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News Article
Women 'angry and frustrated' over smear test review
Patient Safety Learning posted a news article in News
Women affected by a review of cervical smears in the Southern Health Trust have said they are "angry, frustrated and scared" for their future. About 17,500 patients in the trust are to have their previous smears re-checked as part of a major review of cervical screening dating back to 2008. Some of these women will be recalled to have new smear tests carried out. But the process has not started yet and will take at least six months to complete. Letters were sent out by the trust earlier this month to those affected. The Southern Trust says it expects to recall around 4,000 women for a new smear test after it reviews 17,368 historic slides. The Trust's medical director, Dr Steve Austin, told its board meeting that the review of slides was expected to start next week. It also emerged that the number of calls from concerned women has increased with many asking for more "specialist" answers. Read full story Source: BBC News, 27 October 2023 -
Content ArticleReducing inequalities in maternal healthcare in England is an important policy aim. One part of achieving that is to ensure that women from Black, Asian and minority ethnic communities, as well as women from the most deprived areas, see the same midwife or midwifery team throughout their pregnancy and postnatal period. Emma Dodsworth takes a closer look at the data to reveal what progress is being made on this.
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News Article
Alarm at rise in use of mixed-sex wards in NHS England hospitals
Patient Safety Learning posted a news article in News
NHS England has recorded more than 120,000 breaches of its mixed-sex hospital accommodation guidance in the past six years, a 257% increase. Guidance added to the NHS constitution in 2012 states that hospital patients will not share sleeping accommodation with members of the opposite sex “except where appropriate”. Exemptions include critical care wards or patients receiving treatment, such as chemotherapy, where they “may derive comfort from the presence of other patients with similar conditions”. The guidance also says patients should not share toilet or bathroom facilities with members of the opposite sex and should not “have to walk through an area occupied by patients of the opposite sex to reach toilets or bathrooms”. However, data from NHS England analysed by the Observer shows thousands of breaches every month, with patient dignity and safety put at risk. Caitlin (not her real name) worked on an acute mental health ward in a private hospital which switched from 12 women-only beds to 15 mixed beds. “Women on our ward often had a history of sexual or domestic abuse,” she said. “Some had tried to end their life in the wake of this, and a lot of them felt intimidated by the level of aggression shown by some men on the ward.” Women and men had separate wings but shared a communal area. “A lot of the women were really fearful of the men,” she added. Caitlin said the use of mixed-sex accommodation had a negative impact on some women’s recovery. “Women would stay in their rooms, not even coming out to watch TV,” she says. “Some acutely unwell women would display sexually disinhibited behaviour in the communal areas, which is a symptom of their diagnosis. They were put in a position where their dignity could not be protected.” “Women make hundreds of conscious and unconscious decisions to keep ourselves safe from men,” said Karen Ingala-Smith, author of Defending Women’s Spaces. “Women should not have to be on their guard like this when they are in hospital.” Read full story Source: The Guardian, 15 October 2023 -
News Article
NHS psych ward period provision criticised by patients
Patient Safety Learning posted a news article in News
Imagine being on your period and "forced to beg for pads and tampons". According to 24-year-old Lara, that's common for her and others on mental health hospital wards in the UK. When she posted about her experience online, people from across the country responded with their own similar stories. Mental health hospitals have various rules in place for safety reasons, including access to certain items. However, NHS guidance states that period products should be available to anyone who needs them. Lara says this hasn't always been the case for her. "I've had a number of hospital admissions to psychiatric units and on one of my first they confiscated my period products," she says. Lara's currently on one-to-one observations for her own safety, which means someone has to escort her to the toilet and watch her change a pad or tampon. But she says her worst experience was when she's had to wear anti-ligature clothing - again for safety reasons. "I was forced to remove my pants and sanitary pad - which meant I just had to bleed into the clothing," she says. "I understand the need for safety to come first, but this experience was unhygienic, traumatising and embarrassing for people to see." Eleanor is 20 years old and recently spent time in a mental health hospital. At her "most unwell", she says she didn't have access to her own clothing and had to wear the same special clothing Lara spoke about. "I'd have two or three people watching me changing and even though I know it's for my own safety, it's dehumanising," she says. Newsbeat asked a number of unions, organisations and charities to comment on the experiences described but none wanted to provide one. But one mental health professional, Kasper, did agree to discuss it. Kasper agrees that safety is always a top priority but adequate period provision is often overlooked."I'm sure all trusts have a policy, but don't think it's always applied - and my observation is that it very much depends on what staff are on shift, especially when there can be lots of agency workers," Kasper says."We do keep products on my ward, but there's not much of a range. "Patients can't access them and some staff don't know where they are either - so the onus is very much on patients, which can be tricky when they're unwell." Read full story Source: BBC News, 16 October 2023 -
