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USA: For uninsured people with cancer, access to care can be "very random"

Eighteen months after April Adcox learned she had skin cancer, she finally returned to Charleston's Medical University of South Carolina last May to seek treatment.

Adcox had first met with physicians at the academic medical center in late 2020, after a biopsy diagnosed basal cell carcinoma. The operation to remove the cancer would require several physicians, she was told, including a neurosurgeon, because of how close it was to her brain.

But Adcox was uninsured. She had lost her automotive plant job in the early days of the pandemic, and at the time of her diagnosis was equally panicked about the complex surgery and the prospect of a hefty bill. Instead of proceeding with treatment, she attempted to camouflage the expanding cancerous area for more than a year with hats and long bangs.

If Adcox had developed breast or cervical cancer, she likely would have qualified for insurance coverage under a federal law that extends Medicaid eligibility to lower-income patients diagnosed with those two malignancies. For female patients with other types of cancer, as well as pretty much all male patients, the options are scant, especially in South Carolina and the 11 other states that haven't yet implemented Medicaid expansion, according to cancer physicians and health policy experts who study access to care.

In the face of potentially daunting bills, uninsured adults sometimes delay care, which can result in worse survival outcomes, research shows. The odds of patients getting insurance to help cover the cost of treatment play out a bit like a game of roulette, depending upon where they live and what type of cancer they have.

"It is very random — that's, I think, the heartbreaking part about it," said Dr. Evan Graboyes, a head and neck surgeon and one of Adcox's physicians. "Whether you live or die from cancer shouldn't really be related to what state you live in."

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Source: CBS News, 7 April 2023

 

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Third scan could greatly reduce UK breech birth numbers, study suggests

Giving women a third scan at the end of their pregnancy could dramatically reduce the number of unexpected breech births and the risk of babies being born with severe health problems, research suggests.

Pregnant women in the UK have routine scans at 12 and 20 weeks only, with no further scan offered in the third trimester unless they are considered at risk of a complicated pregnancy. The researchers hope their findings could lead to a change in guidance for clinicians that will improve maternity care.

Prof Asma Khalil, who led the study at St George’s, University of London, said: “For the first time we’ve shown that just one extra scan could save mothers-to-be from trauma, an emergency C-section, and their babies from having severe health complications which could otherwise have been prevented.”

She said the two routine scans were “far too early” to establish how the baby would be positioned during labour. “That’s why a third scan at 36-37 weeks could be a gamechanger to pregnancy and birth care.”

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Source: The Guardian, 7 April 2023

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Trust CEOs’ strike warning: ‘If anyone gets sick, we’re stuffed’

The leaders of acute trusts across England have told HSJ the second junior doctor’s strike ‘feels very different’ from the first stoppage, and services are much more vulnerable because of ‘thinner’ consultant coverage.

They also reported that the instruction from NHS England not to proactively cancel elective procedures and apppointments has been largely ignored by trusts.

The chief executive of a large trust in the east of England said they were “more concerned about clinical safety than at any time during covid surges”.

A trust CEO in the North West told HSJ this week’s stoppage “feels much more risky than the previous strike. We have managed to cover rotas but we are very stretched and concerned about short notice cancellation from agencies and short term sickness after bank holiday.”

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Source: HSJ, 11 April 2023

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Sexual assault, crude banter — what it’s like to be a female surgeon

Mehdian-Staffell, 37, is part of a new generation of female surgeons who are challenging the male-dominated culture in the profession.

It is clear that she loves her job. “My aim is not just to be a surgeon – it is to be a damn good one. I didn’t go into it to be average,” she says. But she is also exhausted and demoralised. “The sexism comes from patients as well as other members of staff. People will assume you’re a nurse. I’ve previously worked in departments where the guys all went off to golf and men were prioritised for opportunities over women. Sometimes, as female surgeons, we feel as if we have to work twice as hard.”

She says many of her more recent male colleagues have been supportive, but there is a systemic problem. Even the surgical instruments are made for male hands. Traditionally, surgeons are known as “Mr” rather than “Dr”, but women often get called by their first name.

There have been darker moments. “I’ve been sexually harassed lots of times,” she says.

 In 2021 the Royal College commissioned the human rights lawyer Helena Kennedy to do a review of diversity and inclusion in surgery. “The evidence I had from women was that the culture was very male and the chat in and around the operating theatre for surgeons was often inappropriate. It’s really not a very conducive environment for women.” She made a raft of recommendations to improve the situation but says she is “disappointed” at how slowly they are being implemented.

