO is receiving less and less information about transmission and sequencing,” he said. “This makes us increasingly blind to patterns of transmission and evolution." “When it comes to a deadly virus, ignorance is not bliss.” William Rodriguez, who heads the global diagnostics alliance FIND, also decried that many governments in recent months simply stopped looking for Covid cases. Speaking at the press conference hosted by WHO, he pointed out that in the past four months, amid surging Covid cases from the Omicron variant, “testing rates have plummeted by 70% to 90% worldwide”. The plunging testing rates came despite the fact that there is now more access to accurate testing than ever before. “We have an unprecedented ability to know what is happening,” Rodriguez said. “And yet today, because testing has been the first casualty of a global decision to let down our guard, we’re becoming blind to what is happening with this virus.” Read full story Source: The Guardian, 26 April 2022 -
News Article
‘Computer error’ removed 1,800 patients from trust’s elective waiting list
Patient Safety Learning posted a news article in News
A trust has discovered 1,800 patients who were removed by mistake from its elective waiting list. Barking, Havering and Redbridge University Hospitals Trust chief executive Matthew Trainer wrote to colleagues in the east London health system today to “apologise for the stress this will have caused those experiencing a delay”. Of the 1,800 patients involved, 600 have been waiting more than a year and roughly 200 have been waiting for more than two years. Mr Trainer’s note explained: “The patients have been waiting to see our specialists in routine clinics in gynaecology, neurology, neurosurgery and ophthalmology.” It continued: “As we have been working through our waiting lists, we have discovered a problem with one of them that was used to deal with the backlog created by the pandemic. “It contained routine referrals that were submitted by GPs who wanted their patients to be seen by a specialist, but for whom there were no appointments available due to covid-19. Unfortunately, these patients were removed automatically from this list before they had been seen.” Read full story (paywalled) Source: HSJ, 26 April 2022 -
News ArticlePatients who have “lost hope” of ever seeing a doctor are falling off NHS waiting lists due to poor record-keeping by the SNP government, Scotland’s public spending watchdog has revealed. Stephen Boyle, the auditor-general, said there was no record of patients who drop off the waiting list to go private or who simply give up. Humza Yousaf, the health secretary, said he was aware of “a small number of people” who had gone abroad for transplants, including one of his own constituents. He admitted there was no way of knowing the scale of the issue, or whether the organs were obtained legally. Boyle said: “I don’t wish to be blasé and say it is straightforward, but it really should not be an insurmountable problem to have a clear vision and strategy, reviewed and commented on, with an annual transparent plan to track progress. “The government themselves don’t have the complete data we think they should have to make some of the decisions about the delivery of health and social care services and reform.” Gillian Mackay, an SNP MSP, said some constituents told her that they have been put on a waiting list and “they hear nothing more about when they will be seen, or how they will be prioritised”. Boyle said the NHS needs to “manage patients’ expectations about how long they will have to wait”. He said: “Everybody who is waiting for services needs to have a clear expectation of when they will receive those services, whether it is [for] cancer, or other treatments on clinical prioritisation. There is clear missing part in transparency.” Read full story (paywalled) Source: The Times, 19 April 2022
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News Article
New algorithm will improve bowel-cancer patient care
Patient Safety Learning posted a news article in News
An algorithm which can predict how long a patient might spend in hospital if they’re diagnosed with bowel cancer could save the NHS millions of pounds and help patients feel better prepared. Experts from the University of Portsmouth and the Portsmouth Hospitals University NHS Trust have used artificial intelligence and data analytics to predict the length of hospital stay for bowel cancer patients, whether they will be readmitted after surgery, and their likelihood of death over a one or three-month period. The intelligent model will allow healthcare providers to design the best patient care and prioritise resources. Bowel cancer is one of the most common types of cancer diagnosed in the UK, with more than 42,000 people diagnosed every year. Professor of Intelligent Systems, Adrian Hopgood, from the University of Portsmouth, is one of the lead authors on the new paper. He said: “It is estimated that by 2035 there will be around 2.4 million new cases of bowel cancer annually worldwide. This is a staggering figure and one that can’t be ignored. We need to act now to improve patient outcomes. “This technology can give patients insight into what they’re likely to experience. They can not only be given a good indication of what their longer-term prognosis is, but also what to expect in the shorter term. “If a patient isn’t expecting to find themselves in hospital for two weeks and suddenly they are, that can be quite distressing. However, if they have a predicted length of stay, they have useful information to help them prepare. “Or indeed if a patient is given a prognosis that isn’t good or they have other illnesses, they might decide they don’t want a surgical option resulting in a long stay in hospital.” Read full story Source: University of Plymouth, 30 March 2022 -