News Article
Cervical cancer: 17,500 women to have smear tests re-checked
Patient Safety Learning posted a news article in News
About 17,500 women in Northern Ireland are to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008. Some of these women will be recalled to have new smear tests carried out, BBC News NI can reveal. The Southern Trust said that the women affected should receive letters by post from Tuesday. It follows a highly critical report commissioned by the Royal College of Pathologists (RCPath). It found: Several cytology staff were "significantly underperforming". Mechanisms to check their work were flawed. Action taken by management was inadequate over many years. While a majority of negative results issued by the laboratory were correct, a "significant number" of these would likely have been identified as "potentially abnormal" by other laboratories. Read full story Source: BBC News, 9 October 2023 -
News Article
Two-thirds of England’s maternity units dangerously substandard, says CQC
Patient Safety Learning posted a news article in News
Almost two-thirds of maternity units provide dangerously substandard care that puts women and babies at risk, the NHS watchdog has said in a damning report. The Care Quality Commission (CQC) has rated 65% of maternity services in England as either “inadequate” or “requires improvement” for the safety of care – up from 54% last year. Services are beset by a host of problems, including serious staff shortages and internal tensions, which mean that too many mothers and their babies receive care that is not good enough, it said. Women too often face delays in accessing care, do not receive the one-to-one care from a midwife to which they are entitled or experience communication problems with staff looking after them, including being shouted at by midwives. The CQC judged overall quality of care to be inadequate or require improvement at 85 maternity units, almost as many at which it rated it to be either good or outstanding – 87. The number of units offering substandard care has soared by 30 in the last year, from 55 to 85. It said that, having inspected 73% of all maternity units, “the overarching picture is one of a service and staff under huge pressure. People have described staff going above and beyond for women and other people using maternity services and their families in the face of this pressure. “However, many are still not receiving the safe, high-quality care that they deserve.” Read full story Source: The Guardian, 20 October 2023 -
News Article
Naga Munchetty: I was failed and gaslit by NHS despite debilitating periods
Patient Safety Learning posted a news article in News
Naga Munchetty has said she spent decades being failed, gaslit and “never taken seriously” by doctors, despite suffering debilitatingly heavy periods, repeated vomiting and pain so severe that she would lose consciousness. The BBC presenter, newsreader and journalist told the Commons women and equalities committee on Wednesday that she was “deemed normal” and told to “suck it up” by NHS GPs and doctors during the 35 years she sought help for her symptoms. Munchetty was finally diagnosed with adenomyosis, a condition where the lining of the womb starts growing into the muscle in its walls, in November last year. She said she was consistently told by doctors that “everyone goes through this”. “I was especially told this by male doctors who have never experienced a period but also by female doctors who hadn’t experienced period pain,” said Munchetty. Munchetty’s diagnosis came after she had bled heavily for two weeks and experienced pain so severe she asked her husband to call an ambulance. Only then was she taken seriously, seeing a GP who specialised in women’s reproductive health. That GP advised her to use private healthcare to avoid lengthy NHS waiting lists. Munchetty and Vicky Pattison, a television and media personality, were giving evidence as part of the committee’s inquiry into the challenges that women face being diagnosed and treated for gynaecological and reproductive conditions. The committee is also considering any disparities that exist in diagnosis and treatment, and the impact of women’s experiences on their health and lives. Read full story Source: The Guardian, 19 October 2023 -
News ArticleWomen are being "failed at every stage" when it comes to maternity care, say campaigners, as they call for more support for those experiencing traumatic births. Mumsnet found 79% of the 1,000 women who answered their questionnaire had experienced some form of birth trauma, with 53% saying it had put them off from having more children. And according to the snapshot of UK mothers, 44% also said healthcare professionals had used language implying they were "a failure or to blame" for what happened. Conservative MP Theo Clarke is leading calls for more action after her own experience, where she thought she was "going to die" after suffering a third degree tear and needing emergency surgery. Now, she has set up an all party parliamentary group on birth trauma. She said: "[It is] clear that more compassion, education and better after-care for mothers who suffer birth trauma are desperately needed if we are to see an improvement in mums' physical wellbeing and mental health. "It is vitally important women receive the help and support they deserve." Chief executive of Mumsnet, Justine Roberts, said the trauma had "long-lasting effects", adding: "It's clear that women are being failed at every stage of the maternity care process - with too little information provided beforehand, a lack of compassion from staff during birth, and substandard postnatal care for mothers' physical and mental health." Read full story Source: Sky News, 15 September 2023
