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Digital NHS health check to be launched across England in spring

A digital NHS Health Check is to be rolled out across England from next spring, the government has announced, in an attempt to alleviate the pressure on GP surgeries.

The initiative will deliver 1m checks in the first four years, according to the Department for Health and Social Care (DHSC).

Tens of thousands of cases of hypertension are expected to be identified and hundreds of strokes and heart attacks prevented. Patients will be able to access the check via a mobile phone, tablet or computer, the DHSC said.

Participants will complete an online questionnaire, enter height, weight, and the results of a cholesterol test which they can carry out at home. They will also be asked to have their blood pressure checked at a pharmacy.

The results, which will be available online, will direct people to personalised advice. Referrals to GPs will only be made if further tests and treatment are needed.

Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said: “This initiative will help to reach more people and encourage them to get their blood pressure and cholesterol levels checked so that, where necessary, healthcare professionals can work with them to manage their condition.

“This could play an important role in helping people live healthier for longer and saving lives in the coming years, while reducing pressure on the NHS.”

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Source: The Guardian, 28 June 2023

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NHS staff sickness hits record high in England

Staff sickness in the NHS in England has reached record levels.

Figures for 2022 show an absence rate - the proportion of days lost - of 5.6%, meaning the NHS lost the equivalent of nearly 75,000 staff to illness.

This is higher than during the peak pandemic years of 2020 and 2021 - and a 29% rise on the 2019 rate.

Mental health problems were the most common cause, responsible for nearly a quarter of absences, the Nuffield Trust analysis of official NHS data shows.

Big rises were also seen in cold, coughs, infections and respiratory problems, likely to be linked to the continued circulation of Covid as well as the return of flu last year.

The think tank warned the NHS was stuck in a "seemingly unsustainable cycle" of increased work and burnout, which was contributing to staff leaving.

The analysis, exclusively for BBC News, comes ahead of the publication of the government and NHS England's long-awaited workforce plan.

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Source: BBC News, 29 June 2023

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Paramedic in fatal crash had traumatic flashback

A paramedic was hallucinating after a traumatic call-out when he crashed into a car, an inquest heard.

Jason Allen, 49, and Andrew Ralph, 61, were killed after their car was hit by Kevin Lilwall's ambulance on the A49 in Pengethley, Herefordshire.

An inquest heard Mr Lilwall was having flashbacks to the previous day when he had been in the area responding to the sudden death of a baby.

The paramedic, who had worked for West Midlands Ambulance Service (WMAS) for 28 years, was driving the ambulance when it crossed the white line into the car. The ambulance dashcam showed it heading directly towards Mr Allen’s car for six seconds before the collision.

The families of Mr Allen and Mr Ralph said they had been through hell in the past four years, adding they had never had an apology from Mr Lilwall and only one from WMAS after the inquest.

The hearing in Hereford was told Mr Lilwall had spent more than 25 hours on duty in the previous 36 hours, with just a 10-hour break between shifts.

Medical experts agreed that the hallucination could have been caused by post traumatic stress disorder.

Jason Wiles from WMAS admitted it had been a "missed opportunity" regarding the apology and said it had changed its policy to ensure staff had a break of at least 11 hours between shifts following the crash.

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Source: BBC News, 28 June 2023

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Essex mental health deaths inquiry given legal powers

An inquiry investigating deaths of mental health patients in Essex has been given extra powers, in a victory for campaigners.

Health Secretary Steve Barclay told Parliament that the probe would be placed on a statutory footing. It means the inquiry can force witnesses to give evidence, including former staff who have previously worked for services within the county.

Mr Barclay said he was committed to getting answers for the families.

He told the Commons: "I hope today's announcement will come as some comfort to the brave families who have done so much to raise awareness."

The Secretary of State added that under the new powers anyone refusing to give evidence could be fined.

Melanie Leahy, whose son Matthew died while an inpatient at the Linden Centre in Chelmsford in 2012, is among those who have long campaigned for the inquiry to be upgraded.

