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NHSE begins rollout of mandatory outcomes registry

Trusts must start submitting full data on surgeries which include a high-risk medical device into a new national registry by December as part of a national push to increase accountability and safety around surgery.

NHS England is launching the new mandatory medical device outcome registry this month. The new registry was created in response to Baroness Cumberlege’s “First Do No Harm” review and initial data submissions about surgeries that include a high-risk medical device will begin in June.

Details of the launch arrangements have been set out in a draft letter which HSJ has seen and understands is set to be sent to medical directors and other system leaders imminently.

Relevant procedures include those, for example, involving either a Class III device, like an implant, or a Class IIb therapeutic device, such as drug-eluting balloon catheter.

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Source: HSJ, 16 May 2023

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NHS still waiting for over £1bn capital funding announced five years ago

More than half of £2.7bn awarded to NHS organisations for capital projects in 2017 and 2018 has yet to be delivered, research by HSJ has discovered. 

The government announced almost £3bn  in capital funding to upgrade NHS estates and services in four waves during 2017 and 2018. This was before the pledge to build 40 “new hospitals” by 2030, which has since largely dominated decisions about NHS capital investment.

HSJ looked at the progress of the 143 schemes, worth a total of £2.7bn, known to have been included in the “sustainability and transformation partnership” capital funding programmes. 

Only £1.2bn has been given to the organisations involved, and over a fifth of live schemes – which range from emergency department upgrades to new primary care hubs – have not received any allocated funds to date. 

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Source: HSJ, 15 May 2023

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GMC to investigate ‘stalker’ doctor who shared patient’s records

The UK medical regulator has launched an investigation into a “stalker” doctor who accessed intimate details of the health history of a woman who had begun dating the doctor’s ex-boyfriend.

The General Medical Council (GMC) is investigating whether the doctor – a consultant at Addenbrooke’s hospital in Cambridge – breached their professional, ethical and legal duties to protect the woman’s personal information.

The victim has given the watchdog a statement detailing the consultant’s repeated violations of her medical records and documentation that shows what she did.

The GMC declined to comment because it has not yet decided to open a formal disciplinary case against the consultant, who could face serious sanctions including a ban on working as a doctor. One of the GMC’s investigative officers is examining the victim’s claims and collecting evidence.

The Guardian revealed how the doctor had looked at the victim’s hospital and GP records seven times last August and September, in the early stages of the woman’s relationship with a man the consultant had been involved with for several years.

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Source: The Guardian, 15 May 2023

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Ministers told to set out plan for hiring mental health nurses in England

UK ministers must set out how to recruit and retain thousands more mental health nurses to plug the profession’s biggest staff shortage, healthcare leaders are warning.

Mental health nurses account for nearly a third of all nursing vacancies across England, resulting in overstretched services that are struggling to deliver timely care, according to research carried out by the NHS Confederation’s mental health network.

Sean Duggan, the network’s chief executive, said: “Mental health leaders and their teams are pulling out all the stops in what are very constrained circumstances, but they cannot be expected to solve this staffing crisis alone.

“The knock-on effect means that the mental health crisis the nation is facing will in turn become a crisis for the whole healthcare system and the country. This relentless pressure on mental health staff cannot be allowed to continue with the ultimate impact being on the patients who most need that care.”

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Source: The Guardian, 16 May 2023

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‘Outstanding’ trust drops to ‘requires improvement’ after staff ‘let down by senior leaders’

An ‘outstanding’ trust’s Care Quality Commission rating has been dropped to ‘requires improvement’, after inspectors found potential safety risks and a disconnect between board and ward.

A highly critical report on University Hospitals Sussex Foundation Trust also downgraded its well-led rating to “inadequate” and recommended the trust be placed in segment four – the bottom tier – of NHS England’s system oversight framework. Its main tertiary centre – the Royal Sussex County Hospital – was also rated “inadequate”, including for safety.

Deanna Westwood, Care Quality Commission’s director of operations in the South, said “staff and patients were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment”.

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Source: HSJ,12 May 2023

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Patient aggression up by a fifth despite trust’s interventions

A hospital trust, which has already implemented a series of safety measures to protect employees, has reported a 17% rise in incidents of abuse against staff by patients and the public in the last year. 

Data from the Oxford University Hospital’s clinical incident system, shared with HSJ, shows there were 1,181 cases of violence and aggression against staff in 2022, up from 1,003 in 2021.

Before late 2021, the monthly incident rate very rarely hit 100, while since January 2022 it has topped 100 in seven months, including 162 and 131 incidents respectively in January and February this year.

