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Patient Safety Learning

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  1. Patient Safety Learning
    Private menopause clinics are prescribing HRT at "twice the recommended dose", an investigation has revealed.
    The investigation by The Pharmaceutical Journal has revealed that patients attending private menopause clinics are subject to “unorthodox prescribing” by providers. Many are receiving oestrogen at up to double the recommended dose placing them at higher risk of cancer and vaginal bleeding.
    Nuttan Tanna, a pharmacist consultant in women’s health at London North West University Healthcare NHS Trust, said she had seen referrals for “bleeding investigations” and then found the patient was on "very large doses [of oestrogen] prescribed previously by private providers”.
    Brendon Jiang, a senior clinical pharmacist for North Oxfordshire Rural Alliance Primary Care Network, said that his team were increasingly getting letters from private clinics requesting for patients to be prescribed doses of oestrogen that are off-label or exceed licensed recommendations.
    He also raised concerns that patients were not taking enough progesterone alongside increased doses of oestrogen. Taking increased doses of oestrogen alone can increase the risk of womb cancer but progesterone protects against that risk and therefore the two hormones should be taken together.
    Read full story (paywalled)
    Source: The Telegraph, 19 December 2022
    Further reading on the hub:
    Surgical menopause: a toolkit for healthcare professionals (British Menopause Society) Menopause Support - Getting the most out of your doctor’s appointment World Menopause Day 2022: Raising awareness of surgical menopause All-Party Parliamentary Group on Menopause: Inquiry to assess the impacts of menopause and the case for policy reform - conclusions 
  2. Patient Safety Learning
    NHS trusts in England lost more than a million working days to long-Covid absences last year, analysis suggests.
    Thousands of doctors, nurses and other health professionals have been forced to take long periods off work because of the lingering effects of coronavirus infection.
    Data released to the all-party parliamentary group on coronavirus suggests that long-Covid absences are now higher than they were a year ago.
    Layla Moran, who chairs the group, said: “Long Covid has upended the lives of millions and these figures suggest that the deeply damaging impact it is having on our economy and public services is only getting worse.”
    Read full story (paywalled)
    Source: The Times, 19 December 2022
  3. Patient Safety Learning
    Patients should “make their own way to hospital” if they can do so during Wednesday’s strike by ambulance workers, a cabinet minister said yesterday, as the government warned that the industrial action would put lives at risk.
    Senior government figures said that ambulance unions had still not agreed national criteria for what conditions would be considered life threatening and responded to during the strike.
    Steve Barclay, the health secretary, is understood to be writing to all striking unions, including nurses, seeking discussions on patient safety.
    Yesterday Oliver Dowden, the Cabinet Office minister, said people should still call 999 in an emergency but might in less serious cases have to make their own way to hospital. “We are working to ensure that if you have a serious injury, in particular a life-threatening injury, you can continue to rely on the ambulance service, and we would urge people in those circumstances to dial 999,” he told Sunday with Laura Kuenssberg on BBC1. “If it is the case that you have less serious injuries, you should be in touch with 111, and you should seek to make your way to hospital on your own if you are able to do so.”
    Read full story (paywalled)
    Source: The Times, 19 December 2022
  4. Patient Safety Learning
    Asystemic failure to provide basic physical care on NHS mental health wards is killing patients across the country, despite scores of warnings from coroners over the past decade, The Independent can reveal.
    An investigation has uncovered at least 50 “prevention of future death” reports – used by coroners to warn health services of widespread failures – since 2012, involving 26 NHS trusts and private healthcare providers.
    Cases include deaths caused by malnutrition, lack of exercise, and starvation in patients detained in mental health facilities. Experts warn that poor training and a lack of funding are factors in the neglect of vulnerable patients.
    The Independent investigation uncovered:
    Staff failing to carrying out basic health checks, such as assessment for risk of blood clots. Cases of nurses and care assistants without adequate CPR training. Doctors unable to carry out emergency response procedures. Patients not treated for side effects of antipsychotic medication. Rapidly deteriorating health going unnoticed and untreated. Coroners have exposed multiple cases of mental health patients receiving inadequate treatment in general hospitals, with their illness being mistaken for a psychiatric problem.
    Read full story
    Source: The Independent, 18 December 2022
  5. Patient Safety Learning
    Patients are spending an extra day in hospital on average when admitted as an emergency compared to before covid, consuming millions of additional ‘bed days’, HSJ analysis has found.
