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Patient Safety Learning

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  1. Patient Safety Learning
    Health secretary, Steve Barclay, has named Lady Justice Thirlwall as the chair of the independent inquiry into the crimes committed by former Countess of Chester Hospital nurse, Lucy Letby.
    The inquiry was given statutory powers last week and will be led by one of the country’s most senior judges, who currently sits on the Court of Appeal.
    The announcement came during Barclay’s speech in the House of Commons, where he also announced that the chair of the Essex mental health inquiry will be Baroness Lampard, who investigated the crimes of Jimmy Saville in a similar inquiry led by the Department of Health and Social Care (DHSC).
    The rest of the health secretary’s address centred around patient safety and what the government has done, is doing and will do.
    Barclay drew attention to the appointment of Dr Aidan Fowler as NHS England’s first ever national director of patient safety in 2018, and thus the following patient safety strategy in 2019.
    Read full story
    Source: National Health Executive, 4 September 2023
  2. Patient Safety Learning
    NHS staff will be asked if they have experienced sexual harassment or inappropriate behaviour in the workplace for the first time.
    In a letter, NHS England chief delivery officer Steve Russell said the upcoming annual staff survey would include the following question: “In the last 12 months, how many times have you been the target of unwanted behaviour of a sexual nature in the workplace? This may include offensive or inappropriate sexualised conversation (including jokes), touching or assault.”
    Mr Russell said the anonymous answers to the new question would “help us understand the potential prevalence of sexual misconduct in your organisation and inform further action to protect and support staff across the NHS”. 
    It comes as NHSE launches the health service’s first sexual safety charter to help protect staff from harassment and inappropriate behaviour.
    The charter is an agreement comprising 10 pledges, including commitments to provide staff with clear reporting mechanisms, training, and support from managers.
    Read full story (paywalled)
    Source: HSJ, 6 September 2023
  3. Patient Safety Learning
    Rhiannon Kennedy-Chapman’s early twenties could hardly be described as the best years of her life. Covered in grazes, open sores and dry skin, she was at a loss as to why her body was continuously failing her, despite her efforts to follow medical advice and take her steroid medication.
    Having used both steroid cream and oral tablets since suffering from eczema as a child, she had little concern about the medication when she was once again prescribed it for small patches of eczema.
    “It worked for a bit and then it would stop working. The GP would give me a higher dose and the pattern went on for many months. I went through four different strengths – it would work for a short period of time and when I stopped using it, it would come back even fiercer.
    Little did she know that she was suffering from topical steroid withdrawal (TSW), a rare skin condition caused by the repeated use and cessation of steroid creams.
    A 2021 report by the Medicines and Healthcare Products Regulatory Agency (MHRA) gave guidance on the risks of TSW and it is now included as patient information for all prescribed topical steroids.
    Patients can now also report their suspected reactions to topical steroids via the MHRA’s “yellow card scheme” and eczema charities have called for further research into the causes and long-term effects of TSW.
    Andrew Proctor, chief executive of the National Eczema Society, said it was calling on the UK medicines regulator, the MHRA, to introduce clearer strength and potency labelling of topical steroids to support their safe and effective use.
    “This change needs to happen and is supported by patients and healthcare professional bodies,” he said.
    Read full story
    Source: The Independent, 5 September 2023
  4. Patient Safety Learning
    A senior clinician has raised fundamental concerns about a trust’s probe into dozens of suicide cases, which was sparked by his allegations that staff had tampered with the notes of a patient.
    Cambridgeshire and Peterborough Foundation Trust announced in July there would be an internal review of 60 suicide cases dating back to 2017.
    But a key whistleblower told HSJ he fears it could be a “whitewash” and it should be carried by an external, independent investigator rather than led by the trust.
    The suicides review was prompted by allegations staff had added a care plan into the patient record of Charles Ndhlovu, a day after the 33-year-old had died by suicide in 2017.
    The allegations, not contested by the trust, were based on the findings of an internal investigation in 2021 of the trust’s conduct around Mr Ndhlovu’s case.
    Read full story (paywalled)
    Source: HSJ, 6 September 2023
  5. Patient Safety Learning
    Top boss of NHS complaints in England has told the BBC he wants Martha's rule to be introduced to give patients the power to get an automatic second medical opinion about hospital care, when they think things are going wrong.
