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Found 367 results
  1. Content Article
    Key points The Health Foundation worked with the Commonwealth Fund to survey 9,526 primary care physicians across 10 high-income countries between February and September 2022. This included 1,010 GPs from the UK. They analysed the survey data to understand the experiences of GPs in the UK and how they compare to other countries. A majority of GPs in all countries are dealing with higher workloads than before the pandemic – and many have experienced greater stress and signs of emotional distress. But the experience of GPs in the UK should ring alarm bells for government. 71% say their job is ‘extremely’ or ‘very stressful’ – the highest of the 10 countries surveyed alongside Germany. Things have been getting worse for UK GPs. GPs in the UK were among the most satisfied of any country back in 2012. Now just 24% of UK GPs are ‘extremely’ or ‘very satisfied’ with practising medicine – similar to France but lower than all other countries surveyed. UK GPs are among the most likely to plan to stop seeing patients regularly in the next 1 to 3 years. Half of GPs in the UK think the quality of care they can provide to patients has got worse since the start of the pandemic – and only 14% think it has improved. But the survey also illustrates some of the core strengths of general practice in the UK, including a high proportion of GPs feeling well prepared to manage care for patients with complex needs, and strong performance compared with other countries in use of data to inform care. Decisive policy action is needed to improve the working lives of GPs in the UK – including to boost GP capacity and reduce workload. Policymakers considering options for primary care reform should recognise the strengths of general practice in the UK and work with the profession rather than against it.
  2. News Article
    More than 175,000 patient appointments and surgeries were postponed this week during the three-day junior doctor walk-out, it has emerged. NHS leaders have warned the strikes were the most disruptive yet with more appointments cancelled across three days than across any of the previous nurse strikes. Data published by the NHS showed in total 181,049 patients had their care postponed, this included more than 5,000 mental health and hundreds of community health appointments. The news comes after nursing and ambulance unions accepted a pay offer from the government, for a 5.3 per cent increase in 2023-24, which their members will now vote on. Read full story Source: The Independent, 18 March 2023
  3. News Article
    A woman was denied the chance to have children with her husband after a contraceptive coil was accidentally left in place for 29 years. Jayne Huddleston, from Crewe, had eight rounds of fertility treatment she did not need because the correct checks were not carried out by her doctor. She said the mistake happened in 1990. "The GP said it couldn't be seen, so I was sent for a scan and the scan didn't pick anything up, the GP recommended another coil was fitted," she told the BBC. She was told the coil she had fitted around a year earlier had probably fallen out. When she and her husband, David, then decided they wanted to have a child, the second coil was removed, but the first coil, which had gone undetected, remained inside her. They tried for years to have a baby, with no success, including IVF treatment which cost them thousands of pounds. The mistake was only discovered when she went for an X-ray in 2019 after complaining of back pain and the original coil was revealed. Mr and Mrs Huddleston were awarded a six-figure out of court settlement after taking their case to Irwin Mitchell solicitors. Read full story Source: BBC News, 16 March 2023
  4. News Article
    The disruption caused by the junior doctors' strike in England could take weeks to resolve, health bosses say. Tens of thousands of appointments and treatments, including cancer care, had to be cancelled during the three-day walkout. Patients with appointments coming up may see them cancelled to make room for high-priority cases hit by the strike. Hospitals are also reporting problems discharging patients from wards, as consultants were sent to cover A&E. Saffron Cordery, of NHS Providers, which represents NHS trusts, said the scale and length of the walkout, coupled with the fact it started on a Monday - traditionally the busiest day of the week - had made it more difficult than previous strikes by nurses and ambulance staff. "It will take weeks to recover - just rebooking patients who have treatments and appointments cancelled is a big job," she said. "Patients have to be individually prioritised - it may mean some patients with bookings in the coming weeks being pushed further back." Read full story Source: BBC News, 16 March 2023
  5. News Article
