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New heart failure drug for thousands of UK patients given go ahead

More than a quarter of a million patients living with heart failure could be eligible for a new drug that reduces deaths and hospitalisation after medical regulators gave it the greenlight.

The National Institute for Health and Care Excellence (Nice) has approved dapagliflozin, made by AstraZeneca, for use on the NHS.

It can help treat patients with a form of chronic heart failure that means their blood does not pump blood out to the body as well as it should.

It is estimated almost one million people are living with heart failure in the UK which causes an estimated 65,000 unplanned hospital admissions a year. Around half of patients will die within five years of being diagnosed.

Evidence from a clinical trial shows that adding dapagliflozin to standard care lowers the risk of dying from heart disease and decreases hospitalisation or an urgent outpatient visit because of heart failure by 26% compared with standard care alone.

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Source: The Independent, 24 December 2020

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'Horrendous' ambulance delays at West Midlands hospitals

An ambulance crew had to wait seven hours to hand over a patient in the West Midlands, it has been revealed.

The case on 11 December was highlighted in the West Midlands Ambulance Service's in-house magazine, which said average waits had "ballooned".

It said average waits at one hospital were running at nearly three hours in early December.

The ambulance service said it hoped to put another 40 crews on the road by January.

Delays in hospitals taking over care of patients is considered "risky", NHS England said, because it not only delayed patients receiving specialist assessment and treatment, but also reduced the number of ambulances available to respond to emergencies.

The West Midlands trust's weekly briefing magazine, published on 17 December, said only the East of England trust had experienced a similar level of "horrendous" delays. It added that another four hospitals in the West Midlands had average delays of about two hours.

The "knock-on" effect it said was some high-risk patients were waiting longer for an ambulance than they should.

Meanwhile, some staff had to work late beyond their shifts and missed meal breaks.

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Source: BBC News, 23 December 2020

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The trusts set to have at least a third of beds filled by covid patients on 31 Dec

There are 14 hospital trusts on course to have at least a third of their beds filled by covid patients on New Year’s Eve.

HSJ analysed current occupancy and growth at each general acute trust in the seven days to 21 December. Projecting the same rate of growth forward, the number of trusts with at least a third of their bedbase likely to be taken by covid patients would increase from 5 at present to 14.

Three of the four acute trusts in Kent are projected to have covid bed occupancy of over 40%.

Another two trusts are in areas covered by tier two restrictions. They are Queen Elizabeth in Norfolk, and Countess of Chester. A third, East Sussex, has one of its two general hospitals in “tier four” (St Leonards), and the other in Eastbourne, which is outside the Sussex “tier four” zone.

There are also 27 trusts not in tier four areas which had more than 50 covid patients on 21 December, and where the number of covid patients grew by at least 20 per cent in that week. These include Liverpool University Hospitals and Sheffield Teaching Hospitals.

HSJ last week projected that, if trends continued, English hospitals would have just short of 19,000 covid patients on New Year’s Eve in total — almost exactly the same as the 12 April first wave peak. Current projections put that number at over 20,000.

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Source: HSJ, 23 December 2020

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NHS Trust chiefs warn funding needed for post-COVID digital uptake

A major survey of NHS IT chiefs has revealed that despite more positive attitudes and uptake towards technology as a result of COVID-19, the long-term challenges of digital transformation within hospital trusts remain unchanged and only 14% of respondents believe they have sufficient funding to cover business priorities.

The Digital Health Intelligence NHS IT Leadership Survey, carried out annually by Digital Health Intelligence, offers a 'state of the nation' insight into the priorities, concerns and challenges faced by NHS chief clinical information officers (CCIO’s), Chief Information Officer’s (CIOs) and other relevant digital health leaders.

It revealed that despite record levels of positivity for digital transformation - 83% of respondents said the pandemic had resulted in a more positive attitude to digital among board members, up on 63% the previous year - just 24% are expecting a significant rise in funding and 14% think budgets will decrease.

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Source: Digital Health, 15 December 2020

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Private hospital in Bradford placed in special measures over patient safety

A hospital for men with learning disabilities has been placed in special measures after the Care Quality Commission (CQC) identified “serious risks to patient safety”.

The CQC said it had also suspended its current rating of “good” for caring for Cygnet Woodside, Bradford, West Yorkshire, following an inspection in September.

The commission said it carried out the unannounced inspection following allegations of abuse by staff towards a patient, which are subject to an ongoing police investigation.