The ongoing growth is despite the trust launching a campaign, called “No Excuses”, in January 2022,. Measures include bodyworn cameras, and safety devices with alarms and positioning technology for lone workers. 

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Source: HSJ, 16 May 2023

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Online depression therapy given go-ahead in England

Nine online talking-therapy treatments for anxiety or depression have been given the green light to be used by the NHS in England.

They offer faster access to help but less time with a therapist, which may not suit everyone, the health body recommending them said.

There is huge demand for face-to-face services, with people waiting several weeks to see a therapist.

The new digital therapies, delivered via a website or an app using cognitive-behavioural therapy (CBT), provide an alternative way of accessing support, which may be more convenient for some, the National Institute for Health and Care Excellence (NICE) says.

They could also free up resources and help reduce the wait for care. However, psychiatrists said digital therapies were not a long-term solution.

Mental-health charity Sane said they were no substitute for a one-to-one relationship and could leave people feeling even more isolated than before.

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Source: BBC News, 16 May 2023

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Babies are dying because of NHS failings, poverty and inequality, charities warn

Hundreds of babies are dying unnecessarily because overstretched maternity services are delivering substandard care and struggling to overcome entrenched poverty and racial inequalities, a report has warned.

The report by baby loss charities Sands and Tommy’s says the government’s aim to halve the number of stillbirths and neonatal deaths in England by 2025 is stalling, while there is no target in Scotland, Wales or Northern Ireland.

Stillbirths are creeping up in England after falling in the past decade. Babies dying before and during delivery rose to just over four in every 1,000 births in 2021. Similarly, long-falling rates of neonatal deaths, where newborns die within the first four weeks of birth, are also rising. There were 1.4 deaths of newborn babies for every 1,000 births in 2021, compared with 1.3 in 2020.

Robert Wilson, head of the charities’ joint policy unit, said the government and NHS need to make fundamental changes. “The UK is not making enough progress to reduce rates of pregnancy loss and baby death, and there are worrying signs that these rates are now heading in the wrong direction,” he said.

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Source: The Guardian, 14 May 2023

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Mums renew plea for government allergy tsar

Two mothers have renewed calls for a government allergy tsar following their daughters' deaths from severe allergic reactions.

In a letter to Health Secretary Steve Barclay, Tanya Ednan-Laperouse and Emma Turay, from London, said the deaths were "entirely preventable".

MPs are set to debate two allergy petitions on Monday, including one calling for the introduction of an allergy tsar.

In the letter, Mrs Ednan-Laperouse, from Fulham in west London, and Ms Turay, from Wood Green in north London, tell Mr Barclay: "As mothers, we have come together for change so that our tragedies never happen again.

"There are no clear lines of accountability in relation to overall NHS provision of allergy care, nor for the many other areas where policy change is required.

"This lack of national leadership has been raised time and again by coroners at the inquests of those who died following severe allergic reactions."

Ms Turay explained the issue was raised at the inquest into the death of her daughter, Shante.

"The coroner highlighted the fact that 'there is no person with named accountability for allergy services and allergy provision at NHS England or the Department of Health as a whole'," she said.

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Source: BBC News, 15 May 2023

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Trust’s A&E ‘effectively running primary care service’, says chair

An acute trust chair has said its emergency department is effectively operating as a primary care service. 

Hattie Llewelyn-Davies, who has chaired The Princess Alexandra Hospital Trust since late 2021, told HSJ: “We’ve done an awful lot of changes in the way we run out A&E and same day emergency care service to try and get the flow through working better…

“We have particular problems with the Princess Alexandra because we are right in the middle of Harlow. And we have a GP service and primary care service which is under massive pressure. We have very high levels of deprivation in Harlow.

“When somebody is sick in Harlow and can’t get a doctor’s appointment on the spot, they walk into us. We have a very high level of people coming in, so a very high level of footfall but a very low level of admissions.

“We are therefore running effectively a primary care service through our A&E.”

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Source: HSJ, 15 May 2023

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Hepatitis C home test kits available to most-at-risk in England

Home test kits for a virus which attacks the liver are now available to order online in England, as the NHS tries to reach those needing treatment.

Hepatitis C tends to affect current or past drug users and people who have had contact with infected blood through a tattoo or medical procedure abroad.

It can lead to liver disease and cancer, but symptoms often go unnoticed for many years.

The NHS website says it can usually be cured by taking a course of tablets.

More than 70,000 people are thought to be living with the virus in England. Some may not know they have it, so would be unlikely to go to their GP for a test.