    Rob Behrens said he had been moved by the plea of Merope Mills, who shared the story of her daughter's death.
    Martha was 13 when she died from sepsis. 
    Merope Mills wants hospitals around the country to bring in Martha's rule, which would give parents, carers and patients the right to call for an urgent second clinical opinion from other experts at the same hospital, if they have concerns about their current care.
    It is something that Parliamentary and Health Service Ombudsman Rob Behrens fully supports.
    He told BBC Radio 4's Today programme: "Along with many others, I was moved and in great admiration for what Merope has said and done and I give unambiguous support.
    "Unfortunately, as tragic as this case is, it's not the first and there have been many cases where patients have been failed by their doctors because they haven't been listened to."
    Read full story
    Source: BBC News, 5 September 2023
  6. Patient Safety Learning
    NHS boards have been told to obtain extra assurance around the risks to unsafe concrete beams in their estate, following the sudden closure of school buildings.
    HSJ understands there was a call between national leaders and trust bosses yesterday, to ensure there are additional assessments of the risks around “reinforced autoclaved aerated concrete” in the NHS estate.
    As part of this, trusts which have already identified the beams in their buildings have been told to plan for potential “RAAC failure, including the decant of patients and services where RAAC panels are present in clinical areas”, and to note the learnings from an “evacuation plan” that was tested in the East of England.
    Around 40 hospital buildings across 23 trusts are currently understood to be affected by these lightweight panels, which can be on roofs, floors and walls.
    Trust estates’ teams will already have undertaken assessments and have plans to mitigate the risks, with the government already providing a £700m fund to mitigate immediate safety risks until 2025.
    But in light of fresh concerns around RAAC planks in school buildings, national leaders have asked for additional assurances to be obtained.
    Read full story (paywalled)
    Source: HSJ, 5 September 2023
  7. Patient Safety Learning
    Hospitals are sending frail, vulnerable patients home before they are better and without vital medical care, leaving them unable to fend for themselves.
    Over the past fortnight, The Mail on Sunday has received an alarming number of letters from readers who have told of their anger, frustration and sheer desperation at being denied support they were promised. Many have been left bed-bound and unable to wash, dress or use the bathroom for weeks on end.
    The daughter of an 87-year-old stroke survivor had to put a hospital bed in her living room and provide 24/7 care for her mother after the local health team failed to provide adequate support. Within a year, the woman was dead, having been treated with little more than paracetamol.
    In another case, a 70-year-old woman had to take her immobile 84-year-old husband to the hospital in a taxi every day for several weeks to have vital injections, because carers refused to come to their home.
    And the disabled wife of one 74-year-old man, who fell off a roof and broke his pelvis and ribs, told of the heartbreak at not being able to look after her husband due to her own poor health.
    Campaigners say a Government scheme designed address the ‘problem’ of bed-blockers – the somewhat derogatory term used to describe patients, most of them elderly, who are occupying a hospital bed that they don’t strictly need – is to blame.
    The protocol, called Discharge To Assess, launched eight years ago, aims to get patients home as quickly as possible amid reports that some elderly patients ended up stuck in wards for months on end – usually because the NHS hasn’t been able to organise the next stage of their care, so it’s not safe discharge them.
    Read full story
    Source: Mail Online, 2 September 2023
  8. Patient Safety Learning
    Staffing shortages are likely to restrict the use of a beneficial painkiller in birthing suites, even once its use has been recommended by national guidance.
    Research by HSJ suggests that just over half of trusts are already offering remifentanil to women in labour, although some are having to restrict its use due to lack of staffing.
    Responses to freedom of information requests from 108 trusts revealed 55 offered remifentanil during labour in 2022-23.
    Recent draft National Institute for Health and Care Excellence guidance on intrapartum care, published in April, suggested healthcare professionals “consider intravenous remifentanil patient-controlled analgesia” in obstetric units. This is partly because it reduces the likelihood of forceps or ventouse being required compared to intramuscular pethidine (an opioid commonly used in labour).
