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Coronavirus: Tens of thousands ‘wrongly given’ all clear by Lighthouse Labs

Tens of thousands of people infected with coronavirus were incorrectly given the all clear by England’s Lighthouse Laboratories, a High Court trial will be told next week.

Court documents seen by The Independent show the labs are accused of unfairly selecting software that was shown in a test to produce significant numbers of errors and false negatives, samples that should have been positive or classed as needing to be re-taken.

The two companies behind the Lighthouse Labs in England – Medicines Discovery Catapult Ltd and UK Biocentre Ltd – are accused of treating British company, Diagnostics.ai unfairly and giving preferential treatment to Belgian company UgenTec, despite the British firm’s software performing better in the test.

The case, first revealed by The Independent in June, also includes a judicial review of the procurement decision against health secretary Matt Hancock – one of the first court hearings over the procurement processes followed by the government since the start of the pandemic.

The Independent understands lawyers for Diagnostics.ai will accuse the laboratories of choosing a software solution that went on to produce tens of thousands of incorrect results which will have led to infected people going about their normal lives while at risk of spreading the virus.

In June, UgenTec chief executive Steven Verhoeven told The Independent the suggestion its software had made errors was “incorrect”.

The Department of Health refused to comment on the legal action but said in June that the UgenTec software had been used for several months and was subject to quality assurance processes, though it did not give any further details.

Mr Justice Fraser will hear opening arguments in the case on Monday at the High Court.

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Source: The Independent, 25 September 2020

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"I’m one of the legion of long-Covid sufferers"

Hundreds of thousands who survived the virus still have side-effects that range from loss of smell to chronic fatigue.

"It started with a mild sore throat. I was in Devon at the beginning of the lockdown, and because I hadn’t been on a cruise ship, gone skiing in Italy or partying with the crowds at Cheltenham races, I didn’t think it could be COVID-19. Then I developed sinusitis. My GP was practical: “This is not a symptom of the virus,” he emailed me. But my sense of smell had disappeared. At first this wasn’t a sign but six months later, I still can’t tell the difference between the smell of an overripe banana or lavender. I can distinguish petrol but not gas, dog mess but not roses, bacon but not freshly cut grass. Everything else smells of burnt condensed milk."

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Source: The Times, 23 September 2020

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Investigation launched after seven ‘never events’ in two years at leading trust

An external review has been launched at a leading children’s hospital after a series of “never events”.

According to local commissioners, a review by the Association for Perioperative Practitioners will look into seven incidents at Alder Hey Children’s Foundation Trust over the last two years. The probe had been delayed by the pandemic and began this month.  

Great Ormond Street Hospital for Children FT and Sheffield Children’s FT, the two other dedicated children’s trusts in England, reported one and four never events respectively, between April 2018 and July 2020, according to national data.

In a statement, Alder Hey claimed it could not provide further details of the incidents. But most have been described in its board papers over the past year. They include a 15-year-old who had the wrong tooth removed by the surgical division, a patient who had the wrong eye operated on, a swab that was left inside a patient having their adenoids and tonsils removed, and an incorrect implant being inserted into an orthopaedics patient.

Liverpool Clinical Commissioning’s group’s board papers for September said: “The trust has had a series of seven never events and there is a plan to undertake an external review that has been delayed due to the pandemic response. The trust has approached the Association for Perioperative Practitioners and have agreed the process."

“The trust also plans to work with Imperial College London on a peer review and bespoke human factors training to include simulation training and coaching. The trust also plans to produce an overarching action plan to bring together the themes and learning from the seven never events. This work is still underway and NHSE/I and CCG had requested a copy of this plan.”

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Source: HSJ, 24 September 2020

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Great Ormond Street criticised over Arvind Jain's death

Delays at the Great Ormond Street Hospital led to a boy dying an agonising death, a health watchdog has found.

Arvind Jain, 13, who had Duchenne Muscular Dystrophy, died in August 2009 after waiting months for an operation. The ombudsman's report found he had "suffered considerable distress" and criticised referral procedures as "chaotic and substandard".

The Great Ormond Street Hospital said there were "failings in clinical care".

