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News Article
Half of UK public fear family would not be well looked after in care homes
Patient Safety Learning posted a news article in News
Trust in care homes has slumped, leaving half of the British public lacking confidence that friends or family would be well looked after. Nationwide polling for the Guardian revealed 9 out of 10 older people believe there are not enough care staff, and half have lost confidence in the standard of care homes since the start of the pandemic. The survey conducted by Ipsos this month follows a doubling in public dissatisfaction in the NHS and exposes deepening fears about the fitness of a social care sector that had its weaknesses exposed by Covid-19, which claimed 36,000 lives in care homes in England alone. The Relatives and Residents Association (RRA) said the polling tallied with calls to its helpline about the “harm and anguish caused by poor care and frustration at the inconsistency in standards”. “We must weed out the poor providers and invest in skills – care workers must become our most valued workers, not the least,” said Helen Wildbore, the RRA’s chief executive. “Tomorrow, any one of us could need them.” Read full story Source: The Guardian, 24 April 2023 -
News ArticleUnannounced and out-of-hours spot-checks on mental health services are set to ramp up following a string of abuse scandals, The Independent can reveal. The Care Quality Commission’s new mental health chief Chris Dzikiti said he was “saddened” by “unacceptable” scandals in the last six months, warning the regulator “will use the powers [it has] to hold people to account.” He said the organisation will be carrying out more unannounced inspections of providers, including inspections launched out of normal hours, with the aim to have the “majority” of spot-checks carried out this way. In his first interview since joining the regulator in November Mr Dzikiti, who is mental health nurse by background, said: “I talk to chief execs of mental health services, I talk about [how] as a regulator, we will use the power we have, when [we] see poor practice, we will definitely hold people to account. “In our inspection programmes, we are also increasing the unannounced inspections out of hours inspections, because we need to try and get really deep into the culture of mental health services, especially those areas where we think there’s a higher risk of poor practice. “I will not rest until we get people safe.” Read full story Source: The Independent, 24 April 2023
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News ArticleChronically ill patients across the UK allege they've had to go without vital medication amid delays by a private company contracted by the NHS to deliver drugs. In the last year alone, Sciensus was awarded NHS contracts worth more than £5 million, despite being placed into special measures by health regulators in 2021 following widespread delivery failings. ITV News has revealed that the CQC is currently reviewing whether to take further regulatory action against Sciensus, having been made aware of concerns about the company’s performance. The company, which is based in Burton-on-Trent and says it "works with every NHS Trust in the country", should provide a lifeline for those who rely on specialised medications. These include those with long-term conditions - like cancer, HIV, and haemophilia - which often require drugs that can't be collected from high street or hospital pharmacies. One new mother with rheumatoid arthritis said she was taken to A&E after Sciensus left her without medication for three weeks. The 37-year-old, who wishes to remain anonymous, told ITV News: "I was unable walk with a small baby... it was such a chronic flare that I couldn't walk, which I've never, ever had before in my life." Read full story Source: ITV News, 21 April 2023
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News Article
‘National improvement board’ to be set up by NHS England
Patient Safety Learning posted a news article in News
NHS England has launched a new framework for quality improvement and delivery, including a national board that will pick a “small number of shared national priorities”. The new document says NHSE will “establish a national improvement board, to agree the small number of shared national priorities on which NHS England, with providers and systems, will focus our improvement-led delivery work”. The review says NHSE will, among other actions: Create a “national improvement board” to “agree a small number of shared national priorities and oversee the development and quality assure the impact of the NHS improvement approach”. Set an expectation that all NHS providers, working in partnership with integrated care boards, will embed a quality improvement method aligned with the NHS improvement approach”. Incentivise a universal focus on embedding and sustaining improvement practice”, including with “regulatory incentives alongside clearer and more timely offers of support. Work with the [Care Quality Commission] to align the revised CQC well-led [inspection method] with the improvement approach. Read full story (paywalled) Source: HSJ, 21 April 2023 -
News Article
NHS plans new elective target after April deadline missed
Patient Safety Learning posted a news article in News
