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Content ArticleA Brighton GP surgery is under threat despite providing excellent services and strong links to the local community. This decision flies in the face of the proven 'social value' being delivered and potentially puts patients at risk. The reasons are presented in this excellent article which exposes the continued 'race to the bottom' due to an apparently unnecessary tendering exercise, a decision made behind closed doors and a failure to consult. Quote from Polly Toynbee's article in the Guardian: "Here’s the puzzle. Andrew Lansley’s calamitous system that opened the NHS to “any willing provider” to compete for contracts was supposedly swept away in 2022, replaced with ICBs that strove for cooperation across all NHS and social services in England. Yet some ICBs still apply the old competitive impulse to NHS services, even though they now have an obligation to ensure that tenders help to reduce inequalities."
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Content ArticleThis briefing from the Health Foundation compares trends in mortality within the UK and with 21 high-income countries, based on new research by the London School of Hygiene and Tropical Medicine. The findings are stark, underlining deep inequalities in health between different parts of the UK and a worrying decline in UK health compared with international peers. Key points: Improvements in UK mortality rates slowed significantly in the 2010s, more than in most of the other countries studied. By 2023, the UK female mortality rate was 14% higher than the median of peer countries and the UK male mortality rate was 9% higher. For both, the gap to the median widened significantly after 2011, and the UK’s ranking relative to peer countries has now worsened. Improvements in mortality rates slowed across all UK nations and regions in the 2010s – but there are significant geographic inequalities. Scotland, Wales and Northern Ireland all have higher mortality rates than England. Scotland is performing particularly poorly – of the countries studied, in 2021 only the US had a worse mortality rate. In 2021, mortality rates were 20% higher in the North East and North West of England than in the South West. People aged 25–49 have seen a particularly pronounced relative worsening of mortality rates. In 2023, UK female mortality rates for this age group were 46% higher than the median of peer countries, while male rates were 31% higher. Of the other countries studied, only Canada and the US experienced a similar worsening of mortality rates among this age group over the 2010s. This worsening of mortality rates is a sign of ill health in the working-age population, acting as a drag on economic growth. Of the main three causes of death for people aged 25–49, mortality rates for cancers and circulatory diseases improved between 2001 and 2019, but rates worsened for deaths from external causes. Deaths from external causes explain between 70% and 80% of the divergence in UK mortality rates compared with the median of peer countries over this period. While in the 2010s alcohol-related mortality rates for people aged 25–49 plateaued or declined and mortality rates for suicide (and undetermined intent) slightly increased, the rate of drug-related deaths rose sharply. In contrast, rates of drug-related deaths continued to decline for peer countries. As a result, the drug-related mortality rate in the UK was more than three times higher in 2019 than the median of peer countries. Geographic inequalities in drug-related deaths are stark among people aged 25–49. In 2019, the drug-related mortality rate in Scotland was around 4 times higher than in England. Within England, the drug-related mortality rate in the North East was 3.5 times higher for men and almost 4 times higher for women than in London. With the UK comparing poorly with many other high-income countries, improvement is both possible and urgently needed. This will require long-term action for economic recovery in areas of long run industrial decline; a strong focus on prevention; investment in public health services and action to address risk factors such as smoking, alcohol and poor diet; and a concerted effort to tackle drug-related deaths. These actions should be brought together in a clear strategy for tackling health inequalities. The UK government’s health mission promised just such an approach, but progress so far has been slow. This needs to change or the UK’s health will fall further behind its international peers.
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Content ArticleThe rapid evolution of digital health technologies offers new opportunities for healthcare systems while also increasing pressure on public budgets. Governments and insurers face growing challenges in determining what to fund and at what price. Health technology assessment (HTA) remains a critical tool for informing these decisions, and several OECD countries are exploring ways to adapt their approaches to the fast-changing and diverse landscape of digital medical devices. The absence of a common taxonomy, coupled with the rapid pace of technological advancement, further complicates evaluation, prompting interest in more harmonised HTA approaches. This paper explores how France, Germany, Israel, Korea, Spain, and the United Kingdom are adapting HTA to evaluate certain types of digital medical devices for coverage and pricing decisions. Through desk research and interviews, it describes HTA approaches, focusing on relevant pathways, technology remits, and evaluation methods. Drawing on practical experiences, it highlights key challenges and potential learning opportunities. The findings contribute to ongoing discussions on adapting HTA frameworks to improve the assessment and integration of digital medical devices into healthcare systems.
