An integrated care board (ICB) has advised its GP practices not to give patients automatic access to their records, contradicting NHS England national requirements.
Instead, North East London ICB has suggested practices only allow access where patients request it, and subject to conditions.
The national go-live date for patients to be allowed automatic access to future entries in their records has been repeatedly delayed since initially being set at December 2021. GPs have argued they needed more time to redact sensitive information, ensure records are not inappropriately shared, and train staff. They have cited workload and safeguarding concerns.
The ICB’s chief clinical information officer Osman Bhatti, who is a GP, told HSJ the ICB instead “wanted a process where patients could access both prospective and retrospective records safely, with less workload for GPs and so patients who actually want access can have it”.
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Source: HSJ. 1 June 2023
Patients diagnosed with cancer in 2020 had “significantly lower” survival rates in Scotland a year after having their cases confirmed compared with the previous year, a report has found.
The increase in deaths was an indirect result of the pandemic as coronavirus dissuaded people from getting check-ups or visiting physicians.
Many cancer screening programmes were also paused and infection control measures in healthcare settings caused delays in both diagnosis and treatment.
Andrew Elder, president of the Royal College of Physicians, said the government’s decision to pause screening programmes was “understandable in the extreme circumstances”, but added that the figures were “concerning”. He said: “Fewer and later presentations by patients who may have had more advanced disease clearly have had sometimes tragic consequences that are now being identified in the data.”
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Source: The Times, 31 May 2023
The Royal College of Midwives says the need for a maternity strategy in Northern Ireland has gone beyond urgent and is now critical.
The warning comes as the RCM is publishing a report on Northern Ireland's maternity services at Stormont on Tuesday.
The report will highlight growing challenges as more women across the country with additional health needs are being cared for by maternity services.
The RCM report will outline three steps to deliver high quality and safe services for women and families.
Develop, publish and fund the implementation of a new maternity and neonatal strategy for Northern Ireland.
Sustain the number of places for new student midwives at their recent, higher level.
Focus on retaining the midwives in the HSC.
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Source: ITV News, 30 May 2023
One of the first studies to examine the full lifespan of people living with Down syndrome (DS) has provided evidence in support of health guidelines specifically for people with the condition.
Life expectancy for people with DS had increased dramatically over the last 80 years or so, yet people with the condition still died at an earlier age than people in the general population or those with other intellectual disabilities, said the authors of a new study, published in The Lancet. This meant that there was an "opportunity to improve health outcomes for this minority", they said.
There continued to be disparities in surveillance, diagnosis, and treatment of common health conditions in people with intellectual disabilities, including those with DS, highlighted the authors, with ongoing premature mortality and excess morbidity identified in these groups.
In April 2022, the Down Syndrome Act was introduced in England, which stipulated that the Government must provide information to the NHS and local councils on how to provide the most appropriate care and support for people with DS.
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Source: Medscape, 26 May 2023
Patients are being urged to shop around on the NHS app and website to cut their waiting time for treatment in England.
IT systems have been updated to allow patients to more easily exercise their right to choose where they go for planned care, such as knee operations.
They will now be able to view up to five providers - filtered by distance, waiting times and quality of care.
But hospitals warned staffing shortages still needed to be tackled to make the biggest impact on waits.
The idea of choosing where to go for treatment has been in place since the early 2000s, but few use it.
Currently only1 in 10 exercises their right to choose, with patients reporting they are not always offered a choice of where to go or that it is hard to select different venues.
Ministers believe that by searching the list of different hospitals, patients will be able to reduce their waits - potentially by up to three months, research suggests.
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Source: BBC News, 25 May 2023
The health secretary is set to signal a major delay to one of the headline promises in the last Conservative manifesto by suggesting the delivery of 40 new hospitals in England is likely to be pushed back until after 2030.
In a move that will spark anger among MPs who wanted “spades in the ground” before the next election, government sources said Steve Barclay would make the announcement today.
The pledge to build and fund “40 new hospitals over the next 10 years” was one of the major headlines of Boris Johnson’s pitch to the electorate in 2019.
Sources indicated the government had been ready to make the announcement about the probable delay for some time, but it was repeatedly pushed back because of fears about a backlash from Tory MPs.
