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Covid’s effect on mental health not as great as first thought, study suggests

Covid-19 may not have taken as great a toll on the mental health of most people as earlier research has indicated, a new study suggests.

The pandemic resulted in “minimal” changes in mental health symptoms among the general population, according to a review of 137 studies from around the world led by researchers at McGill University in Canada, and published in the British Medical Journal.

Brett Thombs, a psychiatry professor at McGill University and senior author, said some of the public narrative around the mental health impacts of Covid-19 were based on “poor-quality studies and anecdotes”, which became “self-fulfilling prophecies”, adding that there was a need for more “rigorous science”.

However, some experts disputed this, warning such readings could obscure the impact on individual groups such as children, women and people with low incomes or pre-existing mental health problems. They also said other robust studies had reached different conclusions.

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Source: The Guardian, 8 March 2023

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‘We wouldn’t have sent Dad there’: CQC accused of failing to keep care homes safe

England’s care regulator has been accused of failing to keep private nursing home residents safe after a family alleged a delay in exposing serious risks led to a loved one’s painful premature death.

Relatives of Bernard Chatting, 89, said they relied on a “good” rating from the Care Quality Commission when they moved him into a £1,200-a-week home in Dorset. But after he experienced care so unsafe he ended up in hospital and died a few weeks later, it emerged the CQC already knew the home was failing badly.

The case comes as CQC’s traffic light ratings become increasingly important for people looking to place relatives in England’s 17,000 care homes amid a staffing and funding crisis which experts fear could increase the risk of maltreatment of the most vulnerable citizens. The ratings from inadequate to outstanding are one of the few ways that families can check care standards.

“We wouldn’t have sent Dad there if we knew,” said Chatting’s son-in-law, Phil Davenport. “It is beyond my understanding how the CQC inspect, have serious concerns, and yet not advise the public more quickly.

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Source: The Guardian, 8 March 2023

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New government taskforce to lay foundations for preventative NHS

Patients in England are set to benefit from a radical new project that will look to identify innovative new methods of preventing cardiovascular disease, as the Department of Health and Social Care appoints the first ever Government Champion for Personalised Prevention.

John Deanfield CBE, a Professor of Cardiology at University College London, has been asked by the health secretary to explore how the potential of technology and data can be properly harnessed to allow people to better look after their health and reduce the risk of cardiovascular disease.

Professor Deanfield will spearhead a taskforce comprised of experts in everything from policy and technology to economics and behavioural science to deliver a range of recommendations that will lay the foundations for a modern, tailored cardiovascular disease prevention service.

The Government say the recommendations will:

  • Identify breakthroughs in predicting, preventing, diagnosing and treating risk factors for cardiovascular disease.
  • Advise on how public services, businesses and the population can be encouraged to support prevention outside the NHS.
  • Use personalised data to predict and manage disease more effectively.
  • Bring care closer to homes and communities by establishing new partnerships that advance the way preventative services are delivered.
  • Evaluate how this strategy for cardiovascular disease prevention may impact conditions with shared risk factors.

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Source: NHE, 7 March 2023

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‘Worse than childbirth’: women with endometriosis call for better treatments

Lisa Hague, 38, was diagnosed with endometriosis at the age of 17 after being in such severe pain that she resorted to taking a powerful painkiller, dihydrocodeine, that had been prescribed to her partner for a sports injury. She had an allergic reaction to the codeine and was taken to hospital.

After speaking to a doctor about why she had taken such a risk, she was referred for a laparoscopy and diagnosed. “I’d never heard of endometriosis before and didn’t know anyone that had it,” she says. 

The diagnosis was a relief, but there were few treatment options available and she has had to manage intense pain and very heavy bleeding for a few days each month.

At times, she has resorted to sitting against hot radiators or taking scalding baths to “as a distraction from the internal pain”. “It is very dismissed still at the doctors,” she says.

Hague says there is a “desperate need” for better treatments so that her teenage daughter’s generation do not face the same struggle. “Things have got to have changed since I was 17,” she says.

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Source: The Guardian, 8 March 2023

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Five women sue Texas over abortion access

Five women who say they were denied abortions in Texas despite facing life-threatening health risks have sued the state over its abortion ban.

Texas bars abortions except for medical emergencies, with doctors facing punishment of up to 99 years in jail.

According to the lawsuit, doctors are refusing the procedure even in extreme cases out of fear of prosecution.

The Center for Reproductive Justice has filed the legal action on behalf of the five women and two healthcare providers that are also plaintiffs.

"It is now dangerous to be pregnant in Texas," said Nancy Northup, the centre's president.