The hospital said it was “disappointed” with the CQC’s assessment, stressing that the inspection was triggered by its own management notifying the commission of a concern it had identified. It said the report “does not provide an entirely accurate representation” of the hospital.

Dr Kevin Cleary, the CQC deputy chief inspector of hospitals and lead for mental health, said: “Our latest inspection of Cygnet Woodside found that the hospital was not ensuring its patients’ safety.”

Cleary added: “The service showed warning signs that increased the likelihood of a closed culture developing. This would have put people at serious risk of coming to harm if we didn’t take action.”

He said care was compromised because there was not always the right number or skill level of staff looking after patients.

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Source: Guardian, 23 December 2020

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NHS leaders raise concerns over pace of Covid vaccine rollout

NHS leaders have raised concerns about the rollout of the coronavirus vaccine, with more than half of hospital trusts and two-thirds of GPs yet to receive supplies amid growing alarm over the new fast-spreading variant.

Dr Richard Vautrey, the chair of the British Medical Association’s GP committee, urged the government to speed up delivery of the Pfizer/BioNTech vaccine in order to save lives. Experts also demanded greater transparency from ministers on how many doses are available.

Vautrey said: “We need millions of doses to be made available as soon as possible – urgently – because it’s the number one priority for GP practices, our patients and the nation, especially given the new mutant strain.

“GPs who haven’t got it yet are frustrated because they want to be getting on and vaccinating their patients as well. Their frustration is understandable. They want to protect their patients, especially their vulnerable patients, as quickly as possible.”

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Source: The Guardian, 22 December 2020

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Specialised Commissioning Patient and Public Voice (PPV) roles (closing date 17 January 2021

Patient and Public Voice (PPV) partners play a crucial role in specialised services and are represented across the board on NHS advisory groups and governance structures to ensure that the views of patients, carers and the public are at the heart of what we do.

Specialised Services are currently recruiting to a range of vacancies for PPV partners, all of which can be found here.

NHS England and NHS Improvement are committed to promoting equality and inclusion to ensure that our PPV partners reflect and represent our diverse population, and particularly encourage people from Black, Asian and Minority Ethnic (BAME) backgrounds to apply.

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Source: NHS England/Improvement

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Call-before-you-walk: Acutely ill patients being diverted from A&E departments, GPs warn

Acutely ill patients requiring emergency care are being diverted to their GP via the new NHS 111 First call-before-you-walk A&E triage system, Pulse has learned.

GPs have reported receiving inappropriate NHS 111 referrals including:

  • an acutely dizzy elderly patient who was later confirmed to have had a posterior circulation stroke; 
  • a patient with acute coronary syndrome; and
  • a patient with acute UTI symptoms.

Meanwhile, GPs are also warning that patients are using the triage system as a way of ‘jumping the queue’ because the route is likely to get them an appointment quicker than calling their practice.

From this month, patients in England are being asked to call 111 before attending A&Es – with 111 triaging them to the most appropriate service, including GP practices.

Scottish patients are also being asked to phone ahead of attending A&E; while pilots are ongoing in Northern Ireland; and Wales is in the process of rolling out a ‘contact first’ model following summer pilots.

The BMA has said the influx of inappropriate referrals by NHS 111 is likely being ‘compounded’ by the new 111 First system, which is ‘contributing to the immense pressures currently facing primary care’.

GPs have raised concerns about several cases in which patients should not have been sent to them by 111 because they required more urgent care.

One GP, who asked not to be named, told Pulse: "I had a patient with UTI symptoms – a temperature of 39°C, a heart rate of 140, nausea and abdomen/loin pain. They were told: speak to your GP."

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Source: Pulse, 21 December 2020

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Long Covid sufferers should be offered psychiatric care if symptoms last more than 12 weeks

People who suffer from the debilitating effects of long Covid should be offered psychiatric care, the first clinical guidance to be published on the subject recommends.

The guidelines urge healthcare professionals to look out for signs that patients who continue to suffer symptoms of COVID-19 for weeks after contracting the virus are at risk of self-harm.

In the new advice, the National Institute for Health and Care Excellence (NICE) and the Royal College of General Practitioners, say people with ongoing symptomatic COVID-19 or suspected post-Covid 19 syndrome, whose symptoms last longer than 12 weeks, should be “urgently” referred for assessment if they have severe psychiatric symptoms or are at risk of self-harm or suicide.

