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Content ArticleIn this blog post, Charlotte Augst looks at the impact of the Lucy Letby conviction on views of patient safety and accountability. The case has brought debates about patient safety into the mainstream media and public consciousness, and rather than focus simply on one extreme case, she believes it is important to look into common patterns in the NHS that lead to harm. She highlights that while such an awful case—where a healthcare professional caused deliberate harm to the most vulnerable patients—is shocking, it is also rare. She outlines a need to focus on the systemic issues that are resulting in repeated harm to patients, particularly in maternity services. Patients continue to be harmed because of rifts between management and clinical staff, the inability of the healthcare and regulatory system to really listen to patients, systemic discrimination and cognitive bias. Charlotte argues that while we may find ourselves focusing on the character of a nurse who committed such heinous crimes, we need to pay equal attention to the normalised behaviours and attitudes that harm patients and take place every day throughout the NHS.
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NHS Scotland to improve patient safety through 'compassionate communication'
Patient Safety Learning posted a news article in News
A study conducted by NHS Education for Scotland and Health Improvement Scotland found patients felt safer by having someone listen to their experiences after adverse events. The findings were published in the BMJ and have been positively received by NHS boards across the country. Healthcare Improvement Scotland’s Donna Maclean said: “The compassionate communications training has seen an unprecedented uptake across NHS boards in Scotland, with the first two cohorts currently under way and evaluation taking place also.” Clear communication and a person-centred approach was seen as being central to helping those who have suffered from traumatic events. Researchers found many said their faith was restored in the healthcare system if staff showed compassion and active engagement. This approach is likely to enhance learning and lead to improvements in healthcare. Health boards were advised that long timelines can have a negative impact on the mental health of patients and their families. Rosanna from Glasgow, who was affected by an adverse event, said: “I believe this study and its findings are crucial to truly understanding patients and families going through adverse events. “Not only does the study capture exactly what needs to change, but it also highlights the elements that are most important to us: an apology and assurance that lessons will be learnt is all we really want. Read full story Source: The National, 30 May 2022- Posted
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North East Ambulance Service: Cover-up claims to be probed by government
Patient Safety Learning posted a news article in News
The government is to investigate claims an ambulance service covered up details of the deaths of patients following mistakes by paramedics. It follows the Sunday Times report that North East Ambulance Service (NEAS) withheld information from coroners. Labour's shadow health secretary Wes Streeting described the alleged cover-up as "a national disgrace". Health minister Maria Caulfield said she was "horrified" and there would be a further investigation. The newspaper reported that concerns were raised about more than 90 cases and whistleblowers believed NEAS had prevented full disclosure to relatives of people who died in 2018 and 2019. Speaking in the House of Commons, Mr Streeting asked why the regulator - the Care Quality Commission (CQC) - had failed to take action. Ms Caulfield said that while both the NEAS and the CQC had both reviewed the allegations, further investigation was required. The minister said non-disclosure agreements have "no place in the NHS", adding: "Reputation management is never more important than patient safety." Read full story Source: BBC News, 23 May 2022- Posted
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Website to show NHS delays
Patient Safety Learning posted a news article in News
A website that tells patients how long they are likely to wait for NHS treatment will be made available in Scotland this summer. Humza Yousaf, the Scottish health secretary, said people queuing for tests and procedures and their doctors would be able to access information about any delays in their area using the software. Many patients living in pain are waiting years to have common operations such as hip and knee replacements. In theory, the SNP guarantee hospital treatment within 12 weeks of patients joining the waiting list, but this law was broken extensively before the pandemic and has now been breached hundreds of thousands of times. One orthopaedic surgeon, who did not wish to be named, said he was operating on patients whose joints had entirely collapsed after a two-year wait for a limb replacement made their case an emergency. Other patients who did not reach crisis faced even longer delays, he said. Dr Sandesh Gulhane, a GP and health spokesman for the Scottish Conservative Party, asked Yousaf, during a meeting of the Scottish Parliament’s health committee yesterday: “Why can’t we have in the future, in the [recovery] plan, indicative waiting times which are relatively live so we can all go on a website and see how long we need to wait.” Yousaf said it was fair for patients and NHS staff to expect to have information on waiting times, and that a website to provide this was being developed. “We are working closely with Public Health Scotland, we are working closely with boards to develop the infrastructure in order to collate and publish this data,” he said. “It’s an ambition of ours to have that available in a way that is easy to find, easy to understand, both for the patient but for the health professional too.” Read full story (paywalled) Source: The Times, 11 May 2022- Posted
