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Found 2,344 results
  1. News Article
    NHS guidance which often forces pregnant women who test positive with coronavirus to give birth alone is legally wrong, lawyers warned. Official guidance drawn up by NHS England states that if a woman tests positive for Covid, their husband or partner must self-isolate at home and is not allowed to support them during childbirth. But campaigners and lawyers told The Independent their guidance for visitor restrictions in maternity services during the pandemic is legally inaccurate as people have the “right to private and family life” under Article Eight of the Human Rights Act. Maria Booker, of Birthrights, a leading maternity care charity, said: “The NHS oversimplifies the government’s self-isolating Covid regulations and tells partners they have to stay at home. But this hasn’t taken into account the legal nuance that government rules state people can leave home if they have a reasonable excuse." “A woman being anxious about giving birth alone, which most people will be, is likely to legally constitute as a reasonable excuse." “It is completely inhumane for a woman to give birth without a partner or supporter. It is even scarier giving birth alone you are Covid positive. It is terrifying. Nobody should give birth alone and that includes Covid positive women.” Read full story Source: The Independent, 13 February 2021
  2. News Article
    The backlog of patients who have been waiting for cancer treatment for more than 104 days has more than doubled since last year, according to internal NHS England papers seen by HSJ. At the start of February, the backlog of cases already at more than 15 weeks had hit 6,109, compared to 3,000 at the same point in 2020. National targets state cancer patients should be treated with 62 days of being referred. In the North West region, the backlog has nearly tripled over the same time period, from 289 to 831 (see regional breakdown below). Senior sources told HSJ the increase had been largely driven by acute providers in Greater Manchester and Merseyside. Cases in which patients have to wait more than 104 days for treatment are generally considered serious breaches, and typically trigger a process to identify if the delay has caused harm to the patient. Some local systems have declared a “zero tolerance” for such instances. The data in the papers is provisional. Michelle Mitchell, Cancer Research UK’s chief executive, said the impact of covid-19 on cancer patients has been “devastating”. She added: “The government must urgently make sure the NHS gets the funding it needs to increase cancer service capacity, and give every person with cancer the timely diagnosis and treatment they deserve.” Read full story (paywalled) Source: HSJ, 13 February 2021
  3. News Article
    People with learning disabilities have been given do not resuscitate orders during the second wave of the pandemic, in spite of widespread condemnation of the practice last year and an urgent investigation by the care watchdog. Mencap said it had received reports in January from people with learning disabilities that they had been told they would not be resuscitated if they were taken ill with COVID-19. The Care Quality Commission (CQC) said in December that inappropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices had caused potentially avoidable deaths last year. DNACPRs are usually made for people who are too frail to benefit from CPR, but Mencap said some seem to have been issued for people simply because they had a learning disability. The CQC is due to publish a report on the practice within weeks. The disclosure comes as campaigners put growing pressure on ministers to reconsider a decision not to give people with learning disabilities priority for vaccinations. There is growing evidence that even those with a mild disability are more likely to die if they contract the coronavirus. Read full story Source: The Guardian, 13 February 2021
  4. News Article
    A new trial is to test how well the Oxford-AstraZeneca coronavirus vaccine works in children. Some 300 volunteers will take part, with the first vaccinations in the trial taking place later in February. Researchers will assess whether the jab produces a strong immune response in children aged between six and 17. The vaccine is one of two being used to protect against serious illness and death from Covid in the UK, along with the Pfizer-BioNTech jab. As many as 240 children will receive the vaccine - and the others a control meningitis jab - when the trial gets under way. Andrew Pollard, professor of paediatric infection and immunity, and chief investigator on the Oxford vaccine trial, noted that most children were relatively unaffected by Covid and were unlikely to become unwell with the virus. But he said it was important to establish the safety and immune response to the vaccine in children and young people as some children might benefit from vaccination. Read full story Source: BBC News, 14 February 2021
  5. Content Article
    The coronavirus has a high incidence of patients with severe acute respiratory syndrome (SARS). Many patients infected with COVID-19 need to be admitted to the ICU for invasive ventilation. They are also at a high risk of developing secondary, ventilator-associated pneumonia (VAP).