The guidelines state: “Follow relevant national or local guidelines on referral for people who have anxiety and mood disorders or other psychiatric symptoms. Consider referral for psychological therapies if they have common mental health symptoms, such as symptoms of mild anxiety and mild depression, or to a liaison psychiatry service if they have more complex needs (especially if they have a complex physical and mental health presentation).”

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Source: The Telegraph, 18 December 2020

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Doctors and nurses at London’s frontline hospital denied coronavirus vaccine

Doctors and nurses on the front line of the fight against coronavirus at the Royal London Hospital – which has the largest number of Covid patients in the capital – have been denied the Pfizer vaccine, The Independent has learnt.

Hospital bosses at Barts Health Trust have written to staff today expressing their frustration over the decisions by NHS England, which meant the northeast of London – where the rate of infections and hospitalisations are worst – has not been given access to any vaccines.

The Independent has learned that staff from the Royal London booked appointments to be vaccinated at University College London, but they were turned away because the vaccinations had been earmarked for NHS staff from University College London Hospital Trust.

The trust’s chief medical officer wrote to senior doctors on Monday warning them the crisis facing the hospital would get worse before it gets better.

Professor Alistair Chesser told staff: “It has been frustrating to see the vaccine delivered to other trusts and to GP surgeries but not to us in the last few days given the pressure we are under. Please be assured we are lobbying for our staff and our patients at the very highest levels and will not let this rest.”

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Source: The Independent, 22 December 2020

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Thousands of clinically vulnerable patients in tier 4 areas told to stay indoors

Thousands of people who are at extreme risk from the coronavirus and live in tier 4 areas have been told to stay indoors at all times unless they are exercising or have medical appointments.

The Department of Health and Social Care (DHSC) issued new advice on Monday warning people classed as “clinically extremely vulnerable” to stay home, in a bid to protect them from the new, more infectious strain of COVID-19.

Those affected have been told not to leave their homes even if they cannot work remotely. The government said residents could be eligible for statutory sick pay, employment support allowance, or universal credit as well as the coronavirus job retention scheme.

The DHSC said the high-risk group should stay at home as much as possible. Children who have been advised to shield should not attend school, the department added. 

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Source: The Independent, 21 December 2020

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Cancer care under threat as NHS loses covid private sector back-up

Cancer surgery in London is under threat as rising covid admissions put pressure on services that no longer have back-up capacity from the independent sector, HSJ has learned.

Research by HSJ has discovered that NHS England ended contracts with HCA, The London Clinic and the Cromwell Hospital at the end of August, after concerns about underutilisation.

Under the previous deal with the private sector, rules were in place to make sure low-priority private patients were not treated ahead of NHS patients who needed surgery urgently.

HCA and The Cromwell have confirmed the contracts were ended in August and were not renewed. The London Clinic did not respond to a request for comment.

As of 19 December, there were 2,909 covid inpatients being treated in London hospitals, a rise of 39% over the previous seven days. Barts Health Trust and Barking, Havering and Redbridge University Trust in the east of the city are under particular pressure.

Should the number of covid patients reach a level that requires the capital to instigate surge protocols, theatre space set aside for cancer operations is likely to be commandeered. Under this scenario, the NHS in the capital would no longer have the option to transfer cancer patients to private facilities as it did during the first wave of the pandemic.

A senior London-based source said: “This is a real and imminent threat to London’s ability to perform cancer surgery."

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Source: HSJ, 21 December 2020

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Fife simulator helping medics across the world to prevent late miscarriage and premature labour

A new training aid, developed in Fife, is helping to equip trainee medical staff from around the world with the skills to prevent late miscarriage and premature labour.

It was invented by Dr Graham Tydeman, consultant in obstetrics and gynaecology at Kirkcaldy’s Victoria Hospital, in conjunction with the St Thomas’ Hospital, London, and Limbs and Things.

The lifelike simulator allows trainees to perform hands on cervical cerclage in advance of a real-life emergency. The procedure involves an emergency stitching around the cervix and is necessary when the cervix shortens or opens too early during pregnancy, helping to prevent late miscarriage or extreme premature labour.

It is not a common event and the simulator was developed by Dr Tydeman following a request from medical trainees across the UK.

The device has already been warmly received by hospitals and training institutions across the world – with orders from countries including New Zealand and India.

Dr Tydeman said: “The reason this was developed is that it is not a common procedure and is very difficult to teach trainees."

