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Sam

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  1. Sam
    Patients in England are set to benefit from a radical new project that will look to identify innovative new methods of preventing cardiovascular disease, as the Department of Health and Social Care appoints the first ever Government Champion for Personalised Prevention.
    John Deanfield CBE, a Professor of Cardiology at University College London, has been asked by the health secretary to explore how the potential of technology and data can be properly harnessed to allow people to better look after their health and reduce the risk of cardiovascular disease.
    Professor Deanfield will spearhead a taskforce comprised of experts in everything from policy and technology to economics and behavioural science to deliver a range of recommendations that will lay the foundations for a modern, tailored cardiovascular disease prevention service.
    The Government say the recommendations will:
    Identify breakthroughs in predicting, preventing, diagnosing and treating risk factors for cardiovascular disease. Advise on how public services, businesses and the population can be encouraged to support prevention outside the NHS. Use personalised data to predict and manage disease more effectively. Bring care closer to homes and communities by establishing new partnerships that advance the way preventative services are delivered. Evaluate how this strategy for cardiovascular disease prevention may impact conditions with shared risk factors. Read full story
    Source: NHE, 7 March 2023
  2. Sam
    Elon Musk's attempt to implant microchips into human brains has been rejected by US medical regulators over concerns about the safety of the technology.
    Mr Musk's Neuralink business, which is hoping to insert tiny chips into people's skulls to treat conditions such as paralysis and blindness, was denied initial permission for clinical trials last year.
    US medical regulators were said to have "dozens" of concerns over the risks posed by the device, Reuters reported. Concerns include fears that tiny electrodes could get lodged in other parts of the brain, which could impair cognitive function or rupture blood vessels.
    Neuralink's chips are designed to be threaded into the brain using tiny filaments and harness artificial intelligence technology to pick up brain activity using a so-called "brain computer interface".
    Read full story (paywalled)
    Source: The Times, 3 March 2023
  3. Sam
    Ahead of the 5th Global Ministerial Patient Safety Summit 2023 in Switzerland, the World Patient Safety Epicentre shares three messages and one challenge to the participants attending. 
    1. Please think about changing the term Patient Safety to Safety in Healthcare.
    2. Please consider creating a World Patient Safety Epicentre Safety, People Solutions – Network and Center(s) of Safety in Healthcare Change,
    3. Please invite two people to the discussion.
    4. One challenge - Let’s save 155 patients by 17 September 2023 in each country.
    Read full story
  4. Sam
    The national dentistry budget is set to be underspent by a record £400m this year, due to a shortage of dentists willing to take on NHS work, HSJ has learned.
    The situation is understood to have prompted major concerns in the senior ranks of NHS England, and calls for a “fundamental rethink” of the much-maligned primary dental care contract.
    The unspent funding is due to be used to plug budget deficits in other services and comes as patients in many areas struggle to access NHS dentistry. Healthwatch England described the estimated underspend as an “absolute scandal”.
    Read full story (paywalled)
    Source: HSJ, 21 February 2023
  5. Sam
    The UK risks a shrinking workforce caused by long-term sickness, a new report warns.
    Pensions and health consultants Lane, Clark and Peacock (LCP) says there has been a sharp increase in "economic inactivity" - working-age adults who are not in work or looking for jobs.
    The figure has risen by 516,000 since Covid hit, and early retirement does not appear to explain it.
    The total of long-term sick, meanwhile, has gone up by 353,000, says LCP. It means there are now nearly 2.5 million adults of working age who are long-term sick, official data from the Labour Force survey reveals.
    The LCP says pressure on the NHS can account for some of the increase in long-term sickness. Delays getting non-urgent operations and mental health treatment are possible explanations. Others who would otherwise have had a chronic condition better managed may be in poorer health.
    One of the report authors, Dr Jonathan Pearson-Stuttard, said: "The pandemic made clear the links between health and economic prosperity, yet policy does not yet invest in health, to keeping living in better health for longer. NHS pressures have led to disruption of patient care which is likely to be impacting on people's ability to work now and in the future."