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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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Medical regulator faces questions over board members’ links to drug firms
Patient Safety Learning posted a news article in News
The UK medicines watchdog has been urged to strengthen its conflict of interest policy after it emerged that six of its board members are receiving payments from the pharmaceutical industry. Board members involved in overseeing the regulator’s “strategic direction” also have financial interests in companies including US and Saudi drug giants and firms with ambitions to break into the UK’s healthcare market. Some offer consultancy services while others help run or own shares in drug and medical device firms, according to official transparency records. There is no suggestion of wrongdoing, but the findings have led to concerns about perceived conflicts of interest among senior figures at the Medicines and Healthcare products Regulatory Agency (MHRA), an executive agency of the Department of Health and Social Care responsible for regulating drugs and medical devices and ensuring they are safe. The MHRA said that “in order to be an effective regulator” it needed to “bring together the right expertise from across industry, academia, the public and beyond”, adding that board meetings are held in public and non-executive board members – to whom the potential conflicts relate – are not involved in “any work or decisions relating to the regulation of any products”. But critics raised concerns about the potential for bias – or the perception of it – and called for stricter rules on conflicts of interest for those working in pharmaceutical regulation. Read full story Source: The Guardian, 17 April 2022- Posted
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‘Warts and all’ references for NHS leaders ‘may be attacked’
Patient-Safety-Learning posted a news article in News
NHS England could have gone further to insist that errors and failures by senior NHS leaders are disclosed to future employers, according to the leading barrister who reviewed the NHS’s fit and proper person test (FPPT). Tom Kark KC’s review of the FPPT was delivered to government five years ago and made public the following year, and changes were finally proposed by NHSE earlier this month. In an interview with HSJ, Mr Kark said he broadly welcomed the plans, and that the revised framework should provide greater consistency across NHS boards “if applied correctly”; and could “strengthen the hand” of chairs and chief executives. Part of the purpose of the regime is to prevent senior managers and other board members who make big errors in one role, from keeping this secret from a future employer. Mr Kark told HSJ he had heard evidence that when “someone leaves under a cloud, they pop up somewhere else, and the information is lost.” Read full story (paywalled) Source: HSJ, 16 August 2023- Posted
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Mum fears NHS trust cover-up over Cambridgeshire suicides review
Patient-Safety-Learning posted a news article in News
The mother of a woman who took her own life weeks after being discharged from a mental health ward fears a "culture of cover up" within the NHS trust. Hannah Roberts, 22, died by suicide in 2018 and her mother Sally said there were "discrepancies" in the accounts of the talented musician's discharge. She feels an ongoing internal review into all Cambridgeshire & Peterborough NHS Foundation Trust (CPFT) suicides since 2017 should be independent. CPFT did not respond to her comments. The trust's chief executive Anna Hills previously said the internal review into 63 suicides would "be an important piece of work". Its announcement came after the trust was accused of adding to the records of Charles Ndhlovu, 33, the day after he took his own life to, in his mother's words, "correct their mistakes". Read full story Source: BBC News, 15 August 2023 -
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NHS trust accused of cover-up is refusing to release report into deaths
Patient Safety Learning posted a news article in News