“Increasingly women are understandably asking  about the experience of their surgeon and anyone having this procedure understandably does not want it to be the first one that a doctor has ever done because if it goes wrong there could be tragic consequences with loss of the baby. However, if a trainee has shown suitable skills using this simulator, I would be able to confidently reassure women that the doctor had been adequately trained, although a more experienced person would always help during the actual operation for the first few procedures on real women."

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Source: The Courier, 19 December 2020

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Pressure on hospitals 'at a really dangerous point'

Nearly 90% of hospital beds in England are full as hospitals try to cope with the demands of Covid in addition to normal winter pressures.

Ambulances queuing to offload patients, staff sickness and a lack of beds mean hospitals are "at a really dangerous point", say emergency doctors. This could result in some trusts facing the decision to stop non-Covid work.

Rises in hospital admissions are particularly affecting areas in the south.

The percentage of NHS hospital beds which are occupied is increasing and has reached almost 89% in England for the week ending December 13.

This is the highest occupancy rate so far this year - it's still lower than the same time last year, although the extra burden of Covid is likely to make hospitals feel they are much busier.

A safe level for bed occupancy is below 90% but nearly half of NHS trusts report a figure currently higher than this - the largest proportion this season.

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Source: BBC News, 19 December 2020

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Layla Moran secures first Commons debate on Long Covid

Layla Moran, Lib Dem MP for Oxford West and Abingdon and Chair of the APPG on Coronavirus, has secured the first Commons debate on Long Covid on Thursday 7 January following cross-party support.

The Backbench Business Committee granted the application by Layla Moran, co-sponsored by Dr Dan Poulter MP (Con) and Andrew Gwynne MP (Lab) and supported by many others.  Layla said that the debate “is long overdue” and called on “those with lived experience and clinical experience to tell us your stories” in advance of the debate.

Layla Moran said: “I’m pleased that we’ve been able to secure this important debate on Long Covid, which is long overdue. The APPG on Coronavirus, which I chair, has submitted recommendations to the Government on this, and the debate will give us the opportunity to hold them to account and represent our constituents suffering from it."

“What’s really important now is that as many MPs as possible take part in the debate, so we can give this the profile it deserves and give the Government the opportunity to listen and respond to our concerns. Thank you to my cross-party colleagues for supporting this. I’m calling on those with lived experience and clinical experience to tell us your stories between now and the 7 January. This is a crucial opportunity.”

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Source: Liberal Democrats, 19 December 2020

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Covid infections caught in hospital rise by a third in one week

The number of people likely to have caught COVID-19 in NHS hospitals in England has risen by more than a third in the last week.

The 35% rise in probable hospital-acquired COVID-19 from 6 to 13 December is the highest weekly increase since 30 October, HSJ analysis of NHS England data reveals.

Hospital-acquired infections are rising across areas such as London, the South East, and South West, and also at some hospitals in the North East, Yorkshire and the Midlands.

At some trusts, the weekly total of likely hospital-acquired COVID-19 infections has more than doubled since last week.

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Source: HSJ, 18 December 2020

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Doctors use pandemic as excuse not to offer effective pain relief claim campaigners

Women are undergoing “painful and distressing” diagnostic tests as doctors use the COVID-19 pandemic as an excuse not to offer them their choice of pain relief, HSJ has been told.

At least 70 women who have had hysteroscopies this year in English NHS hospitals said they were left in extreme pain following the procedures, with many suffering trauma for several days, according to a survey by the Campaign Against Painful Hysteroscopies group.

Some women claimed doctors used COVID-19 as an “excuse” not to offer sedation or general anaesthetic. Others said they were offered an inpatient appointment with general anaesthetic, but were also told it would be a long wait and would likely be cancelled due to covid pressures.

Women also said they were told an outpatient procedure would reduce the time spent in hospital and consequently reduce the risk of contracting covid. The only pain relief on offer was often just ibuprofen and some women said facilities like recovery rooms were unavailable.

The vast majority of the women surveyed — more than 90% — said they were traumatised for a day or longer by the pain from the procedure,

A RCOG spokeswoman said: “We are concerned to hear that women are going through painful and distressing hysteroscopy procedures and that they feel COVID-19 is being used as an excuse not to offer a choice of anaesthetic."