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Content ArticleWith Donald Trump’s unpredictable announcements causing the British government to rush for a deal, tariffs and trade negotiations hang over the NHS as an issue once again. The new American administration is threatening to add direct taxes on imported medicines, sworn off by most developed countries for 30 years, to a well-established list of fears around privatisation and the NHS being forced to pay more. From the point of view of healthcare in the UK and the patients that need it, some of those concerns are very real, though usually not immediate. Others are likely overblown. Mark Dayan explains what these tariffs and transatlantic trade negotiations mean for the NHS.
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News Article
Trump’s tariffs could hit UK medicine supply, Wes Streeting warns
Patient Safety Learning posted a news article in News
US tariffs could adversely affect the supply of medicines to the UK, the health secretary has said. Donald Trump announced a wide range of “reciprocal” tariffs on goods imported into the US, including a 10% levy on the UK as well as 20% on the EU, 34% on China and 46% on Vietnam. It triggered a rout on stock markets worldwide, with plunges not seen since the start of the Covid-19 pandemic, wiping out trillions of dollars in value. Wes Streeting told Sky News that the chaos caused by the fears of a global trade war could disrupt supplies of medicine. “As ever in terms of medicines, there’s a number of factors at play,” he said. “There have been challenges in terms of manufacturing, challenges in terms of distribution, and if we start to see tariffs kicking in, that’s another layer of challenge, but we watch this situation extremely closely.” He added: “We are constantly watching and acting on this situation to try and get medicines into the country, to make sure we’ve got availability, to show some flexibility in terms of how medicines are dispensed, to deal with shortages. Speaking on BBC Breakfast, Streeting said patient data was “not for sale” as part of any trade negotiations with the US designed to mitigate the impact of the tariffs. “The NHS is not for sale and our patients’ data is not for sale,” Streeting said. Read full story Source: The Guardian, 8 April 2025 -
News Article
Alarming decline in vaccine update must be tackled, say MPs
Patient Safety Learning posted a news article in News
The UK’s status as a global leader on vaccination is at risk because of falling uptake rates among children and an “alarming” decline in clinical trial activity, MPs have warned. The Health and Social Care Committee said in a report that it was concerned that England did not meet the 95% target for any routine childhood immunisations in 2021-22.1 Committee chair Steve Brine MP said that new spikes in measles cases in London and the West Midlands because of low uptake of MMR vaccines should be a “massive wake-up call” for the government to take action. “Vaccination is the one of the greatest success stories when it comes to preventing infection. Unless the government tackles challenges around declining rates of childhood immunisations and implements reform on clinical trials, however, the UK’s position as a global leader on vaccination risks being lost,” he said. The Health and Social Care Committee said, “It is unacceptable that there are people who are unable to take advantage of the important protection that vaccination offers because of practical challenges of time and location that can and must be tackled.” Read full story Source: BMJ, 27 July 2023 -
News ArticleSuperbugs are on the rise in the UK and the government is failing in its efforts to tackle them, ministers have been warned. The World Health Organization has described antimicrobial resistance (AMR) – where pathogens evolve and develop resistance to antibiotics and other antimicrobials so the drugs usually used to fight them no longer work – as “one of the top global public health and development threats”. AMR is already contributing to more than 35,000 deaths a year in the UK, estimates suggest. But the government “remains a long way” from achieving its aim of containing and controlling AMR, the National Audit Office (NAO) said. If urgent action is not taken to stem the crisis, the consequences for health, life expectancy, the functioning of the NHS and the wider economy would be “huge”, the watchdog said. Read full story Source: The Guardian, 26 February 2025
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News Article
UK falls “well below” EU average on doctors per population, report finds
Patient Safety Learning posted a news article in News
The UK had a shortage of around 176 000 doctors, nurses, and midwives in 2022 and has become over-reliant on international recruitment, warns a report by the Organisation for Economic Co-operation and Development (OECD). The report, which looked at the state of health in the EU, found that in total EU countries had an estimated shortage of 1.2 million doctors, nurses, and midwives. It cited multiple factors, including ageing populations, difficult working conditions, staff burnout, and challenges presented by the covid pandemic. Significant inequalities also continue to exist between EU member states. Read full story (paywalled) Source: BMJ, 21 November 2024 -
Content ArticleThe NHS in England has historically delivered high quality at low cost, but recently, its performance has declined. The challenges facing the NHS hold potential lessons for the United States.
