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Gloucestershire maternity units still shut after staff shortages

Maternity services in Gloucestershire will remain shut for months because of staff shortages, it has been confirmed.

The Aveta Birth Unit in Cheltenham and Stroud's post-natal facilities are not expected to re-open until at least October, bosses say.

The announcement by Gloucestershire Hospitals NHS Foundation Trust means women will have been unable to use the services for more than a year.

Maternity campaigners say new mothers are not getting support they need.

The trust said it had a long-term commitment to both units, but they cannot reopen safely at the moment.

The Aveta unit has been shut since last June and Stroud's six postnatal beds have been closed since September.

It means new mothers are forced to go home 12 hours after giving birth, or if they have medical needs being sent to Gloucestershire Royal Hospital.

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Source: BBC News, 19 May 2023

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Leak shows NHSE ‘sorry’ for endorsing service which ‘hurt patients’

NHS England is ‘sorry’ for backing a mental healthcare model which it now admits has caused hurt to patients, according to a leaked draft policy document.

The serenity integrated mentoring model was launched in 2013 in the Isle of Wight and Hampshire. It quickly became viewed by mental health trusts as an “innovative approach” to helping support frequent users of the emergency services.

A core element of the scheme involves placing a local community police officer within the healthcare team charged with supporting those patients. 

In 2021, the pressure group StopSIM raised concerns about the model, which included a belief that police involvement was potentially coercive, criminalised mental health crises, and could result in withholding healthcare from people, which would breach human rights legislation. The group also argued the SIM programme had not been robustly and clinically evaluated.

As a result, NHSE committed to co-producing policy guidance on SIM with StopSIM. 

The draft document states: “NHS England did not apply sufficient scrutiny to the decision [to endorse SIM] and involve the voice of lived experience sufficiently. This compromised the safety and quality of care for service users and has caused hurt to patients. For this, NHS England is sorry.”

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Source: HSJ, 19 May 2023

Further reading on the hub:

The High Intensity Network (HIN) approach and SIM model for mental health care and 'high intensity users' – what are your views?

 

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Warning as baby dies and seven more fall critically ill with ‘usually mild virus’

A baby has died and seven others were left requiring intensive care after a “usually mild” virus appeared to trigger a serious heart condition, health officials have said.

The World Health Organization (WHO) said it had been notified of an “unusual” increase in myocarditis –inflammation of the heart – among newborns in south Wales infected with an enterovirus over the past year.

While enteroviruses are common and often asymptomatic, they are known to cause “occasional outbreaks in which an unusually high proportion of patients develop clinical disease, sometimes with serious and fatal consequences – in this instance myocarditis”, the UN health agency said.

While prior to the recent cluster of cases, south Wales had experienced only two similar cases in six years, the 10 months to April saw 10 cases of myocarditis in babies under the age of 28 days who tested positive for enterovirus, according to WHO.

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Source: The Independent, 19 May 2023

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Inquiry into major UK maternity scandal slams NHS for failure to consult Black and Asian families

An inquiry into maternity care failings at an NHS trust that left dozens of babies dead or brain-damaged is “wholly insufficient” because only a fraction of Black and Asian women have come forward, its chair has warned.

Donna Ockenden, who is leading a review into Nottingham University Hospitals NHS Trust, suggested the health service must do more to increase the number of responses from ethnic minorities if the trust is to learn from the scandal.

Less than 20 families from Black and Asian communities are currently involved in the inquiry, compared to more than 250 white families, The Independent understands.

It is understood letters have only been sent out in English, while Ms Ockenden pointed to examples of women being unable to access translation services and expectant Muslim mothers being turned away if they objected to male sonographers.

She said the communities’ “mistrust” towards the trust had “deepened”, leaving the review team “climbing a mountain” to engage with them.