    The finding explains in part why fewer people are being treated in hospitals, but more resources are being consumed to do so. This has prompted concerns about an apparent big drop in productivity.
    NHS England chief finance officer Julian Kelly told HSJ the marked increase in length of stay meant hospitals needed to focus on “discharge and decongest” of emergency care, to help recover activity rates and productivity in elective care. The NHS also needs to create more elective capacity insulated from emergency care, he said, and for “local leadership [to] keep people focused”.
    Read full story (paywalled)
    Source: HSJ, 19 December 2022
  6. Patient Safety Learning
    The US Joint Commission will hold a safety briefing with healthcare organisations at the start of every accreditation survey starting in 2023, the organisation has said.
    Site surveyors and staff members preselected by the healthcare organisation will conduct an informal, five-minute briefing to discuss any potential safety concerns — such as fires, an active shooter scenario or other emergencies — and how surveyors should react if safety plans are implemented while they are on site. 
     The change takes effect 1 January 2023 and applies to all accreditation surveys performed by the organisation. 
    Read full story
    Source: Becker's Hospital Review, 13 December 2022
  7. Patient Safety Learning
    Hospital staff in Nottingham have said they are keen to build on the success of its menopause support scheme.
    Nottingham University Hospitals Trust (NUH) said 24% of its staff were aged 45-55, the most common age for the condition.
    Staff can ask for lighter uniforms, shift changes, more time to complete tasks or access to fans in offices. Advice, awareness training and access to specialist staff are also part of the scheme.
    The staff wellbeing team at NUH said they were "inundated" with messages from colleagues who were struggling.
    Jenny Good, NUH Staff Wellbeing Lead, said: "We strongly believe that menopause is an issue for everybody. Everyone knows somebody who will go through it.
    "We wanted to equip everyone who works at NUH with an awareness of what menopause is.
    "We're really proud that we're the first NHS trust to get the accreditation.
    "The conversation has opened up."
    Read full story
    Source: BBC News, 18 December 2022
  8. Patient Safety Learning
    The Conservatives have been accused of “failing women” as analysis reveals gynaecology waiting times have trebled in the past decade, with more than 540,000 waiting for NHS care.
    NHS England data shows that in October 2012, the average waiting time to see a gynaecologist was 4.8 weeks. By October 2022, the most recent month for which figures are available, that figure had increased by 225% to 15.6 weeks.
    Many of the conditions experienced by women waiting to see a gynaecologist are progressive. Left untreated, they can need more complex or invasive surgery. Thousands are living in extreme pain as a result of the long waits, doctors, health experts and charities told the Guardian.
    The figures reveal that 38,231 women have been waiting more than a year. Ten years ago there were 15 women in England waiting longer than 12 months – and no one waiting two years. Today, 69 women have been waiting more than 24 months.
    Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists, said: “This new analysis adds to our own research that gynaecology waiting lists were outstripping other specialities long before the pandemic, and they continue to grow rapidly.
    “Shockingly, the fact we can now track this pattern back 10 years, shows how long overdue action is to address the unequal growth in waiting lists.”
    Thakar added: “Women’s health has been consistently deprioritised. Gynaecology waiting times are currently the longest we’ve seen since waiting list targets were introduced, leaving thousands of women with symptoms including extreme pain, heavy menstrual bleeding and incontinence.”
    Read full story
    Source: The Guardian, 19 December 2022
  9. Patient Safety Learning
    Unions must ensure there will be "sufficient" staffing during this week's ambulance strike to protect patients, the health secretary says.
    Workers in England and Wales will walk out on Wednesday in a dispute over pay, but life-threatening emergencies will be responded to.
    Unions say discussions were still taking place with ambulance trusts to draw up detailed plans for cover.
    Steve Barclay said there is a lack of clarity about what is being offered.
    He said it was for the unions to ensure they "meet their obligations" for emergency cover so that people in crisis get the care they need.
    But Unite leader Sharon Graham, whose union is co-ordinating the ambulance strikes with Unison and GMB, said Mr Barclay will "have to carry the can if patients suffer".
    The ambulance walkouts will involve paramedics as well as control room staff and support workers.
    The action by the three main ambulance unions - Unison, GMB and Unite - will affect non-life threatening calls, meaning those who suffer trips, falls or other injuries may not receive treatment.