    Read full story
    Source: BBC News, 20 February 2023
  6. Sam
    Hundreds of thousands of operations and medical appointments will be cancelled in England next month and progress in tackling the huge care backlog will be derailed as the NHS prepares to face the most widespread industrial action in its history.
    Junior doctors are poised to join nurses and ambulance workers in mass continuous walkouts in March after members of the British Medical Association (BMA) voted overwhelmingly to take industrial action.
    In only the second such action in the 74-year-history of the NHS, junior doctors will walk out for 72 hours – continuously across three days, on dates yet to be confirmed – after 98% of those who voted favoured strike action.
    Amid an increasingly bitter row between health unions and the government, NHS leaders expressed alarm at the enormous disruption now expected next month.
    Read full story
    Source: The Guardian, 20 February 2023
  7. Sam
    Children's services could be forced to close at a hospital that is accused of leaving young patients traumatised and sick through poor care.
    The care regulator said it had taken action to "ensure people are safe" on Skylark ward at Kettering General Hospital (KGH) in Northamptonshire.
    Thirteen parents with serious concerns after their children died or became seriously ill have spoken to the BBC.
    A BBC Look East investigation has heard allegations spanning more than 20 years about the treatment of patients on Skylark ward, a 26-bed children's unit.
    The BBC discovered:
    An independent report found staff left a 12-year-old boy - who died at KGH in December 2019 - for four hours suffering seizures, and suggests little effort was made to obtain critical care support. In April 2019, nurses allegedly dragged a "traumatised" four-year-old girl down a corridor in agony, insisting that she could walk. Medics are accused of refusing to carry out an MRI scan, which would have detected a dangerous cyst on her spine. Mothers claim to have been threatened with safeguarding referrals, with one stating a referral was made against her after she complained her son was struggling to breathe, while another likened it to blackmail. Read full story
    Source: BBC News, 20 February 2023
  8. Sam
    Striking ambulance workers in two regions have said for the first time that they will only answer immediately life-threatening calls — abandoning previous agreements to cover some Category 2 incidents.
    Agreed exemptions (derogations) from ambulance strike action so far this winter have varied regionally and across different unions; but all have so far included some Category 2 cover.
    However, GMB told HSJ its members in the North East and North West today would cover only Category 1 calls – defined as “immediately life threatening” – during their action today.
    Category 2 includes more than any other category, and covers a wide range of incidents including suspected heart attacks and strokes.
    Read full story (paywalled)
    Source: HSJ, 20 February 2023
  9. Sam
    A high court judge has expressed her “deep frustration” at NHS delays and bureaucracy that mean a suicidal 12-year-old girl has been held on her own, in a locked, windowless room with no access to the outdoors for three weeks.
    In a hearing on Thursday, Mrs Justice Lieven told North Staffordshire combined healthcare NHS trust “you are testing my patience”, after she heard that a proposal to move Becky (not her real name), could not progress until a planning meeting that would not be held until next week, and that a move was not anticipated until 2 March.
    Three sets of doctors at the hospital trust have disagreed as to Becky’s diagnosis; at her most recent assessment doctors said she was not eligible to be sectioned, which would trigger the protections provided by the Mental Health Act, because her mental disorder was not of the “nature and degree” as to warrant her detention.
    In a robust exchange, the judge demanded: “Where’s the urgency in this … I cannot believe that the life and health of a 12-year-old girl is hanging on an issue of NHS procurement, when you cannot tell me what it is you’re trying to procure.
    “If the delay is procurement, I’m not having it,” Lieven continued. “I will use the inherent jurisdiction to make an order. We have a 12-year-old child in a completely inappropriate NHS unit for about three weeks, and it’s suddenly dawned on your client that ‘actually we’ll put her in a Tier 4 unit and we might have to do some [building] work.’”
    Sometimes, the judge said, “public bodies have to move faster”.