Rundown NHS hospitals have become a danger to patients, warn health chiefs
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Source: The Guardian, 25 May 2023
Extra beds squeezed into hospitals as part of winter planning are crowding out space for rehab, pushing up length of stay and knock-on costs, and increasing the chance of readmission, NHS leaders have been warned.
Systems and trusts were encouraged to staff thousands of additional ward beds in the run-up to last winter to try to ease emergency care pressures, and government and NHS England have since asked for many of them to be kept open through the year.
However, many of the additional beds are not in proper ward spaces, instead being located in gyms and other areas used for physiotherapy and other rehab. This followed on from some rehab areas already being lost during the pandemic, to be used for beds or storage.
NHSE has sent out a warning about the issue, following a commitment by ministers earlier this year. However, senior figures in physio and older people’s care remain concerned the spaces will not be restored without checks and enforcement, especially as acute trusts remain under pressure to increase general bed space.
Pregnant women and new mothers are facing wide variation in access to mental health support, new figures suggest, as NHS England admits national performance on a key long-term plan goal to expand services is ‘over a year behind trajectory’.
Analysis of access rates for perinatal mental health services from NHS Digital shows the rates of women accessing support within the past 12 months range from 3.7 per cent in Humber and North Yorkshire to 15 per cent in Shropshire, Telford and Wrekin ICS.
The long-term plan target is for 66,000 women per year to be accessing specialist perinatal services, which can help with conditions such as post-partum psychosis, by March 2024. NHSE admitted in its papers that “although access is increasing, performance remains over a year behind trajectory”.
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Source: HSJ, 25 May 2023
Ambulance chiefs have warned a controversial piece of legislation could lead to legal action against their trusts by patients denied an ambulance.
The Strikes (Minimum Service Levels) Bill, which is currently going through Parliament, would enable the health and social care secretary to set minimum levels of staffing for ambulance call centres and crews. Employers would be able to issue “work notices” compelling staff to provide cover during any strike.
But, in its response to the government consultation on how the system would work, the Association of Ambulance Chief Executives has said it does not support the legislation in its current form as it does not believe it will deliver an improvement for patients, or offer a practical means of delivering minimum service levels.
It said the proposed legislation appears to pass responsibility for the service levels to employers, which could leave them “exposed to patient liability risks to a greater extent than before”.
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Source: HSJ, 22 May 2023
Some mental health patients in England are still having to travel more than 300 miles for hospital treatment two years after the government pledged to end the “completely unacceptable” practice.
The number of patients in crisis forced to move potentially hundreds of miles for NHS help is rising again after falling during the pandemic, separating them from family and support networks and potentially delaying their recuperation.
According to official data seen by the Observer, 420 so-called “out of area” treatments started in February because no local beds were available – up from 240 in February last year. The most recent NHS England records show there are 720 out of area placements deemed “inappropriate”, risking the patient’s recovery.
Dr Mayura Deshpande, an associate registrar for policy at the Royal College of Psychiatrists, said targets for eliminating the practice had been “widely missed” and called for an urgent plan for the proper funding of mental health services. “It’s completely unacceptable that some mental health patients are having to travel hundreds of miles for care at a time when they are at their most vulnerable,” she said.
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Source: The Guardian, 20 May 2023
Britain’s reliance on foreign nurses has reached “unsustainable” levels, the government has been warned as new analysis reveals that international recruits has accounted for two thirds of the rise in numbers since 2019.
Ministers have repeatedly promised to boost the domestic supply of health staff amid warnings that reliance on international workers leaves the NHS at the mercy of global labour markets.
Overall, a fifth of the UK’s nursing, midwifery and nursing associate workforce originally trained overseas.
The figures will reignite concerns that nations such as the Philippines, traditionally a key source for the NHS, are being increasingly targeted by countries including Germany and Canada. Senior NHS leaders fear the health service could be left in a precarious position if increased competition results in nurses choosing alternative destinations, resulting in a shortfall for the UK. The health service in England already has one post in ten vacant.
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Source: The Times, 18 May 2023
Healthcare leaders are rolling out new NHS training to help speed up dementia diagnoses among Black and Asian people following criticism about a lack of support for patients from minoritised communities, The Independent has revealed.
An awareness campaign is being launched in England to help those from ethnic minority communities receive a prompt diagnosis and get the support they need at the earliest opportunity.