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Source: The Times, 8 April 2023

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‘He tarnished my reputation’: whistleblower demands action against CQC accuser

A former adviser for the Care Quality Commission (CQC) has called on the regulator to explain what action it has taken against the officials responsible for wrongly dismissing him after he raised whistleblowing concerns.

Shyam Kumar, a surgeon who was part of inspection teams in the North West, told HSJ that he had to live with question marks over his reputation for several years. He is furious that a senior CQC official sought to question his honesty and integrity in evidence submitted to the employment tribunal examing his dismisal.

The tribunal heard Mr Kumar had raised a number of whistleblowing disclosures to the CQC, including concerns about the lack of appropriate expertise on inspection teams.

After a wide-ranging review around its handling of whistleblowing concerns, CQC chief executive Ian Trenholm last week apologised to Mr Kumar for “unacceptably poor treatment” by his organisation, and thanked him for contributing to the review.

However, Mr Kumar told HSJ: “I’m glad the CQC has looked at this and finally acknowledged what they did to me was wrong. But I want to know what has happened to the individuals that were responsible.”

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Source: HSJ, 6 April 2023

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1,643 ‘sexual safety incidents’ in a single 59-bed children’s unit

A single children’s mental health hospital with just 59 beds reported more than 1,600 “sexual safety incidents” in four years, shocking NHS figures reveal.

Huntercombe Hospital in Maidenhead was responsible for more than half of the sex investigations reported in the 209 children’s mental health units across the country.

Despite warnings at a rate of more than one a day to the health service since 2019, no action was taken to stop vulnerable NHS patients being sent to the scandal-hit unit as a result of the 1,643 sexual incident reports.

The private unit is now finally due to be closed after an investigation by The Independent revealed allegations of verbal and physical abuse, prompting the NHS to withdraw patients. The hospital since said it plans to reopen as an adult unit.

Figures obtained from the NHS show Huntercombe’s Maidenhead unit, Taplow Manor, was behind 57% of the 2,875 reported sexual incidents and assaults reported at England’s child and adolescent mental health services (CAMHS) over the past four years. Reported incidents can range from sexually inappropriate language to serious sexual assault and rape.

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Source: The Independent, 11 April 2023

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NHS patient 'stuck in hospital with months to live'

A woman who may only have months to live has told the BBC she is "angry and frustrated" at being in hospital five months after being cleared to go home.

Charlotte Mills-Murray, 34, said attempts to organise care at her family home had been repeatedly delayed.

Charlotte lives with intestinal failure caused by a severe form of Ehlers-Danlos syndrome, which weakens her body's connective tissue.

She was admitted to St James's Hospital in Leeds in June 2022 following an infection, and a new Hickman line - a tube that allows feeding and the administering of pain relief - was inserted.

By November, Charlotte was told she was well enough to be cared for at home, but she remains in hospital following delays in the hiring and training of staff able to support her.

With limited access to a hoist which would enable her to use her wheelchair, Charlotte said she had spent 10 months "stuck in bed".

Because of the complexity of her condition, Charlotte only has months to live. She believes her situation merits greater urgency because of the increased risk of infection in hospital.

Charlotte qualifies for 24-hour home care support through the NHS Continuing Healthcare scheme, but she said decisions over how this would be put in place had been slow and unclear.

The BBC has found a 16% rise over the past year in the number of patients in England who are in hospital despite being well enough to leave.

The Department of Health and Social Care said it was "fully committed to speeding up the safe discharge of patients who no longer need to be in hospital" and was making £1.6bn available in England over the next two years to support this, on top of £700m of extra funding in 2022 to ease NHS pressures over the winter.

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Source: BBC News, 9 April 2023

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Junior doctors’ strike will have ‘catastrophic impact’ on waiting lists

The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said.

Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”.

“These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid."

He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.”

He called on the public to use NHS services responsibly.

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Source; The Guardian, 10 April 2023

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NHS workers betrayed: 'Cover up' allegations as most NHS Trusts say no staff died of Covid on their watch

NHS leaders and ministers face allegations of a “cover up”, as Byline Times reveals that almost two-thirds of NHS employers did not make a single, legally-required report of Covid being caught by staff working during the first 18 months of the pandemic.