    Read full story
    Source: The Guardian, 17 February 2023
  10. Sam
    Women suffering from chronic urinary tract infections (UTIs) are facing mental health crises after being “dismissed and gaslighted” by health professionals for years, according to a leading specialist.
    Daily debilitating pain has left patients feeling suicidal, with those in recovery describing lingering mental health problems “akin to post-traumatic stress disorder (PTSD)”, said Dr Rajvinder Khasriya, an NHS consultant urogynaecologist at the Whittington Hospital in London.
    Patients have said they feel crippling anxiety over planning ahead to ensure there is always a toilet around, even after their condition has been controlled with treatment. 
    Vicky Matthews, who searched for a diagnosis for three years after a recurrent UTI became chronic, said the condition caused a “gradual decline” in her mental health as medical professionals were unable to pinpoint what was causing her pain.
    "I questioned my pain. I questioned what was going on. I questioned whether it was actually real and that was a pretty awful thing to be dealing with on top of having physical pain,” the 43-year-old said, describing what she felt was “mental torture”.
    Read full story
    Source: I News, 12 February 
    Further reading on the hub
    The clinical implications of bacterial pathogenesis and mucosal immunity in chronic urinary track infection
  11. Sam
    A rapid test that can help preserve the hearing of newborn babies is set to be used by NHS hospitals.
    For some babies, commonly used antibiotics can become toxic. The drugs damage sensory cells inside the ear leading to permanent hearing loss.
    The test - which analyses babies' DNA - can quickly spot those who are vulnerable. It means they can be given a different type of antibiotic and avoid having a lifetime of damaged hearing.
    Gentamicin is the first-choice antibiotic if a newborn develops a serious bacterial infection. It is life-saving and safe for the majority of people.
    However, it has a rare side effect. About 1,250 babies in England and Wales are born with a subtle change in their genetic code that allows the antibiotic to bind more strongly to the hair cells in their ears, where it becomes toxic.
    These tiny hairs help convert sounds into the electrical signals that are understood by the brain. If they are damaged, it results in hearing loss.
    The side effect is well known, but until now there was no test that could get the results fast enough. It would be dangerous to delay treatment, and alternative antibiotics are not used as they have their own side effects and because of concerns about antibiotic resistance.
    The new genedrive kit analyses a sample taken from inside the baby's cheek. Tests at two neonatal intensive care units in Manchester and Liverpool showed it could spot who was susceptible to hearing loss in 26 minutes, and using it did not delay treatment.
    Read full story
    Source: BBC News, 9 February 2023
  12. Sam
    Mental health sick days cost the NHS almost half a million pounds as staff anxiety and stress levels haved skyrocketed.
    Costs have almost doubled compared to before the pandemic from £279 million to £468 million.
    The sickness data shared with The Independent by GoodShape, an employee well-being and performance analysis company, shows the number of staff sick days increased in 2022 to 12 million from 7.21 million in 2019. That is despite the overall number of people working in the NHS increasing from 1.2 to 1.3 million.
    The overall cost to the NHS of absences for the five most common reasons – which includes mental health – increased to a “staggering” £1.85 billion from £1.01 billion between 2019 to 2022, according to figures from GoodShape.
    Covid was still the most common reason for staff sickness last year, according to the analysis, accounting for 4.4 million lost days, while mental health was a close second driving 3 million days off due to illness.
    Pat Cullen, chief executive and general secretary for the Royal College of Nursing said in response: “These figures are shocking but not surprising. With 47,000 vacant nurse posts in England alone, the pressures on staff are unrelenting.
    Read full story
    Source: The Independent, 8 February 2023
  13. Sam
    The ‘optimal layout’ for an isolation room to contain the spread of Covid has been created following tests at a London hospital.
    The room was designed by researchers at Imperial College London to reduce the risk of infection for health care staff as far as possible.
    Researchers used a state-of-the-art fluid model to simulate the transmission of the virus within an isolation room at the Royal Brompton Hospital in Chelsea, west London.