The announcement follows a critical report which found that thousands of south Asian people with dementia are being failed by “outdated health services designed for white British patients”.
Dr Bola Owolabi, director of the Healthcare Inequalities Improvement programme at NHS England, said: “The pandemic put a greater spotlight on longstanding health inequalities experienced by different groups across the country.
“While there are many factors involved, the NHS is playing its part in narrowing the gap and ensuring equitable access to services through taking targeted action where needed to improve outcomes."
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Source: The Independent, 21 May 2023
About 23,000 people died in accident and emergency departments last year, according to an estimate by Labour based on Freedom of Information requests to every NHS trust in England.
Half of the trusts responded to the party’s requests and, based on that information, it calculated that just over 23,000 people had died – an increase of more than 20% on 2021, and nearly 40% on 2020.
The increase in deaths corresponds with a sharp rise in NHS waiting times, as hospitals struggle with high demand and a lack of resources after the Covid-19 pandemic.
Wes Streeting, the shadow health secretary, said: “People turning to the NHS in an emergency should know they will be seen and treated before it’s too late. The Conservatives’ failure over 13 years to properly staff or reform the NHS has a cost in lives.”
Maria Caulfield, the health minister, defended the government’s record, however, saying: “We are delivering a record number of tests, speeding up discharge from hospitals, and cutting waiting lists as we also work to halve inflation, grow the economy, reduce debt, and stop the boats.”
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Source: The Guardian, 19 May 2023
An ‘outstanding’ trust’s Care Quality Commission rating has been dropped to ‘requires improvement’, after inspectors found potential safety risks and a disconnect between board and ward.
A highly critical report on University Hospitals Sussex Foundation Trust also downgraded its well-led rating to “inadequate” and recommended the trust be placed in segment four – the bottom tier – of NHS England’s system oversight framework. Its main tertiary centre – the Royal Sussex County Hospital – was also rated “inadequate”, including for safety.
Deanna Westwood, Care Quality Commission’s director of operations in the South, said “staff and patients were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment”.
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Source: HSJ,12 May 2023
The boss of a private healthcare company exposed by the Guardian for putting seriously ill children and adults at risk was warned it was failing patients three years ago.
Darryn Gibson, the chief executive of Sciensus, Britain’s biggest medicines courier, was told in November 2020 that patients with bleeding disorders were being left dangerously exposed to internal bleeding with little or no treatment at home as a result of botched, delayed or missed deliveries.
Gibson received the written warning from Kate Burt, the chief executive of the Haemophilia Society, a leading health charity, after she had become outraged at how vulnerable patients were being let down.
Sciensus blamed IT issues and promised action. However, three years later, patients remain at “very serious” risk of harm because of “recurring” problems with the company, Burt said.
“We continue to receive complaints about missing, incomplete or inaccurate deliveries and are very concerned to see the same issues recurring, indicating that far more needs to be done to improve Sciensus’s ordering and delivery systems,” she said.
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Source: The Guardian, 12 May 2023
A breakthrough AI model can determine a person's risk of developing pancreatic cancer with staggering accuracy, research suggests.
Using medical records and information from previous scans, the AI was able to flag patients at a high risk of developing pancreatic cancer within the next three years with great accuracy.
There are currently no full-proof scans for pancreatic cancer, with doctors using a combination of CT scans, MRIs and other invasive procedures to diagnose it. This keeps many doctors away from recommending these screenings.
Over time, they also hope these AI models will help them develop a reliable way to screen for pancreatic cancer — which already exists for other types of the diseases.
"One of the most important decisions clinicians face day to day is who is at high risk for a disease, and who would benefit from further testing, which can also mean more invasive and more expensive procedures that carry their own risks," Dr Chris Sander, a biologist at Harvard who contributed to the study, said.
"An AI tool that can zero in on those at highest risk for pancreatic cancer who stand to benefit most from further tests could go a long way toward improving clinical decision-making."
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Source: Mail Online, 9 May 2023
A key government pledge to reduce the size of the NHS’s record-breaking care backlog has been broken, the health secretary has admitted.
Steve Barclay slipped out the news in a Commons statement on Tuesday about a totally unrelated area of NHS policy – his new plan to improve access to GP care.