System leaders are discussing pushing back the NHS’s target to virtually eliminate 78-week breaches from the waiting list by this month to ‘June or July’, HSJ understands. The discussions come after the service missed its original targeted trajectory of clearing the backlog by this month, as first proposed in NHS England’s elective recovery plan last February, despite a steep reduction over the past 18 months. Internal NHS forecasts suggest there will be around just over 10,000 long waiters still on the waiting list by the end of April, as HSJ first revealed last month. Senior sources said this week that this figure remained a likely position for the end of the month. HSJ understands there has not been any official communication to trusts about pushing back the 78-week target, and it was not yet clear when the centre’s expectations would be finalised. Read full story (paywalled) Source: HSJ, 21 April 2023 -
News Article
NHS threatens legal action to block second day of nurses’ strike
Patient Safety Learning posted a news article in News
The NHS has launched a legal challenge that could end in the high court to block the second day of an upcoming strike by tens of thousands of nurses. Officials at NHS Employers wrote to the Royal College of Nursing (RCN) on Wednesday saying the union’s plans for a two-day strike were unlawful. In response, it is understood the RCN has said it will “forcibly resist” employers’ attempts to seek a high court injunction designed to block the strike, which they insist is lawful. The threat raises the possibility of a high court clash between NHS lawyers backed by the government and those of the nursing union. It also highlights the increasingly bitter relationship between the government and those representing workers on the frontline of the health service. Read full story Source: The Guardian, 20 April 2023 -
News Article
Top scientists warn ‘the next pandemic is coming and we’re not ready’
Patient Safety Learning posted a news article in News
The UK is not ready for the next global pandemic because public services are being dismantled and key research is being defunded, experts have claimed. More than three years after the global outbreak of coronavirus, top scientists have warned that the UK is no better prepared for a pandemic than it was in 2020. They say another epidemic on the scale of Covid-19 is inevitable, but that disinvestment in infection-monitoring services, dismantling of key infrastructure, and the state of the NHS mean the country is “losing ground”. Sir John Bell, a leading immunologist and a member of the UK’s Covid vaccine taskforce during the pandemic, said it was too easy to dismiss Covid-19 as a “once in a generation crisis”. Writing in The Independent, he warned that it is “a question of when, not if, another pandemic strikes”, adding that the nation needs to adopt an “always on” approach that includes building a more resilient healthcare system, carrying out better surveillance, and identifying future threats. Read full story Source: The Independent, 18 April 2023 -
News Article
Forty trusts are set elective target less ambitious than last year
Patient Safety Learning posted a news article in News
NHS trusts have been given targets to increase elective activity that range from 103% of pre-pandemic levels to nearly 130%, internal data seen by HSJ reveals. The wide gap between the targets, which are based on past performance and reflect the value of activity carried out, indicate the slow pace of recovery at many trusts last year. Forty trusts have been set the least ambitious target, to deliver 103% of pre-covid activity levels in 2023-24, including Leeds Teaching Hospitals, Barts Health, and University Hospitals Birmingham. All providers were supposed to deliver at least 104% of pre-covid activity last year, but few managed to achieve this, with emergency pressures, the impact of covid and flu, and workforce problems hampering efforts to ramp up activity. Amanda Pritchard has previously admitted the health service would have to “re-profile” the trajectory to achieving 130% of pre-covid activity levels by 2025. Read full story (paywalled) Source: HSJ, 20 April 2023 -
News ArticleHealthcare systems across Australia are buckling in the wake of COVID waves and the flu season. Pictures of ambulances piling up outside hospitals have become commonplace in the media. Known as “ramping”, it’s the canary in the coalmine of a health system. As a major symptom of a health system under stress, state governments across Australia are investing unprecedented amounts into ambulance services, emergency departments (EDs) and hospitals. South Australia has committed to an increased recruitment of 350 new paramedics. Likewise, New South Wales has committed to 1,850 extra paramedics. Victoria, meanwhile, has committed an additional A$162 million for system-wide solutions to counter paramedic wait times, on top of the A$12 billion already committed to the wider health system. This could begin to alleviate the system pressures that lead to ambulance ramping. But what happens when the paramedics return yet again to ED with another patient? Will they simply end up ramped again? We also need to consider better care in the community – and paramedics could play a role in this too. Read full story Source: The Conversation, 21 July 2022
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News Article
Hundreds of British people are needlessly going blind. Why?