    They found that the area of highest risk of infection is above a patient’s bed at a height of 0.7 to two metres, where the highest concentration of Covid is found.
    After the virus is expelled from a patient’s mouth, the research team explained that it gets driven vertically by wind forces within the room.
    The research, published in the journal Physics of Fluids, is based on data collected from the room during a Covid patient’s stay.
    The work centred on the location of the room’s air extractor and filtration rates, the location of the bed, and the health and safety of the hospital staff working within the area.
    Read full story
    Source: The Independent, 8 February 2023
  14. Sam
    Vulnerable female patients have been sexually “exposed” on a mixed gender ward deemed not “fit for purpose”, the NHS watchdog has warned.
    The Care Quality Commission found that sexual incidents had occured at Hill Crest, a 25-bed mixed gender mental health unit in Redditch, as male and female were being put at risk.
    It found male patients are able to walk into female bathrooms and bedrooms, leading to risks of sexual assault and relationships. It found that sexual incidents had taken on the unit because of the risks.
    The rate of assaults on mixed sex wards is significantly higher than on single-sex wards, data has shown.
    According to the CQC, the trust graded sexual incidents between patients as “low harm” but did not fully consider them or follow up actions to keep patients safe.
    Read full story
    Source: The Independent, 8 February 2023
  15. Sam
    Nurses could refuse to carry out any further strikes alongside other health workers because of fears over patient safety, The Independent has learnt.
    A mass walkout billed as the largest strike in NHS history is due to take place on Monday as tens of thousands of nurses, paramedics and 999 call handlers walk out in a bid to force ministers to the negotiating table.
    But the coordinated strikes could be a one-off if nurses feel that the decision to take part in direct action compromises patient safety, The Independent has been told.
    One union source said walkouts are not carried out on a “come what may” basis, and that the unions would have to assess whether striking together was “helpful” or not.
    Unions have been escalating their industrial action in recent weeks in an attempt to secure higher pay rises. Any de-escalation in tactics will be seen as a blow to their campaign and a boost to Rishi Sunak’s hopes of riding out the wave of protests.
    With patient safety the priority, sources insisted there are strong local controls that will pull nurses from picket lines if they think there is an issue.
    Read full story
    Source: The Independent, 5 February 2023
  16. Sam
    Free HIV tests that can be done at home are being offered this week to people in England.
    It is part of a government drive to improve diagnosis, which dropped off during the Covid pandemic.
    The kit is small enough to fit through the letterbox and arrives in plain packaging through the post.
    It gives a result within 15 minutes by testing a drop of blood from a finger prick. A "reactive" result means HIV is possible and a clinic check is needed. Support and help is available to arrange this.
    About 4,400 people in England are living with undiagnosed HIV, which comes with serious health risks.
    HIV medication can keep the virus at undetectable levels, meaning you cannot pass HIV on and your health is protected.
    Most people get the virus from someone who is unaware they have it, according to the Terrence Higgins Trust (THT) charity which campaigns about and provides services relating to HIV and sexual health.
    HIV testing rates remain a fifth lower than before the Covid-19 pandemic - with heterosexual men in particular now testing far less than in 2019.
    Read full story
    Source: BBC News, 5 February 2023
  17. Sam
    “Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.”
    While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite.
    The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.”
    Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether.
    Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken.
    “The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK.
    Read full story
    Source: The Guardian, 5 February 2023
  18. Sam
    A little boy whose headaches turned out to be a brain tumour died in his parent’s arms just four months after his diagnosis.
    Rayhan Majid, aged four, died after doctors discovered an aggressive grade three medulloblastoma tumour touching his brainstem.
    His mother Nadia, 45, took Rayhan to see four different GPs on six separate occasions after he started having bad headaches and being sick in October 2017.
    No one thought anything was seriously wrong, but when his headaches didn’t clear up Nadia rushed him to A&E at the Queen Elizabeth University Hospital in Glasgow.
    An MRI scan revealed a 3cm x 4cm mass in Rayhan’s brain.