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Content ArticleThis review by the UCL Institute of Health Equity (IHE) concludes that racism damages health and wellbeing and drives inequalities in London. Racism in the capital is widespread and persistent causing damage to individuals, communities and society as a whole. Its impacts are experienced in different ways and to varying levels of intensity related to individual experiences, socioeconomic position and other dimensions of exclusion such as disability, age and gender. The intersections with other dimensions of exclusion can amplify the effects of racism. The focus of this review is on the effects of racism on health and its contribution to avoidable inequalities in health between ethnic groups – a particularly unacceptable form of health inequity. It is urgent that society tackle the damage to health and wellbeing as a result of racism. The review is part of a series of evidence reviews funded by the Greater London Authority (GLA) to build the evidence for reducing health inequalities in London through action on specific social determinants of health. The other three reviews cover housing, the cost of living and adult skills.
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Content ArticleThe UK is the “sick man” of Europe at the moment—on almost every health indicator including life expectancy, healthy life expectancy, obesity rates and healthcare capacity—we lag behind our peers. Recent data from the Office for National Statistics shows the substantial impact this is having on our national prosperity. The number of people who cannot work primarily because of long-term illness reached a record nearly 2.6 million. In this article for The Guardian, Professor Dame Sally Davies, former chief medical officer for England, argues that this is not the first time the UK has lagged behind on health outcomes and faced the associated economic harm. During the 19th-century Industrial Revolution and the 20th-century post-war period, Britain faced health crises that, like today’s, also undermined labour supply, economic participation and growth. She highlights that in both of these instances, national leaders implemented bold new public health strategies on both health and economic grounds and asks the question, 'Why is the Government not taking a more comprehensive policy approach to tackling the serious health issues we face in 2023?'
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Content ArticleThe Prescribing Safety Assessment (PSA) is a 60-question exam required as part of UK medical training to progress from FY1 to FY2. This independent review into the PSA was commissioned by the Medical Schools Council (MSC) together with the British Pharmacological Society (BPS) in the summer of 2022. It suggests a strategic future direction for the PSA and addresses how the PSA has impacted prescribing assessment and practice for medical students and Foundation Year 1 (FY1) doctors. It is intended to support national decision making about the future of UK prescribing assessment in the context of the imminent introduction of the Medical Licensing Assessment (MLA). Recommendations Appropriate and mandatory assessment of prescribing should remain as a condition of practice for doctors in the UK: evidence of prescribing competence is highly desirable for new UK doctors, and those entering the UK from overseas. The addition of the PSA to the MLA should be considered as a pragmatic suggestion to form a Medical and Prescribing Licensing Assessment (MPLA): this could comprise an additional and separate paper under the umbrella of the MLA. The examination regulations need standardising and publishing: both the PSA and the MLA, when launched (or the MPLA) should publish examination regulations. This will standardise examination delivery between administering institutions and clarify the management of irregularities or appeals. The governance of the PSA should be reviewed to ensure that any examination irregularities are identified and addressed prior to confirming results to candidates. The PSA or combined MPLA should be considered as a requirement for medical practice in the UK: this could be a summative assessment as an exit from medical school or an entry requirement for FY1, and should be required for international medical graduates licensing (IMGs) via the PLAB route for entry at FY1 and FY2. The GMC should have regulatory oversight: the PSA (or MPLA) should be a national requirement for medical practice. As such, it should be subject to regulatory oversight from the GMC. If implemented, the proposed MPLA should be funded in the same way as the MLA: the MPLA should be funded in the same way as the MLA will be funded (by universities). In the case of IMGs, funding would follow the model of the PLAB test (self-funded).
