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Found 553 results
  1. News Article
    East Kent Hospital University Foundation Trust has been criticised for failures in services by the Care Quality Commission, after an unannounced inspection last month, years after major problems began to come to light. The Care Quality Commission has highlighted: Issues with processes for fetal monitoring and escalation at the William Harvey Hospital, Ashford. There had been “incidents highlighting fetal heart monitoring” problems in September and October, and the trust’s measures to improve processes were not “embedded and understood by the clinical team”; Slow maternity triage, due to staffing problems, and infection control problems at the William Harvey. The trust is reviewing how issues with infection prevention and control and cleanliness were not identified or escalated; and Fire safety issues at the Queen Elizabeth, the Queen Mother Hospital, in Thanet with problems linked to fire doors and an easily accessible secondary fire escape route. Three years ago issues with reading and acting on fetal monitoring were highlighted at the inquest into baby Harry Richford, whose poor care by the trust led to an independent inquiry into widespread failings in its maternity services, led by Bill Kirkup. Read full story (paywalled) Source: HSJ, 6 February 2023
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    Inspectors raised serious concerns around leadership and safety at Lister Hospital in Stevenage, run by East and North Hertfordshire Trust, when they visited in October. The maternity service was also rated inadequate for leadership. The CQC also raised concerns about staffing shortages, infection prevention control, care records, cleanliness, waiting times and training. The inspection did, however, find staff worked well together, managers monitored the effectiveness of the service and findings were used to make improvements. Carolyn Jenkinson, the CQC’s head of hospital inspection, said: “This drop in quality and safety was down to insufficient management from leaders to ensure staff understood their roles, and to ensure the service was available to people when they needed it.” Read full story (paywalled) Source: HSJ, 20 January 2023
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    The NHS is falling behind in the race to tackle antibiotic-resistant infections, with the service set to miss two key targets. As part of the government’s 2019 five-year-action plan to tackle the growth in antimicrobial resistance (AMR), the NHS was set the target of reducing the number of healthcare-associated bloodstream infections of three gram-negative bacteria by 25% by March this year, and 50% by the end of March 2024. Infections caused by E. coli, pseudomonas aeruginosa and klebsiella can cause urine or wound infection, blood poisoning or pneumonia. The AMR action plan said: “In the UK, the biggest drivers of resistance [include] a rise in the incidence of infections, particularly gram-negatives.” Last week, health and social care secretary Sajd Javid stressed the continuing importance of the issue, stating that antimicrobial resistance is “one of the biggest health threats facing the world”. Analysis by HSJ has shown there has been only a small decline in the numbers of cases involving the three bacteria since monitoring started. The baseline for measuring the reduction was 2016-17, when there were 23,037 healthcare associated infections related to the bacteria. Read full story (paywalled) Source: HSJ, 21 April 2022
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    Antimicrobial resistance poses a significant threat to humanity, health leaders have warned, as a study reveals it has become a leading cause of death worldwide and is killing about 3,500 people every day. More than 1.2 million – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, according to the most comprehensive estimate to date of the global impact of antimicrobial resistance (AMR). The stark analysis covering more than 200 countries and territories was published in the Lancet. It says AMR is killing more people than HIV/Aids or malaria. Many hundreds of thousands of deaths are occurring due to common, previously treatable infections, the study says, because bacteria that cause them have become resistant to treatment. “These new data reveal the true scale of antimicrobial resistance worldwide, and are a clear signal that we must act now to combat the threat,” said the report’s co-author Prof Chris Murray, of the Institute for Health Metrics and Evaluation at the University of Washington. “We need to leverage this data to course-correct action and drive innovation if we want to stay ahead in the race against antimicrobial resistance.” Read full story Source: The Guardian, 20 January 2022
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    No new Ebola infections have been detected in Uganda for 42 days, and so on Wednesday, the World Health Organization and the Ugandan Ministry of Health officially declared that the country’s most recent outbreak of the deadly virus is at an end. Since the outbreak was officially recognised on September 20, 164 people have had confirmed or probable Ebola infections; there 55 deaths confirmed by lab testing, with another 22 deaths suspected of being caused by the virus. Those who have recovered from the virus will receive ongoing support and will be closely monitored to help scientists understand the long term impacts of the Sudan strain of the virus, for which there are currently no treatment or prevention options. The Ugandan government has also set a goal of finally identifying the animal reservoir for Ebola. Read full story Source: CNN, 11 January 2023
