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Kettering General Hospital chief apologises over children's care

A chief executive whose hospital has been accused of failing children has admitted it has not always "got it right" and apologised at a meeting.

The care regulator has warned Kettering General Hospital (KGH) over its children's and young people's services and rated them inadequate.

Dozens of parents with children who died or became seriously ill have contacted the BBC with concerns.

Deborah Needham told a board meeting she was "here to listen" to worries.

In April it was revealed inspectors from the Care Quality Commission (CQC) raised concerns over sepsis treatment, staff numbers, dirt levels and not having an "open culture" where concerns could be raised without fear, following an inspection in December.

The CQC had inspected the Northamptonshire hospital's paediatric assessment unit, Skylark ward, and the neonatal unit after hearing concerns of safety.

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Source: BBC News, 9 June 2023

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NHS chiefs blame staff shortages for record 7.4m people on waiting lists in England

Health leaders have blamed staff shortages for waiting lists reaching another record high, with 7.4 million people in England waiting to start treatment as of the end of April.

One NHS leader said the figures showed that unsustainable “pressure continues to pile on an overstretched NHS”, and urged the government to speed up publication of its long-awaited workforce plan, which has been repeatedly postponed.

Waiting list figures in England have crept up again after showing signs of improvement in recent months, despite Rishi Sunak citing bringing numbers down as one of the government’s top five priorities for 2023.

Downing Street on Thursday insisted the NHS was “continuing to make progress to ensure patients are seen more quickly”, pointing to record numbers of doctors and nurses in the NHS.

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Source: The Guardian, 8 June 2023

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Patients may be guilty of discrimination if they refuse care of transgender medic, NHS bosses told

Patients may be found guilty of discrimination if they refuse the care of a transgender medic, according to new NHS guidance.

Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth.

However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says.

The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff member in limited circumstances, such as if they are having an intimate examination.

It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”.

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Source: Telegraph, 9 June 2023

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Covid-19: Metformin reduces the risk of developing long term symptoms by 40%, study finds

Metformin—a cheap, safe, and widely available diabetes drug—could reduce the incidence of long covid if given during the acute phase of Covid-19, a new study indicates.

A two week course of metformin given within three days of testing positive for SARS-CoV-2 led to 40% fewer Long Covid diagnoses over the following 10 months compared with people who had taken placebo, according to a randomised controlled trial.

The authors of the study, published in Lancet Infectious Diseases, caution that the trial did not look at whether metformin would be effective as a treatment for those who already have Long Covid.

Jeremy Faust from Harvard Medical School, who was not involved in the research, said the findings, if confirmed, are “profound and potentially landmark.” Writing in a linked comment, he said, “This is the first high quality evidence from a randomised controlled trial to show that the incidence of long covid can be reduced by a medical intervention, metformin—an inexpensive treatment with which clinicians have ample experience".

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Source: BMJ, 8 June 2023

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6,500 staff gap in government cancer plan revealed

Community diagnostic centres (CDCs) — the government’s flagship policy for recovering cancer testing after Covid — will have up to 6,500 fewer staff than they need by 2025, according to NHS England projections seen by HSJ. 

The workforce “gap analysis” modelling highlights large and sustained staffing shortfalls across most professional groups required to run the CDCs until at least 2025. It was released after a Freedom of Information Act request to the Department of Health and Social Care, which said it was given the analysis by NHSE. 

The total gap between demand and supply for the programme by 2025 is estimated at 6,663, out of a total demand of 61,152 (about 1 in 10 staff).

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Source: HSJ, 8 June 2023

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‘Beyond the evidence’: media reports overhype ketamine’s use as a depression treatment, review finds

Many media stories about ketamine as a treatment for psychiatric disorders such as depression “go well beyond the evidence base” by exaggerating the efficacy, safety and longevity of the drug or by overstating the risks, an analysis has found.

Researchers examined 119 articles about ketamine and mental illness published by major print media in Australia, the US and UK over a five-year period. They found articles peaked in 2019, when the US Food and Drug Administration approved a ketamine-derived nasal spray known as esketamine for treatment-resistant depression.

Researchers found 37% of articles contained inaccurate information, largely related to efficacy, safety information and the longevity of the effect of the treatment. Ketamine treatment was portrayed in an “extremely positive light” in 69% of articles, the review found.

“Overly optimistic statements from medical professionals regarding efficacy or safety may encourage patients to seek treatments that may not be clinically appropriate,” says the paper, published  in the journal BJPsych Open.