"Today's announcement marks the start of the next chapter in our mission to find out how our loved ones could be so badly failed by those who were meant to care for them," said Ms Leahy.

"I welcome today's long overdue government announcement and I look forward to working with the inquiry team as they look to shape their terms of reference."

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Source: BBC News, 28 June 2023

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Future HSSIB investigation to examine mental health inpatient settings

Today it was announced by the Secretary of State for Health and Social Care that the future Health Services Safety Investigations Body (HSSIB) will undertake a series of investigations focused on mental health inpatient settings.

The investigations will commence when HSSIB is formally established on 1 October 2023. The HSSIB will conduct investigations around:

  • How providers learn from deaths in their care and use that learning to improve their services, including post-discharge.
  • How young people with mental health needs are cared for in inpatient services and how their care could be improved.
  • How out-of-area placements are handled.
  • How to develop a safe, therapeutic staffing model for all mental health inpatient services.

Rosie Benneyworth, Chief Investigator at HSIB, says: “We welcome the announcement by the Secretary of State and see this as a significant opportunity to use our expertise, and the wider remit that HSSIB will have, to improve safety for those being cared for in mental health inpatient settings across England. The evidence we have gathered through HSIB investigations has helped shed light on some of the wider challenges faced by patients with mental health needs, and the expertise we will carry through from HSIB to HSSIB will help us to further understand these concerns in inpatient settings, and contribute to a system level understanding of the challenges in providing care in mental health hospitals.

“HSSIB will be able to look at inpatient mental health care in both the NHS and the independent sector and any evidence we gather during the investigations is given full protection from disclosure. It is crucial that those impacted by poor care and those working on the frontlines of the inpatient settings can share their experiences, reassured that HSSIB will use this information to improve care and not apportion blame or liability.

“At HSIB we will begin conversations with our national partners across the system, as well as talking to staff, patients and families. This will ensure that when investigations are launched in October, we have identified and will address the most serious risks to mental health inpatients within these areas and will identify recommendations and other safety learning that will lead to changes in the safety culture and how safety is managed within mental health services.”

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Source: HSIB, 28 June 2023

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NHS in Wales and GPs face collapse, BMA union says

GP services "will collapse in Wales and the NHS will follow" soon after unless urgent support is provided, the British Medical Association (BMA) has warned.

As patient levels rise, numbers of GP surgeries and doctors are falling amid inadequate resources and unsustainable workloads, BMA Cymru Wales has claimed.

It has written to the Welsh government, urging more funding and staff help.

The Welsh government said it was acting to cut pressure on GPs and increasing services by community pharmacists.

Launching its Save Our Surgeries campaign, the BMA said the number of GP practices in Wales had decreased by 18% in the past decade from 470 to 386.

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Source: BBC News, 28 June 2023

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Report finds West Midlands ambulance whistleblowers stifled

Ambulance staff in the West Midlands have had their ability to speak up as whistleblowers stifled for many years, an independent inquiry has found.

The investigation, commissioned by NHS England, also identified failings in financial governance at West Midlands Ambulance Service (WMAS).

Five senior and former members of staff spoke out to NHS England.

WMAS accepts it has learning to do, but says the report expresses confidence in the service's ability to address the issues raised.

The whistleblowers included a finance director, medical, operations and quality control staff.

They raised issues through the Freedom to Speak Up scheme with the National NHS England Team.

The inquiry, led by Carole Taylor Brown, had terms of reference which included "Governance, probity, the difficulty of speaking up about these issues and the alleged behaviour of some senior leaders".

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Source: BBC News, 28 June 2023

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Nurses strikes to end but now senior doctors vote to walk out

Nurses strikes are set to end but the disruption for NHS patients will continue as senior doctors are the latest to vote to walk out.

The Royal College of Nursing failed to reach the threshold needed to hold further action, with just 43% of the required 50% of members returning a ballot to hold fresh walkouts.