    Read full story
    Source: BBC News, 19 December 2022
  10. Patient Safety Learning
    Just over half of the 7,000 new virtual ward beds opened under the new national programme are occupied by patients, according to recent internal figures seen by HSJ.
    NHS England director for community transformation Stephanie Sommerville told a recent NHSE webinar that occupancy stood at around 52%.
    Although it is understood programme directors are pleased with the 43% growth in virtual beds since May, Ms Sommerville said it “demonstrate[s] we have a way to go to make sure our virtual wards are really well utilised. Of course, one of the big contributions to delivering more activity to our virtual wards is getting the referrals and admissions process right.”
    While the concept of remotely monitoring patients at home has been around for more than 20 years, NHSE has made expanding remotely monitored care a key ambition in order to tackle the capacity and demand challenges facing the NHS.
    Read full story (paywalled)
    Source: HSJ, 16 December 2022
  11. Patient Safety Learning
    The collaboration seen between the independent sector and the NHS during the peaks of the pandemic “doesn’t exist any more”, the boss of one of the UK’s largest private hospital companies has said.
    Mr Justin Ash, chief executive of Spire Healthcare and a member of the government’s recently convened elective recovery task force, whose purpose is to ”focus on how the NHS can [better] utilise independent sector to cut the backlog’.”
    He told the Westminster Health Forum earlier this week: “In spirit there is collaboration but in practice, it doesn’t exist anymore. There is no more commissioning by trust[s]”.
    Mr Ash told the conference Spire had previously had administrative teams working at 39 different NHS hospitals examining which NHS patients could be treated at one of its facilities. That number was now three, a decline which he described as “a shame”.
    He said: “There has to be a mindset change. We have people say ‘you have our nurses and consultants working for you’.
    “[But] just like patients, nurses and consultants should be able to move around the system [as] one workforce.”
    Read full story  (paywalled)
    Source: HSJ, 16 December 2022
  12. Patient Safety Learning
    With the distressing spate of news reports about mums and ­babies who weren’t kept safe in hospital, an initiative in the Midlands to improve patient safety in maternal and acute care settings comes as a relief.
    The newly announced Midlands Patient Safety Research Collaboration will bring together NHS trusts, ­universities and private business to evaluate how digital tools can help clinical decision making and reduce danger for patients.
    Problems can arise if communication is poor between medics when patients move between departments.
    Professor Alice Turner of Birmingham University said: “The power of new technology available to us means that we can address one of the ongoing areas of risk for patients, which is effective communication and clinical decision making.
    “The new collaboration will be looking at how digital tools can make a real difference to reduce risks and support patient safety in the areas of acute medicine and maternal health.”
    Digital decision-making tools could improve prescribing and personalised management for patients needing emergency care.
    Importantly, these tools should provide a smoother flow of information between healthcare professionals in acute care between hospitals, doctors and the West Midlands Ambulance Service, and hopefully reduce risks of patient harm at key points during acute care.
    Read full story
    Source: The Mirror, 18 December 2022
  13. Patient Safety Learning
    The reform of the UK’s Medical Device regulation offers a golden opportunity to drive innovation and growth in the UK’s Life Science sector while ensuring patient safety remains at the heart of the regulatory approach. But there is an urgent need for action to ensure we do not lose this opportunity.
    Senior members of the Life Sciences Council, Will Quince MP, Minister of State at the Department of Health and Social Care, Dr June Raine, CEO, Medicines and Healthcare products Regulatory Agency (MHRA) and Peter Ellingworth, CEO, Association of British HealthTech Industries (ABHI) have today announced a new agreement to accelerate the delivery of the future UK HealthTech regulatory system.
    Acknowledging the Chancellor’s priorities of stability and growth supported by regulatory reforms, and the importance of the success of the system to UK patients and the Life Science sector, they have formed an advisory group on behalf of the Life Sciences Council to drive the delivery of the ambition of the Life Sciences Vision to have a best in class regulatory system.
    The advisory group has agreed that aligned proposals will be published on three priority areas:
    international recognition routes for innovation system capacity. Read full press release
    Source; Gov.UK, 16 December 2022
  14. Patient Safety Learning
    Patients are not safe from harm in three out of seven emergency departments, a damning new Hiqa inspection report has revealed. 
    The report was released on the same day as an Oireachtas committee was warned of a growing crisis in primary care, with patients in some parts of the country unable to access basic GP services. 