Arvind's sister Shushma said: "To read that he was suffering all the time, that was disgusting. He had been asking us repeatedly if he would get the operation and we would be constantly reassuring him that he would not die."

The degenerative disease Arvind, who lived in Cricklewood, north London, suffered from was not immediately life threatening but in January 2009 his condition had become acute enough for him to struggle with swallowing and feeding. He had a temporary medical solution where a tube was inserted through his nose to help him get the required nutrition. He also experienced a number of other medical complications although none of these was considered life-threatening.

The permanent solution recommended by his consultant paediatric neurologist was a gastrostomy insertion which would allow Arvind to feed through his stomach.

The Great Ormond Street Hospital Trust (GOSH) excels in such procedures, however, a series of communication errors meant despite repeated and urgent requests from his neurological consultant, proper investigations were not carried out into Arvind's suitability for the operation.

After five months of delays he and his family were reassured that as soon as he got the operation he would be much more comfortable. Another hospital also offered to carry out the operation in the event that the delays continued. But the surgical team that was due to carry out the operation never managed to assess Arvind.

His condition deteriorated to the point where he was not well enough to be operated on and Arvind died on 9 August 2009.

The Parliamentary and Health Service Ombudsman's report said he "suffered considerable distress and discomfort". It also describes a series of basic shortcomings in Arvind's care.

The report said: "The standard of care provided for Arvind fell so far below the applicable standards as to amount to service failure."

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Source: BBC News, 23 September 2020

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True Global Solidarity: Spectacular World Patient Safety Day around the world

Dr Neelam Dhingra, Coordinator, Patient Safety and Risk Management, World Health Organization, reflects on World Patient Safety Day 2020.WPSD.png.da03fa56e160d143a1492a93e3ae8072.png

"Dear Colleagues

Congratulations. This is a moment of pride for all of us!

The WHO Patient Safety Flagship would like to express its deepest appreciation to members of the Global Patient Safety Network for an outstanding commemoration of the World Patient Safety Day 2020 around the world. The response to the call was phenomenal and we have already received great stories and truly inspiring reports from multiple countries, regions, partners and stakeholders showcasing a variety of activities. A number of global virtual events amplifying the messaging for the day. “Safe health workers, Safe patients” and “Speak up for Health worker safety!”. Moreover, hundreds, if not thousands, of iconic monuments, landmarks and health care facilities were lit up in colour orange from all over the world. We are working on a short summary and a full report illustrating all these amazing contributions. Most importantly, the day was a witness to expression of strong commitment and leadership of ministries of health for urgent and sustainable action, from countries across the world.

At WHO headquarters on 17 September 2020, a landmark Charter “Health worker Safety: A priority for patient safety”, was launched at a World Patient Safety Day Press Conference (https://twitter.com/who/status/1306496780649938944?s=24) by WHO Director General, Dr. Tedros Adhanom Ghebreyesus in the presence of International Labour Organization Director General, Dr Guy Ryder and Rt. Hon Mr Jeremy Hunt, Chair, Health and Social Care Select Committee, House of Commons of the UK, who played a key role in establishing World Patient Safety Day, an active campaigner on patient safety globally and also the Co-Chair of WHO Steering Committee on World Patient Safety Day.

WHO Member States and all relevant stakeholders are invited to support health worker safety by endorsing and signing up to the Charter.

Charter: Health worker safety: a priority for patient safety

https://bit.ly/2FNEzRu  

Sign up: https://www.who.int/campaigns/world-patient-safety-day/sign-up-to-the-charter---health-worker-safety

A Global Virtual Event “One world: Global solidarity for health worker safety and patient safety” was held showcasing rich participations from members of this very network, regions and countries. WHO Deputy Director General, Dr Zsuzsanna Jakab, and also the Co-Chair of WHO Steering Committee on World Patient Safety Day, in her closing remarks emphasised 'World Patient Safety Day 2020 should not be seen only as Day but a platform for change.  WHO will work with partners to advance the themes of the Day throughout the entire year'.