“Disconcertingly, some articles included strong statements about treatment efficacy that went well beyond the evidence base. Conversely, exaggeration of the risks may discourage patients from pursuing a treatment that may be suitable for them.”

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Source: The Guardian, 8 June 2023

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Long Covid can impair quality of life more than advanced cancers, study says

Many people with Long Covid have a lower health-related quality of life than people with some advanced cancers, research suggests.

Fatigue is the symptom with the greatest impact on the daily lives of Long Covid patients, according to a study led by researchers at University College London (UCL) and the University of Exeter. They found that many were seriously ill and had fatigue scores worse than or similar to people with cancer-related anaemia or severe kidney disease.

Their health-related quality of life scores were also lower than those of people with advanced metastatic cancers, such as stage 4 lung cancer. Overall, the impact of long Covid on the daily activities of patients was worse than that for stroke patients and comparable to people with Parkinson’s disease.

The study co-author Prof William Henley, of Exeter University medical school, said: “Long Covid is an invisible condition, and many people are left trying to manage significant changes to how they can function.

“Shockingly, our research has revealed that Long Covid can leave people with worse fatigue and quality of life than some cancers, yet the support and understanding is not at the same level. We urgently need more research to enable the development of evidence-based services to support people trying to manage this debilitating new condition.”

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Source: The Guardian, 8 June 2023

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Ministers failing to reform ‘restrictive’ primary care rules

The government has failed to change ‘restrictive’ legislation which would enable primary care reform – despite repeated announcements – a pharmacy leader has said.

Currently, pharmacy technicians cannot take on dispensing tasks without supervision from a pharmacist but the government promised in 2019 to look at how legislation can be updated to allow pharmacy technicians to take more of a role in dispensing, as part of the current five-year Community Pharmacy Contractual Framework, which ends next year.

The government has repeatedly announced and reannounced over the past five years that it wants to remove restrictions to give community pharmacy an expanded role.

But in a new report shared exclusively with HSJ, the Company Chemists’ Association – the trade body with members including Asda, Boots, Lloyds Pharmacy and Superdrug – highlights that government has failed to make progress.

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Source: HSJ, 7 June 2023

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NHS struggling to provide safe cancer care, say senior doctors

The Royal College of Radiologists is warning that all four UK nations are facing "chronic staff shortages", with cancer patients waiting too long for vital tests and treatments.

Half of all cancer units are now reporting frequent delays for both radiotherapy and chemotherapy.

Ministers say a workforce strategy for the NHS in England is due shortly.

The plan, which is meant to spell out how the government will plug staffing gaps over the next 15 years, has been repeatedly delayed, to the frustration of some in the health service.

In June 2022, Carol Fletcher, from South Wales, finally had her routine screening appointment for breast cancer, which was itself overdue.

"It took another eight weeks after my mammogram before I was told there might be something wrong," she said.

Since her cancer diagnosis, there have been more waits - for scans, tests, surgery and then chemo.

"I was told that I might not get results back [quickly] after my mastectomy because they haven't got enough pathologists, so there was another eight-week delay for chemotherapy," she said.

"I can't plan for the future and it's had a huge impact on my family."

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Source: BBC News, 8 June 2023

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Adenomyosis: NHS failing women, health ambassador says

The NHS in England is "failing women", the government's women's health ambassador has said.

Prof Dame Lesley Regan, appointed to support the Women's Health Strategy implementation, was speaking to BBC Radio 5 Live's Naga Munchetty.

Last month, Munchetty, 48, revealed she had been diagnosed with the womb condition adenomyosis, after waiting years in severe pain.

Dame Lesley said she wanted women to be able to self-refer to specialists.

Women and girls should not have to seek "permission [to] go and have your crippling menstrual pain sorted out", she said.

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Source: BBC News, 6 June 2023

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Ministers seek volunteer social care army to speed up hospital discharges

Health ministers are to recruit a new volunteer army for social care to ferry medical equipment and drugs to people’s homes in a bid to free up congested hospital wards.

Under the plan, members of the public will be able to sign up on the GoodSam app for roles such as “check in and chat”, which involves support over the phone for people struggling with loneliness.

There will also be the chance to “pick up and deliver”, helping to transport medicines or small items of medical equipment to people’s homes from NHS sites so they can be discharged from hospital, and “community response” roles will involve collecting and delivering shopping and prescriptions.

The joint NHS and social care volunteers responders programme for England is being launched on Wednesday amid a social care staffing crisis with 165,000 vacancies and millions of hours of care needs not being met. At the end of April, 49,000 people every day had to stay in NHS hospitals in England despite no longer meeting the criteria to be there.