  6. Content Article
    In a BMJ interview, former health secretary Jeremy Hunt tells Gareth Iacobucci his regrets from his time in charge, how they made the pandemic worse, and why this has fuelled him to be so outspoken since.
  7. Content Article
    More than 1·8 million lives have been lost due to COVID-19. Two frontrunner vaccines from Moderna and Pfizer-BioNTech promise some relief, with data suggesting 95% efficacy,1 and have been granted emergency use authorisations in several countries. In an open letter responding to these developments, participants in COVID-19 vaccine trials argued that those who received placebos should be unmasked and given priority access to authorised vaccines. The letter cited the American Medical Association's Code of Medical Ethics, which highlights the importance of minimising the time research participants spend in a placebo group. Fulfilling these requests could help to foster trust in medicine and research, reward those who take risks for the many, and prevent future harm from COVID-19 for these participants. However, granting these requests also comes with tradeoffs and highlights competing interests inherent in vaccine development. Importantly, these requests also reveal shortcomings in bioethical resources, particularly clinical equipoise conceptualisations. Friesen et al. discuss this further in this Lancet correspondence.
  8. Content Article
    The scale of the emergency response to the COVID-19 pandemic has been extraordinary, but what comes next? The King's Fund spoke with people involved in response efforts for disasters from around the world, from the Christchurch earthquakes in New Zealand to the Grenfell Tower fire in London, to understand what the health and care system can learn from the experience of recovery from other disasters as it responds to the pandemic.
  9. News Article
    The NHS must have a realistic and steady approach to resuming services disrupted by the pandemic that explicitly recognises the need for staff to recover, NHS leaders have said. In a letter to the prime minister leaders from the NHS Confederation, which represents healthcare providers, warned, “The NHS cannot recover its services at the same rate of increase when staff are so exhausted.” The letter noted that there were over 5000 more patients with COVID-19 in UK hospitals right now that at the peak of the first wave and that this was taking its toll on staff. The leaders called for sustained local mental health support for the NHS workforce beyond the end of March and for a long term, fully funded plan to increase staffing numbers. The government must also set out clear expectations for the public on when routine procedures and other treatments would be fully back on line, they added. “With a workforce on its knees and many of the pre-pandemic challenges still very much at play they need your government both to acknowledge the consequences of the immense pressure their workers have been under so far, and to be realistic and honest with the public about what the NHS can safely deliver moving forward,” the letter said. Layla McCay, director of policy at the NHS Confederation, said that while health leaders would continue to prioritise urgent care and patients with the greatest clinical need, the prime minister must “be upfront with the public about what the NHS can safely deliver in this next phase.” Read full story Source: The BMJ, 11 February 2021
  10. News Article
    The number of patients in critical care grew at one in four English hospital trusts in the past week, despite overall covid-19 occupancy falling, HSJ can reveal. It comes with adult critical care occupancy still very high in many areas — 10 trusts still have at least double the number of patients that they normally have space for. It highlights the ongoing pressure still on hospitals, with the prime minister due to decide in coming days on a timetable for loosening lockdown. HSJ analysis of NHS sitrep data shows that 31 trusts (of a total 125 general acute trusts) saw the number of critically ill adults climb between 2 and 9 February. Twenty-five of these trusts were either at or above their total capacity available last winter. The critical care units still seeing increasing pressure when compared to last year are spread nationally, but are predominantly in Yorkshire, Midlands and the North West, where the covid third wave peaked later. Read full story (paywalled) Source: HSJ, 11 February 2021
  11. News Article