An ambulance trust accused of hiding information from a coroner about patients that died is keeping a damning internal report about the deaths secret, the Guardian can reveal. A consultant paramedic implicated in the alleged cover-ups continues to be involved in decisions to keep the report from the public. Earlier this month, North East Ambulance Service (NEAS) apologised to relatives after a review into claims it covered up errors by paramedics and withheld evidence from the local coroner about the deceased patients. But a bereaved family left in the dark about mistakes made before their daughter’s death have rejected the apology. Now, it has emerged that a 2020 internal interim report on the alleged cover-up continues to be kept secret by the trust. The damning report by consultants AuditOne has been leaked to the Guardian after first being exposed by the Sunday Times. Paul Aitken-Fell, a consultant paramedic blamed in the report for amending information sent to the coroner and removing crucial passages about mistakes by the trust’s paramedics, remains in post. He also holds the gatekeeper role of FoI review officer, and as such has endorsed decisions to refuse to release the report to members of the public who ask for it. Read full story Source: The Guardian, 24 July 2023- Posted
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Covid Inquiry: Bodies were treated like toxic waste, says daughter
Patient Safety Learning posted a news article in News
The bodies of people who died with Covid were treated like "toxic waste" and families were left in shock, a bereaved woman has told the inquiry. Anna-Louise Marsh-Rees said her father Ian died "gasping for breath" after catching the virus while in hospital. Ms Marsh-Rees, who leads Covid-19 Bereaved Families for Justice Cymru, said he was "zipped away", and his belongings put in a Tesco carrier bag. Ian Marsh-Rees died after catching the virus while in hospital, aged 85. His daughter said finding information regarding his care in hospital and how he became infected was "almost like an Agatha Christie mystery". She said no GP ever suggested he might have Covid, although she now knows his discharge notes said he had been exposed to Covid. "It wasn't until we saw his notes some months later that we saw the DNA CPR (do not attempt CPR) placed on him, and this was without consultation with us," she said. "It kind of haunts us all that… people used to say 'well they're in the right place' when they go to hospital. I'm not sure they would say that any more," Ms Marsh-Rees said. She now wants to change the way deaths are handled by health boards. She said it was important to prepare families before and support them after the death of a loved one, from palliative care to dignity in death. Read full story Source: BBC News, 18 July 2023- Posted
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News ArticleThe government’s national review of mental health hospitals must urgently address the “lack of sympathy and compassion” towards patients if safety is to improve, the health ombudsman has said. Rob Berhens said the investigation, prompted by The Independent’s reporting on deaths and abuse of vulnerable patients, must look at three key issues, including a lack of empathy for those with mental health challenges, a lack of resources and poor working conditions for staff. Health Secretary Steve Barclay announced last week that a new safety body, the Health Services Safety Investigations Body (HSIB), would look into the care of young people, examine staffing levels and scrutinise the quality of care within mental health units. Mr Berhens said: “I trust [HSIB] to be able to understand what are the key issues, they’re about the lack of sympathy and compassion for people who have mental health challenges, which to me is a human rights issue." Read full story Source: The Independent, 1 July 2023
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News ArticleThe NHS have duped thousands of women into believing the most common incontinence mesh operation is safe, by not adding loss of sex life into its risk figures, campaigners say. The move keeps figures low so surgeons can reassure women that it is a safe day case operation. The discovery is buried in a report from five years ago, and when questioned on it, the MHRA, tasked with making sure implants are safe for patients, passed the buck and blamed the report authors. The revelation comes after a debate in Westminster, where health minister Jackie Doyle Price said there was not enough evidence to suspend the plastic implants and quoted a risk of 1-3%. However, those figures were blown out of the water just weeks before the debate in a landmark study using the NHS’s own hospital re-admission figures which show TVT mesh tape risk is at least 10%. Campaigners say even that is not a reflection of the true scale of the mesh disaster because it does not take into account women going to doctors for pain medication or those suffering in silence. Read full story Source: Cambs Times, 31 October 201t
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Doctor struck off for ‘repeated dishonesty’ over death of child in 1995
Patient Safety Learning posted a news article in News