News of the planned announcement from the care minister, Helen Whately, has sparked concern among workers in the sector, who warned that volunteering could not solve the social care recruitment and retention crisis. Helen Wildbore, director of Care Rights UK, which represents relatives and residents, said it “feels like a desperate measure to try and save a system that is crumbling”.

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Source: The Guardian, 6 June 2023

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Plan for GPs to offer NHS patients weight-loss jab

GPs in England may start offering weight-loss jabs to some patients to reduce obesity-related illnesses and resultant pressure on hospitals.

Wegovy was approved for NHS use after research suggested users could shed over 10% of their body weight.

The drug blunts appetite, so users feel full and eat less.

Rishi Sunak said it could be a "game-changer" as he announced a £40 million pilot scheme to increase access to specialist weight management services.

But experts warn "skinny jabs" - widely used in the US and endorsed by many celebrities - are not a quick fix or a substitute for a healthy diet and exercise.

NHS drugs watchdog, the National Institute for Health and Care Excellence (NICE), says patients can access Wegovy for a maximum of two years via specialist weight-management services.

The new scheme will test how GPs could safely prescribe such drugs and the NHS provide support in the community or digitally, contributing to the government's wider ambition to reduce pressure on hospitals and give patients access to the care they need where it is most convenient for them.

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Source: BBC News, 7 June 2023

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ICSs most ‘off target’ on recovery named by NHS England

Seven integrated care systems and one ambulance trust have been placed in ‘intensive support’ because of their performance against urgent and emergency care metrics.

NHS England launched the new intervention regime for emergency care earlier this year to measure progress against the urgent and emergency care recovery plan.

The most troubled systems and organisations are now placed in a first “tier” and will receive central support from NHSE. Other systems requiring support from NHSE regional teams are placed in a secondary tier. This tiered approach is already in place for cancer and elective performance.

Support will include help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”.

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Source: HSJ, 7 June 2023

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Syphilis and gonorrhoea hit record levels in England

Gonorrhoea cases hit record levels last year, while syphilis diagnosis reached the highest level since just after the Second World War, new figures show.

New data from the UK Health Security Agency (UKSA) shows 8,692 cases of syphilis were recorded in 2022, the largest annual figures since 1948.

Gonorrhoea cases hit a high of 82,592 last year - a 50% increase compared to 2021. This is the highest number in any one year since records began in 1918, according to the UKHSA.

The public health authority said gonorrhoea cases are becoming “increasingly resistant” to antibiotics and are “at risk of becoming untreatable in the future.”

Overall there was a 24% increase in sexually transmitted infection diagnoses in 2022 and local council leaders warned sexual health services are “at risk of breaking point” as demand rises alongside real-term cuts to funding.

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Source: The Independent, 7 June 2023

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Doctors to take legal action against GMC over ‘inaction’ on Covid vaccine misinformation

A group of doctors, including some GPs, has begun legal proceedings against the GMC based on what they say is a failure to act on Covid-19 vaccine misinformation.

On Friday, the group, whose members wish to remain anonymous, sent a formal pre-action protocol letter to the GMC, which is a warning that legal action is imminent. 

In January, these doctors called on the regulator to investigate Dr Aseem Malhotra’s fitness to practise due to what they claim is his ‘high-profile promotion of misinformation about Covid-19 mRNA vaccines’.

Dr Malhotra, a consultant cardiologist, campaigner and author, has over half a million followers on Twitter, with most recent posts focusing on the Covid vaccine.

The upcoming action, which is led by lawyers from the Good Law Project, is based on the GMC’s refusal to carry out an investigation.

Professor Trish Greenhalgh, a GP and academic in primary care at the University of Oxford who has been in touch with the group, told Pulse the ‘scandal is that the GMC do not think it’s their job to investigate doctors who have massive, massive followings on social media and who fan the flames of disinformation’. 

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Source: Pulse, 5 June 2023

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New super registry: all implanted medical devices to be tracked

A ground-breaking, mandatory national medical device outcome registry has been launched to collate detailed information on all procedures involving high-risk (Class III/IIb) devices, including pacemakers, hip joint replacements and breast implants.

Led by NHS England’s Outcomes and Registries programme, and developed in partnership with NEC Software Solutions (NEC), the Medical Device Outcome Registry platform (MDOR) will capture data on over two million medical device procedures and more than 10 million unique devices used on patients each year across the NHS and independent healthcare sector, addressing recommendations from the Cumberlege review and Patterson inquiry.  