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Source: BBC News, 13 May 2023

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Nurses ‘fear being taken to court’ over degrading treatment of patients in corridors

Nurses fear they could be taken to court or struck off over the level of care they are able to give to patients, a union has warned, as the NHS stands on the brink of six more months of strikes.

The Royal College of Nursing, one of the two unions to turn down the recent government pay offer to NHS staff, revealed that over nine in 10 A&E nurses had raised concerns that patients may be receiving unsafe care and that patient dignity, privacy and confidentiality is compromised.

Six in 10 fear they will be struck off the nursing register or have a court case brought against them as a result of patient harm due to their working conditions, the RCN said.

Ms Cullen insisted that patient safety is “at the centre of everything that we do” but warned that it “cannot be guaranteed on any day of the week”, given it is missing 47,000 nurses “every single day and night”.

Speaking before its annual congress in Brighton, which begins on Monday, some nurses described themselves as “broken” and feeling “suicidal”, with corridor treatment being deemed “degrading for patients” and as “destroying staff morale”.

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Source: The Independent, 15 May 2023

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Quarter of people with dementia symptoms delay seeing doctor

Almost a quarter of people with dementia symptoms waited more than six months before seeing a doctor, new research shows.

A new survey for the Alzheimer’s Society to mark Dementia Action Week also found one in three people who notice they or a loved one has symptoms keep their fears to themselves or dismiss them as old age.

Just 15% of the 1,137 people surveyed raised the issue straight away and 11% said they hadn’t raised concerns after first spotting symptoms.

Kate Lee, chief executive of the Alzheimer’s Society, said: “We can’t continue to avoid the ‘d’ word – we need to face dementia head-on.

“As soon as you realise something is not right, come to Alzheimer’s Society – you can use our symptoms checklist to help have that all-important first chat with your GP.”

An early diagnosis is crucial to help manage symptoms, according to the charity, which has launched a new campaign called – It’s not called getting old, it’s called getting ill – to encourage people to seek support in getting a diagnosis.

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Source: The Independent, 15 May 2023

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Baby heart death parents left waiting 14 months for answers

Grieving parents have been left waiting more than 14 months for answers about why their 12-day-old son died.

Elijah was born at Merthyr Tydfil's Prince Charles Hospital on 25 February 2022 and died after being diagnosed with enterovirus and myocarditis.

Joann and Christian Edwards said they were told they would have a report by the end of 2022, but are still waiting.

Joann and Christian, from Mountain Ash, Rhondda Cynon Taf, said they were told Elijah's myocarditis was a "one off" but subsequently read about 10 babies, including one who died, getting severe enterovirus with myocarditis across south Wales.

Public Health Wales (PHW) said Elijah's death was not being looked into as part of an investigation into this cluster of cases, as the dates were set at June 2022 to April 2023 to coincide with the enterovirus season.

But it said it would look to include Elijah's death as part of a "wider clinical investigation" of the cases.

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Source: BBC News, 15 May 2023

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Warnings over NHS data privacy after ‘stalker’ doctor shares woman’s records

The confidentiality of NHS medical records has been thrown into doubt after a “stalker” hospital doctor accessed and shared highly sensitive information about a woman who had started dating her ex-boyfriend, despite not being involved in her care.

The victim was left in “fear, shock and horror” when she learned that the doctor had used her hospital’s medical records system to look at the woman’s GP records and read – and share – intimate details, known only to a few people, about her and her children.

“I felt violated when I learned that this woman, who I didn’t know, had managed to access on a number of occasions details of my life that I had shared with my GP and only my family and very closest friends. It was about something sensitive involving myself and my children, about a family tragedy,” the woman said.

The case has prompted warnings that any doctor in England could abuse their privileged access to private medical records for personal rather than clinical reasons.

Sam Smith, of the health data privacy group MedConfidential, said: “This is an utterly appalling case. It’s an individual problem that the doctor did this. But it’s a systemic problem that they could do it, and that flaws in the way the NHS’s data management systems work meant that any doctor can do something like this to any patient.

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Source: The Guardian, 14 May 2023

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Patient safety at risk in crumbling hospital Boris Johnson promised to replace

Patients, doctors and nurses are enduring constant ward closures and flooding in “dilapidated and unpleasant” buildings because a new hospital promised by the government has still not been delivered, one of its most senior medics has warned.

Patient safety could soon be at risk unless the replacement for St Helier Hospital, in south London, is finally confirmed by ministers, according to the outgoing chief medical officer of its NHS trust. Some of the buildings pre-date the NHS, while wards have been shut due to sinking foundations.