Patient Safety Learning posted a news article in News
The backlog for ophthalmology appointments in England is the second-largest in the NHS, with UK eye doctors concerned about the number of patients losing sight unnecessarily. Their shock is palpable. How this could be happening in a rich country such as Britain? There are treatments for common blindness-causing conditions such as macular degeneration, but to get them patients must be able to access the service. And right now the NHS doesn’t have the capacity to deliver them in a timely way. As junior doctors’ unions – and possibly those of consultants and nurses – proceed with strike action, it’s easy to attack medical professionals with the question: “How many people are dying because of your actions?” The truth is that the entire system has been struggling, and people have been dying anyway because of system failures. Now add to this people living with disabilities that were preventable, such as going blind. When Labour was in power, it made a real effort, including with financial allocation, to reduce waiting-list times for non-emergency care. But since the Tories were elected in 2010, years of austerity and public-sector neglect – and the shifting of resources and wealthy patients into a lucrative and growing private sector – has meant that the NHS has been transformed from a robust, preventive healthcare service into an acute one. Its basic offering is now: “If you’re dying, we will save you.” Read full story Source: The Guardian, 19 April 2023 -
News ArticlePatients were left on trolleys for up to four days at a major NHS hospital where whistleblowers raised concerns over “unsafe” staffing levels, it has emerged. In a scathing report, the NHS safety watchdog said it found patients waiting on trolleys, in corridors and outside nursing bays at Good Hope and Heartlands hospital, run by the scandal-hit University Hospitals Birmingham NHS Foundation Trust. In one incident flagged by the Care Quality Commission (CQC), a patient’s skin ulcers had grown significantly worse while they waited for four days on a trolley without an appropriate mattress. At the time of the inspection, most patients had been waiting for more than two days on trolleys, according to the CQC. The inspection took place in December, after concerns were raised by patients and families over care. The CQC said staff told inspectors they’d been left in “unsafe situations” due to poor staffing. Read full story Source: The Independent, 19 April 2023
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News Article
Junior doctors’ April strike led to 195,000 NHS hospital cancellations
Patient Safety Learning posted a news article in News
Almost 200,000 hospital appointments and procedures in England were cancelled during last week’s junior doctors’ strikes, it has been revealed. There were 20,000 more appointments cancelled in the strikes that ran between 11 and 15 April than in the shorter strike in March, NHS England figures show. A total of 27,361 staff were not at work during the peak of the strikes, though the true figure could be higher as some workforce data was incomplete. The NHS’s national medical director, Prof Sir Stephen Powis, said the figures showed the “colossal impact of industrial action on planned care in the NHS”, with nearly half a million appointments rescheduled over the last five months. He said every postponed appointment had “an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days”. Read full story Source: The Guardian, 17 April 2023 -
News ArticleAn all-out nurses’ strike over the May bank holiday will present “serious risks and challenges” to the NHS, a health leader has warned. Sir Julian Hartley, chief executive of NHS Providers, said the “unprecedented” strike action – which will involve staff in emergency departments, intensive care units and cancer care for the first time – was “extremely worrying”. He also said the threat of coordinated industrial action with junior doctors could result in the “most difficult challenge” for the NHS to date. Sir Julian told BBC Breakfast: “If this takes place in the way that it’s been described, then it would be the first time that we’ve seen nurses not working in those key areas, which of course would present serious risks and challenges for trusts to manage and mitigate that.” Nick Hulme, chief executive of Ipswich and Colchester hospitals, told Radio 4 the latest round of nurses’ strikes will “significantly increase the risk to patients”, adding cancer patients will face greater risks as care could be delayed. He said: “If there is a delay to cancer care, some delays won’t cause significant effects, but there are many people who have been waiting far too long for care and this will only exacerbate that risk." Read full story Source: The Independent, 16 April 2023
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News Article
Deaths rise as junior doctors go on strike