Collecting key details of the procedure, the clinicians involved and devices used, the registry will include clinical observational and patient outcome data, providing a single, comprehensive repository to improve patient safety and outcomes.  

Scott Pryde, delivery director for the Outcomes and Registries Programme, NHS England, said: “Millions of people receive high-risk medical devices and implants every year. Whereas most procedures are a complete success, when things go wrong it can result in serious harm for the patients affected. The Medical Device Outcome Registry will be responsive to concerns about the safety and outcomes of patients who receive high-risk medical devices, such as implants, and will use the data to actively detect, predict and prevent patient harm, and improve outcomes for patients".  

“The result will be in a step change in improving patient safety in these procedures, providing clinicians and healthcare teams with secure access to critical information they can use to inform clinical decisions and improve the experience of patients before, during and after their procedures.”  

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Source: Clinical Services Journal, 31 May 2023

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Urgent warning over fake oxygen supplied to dentists as health chiefs launch criminal probe

Dentists across Britain have been given 'falsified' oxygen supplies. 'Several' practices have been told to immediately stop using a batch of tanks and replace them with 'legitimate stock'.

Tricodent Limited, the Sussex-based firm which supplied the oxygen, is now under criminal investigation. 

The Medicines and Healthcare products Regulatory Agency (MHRA) has not said how the oxygen was falsified, and they stated that the risk to public health and patient safety was 'low'.

The MHRA alert urged affected practices to check their oxygen cylinders. If any are labelled 'Medical Oxygen B.P PL No 04280/0001 MEDIGAS OXYGEN', they should be replaced with legitimate stock immediately, the MHRA said.

All remaining stock must be quarantined, the agency added.

The MHRA did not, however, confirm the number or locations of impacted practices.

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Source: Mail Online, 6 June 2023

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USA: Over 400 patients mistakenly told they may have cancer due to software glitch

Grail, a company that developed blood tests to detect cancer, mistakenly sent approximately 400 customers letters saying they might be positive for the disease, The New York Times has reported.

Grail's Galleri test uses blood to detect cancer signals shared by 50 types of cancers and is available only by prescription, according to the report. Grail said in a statement that one of its vendors sent hundreds of letters with incorrect test results due to a "software configuration issue." 

"No patient health information has been disclosed or breached due to this issue, and no patient harm or adverse events have been reported," Grail's statement said.

The issue was not caused by incorrect test results, according to the company. More than half of people who received the erroneous letter had not yet had their blood drawn for the test. PWNHealth said in a statement that the system it uses to send template messages to people had a "misconfiguration." 

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Source: Becker's Hospital Review, 4 June 2023

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Discrimination, racism, violence are common and weighing heavily on US healthcare workers

Two new healthcare workforce surveys outline widespread reports of discrimination, racism and workplace violence in the USA perpetuated by patients and coworkers alike.

Among the findings were acknowledgments from respondents that incidents of discrimination are rarely reported to management or law enforcement.

Additionally, more than half of the respondents to one survey said that they believed that incidents of workplace violence have increased over the course of their tenure, while nearly half of the nurses who responded to the other survey said they believe “a culture of racism/discrimination” was present as early as in nursing school.

“If we are to truly provide just and equitable care to our patients, we as nurses must hold ourselves accountable for our own behavior and work to change the systems that perpetuate racism and other forms of discrimination,” said Beth Toner, RN, director of program communications at the Robert Wood Johnson Foundation (RWJF).

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Source: Fierce Healthcare, 2 June 2023

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Multi-cancer blood test shows real promise in NHS study

A blood test for more than 50 types of cancer has shown real promise in a major NHS trial, researchers say.

The test correctly revealed two out of every three cancers among 5,000 people who had visited their GP with suspected symptoms, in England or Wales.

In 85% of those positive cases, it also pinpointed the original site of cancer.

The Galleri test looks for distinct changes in bits of genetic code that leak from different cancers. Spotting treatable cancer early can save lives.

The test remains very much a "work in progress", the researchers, from Oxford University, say, but could increase the number of cancers identified.

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Source: BBS News, 2 June 2023

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Mayor intervenes in NHSE reconfiguration row

The mayor of London is independently reviewing NHS England plans to reconfigure children’s cancer services in the capital, which were triggered when the commissioner finally accepted the current arrangements are unsafe.

In a letter to NHSE London director Caroline Clarke, Sadiq Khan’s health adviser said the mayor would apply his six tests for major reconfigurations to both the options proposed for the “principal treatment centre” for paediatric cancer in south London.