Writing in the Observer, Dr Ruth Charlton, the chief medical officer of Epsom and St Helier University Hospitals NHS Trust, warns:

“Right now, we are delivering safe care – but it’s not easy in such a dilapidated and unpleasant environment, and I fear we won’t be able to provide the level of care we’d like to – or should be – for much longer,” she writes. “Our patients and our staff deserve so much better than this current state – where wards are being shut down because the foundations are sinking, and floods and leaks are a certainty every winter.

“Every day we wait costs money, and each year we have to spend more and more on updating our old, rundown buildings – diverting scarce resources from the front line … there’s no other option. We must progress our plans to build our new hospital and make improvements to our existing sites.”

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Source: The Guardian, 13 May 2023

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ADHD: Private clinics exposed by BBC undercover investigation

Patients are being offered powerful drugs and told they have attention deficit hyperactivity disorder (ADHD) after unreliable online assessments, a BBC investigation has discovered.

Three private clinics diagnosed an undercover reporter via video calls. But a more detailed, in-person NHS assessment showed he didn't have the condition.

Panorama spoke to dozens of patients and whistleblowers after receiving tip-offs about rushed and poor-quality assessments at some private clinics, including Harley Psychiatrists, ADHD Direct and ADHD 360.

The investigation found that:

  • Clinics carried out only limited mental health assessments of patients.
  • Powerful drugs were prescribed for long-term use, without advice on possible serious side effects or proper consideration of patients' medical history.
  • Patients posting negative reviews were threatened with legal action.
  • The NHS is paying for thousands of patients to go to private clinics for assessments.

Commenting on Panorama's findings, Dr Mike Smith - an NHS consultant psychiatrist - said he was seriously concerned about the number of people who might "potentially have received an incorrect diagnosis and been started on medications inappropriately".

"The scale is massive."

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Source: BBC News, 

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Medicines courier Sciensus was warned it was failing patients three years ago

The boss of a private healthcare company exposed by the Guardian for putting seriously ill children and adults at risk was warned it was failing patients three years ago.

Darryn Gibson, the chief executive of Sciensus, Britain’s biggest medicines courier, was told in November 2020 that patients with bleeding disorders were being left dangerously exposed to internal bleeding with little or no treatment at home as a result of botched, delayed or missed deliveries.

Gibson received the written warning from Kate Burt, the chief executive of the Haemophilia Society, a leading health charity, after she had become outraged at how vulnerable patients were being let down.

Sciensus blamed IT issues and promised action. However, three years later, patients remain at “very serious” risk of harm because of “recurring” problems with the company, Burt said.

“We continue to receive complaints about missing, incomplete or inaccurate deliveries and are very concerned to see the same issues recurring, indicating that far more needs to be done to improve Sciensus’s ordering and delivery systems,” she said.

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Source: The Guardian, 12 May 2023

 

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Children’s surgery waiting lists hits record high as NHS fails to tackle spiralling backlog

Hospitals are failing to tackle spiralling children's surgery waiting lists as the backlog hits more than 400,000 for the first time.

Leaked documents show children’s waiting lists for both inpatient and outpatient care are “increasing at double the rate of adults” and, despite efforts, services have failed to catch up after they were paused during the pandemic.

NHS leaders have repeatedly raised concerns about the backlog amid warnings that services for young people have been “deprioritised” to cut adult lists.

One NHS leader warned that the long waits would be likely to affect some children’s “ability to lead full and active lives” and worsen existing inequalities between adult and children’s care.

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Source: The Independent, 11 May 2023

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Artificial intelligence could ‘transform’ heart attack diagnosis, scientists say

Artificial intelligence (AI) could be “transformational” in improving heart attack diagnosis to reduce pressure on emergency departments, a new study suggests.

Doctors could soon use an algorithm developed using AI to diagnose heart attacks with better speed and accuracy than ever before, the research from the University of Edinburgh indicates.

It could also help tackle dangerous inequalities in diagnosing the condition, scientists suggest.

Researchers found that, compared to current testing methods, the algorithm called CoDE-ACS was able to rule out a heart attack in more than double the number of patients, with an accuracy of 99.6%.

Nicholas Mills, British Heart Foundation (BHF) professor of cardiology at the Centre for Cardiovascular Science, University of Edinburgh, who led the research, said: “For patients with acute chest pain due to a heart attack, early diagnosis and treatment saves lives.

“Unfortunately, many conditions cause these common symptoms, and the diagnosis is not always straight forward.

“Harnessing data and artificial intelligence to support clinical decisions has enormous potential to improve care for patients and efficiency in our busy emergency departments.”

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Source: The Independent, 11 May 2023

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World-renowned NHS centre downgraded by watchdog

A world-renowned cancer centre hit by whistleblowing concerns over alleged bullying has been downgraded by the health watchdog.