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News Article
Millions of women in UK face severe period pain but symptoms dismissed
Patient Safety Learning posted a news article in News
Millions of women and girls experience debilitating periods, yet nearly one-third never seek medical help, and more than half say their symptoms are not taken seriously, according to research. A survey of 3,000 women and girls for the Wellbeing of Women charity found that they are often dismissed as “just having a period”, despite experiencing severe pain, heavy bleeding and irregular cycles that can lead to mental health problems. Almost all of those surveyed, who were between 16 and 40 years old and based in the UK, had experienced period pain (96%), with 59% saying their pain was severe. 91% had experienced heavy periods, with 49% saying their bleeding was severe. Prof Dame Lesley Regan, the chair of Wellbeing of Women, said: “It’s simply unacceptable that anyone is expected to suffer with period symptoms that disrupt their lives, including taking time off school, work, or their caring responsibilities, all of which may result in avoidable mental health problems. “Periods should not affect women’s lives in this way. If they do, it can be a sign of a gynaecological condition that requires attention and ongoing support – not dismissal.” Wellbeing of Women has launched its “Just a Period” campaign, which Regan said aims to address “the many years of medical bias, neglect and stigma in women’s health”. This includes tips on how to get the most out of seeing your GP and what women should do if they feel they have been dismissed. Read full story Source: The Guardian, 14 September 2023 -
News ArticleSenior doctors say female medics have felt pressured into sexual activity with colleagues. Four women who head up medical royal colleges in Wales have written an open letter describing misogyny, bullying and sexual harassment in the workplace. They told BBC Wales that female staff had been asked for sex by male colleagues while on shift. The Welsh government said: "Harassment and sexual violence is abhorrent and has no place in our NHS." Chairwoman of the Royal College of Psychiatrists in Wales, Dr Maria Atkins, said: "I've heard from multiple women over the years that during night-time shifts, they've been propositioned by male colleagues and felt pressured to engage in sexual acts. "When they've refused they are penalised. "It can be very damaging to some less experienced or younger women, because they will be discouraged from engaging with a team, which might have been the specialty of medicine that they wanted to progress their career in." Read full story Source: BBC News, 22 September 2023
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Content Article
Researchers at the University of Hertfordshire are carrying out a study to better understand women’s negative experiences of IUD procedures. They hope this research will be used to develop new guidance for patients and professionals that reduces the risk of coil procedures being experienced as distressing. If you are aged 16+, have had a coil fitting/removal in the last 2 years in a UK health settings (GPs, sexual health clinics, gynaecologist, and any other medical setting) that you found distressing, and are able to provide a valid UK phone number (mobile or landline), then you are eligible to participate. Full details of the research and how to take part can be found via the link below or by contacting Sabrina at s.pilav@herts.ac.uk. -
News Article
Women at greater risk of heart attack death due to medical sexism
Patient Safety Learning posted a news article in News
Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows. Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades. It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure. Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram. Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers. Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system." “The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added. Read full story (paywalled) Source: The Times, 5 October 2023 -
Content ArticleAortic valve replacement (AVR) is a life-saving procedure for symptomatic severe aortic stenosis (AS), which relieves symptoms, increases life expectancy and improves quality of life. Little is known about the rate of AVR provision by gender, race or social deprivation level in the NHS across England. However, a large analysis examining AVR on the health service in England – the first of its kind – reveals striking inequalities in its provision. Women, black and Asian people, and those living in the poorest parts of the country are much less likely to receive the life-saving procedure, the study shows. “In this large, national dataset, female gender, black or south Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England,” the authors wrote. Dr Clare Appleby, a consultant cardiologist at the Liverpool Heart and Chest hospital NHS foundation trust and an author of the study, said public health initiatives to understand and tackle these inequalities should be prioritised. “Severe symptomatic aortic stenosis is a serious disease that causes mortality and reduces quality of life for patients,” she said. “Left untreated it has a worse prognosis than many common metastatic cancers, with average survival being 50% at two years, and around 20% at five years.” Further research and public health initiatives to understand and address inequalities in the timely provision of AVR are important and should be prioritised in England.