One of the women, Amanda Zurawski, said she had become pregnant after 18 months of fertility treatments. She had just entered her second trimester when she was told she had dilated prematurely and that the loss of her foetus, whom she and her husband had named Willow, was "inevitable".

"But even though we would, with complete certainty, lose Willow, my doctor could not intervene while her heart was still beating or until I was sick enough for the ethics board at the hospital to consider my life at risk," Ms Zurawski said.

For three days, trapped in a "bizarre and avoidable hell", Ms Zurawski was forced to wait until her body entered sepsis - also known as blood poisoning - and doctors were allowed to perform an abortion, according to the lawsuit.

Ms Zurawski spent three days in intensive care, leaving the hospital after a week, the legal action says. The ordeal has made it harder for her to conceive in future, she said.

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Source: BBC News, 8 March 2023

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Trust spent £680k in failed attempt to fight whistleblower

A trust spent £460,000 on legal fees trying to fight a patient safety whistleblowing case that it lost, it can be revealed.

An employment tribunal judge rejected the idea that a consultant nephrologist had done anything to bring about her dismissal from Portsmouth Hospitals University Trust.

Jasna Macanovic was subjected to what the tribunal earlier this year called “a campaign of harassment”, after she warned colleagues that a procedure they were using was harming patients.

After relationships broke down in the Wessex Kidney Unit, she was referred to a disciplinary panel at which two board members – the former nursing director and the current medical director – offered her a good reference if she would resign. She refused and was dismissed in March 2018. The judge noted the offer was clear evidence that the disciplinary process was a foregone conclusion.

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Source: HSJ, 8 March 2023

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Three-quarters of children detained under mental health act are girls, new report warns

Nearly three-quarters of children detained under the mental health act are girls, a new report has found, amid warnings youngsters face a “postcode lottery” in their wait for treatment.

Average waiting times between children being referred to mental health services and starting treatment have increased for the first time since 2017 with the children’s commissioner describing support across the country as “patchy”.

In the annual report on children’s mental health services, the watchdog warned that, although the average wait is 40 days, some children are waiting as long as 80 days for treatment after being referred in 2021-22.

The analysis, published on International Women’s day, also says young girls represented the highest proportion of children detained under the mental health act last year, highlighting “stark and worrying” gender inequalities.

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Source: The Independent, 7 March 2023

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Baby died after deadly bowel condition was mistaken for cow’s milk allergy

A two-month-old baby died after doctors mistook symptoms of a suspected perforated bowel for a cow’s milk intolerance.

Nailah Ally was diagnosed with a hole in the heart before she was born and necrotising enterocolitis (NEC) shortly after her birth in October 2019.

Nailah died from multiple organ failure after she was sent home from hospital and went into septic shock

A consultant believed Nailah might have an intolerance to cow’s milk and changed the formula she was being fed.

A spokesman for the family said: “Nailah’s case not only vividly highlights the dangers of sepsis, but the potential consequences of poor communication between doctors as well as between doctors and families.”

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Source: The Telegraph, 7 March 2023

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Number of patients hurt by rogue surgeon unknown

Former patients of a surgeon who has been struck off say their lives have been ruined by his misconduct.

The number of people harmed by Jeremy Parker is unknown but at least 123 are taking legal action.

Their lawyer said the scale of harm caused by his malpractice "could be huge".

A total of 53 allegations against him were found "proved" including dishonestly adding to the case notes of 14 patients, botching operations, not diagnosing infections, failing to consult colleagues and not obtaining patient consent.

The General Medical Council also confirmed a patient had a leg amputated below the right knee after a procedure carried out by Mr Parker went awry.

Christian Beadell from Fletchers Solicitors, which is representing former patients in a class action, said East Suffolk and North Essex NHS Trust (ESNEFT) had not answered questions over whether it had initiated a recall process to determine the number patients harmed.

"It's difficult to say how many patients have been injured by him," Mr Beadell said.

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Source: BBC News, 8 March 2023

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Ministers blasted by scandal inquiry chair

The government’s response to the East Kent maternity scandal inquiry has been condemned as ‘very disappointing’ by its chair. 

More than four months on from the inquiry report, ministers this morning issued what they called an “initial response” to it, as a brief written statement to Parliament. It contained few specific proposals, instead saying government was kicking off a series of other reviews, and “working” with various other agencies.

Inquiry chair Bill Kirkup, the well-regarded former medic and expert in care failures, told HSJ the response was poor and should have been “wider and deeper”.

Dr Kirkup said the response showed government had “not grasped how fundamental” some of the issues outlined in his report were, and “what sort of initiative” was needed to address them.