The Care Quality Commission (CQC) told The Christie NHS Foundation Trust in Manchester it "requires improvement" in safety and leadership.

A former trust nurse told the BBC leaders had intimidated staff to stop them voicing concerns to inspectors.

Rebecca Wight worked at The Christie - Europe's largest cancer centre - from 2014 but quit her role as an advanced nurse practitioner in December, claiming her whistleblowing attempts had been ignored.

She told BBC Newsnight the trust had attempted to manipulate the inspection by intimidating those who wished to paint an honest picture.

Roger Kline, an NHS workforce and culture expert from Middlesex University Business School, told BBC Newsnight there was a culture at The Christie which was "unwelcoming of people raising concerns".

He said: "The trust response is more likely... to see the person raising the concerns as the problem rather than the issues they have raised," adding this was "not good for patient care".

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Source: BBC News, 12 May 2023

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Monkeypox: WHO declares global emergency over

Monkeypox is no longer a global public health emergency, the World Health Organization (WHO) has said, almost a year after the threat was raised.

The virus is still around and further waves and outbreaks could continue, but the highest level of alert is over, the WHO added.

The global health body's chief Tedros Adhanom Ghebreyesus called on countries to "remain vigilant".

More than 87,000 cases and 140 deaths have been reported from 111 countries during the global outbreak, according to a WHO count.

But almost 90% fewer cases were recorded over the last three months compared with the previous three-month period, meaning the highest level of alert is no longer required, Tedros said.

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Source: BBC News, 11 May 2023

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WHO issues warning on weight loss drug Wegovy

New weight loss drugs such as Wegovy will not be a “silver bullet” in tackling obesity, the World Health Organization (WHO) has warned.

Francesco Branca, WHO director of food and nutrition safety, said weight loss drugs must be used alongside a healthy diet and exercise.

Ms Branca’s comments come as the health body conducts its first review of obesity management guidelines in two decades.

Semaglutide, marketed as Wegovy by drugmaker Novo Nordisk, is an appetite suppressant drug that has been approved by the UK medicines regulator and described by some as a “game changer” in helping people to shed weight.

People will only be given Wegovy on prescription as part of a specialist weight management service involving input from several professionals and for a maximum of two years.

Some experts described the decision as a “pivotal moment” for the treatment of people living with obesity but others warned that the drug is not a “quick fix”.

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Source: The Independent, 12 May 2023

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Legal action may be needed to lower ‘appalling’ death rates of black women in childbirth

 

The death rates for black women in childbirth were revealed in a recent report from MPs and were described as “appalling”, yet action, not words, are needed for what could be considered breaches of the Human Rights Act.

Ministers are not giving priority to reducing the gap in health inequalities, write Nicola Wainwright and Suleikha Ali in a commentary to the Times. 

"If the response to the review is foot-dragging from the government and senior health service officials, then legal action may be the only way to draw focus to this issue and to try to reduce the number of ethnic minority women and babies dying unnecessarily."

The report, published by the women and equalities committee last month, highlights the “glaring and persistent” disparities faced by ethnic minority women compared to their white counterparts with regards to pregnancy and birth. However, these same disparities have been known and reported on for 20 years, while progress on improving the situation has been shockingly slow.

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Source: The Times, 11 May 2023

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'Hidden' rise in blood clot deaths 'breaking families' warns charity

Thrombosis UK has warned that deaths involving blood clots are higher than expected as it called for more transparency over the work hospitals are doing to reduce the risk for patients.

Before the pandemic hit, hospitals were regularly publishing data on the number of patients who had been risk assessed for blood clots. In March 2020, the NHS in England took the decision to suspend the data collection on venous thromboembolism (also known as VTE) risk assessments to “release capacity in providers and commissioners to manage the Covid-19 pandemic”.

But the data collection and publication is yet to resume. The charity said the data shows how many VTE cases are missed in hospitals.

One bereaved man described how his mother died last year after the condition was missed. Tim Edwards, 42, said healthcare workers missed signs of the condition while Jennifer Edwards, 74, was in hospital on the south coast.

Despite having many symptoms of a pulmonary embolism she was discharged home and died three days later. Mr Edwards said: ““My mother’s symptoms were missed from her admission to hospital right up to her time in the cardiology department.

“She was discharged and passed away three days after phoning the NHS with shortness of breath. She should not have died. I took it upon myself to enquire about the circumstances surrounding her death and was overwhelmed by the lack of care taken.

“Sadly, I know this is not an isolated case.”

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Source: Wales Online, 12 May 2023

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