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    People have been urged to wear face coverings and remain at home if feeling unwell, as an already crisis-stricken NHS faces down multiple waves of winter illnesses. With children returning to school at a time when high levels of flu, Covid-19 and scarlet fever are all being reported, the UK Health Security Agency (UKHSA) has issued fresh guidance in a bid to minimise the diseases’ spread. Parents have been urged to keep children at home if they are unwell and have a fever, with adults told to only go out if necessary and wear face coverings if they are ill and avoid visiting vulnerable people. While transport secretary Mark Harper said the advice was “very sensible”, Downing Street insisted that such guidance was “pretty longstanding”, stressing that it was “not mandatory” and remained a far cry from ministers “telling people what to do” at the height of the pandemic. The government has also reintroduced travel bans for those testing positive for Covid-19 in China from 5 January amid a mass outbreak there. It comes as pressure on the NHS continues to grow, but Rishi Sunak said he was “confident” the NHS has the funding it needs despite accusations from senior doctors his government is in denial about the scale of the crisis in the health service. Read full story Source: The Independent, 3 January 2023
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    Flu and Covid are on the rise in England, with experts stressing the importance of vaccination and warning that people who feel unwell should stay at home rather than mingling with others during the festive season. The figures come as cases of scarlet fever and strep A infections continue to rise. The UK Health Security Agency (UKHSA) added that while invasive strep A infections remain rare there have now been a total of 94 deaths in England, including 21 children. Dr Colin Brown, the deputy director at UKHSA, sought to reassure parents. “I understand how this large rise in scarlet fever and ‘strep throat’ may be concerning to parents, however the condition can be easily treated with antibiotics and it is very rare that a child will go on to become more seriously ill,” he said, adding that parents should visit NHS.UK, contact 111 online or their GP surgery if their child has symptoms so they can be assessed for treatment. Dr Mary Ramsay, the director of public health programmes at UKHSA, noted a link between indoor mixing and the rise in cases and hospital admissions for flu and Covid. “Both Covid and flu can cause severe illness or even death for those most vulnerable in our communities, and so it is also important to avoid contact with other people if you are unwell in order to help stop infections spreading over the Christmas and new year period,” she said. Read full story Source: The Guardian, 23 December 2022
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    Antibiotics could be given to children at schools affected by Strep A to stop the spread of the infection, schools minister Nick Gibb has said. Mr Gibb told Sky News that the UK Health and Security Agency (UKHSA) is "working closely with the schools involved and giving very specific advice to those schools which may involve the use of penicillin". He added that health officials will "have more to say about that". "They're providing more general advice to parents, which is to look out for the symptoms - so, sore throat, fever, high temperature and also a red or raised rash on the skin are symptoms of this invasive Strep A outbreak." His comments came after the ninth death of a child from the infection. Read full story Source: Sky News, 6 December 2022
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    Public health leaders were slow to act on repeated warnings over Christmas 2020 that contact tracing and isolation should be triggered immediately after a positive lateral flow test result, leaked evidence to the Covid inquiry shows. A scathing “lessons learned” document written by Dr Achim Wolf, a senior test and trace official, and submitted to the inquiry, gives his account of a trail of missed opportunities to improve the NHS test-and-trace regime in the first winter and spring of the pandemic – before vaccines were available. It suggests that people will have unnecessarily spread the virus to friends and relatives in the first Christmas of the pandemic and subsequent January lockdown period because they were not legally required to isolate and have their contacts traced as soon as they got a positive lateral flow test. Instead, for around two months, those eligible for rapid testing were told to get a confirmatory PCR test after a positive lateral flow. About a third of those who subsequently got a negative PCR result were likely to have had Covid anyway. In the “lessons learned” document seen by the Guardian, Wolf says: “Over the winter months, the prevalence in individuals who had 1) a positive lateral flow; followed by 2) a negative PCR; may have been upwards of 30%. These individuals were then allowed to return to their high-risk workplaces.” The former head of policy at NHS test and trace highlights how it took too long to get clear advice from Public Health England about policy on contact tracing and isolation rules in the face of changing scientific evidence on the accuracy of lateral flows. Read full story Source: The Guardian, 30 November 2022
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    Staff mistakes in a private laboratory may have caused 23 extra deaths from Covid-19. The UK Health Security Agency (UKHSA) made the claim in a report into errors at the Immensa lab in Wolverhampton. It said as many as 39,000 positive results were wrongly reported as negative in September and October 2021. The mistakes led to "increased numbers of [hospital] admissions and deaths", the report, published on Tuesday, concluded. Thousands of people, many in the South West, were wrongly told to stop testing after their results were processed by Immensa. The Wolverhampton laboratory was used for additional testing capacity for NHS Test and Trace from early September 2021, but testing was suspended on 12 October following reports of inaccurate results. Experts said high case rates in some areas were down to people unwittingly infecting others when they should have been isolating. UKHSA experts said the mistakes could have led to as many as 55,000 additional infections in areas where the false negatives were reported. "Each incorrect negative test likely led to just over two additional infections," the report said. "In those same geographical areas, our results also suggest an increased number of admissions and deaths." Read full story Source: BBC News, 29 November 2022
  19. News Article