But more than 24,000 members of the British Medical Association (BMA) backed industrial action by 86% on a turnout of 71%, well above the legal threshold of 50%, with senior doctors set to strike on 20 and 21 July. It comes after the union last week announced a five-day strike by junior doctors will be held from 13 July.

NHS leaders have said consecutive walkouts from junior doctors and now consultants presents a “huge risk” for the health service.

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Source: The Independent, 27 June 2023

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Matt Hancock says UK's pandemic strategy was completely wrong

Ex-health secretary Matt Hancock has criticised the UK's pandemic planning before Covid hit, saying it was "completely wrong".

He told the Covid Inquiry that planning was focused on the provision of body bags and how to bury the dead, rather than stopping the virus taking hold.

He said he was "profoundly sorry" for each death.

After giving evidence he approached some of the bereaved families, but they turned their backs on him as he left.

The former health secretary, who answered questions from the inquiry on Tuesday, said he understood his apology might be difficult for families to accept, even though it was "honest and heartfelt".

Under questioning from Hugo Keith KC, lead counsel to the Covid Inquiry, Mr Hancock stressed that the "attitude, the doctrine of the UK was to plan for the consequences of a disaster".

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Source: BBC News, 27 June 2023

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Hundreds died on same day as being discharged, trust review finds

An independent review has raised concerns about a mental health trust’s reporting systems and has highlighted a significant number of patient deaths shortly after leaving the trust’s care, including almost 300 who died on the same day they were discharged. 

However, the review into how Norfolk and Suffolk Foundation Trust collects, processes and reports mortality data made no conclusions on the number of avoidable deaths – the issue which had originally prompted the probe. 

Local NHS leaders argued the review’s purpose was focused on auditing the trust’s processes, and this had been delivered. But a local MP, Clive Lewis, accused it of “explicitly dodg[ing] the big questions”. 

The report, which looked at data from between April 2019 and October 2022, has however raised concerns about the number of patients dying soon after being discharged.

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Source: HSJ, 28 June 2023

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NI’s £800m use of prescribed medicines higher than anywhere else in UK

Northern Ireland’s chief pharmaceutical officer has said that the use of prescribed medicines and the associated costs remains too high, exceeding £800m a year.

In a blog to reflect on the 75th anniversary of the NHS, Professor Cathy Harrison added that medicine costs in NI are the second largest single investment made in the health service, after staff.

“The average number of prescription items a year is 21 per person, at a cost of £227. This cost is the highest in the UK and the volume of prescription items is still rising each year,” she said.

“There is an uncomfortable truth that manifests in the prescribing data for medicines. In Northern Ireland, we continue to use more of almost every type of medicine than other parts of the UK.

“That includes more antibiotics, more painkillers, more baby milks, more nutritional supplements, even more oxygen.”

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Source: Belfast Telegraph, 27 June 2023

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The stubborn regional variation in early cancer detection

The gap between the areas with the best and worst records on the early detection of cancer has remained almost unchanged over the past five years, new NHS England data indicates.

The proportion of cancers detected at stages one and two – when they are more curable – has improved by 2.7 percentage points to 58.1% nationally, but this masks significant regional variation.

In the 12 months to February 2019, the percentage point difference between the top performing cancer alliance – Thames Valley (63.1%t) – and the worst performing – Lancashire and South Cumbria (51.6%) – was 11.5.

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Source: HSJ, 27 June 2023

 

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UK risks becoming reliant on overseas care workers, report warns

The UK risks becoming highly reliant on overseas care workers after nearly 58,000 visas were issued for the sector last year, a report says.

Analysis by the Migration Observatory at the University of Oxford found that the demand for foreign staff had left the NHS and care homes open to “vulnerabilities” including “exposure to international competition for health workers and risks of exploitation”.

The study, commissioned by the employment group ReWAGE, also examined where care workers were coming from. In 2022, 99% of care workers sponsored for work visas in the UK were from non-EU countries. The top countries were India (33%), Zimbabwe (16%), Nigeria (15%) and the Philippines (11%).