A number of advocacy, policy, technical products were launched at the event including:

1. World Patient Safety Day 2020-21 Goals. From this year onwards, WHO will launch theme-related goals with the aim of achieving tangible and measurable improvements at the point of health service delivery. Ministries of health and health care organizations are encouraged to incorporate these goals into ongoing service improvement programmes and drives. As a new set of goals will be proposed each year, implementation teams at health care facilities are advised to institutionalize patient safety improvements achieved, and to take on new goals as well as sustaining action on goals from the previous year. WHO is setting up an online platform where health care facilities and organizations can report progress and learn from each other. A certificate of appreciation will be provided to the registered facilities. The World Patient Safety Day goals 2020–2021 are aimed at improving health worker safety. Please sign up to the goals.

Goals https://www.who.int/publications/i/item/who-uhl-ihs-2020.8

Sign up: https://www.who.int/campaigns/world-patient-safety-day/sign-up-for-wpsd-2020-2021-goals

2. Patient safety incident reporting and learning systems: technical report and guidance: https://www.who.int/publications/i/item/9789240010338

3. WHO-ILO joint publication "Caring for those who care: National Programmes for Occupational Health for Health Workers" https://www.who.int/publications/i/item/caring-for-those-who-care

4. Protection of health and safety of health workers: Checklist for healthcare facilities https://www.who.int/publications/i/item/protection-of-health-and-safety-of-health-workers

5. An OpenWHO course on: Occupational health and safety for health workers in the context of COVID-19
https://openwho.org/courses/COVID-19-occupational-health-and-safety?tracking_user=79KWbMERvlyJs93otUBThL&tracking_type=news&tracking_id=5G2Mpe2LUQH0UI1yw8p8pV

World Patient Safety Day provides a torch bearing platform, which brings spotlight on global, national and local patient safety issues. This year the World Patient Safety Day brought a spotlight on health worker safety and its impact and interaction with patient safety.

This year’s WPSD came as a result of close collaboration between WHO and all stakeholders.  We strongly believe that the amazing sense of ownership was the key factor for success. For that, we thank you all.

Thanks and best regards,"

Dr Neelam Dhingra

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10,000 more deaths than usual occurred in UK homes since June

Some 10,000 more deaths than usual have occurred in peoples’ private homes since mid June, long after the peak in Covid deaths, prompting fears that people may still be avoiding health services and delaying sending their loved ones to care homes.

It brings to more than 30,000 the total number of excess deaths happening in people’s homes across the UK since the start of the pandemic.

Excess deaths are a count of those deaths which are over and above a “normal” year, based on the average number of deaths that occurred in the past five years.

In the past three months the number of excess deaths across all settings, has, in the main been lower than that of previous years. However, deaths in private homes buck the trend with an average of 824 excess deaths per week in people’s homes in the 13 weeks to mid-September.

Experts are citing resistance from the public to enter hospitals or home care settings and “deconditioning” caused by decreased physical activity among older people shielding at home, for example not walking around a supermarket or garden centre as they might normally.

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Source: The Guardian, 24 September 2020

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Maternity units told to allow partners and visitors so mothers are not left to give birth alone

Hospitals have been ordered to allow partners and visitors onto maternity wards so pregnant women are not forced to give birth on their own.

NHS England and NHS Improvement have written to all of the directors of nursing and heads of midwifery to ask them to urgently change the rules around visiting.

The letter, which is dated 19 September and seen by The Independent, says NHS guidance was released on 8 September so partners and visitors can attend maternity units now “the peak of the first wave has passed”.

“We thank you and are grateful the majority of services have quickly implemented this guidance and relaxed visiting restrictions,” it reads. “To those that are still working through the guidance, this must happen now so that partners are able to attend maternity units for appointments and births.”

The letter adds: “Pregnancy can be a stressful time for women and their families, and all the more so during a pandemic, so it is vital that everything possible is done to support them through this time.”

Make Birth Better, a campaign group which polled 458 pregnant women for a new study they shared exclusively, said mothers-to-be have been forced to give birth without partners and have had less access to pain relief in the wake of the public health crisis.

Half of those polled were forced to alter their own childbirth plans as a result of the COVID-19 outbreak – while almost half of those who were dependant on support from a specialist mental health midwife said help had stopped.

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Source: The Independent, 23 September 2020

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Hundreds of hospital ventilators could stop working, NHS warned

Hospitals have been warned hundreds of ventilators used to keep sedated patients alive are at risk of suddenly shutting down because of a fault, in some cases without warning.