    The patient lay slumped next to a pile of pills and a personally signed note reading: 'do not resuscitate me'. His breathing was agonal, his skin mottled, his pupils fixed, no pulse discernible. The attending doctor, in agreement with both paramedics and family member, decided to respect his wishes. Yet, this GP was placed under investigation for gross negligence manslaughter by the Crown Prosecution Service (CPS) for not resuscitating the patient, setting in motion a sequence of investigations, including by the coroner and the General Medical Council (GMC), that were triggered by the statement of one policeman at the scene. All investigations and allegations were eventually dismissed but not until the GP had been through years of significant physical and mental stress. Still today, questions remain unanswered – in particular, concerning the actions of the police and the CPS. Speaking under the condition of anonymity, the GP spoke to Medscape News UK, and said that now, over 7 years after that fateful home visit, she remained resolute that she made the correct clinical decisions at the time. "It has all been very stressful for me. What was behind this case? What was driving this potential prosecution? And throughout, the patient, the family and their concerns were completely forgotten in the pursuit of so-called justice," she pointed out. Read full story Source: Medscape News, 9 March 2023
  6. News Article
    Ministers and NHS England have not sufficiently warned the public of the risk to patient harm posed by next week’s junior doctors strike, some of the NHS’s most senior trust chief executives have warned. The senior leaders contacted HSJ with their concerns after a group call between trust leaders and NHSE bosses on Thursday. The chief executives and medical directors, who spoke to HSJ on condition of anonymity, made a series of robust criticisms which focussed on the lack of awareness of danger presented by the junior doctor’s industrial action, a lack of thorough communication of that to the public, and the insistence that trusts negotiate strike agreement with the British Medical Association at a local level. One comment on the chat function stated: ”Public awareness of the impact of this strike seems far lower than for e.g. the ambulance strike, but from a an acute trust perspective this will have a much bigger impact on patient care and safety. Junior doctors’ are not newly qualified students - they are the backbone of day to day medical management in our services. I am concerned we might be giving false assurance about the quality of service we can offer next week.” Read full story (paywalled) Source: HSJ, 10 March 2023
  7. News Article
    In posts on two Facebook forums, GP Survival and Resilient GP, family doctors write anonymously, revealing their concerns about how hard they sometimes find it to get an ambulance to attend to a sick patient – and the risks that can pose. “I ended up in the back of a police car with sirens going with a stranger who’d had a probable stroke on the street. Category 2 ambulance hadn’t come after 45 minutes so flagged down a cop car. They bundled us in. “Emergency department full of waiting ambulances unable to unload and I eventually left him in the very capable hands of the stroke team. Terrifying how broken our system is and how many people had likely just walked past him before I spotted him from my car." “Our emergency care practitioner called an ambulance at 6pm on Wednesday 6 July. Very elderly gentleman. Off legs, urinary symptoms, not eating/drinking. Guess when crew arrived? This morning, Friday 8 July, around 10am – 40 hours [later]. And the ECP had to wait 35 minutes just for 999 call to be answered!” “I recently complained [to the local ambulance service] for first time ever when ambulance refused to take a very sick patient of mine into hospital that I’d assessed over the phone because ‘her obs are normal’. They weren’t but even if they had been the reliance on these alone, ignoring the medical background, the family history and my history was just wrong. “I then had to go out and see her, re-call 999 (with many hours additional delay) and she died after a few days in hospital.” Read full story Source: The Guardian, 9 March 2023
  8. News Article
    More than three years into the Covid pandemic, there are a host of important unanswered questions about Long Covid, which significantly limit healthcare providers’ ability to treat patients with the condition, according to US physicians and scientists. That vacuum of information remains as much of the US has moved on from the pandemic, while Covid long-haulers continue to face stigma and questions over whether their symptoms are real, providers say. “We don’t quite have our finger on the pulse of what’s wrong, what biologically is causing it, and that’s a big problem,” said Dr Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center. “It’s hard to direct drugs or treatments without having the biological underpinnings for why someone is feeling so fatigued with exercise.” In addition to the ambiguity around the root causes of Long Covid, there are also challenges in research because of how Covid can produce so many different symptoms. The Centers for Disease Control and Prevention list includes fatigue, respiratory issues and difficulty thinking or concentrating but also states that “post-Covid conditions may not affect everyone the same way”. “Everyone has a different constellation of symptoms,” said Dr Steven Deeks, an infectious disease specialist at the University of California, San Francisco. “Some people get better over time, some people wax and wane, some people get worse,” and so it is difficult for researchers to determine when a study should end and compare a drug versus a placebo. Read full story Source: The Guardian, 6 March 2023