    Emergency Departments in Cork University Hospital (CUH) and University Hospital Limerick (UHL) were among seven EDs assessed by the health watchdog.
    In three EDs, including Cork and Limerick, inspectors found failures to ensure “service providers protect service users from the risk of harm.” 
    Inspectors also found patients’ “dignity, privacy and autonomy” was not respected in UHL, while CUH was only partially compliant in this area.
    The report also highlighted lengthy waiting times, including one patient who spent 116 hours on a trolley at UHL.
    Read full story
    Source: The Irish Examiner, 15 December 2022
  15. Patient Safety Learning
    As many as 250,000 people die every year because they are misdiagnosed in the emergency room, with doctors failing to identify serious medical conditions like stroke, sepsis and pneumonia, according to a new analysis from the US federal government.
    The study by the Agency for Healthcare Research and Quality estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result.
    Researchers from Johns Hopkins University analysed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake.
    While these errors remain relatively rare, they are most likely to occur when someone presents with symptoms that are not typical.
    “This is the elephant in the room no one is paying attention to,” said Dr. David E. Newman-Toker, a neurologist at Johns Hopkins University and director of its Armstrong Institute Center for Diagnostic Excellence, and one of the study’s authors.
    The findings underscore the need to look harder at where errors are being made and the medical training, technology and support that could help doctors avoid them, Dr. Newman-Toker said. “It’s not about laying the blame on the feet of emergency room physicians,” he said.
    Read full story
    Source: New York Times, 15 December 2022
  16. Patient Safety Learning
    Four out of five Britons are worried about the NHS’s ability to provide safe care for patients during strikes by nurses and ambulance workers, a new poll has found.
    While around half of those surveyed said they support the planned industrial action, the majority expressed concern about the impact on patient safety.
    The Ipsos poll of 1,100 adults found that 80% were very or fairly concerned about the ability of the NHS to provide safe care for people during the nurses’ strike, which began on Thursday.
    Meanwhile, 82% of those questioned in the survey said they are very or fairly concerned about patient safety during the ambulance workers’ industrial action, with the first strike planned for 21 December.
    The new poll comes as the NHS continues to face high demand and widespread staffing gaps, with health leaders fearing this winter will be the most difficult in the health service’s history.
    Ambulances have been struggling to meet response times targets, while new data published on Thursday shows handover delays at hospitals in England have hit a new high.
    But the Ipsos survey suggests that, nevertheless, more people are supportive of the industrial action than are opposed to it.
    Some 50% of those questioned said they either strongly support or tend to support the industrial action by nurses, while 47% are supportive of the ambulance worker strikes.
    Read full story
    Source: The National, 15 December 2022
  17. Patient Safety Learning
    One in eight adults in the UK have paid for private medical care in the last year because of long delays in getting NHS treatment, renewing fears that the NHS is becoming “a two-tier system”.
    “Around one in eight (13%) adults reported they had paid for private medical care, with 5% using private insurance and 7% paying for the treatment themselves,” according to a new report by the Office for National Statistics (ONS).
    Patients also say that waiting for tests or treatment is badly affecting them, including making their illness worse.
    The ONS survey of 2,510 adults across the UK found that one in five were waiting for an appointment, test or treatment at an NHS hospital. Of those in that situation:
    Three-quarters said their delay had had either a strongly (34%) or slightly (42%) negative impact on their life 36% said waiting had made their condition worse 59% said it had damaged their wellbeing A third said long waits had affected either their mobility (33%) or ability to exercise (34%) Read full story
    Source: The Guardian, 16 December 2022
  18. Patient Safety Learning
    Flu hospitalisations in England have jumped by more than 40 per cent in a week as the NHS braces for one of the worst outbreaks of the virus in recent years.
    Analysis of NHS data by The Telegraph shows that rates are more than eight times higher than expected at this time of year.
    On the current trajectory, admissions next week could pass the peak of the 2017-18 outbreak – one of the worst of the last 20 years – which led to nearly 30,000 deaths.
    Flu hospitalisations are so high that they have overtaken Covid admissions for the first time since the start of the pandemic.
    The rise could not come at a worse time for the NHS. It is already suffering the biggest treatment backlog in its history, which is set to be exacerbated by strikes by nurses and ambulance paramedics.