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News Article
Greenland women seek compensation over involuntary birth control
Patient Safety Learning posted a news article in News
A group of 67 women from Greenland are seeking compensation from the Danish government over a campaign of involuntary birth control in the 1960s. At least 4,500 women, some of them teenagers, were fitted with coils under a programme intended to limit birth rates among the indigenous population. An inquiry is due to conclude in 2025, but the women, some of whom are in their 70s, want compensation now. They are seeking 300,000 kroner (£34,880; $42,150) each. Records from the national archives showed that, between 1966 and 1970 alone, intrauterine devices (IUDs) were fitted into the women, some as young as 13, without their knowledge or consent. A commission set up by the Danish and Greenlandic governments to investigate the programme is not due to deliver its findings until May 2025. "We don't want to wait for the results of the inquiry," said psychologist Naja Lyberth, who initiated the compensation claim. "We are getting older. The oldest of us, who had IUDs inserted in the 1960s, were born in the 1940s and are approaching 80. We want to act now." Ms Lyberth said that, in some cases, the devices fitted had been too big for the girls' bodies, causing serious health complications or even infertility, while in others the women had been unaware of the devices until they were discovered recently by gynaecologists. She accused the Danish government of the time of wanting to control the size of Greenland's population in order to save money on welfare. "It's already 100% clear that the government has broken the law by violating our human rights and causing us serious harm," she said. Read full story Source: BBC News, 3 October 2023 -
News Article
Doctors used to diagnosing men may not spot 35,000 women with diabetes
Patient Safety Learning posted a news article in News
Thousands of women may be missing out on a diagnosis of type 2 diabetes because the thresholds are geared towards men, research suggests. Scientists assessed test results from more than one million patients across the country and concluded that the bar for diagnosis might be set too high for women. They calculated that, if thresholds were lowered slightly, an extra 35,000 women under the age of 50 in England would be diagnosed with type 2 diabetes — increasing the number in this age group with the condition by 17%. Under the present guidelines, those 35,000 women would be given the all-clear and would miss out on the chance of earlier treatment and lifestyle advice, increasing their risk of complications in later life. The team, led by doctors at the University of Manchester and including researchers from hospitals nationwide, stressed that their findings were preliminary, and needed further assessment before their hypothesis was confirmed. But, if proved correct, they believe that about 65 young women may be dying of diabetes each year without a diagnosis. Read full story (paywalled) Source: The Times, 1 October 2023 -
News Article
Births being delayed by strikes, says CEO
Patient Safety Learning posted a news article in News
Women have faced delays in giving birth due to the ongoing strikes, a major trust’s chief executive has said. Matthew Hopkins, who joined Mid and South Essex Foundation Trust last month, told a board meeting on Thursday that industrial action was having a “significant and growing” impact on patients. He added that this extended beyond delays to outpatient appointments and elective operations, saying: “It is also delaying mums giving birth, because we are seeing delays now in being able to conduct our elective Caesarian sections.” Mr Hopkins said the impact was also “really significant” on staff, with those covering for colleagues “very, very tired”. “It is important we give a very clear message to the two sides of the argument – government and the [British Medical Association] – that we need a light at the end of the tunnel, and staff need a light at the end of the tunnel. “Going into winter, with this continuing disruption for our patients and our staff, is in my view unacceptable.” Read full story (paywalled) Source: HSJ, 28 September 2023 -
News ArticleThousands of women are having induction of labour delayed because of a shortage of staff, raising concerns about the safety of them and their babies, HSJ has found. The issue has been highlighted at seven hospitals in Care Quality Commission reports over the past six months, and HSJ has identified a further three trusts declaring they are concerned about it in their own board papers over the same period. At University Hospitals of Leicester Trust, more than 1,300 “red flags” were raised in a five-month period due to delays in the induction of labour, linked to staffing levels, the CQC said earlier this month. Most were dealys in continuing inductions, and a smaller number were delays between admission and beginning an induction. UHL indicated it had set its own “red flag” bar locally, so all the delays did not represent a national alert. Carolyn Jenkinson, CQC deputy director of secondary and specialist healthcare, told HSJ: “At some maternity services we’ve found women having to wait long periods of time to be induced or for transfer to a labour ward once the induction process has started, and in some cases a lack of effective monitoring during periods of delay. “Where we have found concerns about delayed treatment – including induction of labour – we have made clear to those trusts that effective oversight of the issue is vital and that all action possible should be taken to mitigate any risk and keep people using the service safe.” Read full story (paywalled) Source: HSJ, 27 September 2023
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Content ArticleWomen interact with cancer in complex ways, as healthy individuals participating in cancer prevention, as patients, as health professionals, researchers, policymakers, and as unpaid caregivers. In all these domains, women often are subject to overlapping forms of discrimination, such as due to age, race, ethnicity and socio-economic status, that render them structurally marginalised. These myriad factors can restrict a woman’s rights and opportunities to avoid cancer risks, are a barrier to diagnosis and quality cancer care, maintain an unpaid caregiver workforce that is predominantly female, and hinder women’s professional advancement.