Patient Safety Learning posted a news article in News
Junior doctors have been accused of putting “politics above patient safety” as figures showed excess deaths almost tripled after their strikes. Office of National Statistics (ONS) figures showed the number of deaths above average increased significantly in the two weeks during and after the first round of industrial action by the British Medical Association (BMA). Junior doctors walked out for 72 hours between March 13 and 15, with more than 175,000 appointments and operations cancelled. Health experts said the walkout around that time could be linked to the rise. A government source said: “The militant leaders of the BMA junior doctors committee seem willing to put politics above patient safety. They have adopted increasingly hardline tactics whilst demanding a completely unrealistic 35 per cent pay rise. Read full story (paywalled) Source: The Telegraph, 13 April 2023 -
News Article
Covid: Staff propped up care homes without extra pay, says report
Patient Safety Learning posted a news article in News
Many care home staff worked extra hours without extra pay to prop up the system during the pandemic, a study suggests. Public money helped stabilise UK care homes during the first wave of Covid-19 but it was withdrawn too soon and not focused on staff, says the research, led by Warwick Business School. The researchers studied the accounts of more than 4,000 UK care home companies, from just before the pandemic and during the first year of the health crisis. They found nearly two thirds (60%) of care homes were already financially fragile as the pandemic took hold. The report concludes: "The decision by government to end financial support for care home companies after the peak of the pandemic had passed has likely contributed to the current financial and operational difficulties experienced by the sector." It states the financial plight of many staff and the immense pressure they were under "means it is not surprising the care home sector has struggled to both recruit and retain staff once lockdown restrictions were removed and the wider economy re-opened". Read full story Source: BBC News, 12 April 2023 -
News Article
USA: For uninsured people with cancer, access to care can be "very random"
Patient Safety Learning posted a news article in News
Eighteen months after April Adcox learned she had skin cancer, she finally returned to Charleston's Medical University of South Carolina last May to seek treatment. Adcox had first met with physicians at the academic medical center in late 2020, after a biopsy diagnosed basal cell carcinoma. The operation to remove the cancer would require several physicians, she was told, including a neurosurgeon, because of how close it was to her brain. But Adcox was uninsured. She had lost her automotive plant job in the early days of the pandemic, and at the time of her diagnosis was equally panicked about the complex surgery and the prospect of a hefty bill. Instead of proceeding with treatment, she attempted to camouflage the expanding cancerous area for more than a year with hats and long bangs. If Adcox had developed breast or cervical cancer, she likely would have qualified for insurance coverage under a federal law that extends Medicaid eligibility to lower-income patients diagnosed with those two malignancies. For female patients with other types of cancer, as well as pretty much all male patients, the options are scant, especially in South Carolina and the 11 other states that haven't yet implemented Medicaid expansion, according to cancer physicians and health policy experts who study access to care. In the face of potentially daunting bills, uninsured adults sometimes delay care, which can result in worse survival outcomes, research shows. The odds of patients getting insurance to help cover the cost of treatment play out a bit like a game of roulette, depending upon where they live and what type of cancer they have. "It is very random — that's, I think, the heartbreaking part about it," said Dr. Evan Graboyes, a head and neck surgeon and one of Adcox's physicians. "Whether you live or die from cancer shouldn't really be related to what state you live in." Read full story Source: CBS News, 7 April 2023 -
News Article
Tory ‘neglect’ blamed for 3.6m abandoned calls to NHS 111 in England
Patient Safety Learning posted a news article in News