    Nearly 6 out of every 10 people who died with coronavirus in England last year were disabled, figures suggest. Some 30,296 of the 50,888 deaths between January and November were people with a disability, Office for National Statistics (ONS) data shows. It also suggests the risk of death is three times greater for more severely disabled people. Charities have called for urgent government action, describing the data as "horrifying and tragic". The ONS figures suggest disabled people were disproportionately affected by the pandemic - accounting for 17.2% of the study population but nearly 60% of coronavirus deaths. Among women, the risk of death involving coronavirus was 3.5 times greater for more-disabled women - defined as having their day-to-day activities "limited a lot" by their health - compared with non-disabled women. For less-disabled women, defined as having their day-to-day activities "limited a little", the risk was two times greater. Compared to non-disabled men, the data showed that the risk was 3.1 times greater for more-disabled men, and 1.9 times greater for less-disabled men. Looking at people with a medically diagnosed learning disability, the risk of death involving Covid was 3.7 times greater for both men and women compared with people who did not have a learning disability. Read full story Source: BBC News, 11 February 2021
  12. News Article
    A drug used to treat rheumatoid arthritis could cut the number of Covid deaths and speed up recovery, a new scientific trial has found. The drug, tocilizumab, could save the lives of one in 25 coronavirus patients in hospital and reduce the need for ventilators in intensive care. Researchers say around half of the people admitted to hospital with coronavirus could benefit from the treatment. Scientists from the nationwide Recovery trial said when tocilizumab was given alongside the steroid dexamethasone, it reduced the absolute risk of mortality by four percentage points. The medicine was already being used by the NHS to treat some coronavirus patients after early results last month showed it reduced the risk of death as well as time spent in hospital by up to 10 days. As a result of the latest findings, the health secretary said the drug would be made more widely available on the NHS to help treat Covid patients. Read full story Source: The Independent, 11 February 2021
  13. Content Article
    The COVID-19 pandemic has caused unprecedented morbidity, mortality and global disruption. Following the initial surge of infections, focus shifted to managing the longer-term sequelae of illness in survivors. ‘Post-acute COVID’ (also known as ‘Long COVID’) is emerging as a prevalent syndrome. It encompasses a plethora of debilitating symptoms (including breathlessness, chest pain, palpitations and orthostatic intolerance) which can last for weeks or more following mild illness. Dani et al. describe a series of individuals with symptoms of ‘Long COVID’, and posit that this condition may be related to a virus- or immune-mediated disruption of the autonomic nervous system resulting in orthostatic intolerance syndromes. They suggest that all physicians should be equipped to recognise such cases, appreciate the symptom burden and provide supportive management. They present our rationale for an underlying impaired autonomic physiology post-COVID-19 and suggest means of management.
  14. Content Article
    In The Lancet correspondence, Norton and colleagues on behalf of the ISARIC and GloPID-R Long COVID Forum Working Group, write following an international, multistakeholder forum, in which peoples’ voices were central, to expand the call to action and to identify how we can prevent long COVID from becoming the long-lasting legacy of COVID-19.
  15. Content Article
    The outbreak of COVID-19 changed everything, for everyone, across the globe. New ways of working and every day challenges were a reality for us all, none more so than for key workers.  But the pandemic also highlighted the role whistleblowing plays in all of our lives and the perils of not listening to whistleblowers and their concerns. From the late Wuhan doctor, Dr Li Wenliang, who selflessly tried to warn of the dangers of the coronavirus outbreak (and was later reprimanded for his “false comments”), to our own NHS staff and care home workers speaking out about PPE safety concerns and working conditions, and the furlough fraud crisis, whistleblowing has been centre-stage during COVID-19. This report from Protect considers the concerns whistleblowers raised with our Advice Line in the first six months of lockdown in the UK (March - September 2020). 