    However, the drug is not yet mentioned in official NICE guidelines and the opioid’s use in labour is currently off-label (its more common licenced use is alongside anaesthesia in surgery). A Royal College of Anaesthetists spokesperson said the use of drugs off-label “is extremely common in obstetrics given that drug trials do not often include pregnant women”.
    Read full story (paywalled)
    Source: HSJ, 1 September 2023
  9. Patient Safety Learning
    Integrated care systems (ICSs) should factor patient safety into all their operational and financial decisions, the Healthcare Safety Investigations Branch’s chief investigator has urged.
    Rosie Benneyworth, who was appointed as interim chief investigator last summer, said other safety-critical industries made decisions on the basis of a “triad” of operations, finances and safety. She said the NHS needed to be “more proactive” to take action before things go wrong.
    Dr Benneyworth said in an interview with HSJ: “I think it’s fundamental that ICSs put safety at the core of everything they do. And I don’t think operational decisions or financial decisions should be made without considering the implications for safety.”
    Dr Benneyworth – a former GP and commissioner – also spoke about whistleblowing in the wake of the Lucy Letby scandal, saying national organisations should “lead the way” on being proactive over safety and supporting whistleblowers. Major cultural problems were uncovered at HSIB several years ago, while NHSE has been under the spotlight in recent weeks for implementation of the “fit and proper person” test for board members.
    “I think it’s very difficult as national organisations to tell providers what they should [be] doing, if we’re not doing it ourselves,” Dr Benneyworth said.
    She added: “What we need is a much more proactive approach to safety, where we actually identify those things that could go wrong and take action before they do go wrong."
    Read full story (paywalled)
    Source: HSJ, 5 September 2023
  10. Patient Safety Learning
    Babies could be needlessly hospitalised this winter because the government has delayed a vaccine that protects them from a life-threatening virus, the UK’s top children’s doctor has warned.
    Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health (RCPCH), said she was “frustrated” by delays in introducing a new vaccine for respiratory syncytial virus (RSV), which drives 30,000 hospital admissions each winter and leads to dozens of deaths.
    She warned the delay meant thousands of children’s operations will have to be cancelled as RSV patients fill up beds – piling further pressure on already soaring waiting lists.
    It comes after the UK’s most senior A&E doctor, Dr Adrian Boyle, told The Independent that the government’s failure to prepare the NHS for winter could see thousands of people die needlessly this year.
    The Joint Committee on Vaccination and Immunisation (JCVI) said in June that a rollout of two RSV vaccines, one for babies and one for pregnant women, would be “cost-effective”, while the UK Health Security Agency (UKHSA) said there was a “strong case” for a jab.
    But it confirmed there was no timeframe for when vaccinations could start.
    Read full story
    Source: The Independent, 4 September 2023
  11. Patient Safety Learning
    Two hundred women in the UK who claim they were left in pain after having a permanent contraception device fitted, can now take group legal action through the courts, against its manufacturer.
    The Essure coil "has caused irreparable damage physically and mentally", the women's lawyers say.
    German maker Bayer says it will defend itself vigorously against the claims.
    When Essure was withdrawn from sale, in 2017, the UK medicines regulator said there was no risk to safety.
    Lawyers in England began legal action in 2020 and now have permission to bring a group claim on behalf of 200 women.
    Other women wishing to join the group action have until 2024 to do so.
    The Essure device is a small metal coil inserted into a woman's fallopian tubes. Scar tissue forms around the coil, creating a barrier that keeps sperm from reaching the eggs.
    Launched in 2002, the device was marketed as a simpler alternative to sterilisation by surgery.
    But some women say they suffered constant pain and complications, including heavy bleeding, with some ending up having hysterectomies or the device removed altogether.
    Read full story
    Source: BBC News, 5 September 2023
  12. Patient Safety Learning
    NHS Tayside has been criticised over its handling of disgraced brain surgeon Sam Eljamel in a new report.
    The internal due diligence review criticised health board management for putting the doctor under indirect supervision in June 2013 rather than suspending him.
    The surgeon harmed dozens of patients but was allowed to continue operating until he was suspended in late 2013.
    Some of his patients were left with life-changing injuries.
    He was employed as a surgeon by NHS Tayside for 18 years and later became the head of the neurosurgery department in Ninewells Hospital in Dundee.