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Source: HSJ, 7 March 2023

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‘We are struggling’: US doctors faced with vacuum of information on Long Covid

More than three years into the Covid pandemic, there are a host of important unanswered questions about Long Covid, which significantly limit healthcare providers’ ability to treat patients with the condition, according to US physicians and scientists.

That vacuum of information remains as much of the US has moved on from the pandemic, while Covid long-haulers continue to face stigma and questions over whether their symptoms are real, providers say.

“We don’t quite have our finger on the pulse of what’s wrong, what biologically is causing it, and that’s a big problem,” said Dr Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center. “It’s hard to direct drugs or treatments without having the biological underpinnings for why someone is feeling so fatigued with exercise.”

In addition to the ambiguity around the root causes of Long Covid, there are also challenges in research because of how Covid can produce so many different symptoms. The Centers for Disease Control and Prevention list includes fatigue, respiratory issues and difficulty thinking or concentrating but also states that “post-Covid conditions may not affect everyone the same way”.

“Everyone has a different constellation of symptoms,” said Dr Steven Deeks, an infectious disease specialist at the University of California, San Francisco. “Some people get better over time, some people wax and wane, some people get worse,” and so it is difficult for researchers to determine when a study should end and compare a drug versus a placebo.

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Source: The Guardian, 6 March 2023

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Rheumatic patients 'left behind' after lockdown

Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research.

The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them.

Researchers interviewed 15 rheumatology patients from the Bristol area. Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives.

"I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards.

"How do I get food? I cannot leave the house. How can I see friends? I was not allowed to."

Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield.

"It is a new normal, which is about being on high alert and managing risk every day," she said.

Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment".

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Source: BBC News, 6 March 2023

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Nursing shortages are delaying spinal operations

Nursing shortages are contributing to children waiting up to three times longer for spinal surgery than pre-pandemic, a top surgeon has claimed.

Chris Adams says up to one in four operations are cancelled at NHS Lothian, with staffing the main reason.

Mr Adams also claims that some children are not being put on waiting lists as early as they should be.

NHS Lothian disputes some of Mr Adams' statements but says "significant pressures" are affecting waiting times.

The senior clinician, one of Scotland's three paediatric spinal surgeons, said he was speaking out of behalf of spinal patients and their families

The surgeon's claims appear in a new BBC Disclosure investigation into Scotland's NHS, which reveals that some children are waiting up to three times longer than pre-pandemic for spinal surgery, with some waiting more than a year. At least 51 out of a possible 190 planned spinal surgeries at RHCYP were cancelled at short notice in 2022, with nursing shortages understood to be the main cause

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Source: BBC News, 7 March 2023

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Surge in patients paying for GP appointments as pressure on NHS grows

Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice.

Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021.

The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022.

It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”.

On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.”

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Source: The Independent, 4 March 2023

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Elon Musk's bid to implant microchips in human brains rejected over safety concerns

Elon Musk's attempt to implant microchips into human brains has been rejected by US medical regulators over concerns about the safety of the technology.

Mr Musk's Neuralink business, which is hoping to insert tiny chips into people's skulls to treat conditions such as paralysis and blindness, was denied initial permission for clinical trials last year.

US medical regulators were said to have "dozens" of concerns over the risks posed by the device, Reuters reported. Concerns include fears that tiny electrodes could get lodged in other parts of the brain, which could impair cognitive function or rupture blood vessels.

Neuralink's chips are designed to be threaded into the brain using tiny filaments and harness artificial intelligence technology to pick up brain activity using a so-called "brain computer interface".

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Source: The Times, 3 March 2023

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Medical records changed as hospitals cover up mistakes, watchdog warns

Hospitals are still covering up serious mistakes in patient care and fobbing off families that raise concerns, the head of the watchdog that investigates complaints against the NHS has warned.

Rob Behrens told The Times he had seen cases of medical records being changed after a death and spoken to doctors who were too scared to speak out about failings in their hospitals.

He called on ministers to change the law to introduce a “duty of candour” on health and other public service staff to “transform” the system and make it more accountable to patients.

He warned: “There is a deep reluctance to explain and give an account of what you do in the health service or the public service for fear of retribution. The things that really get to me are the avoidable deaths of babies in the health service — dying because there’s been poor coordination or they’d been wrongly diagnosed or the parents hadn’t been listened to. That is shocking.”

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Source: The Times. 6 March 2023

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‘It’s not just about dying’: Uganda’s pioneers of palliative care undaunted by huge challenges

 

Morphine was first introduced in Uganda 30 years ago, but as the burden of cancer increases, thousands of people still lack access to even basic treatment or pain relief.