“The covid-19 pandemic has put incredible strain on the health services, and the risk of transmission of the virus has meant they’ve had to adapt their procedures. Whilst all women should be offered a choice of anaesthesia and treatment settings for hysteroscopic procedures, an outpatient setting avoids hospital admission and reduces the risk of exposure to the virus."

“The RCOG guidance on this is very clear — all pain relief options should be discussed with women, as well as the risks and benefits of each. Women should be given the choice of a local or general anaesthetic. If the procedure is still too painful, no matter what anaesthetic options are chosen, it must be stopped and a further discussion of pain relief options should then take place. It’s vital that women are listened to and their choice is fully supported.”

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Source: HSJ, 21 December 2020

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Shortages of staff and equipment weigh on doctors’ decisions, survey reveals

Staff shortages and a lack of equipment are affecting the day-to-day decisions about patient care by doctors and nurses, a new YouGov survey has revealed.

The representative survey of NHS clinicians revealed more than half, 54%, admitted that factors such as a lack of staff played a role in their decisions about patients beyond what was in their best interests.

Almost a third of staff, 31%, said staffing levels were the top factor affecting decisions about patients. A fifth said the availability of services such as key tests were a significant factor; 16% cited a lack of equipment; and 12% cited beds. 10% of clinicians said a fear of being sued was part of their decision-making.

YouGov carried out the research for JMW Solicitors and weighted the responses to be representative of the NHS workforce population.

It also revealed more than two-fifths of clinicians, 42%, believe a “blame culture” in the NHS plays a top role in preventing staff admitting to mistakes in care.

In maternity services specifically, 68% of nurses and midwives said at least one factor other than what was in patients’ best interest played a role in their decisions.

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Source: The Independent, 20 December 2020

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Long Covid: Hospital patients to get checks at six weeks

Patients in hospital with coronavirus should be offered a follow-up six weeks later to check for "long Covid" symptoms, doctors are being advised.

The guidance, drawn up by health officials across the UK, says the long-term effects can be "significant". They identified 28 of the most common symptoms, from breathlessness and dizziness to chest pain.

Mental health problems including depression, anxiety and struggling to think clearly, have also been reported.

"Because this is a new condition, there is still much that we don't know about it," said Paul Chrisp of the National Institute for Health and Care Excellence, which produces health guidance.

The NHS has opened 69 specialist clinics across England to offer rehabilitation to people recovering from the disease.

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Source: BBC News, 18 December 2020

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Teaching trust’s staff ‘utterly rinsed and completely wiped out’ by elective targets

A major London trust’s critical care staff have urged leaders to review elective work targets amid serious concerns over workload, safe staffing and burnout, HSJ  has learned.

In a letter to Guy’s and St Thomas’ Foundation Trust’s board, staff represented by trade union Unite said they had “repeatedly” raised concerns about the provider’s approach to elective work, as well as winter pressures and second wave planning, and the implications this has had for “the health, safety and wellbeing of both staff and patients”. 

The letter — which was also addressed to the trust’s health and safety committee and has been seen by HSJ —  said: “Our primary concern is that the trust’s endeavours, and understandable need to square these circles, may be unrealistic given the current pressures on staffing and the high rates of sickness and burnout the trust is continuing to experience.

“This is especially in critical care, where we are concerned this may compromise patient safety and is already damaging staff wellbeing and morale.”

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Source: HSJ, 18 December 2020

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Clapped-out kit, long delays, too few beds and staff: NHS enters 2021 in a sorry state

Think 2020 has been awful for the NHS? Next year is shaping up to be far worse – and most of the huge hole it’s in was dug long before Covid. The virus has merely finished off the job.

The health service does not have the beds, staff or equipment to recover the ground it lost during the first two waves of the coronavirus pandemic, but the government is blocking desperately needed improvements, and another round of organisational upheaval is on its way.

Roughly one in 11 clinical posts are vacant, and it would hardly be a surprise to see many staff rush for the retirement door once the worst of the pandemic is behind us. The NHS can’t solve the problem without long-term certainty over funding for staff.

Around 140,000 patients in England have been waiting more than a year for surgeries such as a hip replacements, up a hundredfold from a year ago. With the whole system beset by delays long before we had even heard of coronavirus, the lack of spare capacity means it will take years to help many patients.

Unprecedented interruptions and delays to cancer tests and treatments have been exacerbated by the pitiful state of diagnostic equipment. Access to CT and MRI scanners is far behind countries with a fraction of our wealth, such as Slovenia and Slovakia. Y

In the midst of all this turmoil, the NHS in England faces another round of legislative and organisational upheaval next year, the likely arrival of a new chief executive, and a potential fight with Downing Street over the extent of political control.