  9. News Article
    A consultant has said that doctors were put under pressure by hospital management not to make a fuss when they raised concerns about nurse Lucy Letby. Dr Ravi Jayaram said his team first raised concerns about unusual episodes involving babies in October 2015 but nothing was done Ms Letby, 33, is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital between 2015 and 2016. He told the court the matter was raised again in February 2016 and the hospital's medical director was told at this point. The consultants asked for a meeting but did not hear back for another three months, the court heard. Ms Letby was not removed from front-line nursing until summer 2016. Dr Jayaram told jurors that he wished he had bypassed hospital management and gone to the police. He said: "We were getting a reasonable amount of pressure from senior management at the hospital not to make a fuss." Read full story Source: BBC News, 28 February 2023
  10. News Article
    Record levels of NHS staff are seeking mental health help as clinicians warn the “crisis” facing workers is “worse than the pandemic”. Hundreds of staff are being referred to the specialist mental health service, NHS Practitioner Health, with 842 workers referred in October 2022 – up from 534 in the same month the year before and 371 in 2020. Around 40% of the staff seeking the service are GPs and 50% are hospital doctors. The news comes as The Independent reported that the NHS and government are set to axe funding for 40 mental health hubs set up for health and social care workers following the pandemic. Amandip Sidhu, of Doctors in Distress, which offers workers mental health support, said: “Health workers believe that the crisis they are currently dealing with is worse than during the pandemic and exacerbated by the fact there is no end in sight, with little evidence that decision-makers are taking steps to improve the situation. “The fact that the public, their patients, lack sympathy or understanding is making many medics feel isolated and completely unappreciated.” Read full story Source: The Independent, 23 February 2023
  11. News Article
    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
  12. News Article
    Hundreds of thousands of operations and medical appointments will be cancelled in England next month and progress in tackling the huge care backlog will be derailed as the NHS prepares to face the most widespread industrial action in its history. Junior doctors are poised to join nurses and ambulance workers in mass continuous walkouts in March after members of the British Medical Association (BMA) voted overwhelmingly to take industrial action. In only the second such action in the 74-year-history of the NHS, junior doctors will walk out for 72 hours – continuously across three days, on dates yet to be confirmed – after 98% of those who voted favoured strike action. Amid an increasingly bitter row between health unions and the government, NHS leaders expressed alarm at the enormous disruption now expected next month. Read full story Source: The Guardian, 20 February 2023
  13. Content Article
    “Yes.” This was the dismaying response of consultant breast surgeon, Mr Hemant Ingle, when asked at a talk, hosted by the Centre for Health and the Public Interest (CHPI), whether he thought another scandal on the scale of that caused by Ian Paterson could unfold today. Disgraced breast surgeon Paterson is currently serving a 20-year sentence after unnecessarily operating on over 1,200 patients at NHS and private hospitals in the West Midlands area between 1997 and 2011. Three months into my first year of General Practice Specialty Training, I sat in that auditorium utterly stunned at Mr Ingle’s candour. Was it pessimism or devastating realism? Having watched the appalling events unfold in a screening of the ITV documentary ‘Bodies of Evidence: The Butcher Surgeon’, we were honoured to be joined by a panel of experts, including Debbie Douglas, one of the indescribably courageous patients who helped to expose Paterson. Over the next hour, the panel unpacked the factors deemed to have enabled Paterson’s actions, his potential motives and the consequences of the subsequent inquiry for society at large. It made for disturbing listening. Having trained entirely within the public sector, as all new medical graduates must do in the UK, I was completely ignorant to the circumstances within private hospitals which had catalysed Paterson’s reign of terror. I had no idea that private hospitals bore no responsibility for the patients treated within their walls, that doctors working in such hospitals often had no requirement to adhere to otherwise national guidance on healthcare provision, that private hospitals may have no facility to