A doctor who attempted to cover up the true circumstances of the death in 1995 of a four-year-old patient has been struck off. Consultant paediatric anaesthetist Dr Robert Taylor dishonestly misled police and a public inquiry about his treatment of Adam Strain, who died at the Royal Belfast Hospital for Sick Children, a medical tribunal found. The youngster was admitted for a kidney transplant at the hospital following renal failure but did not survive surgery in November 1995. Six months later an inquest ruled Adam died from cerebral oedema – brain swelling – partly due to the onset of dilutional hyponatraemia, which occurs when there is a shortage of sodium in the bloodstream. Two expert anaesthetists told the coroner that the administration of an excess volume of fluids containing small amounts of sodium caused the hyponatraemia. But Dr Taylor resisted any criticism of his fluid management and refused to accept the condition had been caused by his administration of too much of the wrong type of fluid. In 2004 a UTV documentary When Hospitals Kill raised concerns about the treatment of a number of children, including Adam, and led to the launch of the Hyponatraemia Inquiry. The tribunal found Dr Taylor acted dishonestly on four occasions in his dealings with the the public inquiry, including failing to disclose to the inquiry a number of clinical errors he made and falsely claiming to detectives he spoke to Adam’s mother before surgery. Read full story Source: The Independent, 22 June 2022- Posted
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NHS hospital failed to disclose babies’ deadly bacteria infections
Patient Safety Learning posted a news article in News
A leading NHS hospital failed to publicly disclose that four very ill premature babies in its care were infected with a deadly bacterium, one of whom died soon after, the Guardian has revealed. St Thomas’ hospital did not admit publicly that it had suffered an outbreak of Bacillus cereus in the neonatal intensive care unit (NICU) of its Evelina children’s hospital in late 2013 and early 2014. It occurred six months before a well publicised similar incident in June 2014 in which 19 premature babies at nine hospitals in England became infected with it after receiving contaminated baby feed directly into their bloodstream. Three of them died, including two at St Thomas’. Leaked documents show that both the first outbreak and newborn baby’s death were investigated but never publicly acknowledged by the NHS trust that runs the hospital. GSTT insists that it did not acknowledge the baby’s death publicly in any reports because it believed the child had died of other medical conditions, not the bacteria. However, it declined to say if it had told the baby’s parents that it had become infected with Bacillus cereus. Read full story Source: The Guardian, 23 June 2022- Posted
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News ArticleThere’s little question that US hospitals—up against COVID, patient surges, and labor and supply shortages—have become less safe for patients during the pandemic, as preventable events and complications have become more common. Leaders with the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) said as much, earlier this year, in an article for the New England Journal of Medicine: “Many indicators make it clear that health care safety has declined,” they wrote, noting, “the fact that the pandemic degraded patient safety so quickly and severely suggests that our health care system lacks a sufficiently resilient safety culture and infrastructure.” Despite such frank assessments, CMS is now at odds with public safety advocates about whether to make some of the hospital-specific data behind those trends publicly available. Read full story (paywalled) Source: Fortune, 14 June 2022
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Patient safety concerns over 'toxic culture' hospital probe
Patient Safety Learning posted a news article in News
An NHS England investigation into claims of a toxic culture at a hospital trust has been described as lacking transparency and undermining trust. The Parliamentary Health Service Ombudsman also said there were "very serious" patient safety issues at University Hospitals Birmingham (UHB). Criticism is contained in letters seen by the BBC between the ombudsman, the trust and NHS England. The inquiries, commissioned by the Birmingham and Solihull Integrated Care Board and the local NHS, were begun in response to an investigation by BBC Newsnight and BBC West Midlands which heard from current and former clinicians from the trust, who accused it of being "mafia-like". One of England's biggest hospital trusts, UHB has been in the spotlight for months after three probes were started following allegations doctors there were threatened for raising safety concerns. The trust denies this and says its "first priority is patient safety". The ombudsman, however, said he was sceptical about the reviews' transparency and independence. His finding of "very serious" patient safety issues at UHB is based on the trust's response to the ombudsman's recommendations and findings, including a case of an avoidable patient death. Read full story Source; BBC News, 14 March 2023- Posted
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Revealed: experts who praised new ‘skinny jab’ received payments from drug maker
Patient Safety Learning posted a news article in News