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Source: The Independent, 18 May 2023

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Male GPs in England less likely to refer patients for IVF, report finds

Male GPs are less likely to refer eligible patients for IVF, research by a fertility charity suggests, raising concerns about access to NHS-funded treatment.

The Progress Educational Trust’s (PET) report highlights “utter confusion” and a lack of knowledge among GPs about eligibility criteria for NHS-funded treatment, which it says is exacerbating the so-called IVF postcode lottery. GPs typically make the initial referral to fertility clinics, meaning that they play a crucial role in access.

“For NHS treatment, GPs are the main initial gatekeeper. If you’re not getting pregnant, that’s who you go to for advice and support,” said Sarah Norcross, the director of PET. “It struck me that, when people have a known cause of infertility, male GPs still weren’t passing them on.”

The report is based on a survey of 200 GPs and commissioners across England, carried out by an independent research company, which investigated knowledge of national fertility guidelines and criteria they use for referral decisions.

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Source: The Guardian, 19 May 2023

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150 ‘sexual safety incidents’ reported at ‘inadequate’ service in six months

A mental health trust’s acute and intensive care wards have been downgraded to “inadequate”, following a series of incidents including sexual assaults, fire setting, and patients taking their own lives while on leave.

The Care Quality Commission (CQC) inspection was prompted by reports of several serious incidents involving patients in these services. These included three occasions where patients had taken their own lives while on leave from wards, and four incidents where fires had been set at the Redwoods Centre in Shrewsbury.

Inspectors also identified a steep rise in mixed accommodation breaches, with just one ward out of the four inspected at St George’s Hospital in Stafford and none of the three inspected at Redwoods providing single sex units. 

The CQC report added “there were concerns about the implications of mixed sex ward environments contributing to sexual safety incidents”, with 158 such incidents recorded in a six-month period leading up to the inspection. These included assaults, verbal threats of sexual assault, and sexual orientation related abuse, with 126 recorded at Redwoods and 32 at St George’s.

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Source: HSJ, 19 May 2023

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Use private sector more for NHS patients, says Labour

The government in England should increase its use of the private sector to tackle the NHS backlog, Labour says.

It said as many as 300,000 patients have missed out on treatment since it called for greater use of private clinics in January 2022.

And the party said it was unjust that the lack of action meant only those who could afford to pay for treatment themselves were being seen on time.

The government said it was delivering by cutting long waits. However, data published by NHS England last week showed key targets to tackle the backlogs in cancer care and routine treatment had been missed.

Overall, there are now a record 7.3 million people on a hospital waiting list, which is nearly three million higher than it was before the pandemic started.

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Source: BBC News, 19 May 2023

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'Multiple systemic failures' found at Royal Infirmary of Edinburgh A&E

Patients spent up to 25 hours on trolleys in corridors waiting for treatment and in some cases were left lying on "urine-soaked sheets" and in another on a "blood-stained pillow for several hours" at the Royal Infirmary of Edinburgh.

Healthcare Improvement Scotland (HIS) inspectors also raised concerns over fire safety in the overcrowded A&E after two visits to the hospital - the first of which was carried out between February 20 to 22 and a further unannounced follow-up in March.

The watchdog found "multiple systemic failures" in a report published on Thursday but NHS Lothian said a major improvement drive was already underway.

The health board added that the hospital was had just endured its busiest winter on record ahead of the inspections.

At the time of the inspection, the emergency department was on some days operating at over three times its capacity.

The report described this as unsafe and a "fire safety risk" with the evacuation plan in place at the time not reflecting the "significant" impact of overcrowding. 

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Source: The Herald, 18 May 2023

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Call for national guidelines on discussing past trauma in maternity appointments

National guidelines are needed to help maternity care professionals navigate discussions with pregnant women about past traumas, experts have said.

Their study, published in the journal Plos One, also found that while talking about previously experienced traumas can be valuable, they can also trigger painful memories if not approached sensitively.