About 70% of the 2,000 patients on Hospice Africa Uganda (HAU)’s programme have cancer, and some are HIV positive, too. Few can afford tests or treatment for their conditions and, even when they can, it is not uncommon for doctors to misdiagnose or fail to prescribe adequate pain relief. Often, by the time a patient is referred to HAU, their condition is incurable, much to the frustration of the team, whose goal is to offer palliative care from the moment a person is diagnosed with a life-limiting condition.

“One of our biggest challenges is to remove the stigma [around palliative care]. Some people think it is about dying, but it is for anyone with a chronic illness that is not going away,” says Antonia Kamate Tukundane, programmes manager at HAU’s Mbarara site in south-west Uganda. “Palliative care focuses on holistic care: How are you? How is your family? What other things are affecting your illness? We provide something the doctors and nurses have no time for.

Dr Anne Merriman at home in Kampala. She founded Hospice Africa Uganda in 1993, with a vision to introduce “palliative care for all in need in Africa”

“Sometimes the patient comes to us very ill and passes on, but if we had known the patient earlier we could have explained what was happening to their body; agreed on realistic goals; all this is so helpful for the patient. Those who find us are glad they did.”

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Source: The Guardian, 6 March 2023

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Maternity units must only remove gas and air as a ‘last resort’

Hospital trusts must only remove gas and air on maternity wards as a “last resort”, NHS England has said.

Several hospitals temporarily suspended the use of gas and air following concerns that midwives and staff are being exposed to too-high levels of gas over prolonged periods of time.

Some pregnant women have posted on social media, saying the decisions have left them feeling anxious and worried about their pain relief options.

Some NHS trusts have also come under fire for the way they communicated the message that gas and air would be suspended.

In new guidance to trusts, NHS England said it had looked at the health impacts for staff of levels of nitrous oxide exceeding prescribed levels, “drawing upon relevant legislation and existing guidance on the safe management of gas and air in healthcare settings”.

It said trusts must ensure they are compliant with legislation and national guidance on the use of gas, but must only remove it for women as a last resort and must tell them about other pain relief.

“Where, following the meeting of the (medical gas) committee, there is concern that the trust is not compliant, then this should be formally reported by the trust to the NHS England regional operations centre for the attention of the regional chief midwife,” the guidance said.

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Source: The Independent, 3 March 2023

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Less than 3% of NHS England trusts hit key cancer waiting-time target

Patients are being warned of a “shocking gap in cancer care” as new figures reveal that fewer than 3% of England’s NHS trusts met a key waiting-times target last year for cancer patients to be treated within two months of an urgent GP referral.

Of 125 hospital trusts in England analysed, only three (2.4%) hit the standard of treating 85% of patients within 62 days after an urgent referral in 2022. Some trusts have not hit the standard for at least eight years.

More than 66,000 patients were forced to wait more than two months for their first treatment last year after a referral, the figures reveal. One leading cancer charity said this weekend the cancer care system was not fit for purpose, with “lives left hanging in the balance”.

Daisy Cooper, the Lib Dems health spokesperson, said the figures showed that even before the pandemic struck, the number of hospital trusts meeting targets was falling rapidly. “Now the situation is so bad that barely any hospitals are able to provide patients with the treatment they need on time. Ministers have consistently failed to plan ahead or provide adequate funding, while taking patients and NHS staff for granted. There is a shocking gap in cancer care from one area to another,” she said.

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Source: The Guardian, 5 March 2023

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More than half of ambulance workers have seen patient die because of delay

More than half of ambulance workers have seen a patient die because of a delay in reaching them after a 999 call or overcrowding in A&E, a new survey has found.

The findings, from a survey of frontline paramedics and other ambulance staff, are another stark illustration of the patient safety risks created by the crisis in NHS urgent and emergency care.

“These findings are utterly terrifying,” said Rachel Harrison, the national secretary of the GMB union, which sought the views of more than 1,200 members working in NHS ambulance services in England and Wales.

It asked them if they had ever witnessed a death that had occurred because of a delay involving an ambulance or other part of the care system. Just over half (53%) said they had done so and another 30% were aware of it happening with a colleague.

The findings are disclosed in a Channel 4 Dispatches documentary being shown this Thursday about how long delays in ambulance crews handing over patients to A&E staff, and thus being unable to respond quickly to 999 calls, are affecting both patients and staff.

“The delay and dilation of care that we see is just unconscionable,” Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, told the programme.

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Source: The Guardian, 6 March 2023

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The patients who gave up waiting on the NHS

There are 625,000 people on a hospital waiting list in Scotland. That figure is the highest on record and equivalent to one in nine of the population.