The drug giant behind weight loss injections newly approved for NHS use spent millions in just three years on an “orchestrated PR campaign” to boost its UK influence. As part of its strategy, Novo Nordisk paid £21.7m to health organisations and professionals who in some cases went on to praise the treatment without always making clear their links to the firm, an Observer investigation has found. Among the vocal champions of the Wegovy jabs was a clinical expert who gave evidence to the National Institute for Health and Care Excellence (NICE) and others who publicly praised the so-called “skinny jabs” as a “gamechanger”. The revelations come as the Danish drug giant is investigated by the UK’s pharmaceutical watchdog after it was found to have breached the industry code seven times in relation to a “disguised promotional campaign” of another of its weight loss drugs via online webinars for healthcare professionals. Prof Allyson Pollock, professor of public health at Newcastle University, said Novo’s campaign was “not unusual” in the drugs industry and called for measures to improve trust. “The public really aren’t being made aware enough about the potential for bias and over-claiming,” she said. Read full story Source: The Guardian, 12 March 2023- Posted
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Medical records changed as hospitals cover up mistakes, watchdog warns
Patient Safety Learning posted a news article in News
Hospitals are still covering up serious mistakes in patient care and fobbing off families that raise concerns, the head of the watchdog that investigates complaints against the NHS has warned. Rob Behrens told The Times he had seen cases of medical records being changed after a death and spoken to doctors who were too scared to speak out about failings in their hospitals. He called on ministers to change the law to introduce a “duty of candour” on health and other public service staff to “transform” the system and make it more accountable to patients. He warned: “There is a deep reluctance to explain and give an account of what you do in the health service or the public service for fear of retribution. The things that really get to me are the avoidable deaths of babies in the health service — dying because there’s been poor coordination or they’d been wrongly diagnosed or the parents hadn’t been listened to. That is shocking.” Read full story (paywalled) Source: The Times. 6 March 2023- Posted
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Pharma boss apologises for not disclosing sponsorship of anti-obesity training
Patient Safety Learning posted a news article in News
The chief executive of pharma group Novo Nordisk has apologised for breaking the UK industry code by failing to disclose its sponsorship of obesity and weight management training courses for healthcare professionals that also promoted its weight loss drug. The webinars, which were viewed by thousands of healthcare professionals, preferentially included positive information about Novo’s weight loss drug Saxenda, which the self-regulatory watchdog deemed a “disguised” large-scale promotional campaign. The industry self-regulatory body published a strongly worded reprimand last year, saying it was “concerned about the company’s compliance culture . . . internal governance systems and processes, and a perceived naivety and lack of accountability from Novo Nordisk”. It also said it was concerned about “the potential impact on patient safety” because the webinars, which were run by a third-party provider but sponsored by Novo, showed a “lack of balance” in how they compared the side effects of Saxenda and its competitors. Read full story (paywalled) Source: The Financial Times, 12 February 2023- Posted
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News ArticleSome of the country’s most senior NHS clinicians are earning a lucrative sideline running private firms that offer to cut waiting lists at their own hospitals, the Observer can reveal. Top consultants in Manchester, Sheffield and London are among directors of “insourcing” agencies that charge the health service to treat patients at weekends and evenings and have won millions of pounds of work. Some hold leadership roles at NHS trusts that have awarded contracts to their own companies, raising concerns about potential conflicts of interest. One deputy medical director jointly ran a firm that provided “insourcing” solutions to his own NHS trust before it was sold in a £13m deal last year. Other consultants have set up firms that they and their colleagues work shifts through themselves, often at rates above NHS price caps. The Centre for Health and the Public Interest, an independent thinktank, called for a ban on such arrangements. The General Medical Council said current conflict of interest policies did not always deliver “the transparency and assurance that patients rightly expect”. Read full story Source: The Guardian, 12 February 2023
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NHSE must ‘demonstrate it is trustworthy’ on data, says watchdog
Patient Safety Learning posted a news article in News
The independent data watchdog has called for greater clarity from NHS England on how it will ensure there are “as strong… if not stronger” safeguards on health and care data following its takeover of NHS Digital. NHS Digital – whose role included controlling access to large amounts of NHS data – became part of NHS England on 1 February, and its teams and functions are due to merge in coming months. In an interview with HSJ, national data guardian Nicola Byrne said the merger creates “an inherent tension in having one organisation be both data custodian and the organisation seeking to access the data”, although it “makes sense in terms of streamlining and efficiencies”. Concerns have been raised about the merger’s information governance implications by campaign group medConfidential, the British Medical Association and politicians. These include that there would be less transparency over the handling of data, and that NHSE would be “marking its own homework” as both controller of, and a major user of, data. Read full story (paywalled) Source: HSJ, 8 February 2023- Posted