The Medicines and Healthcare products Regulatory Agency, which said there were approximately 303 Philips Respironics V60 ventilators used in the UK, has warned hospitals over a delay in replacement parts arriving in the UK to fix the problem.

It has issued a safety alert to hospitals to make them aware of the increased risk.

The regulator said it had received one report of a ventilator suddenly shutting down but said there was no report of any injury to patients.

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Source: The Independent, 23 September 2020

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NHS trust fined for lack of candour in first prosecution of its kind

A hospital trust has been fined for failing to be open and transparent with the bereaved family of a 91-year-old woman in the first prosecution of its kind.

Elsie Woodfield died at Derriford hospital in Plymouth after suffering a perforated oesophagus during an endoscopy.

The Care Quality Commission (CQC) took University Hospitals Plymouth NHS trust to court under duty of candour regulations, accusing it of not being open with Woodfield’s family about her death and not apologising in a timely way.

Judge Joanna Matson was told Woodfield’s daughter Anna Davidson eventually received a letter apologising over her mother’s death, which happened in December 2017, but she felt it lacked remorse.

Davidson said she still had many unanswered questions and found it “impossible to grieve”.

The judge said: “This offence is a very good example of why these regulatory offences are very important. Not only have [the family] had to come to terms with their tragic death, but their loss has been compounded by the trust’s lack of candour.”

Speaking afterwards, Nigel Acheson, the CQC’s deputy chief inspector of hospitals, said: “All care providers have a duty to be open and transparent with patients and their loved ones, particularly when something goes wrong, and this case sends a clear message that we will not hesitate to take action when that does not happen."

Lenny Byrne, the trust’s chief nurse, issued a “wholehearted apology” to Woodfield’s family. “We pleaded guilty to failure to comply with the duty of candour and fully accept the court’s decision. We have made significant changes in our processes.”

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Source: The Guardian, 23 September 2020

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‘Long covid’ clinics still not operating despite Hancock claim

The government and NHS England appear unable to identify units set up to treat ‘long covid’, contrary to a claim by Matt Hancock in Parliament that the NHS had ‘set up clinics and announced them in July’. 

There are growing calls for wider services to support people who have had COVID-19 and continue to suffer serious follow-up illness for weeks or months. Hospitals run follow-up clinics for those who were previously admitted with the virus, but these are not generally open to those who were never admitted.

Earlier this month the health secretary told the Commons health committee: “The NHS set up long covid clinics and announced them in July and I am concerned by reports from Royal College of General Practitioners that not all GPs know how to get into those services.”

Asked by HSJ for details, DHSC and NHS England declined to comment on how many clinics had been set up to date, where they were located, how they were funded or how many more clinics were expected to be “rolled out”.

However, two charities and support groups — Patient Safety Learning and the Long Covid Support Group — told HSJ they were not aware of dedicated long covid clinics for community patients. An enquiry from Patient Safety Learning to NHS England has not been answered.

The number of people affected by long covid is unclear due to a lack of research but there are suggestions it could be half a million or more. Symptoms can include fatigue, sleeplessness, night-time hypoxia, “brain fog” and cardiac problems. It appears to affect more people who were not hospitalised with coronavirus than those who were were. There is some evidence that small clinics have been set up locally on a piecemeal basis, without national funding.

HSJ has only been able to identify only one genuine “long covid clinics” open to those who have never been in hospital with covid. 

Trisha Greenhalgh, an Oxford University professor of primary care health sciences who has interviewed around 100 long covid sufferers, told HSJ: “Nobody I have interviewed had been seen in a long covid clinic but there is an awful lot of people who would like to be referred and who sound like the need to be but they haven’t.”

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Source: HSJ, 23 September 2020

Read the letter Patient Safety Learning sent to NHS England

hub Community thread - Long Covid: Where are these clinics?

 

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Yew Trees hospital: Ten staff suspended at mental health unit

Ten workers at a mental health unit have been suspended amid claims patients were "dragged, slapped and kicked". Inspectors said CCTV footage recorded at the Yew Trees hospital in Kirby-le-Soken, Essex, appeared to show episodes of "physical and emotional abuse".