News Article
AI software predicting daily A&E admissions rolled out in 100 NHS hospitals
Patient Safety Learning posted a news article in News
New artificial intelligence software being rolled-out in NHS hospitals will be able to predict daily A&E admissions weeks in advance. The software, which launched in 100 hospitals across England on Monday, analyses data, including Covid infections rates, 111 calls and traffic to predict the number of patients that will seek emergency care. It also takes into consideration public holidays, such as New Year’s Eve, when A&E is more likely to be busy. The AI software is being rolled after trials showed an “impressive” ability to forecast admissions up to three weeks in advance. The NHS believes it will help tackle the record waiting list and allow hospitals to more easily manage their patient and bed capacity, prepare for busier days and staff up when needed. Nine trusts were given the software to use during the pandemic which notified them of expected spikes in cases, staff levels and numbers of beds and equipment necessary. However, hospitals receiving the new equipment have also been warned uncertainties within the data mean the system should be used as a “starting point to consider an operational response, not as a definite signal for action.” Read full story Source: The Independent, 28 March 2022 -
News ArticleDuring the peak of the omicron variant wave of the coronavirus this winter, Black adults in the United States were hospitalised at rates higher than at any moment in the pandemic, according to a report published last week by the Centers for Disease Control and Prevention. Black adults were four times as likely to be hospitalised compared with White adults during the height of the omicron variant surge, which started in mid-December and continued through January, the report said. In January, the CDC found, hospitalisation rates for Black patients reached the highest level for any racial or ethnic group since the dawn of the pandemic. As the highly transmissible omicron variant usurped the delta variant’s dominance, people who were unvaccinated were 12 times more likely to be hospitalised than those who were vaccinated and boosted against the coronavirus, according to the report. And fewer Black adults had been immunised compared with White adults, said the report, which analysed hospitalization rates in 99 counties in 14 states. Teresa Y. Smith saw evidence of the phenomenon outlined in the CDC’s report as she treated patients as an emergency physician at SUNY Downstate in Brooklyn. She has felt the crush of the pandemic’s unequal impact since the pre-vaccine waves but has contended with the consequences of health disparities for much longer. Her hospital sits in a heavily Black and Latino borough, where — as in so many communities of color across the country — social, political, economic and environmental factors erode health and shorten lives. In December, she watched as the number of cases and admissions resulting from the omicron variant “just exploded in a short, short amount of time,” saying then, “there is no subtlety to it.” And while the vaccinated patients she treated were less likely to be “lethally sick,” many still needed to be admitted to the hospital. Read full story Source: The Washington Post, 18 March 2022
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News ArticleThe number of people who have died from Covid in Britain during the pandemic is impossible to determine because of the inconsistent definitions of what is meant by a coronavirus death, researchers have concluded. Experts from Oxford University discovered that public health and statistics organisations across the UK are operating under 14 different definitions to classify a death from Covid. Freedom of Information (FOI) requests show that many people who died in the first wave never tested positive for the virus, particularly older people who died in care homes. Instead, their deaths were registered as Covid simply based on a statement of the care home provider, and because coronavirus was rife at the time. The authors also point out that it is unlikely that a Covid infection on its own could cause death in the absence of contributing factors, such as other illness, or the infection leading to a more deadly condition such as pneumonia. The report also found that in some trusts, up to 95% of Covid deaths were in people with Do Not Resuscitate (DNR) orders. The team said the confusion meant they were unable to separate deaths caused by Covid from those triggered by the pandemic response, and called for a proportion of deaths to be verified by post-mortem in future pandemics to determine the true reason. Read full story (paywalled) Source: The Telegraph, 19 March 2022
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News Article
Javid ‘unconcerned’ as Covid admissions rise 46% in a fortnight
Patient Safety Learning posted a news article in News
Admissions of covid positive patients to English hospitals are once again rising steadily across England. The seven day total of new confirmed covid cases in hospitals on 12 March (the latest data available) stood at 9,642. This is 46% higher than the seven day total of 6,612 recorded on 25 February, the day before the current rise began. Asked on Radio 4’s Today programme yesterday about the rise in Covid infections, health and social care secretary Sajid Javid said there was “nothing in the [covid] data that gives us any cause for concern”. The Covid admissions figures used include patients who are already covid-positive when admitted, are diagnosed on admission, or are diagnosed while in hospital, so in some cases have caught Covid while in hospital. Read full story (paywalled) Source: HSJ, 15 May 2022