Patients contacting NHS 111 in England are having to wait so long for medical help that they are abandoning millions of calls, with 3.6m ditched in the past 12 months, official figures reveal. The national helpline service is supposed to make it quicker and easier for patients to get the right advice or treatment they need, either for their physical or mental health. It is billed as being open 24 hours a day, seven days a week. However, analysis by the House of Commons Library, commissioned by the Liberal Democrats, shows callers are waiting so long to speak to someone that nearly one in five give up. In 2022, 3,682,516 calls to NHS 111 were abandoned. MPs said the “dire” figures exposed how the NHS had reached “breaking point” after years of “neglect and underfunding” by the government. The data suggests that, on average, more than 10,000 callers hang up every day without receiving medical advice or treatment. As well as being distressing for those who are unwell, abandoned NHS 111 calls pose a risk to patient safety. The problem also increases pressure on other urgent care services as people seek care elsewhere. Read full story Source: The Guardian, 10 April 2023 -
News Article
‘He tarnished my reputation’: whistleblower demands action against CQC accuser
Patient Safety Learning posted a news article in News
A former adviser for the Care Quality Commission (CQC) has called on the regulator to explain what action it has taken against the officials responsible for wrongly dismissing him after he raised whistleblowing concerns. Shyam Kumar, a surgeon who was part of inspection teams in the North West, told HSJ that he had to live with question marks over his reputation for several years. He is furious that a senior CQC official sought to question his honesty and integrity in evidence submitted to the employment tribunal examing his dismisal. The tribunal heard Mr Kumar had raised a number of whistleblowing disclosures to the CQC, including concerns about the lack of appropriate expertise on inspection teams. After a wide-ranging review around its handling of whistleblowing concerns, CQC chief executive Ian Trenholm last week apologised to Mr Kumar for “unacceptably poor treatment” by his organisation, and thanked him for contributing to the review. However, Mr Kumar told HSJ: “I’m glad the CQC has looked at this and finally acknowledged what they did to me was wrong. But I want to know what has happened to the individuals that were responsible.” Read full story (paywalled) Source: HSJ, 6 April 2023 -
News Article
NHS patient 'stuck in hospital with months to live'
Patient Safety Learning posted a news article in News
A woman who may only have months to live has told the BBC she is "angry and frustrated" at being in hospital five months after being cleared to go home. Charlotte Mills-Murray, 34, said attempts to organise care at her family home had been repeatedly delayed. Charlotte lives with intestinal failure caused by a severe form of Ehlers-Danlos syndrome, which weakens her body's connective tissue. She was admitted to St James's Hospital in Leeds in June 2022 following an infection, and a new Hickman line - a tube that allows feeding and the administering of pain relief - was inserted. By November, Charlotte was told she was well enough to be cared for at home, but she remains in hospital following delays in the hiring and training of staff able to support her. With limited access to a hoist which would enable her to use her wheelchair, Charlotte said she had spent 10 months "stuck in bed". Because of the complexity of her condition, Charlotte only has months to live. She believes her situation merits greater urgency because of the increased risk of infection in hospital. Charlotte qualifies for 24-hour home care support through the NHS Continuing Healthcare scheme, but she said decisions over how this would be put in place had been slow and unclear. The BBC has found a 16% rise over the past year in the number of patients in England who are in hospital despite being well enough to leave. The Department of Health and Social Care said it was "fully committed to speeding up the safe discharge of patients who no longer need to be in hospital" and was making £1.6bn available in England over the next two years to support this, on top of £700m of extra funding in 2022 to ease NHS pressures over the winter. Read full story Source: BBC News, 9 April 2023 -
News Article
Junior doctors’ strike will have ‘catastrophic impact’ on waiting lists
Patient Safety Learning posted a news article in News
The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said. Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”. “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid." He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.” He called on the public to use NHS services responsibly. Read full story Source; The Guardian, 10 April 2023 -
News Article
NHS England should scrap many of its national targets, review says
Patient Safety Learning posted a news article in News
The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary. The study by Patricia Hewitt, commissioned by the government said that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective. It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times. The review sets out new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff. It adds that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”. Read full story Source: The Guardian, 3 April 2023 -