The details emerged in a Care Quality Commission (CQC) report after the unit was inspected in July and August. A spokeswoman for the care provider said footage had been passed to police.

The unannounced inspections were prompted by managers at Cygnet Health Care, who monitored CCTV footage of an incident on 18 July.

At the time, the 10-bed hospital held eight adult female patients with autism or learning difficulties.

The CQC reviewed 21 separate pieces of footage, concluding that 40% "included examples of inappropriate staff behaviour". "People who lived there were subjected not only to poor care, but to abuse," a CQC spokesman said.

Workers were captured "physically and emotionally abusing a patient", and failing to use "appropriate restraint techniques", the report said. It identified "negative interactions where staff visibly became angry with patients" and two cases where staff "dragged patients across the floor".

"We witnessed abusive, disrespectful, intimidating, aggressive and inappropriate behaviour," the inspectors said.

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Source: BBC News, 23 September 2020

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Covid ban on care home visitors risks premature deaths, experts warn

Sweeping bans on visiting at thousands of care homes risk residents dying prematurely this winter as they give up hope in the absence of loved ones, experts in elderly care have warned.

More than 2,700 care homes in England are either already shut or will be told to do so imminently by local public health officials, according to a Guardian analysis of new government rules announced to protect the most vulnerable from COVID-19.

Care groups are calling for the government to make limited visiting possible, including by designating selected family members as key workers.

Since Friday any care homes in local authority areas named by Public Health England for wider anti-Covid interventions must immediately move to stop visiting, except in exceptional circumstances such as end of life. It also halts visits to windows and gardens and follows seven months of restrictions in many care homes that closed their doors to routine visits in March.

The blanket bans will result in the “raw reality of residents going downhill fast, giving up hope and ultimately dying sooner than would otherwise be the case”, warned the charity Age UK and the National Care Forum (NCF), which represents charitable care providers.

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Source: The Guardian, 23 September 2020

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Growing numbers of NHS nurses quit within three years, study finds

Gruelling 12-hour shifts, exhaustion and burnout are leading growing numbers of nurses to quit the NHS within three years of joining, new research reveals.

Stress, lack of access to food and drink while at work, and the relentless demands of caring for patients are also key factors in the exodus, the King’s Fund thinktank found.

The NHS must make it an urgent priority to tackle the worryingly poor working conditions nurses and midwives face in many hospitals or face worsening workforce shortages, it said.

“Staff stress, absenteeism and turnover in the professions have reached alarmingly high levels,” the thinktank said after investigating the working conditions faced by NHS nurses and midwives.

“This has been compounded by the Covid-19 pandemic, which has laid bare and exacerbated longer-term issues including chronic excessive workload, inadequate working conditions, staff burnout and inequalities, particularly among minority ethnic groups.”

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Source: 23 September 2020

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GPs asked for further support to care providers

NHS England has been asked for a “clear plan and timescale” for development during covid of its controversial scheme which aims to provide extra support for care homes.

In its adult social care winter plan the government has advised NHS England to push forward with the rollout of the “enhanced health in care homes” programme, ensuring that all care homes are assigned to primary care networks by 1 October.

The scheme requires GP practices to provide extra clinical support and advice to homes.

PCNs should also nominate a clinical lead for the care homes and work with other providers, such as social prescribing link workers, health and wellbeing coaches and care co-ordinators, to provide personalised care. 

The winter plan responds to a number of recommendations published by the COVID-19 support taskforce, after reviewing the management of the virus in the sector. It asks NHSE to provide a clear plan and timetable for its “enhanced health in care homes” programme. 

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Source: HSJ, 23 September 2020

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Hospital prosecuted in first-ever case for 'lack of candour' after woman's death

An NHS trust is to appear in court today charged with breaking the law on being open and transparent after a woman’s death in the first ever court case of its kind.

The Care Quality Commission (CQC) has brought a criminal prosecution against University Hospitals Plymouth Trust which will appear at Plymouth Magistrates Court tomorrow morning.