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Source: The Guardian, 18 December 2020

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Troubled children’s service taken out of special measures

An independent children’s and adolescents’ mental health service has been taken out of special measures after cutting beds by two-thirds.

The Care Quality Commission has rated St Andrew’s Healthcare’s CAMHS unit in Northamptonshire “requires improvement” but removed it from special measures. Among improvements noticed were a major change in the service’s leadership and staff raising concerns openly and honestly.

The unit was rated “inadequate” and served with a section 31 notice following inspections in June and December last year. 

After its December inspection, the charity reduced the number of beds within its CAMHS offering from 90 to 30. Around the same time, St Andrew’s Healthcare chief executive Katie Fisher also revealed plans to shrink its services by half to address the serious quality issues.

Speaking to HSJ, St Andrew’s Healthcare chief executive, Kate Fisher, who was appointed in 2018, said: “this isn’t just words, we are absolutely walking the walk and seeing through the strategy we set ourselves.”

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Source: HSJ, 18 December 2020

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Long COVID patients to get help at more than 60 clinics

Thousands of patients suffering with the long term symptoms of coronavirus can now access specialist help at more than 60 sites, NHS England announced today.

The assessment centres are taking referrals from GPs for people experiencing brain fog, anxiety, depression, breathlessness, fatigue and other debilitating symptoms.

NHS England has provided £10 million for the network of clinics, which started opening last month. There are now 69 operating across the country with hundreds of patients already getting help.

The new centres bring together doctors, nurses, physiotherapists and occupational therapists to offer both physical and psychological assessments and refer patients to the right treatment and rehabilitation services.

Ten sites are now operational in London, seven in the East of England, eight in the Midlands, South East and South West respectively, nine in the North West and a further 18 across the North East and Yorkshire.

A further 12 sites are earmarked to launch in January in the East Midlands, Lancashire, Cornwall and Isle of Wight.

The National Institute for Clinical Excellence (NICE) has today also issued official guidance on best practice for recognising, investigating and rehabilitating patients with long COVID.

Patients can access services if they are referred by a GP or another healthcare professional, so that doctors can first rule out other possible underlying causes for symptoms.

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Source: NHS England, 18 December 2020

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Nurses reissue call for safe staffing levels one year after strike

More needs to be done to tackle safe staffing levels in Northern Ireland's health service, according to the Royal College of Nursing (RCN).

A year on from the nurses' strike, the union has warned that problems caused by poor workforce planning and chronic underfunding have not been addressed.

Instead they have been exacerbated by the CoOVID-19 pandemic, said the RCN.

The Department of Health said dealing with staff shortfalls was a "key priority" for the health minister.

Pat Cullen, the Northern Ireland director of the RCN, said "very little has actually changed" since about 15,000 healthcare workers took to the picket line in December last year for a series of protests over pay and safe staffing levels.

"We need to remind the government that many of these issues have sadly not gone away," she added.

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Source: BBC News, 18 December 2020

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London hospitals cancel operations to free up staffing as critical care beds fill up

London’s hospitals are already beginning to run out of critical care beds ahead of the Christmas relaxation of rules – which is expected to increase cases further, a leaked NHS briefing has warned.

The update on the situation in the capital comes as major hospitals have already started to cancel operations for other patients in order to find enough staff to deal with the rise in patients as NHS trusts open up extra surge capacity.

More operations are expected to be cancelled in hospitals across London, with staff warned they could be redeployed at short notice.

On Wednesday, there were a total of 2,289 coronavirus patients in London hospitals, an increase of 2 per cent on the day before. But the numbers of coronavirus patients in critical care beds jumped 8.6% in a single day, increasing from 302 to 345 patients on Wednesday, while an additional 900 people who have tested positive were receiving oxygen.

Across London, there were just 49 adult critical care beds available on Wednesday. In total there were 904 beds occupied, 328 by patients with COVID-19. This meant the capital’s total critical care bed occupancy rate was almost 95%.

Although the number of patients is much lower than it was the first wave, many hospitals are still treating routine and non-Covid patients – meaning they are struggling to staff critical wards and keep other services running.

A briefing for NHS managers warned them: “A reduction of elective [routine] activity is likely to be needed in line with increasing acute activity.”

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Source: The Independent, 17 December 2020

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