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News Article
Primodos: Pregnancy test damages claims thrown out by judge
Patient Safety Learning posted a news article in News
Claims for damages by more than 170 people who say they were affected by hormone-based pregnancy test drugs have been thrown out by a High Court judge. The drugs, including Primodos, were given to women to test if they were pregnant from the 1950s to 1970s and alleged to have caused birth defects. But the judge ruled there was no new evidence linking the tests with foetal harm and "no real prospect of success". Campaigners say they are "profoundly disappointed" with the judgement. Legal action had been brought against three drug companies - Bayer Pharma, Schering Health Care, Aventis Pharma - as well as the government in a bid for compensation. However, they argued there was no evidence of a "causal association" between the hormone pregnancy tests and the harm suffered by the claimants. Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said she was "profoundly disappointed" with the judgement. "We do not accept the defendants' claim that our evidence did not provide sufficient scientific evidence and look forward to the additional scientific evidence, to support our original argument, which is due to be published shortly," she added. Read full story Source: BBC News, 28 May 2023 Further reading on the hub: Patient Safety Spotlight interview with Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests -
Content Article
“Almost every Gynecologic surgeon I know has a story about being told that they were wasting their talent". It was this tweet from US-based gynaecology surgeon Jocelyn Fitzgerald that caught my eye a few months ago. I’m passionate about women’s health and immediately wanted to find out more about how this translated in terms of patient safety. So, in August we met, and Dr. Fitzgerald explained some of the barriers and challenges she faces in delivering safe and equitable care.- Posted
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Content Article
The well-being of Black mothers during and after pregnancy has been disproportionately affected by cultural barriers that hinder access to adequate mental health care. Addressing and breaking these barriers is essential to ensuring the well-being of Black mothers and promoting healthy outcomes for their children. Black Maternal Mental Health Week is led by The Motherhood Group and the theme for 2023 is Breaking Cultural Barriers. -
News ArticleHospitals are still promoting a “natural birth is best” philosophy – despite a succession of maternity scandals highlighting the dangers of the approach. A Telegraph investigation has found a number of trusts continuing to push women towards “normal” births – meaning that caesarean sections and other interventions are discouraged. On Saturday, the Health Secretary has expressed concern about the revelation, vowing to raise the matter with senior officials. Guidelines for the NHS make it categorically clear that a woman seeking a caesarean section should be supported in her choice, after “an informed discussion about the options”. Maternity services were last year warned by health chiefs to take care in the language they used, amid concern about “bias” towards natural births. The warning from maternity officials followed concern that women were being left in pain and fear, with their preferences routinely ignored. The findings come 18 months after Dame Donna Ockenden published a scathing report into maternity care at Shrewsbury and Telford NHS Trust, which warned that a focus on natural birth put women in danger. Read full story (paywalled) Source: The Telegraph, 23 September 2023
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Content ArticleExtensive cultural change is needed in the NHS to tackle sexual violence and prevent further institutional harm to patients and staff, writes Philippa Greenfield, co-presidential lead for women and mental health, consultant general adult psychiatrist, named doctor for adult safeguarding and trauma informed lead.
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Content Article
I am passionate about women's health and have worked with campaigners, clinicians and patients for a number of years to look at the barriers that women face in receiving safe care and the challenges clinicians face in delivering it. We know the medical system has historically been based on the white, male patient which has led to huge gaps in knowledge and understanding around women's health. But we are not just playing catch up to address past racism and patriarchy that is embedded in the system, we are continuing to highlight and fight it where it still exists. On Saturday I attended the Women's Health Summit, organised by Five X More. It was a powerful event, designed to look at aspects of women's health throughout their life journey. Attended by mums, charity representatives, media, clinicians, patients, leaders and more, united by a desire to change things. I laughed, I talked and I cried. One of the final calls to action of the day was to find your skill, find your voice and do more. So, I start where I am most at home - in writing. -
Content ArticleNHS England is undertaking an audit of NHS specialised hospital services for patients with complications of mesh inserted for urinary incontinence and vaginal prolapse (Mesh Centres) and would like to hear from women who have had Mesh implanted. They'd like to hear from women who have had, or have considered having treatment for their Mesh complications, both surgical (mesh removal) and non-surgical treatment (including physiotherapy and pain management, for example). As part of the audit, Sally Cavanagh who works for NHS England was asked to team up with Kath Sansom from Sling The Mesh and Paula Goss from Rectopexy Mesh Victims & Support, to develop the survey. It is designed to capture feedback about how women reached the decision to seek, or not seek surgical Mesh removal, how they made their treatment decision and their experiences with health services and health staff involved in their treatment for complications of Mesh. The deadline to submit the survey is midnight Wednesday 11 October 2023.