The authors also raised concerns about the support available for professionals who may not feel equipped to explore challenging topics such as domestic or sexual abuse, childhood trauma and birth trauma without adequate guidelines or referral pathways.

Joanne Cull, a midwife and PhD student at the University of Central Lancashire’s School of Community Health and Midwifery, who is corresponding author on the study, said: “As awareness of the long-term effects of trauma on health and wellbeing has grown, there has been a move toward asking pregnant women about previous trauma, usually at the first appointment.

“No national guidance on this has been published in the UK so NHS Trusts have implemented this on a piecemeal approach.”

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Source: The Independent, 17 May 2023

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USA: Drug shortages near an all-time high, leading to rationing

Thousands of patients are facing delays in getting treatments for cancer and other life-threatening diseases, with drug shortages in the United States approaching record levels.

Hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns.

The shortages are so acute that they are commanding the attention of the White House and Congress.

The Biden administration has assembled a team to find long-term solutions for shoring up the pharmaceutical supply chain, at a time when the United States remains heavily reliant on medicines and drug ingredients from India and China. And in recent weeks, generic drug makers, supply-chain experts and patient advocates have appeared before lawmakers to discuss the problems.

The scarcity of generic forms of chemotherapy to treat lung, breast, bladder and ovarian cancers has only heightened concerns.

“This is, in my opinion, a public health emergency,” said Dr. Amanda Fader, a professor at the Johns Hopkins School of Medicine and a president-elect of the Society of Gynecologic Oncology, “because of the breadth of the individuals it affects and the number of chemotherapy agents that are in shortage right now.”

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Source: New York Times, 17 May 2023

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Staff suspended after ‘sleeping in patient’s bed’

Staff were suspended by their trust after they were found to have been sleeping in a patient’s bed, a Care Quality Commission (CQC) report has revealed.

The regulator inspected acute wards for adults and psychiatric intensive care units at Black Country Healthcare Foundation Trust in February, after safeguarding concerns were raised.

As HSJ revealed earlier this year, inspectors investigated a series of incidents, while a referral was also made to the police. As well as reports of staff using a mental health inpatient’s bed, there were complaints involving alleged inappropriate sexual behaviour and a governance breach. The concerns were said to relate to Hallam Street hospital in West Bromwich and Penn Hospital in Wolverhampton. 

The CQC inspection report said it inspected the service following allegations that “abuse had occurred” and a “multi-agency safeguarding meeting was convened to discuss the investigations of these”.

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Source: HSJ, 18 May 2023

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Obese patients cost NHS double the amount of healthy people

Obese patients cost the NHS double the amount that people who are a healthy weight do, a landmark new study has revealed.

One million patients who were a healthy weight cost the NHS £638 on average in 2019, the research found. Meanwhile, £1,375 was spent per year on morbidly obese patients with a body mass index (BMI) of more than 40.

Experts warned the future viability of the NHS relies on combatting increasing obesity as it was leading to record levels of long-term sickness.

The research, presented at the European Congress of Obesity in Dublin, is the first to show how NHS spending varies depending on a patient’s weight.

The findings showed a staggering rise in spending on heavier patients because they develop obesity-related conditions like type 2 diabetes and heart disease.

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Source: The Independent, 18 May 2023

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Quick blood tests to spot cancer: will they help or harm patients?

Investors are pouring billions into companies claiming they can analyse DNA to find the disease early. But some scientists question if they really work.

A pioneering group of people in the US and UK who have elected to take part in a new form of cancer screening known as multi-cancer early detection tests (MCED). The tests use gene sequencing or other novel technologies to detect fragments of DNA expelled by cancerous cells which circulate in people’s blood, allowing the identification of multiple types of cancer from a single blood draw. They have been hailed as “revolutionary” and “cutting edge” by British and US health chiefs.

Health bodies in both nations have set up MCED clinical trials in the hope that the tests can be rolled out to the population at large. The UK’s NHS is participating in a clinical trial of the Galleri test involving 140,000 patients. 