Backlogs have soared since the Covid pandemic and more people faced with long waits are seeking private treatment.

An opinion poll commissioned by BBC Scotland suggests one in five of those who replied said they - or one of their family - had paid for private medical care in the past 12 months.

Most (73%) said they would have preferred to use the NHS.

Linda Fyfe, from South Ayrshire, was among those not prepared to wait for NHS treatment when she needed a hip replacement.

Within months Linda went from living with the "bearable" pain in her right hip to being unable to comfortably move more than 100 yards.

The 75-year-old said the pain changed her whole lifestyle and she could not wait between 12 and 18 months for an operation on the NHS.

The retired social work administrator was quoted £14,000 to go private in the UK but this was more than she could afford. She opted to have the same procedure done in Lithuania for about half the price. 

The Kaunas clinic that treated Linda said it sees about 10 people a month from Scotland and more from across the UK."I made the right decision. I couldn't have gone another year or 18 months and it might even have taken longer.

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Source: BBC News, 6 March 2023

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Inside the A&E crisis: ‘We were lined up so patients wouldn’t see the bodies’

An NHS whistleblower has sacrificed his career to capture on hidden camera the brutal reality of working in an ambulance service.

After watching yet another patient die needlessly in the back of his ambulance, Daniel Waterhouse became a whistleblower. That decision would end his career with the NHS at the age of only 30.

Waterhouse, from Finchley, north London, said his decision to go undercover for a Channel 4 Dispatches programme to be broadcast on Thursday was not easy.

“I thought about it for quite a while,” said Waterhouse, an emergency medical technician who wore hidden cameras and microphones while on shift for the East of England Ambulance Service. “It was a moral choice, and there’s a caveat to that as well, because going undercover in those situations could be considered immoral and will draw criticism I’m sure.

“But I think patient safety outweighs that, and those occasions were so strong in my head that I thought, ‘If only some change can happen, where some people don’t have to go through that and die or suffer permanent disability, then it would be worth it’.”

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Source: The Times, 3 March 2023

 

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Scotland first country in the world to ban environmentally harmful anaesthetic

Scotland has become the first country in the world to stop its hospitals using the anaesthetic desflurane because of the threat it poses to the environment.

NHS data suggests the gas, used to keep people unconscious during surgery, has a global warming potential 2,500 times greater than carbon dioxide.

Banning it in Scotland - from its peak use in 2017 - would cut emissions equal to powering 1,700 homes a year.

In the last few years, more than 40 hospital trusts in England and a number of hospitals in Wales have stopped using it.

Dr Kenneth Barker, anaesthetist and clinical lead for Scotland's national green theatres programme, said he was shocked to find the anaesthetic drug he had used for more than a decade for many major and routine operations was so harmful to the environment.

"I realised in 2017 that the amount of desflurane we used in a typical day's work as an anaesthetist resulted in emissions equivalent to me driving 670 miles that day," he said.

"I decided to stop using it straight away and many fellow anaesthetists have got on board.

"When you are faced with something as obvious as this and with the significance it has to the environment - I am very glad we have got to this stage."

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Source: BBC News, 3 March 2023

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Los Angeles hospital under investigation accused of ignoring Black woman’s pain

April Valentine planned to have a complication-free delivery and to enjoy her life as a first-time parent to a healthy baby girl. Instead, California’s department of health and human services is investigating the circumstances of the April's death during childbirth.

April, a 31-year-old Black woman, went to Centinela hospital in Inglewood on 9 January and died the next day. Her daughter Aniya was born via an emergency caesarean section. Her family and friends say that staff at the hospital ignored the pregnant woman’s complaints of pain, refused to let her doula be in the hospital room during the birth and neglected Valentine as her child’s father performed CPR on her.

“It’s hard to even sleep, to even look at my child after seeing what I saw in that hospital that night,” said Nigha Robertson, Valentine’s boyfriend and Aniya’s father, to the Los Angeles county board of supervisors during its 31 January meeting. “I’m the only one who touched her, I’m the one who did CPR. Nobody touched her, we screamed and begged for help … they just let her lay there and die.”

During the 31 January board of supervisors meeting, people who spoke in support of Valentine said that Centinela hospital is known around the community for being one of the “worst hospitals in the county” for Black and Latina mothers and their infants. 

Since 2000, the maternal mortality rate in the US has risen nearly 60%, with about 700 people dying during pregnancy or within a year of giving birth each year. More than 80% of the deaths are preventable, according to the US Centers for Disease Control and Prevention. The US has the highest maternal mortality rate among industrialized countries and Black women are three times more likely to die during childbirth than white women.

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Source: The Guardian, 3 March 2023

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