He disclosed to MPs that the NHS in England had missed its target to ensure that all patients who had been waiting 18 months for an operation in hospital would be treated by April.
It is thought that about 10,000 people who had been waiting for at least 78 weeks were still languishing on the 7.2 million-strong waiting list at the end of April.
The failure to eradicate 18-month waits for care is embarrassing for Rishi Sunak, who made “cut waiting lists” one of his five key pledges and insisted as recently as January that the promise, which NHS England and the then health secretary Sajid Javid first made in the elective surgery recovery plan last year, would be honoured.
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Source: The Guardian, 9 May 2023
Children with serious health conditions are getting sicker as a result of persistent failings by Sciensus, a private company paid millions by the NHS to deliver essential medication, the Guardian can reveal.
Parents of sick children say they are repeatedly let down by botched, delayed or missed deliveries, while NHS paediatric clinicians warn some are suffering avoidable harm as a result.
Sciensus failed to send injections to Autumn Powell, an eight-year-old girl with Crohn’s disease, four times this year, according to her mother, Dallas Powell. As a result, she has suffered stomach cramping, pain and fatigue, and been off school sick.
“It makes me mad, frustrated, but mostly it’s heartbreaking seeing my child suffering – and feeling helpless,” Powell said. “I am not one to go and complain publicly, but this is serious.”
In a complaint to the Care Quality Commission (CQC), the care regulator, three NHS paediatric clinicians working at two of the UK’s largest children’s hospitals have raised multiple concerns about Sciensus.
Medicines ordered by the NHS to be sent urgently to sick children were delayed or never arrived, they said. Parents of those with serious health conditions also experienced difficulties with the company’s app. In some cases Sciensus did not respond to emails and calls about children’s missing medicines.
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Source: The Guardian, 9 May 2023
Chronically ill patients across the UK allege they've had to go without vital medication amid delays by a private company contracted by the NHS to deliver drugs.
In the last year alone, Sciensus was awarded NHS contracts worth more than £5 million, despite being placed into special measures by health regulators in 2021 following widespread delivery failings.
ITV News has revealed that the CQC is currently reviewing whether to take further regulatory action against Sciensus, having been made aware of concerns about the company’s performance.
The company, which is based in Burton-on-Trent and says it "works with every NHS Trust in the country", should provide a lifeline for those who rely on specialised medications.
These include those with long-term conditions - like cancer, HIV, and haemophilia - which often require drugs that can't be collected from high street or hospital pharmacies.
One new mother with rheumatoid arthritis said she was taken to A&E after Sciensus left her without medication for three weeks.
The 37-year-old, who wishes to remain anonymous, told ITV News: "I was unable walk with a small baby... it was such a chronic flare that I couldn't walk, which I've never, ever had before in my life."
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Source: ITV News, 21 April 2023
NHS leaders and ministers face allegations of a “cover up”, as Byline Times reveals that almost two-thirds of NHS employers did not make a single, legally-required report of Covid being caught by staff working during the first 18 months of the pandemic.
And four-fifths (82%) of NHS employers have not reported a single death of a worker from Covid caught while working in those first two waves.
The Reporting of Injuries, Diseases & Dangerous Occurrences (RIDDOR) rules mean that employers have a legal duty to report certain serious workplace accidents and occupational diseases – including Covid.
The lack of acceptance of responsibility from NHS employers has left some families in limbo – and angry at what they consider to be deliberate “denial” of the experiences of those who died serving the public.
David Osborn, a health and safety consultant and member of the Covid-19 Airborne Transmission Alliance (CATA), co-wrote the research. He said: “One wonders how many bereaved families who have been denied this payment did not have the benefit of [these reports] to support their case.”
Osborn wrote to Sarah Albon, Chief Executive of the Health and Safety Executive, to raise his concerns after speaking with family members of NHS workers who had died of Covid, saying the reports of zero NHS worker deaths from Covid caught in the workplace are “difficult, nigh impossible, to believe.”
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Source: Byline Times, 6 April 2023
A leading surgeon says a major drop-out rate of trainee doctors is "an accident waiting to happen" for the NHS.
Nigel Mercer was tasked with prioritising surgery across the NHS during the pandemic when services were under intense pressure.