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North East ambulance staff lacked critical medicines, CQC finds
Patient Safety Learning posted a news article in News
Ambulance crews in the North East frequently responded to emergencies without access to life-saving drugs, a damning inspection report has found. The study of North East Ambulance Service NHS Trust (NEAS) concluded patients were potentially put at risk by the poor management of medicines. The Care Quality Commission (CQC) found a deterioration of services and rated NEAS's urgent care as "inadequate". In response, NEAS said it had faced a year of "unprecedented pressures". The damaging assessment follows the launch of a full independent NHS review into numerous "tragic failings" involving patients. Announcing the review, the then health secretary Sajid Javid said he was "deeply concerned" about claims NEAS had covered up mistakes. Whistleblowers have told Newsnight multiple deaths were not investigated properly because information was not always provided to coroners and families. Read full story Source: BBC News, 1 February 2023- Posted
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NHS set to publish hidden figures which expose true scale of A&E waiting times
Patient Safety Learning posted a news article in News
The NHS will start publishing “hidden” figures on A&E waiting times following several leaks reported by The Independent. After unveiling its emergency care plan on Monday, NHS England confirmed it would release internal data each month - currently only made public once a year - showing how many people are waiting for longer than 12 hours after arriving at an emergency department. The Independent has published several leaks of this data, which shows that these waiting times can be up to five times higher than publicly available NHS figures. Official monthly figures only count the number of hours patients wait after a decision to admit them has been made, and so mask the true scale of the problem. The move comes after health secretary Steve Barclay said the NHS would, from April, publish this “real” number in a bid for “greater transparency.” Writing in The Telegraph, he said: “Too much of the debate about A&E and ambulance services is based on anecdotal evidence. I want NHS managers and the wider public to have access to the same facts from the front line, starting with publishing the number of 12-hour waits from the time of arrival in A&E from April.” Read full story Source: The Independent, 31 January 2023- Posted
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News ArticleConsultants who blew the whistle at a major teaching trust have raised “grave concerns” about the impartiality of three reviews into the safety and bullying allegations they made. Last month, Birmingham and Solihull Integrated Care Board announced three investigations into University Hospitals Birmingham, following worries about bullying and poor workplace culture. Former trust consultants Manos Nikolousis, John Watkinson and Tristan Reuser have now written to the cross-party reference group holding the investigations to account. Their letter, seen by HSJ, outlines their concerns about potential conflicts of interest. The first investigation is reviewing the trusts’ handling of 12 never events, staff deaths including a recent suicide, and 26 GMC referrals. It is being run by former NHS England deputy medical director Mike Bewick and may report as early as next week. The second and third reveiws will assess trust leadership and broader cultural issues respectively, and will be carried out with UHB and NHSE. Read full story (paywalled) Source: HSJ, 18 January 2023
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News ArticleGerman public research funder Deutsche Forschungsgemeinschaft (DFG) is conducting an audit of the clinical trials it has supported in the past. The audit was announced in response to a request from TranspariMED asking DFG for a list of all its trials completed between 2009 and 2017, to which DFG replied that it currently has no such comprehensive dataset. DFG stated that it is "currently preparing an evaluation of its clinical trials programme. In the framework of this evaluation the data you requested will be collected and analysed, as the outcomes of trials supported by DFG is of high interest including for DFG itself." TranspariMED, an organisation which aims to end evidence distortion in medicine, sees this development as a good opportunity for DFG to check whether and when clinical trials were registered and their results made public. Previous research has shown that nearly a third of German academic trials never make their results public. This not only wastes public money, but also harms patients because it leaves gaps in the evidence base on the efficacy and safety of drugs, medical devices, and non-drug treatments. Due to gaps in German law, there is still no legal obligation to make the results of many German clinical trials public. Read full story Source: TranspariMed, 20 December 2022