provide adequate emergency treatment to those suffering medical complications after procedures performed on their own premises. Before that evening, I had never before heard a patient state so heartbreakingly that they struggled to trust medical professionals. That disquieting symposium was not my first exposure to the sinister side of medicine. Seeking supplementary education in a field strikingly neglected in my own core undergraduate and postgraduate medical education, I had, just a few weeks before the CHPI event, joined a webinar hosted by the British Society of Sexual Medicine (BSSM). One of the presenters was a patient who had experienced first-hand the pernicious effects of vaginal mesh insertion. Whilst her story had a positive outcome, other vaginal mesh patients have not been so fortunate. Thousands of women continue to suffer from chronic pain, fatigue and urinary dysfunction, amongst countless other symptoms. Through subsequent investigations, it has emerged that vaginal mesh manufacturers had significant financial links to clinicians, researchers and Royal Colleges, and that side effects and complications were widely under-reported. Campaigns such as Sling The Mesh, founded by Kath Sansom, ensure that this landscape is changing, but it should not have come to this. I’m not sure how to feel any more. I’ve spent a lot of time with doctors over the last eleven years. At sixth form, I would send countless unsolicited emails to consultants at local hospitals, pleading for the chance to observe their surgeries, to shadow their ward rounds. Throughout university, I scribbled down every word of juniors, registrars, consultants, hoovering each crumb of knowledge that might make me the best doctor that I could be. Since I graduated in 2020, and started working as a Foundation Year Doctor in London, these professionals have become my peers, my colleagues, my 'bosses'. Whilst of course, some have been more personable, more welcoming, than others, I have thankfully never had the misfortune of encountering a character like Paterson. In Ipsos' 'Global Trustworthiness Index', most recently released in October 2021, doctors were ranked highest in 28 countries, with over 70% of UK respondents believing us to be the most reliable of all professionals. This was the mindset in which I trained; I felt comfortable and worthy of such an accolade. I want to be the person that patients can rely on at their most vulnerable, that relatives feel they can approach with any worry, large or small. To hear now that, for entirely good reason, the implicit confidence that the public had in their medical professionals is no longer a guarantee, made me feel rather unsteady. How do I feel about being part of a profession in which such deceit can go unchallenged? Do I want to be associated with 'experts' who fail to acknowledge the legitimate anxieties of their patients? I'm not going to leave medicine. Fortunately, the Patersons of the world are hugely outnumbered by respectable, conscientious, genuine, caring doctors – those that do earn the premier spot in an Ipsos poll. However, I do think that I have been naïve. Whilst Paterson’s actions are deplorable, a single ‘rogue’ surgeon can be dealt with. This is not to downplay the absolute devastation and anguish that he has caused his patients and their loved ones, and not to diminish the fact that his ousting took far too many attempts from those bold enough to question him, and not nearly enough support from those who should have held him accountable. It is the systemic failures which allowed Paterson to operate unmonitored, which enabled vaginal mesh surgeries to continue unchecked, which permitted side effects to go unrecorded, that I find so unsettlingly insidious. Whether these repeated failures in the healthcare system are underpinned only by financial motives, by greed, as seems the most obvious explanation, we may never know, and perhaps finding reason should not be our priority. As a doctor, my duty is to advocate. Fortuitously for themselves and those whom they are now able to advise and support, both Debbie Douglas and the patient featured in the BSSM webinar are intelligent, well-spoken, confident women. Others affected by the scandals mentioned here, and countless more that are not, may not be so well-equipped. Those who are perhaps older, less educated, who do not speak English as a first language, with other medical conditions rendering them less able to campaign, rely on others to do so on their behalf. This is only one piece of the jigsaw – in order for patients to request help, they must know who is able to help them, and must feel secure and empowered to ask for assistance. Similarly, doctors must feel emboldened in discussing issues with appropriate colleagues. This is not necessarily easy. A conversation after the CHPI panel discussion highlighted how GPs in particular, often mistakenly viewed as lesser doctors, may feel pressured to maintain respect for themselves within the medical profession and, thus, be reluctant to escalate patient concerns for fear of ridicule from secondary or tertiary care. It goes without saying that such anxiety