Dr Madeleine Sumption, the director of the Migration Observatory, said: “Health and care employers have benefited a lot from international recruitment.

“But relying this much on overseas recruits also brings risks. For example, care workers on temporary visas are vulnerable to exploitation and the rapid growth in overseas recruitments makes monitoring pay and conditions a real challenge.”

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Source: The Guardian, 27 June 2023

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U.S. News & World Report's best children's hospitals 2023-24 honor roll

U.S. News & World Report's Best Children's Hospital list for 2023-2024, released 21 June, said 11 children's hospitals are at the top of their game when it comes to 10 pediatric specialties. This year, 11 children's hospitals are included on this list due to a tie in the diabetes and endocrinology category.

U.S. News gathered subjective data from more than 15,000 pediatric specialists and clinical data from close to 200 children's hospitals to develop its Best Children's Hospitals 2023-2024 listings. 

For the first time, Cincinnati Children's Hospital Medical Center took the top spot on the list. The hospital has the only level 4 neonatal intensive care unit, which offers care to infants at all level 3 NICUs in the area. The hospital discovered a "super antibody" it believes will inform new vaccines and offered a specialized approach to reduce stays in the NICU for opioid-exposed newborns.

Steve Davis, MD, president and CEO: "This distinction only confirms what we have always known — that we have outstanding, talented team members who are unmatched in their dedication to ensuring that all children have access to exceptional care."

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Source: Becker's Hospital Review, 23 June 2023

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USA: Number of health systems allegedly denying care to indebted patients grows

Recently Minneapolis-based Allina Health was highlighted by The New York Times for pulling back from its policy of denying nonemergency care to some indebted patients. However, a recent investigation showed it is not the only health system to allegedly have engaged in the practice.

According to KFF Health News, about 20% of US nationwide hospitals in a random sample pursued similar policies of care denial.

The Lown Institute went further, naming major health systems including Rochester, Minn.-based  Mayo Clinic, St. Louis-based Ascension, Indianapolis-based Indiana University Health, Livonia, Mich.-based Trinity Health and Los Angeles-based Cedars-Sinai as operating facilities where the practice is followed.

IU Health, Ascension, Trinity Health and Cedars-Sinai denied they have such practices.

"We do not restrict medically necessary non-emergency care for patients with unpaid bills," an Ascension spokesperson said.

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Source: Becker Hospital Review, 26 June 2023

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Bereaved call for body to enforce coroners’ advice

Relatives of a teenage rape survivor who died after failures by mental health services are joining other families to demand a new body to enforce coroners’ recommendations to prevent future deaths.

Campaigners claim the failure to act on hundreds of coroners’ recommendations every year, and to learn from the findings of often expensive inquiries into disasters, means the same mistakes are being repeated.

Gaia Pope, 19, was diagnosed with post-traumatic stress disorder after revealing that she had been drugged and raped when she was 16. She was found dead in undergrowth on a cliff 11 days after disappearing in Swanage, Dorset, in 2017.

After one of the longest inquests in legal history, the coroner, Rachael Griffin, made multiple reports last year to authorities including the NHS and police to prevent future deaths, but Pope’s family says most have not been acted upon.

The Inquest campaign, which works with families bereaved by state-related deaths, is calling for a “national oversight mechanism” to collate recommendations and responses in a new national database, analyse responses from public bodies, follow up on progress and share common findings.

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Source: The Times, 27 June 2023

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Health service chief critical of Covid-19 ‘Protect the NHS’ slogan

The head of NHS England was critical of the government’s slogan urging people to “protect the NHS” at the start of the Covid pandemic, amid concerns it would stop people coming forward for much-needed treatment.

Simon Stevens, who led the NHS until July 2021, was one of the slogan’s “greatest critics” and was not involved in the government discussion that led to the phrase being deployed.

“It was a tremendously powerful slogan,” writes journalist Isabel Hardman in Fighting for Life: The Twelve Battles That Made Our NHS, and the Struggle for Its Future.

