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Sam

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  1. Sam
    Antimicrobial resistance poses a significant threat to humanity, health leaders have warned, as a study reveals it has become a leading cause of death worldwide and is killing about 3,500 people every day.
    More than 1.2 million – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, according to the most comprehensive estimate to date of the global impact of antimicrobial resistance (AMR).

    The stark analysis covering more than 200 countries and territories was published in the Lancet. It says AMR is killing more people than HIV/Aids or malaria. Many hundreds of thousands of deaths are occurring due to common, previously treatable infections, the study says, because bacteria that cause them have become resistant to treatment.
    “These new data reveal the true scale of antimicrobial resistance worldwide, and are a clear signal that we must act now to combat the threat,” said the report’s co-author Prof Chris Murray, of the Institute for Health Metrics and Evaluation at the University of Washington.
    “We need to leverage this data to course-correct action and drive innovation if we want to stay ahead in the race against antimicrobial resistance.”
    Read full story
    Source: The Guardian, 20 January 2022
  2. Sam
    Families of people with dementia have said there is a national crisis in care safety as it emerged that more than half of residential homes reported on by inspectors this year were rated “inadequate” or requiring improvement – up from less than a third pre-pandemic.
    Serious and often shocking failings uncovered in previously “good” homes in recent months include people left in bed “for months”, pain medicine not being administered, violence between residents and malnutrition – including one person who didn’t eat for a month.
    In homes in England where standards have slumped from “good” to “inadequate”, residents’ dressings went unchanged for 20 days, there were “revolting” filthy carpets, “unexplained and unwitnessed wounds” and equipment was ”encrusted with dirt”, inspectors’ reports showed.
    Nearly one in 10 care homes in England that offer dementia support reported on by Care Quality Commission inspectors in 2022 were given the very worst rating – more than three times the ratio in 2019, according to Guardian analysis.
    Read full story
    Source: 29 December 2022
     
  3. Sam
    A GP surgery accidentally told patients they had aggressive lung cancer instead of wishing them a merry Christmas.
    Askern Medical Practice sent the text message to people registered with the surgery in Doncaster on 23 December.
    Sarah Hargreaves, who was waiting for medical test results, said she "broke down" when she received the text, only to be later told it was sent in error.
    The first text told recipients they had "aggressive lung cancer with metastases", a type of secondary malignant growth.
    It directed patients to fill out a DS1500 form, which allows people with terminal diseases to claim certain benefits.
    However, about an hour later people received a second text telling them it was an error and it was meant to wish them a merry Christmas instead.
    Read full story
    Source: BBC News, 29 December 2022
  4. Sam
    Technology that accurately predicts when patients will be ready to leave hospital upon their arrival in A&E is being introduced to solve the NHS bed-blocking crisis.
    The artificial intelligence (AI) software analyses data including age, medical conditions and previous hospital stays to estimate how long a patient will need to remain.
    Hospital managers can then alert social care services in advance about the date when patients are expected to be discharged, allowing care home beds or community care packages to be prepared.
    Nurses said the technology had “revolutionised” their ability to discharge patients on time, meaning people who would otherwise have been stuck in hospital had got home for Christmas.
    The new technology, developed by the British AI company Faculty, is being tested at four NHS hospitals in Wales belonging to the Hywel Dda health board. Analysis suggests that the tool will save NHS trusts 3,000 bed days and £1.4 million a year by speeding up discharges, which in turn frees beds for elective procedures such as hip replacements.
    Read full story (paywalled)
    Source: The Times, 26 December 2022
  5. Sam
    Woodside Care Village in Warwick is staged like a town centre in miniature, with benches and a fountain, cafe tables and front doors to homes styled as either “town”, “country” or “classical”. But none of the places are quite what they seem, because here everything has a greater purpose: to improve the wellbeing of people with dementia.
    Modelled on a groundbreaking Dutch experiment in looking after people with Alzheimer’s disease, the purpose-built facility, which opened in 2019, is quietly breaking new ground for a better kind of dementia care.
    “Everything is dressed and staged to look familiar,” said Jo Cheshire, the communications manager for the home’s operator, WCS. “We try to make sure people aren’t severing their links with the past. We have one lady who works in the launderette with a badge, because that’s what she did before. It feels like they are contributing to the community.”
    “The idea is you have freedom,” said Cheshire. “If you come upon a locked door it can increase agitation, that’s unsettling for the other residents and it makes the carer’s job harder.”