  16. News Article
    People previously admitted to hospital or needing "continuous or repeated" steroid use because of asthma are to be prioritised for the Covid vaccine. The most severe cases will fall into priority-group four, the "clinically extremely vulnerable", who should have received a letter advising they shield. And the government has now confirmed the rest who meet the above category will be included in group six, the clinically "at risk", including some but not all those usually eligible for a free flu jab. It follows patients' calls for clarity. The government said it was following independent experts' advice. Read full story Source: BBC News, 11 February 2021
  17. News Article
    More than 100,000 people were waiting for ‘urgent’ priority two operations in late January, as planned care rates plummeted amid the covid third wave, according to NHS data seen by HSJ. However, the rate of elective procedures carried out last month appears to have been a lot higher than in the spring wave of coronavirus, despite there being more covid patients in hospital this time. In the three weeks to 20 December, the NHS was reporting around 110,000 day cases and 18,000 planned overnight admissions each week. But during January these totals dropped to around 85,000 day cases and 10,000 planned overnight admissions per week. This equates to a reduction of 23% and 44%, respectively. Regions that were more severely impacted by the third wave of coronavirus saw steeper reductions as covid pressures forced staff working in routine care services to be redeployed. In London and the South East, day case activity reduced by around 40% between the same periods, while elective overnight admissions fell by around 57%. Read full story (paywalled) Source: HSJ, 10 February 2021
  18. News Article
    The MP leading an investigation into coronavirus fears long Covid could cost the UK around £2.5 billion a year. Layla Moran believes the emerging crisis is comparable to the impact rheumatoid arthritis has on the health service, with hundreds of thousands of people expected to be dealing with the condition for months. The ONS says around one in ten people who test positive will go on to develop long Covid, a catch all term to describe a host of ongoing symptoms in coronavirus patients. More than 1.7 million COVID-19 infections have been reported since Christmas Day in the UK. Speaking exclusively to Metro.co.uk, Ms Moran – who chairs the All Party Parliamentary Group (APPG) on coronavirus, said: "The amount of money that we are expecting to spend long term on long Covid could be similar to rheumatoid arthritis. How many people know someone with rheumatoid arthritis? It is going to be higher for long Covid." Read full story Source: The Metro, 10 February 2021
  19. Content Article
    During the first wave of the COVID-19 pandemic in England, several population characteristics were associated with an increased risk of death from the virus, including age, ethnicity, income, deprivation, care home residence and housing conditions. Public health agencies wanted to understand how these vulnerability factors were distributed across their communities.  Daras et al. from the NIHR Applied Research Collaboration North West Coast (NIHR ARC NWC) analysed 6,789 small areas in England and assessed the association between COVID-19 mortality in each area and five vulnerability measures relating to ethnicity, poverty, and prevalence of long-term health conditions, living in care homes and living in overcrowded housing. They developed a Small Area Vulnerability Index (SAVI) modelling tool, which forecasts the vulnerability of the local population to the virus.  The data identified noticeably higher levels of vulnerability to COVID-19 clustered within specific communities in the North West, West Midlands and North East regions.