But not everyone is convinced the tests live up to the hype. Several health experts and scientists told the Financial Times that the tests could harm rather than help some patients due to risks associated with misdiagnosis, over-diagnosis and over-treatment.

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Source: The Financial Times, 17 May 2023

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Anti-abortion laws harm patients facing dangerous and life-threatening complications, report finds

Healthcare providers caring for pregnant patients in the months after the US Supreme Court’s decision to strike down Roe v Wade have been unable to provide standard medical care in states where abortion is effectively outlawed, leading to delays and worsening and dangerous health outcomes for patients, according to an expansive new report.

In the wake of the Supreme Court’s ruling last year, individual reports from patients and providers have shed some light on the wide range of harm facing pregnant women in states where access to abortion care is restricted or outright banned.

But a first-of-its-kind report from the University of California San Francisco captures examples from across the country, documenting 50 cases in more than a dozen states that enacted abortion bans within the last 10 months, painting a “stark picture of how the fall of Roe is impacting healthcare in states that restrict abortion,” according to the report’s author Dr Daniel Grossman.

“Banning abortion and tying providers’ hands impacts every aspect of care and will do so for years to come,” he said in a statement accompanying the report. “Pregnant people deserve better than regressive policies that put their health and lives at risk.”

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Source: The Independent, 16 May 2023

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‘Pathetic and dishonest’: trust’s deputy CEO blasts NHSE approach to cancer

NHS England’s approach to recovering cancer services has been described as ‘pathetic and dishonest’ by the deputy chief executive of a major trust.

Andy Welch, deputy chief executive and medical director of Newcastle Hospitals Foundation Trust, has publicly criticised comments made in November by NHSE’s national cancer director Dame Cally Palmer, who said “we have our foot on the gas” towards reaching cancer waiting time targets.

Mr Welch is an outspoken figure who has also slammed NHSE for “destroying” the morale of midwives through its “failed ‘continuity of care’ concept”, and described the potential “toppling” of the government as “brilliant” within the last three weeks alone.

The Newcastle medic is the chair of the Northern Cancer Alliance. His criticism of Dame Cally comes as performance against the flagship cancer target remains largely unchanged since last year.  

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Source: HSJ, 18 May 2023

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Poverty and clinical need both key when prioritising patients for treatment says NHSE lead

Factors like deprivation should be considered in prioritising waiting lists, NHS England’s inequalities director has said, but in a ‘very sophisticated, thoughtful way’ alongside clinical need and waiting times.

NHSE said in summer 2020 the service would “restore services inclusively”, and some systems and trusts have developed tools they say could allow them to consider factors such as deprivation, race, employment, and lifestyle risk factors, such as smoking.

But the issue has been controversial. Research for University Hospitals Coventry and Warwickshire Trust, which has developed a new prioritisation system, found many members of the public are opposed to taking these factors into account.

NHSE standard contract guidance for 2023-24, seemingly cautioning against such moves, said: “[The Department of Health and Social Care] asked us to make clear that providers are ‘recommended to prioritise waiting lists according to clinical need and then in chronological order from the longest waiting patient.’” 

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Source: HSJ, 18 May 2023

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Gosport hospital drug deaths: Police identify 19 suspects

Nineteen suspects have been identified by police as part of a new inquiry into hundreds of deaths at a hospital.

An independent panel found 456 patients died after being given opiates inappropriately at Gosport War Memorial Hospital between 1987 and 2001.

The new criminal investigation is being led by Kent Police after three previous ones by Hampshire Constabulary resulted in no prosecutions.

Police said interviews with the suspects under caution were ongoing.

Detectives are examining more than 750 patient records as part of Operation Magenta after families, who have also campaigned for judge-led "Hillsborough-style" inquests, repeatedly called for justice.