NHSE London is currently running a process to decide the principal treatment centre's location. An earlier assessment put the bid from the Evelina Hospital, part of Guy’s and St Thomas’ Foundation Trust, ahead of the other bidder, St George’s University Hospitals FT.

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Source: HSJ, 5 June 2023

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Mum alarmed at 'out-of-depth' admission

The mother of a seriously ill boy said she was "very alarmed" when a doctor at an under-fire children's ward admitted they were "out of their depth".

In October, Carys's five-year-old son Charlie was discharged from Kettering General, but she returned him the next day in a "sort of lifeless" state.

She said it seemed "quite chaotic" on Skylark ward before he was transferred to another hospital for further tests.

Since the BBC's report in February that highlighted the concerns of parents with children who died or became seriously ill at the hospital, dozens more have come forward.

In April, Care Quality Commission (CQC) inspectors rated the Northamptonshire hospital's children's and young people's services inadequate.

Among the findings, inspectors said "staff did not always effectively identify and quickly act upon patients at risk of deterioration".

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Source: BBC News, 6 June 2023

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Global ‘silver tsunami’ of older cancer patients is coming, experts warn

The world must urgently prepare for a global “tsunami” of millions of older cancer patients or risk healthcare systems being unable to cope, leading doctors have warned.

With life expectancy increasing and a rapidly soaring population of older people, a looming increase in elderly patients with cancer was now a “serious public health concern”, the American Society of Clinical Oncology (ASCO) said in a report. Cancer centres must prepare for “the silver oncologic tsunami”, the experts added.

At ASCO’s annual meeting in Chicago, the world’s largest cancer conference, Dr Andrew Chapman, the director of the Sidney Kimmel Cancer Center-Jefferson Health and a specialist in geriatric oncology, said: “As the population expands and the incidence goes way up, are we really prepared to deal with those needs? I think globally, we’re not prepared.”

“We know cancer is a disease that is associated with ageing, and there are a number of biological mechanisms as to why that is,” Chapman said. “What is often times missed is that the older adults’ goals, wants, needs, preferences, and issues are much different than those of the average adult.

“Sometimes there’s a nihilism – ‘if you’re older we’re not going to bother’ – which is horrible,” he added.

Dr Julie Gralow, the chief medical officer and executive vice-president of ASCO, said healthcare systems should act immediately to avoid being overwhelmed by the dramatic rise in older cancer patients. “By 2040, the global burden is expected to grow to 27.5m new cancer cases and 16.3m cancer deaths simply due to the growth and ageing of the population.”

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Source: The Guardian, 5 June 2023

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NHS hospital investigated over ‘gross negligence’ following baby’s death

One of the NHS’ largest hospital trusts is being investigated over “possible gross negligence manslaughter” after a baby died 24 hours after her birth.

Polly Lindop died at St Mary’s Hospital on 13 March and Greater Manchester Police have now launched a probe into her death.

Police said its major incident team launched the investigation into “possible Gross Negligence manslaughter” after concerns were raised to the force and local coroner.

DCI Mark Davis of GMP’s major incident team said: “First, I want to express my condolences to the parents of Polly at what is an extremely difficult time for them. Our thoughts will remain with them as we carry out our investigation.

“A number of hospital staff have been spoken to as witnesses by officers and no arrests have been made at this time.

“The hospital trust has been fully cooperative with the police and all relevant authorities have been kept informed. The investigation into Polly’s death is on-going and her family will continue to be kept updated in relation to any significant developments.”

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Source: The Independent, 5 June 2023

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NHSE merger halts plan to boost district nurses

Plans to procure more district nursing courses to start this September have been paused because of the merger of Health Education England into NHS England, HSJ understands.

An email sent last month from a commissioning officer at NHSE’s workforce, training and education directorate – the new HEE – said procurement of new district nursing courses from universities would be paused “until further notice”, due to the “ongoing merger”.

Since 2009, the number of district nurses working in the English NHS has fallen drastically, from around 7,000 to around 3,900.

Steph Lawrence, executive director of nursing and allied health professionals at Leeds Community Healthcare Trust, said the decision to pause the expansion of courses was a “huge concern” as numbers of district nurses need to grow “at a much faster rate”.

“This is a major safety issue for safe and effective care in the community if we don’t have the appropriate numbers of nurses trained. We may also lose nurses as well who want to progress and expand their knowledge,” Ms Lawrence said.

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Source: HSJ, 5 June 2023

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