    Rayhan underwent surgery to remove as much of the tumour as possible and was told he would need six weeks of radiotherapy and four months of chemotherapy.
    But before the treatment even started another MRI scan revealed the devastating news that the cancer has spread.
    Read full story
    Source: The Independent, 30 January 2023
  19. Sam
    An acute trust has been fined a record sum by the Care Quality Commission for failing to provide safe maternity care, which resulted in the death of a baby after 23 minutes.
    Nottingham University Hospitals must pay a fine of £800,000 within two years. It is only the second time the regulator has brought a case against a NHS maternity service, and the highest fine ever given for failings of this nature.
    The trust pleaded guilty earlier this week to two charges of failing to provide safe care and treatment to Sarah Andrews and her baby daughter Wynter Andrews at Queen’s Medical Centre in 2019, a short time after her birth by Caesarean section. This guilty plea saw the fine reduced from £1.2m. 
    An inquest in 2020 found the death was a “clear and obvious case of neglect”. It was also found there was “an unsafe culture prevailing within maternity services”, including a “failure to listen and respond to staff safety concerns”.
    Read full story (paywalled)
    Source: HSJ, 27 January 2023
  20. Sam
    “Pointless” bureaucracy is helping hospitals grind to a halt, a leading doctor has warned.
    Dr Gordon Caldwell, who has just retired after 40 years as an NHS hospital consultant, said “horribly inefficient” paperwork around patients moving in and out of wards is fuelling record delays.
    The senior doctor took a photograph of all the forms required for one medical admission to an NHS hospital, laid against his 5ft 10in frame.
    Dr Caldwell said promises by the NHS to “digitise” the health service had simply seen needless bureaucracy transferred on to poor computer systems that were often incompatible with each other.
    The specialist in general medicine and diabetes endocrinology said: “A few years ago there were estimates that nurses were spending around 50 per cent of their time on paperwork;  now I’d say it’s closer to 70 per cent.”
    “It’s bureaucratic and it’s very slow and horribly inefficient,” he said.
    Read full story (paywalled)
    Source: The Times, 21 January 2023
  21. Sam
    Thousands of NHS operations and appointments have had to be cancelled because of the nurses' strikes in England this week.
    Over the two days, NHS England said 27,800 bookings had to be rescheduled, including 5,000 operations and treatments.
    There were more than 30 hospital trusts affected with some saying between 10% to 20% of normal activity was lost.
    They warned the dispute was hampering progress in reducing the backlog.
    Saffron Cordery, of NHS Providers, which represents hospital bosses, said the strike days caused "significant disruption" and were "some of the hardest" hospitals have had to cope with this winter.
    She said it would have a "big knock-on effect on efforts to tackle the backlog".
    "The ramifications go well beyond the day itself. We are deeply concerned by this pile-up of demand, which will only continue with more strikes on the horizon."
    Read full story
    Source: BBC News, 21 January 2023
  22. Sam
    Ministers must use legislation to address an “unacceptable and inexcusable” failure to address racial disparity in the use of the Mental Health Act (MHA), MPs and peers have said.
    The joint committee on the draft mental health bill says the bill does not go far enough to tackle failures that were identified in a landmark independent review five years ago, but which still persist and may even be getting worse.
    The committee says the landmark 2018 review of the MHA by Prof Simon Wessely – which the bill is a response to – was intended to address racial and ethnic inequalities, but that those problems have not improved since then “and, on some key metrics, are getting rapidly worse”.
    Lady Buscombe, the committee chair, said: “We believe stronger measures are needed to bring about change, in particular to tackle racial disparity in the use of the MHA. The failure to date is unacceptable and inexcusable.
    “The government should strengthen its proposal on advanced choice and give patients a statutory right to request an advance choice document setting out their preferences for future care and treatment, thereby strengthening both patient choice and their voice.”
    A Department of Health and Social Care spokesperson said: “We are taking action to address the unequal treatment of people from Black and other ethnic minority backgrounds with mental illness – including by tightening the criteria under which people can be detained and subject to community treatment orders.