    NHS Tayside has apologised to former patients of Prof Eljamel and committed to assisting in the Scottish government's independent commission for patient concerns.
    The health board claimed it became aware of concerns around the surgeon in June 2013, but an NHS whistleblower told the BBC the health board knew as early as 2009 that there were serious concerns.
    He is now working as a surgeon in Libya.
    Read full story
    Source: BBC News, 1 September 2023
  13. Patient Safety Learning
    NHS clinicians who were sacked after blowing the whistle about avoidable patient deaths say they fear lessons from the Lucy Letby murder trial have not been learned and the case will make no difference to their own claims for unfair dismissal.
    They say hospital bosses are still more concerned about reputation than patient safety, despite what emerged in the Letby case about the tragic consequences of ignoring consultants who first raised suspicions about her killing babies.
    Mansoor Foroughi is appealing against his dismissal by University Hospital Sussex NHS trust in December 2021 after raising concerns about patient deaths. 
    Mansoor Foroughi, a consultant neurosurgeon, was sacked by University Hospital Sussex NHS trust (UHST) in December 2021 for allegedly acting in bad faith when he raised the alarm about 19 deaths and 23 cases of serious patient harm that he said had been covered up in the previous six years. Those deaths and at least 20 others are now being investigated by Sussex police after allegations of medical negligence.
    Foroughi, whose appeal against his dismissal is due to be held in the coming months, told the Guardian: “I don’t think mine or anyone’s chances of success has increased [after Letby], and only a change in the law will do that.”
    Read full story
    Source: The Guardian, 1 September 2023
  14. Patient Safety Learning
    Blood clots in the brain or the lungs might explain some common symptoms of "Long Covid", including brain fog and fatigue, a UK study suggests.
    In the study, of 1,837 people admitted to hospital because of Covid, researchers say two blood proteins point to clots being one cause.
    It is thought 16% of such patients have trouble thinking, concentrating or remembering for at least six months.
    But the research team, from the universities of Oxford and Leicester, stress:
    Their findings are relevant only to patients admitted to hospital. They are "the first piece of the jigsaw" but further research is needed before they can propose or test any potential treatments. They tracked cognitive problems at six and 12 months only and through tests and questionnaires, which may "lack sensitivity". Identifying predictors and possible mechanisms was "a key step" in understanding post-Covid brain fog, study author Prof Paul Harrison, from the University of Oxford, said.
    Leicester's professor of respiratory medicine, Chris Brightling, said: "It's a combination of someone's health before, the acute event itself and what happens afterwards that lead on to physical and mental health consequences."
    Read full story
    Source: BBC News, 31 August 2023
  15. Patient Safety Learning
    Junior doctors and consultants in England are to coincide strikes during the autumn in an escalation of the pay dispute with the government.
    It will be the first time in this dispute they have walked together and comes after junior doctors voted in favour of continuing with strikes.
    In the British Medical Association ballot 98% voted in favour, giving the union a fresh six-month mandate.
    Junior doctors have already staged five walkouts this year.
    They will strike on 20 to 22 September - the first day of which coincides with a walkout by consultants.
    They will then walkout on 2 to 4 October, which is when consultants will also be striking.
    When the two groups strike together cover will be provided to staff emergency services as well as a small amount of cover on the wards.
    Read full story
    Source: BBC News, 31 August 2023
  16. Patient Safety Learning
    An integrated care board chair is keeping her job despite complaints being upheld against her in a previous role, it has emerged.
    Danielle Oum left her position as Birmingham and Solihull Mental Health Foundation Trust chair last October.
    It later emerged that an independent investigation carried out the month before her departure, the results of which were leaked to HSJ, had upheld several complaints against her and found she did not always act with “honesty, truthfulness and clarity”.
    She was appointed to the ICB position in October 2021, four months before the complaints were made against her by an individual at the trust.
    But NHS England now says it has reviewed the matter and concluded that it “continue[s] to offer Danielle our full support in her role as chair of Coventry and Warwickshire ICB”.
    Following the independent investigation, which upheld 16 complaints against Ms Oum in total, NHSE carried out its own review of the issues.