And four-fifths (82%) of NHS employers have not reported a single death of a worker from Covid caught while working in those first two waves.

The Reporting of Injuries, Diseases & Dangerous Occurrences (RIDDOR) rules mean that employers have a legal duty to report certain serious workplace accidents and occupational diseases – including Covid. 

The lack of acceptance of responsibility from NHS employers has left some families in limbo – and angry at what they consider to be deliberate “denial” of the experiences of those who died serving the public.  

David Osborn, a health and safety consultant and member of the Covid-19 Airborne Transmission Alliance (CATA), co-wrote the research. He said: “One wonders how many bereaved families who have been denied this payment did not have the benefit of [these reports] to support their case.”

Osborn wrote to Sarah Albon, Chief Executive of the Health and Safety Executive, to raise his concerns after speaking with family members of NHS workers who had died of Covid, saying the reports of zero NHS worker deaths from Covid caught in the workplace are “difficult, nigh impossible, to believe.” 

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Source: Byline Times, 6 April 2023

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Survey finds 'alarming' number of vacancies in speech and language therapy

The chief executive of the Royal College of Speech and Language Therapists (RCSLT) said it is "alarming" that a survey found almost 1 in 4 jobs are vacant across the UK.

A survey by the professional body found speech and language therapy (SLT) vacancies across the UK had reached 23% with almost all children's services (96%) and 9 out of 10 adult services (90%) which responded saying recruitment is more or much more challenging than at any time in the past three years.

A delay to receiving SLT support can affect a person's ability to communicate with friends and family or to eat and drink as well as a child's ability to access the school curriculum, to regulate their behaviour or to form friendships.

The COVID-19 pandemic added to the pressure on SLT services, exacerbating waiting times for assessment and support, as well as adding referrals to see young children whose language and social development was hampered by pandemic restrictions which meant they were not mixing with other children or adults at play groups, nurseries, and schools.

RCSLT's new Chief Executive, Steve Jamieson, said, "By the time they are seen by a SLT their needs are a lot more complex and difficult to manage and to treat.”

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Source: Medscape, 5 April 2023

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Tuberculosis warning as cases of disease rise for first time in decades in Europe

Disruption caused by the coronavirus pandemic is being blamed for the first recorded rise in tuberculosis (TB) cases and deaths in Europe for two decades.

Some 27,300 people died from TB in the World Health Organization’s Europe region in 2021, up from 27,000 deaths the previous year, according to a new surveillance report by WHO and European Union’s disease prevention agency.

The rate of new cases and relapses in the region is also estimated to have increased by 1.2 per cent compared to 2020, in a reversal analysts said “reflects the impact of disruption to TB services caused by the Covid-19 pandemic.” The report comes days after the UK Health Security Agency (UKHSA) reported a 7.3 per cent rise in cases in England in 2021, a year that saw new 4,425 cases.

Dr Esther Robinson, head of the UKHSA's TB unit, said, "Tuberculosis remains a risk to some of the most vulnerable people in our society and this data highlights that progress towards elimination has stalled."

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Source: Independent, 3 April 2023

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Maker of eyedrops linked to deadly infections couldn’t ensure factory was sterile, FDA says

The manufacturer of eyedrops recently linked to deaths and injuries lacked measures to assure sterility at its factory in India, according to U.S. health inspectors.

Food and Drug Administration officials uncovered about a dozen problems with how Global Pharma Healthcare made and tested its eyedrops during an inspection from late February through early March. The FDA released its preliminary inspection report Monday.

The company uses procedures that can’t actually ensure its products are sterile, FDA staff wrote. In particular, the inspectors found that the plant had used “a deficient manufacturing process” between December 2020 and April 2022 for products that were later shipped to the US.

The plant in India’s southern Tamil Nadu state produced eyedrops that have been linked to 68 bacterial infections in the U.S., including three deaths and eight cases of vision loss. Four people have had their eyeballs surgically removed due to infection. The drops were recalled in February by two U.S. distributors, EzriCare and Delsam Phama.

In a statement, the FDA's Jeremy Khan wrote, “We urge consumers to stop using these products which may be harmful to their health.”

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Source: NBC News, 4 April 2023

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Children's hospital forced to close may reopen due to legal loophole

A scandal-hit children’s mental health hospital set to close after an investigation uncovered allegations of severe abuse could reopen within months due to a legal loophole, it can be revealed.