The trust is charged with breaching the duty of candour regulations under the Health and Social Care Act 2008 which require hospitals to be honest with families and patients after a safety incident or error in their care. Hospitals are legally required to notify patients or families and investigate what has happened and communicate the findings to families and offer an apology.

The case relates to how the Plymouth trust communicated with a woman’s family after her death which happened after she underwent an endoscopy procedure at Derriford Hospital in December 2017.

The trust was required by law to communicate in an open and transparent way. The CQC has accused the trust of failing to do this.

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Source: The Independent, 22 September 2020

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Trust acts after BAME staff report ‘systematic bullying’

NHS leaders are being encouraged to have ‘difficult discussions’ about inequalities, after a trust found its BAME staff reported being ‘systematically… bullied and harassed’, along with other signs of discrimination.

A report published by Newcastle Hospitals Foundation Trust found the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers.

It claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust.

The new report revealed that, in a trust survey carried out last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues; had left departments after being given no chance of progression; and been “systematically… bullied and harassed”.

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Source: HSJ, 22 September 2020

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Flu and COVID-19 at same time significantly increases risk of death

Having flu and COVID-19 together significantly increases your risk of death, say government scientists who are urging all those at risk of getting or transmitting flu to get the vaccine in the coming weeks and months.

The evidence for the double whammy is currently limited and comes mostly from a study with small numbers – 58 people – carried out in the UK during the early phase of the pandemic.

“As I understand it, it’s 43% of those with co-infection died compared with 26.9% of those who tested positive for Covid only,” said England’s deputy chief medical officer, Prof Jonathan Van-Tam. These were people who had been hospitalised and had been tested for both viruses, he said, and so were very ill – but the rate of death from Covid alone in the study between January and April was similar to the known rate of Covid hospital mortality generally of around 25% or 26%.

"I think it is the relative difference in size of those rates that’s rather more important than the absolute rate,” he said. The study may have been small and they would be doing further studies this season, but the findings tallied with other work that has been done, he said.

“If you get both, you are in some serious trouble, and the people who are most likely to get both of these infections may be the very people who can least afford to in terms of their own immune system, or their risk for serious outcomes. So please protect yourself against flu, this year,” says said Prof Yvonne Doyle, medical director of Public Health England

The government has bought 30,000,000 doses of flu vaccine, which is more than ever before. They will arrive in batches, so the elderly – over 65 – and those with medical conditions will be called for immunisation first. Relatives of those who are on the shielding list will also be called up. The letters will begin to go out this week.

Because of the threat of Covid and the risk that people with flu could be infected if admitted to hospital, all those aged 50-64 will be offered flu vaccination, but not straight away. They should wait to be called by their GP.

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Source: The Guardian, 22 September 2020

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Overcrowded A&Es ‘much more dangerous now because of covid’

Emergency departments across England are reporting ‘dangerous’ overcrowding similar to levels seen pre-covid, and struggling to maintain social distancing, A&E leaders have warned.

The Royal College of Emergency Medicine said it was concerned about covid spreading among the most vulnerable patients, as overall transmission rates continue to rise sharply across the UK.

It was always anticipated that A&E activity would return to pre-covid levels this winter, following a significant drop-off in A&E activity during the spring and early summer, and that service transformation would be needed to help maintain social distancing. But the emergence of widespread overcrowding so far ahead of winter is of serious concern to system leaders.

A&E staff were already being forced to make difficult trade-offs over which patients to isolate, the college’s vice president told HSJ. He also urged NHS leaders not to place unrealistic expectations on the impact a new model involving walk-in patients booking slots by phone could make on addressing overcrowding in emergency departments.

RCEM vice president Adrian Boyle said the NHS was “largely back to the pre-covid levels of crowding” but it was “much more dangerous now because of covid”.

He said: “We are hearing that most emergency departments can’t maintain social distancing safely and staff are having to make fairly difficult trade-offs about which people need to be isolated. No one can be safely social distanced in a corridor.”

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Source: HSJ, 21 September 2020

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'I'm traumatised now': Covid bereaved call for inquiry into NHS 111

Hundreds of people believe the helpline failed their relatives. Now they are demanding their voices be heard. 

Families whose relatives died from COVID-19 in the early period of the pandemic are calling for an inquiry into the NHS 111 service, arguing that many critically ill people were given inadequate advice and told to stay at home.