should never alter the care we provide to patients. However, this perceived imbalance of medical aptitude, resulting in such a discrepancy in the level of esteem to which medical professionals are held, is just one example of a saddening toxic facet of the medical world. This is also reflected in the response to whistleblowers, both in the moment and through the lasting effect on a professional’s career, as exemplified by Mr Hemant Ingle speaking of the hospital that previously employed both himself and Paterson: “They don’t like me, of course they don’t”. Only by changing this mindset, and curating a more supportive, protective, transparent culture, where healthcare professionals of all levels and types can freely voice concerns, can we ever hope to avoid such disasters in the future. So, in real terms, what should I do as a training GP? Put simply, I must abide by the GMC’s ‘Duties of a Doctor’. Firstly, I must remain aware and knowledgeable of current biomedical and medicolegal affairs to ensure that I do not inadvertently, even if innocently, reassure or dismiss patient concerns through ignorance. Attending regular knowledge update courses and accessing appropriate journal articles are more formal avenues of learning, but I should supplement these by keeping abreast of health news in popular media, such that I may pre-empt problems with which patients may present. This is all with the understanding that I must never act beyond the limits of my competence and must never allow fear of criticism to prevent me from seeking advice, whether this is from more senior colleagues, supervisors or specialist doctors. For my patients, and indeed for colleagues who may come to me with their own queries, I should reciprocate by remaining approachable and sympathetic. My interactions with colleagues and patients alike should take place in a partnership model – while of course there are many times when hierarchy can be appropriate, I aspire to be the doctor who equips her patients to become experts in their own health and to advocate for themselves. I will strive to communicate with patients in formats appropriate to each individual. Once a patient has chosen to trust me, I must be mindful of the fact that trust can just as easily be lost as gained. I shall keep patient safety at the fore by following GMC guidance on raising and acting upon concerns, reporting any adverse effects of medication or treatment that are divulged to me, obeying my duty of candour if I believe a patient to have been placed at risk, not allowing any conflicts of interest to influence patient care, and acting with overarching honesty and integrity. Yes, another Paterson-level scandal could, and will almost certainly, unfold again. However, if I aspire to achieve each aim outlined above, I will indeed become the kind of doctor that sixteen-year-old me held in such high regard. Until we fix the system, all I can do is my best.
  14. News Article
    Two health watchdogs have issued safety warnings after junior staff were left to work unsupervised on maternity wards previously criticised after a baby’s death. Training regulator, Health Education England (HEE), criticised the “unacceptable” behaviour of consultants who left junior doctors to work without any superiors at South Devon and Torbay Hospital Foundation Trust’s wards. The maternity safety watchdog Healthcare Safety Investigation Branch (HSIB) also raised “urgent concerns” over student midwives and “unregistered midwives” providing care without supervision. The latest criticism comes after the trust was condemned over the death of Arabella Sparkes, who lived just 17 days in May 2020 after she was starved of oxygen. According to a report from December 2022, seen by The Independent, the HEE was forced to review how trainees were working at the trust’s maternity department after concerns were raised to the regulator. It was the second visit carried out following concerns about the department, and reviewers found there had been “slow progress” against concerns raised a year earlier. Read full story Source: The Independent, 16 February 2023
  15. News Article
    The number of GPs seeing patients outside standard surgery hours in Scotland has dropped by almost a quarter in three years. Nurses and paramedics have had to fill in for doctors in the out-of-hours urgent care centres because GPs could not be found to cover the shifts. Some health boards have had to close their centres and send patients to overstretched A&Es instead because of the GP shortage. Dr Andrew Buist, chairman of the British Medical Association’s Scottish GP committee, said, “Patient demand is outstripping GP capacity across the whole service, including out-of-hours. We simply do not have enough GPs in Scotland. Those who are working in out-of-hours may be doing more hours now than they perhaps did in 2019 which comes as no surprise if there are fewer GPs to go around but it is unsustainable and puts those working in the service at risk of exhaustion and burnout.” Read full story (paywalled) Source: The Times, 15 February 2023
  16. News Article
    A 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