    A coroner has written to the health secretary warning a lack of guidance around a bacteria that could contaminate new hospitals' water supply may lead to future deaths. It follows inquests into the deaths of Anne Martinez, 65, and Karen Starling, 54, who died a year after undergoing double lung transplants at the Royal Papworth Hospital in Cambridge in 2019. Both were exposed to Mycobacterium abscessus, likely to have come from the site's water supply. The coroner said there was evidence the risks of similar contamination was "especially acute for new hospitals". In a prevention of future deaths report, external, Keith Morton KC, assistant coroner for Cambridgeshire and Peterborough, said 34 people had contracted the bacteria at the hospital since it opened at its new site in 2019. He said the bacteria "poses a risk of death to those who are immuno-suppressed" and there was a "lack of understanding" about how it entered the water system. There was "no guidance on the identification and control" of mycobacterium abscesses, the coroner said. Mr Morton said documentation on safe water in hospitals needed "urgent review and amendment". "Consideration needs to be given to whether special or additional measures are required in respect of the design, installation, commissioning and operation of hospital water systems in new hospitals," he said. Read full story Source: BBC News, 22 November 2022
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    Coroner's concerns 1 It is recognised that M. abscessus poses a risk of death to those who are immunosuppressed. That will be so for many patients at specialist hospitals such as Royal Papworth and more generally for hospital patients. To date, 34 patients at Royal Papworth have contracted M. abscessus from the hospital’s water. Cases continue to be reported, albeit at a declining rate. 2 There is an incomplete understanding of how M. abscessus may enter and/or colonise a hospital water system. 3 Health Technical Memorandum 04-01 Safe Water in Healthcare Premises was published by the Department of Health in 2016. It is concerned with the design, installation, commissioning and operation of hospital water systems. This guidance requires urgent review and amendment, whether by way of an Addendum or otherwise because: a. It is a key document for hospital estate managers and Water Safety Groups; b. It purports to provide comprehensive guidance on waterborne bacteria; c. However, it provides no relevant guidance in relation to mycobacteria and none in relation to M. abscessus. It provides no guidance on the identification and control of M. abscessus. It does not require routine testing for mycobacteria, including M. abscessus or provide guidance on acceptable levels (if any). Compliance with the guidance does not identify or guard against the risk from M. abscessus; d. It provides no guidance on any additional measures that may be required in respect of “augmented care” patients, including those who are immunosuppressed; e. It is not in any event consistent with British Standard BS 8580-2:2022 on Water Safety. 4 There is evidence that the risk from M. abscessus is especially acute for new hospitals. Consideration needs to be given to whether special or additional measures are required in respect of the design, installation, commissioning and operation of hospital water system in new hospitals.
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    The IIAC recommends the following prescription should be added to the list of prescribed diseases for which benefit is payable. This applies to workers in hospitals and other healthcare settings and care home/home care workers working in proximity to patients in the two weeks prior to infection: Persisting pneumonitis or lung fibrosis following acute Covid-19 pneumonitis. Persisting pulmonary hypertension caused by a pulmonary embolism developing between 3 days before and 90 days after a diagnosis of Covid-19. Ischaemic stroke developing within 28 days of a Covid-19 diagnosis. Myocardial infarction developing within 28 days of a Covid-19 diagnosis. Symptoms of Post Intensive Care Syndrome following ventilatory support treatment for Covid-19.
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    The report recommends the following actions to address the threat of AMR: NHS England, in collaboration with NICE, should urgently commission a national assessment of the clinical and cost-effectiveness of using rapid diagnostic tools. As part of this assessment, differences in the effectiveness of using diagnostics to support prescribing in primary and secondary care should be considered. NHS England should centrally purchase diagnostic tools, to more rapidly increase the percentage of prescriptions that are supported by a diagnostic test, drawing on evidence collected from the national assessment and Wales’ use of a central budget for diagnosing respiratory tract infections. Public health departments should work with charities and patient organisations to develop AMR awareness campaigns in the vein of those delivered during the COVID-19 pandemic, which highlight the experience of individuals living with drug-resistant infection and their families. As far as possible, these campaigns should be led by local Directors of Public Health, to increase the trust that local communities have in AMR messaging. A high-level AMR committee should be formed of permanent secretaries from the Department of Health and Social Care, the Department of Food, Environment and Rural Affairs, the Head of AMR at NHS England, and Chief Executives of the UK Health Security Agency and the Veterinary Medicines Directorate. This group should meet at an appropriate frequency to track progress against the Government’s twenty-year vision for AMR, promote cross-government coordination, and assess present and future social and economic impacts posed by AMR. To drive AMR preparedness and health security coordination at Cabinet Level, the Government should create a subcommittee of the National Security Council dedicated to assessing progress against the five-year action plan and twenty-year vision for AMR, and discuss future risks to health security. A named minister for health security should convene the subcommittee.
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