The COVID-19 Bereaved Families for Justice group says approximately a fifth of its 1,800 members – more than 350 people – believe the 111 service failed to recognise how seriously ill their relatives were and direct them to appropriate care.

“We believe that in some cases it is likely these issues directly contributed to loved ones dying, due to causing a delay in receiving treatment, or a total lack of treatment leading to them passing away at home,” said the group’s co-founder Jo Goodman, whose father, Stuart Goodman, died on 2 April aged 72.

Many families have said they had trouble even getting through to the 111 phone line, the designated first step, alongside 111 online, for people concerned they may have COVID-19.

The service recorded a huge rise in calls to almost 3m in March, and official NHS figures show that 38.7% were abandoned after callers waited longer than 30 seconds for a response. Some families who did get through have said the call handlers worked through fixed scripts and asked for yes or no answers, which led to their relatives being told they were not in need of medical care.

“Despite having very severe symptoms including skin discolouration, fainting, total lack of energy, inability to eat and breathlessness, as well as other family members explaining the level of distress they were in, this was not considered sufficient to be admitted to hospital or have an ambulance sent out,” Goodman said.

Some families also say their relatives’ health risk factors, such as having diabetes, were not taken into account, and that not all the 111 questions were appropriate for black, Asian and minority ethnic people, including a question to check for breathlessness that asked if their lips had turned blue.

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Source: The Guardian, 21 September 2020

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Jeremy Hunt: It’s crazy that six people can meet in a pub while mums endure the misery of lone births

Covid has brought many hidden tragedies: elderly residents in care homes bereft of family visits, families in quarantine missing loved one’s funerals, and mums forced to go through labour alone. 

Much of this has been necessary, however painful, but Jeremy Hunt fears we’re getting the balance badly wrong in maternity care. That’s why he is backing The Mail on Sunday’s campaign to end lone births, which has been championed in Parliament by Alicia Kearns.

Infection control in hospitals is critically important, but mothers’ mental health can’t be pushed down the priority list. 

Imagine the agony of a new mum sent for a scan on her own, only to be told that her much longed-for baby has no heartbeat. Or the woman labouring in agony for hours who is told she is not yet sufficiently dilated to merit her partner joining her for moral support.

"I have heard some truly heartbreaking stories, which quite frankly should have no place in a modern, compassionate health service. One woman who gave birth to a stillborn baby alone at 41 weeks; another woman who was left alone after surgery due to a miscarriage at 12 weeks," says Jeremy.

Perhaps most concerningly of all, there are reports of partners being asked to leave their new babies and often traumatised mothers almost immediately after birth. That means they miss out on vital bonding time and mums lose crucial support to help them recover mentally and physically, in some cases with partners not allowed back to meet their new child properly for several days.

"This is a question of basic compassion and decency – the very values that the NHS embodies and the reason we’re all so proud of our universal health service – so we need every hospital to commit to urgent action without delay."

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Source: MailOnline, 19 September 2020

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BAME Britons still lack protection from Covid, says doctors' chief

A third of coronavirus patients in intensive care are from black, Asian and minority ethnic backgrounds, prompting the head of the British Medical Association to warn that government inaction will be responsible for further disproportionate deaths.

Chaand Nagpaul, the BMA Council chair, was the first public figure to call for an inquiry into whether and why there was a disparity between BAME and white people in Britain in terms of how they were being affected by the pandemic, in April.

Subsequent studies, including a Public Health England (PHE) analysis in early June, confirmed people of certain ethnicities were at greater risk but Nagpaul said no remedial action had been taken by the government.

Nagpaul told the Guardian: “We are continuing to see BAME people suffering disproportionately in terms of intensive care admissions so not acting means that we’re not protecting our vulnerable communities. Action was needed back in July and it’s certainly needed now more than ever.

“As the infection rate rises, there’s no reason to believe that the BAME population will not suffer again because no action has been taken to protect them. They are still at higher risk of serious ill health and dying.”