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Source: BBC, 17 May 2023

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NHS clinic to offer depression magnet therapy

A therapy using magnets to treat severe depression is available on the NHS in the West for the first time.

Wellsprings clinic in Taunton can now deliver the repetitive Transcranial Magnetic Stimulation treatment (rTMS) to NHS patients through a referral.

During a session, a strong magnetic field is used to stimulate or inhibit different parts of the brain.

The National Institute for Health and Care Excellence (NICE) said it had "no major safety concerns" for the therapy.

Mark Rickman, 60, from Dartmoor deals with bipolar and depression and said rTMS has had a positive impact on him.

Mr Rickman previously tried Electroconvulsive Therapy (ECT), where electric shocks cause a brief surge of electrical activity in the brain, but said it was "debilitating" compared to rTMS.

NICE cleared rTMS for use in 2015, for people who had not responded well to antidepressants, and had "no major concerns" about the therapy.

The main side effects were said to be headaches, and patients at risk of seizures are screened.

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Source: BBC News, 18 May 2023

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Allegations of bullying within maternity programme of HSIB

It was created with the very best of intentions – to help hospitals learn lessons when a baby or mother is harmed or dies.

But a Channel 4 News investigation has been hearing that the maternity programme of the Healthcare Safety Investigation Branch – or HSIB – was riddled with flaws.

One former senior staff member spoke to Channel 4 about bullying within the organisation and failings which could have led to harm.

In a previous report, Channel 4 heard from the mothers of Beatrice and Marnie, who were stillborn and other parents have come forward with their experience.

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Source: Channel 4 News, 16 May 2023

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Hospitals are giving less qualified staff nurses uniforms, conference hears

Hospitals are deploying staff with less training than nurses – wearing the same uniforms – a conference has heard.

Nurses said trusts trying to make “cost savings” were using cheaper nursing associates, and treating student nurses as free labour, to try to plug gaps that should be filled by more qualified staff.

They are trained in similar basic skills to nurses, but have two years of training and a foundation degree qualification, compared to three years studying and a university degree for registered nurses.

Nurses at the RCN annual congress in Brighton said the associate workers are frequently being given equally complex tasks, as pressures mounted.

In some cases, they were even being given the same uniforms, meaning patients cannot distinguish between nurses and less-qualified staff, nurses said.

Meanwhile, student nurses, who should be shadowing trained staff to learn new skills, were increasingly being asked to fill in for healthcare assistants, the conference heard.

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Source: The Telegraph, 16 May 2023

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Over 26,000 adults with severe mental illness die prematurely from preventable illness each year

More than 26,000 adults with severe mental illness die prematurely each year from preventable physical illnesses, analysis by the Royal College of Psychiatrists suggests. 

New data from the Office for Health Improvement & Disparities shows 120,273 adults in England with severe mental illness, including psychosis, post-traumatic stress disorder and schizophrenia, died before the age of 75 between 2018 and 2020. 

Of these, the College estimates 80,182 deaths (two in three) were potentially preventable, which is an average of 26,727 people each year. 

Preventable deaths include deaths from diseases like cancer and heart disease which could have been prevented with earlier detection and treatment or lifestyle changes. While adults with severe mental illness are more likely to engage in unhealthy behaviours like smoking and drinking alcohol excessively, they are also less likely to access screening and treatment for a range of reasons including stigma associated with having a mental illness.  

While cancer is the leading cause of premature death among those with a severe mental illness, it also significantly increases the risk of dying before the age of 75 across a range of physical health conditions. Adults with severe mental illness are on average:

  • 6.6 times more likely to die prematurely from respiratory disease
  • 6.5 times more likely to die prematurely from liver disease
  • 4.1 times more likely to die prematurely from cardiovascular disease
  • 2.3 times more likely to die prematurely from cancer.

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Source: Royal College of Psychiatrists, 17 May 2023

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Do not resuscitate: Man choked to death after paramedics stood down

Experts are calling for "do not resuscitate" orders to be scrapped, saying they are being misused and putting people's lives at risk. One woman told BBC News that her elderly father might still be alive if the DNR in his medical file had been properly checked.