    “The government will now review the committee’s recommendations and respond in due course.”
    Read full story
    Source: The Guardian, 19 January 2023
  23. Sam
    Consultants who blew the whistle at a major teaching trust have raised “grave concerns” about the impartiality of three reviews into the safety and bullying allegations they made.
    Last month, Birmingham and Solihull Integrated Care Board announced three investigations into University Hospitals Birmingham, following worries about bullying and poor workplace culture.
    Former trust consultants Manos Nikolousis, John Watkinson and Tristan Reuser have now written to the cross-party reference group holding the investigations to account. Their letter, seen by HSJ, outlines their concerns about potential conflicts of interest.
    The first investigation is reviewing the trusts’ handling of 12 never events, staff deaths including a recent suicide, and 26 GMC referrals. It is being run by former NHS England deputy medical director Mike Bewick and may report as early as next week.
    The second and third reveiws will assess trust leadership and broader cultural issues respectively, and will be carried out with UHB and NHSE. 
    Read full story (paywalled)
    Source: HSJ, 18 January 2023
  24. Sam
    An artificial pancreas has been successfully trialled in patients with type 2 diabetes, a university said.
    Scientists at the University of Cambridge developed the device which combines a glucose monitor and insulin pump with an app.
    The app uses an algorithm that predicts how much insulin is required to keep glucose levels in the target range.
    Average glucose levels fell while patients trialled the device, the university said.
    The researchers have previously shown that an artificial pancreas run by a similar algorithm is effective for patients living with type 1 diabetes, where the body's immune system attacks and destroys the cells that produce insulin.
    Dr Charlotte Boughton from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge, who co-led the study, said: "Many people with type 2 diabetes struggle to manage their blood sugar levels using the currently available treatments, such as insulin injections.
    "The artificial pancreas can provide a safe and effective approach to help them, and the technology is simple to use and can be implemented safely at home."
    Read full story
    Source: BBC News, 19 January 2023
    You may also be interested in:
    Top picks: 5 key resources about diabetes Diabetes technology is life-changing, but we need to be prepared when it fails How safe are closed loop artificial pancreas systems?
  25. Sam
    A new state of the art institute for antimicrobial research is to open at Oxford University thanks to a £100 million donation from Ineos.
    Ineos, one of the world’s largest manufacturing companies, and the University of Oxford are launching a new world-leading institute to combat the growing global issue of antimicrobial resistance (AMR), which currently causes an estimated 1.5 million excess deaths each year- and could cause over 10m deaths per year by 2050. Predicted to also create a global economic toll of $100 trillion by mid-century, it is arguably the greatest economic and healthcare challenge facing the world post-Covid.
    It is bacterial resistance, caused by overuse and misuse of antibiotics, which arguably poses the broadest threat to global populations. The world is fast running out of effective antibiotics as bacteria evolve to develop resistance to our taken-for-granted treatments. Without urgent collaborative action to prevent common microbes becoming multi-drug resistant (commonly known as ‘superbugs’), we could return to a world where taken-for-granted treatments such as chemotherapy and hip replacements could become too risky, childbirth becomes extremely dangerous, and even a basic scratch could kill.
    The rapid progression of antibacterial resistance is a natural process, exacerbated by significant overuse and misuse of antibiotics not only in human populations but especially in agriculture. Meanwhile, the field of new drug discovery has attracted insufficient scientific interest and funding in recent decades meaning no new antibiotics have been successfully developed since the 1980s.
    Alongside its drug discovery work, the IOI intends to partner with other global leaders in the field of Antimicrobial Resistance (AMR) to raise awareness and promote responsible use of antimicrobial drugs. The academic team will contribute to research on the type and extent of drug resistant microbes across the world, and critically, will seek to attract and train the brightest minds in science to tackle this ‘silent pandemic’.
    Read full story
    Source: University of Oxford, 19 January 2021
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