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Source: The Guardian, 20 September 2020

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Coronavirus: Care regulator warns hospitals and nursing homes over infection risk as it urges the public to give more feedback

Watchdog chief says increasing patient feedback will be the fuel to drive improvements in patient safety

Some hospitals and care homes are failing to take action to protect patients from coronavirus as cases rise across the country, the head of the care watchdog has warned.

In an interview with The Independent, Ian Trenholm, the chief executive of the Care Quality Commission (CQC), said a series of inspections had revealed a minority of homes and hospitals were not doing enough to prevent infection. 

He said in one case a care home appeared to have made a “conscious decision” not to follow the rules on wearing masks and gloves and was now in the process of being closed down by the watchdog due to safety fears.

Mr Trenholm also revealed the CQC would be looking closely at patients struggling to access services because of the impact of COVID-19 and he warned it would act if some groups were disproportionately affected.

The CQC is being forced to move away from its regular inspections of hospitals, care homes and GPs due to the pandemic but Mr Trenholm said it would be redoubling efforts to encourage patients to give feedback on the care they received, adding the watchdog would be more explicit in future about the action it takes.

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Source: The Independent, 21 September 2020

 

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Some hospitals in England to be kept Covid-free in second wave

A series of hospitals will be designated as coronavirus-free zones during the second wave of the outbreak in a significant policy shift designed to ensure the NHS continues treatment for cancer and other conditions, the Guardian has learned.

NHS England is determined not to repeat the widespread suspension of normal service that occurred in the first wave, which doctors and charities have criticised for damaging patients’ health, leading to more deaths and creating a backlog of millions of treatments.

In a tacit admission that the March shutdown denied patients vital care, NHS bosses have drawn up plans for certain hospitals – mainly small district generals – to treat no COVID-19 patients and focus instead on common planned operations such as cancer surgery, hip and knee replacements, and cataract removals.

Under NHS plans, such “clean” hospitals will as far as possible be kept free of coronavirus patients in a reversal of the approach taken in spring. That should reduce the risk of patients admitted for normal care becoming infected with COVID-19 while on wards.

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Source: The Guardian, 21 September 2020

 

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Cases of 'long Covid' on the rise as patients suffer after-effects months after recovery

'Long Covid' is leaving people with so-called ‘brain fog’ for months after their initial recovery, NHS experts have revealed.

Dr Michael Beckles, consultant respiratory and general physician at The Wellington Hospital, and the Royal Free NHS Foundation, said he has seen a number of patients suffering from ongoing effects of the disease. He said the main symptom being reported is breathlessness, with patients also describing a brain fog.

Dr Beckles said: "I'm seeing more and more patients who have had Covid-19 infection confirmed in the laboratory and on X-ray, who have cleared the infection, and are now still presenting with persistent symptoms. "Some of those symptoms are respiratory, such as breathlessness, chronic cough. "And some have other symptoms such as what the patients describe as brain fog, and I understand that to be a difficulty in concentration."

"Some still have loss of sense of taste or smell."

He added that it can be frustrating for patients because investigations after the infection can be normal, yet the symptoms persist.

Dr Beckles is part of a team of specialists at the new post-COVID-19 rehabilitation unit at The Wellington Hospital.

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Source: The Telegraph, 21 September 2020

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Medics missing mental illness diagnosis in more than one in four patients, data suggests

More than one in four patients with severe mental health conditions are missing diagnosis when they are admitted to hospital for other reasons, new research suggests.

According to data analysed by scientists at University College London, those who are missing these mental illness diagnoses are more likely to be from ethnic minority groups or have a previously diagnosed mental illnesses.

However, the situation has improved – in 2006 it was found that mental health diagnoses were missed in more than 50% of cases.

"We found encouraging signs that clinicians are more frequently identifying severe mental illnesses in hospital patients than they were a decade ago,” Hassan Mansour, a research assistant at UCL psychiatry, said.

“But there's a lot more that can be done, particularly to address disparities between ethnic groups, to ensure that everyone gets the best care available.

Training in culturally-sensitive diagnosis may be needed to reduce inequalities in medical care."

The researchers have suggested these findings may be due to language barriers or stigma felt by patients. It was also suggested that clinicians may be less able to detect these conditions in people from other ethnic and cultural groups.

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Source: The Independent, 18 September 2020

 

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