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Content ArticleIn this report, Professor Brian Edwards summarises contributions given to the UK Covid-19 Inquiry by various politicians and senior civil servants, relating to how prepared the UK and Scottish Governments were for the Covid-19 pandemic. It contains reflections on the contributions of: Nicola Sturgeon (First Minister of Scotland during the pandemic) Matt Hancock (Secretary of State for Health and Social Care during the pandemic) Jenny Harries (Chief Executive of the UK Health Security Agency) Emma Reed (civil servant, DHSC)
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Content Article
UK Covid-19 Inquiry - Every Story Matters (June 2023)
Patient-Safety-Learning posted an article in Covid-19 Inquiry
The UK Covid-19 Inquiry is the independent public inquiry set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. In order to fully understand the impact of the pandemic on the UK population, the Inquiry is inviting the public to share their experiences of the pandemic by launching Every Story Matters. It will inform the Inquiry’s work by gathering pandemic experiences which can be brought together and represent the whole of the UK, including those seldom heard. The output of Every Story Matters will be a unique, comprehensive account of the UK population’s experiences of the pandemic, to be submitted to the Inquiry’s legal process as evidence. Share your story here. Every Story Matters provide a toolkit that contains information and creative assets that can be used to encourage participation in Every Story Matters. Every Story Matters aims to provide inclusive methods for people to talk about their experience of the pandemic, so anyone that wants to share their story feels heard, valued, and can contribute to the Inquiry. tips on engaging people to take part in Every Story Matters print campaign assets to download online campaign assets to download information on how to use campaign assets information on accessible engagement options. -
Content Article“Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Dan talks to us about how his experiences as a paediatrician and military doctor have influenced his view of patient safety. He also describes the increasing complexity in healthcare systems and highlights the need for the Government to commit policy and resources to building and sustaining the NHS workforce. -
Content ArticleAre whistleblower reward programmes a charter for malicious complaints, as some claim, or are they a genuine incentive providing a safety net against retaliation? How successful are these programmes in recovering fraud and other proceeds of crime and serious organised crime? This paper aims to answer these questions—it was produced by WhistleblowersUK in collaboration with US lawyers who contributed to the development and improvement of US reward programmes. It aims to address questions about the legislation around US reward programmes, dispel some of the myths and look at some of the objections attributed to British attitudes about rewarding whistleblowers.
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News ArticleA group of potent synthetic opioids called nitazenes have been linked to a rise in overdoses and deaths in people who use drugs, primarily heroin, in England over the past two months, drug regulators have warned. The Office for Health Improvements and Disparities has issued a National Patient Safety Alert on potent synthetic opioids implicated in heroin overdoses and deaths. In the past 8 weeks there has been an elevated number of overdoses (with some deaths) in people who use drugs, primarily heroin, in many parts of the country (reports are geographically widespread, with most regions affected but only a few cities or towns in each region). Testing in some of these cases has found nitazenes, a group of potent synthetic opioids. Nitazenes have been identified previously in this country, but their use has been more common in the USA. Their potency and toxicity are uncertain but perhaps similar to, or more than fentanyl, which is about 100x morphine. The National Patient Safety Alert provides further background and clinical information and actions for providers.
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Content ArticleThere has been growing concern about doctors’ conflicts of interests (COIs) but it is unclear what processes and tools exist to enable the consistent declaration and management of such interests. This study in the Journal of the Royal Society of Medicine mapped existing policies across a variety of organisations and settings to better understand the degree of variation and identify opportunities for improvement. The analysis of organisational policies revealed wide variation in what interests should be declared, when and how. This variation suggests that the current system may not be adequate to maintain a high level of professional integrity in all settings and that there is a need for better standardisation that reduces the risk of errors while addressing the needs of doctors, organisations and the public.