  20. News Article
    Elective activity levels were significantly lower in January than were achieved before Christmas, according to provisional NHS data seen by HSJ. In the three weeks to 20 December, the NHS was reporting around 110,000 day cases and 18,000 ordinary admissions each week. But during January these totals dropped to around 85,000 day cases and 10,000 ordinary admissions per week. This equates to a reduction of 23% and 44%, respectively. Regions that were more severely impacted by the third wave of coronavirus saw steeper reductions as covid pressures forced staff working in routine care services to be redeployed. In London and the South East, day case activity reduced by around 40 per cent between the same periods, while ordinary admissions fell by around 57%. Data for the Christmas fortnight was discounted, as activity always falls dramatically in this period. However, the activity levels in January appear to be significantly higher than those reported in the first wave of coronavirus in the spring. Read full story (paywalled) Source: HSJ, 10 February 2021
  21. News Article
    Care home staff were without personal protective equipment (PPE) early in the pandemic because the government prioritised the NHS, MPs have said. The Commons Public Accounts Committee said care homes received only a fraction of the PPE needed compared with the health service. It said social care "was only taken seriously after the high mortality rate in care homes became apparent". The government said it worked "tirelessly" to provide PPE. The report from the Public Accounts Committee said many healthcare workers were put in an "appalling situation" where they had to care for people with Covid-19 or suspected Covid-19 "without sufficient PPE to protect themselves from infection". It said the social care sector did not receive "anywhere near enough" to meet its needs. Health and social care staff suffered PPE shortages, it said, with some forced to reuse single-use items as stocks ran "perilously low". Read full story Source: BBC News, 10 February 2021
  22. Event
    until
    This Westminster Health Forum event discusses key priorities and next steps for improving older people’s care. The conference will be an opportunity to assess the management of care through the pandemic and the policy support required to tackle the critical challenges currently being faced around community support, integrated care, and managing and preventing long-term conditions. Areas for discussion include: progress on integrated care systems and on community care rollout of urgent rapid response teams and reducing the length of hospital admissions delivery of care during the COVID-19 crisis, and the vaccination programme digital remote management of long term conditions self-funding of older people’s care prevention, including weight management service tackling loneliness. Register
  23. Event
    until
    This Westminster Health Forum event will examine the key policy priorities for tackling health inequalities in the national recovery from COVID-19. Includes a keynote contribution from Professor Sir Michael Marmot, Professor of Epidemiology and Director, Institute of Health Equity, University College London. Key areas for discussion will also include: research and evidence - understanding the impact of the pandemic on inequalities and key challenges it has highlighted, and the use of data and population health approaches policy priorities - including investment and cross-government coordination tackling variation - supporting vulnerable communities, addressing regional imbalances, and tackling digital exclusion initiatives at a local level - place-based working, healthy communities, and the role of health service networks, local authorities, the third sector, and community groups. Register
  24. News Article
    Tens of thousands of nurses across the UK have not had their first coronavirus vaccine, sparking fears that they could contract COVID-19 or infect patients. A Royal College of Nursing (RCN) survey of 24,370 nurses found that 85% had had at least one dose, with the remaining 15% unvaccinated. The findings show that the government is in danger of failing to deliver one of the main elements of its pledge that all 15 million Britons in the top four priority groups for immunisation – which includes all health and social care staff – should have been offered a first shot by next Monday, 15 February. “It is extremely worrying that, as our survey suggests, many thousands of nursing staff have yet to be given their COVID-19 vaccine less than a week before the government’s deadline,” said Dame Donna Kinnair, the RCN’s chief executive and general secretary. “With only days to go, every effort must be made to reach all nursing staff to ensure their protection and that of the patients and vulnerable people they care for.” Read full story Source: The Guardian, 9 February 2021
  25. News Article
    One in three Covid patients put on a ventilator experience extensive symptoms of post-traumatic stress disorder (PTSD), according to research, which adds to mounting evidence of the virus’s impact on mental health. The study of 13,049 patients with confirmed or suspected coronavirus, by Imperial College London and the University of Southampton, found that one in five who were admitted to hospital but did not require a ventilator also experienced extensive symptoms of PTSD. The most common PTSD symptom experienced by COVID-19 patients was intrusive images, sometimes known as flashbacks. Examples of these could be images of the intensive care unit (ICU) environment, ICU doctors wearing full personal protective equipment or other patients in the ICU. The study, published in the Royal College of Psychiatrists’ BJPsych Open, on Tuesday, found lower levels of extensive symptoms of PTSD for patients given medical help at home (approximately one in six) and patients who required no help at home but experienced breathing problems (one in ten). Dr Adam Hampshire, from Imperial College London, said: “We can see that the pandemic is likely to be having an acute and lasting impact, including for a significant proportion of patients who remained at home with respiratory problems and received no medical help. This evidence could be important for informing future therapy and reducing the long-term health burden of this disease.” Read full story Source: The Guardian, 9 February 2021
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