    Read full story
    Source: The Telegraph, 15 December 2022
  19. Patient Safety Learning
    Three more children have died from strep A, it has emerged, and pharmacists in the UK have been told they can supply alternative antibiotics to those originally prescribed, in a bid to ease shortages of certain forms of penicillin.
    The UK Health Security Agency (UKHSA) data shows at least 19 children have now died across the UK, while there are 7,750 cases of scarlet fever so far this season. This is more than treble the 2,538 at the same point in the year during the last comparably high season in 2017 to 2018.
    The Department of Health and Social Care (DHSC) has issued serious shortage protocols (SSPs) for three penicillin medicines amid increased demand for the antibiotics.
    Pharmacists and GPs in the UK have faced serious difficulties in securing supplies of penicillin and amoxycillin, antibiotics used to treat infections including strep A. As a result, parents have reported having to visit a string of pharmacies to obtain medicines prescribed for their sick children, while the price of some antibiotics has risen sharply – a situation pharmacists say has left them facing losses.
    The health minister Will Quince said: “The increased demand for the antibiotics prescribed to treat strep A has meant some pharmacists have been unable to supply the medicine shown on the prescription.
    “These serious shortage protocols will allow pharmacists to supply an alternative form of penicillin, which will make things easier for them, patients, and GPs.
    “We are taking decisive action to address these temporary issues and improve access to these medicines by continuing to work with manufacturers and wholesalers to speed up deliveries, bring forward stock they have to help ensure it gets to where it’s needed, and boost supply to meet demand as quickly as possible.”
    Read full story
    Source: The Guardian, 15 December 2022
  20. Patient Safety Learning
    There is a "moral case" for compensation to be paid to people affected by the contaminated blood scandal, the government has said.
    But Paymaster General Jeremy Quin told MPs he could not commit to a timetable.
    In August, the government announced that 4,000 UK victims would receive interim payments of £100,000.
    Tens of thousands of people contracted HIV or hepatitis C in the 1970s and 80s after being given infected blood. 
    In September, modelling by a group of academics commissioned by the public inquiry estimated that 26,800 people were infected after being given contaminated transfusions between 1970 and 1991.
    The study calculated that 1,820 of those died as a result, but that the number could be as high as 3,320.
    The inquiry, chaired by retired High Court judge Sir Brian Langstaff, began taking evidence in 2018.
    The interim compensation announcement in August came after Sir Brian argued there was a compelling case to make payments quickly - saying victims were on borrowed time because of their failing health.
    Payments have been made to those whose health is failing after developing hepatitis C and HIV, and partners of people who have died.
    But families have complained that many people affected, such as bereaved parents, missed out.
    Read full story
    Source: BBC News, 15 December 2022
  21. Patient Safety Learning
    Elderly people who fall may only be sent an ambulance after they have spent four hours on the floor, and some category 2 calls may not be responded to under one of the first agreements with ambulance unions about next week’s strikes.
    But the deal between South East Coast Ambulance Service and the GMB union will see many union staff continue to work on ambulances and in control rooms – and others may be asked to come off the picket line if operational pressures escalate.
    HSJ has seen the details of the deal – thought to be one of the first agreed before next Wednesday’s strike. Some other trusts are hoping to conclude negotiations shortly, but for several — such as in the North West and London — it is thought no strike “derogations” (exceptions) have so far been agreed, and managers are concerned that unions are resistant. Trusts have been pushing for more cover on strike days – especially around category 2 calls.
    Read full story (paywalled)
    Source: HSJ, 15 December 2022
  22. Patient Safety Learning
    The ambulance staff strike next week represents a far higher risk to patient safety and services than the nurses’ strike, but a blanket elective ban will only be used as “an absolute last resort”, a senior NHS England director said today.
    However, NHSE elective recovery chief Sir Jim Mackey’s comments come despite several local leaders telling HSJ significant amounts of elective activity are likely to need to be postponed due to the ambulance staff walkout on 21 and 28 December, to free up capacity to deal with emergency care pressure.
    Speaking at a King’s Fund conference this morning, Sir Jim said: “The ambulance strike is a completely different order of magnitude of risk [than the nurses’ strike]. I think that’s the main thing people are worried about because of the complexity and fragility of urgent care.”
    However, he added: “If we were to give [national guidance on what elective activity to cancel] today, the only guidance we could give would be to cancel absolutely everything, and that’s really not going to help anybody…
    “I think we’ll just have to take it day-by-day and keep learning from each other and sharing intelligence… and then, if at some point, there is a case for blanket order, we’ll consider that… But, we really want to do that as an absolute last resort.”