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Content ArticleThe Women's Health Strategy for England was developed and published in 2022 in response to the growing recognition of the unique health needs and challenges faced by women in England (and the U.K.) and was brought forward to address longstanding gaps in women's healthcare and to promote better health outcomes for women across the country. This Forbes article looks at why women’s health should be included in every government’s agenda. The author speaks to Professor Dame Lesley Regan, Women's Health Ambassador for England about the progress of the strategy and Dr. Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists about the need to ensure underrepresented groups are included in the strategy.
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Content ArticleThis BMJ article by journalist Andrew Kersley reports on a meeting of 157 medical experts and academics held at the Royal Society of Medicine on poverty and the cost-of-living crisis, which took place in May 2023. One academic at the event warned that the long term effect of ongoing economic inequality on life expectancy was worse than six unmitigated covid pandemics. The three solutions proposed at the meeting that received the most support were: a national strategy to tackle poverty the nationwide delivery of “more affordable, quality, secure social and rental housing” urgently increasing the rate of Universal Credit as well as removing the restrictions related to total benefits and multiple children.
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Content ArticleFor decades the NHS has collected routine data on millions of patients. In a world where big data has increasing value, the UK has an opportunity to truly leverage its health data assets to benefit people in the UK and across the world—both through better health and through the generation of more research and development and economic growth. This report by the Institute of Global Health Innovation at Imperial College London provides a broad overview of the UK’s health data policy landscape. It identifies strategic and technical recommendations to move towards a health data policy ecosystem that allows clinical, societal or financial value to be more readily extracted from patient data.
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Content ArticleUnpaid carers play a substantial and vital role in meeting social care needs. The care they provide has enormous value, both for the people they care for and for wider society. Many carers experience great satisfaction from their role, and through the help and support they provide to friends and family members they may also reduce the costs of formal social care provision. At the same time, caring responsibilities can come at a high personal and financial cost, despite the 2014 Care Act giving carers the right to receive support. 1 in 5 carers report feeling socially isolated and 4 in 10 report financial difficulties because of their caring role. This report by The Health Foundation aims to explore national data on the number of unpaid carers and trends over time, as well as which groups are more likely to have caring responsibilities and who they provide care for. It gives an overview of the types of support available to carers, and what we know–and don’t know–about how many carers are accessing support.
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Content ArticleThis report is the National Confidential Inquiry into Suicide and Safety in Mental Health's (NCISH) annual report on UK patient and general population data for 2010-2020. It includes findings relating to people aged 10 and above who died by suicide between 2010 and 2020 across all UK countries as well as people under mental health care who have been convicted of homicide, and those in the general population. Key findings relating to general population suicide include: There were 68,357 suicides in the UK between 2010 and 2020, an average of 6,214 deaths per year. The rate of suicide decreased by 6% in the UK in 2020, the first year of the Covid-19 pandemic, compared to 2019, and the decrease was particularly seen in men. Suicide rates increased in 2018-19 compared to 2017 in all countries except Wales. All UK countries showed a fall in rates in 2020. In addition, this report contains key findings relating to patient suicide (people in contact with mental health services within 12 months of suicide): Clinical and social characteristics, as well as clinical care Suicide by patients with economic adversity Suicide by patients aged under 25 years Suicide by patients given a diagnosis of personality disorder Suicide by patients who identified as lesbian, gay, bisexual or trans Suicide-related internet use.
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Content ArticleThe National Clinical Guideline for Stroke for the UK and Ireland provides authoritative, evidence-based practice guidance to improve the quality of care delivered to every adult who has a stroke in the United Kingdom and Ireland, regardless of age, gender, type of stroke, location, or any other feature. The guideline is intended for: Those providing care – nurses, doctors, therapists, care staff. Those receiving care – patients, their families, their carers. Those commissioning, providing or sanctioning stroke services. Anyone seeking to improve the care of people with stroke. The guideline is an initiative of the Intercollegiate Stroke Working Party.