Taplow Manor hospital, in Maidenhead, will shut in May after the Independent exposed claims of “systemic abuse” and poor care from more than 50 former patients. Police are currently carrying out two investigations into the hospital–one into a patient death and a second into the alleged rape of a child involving staff.

Active Care Group, which runs the hospital, announced last week that would close but in letters sent to staff since then, it said it was looking to retrain them with plans to “reopen as an adult acute service” in a matter of months. A loophole in the regulations means that there is nothing to stop healthcare providers from applying to the watchdog, the Care Quality Commission, to reopen, even if serious concerns have been raised about the closed operation.

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Source: Independent, 4 April 2023

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Former nursing home manager fined £40,000 after death of two residents

A former nursing home manager has been fined £40,000 after pleading guilty to two offences of failing to provide safe care and treatment to two residents at Rossendale Nursing Home in Lancashire.

Caroline Taylforth, who established her first residential care home in 1997, was prosecuted by the CQC. She was the registered manager at Rossendale Nursing Home at the time of the incidents, and admitted mistakes she had made that meant two residents did not receive safe care and treatment, and resulted in "avoidable harm" while in her care, said a CQC spokesperson.

The first offence was for failures in the care of resident Patricia Sutton, aged 77, who was admitted to the home on 11 October 2018 and had a significant medical history. On 6 November 2019, Patricia Sutton was eating dinner in the dining room and started choking. She was taken to hospital and died later that day. Ms Sutton had previously been involved in three other choking incidents and should have been referred to a speech and language therapist after the second one occurred to properly assess the risks, said the CQC. However, Ms Taylforth "did not safely assess, monitor or manage the risk or make this referral", the CQC concluded.

The CQC also prosecuted Ms Taylforth for another incident concerning Dereck John Chapman, aged 82, who was admitted to the home on 22 October 2019 with multiple health issues and was also prone to having falls. Following admission to the home, Mr Chapman suffered at least 14 falls. Ms Taylforth "failed to mitigate" the risk of falls and "failed to ensure" Mr Chapman was promptly referred to appropriate services, such as the falls team, GP, and local authority following known incidents, particularly those resulting in injuries, criticised the CQC.

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Source: Medscape, 6 April 2023

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‘Fit-notes’ from nurses and physios to ease GP pressure

Nurses and physiotherapists can now provide ill patients with “fit-notes” to stay off work in an attempt to ease pressure on GP services. A range of health staff including pharmacists and occupational therapists are certifying illness sign-offs under moves to free up doctors to tackle the treatment backlog.

NHS Grampian has successfully completed a pilot scheme at a GP practice which staff described as “really positive” and a step in the right direction.

David Cooper, a GP from Old Machar Medical Practice in Aberdeen, said: “It is a more efficient way for us to work as a practice. For the nurses, physiotherapists and others who are working closely with a patient, it makes sense for them to be able to work on fit-notes without having to refer back to a GP for sign off. “We have found it works particularly well for those with chronic, long-term conditions or illness and the process behind the scenes is also now electronic so it saves paper, time and energy.”

Paul Gray, a physiotherapist at Old Machar, said: “It makes the patient’s journey easier and it is better for people to access them from those who are assessing your physical capabilities."

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Source: The Times, 6 April 2023

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Three years of breathing polluted air increases risk of lung cancer

Just three years of breathing polluted air can increase a person’s risk of lung cancer, a study has found.

Scientists have found, for the first time, the mechanism that proves air pollution causes lung cancer to develop.

Research funded by Cancer Research UK and conducted by the Francis Crick Institute showed that small pieces of carbon particulates, known as PM2.5, enter deep into the lungs and lead to tumour development. A key gene, known as EGFR, mutates and then the presence of the air pollution exacerbates the growth and expansion of these mutated cells, the study found.

The scientists are hopeful that by shedding light on how lung cancer develops they can help to prevent it. Prof Charles Swanton, the chief clinician for Cancer Research UK and lead investigator on the study, said a statin-like drug to protect against lung cancer and ensure the inflammation that can lead to the disease is kept under control could be developed in as little as 10 years.

Prof Swanton said: “Our study has fundamentally changed how we view lung cancer in people who have never smoked."