    Read full story (paywalled)
    Source: HSJ, 15 December 2022
  23. Patient Safety Learning
    In Kisii town, south-west Kenya, a rundown roadside building houses a pharmacy. Like many others in the area, the pharmacy doubles as a clinic.
    Lilian Kemunto (not her real name), a former surgical nurse, set it up after she retired in 2018. She mainly does health check-ups but has also offered female genital mutilation (FGM) services on request.
    Kemunto has performed cuts since the 90s, after receiving training in basic surgical techniques from male colleagues in the local hospital where she worked. She would do the cuts in the hospital at night, but it was risky, she says, because management didn’t approve. “They would tell us: ‘Just do it, but if you’re caught, you’re on your own.’”
    She preferred cutting girls in a private home, in the middle of the night, saying it was much easier: “By 6am, the girls are back in their own homes, like nothing happened.”
    In Kisii county, medicalisation is standard. Two out of three cases of cutting are performed by health practitioners, in contrast to much of the country, where 70% of FGM cases are performed by traditional practitioners.
    Kemunto says she tries to avoid mishaps, and at a minimum requires some anaesthesia, a surgical blade, sterile towels, and cleaning solution to proceed.
    She also claims to use a non-invasive procedure: a small incision of the clitoris that practitioners call a “signature”. Kisii’s FGM practice is considered less severe than other areas, and anti-FGM campaigners are concerned that there’s a growing acceptance of the practice as more safe, hygienic and cosmetic.
    FGM rates in Kenya have gone down significantly over the past decade. The country passed strong laws in 2011, imposed hefty fines on practitioners, and stepped up surveillance and enforcement. But medicalisation is posing a new challenge for the east African nation, which has a 15% medicalisation rate: one of the highest in Africa.
    Earlier this month, Kenyan president William Ruto backed the country’s chief justice who said that FGM “should not be a conversation we are having in Kenya in the 21st century”, and reiterated his administration’s commitment to eradicating the practice.
    Read full story
    Source: The Guardian, 15 December 2022
  24. Patient Safety Learning
    A coroner says an investigation into the death of a newborn baby at a hospital was compromised by the way the placenta was dealt with.
    Quinn Lias Parker was born at Nottingham's City Hospital in July 2021 but died two days later from multiple organ failure.
    It later emerged the placenta was dissected by pathology staff when it should have been preserved.
    Hospital bosses said procedures had since been revised.
    An inquest into Quinn's death, held in April, returned a narrative verdict. 
    After Quinn's birth, Ms Studencki's placenta was sent from the hospital's maternity unit to pathology, where it was dissected - meaning it was cut up for examination. 
    But Dr Elizabeth Didcock, assistant coroner for Nottinghamshire, said the dissection meant the post-mortem examination was compromised.
    In a prevention of future deaths report, she detailed how Quinn was born in a "poor condition" and there was a "high probability that he would not survive" and therefore "thought needed to be given to the preservation of the placenta" to ensure it could be used in an examination.
    "It is not clear to me exactly how the placenta was cut into after Quinn's death without discussion with the coroner," she said.
    "What is clear is that the outcome has been highly detrimental to the independent investigation by the coroner and other agencies investigating the circumstances of this case.
    "This death follows a number of similar early neonatal deaths in Nottingham, where the placenta has not been retained, and therefore key information regarding placental pathology has been lost."
  25. Patient Safety Learning
    Pharmacists say supplies of key antibiotics to treat strep A have "gone from bad to worse" in the past week.
    The Association of Independent Multiple Pharmacies (AIMP) said the situation was "unacceptable" and it was time for the government to get a plan in place.
    Four antibiotics, which treat different conditions, have been added to a list of products that the UK cannot export.
    The UK government says it is working urgently with manufacturers and wholesalers to speed up deliveries.
    However, Leyla Hannbeck, chief executive of the AIMP, which represents 4,000 pharmacies in the UK, said the supply of antibiotics to treat bacterial infections including strep A and scarlet fever was "very poor".
    She said the problem had been highlighted a week ago, but it was now getting worse, making it very difficult to get hold of any antibiotics.
    "People are having to go from one pharmacy to another - it's chaos," she said.
    "Supplies are not coming through to us and it feels like no-one cares."
    Read full story
    Source: BBC News, 14 December 2022
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