News Article
NHS England warns against block cancellations during ‘unprecedented’ strikes
Patient Safety Learning posted a news article in News
NHS England has told trust, system and regional leaders to avoid “block rescheduling” of elective cases during the four-day junior doctors’ strike next month. In a letter sent by national medical director Sir Steve Powis and NHSE’s chief operating officer Sir David Sloman, NHS leaders are asked instead to use “rolling day-to-day cancellations” and reschedule cases “based on clinical risk”. The letter also urges leaders to maintain “as much day case and outpatient capacity as possible” and to use digital or virtual consultations to support outpatient delivery. However, it acknowledges that because of the “unprecedented scale and timing of these strikes we accept that rescheduling activity is going to be essential to minimise risks to patients”. Read full story (paywalled) Source: HSJ, 31 March 2023 -
News Article
Thousands of children in England facing ‘unacceptable’ NHS delays
Patient Safety Learning posted a news article in News
Thousands of children experiencing “unacceptable” long waits for NHS treatment face a “lifelong” impact on their health, a senior doctor has warned, as shocking figures reveal that nearly 15,000 paediatric operations were cancelled over the last year. Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said the mounting treatment backlog in England risked “serious” and “devastating” physical and mental consequences for children and their families. She sounded the alarm as data obtained under freedom of information laws by the Liberal Democrats showed that a record high 14,628 children’s operations were postponed in 2022, up from 11,870 the year before and the highest in five years of data examined. Some children have now waited several years for surgery, according to the data. Delaying a child’s operation risks having a “lifelong impact” on their development, Kingdon said, and also “seriously impact” their mental health, with knock-on effects on their ability to socialise, go to school and reach their full potential. Read full story Source: The Guardian, 3 April 2023 -
News ArticleExhausted after three sleepless days in labour, Jane O’Hara, then 34, screamed and burst into tears when the midwives and doctors at Harrogate District Hospital told her the natural birth she wanted was not going to happen. She ended up needing life-saving surgery and 11 pints of blood after a severe haemorrhage. Mercifully, Ivy was fine and is now a healthy 12-year-old. In recent weeks, the NHS has been rocked by the conclusions of an inquiry into the worst maternity disaster in its history: 201 babies and nine mothers died and another 94 babies suffered brain damage as a result of avoidable poor care at Shrewsbury and Telford Hospital NHS Trust. This has been linked to a culture of promoting natural — that is, vaginal — birth and avoiding caesarean sections. Blame thus far has been aimed largely at the NHS — but parents have started speaking out online about what they believe has been the role of the National Childbirth Trust (NCT), a leading provider of antenatal classes in Britain, in promoting vaginal births. “I can absolutely point to key decisions that I made that were influenced by the NCT’s mantra. I was led into a position where I believed I had more control over my birth than I actually did,” says O’Hara, who is now a professor of healthcare quality and safety at the University of Leeds. She believes she was a victim of a “normal birth” ideology that was heavily promoted at the NCT classes she attended. Read full story (paywalled) Source: The Times, 10 April 2022
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News ArticleThe leaders of University Hospitals Birmingham (UHB) must acknowledge and seek to tackle the organisation’s pervasive bullying culture, and those who cannot may need to leave, the lead author of its patient safety review has warned. In an interview with HSJ, Mike Bewick said humility is required to address major cultural issues identified through conversations he had with senior medics and former employees. Professor Bewick’s overall view was that UHB was a “safe” place to receive care, but his team had been “disturbed” by consistent reporting of a bullying culture. Professor Bewick wrote in his report that even during his six-week review, initial goodwill from the trust had “dissipated”, adding his team has seen an organisation that is “culturally very reluctant to accept criticism”. Speaking to HSJ, he acknowledged there were people within UHB who do not accept cultural problems, adding: “I would hope they see the right thing to do is to accept [they] didn’t get everything right, to do a bit of mea culpa, have some humility, and move on. Because I don’t think there’s necessarily a place for people who can’t move on.” Read full story (paywalled) Source: HSJ, 28 March 2023