    NHSE said its review involved a “rigorous fact-finding process” and it was grateful to those who raised “freedom to speak up” concerns.
    It said in a statement: “A thorough review has taken place at regional and national level, and the committee responsible for adjudicating these issues has delivered what we believe is a fair decision."
    Read full story (paywalled)
    Source: HSJ, 31 August 2023
  17. Patient Safety Learning
    More than 120,000 people in England died last year while on the NHS waiting list for hospital treatment, figures obtained by Labour appear to show.
    That would be a record high number of such deaths, and is double the 60,000 patients who died in 2017/18.
    For example, the Royal Free hospital in London said it had had 3,615 such deaths, while there were 2,888 at the Morecambe Bay trust in Cumbria and 2,039 at Leeds teaching hospitals trust.
    Hospital bosses said the deaths highlighted the dangers of patients having to endure long waits for care and reflected a “decade of underinvestment” that had left the NHS with too few staff and beds.
    Healthwatch England, a patient advocacy group that scrutinises NHS performance, said the number of people dying while waiting for care was “a national tragedy”.
    Louise Ansari, the chief executive, said: “We know that delays to care have significant impacts on people’s lives, putting many in danger.”
    Read full story
    Source: The Guardian, 31 August 2023
  18. Patient Safety Learning
    An NHS body is encouraging women with breast cancer from minority backgrounds to take part in more clinical trials, after research found they are under-represented in studies that can offer life-saving treatment.
    The pilot project, supported by the NHS Race and Health Observatory, is intended to improve representation in breast cancer clinical trials partly through culturally sensitive communications to people from racially diverse backgrounds.
    Research from the UK Health Security Agency suggests young black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research.
    Their lack of inclusion in trials could be partly down to distrust of the research process and a lack of knowledge, according to research by the UK’s National Institute for Health Research.
    The project, which works in conjunction with Macmillan Cancer Support and the pharmaceutical company Roche, will run for a year and look at developing new ways for people with breast cancer to access clinical trials. It will develop action plans to improve representation and provide enhanced support for patients.
    Read full story
    Source: The Guardian, 31 August 2023
  19. Patient Safety Learning
    Around one in ten NHS nursing jobs remain unfilled leaving already stretched service struggling to cope.
    The number of unfilled NHS nursing jobs in England has risen again after falling slightly earlier this year.
    Between March and June of this year, the number of vacant nursing positions across the NHS in England increased by 3,243 taking the total to a staggering 43,339.
    With the number of applications to study nursing also falling by a massive 13,380 in just two years, experts admit they are concerned about how the NHS is going to cope.
    In real terms, the figures mean around one in ten NHS nursing jobs remain unfilled.
    The Royal College of Nursing (RCN) has warned the high vacancy rate will leave the health service “underprepared” for winter.
    Read full story
    Source: Nursing Notes, 25 August 2023
  20. Patient Safety Learning
    The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas.
    The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. 
    The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend.
    The research findings include:
    ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments; “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”; Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.” Read full story (paywalled)
    Source: HSJ, 25 August 2023
  21. Patient Safety Learning
    Whistleblowers who first revealed a toxic environment at one of England's largest NHS trusts say they do not believe crucial changes will be made.
    In a letter, they said families who suffered due to management failings at University Hospitals Birmingham (UHB) "have every reason to feel let down".
    Investigations have been examining UHB after staff told the BBC a climate of fear put patients at risk.
    The letter was written by three doctors to the Labour MP For Birmingham Edgbaston, Preet Gill, who is heading a cross-party reference group on the trust.
    In their letter, the consultants raise concerns about the appointment from within the trust of new chief executive Jonathan Brotherton and feel the management team remains largely unchanged.
    "More than six months have elapsed since we spoke to you of the need to repay the debt owed to those UHB staff, patients and their families who have suffered as a result of the board's serious failings," they wrote.
    "They now have every reason to feel let down."
    Read full story
    Source: BBC News, 29 August 2023
  22. Patient Safety Learning
    At the end of the COVID pandemic, more than half (54%) of US children were covered by Medicaid or CHIP; the vast majority by Medicaid. So, the lifting of the pandemic-related Medicaid continuous enrolment protection this spring is a really big deal, putting low-income children at risk of losing access to health care and/or exposing their families to medical debt.