“It was popular in government – but not universally so. In fact, one of its greatest critics was Simon Stevens. Stevens wasn’t on the calls where [government advisers] came up with ‘Protect the NHS’, and initially he complained in private that it gave the impression that the public was there for the health service – not the health service being there for the public.

“Either way, the focus quickly became about the importance of ‘protecting the NHS’. But there was never a clear definition of what it was being protected from.”

Later in 2020, Lord Stevens referred to his concerns about the slogan, writing: “Rather than say ‘Protect the NHS’, health service staff prefer to say: ‘Help us help you’.”

Senior NHS figures also attempted to battle against the slogan from the spring of 2020, urging patients to come forward as normal.

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Source: The Guardian, 25 June 2023

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AI cuts treatment time for cancer radiotherapy

A new type of artificial-intelligence technology that cuts the time cancer patients must wait before starting radiotherapy is to be offered at cost price to all NHS trusts in England.

It helps doctors calculate where to direct the therapeutic radiation beams, to kill cancerous cells while sparing as many healthy ones as possible.

Researchers at Addenbrooke's Hospital trained the AI program with Microsoft.

For each patient, doctors typically spend between 25 minutes and two hours working through about 100 scan cross-sections, carefully "contouring" or outlining bones and organs. But the AI program works two and a half times quicker, the researchers say.

When treating the prostate gland, for example, medics want to avoid damage to the nearby bladder or rectum, which could leave patients with lifelong continence issues.

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Source: BBC News, 27 June 2023

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Black patients worst affected by 2016 junior doctors’ strike

Black patients at trusts most affected by 2016’s junior doctors’ strike suffered significantly more than their white or Asian counterparts, a new analysis has suggested.

Research by the Institute for Fiscal Studies analysed 30-day readmission rates after the 48-hour junior doctors’ strike in April 2016.

The co-authors of the research, George Stoye and Max Warner, said: “We find that patients treated in hospitals that were more exposed to the strike did not, on average, experience worse outcomes.”

However, they added that black patients were “more negatively affected by exposure to the strikes than white patients in the same hospitals”. The April 2016 strike affected both elective and emergency care and was the last before the dispute ended. 

The current junior doctors’ strike has been ongoing since March. It also affects emergency and elective care but stoppages have been longer, with a five-day strike planned in July.

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Source: HSJ, 27 June 2023

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NHS may have missed thousands of deaf children in ‘huge national failure’

NHS trusts across England are scrambling to trace thousands of children for urgent hearing tests amid fears that cases of infant deafness may have been missed for years.

An internal NHS report has exposed poor-quality testing within paediatric audiology departments at five hospitals and warned of systemic failings. At another NHS trust, almost 1,500 children were found to have missed out on appointments dating back to 2012. 

Vital quality inspections of departments checking infants for hearing loss were stopped ten years ago. Whistleblowers who previously worked for the NHS’s newborn hearing screening programme have revealed that concerns were raised shortly before they were told to stop carrying out checks.

They say that thousands of children may have been mistreated for deafness and hearing loss in the past decade.

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Source: The Times, 25 June 2023

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NHS not ministers should decide future ‘new hospitals’, says DHSC chief

A permanent change in approach is needed for deciding which hospitals are built and  when, and should be led by the NHS not politicians, the government’s ‘new hospitals programme’ boss has told HSJ.

Natalie Forrest, who is leading the government’s drive to build “40 new hospitals” by 2030, said the service must move beyond political targets, and towards the NHS having more autonomy to work through a list of rebuilds needed. 

Ms Forrest, who has led the programme since 2021, said: “There shouldn’t be a special group that are getting rebuilt, and everyone else has to watch from the sidelines.” 

The former Chase Farm Hospital chief said she believed this was now the direction of travel, and that a commitment from ministers for a “rolling programme” beyond 2030 represented the “biggest success [for the NHP] so far”. 