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Source: The Telegraph, 5 April 2023

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New tool can spot those most at risk of developing lung cancer, say researchers

Lives could be saved by a new tool that identifies those most at risk of developing lung cancer, according to researchers.

The CanPredict tool can spot those most at risk of developing the disease over the next decade and put them forward for screening tests earlier, researchers from the University of Oxford and the University of Nottingham said. They created and tested CanPredict using the anonymised health records of more than 19 million adults from across the UK and hope it can save “time, money and, most importantly, lives”.

Lung cancer is the leading cause of cancer deaths worldwide and the second most common form of the disease, but early diagnosis has been shown to improve survival rates.

Professor Julia Hippisley-Cox, senior author and professor of clinical epidemiology and general practice at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: “We hope that this new validated risk tool will help better prioritise patients for screening and ultimately help spot lung cancer earlier when treatments are more likely to help. We’d like to thank the many thousands of GPs who have shared anonymised data for research without whom this would not have been possible.”

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Source: The Independent, 6 April 2023

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‘Cover-up’ fears over trust’s toxic culture

An independent group overseeing the reviews into a toxic culture at University Hospitals Birmingham have raised concerns over a possible ‘cover up’ of key reports.

The cross-party reference group, which includes MPs, council and Healthwatch officials, has demanded transparency over key decisions, and says there are continuing concerns over the trust’s leadership. It has been scrutinising a review into patient safety concerns at UHB, which found the trust’s executive had become “overzealous and coercive”.

On the day this review was released, it was revealed that UHB’s former CEO David Rosser had decided to retire.

The group, chaired by MP Preet Gill, said in a statement: “The allegations made by whistleblowers were not isolated incidents, but the result of a deep-seated and toxic culture. While Dr Rosser has recently announced his retirement, one member of staff, albeit a chief executive, cannot be responsible for this alone. Feedback from staff has made it clear that there must be collective accountability by the senior leadership for the distressing culture afflicting the trust."

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Source: HSJ, 5 April 2023

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Fears for vulnerable patients as NHSE changes covid treatment rules

Some of the most vulnerable patients could risk missing out on covid treatment because new rules will place the onus on them to access antiviral medication themselves instead of the NHS contacting them directly, senior figures have warned.

The warnings follow NHS England’s national medical director Sir Stephen Powis writing to local leaders last week advising them the national commissioner will no longer identify patients who are eligible for covid treatment.

This means eligible patients will need to contact local services themselves, rather than being approached proactively by a covid medicines delivery unit.

Patients Association chief executive Rachel Power said: “Expecting patients ill with covid to know they’re eligible for these treatments and ask for them is unreasonable. How will they know they’re eligible or who to contact?”

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Source: HSJ, 6 April 2023

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Judge says parents and children should receive infected blood payments

The parents and children of victims of the contaminated blood scandal should receive government compensation, a judge has said.

The chairman of the infected blood public inquiry, Sir Brian Langstaff, said it was time to "recognise deaths which have so far gone unrecognised". More than 3,000 people died after contracting HIV or hepatitis C via NHS treatments in the 1970s and 80s.

The government must now respond to the recommendations.

In August 2022, the government agreed to make the first interim compensation payments of £100,000 each to about 4,000 surviving victims, and bereaved widows. 

Sir Brian said, "It is a fact that around 380 children with bleeding disorders were infected with HIV. Some of them died in childhood. But their parents have never received compensation. Children who were orphaned as a result of infections transmitted by blood transfusions and blood products have never had their losses recognised. It's time to put that right."

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Source: BBC News

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Delays in patients leaving hospital could cost NHS 'average of £395 per night'

Delays in people leaving hospital in England could be costing an average of £395 per night, according to researchers at a health think tank.

The direct costs of delayed discharges, where patients are considered medically fit to leave hospital, is estimated to be around £1.89 billion for the past financial year, the King's Fund said. This estimate does not count extra costs, including cancelled operations or staff time spent arranging care packages. Ambulance handover delays are often linked to a shortage of space caused by people who no longer need to be in hospital beds.

The most recent PA analysis of NHS figures showed an average of 13,300 beds per day in the week to March 26 were filled by people ready to be discharged, compared with 12,643 at that point last year. Overall, 42% of medically fit patients in England were discharged, though the rate varied between regions, from 31% in the North West to 52% in eastern England.