    In fact, researchers at federal Office of the Assistant Secretary for Planning and Evaluation (ASPE) projected that just shy of three-quarters of children losing Medicaid would be disenrolled despite remaining eligible. Children are most at risk of losing coverage during the unwinding despite being eligible and the likelihood that the child uninsured rate will go up if states do not take care in the process.
    Over half a million children have lost Medicaid already in 21 states where there is data. And that large number doesn’t include Texas, a state that disenrolled more than 500,000 people on June 1st, and where state agency employees recently blew the whistle on systems errors that caused inappropriate terminations.
    The Biden Administration must take swift and definitive action to pause all terminations in states with systemic problems. Governors who see large numbers of children losing coverage must pause the process. Coverage must be reinstated for those who lose coverage inappropriately. The time for action to protect children is now.
    Read full story
    Source: McCourt School of Public Policy at Georgetown University, 23 August 2023
  23. Patient Safety Learning
    Fewer than 20 countries worldwide still report COVID-19 hospitalisation and ICU data to the World Health Organization (WHO), leaving the UN health body blind to the impact and evolution of the virus in most of the world, agency leaders have said.
    The decline in data reporting is a major setback for the WHO’s efforts to track the pandemic. Without reliable data, the WHO cannot accurately assess the burden of disease, identify new variants, or target its resources where they are most needed.
    “We don’t have good visibility of the impact of COVID-19 around the world,” said Dr. Maria Van Kerkhove, who leads the WHO’s COVID-19 task force. “It is really important that surveillance continues, and this is on the shoulders of governments right now.”
    “While we are certainly not in the same situation that we were in a year ago or two years ago, SARS-Cov-2 circulates in all countries right now,” said Van Kerkhove. “It is still causing a large number of infections, hospitalisations, admissions to the ICU and deaths.”
    The current set of dominant COVID-19 variants can still cause the “full spectrum” of disease, from asymptomatic infections to severe disease and death, Kerkhove said.
    Read full story
    Source: Health Policy Watch, 25 August 2023
  24. Patient Safety Learning
    A critical report into how a mental health trust mismanaged its mortality figures was edited to remove criticism of its leadership, the BBC has found.
    In June, auditors Grant Thornton revealed how the Norfolk and Suffolk NHS Foundation Trust (NSFT) had lost track of patient deaths.
    But earlier drafts included language around governance failures that were missing in the final version.
    NSFT and Grant Thornton said the changes were due to fact-checking.
    A number of drafts of the report were produced, with the first dated 23 February this year.
    The first version described "poor governance" in the way deaths data was managed, with governance also being called "weak" and "inadequate".
    But many of these critical words were missing from the report released to the public, with "governance" also being replaced with "controls", according to leaked documents.
    After losing her son Tim in 2014, Caroline Aldridge has been highlighting what she and others claimed had been the trust's undercounting of deaths.
    "I think people need to know what was removed and what was changed, because I suspect that the first report is a lot nearer to the truth," she said.
    Ms Aldridge added: "It takes all responsibility from governance, removing the words 'inadequate', 'poor', 'weak' governance, removing significant pieces of information that's not factual accuracy.
    "We cannot have people watering it [the report] down when it's about deaths."
    Read full story
    Source: BBC News, 29 August 2023
  25. Patient Safety Learning
    Amanda Pritchard has said it is time to ‘look again’ at whether NHS England should be given formal powers to disbar managers for ‘serious misconduct’.
    In an email to regional leaders and some national bodies yesterday, seen by HSJ, the chief executive officer of NHS England said the murder trial of neonatal nurse Lucy Letby has brought the issue of professional regulation for managers back into focus. She has planned an urgent meeting next week to discuss the options.
    Ms Pritchard said she wanted the meeting to explore; the feasibility of NHSE being given the powers and resources to act as a regulator; who this could apply to and how it could operate; and how a dedicated regulatory body for NHS leaders might fulfil the role.
    She stressed any new powers would need to be determined by the government, but said the NHS “should contribute proactively and fully, and with an open mind, to this decision-making process”.
    Read full story (paywalled)
    Source: HSJ, 25 August 2023
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