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Source: HSJ, 26 June 2023

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All people in England who have smoked to be offered middle-age lung screening

Everyone who has ever smoked in England is to be offered lung screening in middle age under plans to detect and treat cancer earlier.

Lung cancer kills about 35,000 people every year, and is the most common cause of cancer death in the UK, accounting for one in five. It also has one of the worst cancer survival rates, which is largely attributed to diagnoses at a late stage when treatment is less likely to be effective.

Millions of people will be invited for lung checks in an effort to improve survival rates. About a million screenings of people aged 55 to 74 will be carried out every year under the programme.

It follows a successful pilot of the scheme in deprived areas of the country where people are four times more likely to smoke. It resulted in more than 2,000 people being detected as having cancer, 76% of them at an earlier stage compared with 29% outside the programme in 2019.

“Identifying lung cancer early saves lives, and the expansion of the NHS’s targeted lung health check programme is another landmark step forward in our drive to find and treat more people living with this devastating disease at the earliest stage,” said the chief executive of NHS England, Amanda Pritchard.

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Source: The Guardian, 26 June 2023

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NHS plans: Sunak says expansion means 'more doctors, nurses, and GPs'

The NHS is set to undergo the "largest expansion in training and workforce" in its history, Rishi Sunak has said.

Speaking to the BBC, the prime minister said the plans would reduce "reliance on foreign-trained healthcare professionals".

It comes at a time of record-high waiting lists in the NHS and junior doctors set to stage a five-day strike next month.

The full plans are expected to be published next week.

Pressed about the length of time it would take to see the results of the changes, Mr Sunak accepted it could take "five, ten, fifteen years for these things to come through", but that did not mean it was not the right thing to do.

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Source: BBC News, 25 June 2023

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NHS’s mounting failures and political neglect laid bare in sobering report

What would the NHS see if it looked in a mirror, asks Siva Anandaciva, author of the King’s Fund’s study comparing the health service with those of 18 other rich countries, in the introduction to his timely and sobering 118-page report.

The answer, he says, is “a service that has seen better days”.

Britons die sooner from cancer and heart disease than people in many other rich countries, partly because of the NHS’s lack of beds, staff and scanners, a study has found.

The UK “underperforms significantly” on tackling its biggest killer diseases, in part because the NHS has been weakened by years of underinvestment, according to the report from the King’s Fund health thinktank. It “performs poorly” as judged by the number of avoidable deaths resulting from disease and injury and also by fatalities that could have been prevented had patients received better or quicker treatment.

The comparative study of 19 well-off nations concluded that Britain achieves only “below average” health outcomes because it spends a “below average” amount for every person on healthcare.

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Source: The Guardian, 26 June 2023

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Major study will use philosophical expertise to highlight patient voices in healthcare research and practice

A new six-year study, which aims to prevent the ‘silencing’ of patient voices and improve patient trust in the healthcare system, is due to begin thanks to a major funding award

Researchers at the University of Nottingham, University of Bristol and University of Birmingham have received a £2.6M Wellcome Discovery Grant for the 'Epistemic Injustice in Healthcare (EPIC)’ project. The study will use philosophical expertise to explore forms of 'silencing'.

Patients regularly report that their testimonies and perspectives are ignored, dismissed or explained away by the healthcare profession. These experiences are injustices because they are unfair and harmful - and philosophers call them ‘epistemic injustices’ because they jeopardise patient care and undermine trust in healthcare staff and systems.

By studying these epistemic injustices, EPIC will find ways to correct them and improve the relationship between patients and healthcare practitioners.

"Patients have long reported feeling ignored, dismissed, or silenced in ways that jeopardise their care and intensify their suffering. The challenge is to understand how this silencing happens and what can be done about it, in ways that can help patients and healthcare practitioners alike. The NHS is right to seek 'patient perspectives' and listen to 'patient voices'. Project EPIC will help them to do that better by fully diagnosing the causes of that silencing." Dr Ian James Kidd, EPIC Co-Investigator & Assistant Professor in the Department of Philosophy.

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Source: University of Nottingham

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