When Robert Murray began choking on a piece of fruit at breakfast, staff at his care home called 999. He'd stopped breathing and the ambulance service operator immediately sent paramedics to attend.

But seconds later, the care home told the dispatcher that the 80-year-old had a do not resuscitate form (DNR) in his medical records. The paramedics were stood down. Mr Murray died minutes later.

However, it was all a terrible mistake. It hadn't been made clear to the ambulance service that Mr Murray was choking - the DNR was only meant to apply should he have a cardiac arrest.

Mr Murray's death, at a nursing home in Eastbourne in June 2021, is an example of what experts call "mission creep" in the use of DNR - also known as DNACPR (Do Not Attempt Cardiac Pulmonary Resuscitation) - decisions.

Researchers from Essex University say some care home residents are "being inappropriately denied transfer to hospital or access to certain medicines" due to the recommendations.

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Source: BBC News, 16 May 2023

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Intervention at major trust as junior doctors flag patient safety risks

Trainee medics in a troubled maternity department have flagged concerns with national regulators over the safety of patients, it has emerged.

Last year the General Medical Council said it had concerns about the treatment of obstetric and gynaecology trainees at University Hospitals Birmingham and placed medics at Good Hope Hospital and Heartlands Hospital under intensive support known as “enhanced monitoring”.

The GMC’s review flagged serious concerns about emergency gynaecology cover arrangements and said there was a real risk trainees would become hesitant and reluctant to call on consultant support. In September it placed additional restrictions on training, due to “ongoing significant concerns about the learning environment and patient safety”.

Now it has emerged in board papers for Birmingham and Solihull integrated care board that Health Education England, now part of NHS England, and the GMC carried out a follow-up visit to UHB in late March to review progress. 

Board documents state that “several patient safety concerns [were] reported by postgraduate doctors in training to the visiting team”, with a subsequent feedback letter from HEE urging immediate changes to dedicated consultant time and job plans.

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Source: HSJ, 17 May 2023

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Untested AI-based tools could harm patients, WHO warns

As excitement builds throughout health and information systems worldwide over the rich potential benefits of new tools generated by artificial intelligence (AI), the World Health Organization (WHO) has called for action to ensure that patients are properly protected.

Cautionary measures normally applied to any new technology are not being exercised consistently with regard to large language model (LLM) tools, which use AI for crunching data, creating content, and answering questions, WHO warned.

“Precipitous adoption of untested systems could lead to errors by healthcare workers, cause harm to patients, erode trust in AI, and thereby undermine or delay the potential long-term benefits and uses of such technologies around the world,” the agency said.

As such, WHO proposed that these concerns are addressed and clear evidence of benefits are measured before their widespread use in routine health care and medicine.

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Source: United Nations News, 16 May 2023

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Blind people at risk due to ‘inaccessible’ health information from NHS, charity warns

Blind people are being put “at risk” when the NHS provides them with “inaccessible” information about their health, a charity has warned.

People with sight loss have missed appointments, cancer screenings or been unable to use home test kits because of a lack of clear instructions in an accessible format, according to the sight loss charity RNIB.

It warned that denying people access to their information can also “cause embarrassment and loss of dignity”.

Linda Hansen, from Bradford, who is severely sight-impaired, said that she needed to get her daughter to read her the results of a medical exam which was sent to her in print format.

Ms Hansen, 62, said: “I can get my bank statement or a gas bill in accessible formats, but yet I still receive health information that I can’t read. What could be more personal than your health status?”

A new RNIB campaign – My Info My Way – has been launched calling for all blind and partially sighted people to be given accessible information.

The charity said that a failure to provide information in an accessible format is putting blind and partially sighted people “at risk”.

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Source: The Independent, 16 May 2023

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