    Staff ratios are higher than normal, at two staff for every five or six people rather than the usual one. This means staff can spend more time interacting with the residents.
    Staff are briefed with a “this is me” document, which details the likes and dislikes of each person with dementia and has photos through their lives, the time they like to get up, when they like to eat. 
    A clinical trial of such “person-centred” dementia care in 69 care homes in London and Buckinghamshire published in 2020 showed that it improved quality of life for people with dementia and reduced agitation and the burden of depression or aggression. It also reduced hospital and GP visits.
    Read full story
    Source: The Guardian, 30 December 2022
  6. Sam
    Some integrated care systems (ICSs) still require “an awful lot of control” from the centre, Patricia Hewitt has told HSJ, tempering any expectations that her government-commissioned review will bring about a wholesale roll-back of national performance management.
    The former Labour health secretary, who is also an integrated care board chair, was commissioned in November by chancellor Jeremy Hunt and health secretary Steve Barclay to review ICS autonomy and accountability.
    In her first interview since she started the work, Ms Hewitt also said: 
    She had not ruled out “legislative tweaks” as a result of her review, but emphasised ICBs already had substantial ”soft power”; Some ICBs were still indulging in ‘old school’ combative behaviour, and stressed they should not become ‘top down regulators’; She wanted to “catalyse” the Care Quality Commission’s move to focus on systems and integration; and It appeared there were probably too many non-clinical support staff in the NHS, but not too many managers, and she would look more closely at the issue. Read full story
    Source: HSJ, 30 December 2022
  7. Sam
    The government could scrap a number of NHS targets after a review of the health service, it has been reported.
    Chancellor Jeremy Hunt and health secretary Steve Barclay commissioned Patricia Hewitt, a former Labour health secretary, last month to review how the NHS’s new integrated care systems should work, as well as how the health service should work to “empower local leaders”, giving them more autonomy.
    According to the i newspaper, the government could abolish a majority of health service targets as a result of the review, so it can be run along similar lines to schools. Ms Hewitt is set to publish her review next spring.
    The newspaper said ministers believe the NHS has become “overly centralised”, with doctors and trusts having to meet many different targets - more than 70 for GPs - and forced to tailor their work to meet them.
    Instead, the government would rather run the NHS “more like we do the schools system”, a senior government source told the i, giving local leaders increased responsibility on how to effectively meet NHS goals.
    The idea of fewer targets was received positively by the Royal College of GPs, which described many of the targets as “tick box exercises”.
    Professor Kamila Hawthorne, chair of the Royal College of GPs, told the newspaper that GPs are working under “intense workload” and pressure, with a “bureaucratic burden” adding to their workload.
    Read full story
    Source: The Independent, 26 December 2022
  8. Sam
    Hundreds of thousands of children have been left waiting by the NHS for the developmental therapies they need, with some waiting more than two years, The Independent can reveal.
    The long waiting lists for services such as speech and language therapy will see a generation of children held back in their development and will “impact Britain for the long haul”, according to the head of the Royal College of Paediatrics and Child Health (RCPCH).
    More than 1,500 children have been left waiting for two years for NHS therapies, according to internal data obtained by The Independent, while a further 9,000 have been waiting for more than a year. The total waiting list for children’s care in the community is 209,000.
    Dr Camilla Kingdon, president of the RCPCH, told The Independent: “The extent of the community waiting lists is extremely alarming. Community health services such as autism services, mental health support and speech and language therapy play a vital role in a child’s development into healthy adulthood, and in helping children from all backgrounds reach their full potential.
    “A lack of access to community health services also has direct implications for children and families in socio-economic terms. Delays accessing these essential services can impact social development, school readiness and educational outcomes, and further drive health inequalities across the country.”
    She said health and care staff are working immensely hard, but that without support they will struggle to address the long delays, which will “impact Britain for the long haul”.
    Read full story
    Source: The Independent, 26 December 2022 
  9. Sam
    Coronavirus modelling data will stop being published in early January, the UK Health Security Agency (UKHSA) says.
    Statistics covering the growth rate of the virus are currently released fortnightly, but the agency says this is no longer necessary.
    Chief data scientist Dr Nick Watkins said this is due to the UK living with Covid-19 because of vaccines and therapeutics.
    At the height of the pandemic both the R rate and growth rate for England were published weekly. Since April this year it has been published fortnightly.