His biggest fear with what he sees as an up to 40% drop-out rate is whether there will be enough doctors to replace his generation of medics.
The government said the majority of trainees go on to work in the NHS.
"[But] at the moment everyone is so fed up with the system," Mr Mercer said
Concerns over pay and conditions are leading many trainees to consider moving to other countries, he said.
"You can get much more pay over in Australia and New Zealand and we reckon it's now 40% of medical graduates who are going to leave after their training and that's criminal," he continued.
"That's an accident waiting to happen, but if we don't produce high-quality paramedical staff there won't be the ability to train anybody.
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Source: BBC News, 12 April 2023
Some of Britain’s most vulnerable children are being moved to care homes more than 300 miles away from the neighbourhoods they grew up in, according to an Observer investigation revealing a “national scandal”.
The shocking figures make clear for the first time the scale of the crisis that has long worried child welfare experts. They show dozens of children from London alone are in foster or care homes more than 250 miles from the city, as councils battle a significant shortfall in provision. Children from the capital have been placed in homes near Perth, Glasgow, Knowsley, Leeds and Carlisle.
Care experts said that the pattern is being repeated across the country, removing children from critical support networks and familiar surroundings.
About 600 children from London are in foster or residential care more than 50 miles from their home neighbourhoods. Councils have warned they often have to compete for limited places, and face “rising costs and profiteering on the backs of vulnerable children”.
Some children need to be placed in certain locations for their own safety. However, there is widespread acceptance that the care system is failing to provide enough appropriate places in the right areas. Experts warn that relocating children removed them from schools, friends and extended family, as well as clubs and activities that were often key to their wellbeing. They warned it also put some at greater risk of exploitation.
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Source: The Guardian, 3 April 2023
Ministers and NHS England have not sufficiently warned the public of the risk to patient harm posed by next week’s junior doctors strike, some of the NHS’s most senior trust chief executives have warned.
The senior leaders contacted HSJ with their concerns after a group call between trust leaders and NHSE bosses on Thursday.
The chief executives and medical directors, who spoke to HSJ on condition of anonymity, made a series of robust criticisms which focussed on the lack of awareness of danger presented by the junior doctor’s industrial action, a lack of thorough communication of that to the public, and the insistence that trusts negotiate strike agreement with the British Medical Association at a local level.
One comment on the chat function stated: ”Public awareness of the impact of this strike seems far lower than for e.g. the ambulance strike, but from a an acute trust perspective this will have a much bigger impact on patient care and safety. Junior doctors’ are not newly qualified students - they are the backbone of day to day medical management in our services. I am concerned we might be giving false assurance about the quality of service we can offer next week.”
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Source: HSJ, 10 March 2023
NHS staff are significantly less comfortable raising concerns and are less confident in their organisation to address them, the service’s annual staff survey has revealed.
The 2022 results, with a response rate of 46%, showed a decline on all measures relating to raising concerns about clinical safety and speaking up more generally, with the greatest deterioration seen in the percentage of staff who would feel secure raising concerns about unsafe clinical practice.
Helen Hughes, chief executive of charity Patient Safety Learning, warned an “alarmingly high” number of staff could not say they felt safe raising concerns.
Ms Hughes continued: “If we are to effectively learn from and prevent future incidents of avoidable harm, staff need to feel safe to raise and discuss patient safety incidents.
“This year’s staff survey results are a clear indication that too often this is still not the case. This is reinforced by the experiences and testimonies of many whistleblowers and the findings of numerous inquiries into major patient safety scandals.”
She added there were a lack of “tangible measures” in place to create a safety culture where staff feel safe to speak up and called for “more resources to support improvement and evaluate their impact”.
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Source: HSJ, 9 March 2023
Which trusts receive the highest recommendations from staff as a place to work? HSJ has analysed the full results of today’s 2022 NHS Staff Survey for general acute and acute/community trusts.
HSJ has also analysed the results for mental health trusts and ambulance and community trusts.
More than 630,000 staff responded to the NHS staff survey between September and December 2022 – a 46% response rate, down from 48% in 2021.
Nationally, across all trust types, 57.4% said they would recommend their organisation as a place to work in 2022. That was down from 59.4% in 2021, and from 63.4% in 2019.
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Source: HSJ, 9 March 2023