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Source: Medscape, April 2023

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Rare encephalitis tick disease found in England

A virus carried by ticks, which is common in many parts of the world, is now present in the UK and health officials are reminding the public how to avoid bites from the tiny bugs.

They say the risk of tick-borne encephalitis is very low—only one person is confirmed to have been infected in England so far, last year. But the tick species which carries the virus is widespread in the UK. Most people do not develop symptoms but swelling to the brain is possible.

The UK Health Security Agency has recommended changes to testing in hospital so that any new cases can be picked up quickly. 

Health officials say anyone who becomes unwell after a tick bite should see a GP. More serious symptoms to look out for include severe headache, stiff neck, unexplained seizure, sudden confusion and weakness in arms and legs.

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Source: BBC News, 5 April 2023

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New test holds promise for oral cancer detection


A new non-invasive diagnostic test for oral cancer test developed by researchers at the University of Surrey is said to be over 92% accurate at detecting oral squamous cell carcinoma (OSCC) and more than 80% accurate at identifying pre-cancerous oral epithelial dysplasia (OED), according to a proof-of-concept study. 

The news comes in the wake of a recent report showing that cases of oral cancer in the UK increased by 34% over the last decade and have more than doubled compared with 20 years ago. The State of mouth cancer UK report 2022, released last November by the Oral Health Foundation, showed that there were 8846 new cases of mouth cancer diagnosed in the UK over the previous year, with 3034 deaths from the disease.

The test could pave the way for better oral cancer detection, the researchers said. The samples were collected in dental surgeries and mailed to their laboratory for analysis, which demonstrated that the test could be "used in primary care to identify patients in need of specialist care".

Study co-author Dr Fatima Labeed, senior lecturer in human biology from the University of Surrey, said: "Over 300,000 people are diagnosed with oral cancer worldwide–a disease with an alarming mortality rate of around 50%. This suggests that the scientific community doesn't have the tools available to identify oral cancer early enough, and we hope that PANDORA paves the way for more effective clinical diagnostic tools for this terrible disease."

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Source: Medscape, 5 April 2023

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Critically ill patients ‘will inevitably die’ due to junior doctors’ strike

Critically ill patients “will inevitably die” because hospitals are having to cancel surgery as a direct result of next week’s junior doctors’ strike in England, leading heart experts have warned.

There were bound to be fatalities among people with serious heart problems whose precarious health meant they were “a ticking timebomb” and needed surgery as soon as possible, they said. They added that patients would face an even greater risk than usual of being harmed or dying if their time-sensitive operation was delayed because NHS heart units would have too few medics available during the four-day stoppage by junior doctors to run normal operating lists.

The trio of cardiac experts are senior doctors at the Royal Brompton and Harefield specialist heart and lung hospitals in London. Those facilities, plus the cardiac unit at St Thomas’ hospital in the capital, have between them postponed between 30 and 40 operations they were due to conduct next week on “P2” patients, whose fragile health means they need surgery within 28 days.

“It is no exaggeration to say that delaying surgery for this group [P2s] will result in harm. For some, this may be life-changing. For others, it may mean premature death,” said Dr Richard Grocott-Mason, a cardiologist who is also the chief executive of the Royal Brompton and Harefield hospitals.

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Source: The Guardian, 4 April 2023

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New Marburg outbreaks in Africa raise alarm about the deadly virus’s spread

Two concurrent outbreaks of the Marburg virus, a close cousin of Ebola that can kill as many as 90 percent of the people it infects, are raising critical questions about the behaviour of this mysterious bat-borne pathogen and global efforts to prepare for potential pandemics.

Marburg causes high fever, vomiting, diarrhoea and bleeding from orifices. It spreads between people via direct contact with the blood or other bodily fluids of infected people and with surfaces and materials such as clothing contaminated with these fluids.

One of the two outbreaks, in Tanzania in East Africa, seems to have been brought under control, with just two people left in quarantine. But in the other, in Equatorial Guinea on the west coast, spread of the virus is ongoing, and the World Health Organization (WHO) said last week that the country was not being transparent in reporting cases.

The WHO said both outbreaks pose regional risks: Equatorial Guinea has porous borders with Cameroon and Gabon, and so far the cases have appeared in geographically diffuse parts of the country. In Tanzania, the Kagera region has busy borders with Uganda, Rwanda and Burundi.

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New York Times, 5 April 2023

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