    Dr Watkins said it served as a useful and simple indicator to inform public health action and government decisions.
    "Vaccines and therapeutics have allowed us to move to a phase where we are living with Covid-19," Dr Watkins said.
    "We continue to monitor Covid-19 activity in a similar way to how we monitor a number of other common illnesses and diseases.
    "All data publications are kept under constant review and this modelling data can be reintroduced promptly if needed, for example, if a new variant of concern was to be identified."
    Read full story
    Source: BBC News, 26 December 2022
  10. Sam
    The NHS is set to eliminate hepatitis C in England by 2025 due to targeted screening campaigns for those at risk and effective drug treatments, according to health officials. NHS England said the measures are helping to dramatically cut deaths from the virus five years ahead of global targets.
    Deaths from hepatitis C – including liver disease and cancer – have fallen by 35% since NHS England struck a five-year deal worth almost £1bn to buy antiviral drugs for thousands of patients in 2018.
    The World Health Organization’s target of a 10% reduction in hepatitis C-related death by 2020 has been exceeded threefold in England.
    An NHS screening programme launched in September is also enabling up to 80,000 people unknowingly living with the disease to get a diagnosis and treatment sooner by searching health records for key risk factors, such as historic blood transfusions or HIV.
    Prof Sir Stephen Powis, NHS England’s national medical director, said the health service was “leading the world” in the drive to save lives and eliminate hepatitis C while also tackling health inequalities.
    He said: “Thanks to targeted screening and because the NHS has a proven track record of striking medicine agreements that give patients access to the latest drugs, we are on track to beat global targets and become the first country to eliminate hepatitis C.”
    Read full story
    Source: The Guardian, 28 December 2022
  11. Sam
    The health service in England is returning to a payment-by-results-style system for elective activity, new guidance confirms.
    Providers struggled to hit elective targets in 2022-23, in large part due to ongoing covid, emergency care and staffing pressures, but some have argued that incentives to carry out more activity are too weak.
    Proposals for the NHS payment system for 2023-24 issued state: “The large backlog in elective care is a significant issue for the NHS and the patients who rely on it. We want the NHSPS to include an elective funding mechanism which means that providers are paid based on the level of activity they deliver.”
    The plans add: “The approach we are proposing gives providers maximum financial incentive to deliver the elective activity targets they are being set.”
    Read full story (paywalled)
    Source: HSJ, 23 December 2022
  12. Sam
    German public research funder Deutsche Forschungsgemeinschaft (DFG) is conducting an audit of the clinical trials it has supported in the past. The audit was announced in response to a request from TranspariMED asking DFG for a list of all its trials completed between 2009 and 2017, to which DFG replied that it currently has no such comprehensive dataset.
    DFG stated that it is "currently preparing an evaluation of its clinical trials programme. In the framework of this evaluation the data you requested will be collected and analysed, as the outcomes of trials supported by DFG is of high interest including for DFG itself."
    TranspariMED, an organisation which aims to end evidence distortion in medicine, sees this development as a good opportunity for DFG to check whether and when clinical trials were registered and their results made public.
    Previous research has shown that nearly a third of German academic trials never make their results public.
    This not only wastes public money, but also harms patients because it leaves gaps in the evidence base on the efficacy and safety of drugs, medical devices, and non-drug treatments.
    Due to gaps in German law, there is still no legal obligation to make the results of many German clinical trials public.
    Read full story
    Source: TranspariMed, 20 December 2022
  13. Sam
    Vulnerable patients, including some children, have faced long delays for a suitable bed as organisations argue over whose responsibility it is to fund and deliver their care, HSJ understands.
    In a letter outlining winter arrangements, NHS England has warned trust leaders and commissioners against delaying emergency mental health admissions – typically needed when a patient is away from home, and understood to be more common over the Christmas period – while determining which area has which responsibility.
    National mental health director Claire Murdoch wrote: “It is not acceptable to delay an emergency mental health admission while determining which area has clinical and financial responsibility for the care of an individual.”
    She added such admissions should be arranged “as quickly as possible, and without delay caused by any financial sign-off process”. 
    It comes as HSJ has been told patients can often end up waiting for several days in emergency departments or in “inappropriate” out of area or acute beds when disputes occur over who is responsible for their care.
    Read full story (paywalled)
    Source: HSJ, 15 December 2022
  14. Sam
    Nearly 8,900 more people have died of cancer than expected in Britain since the start of the pandemic, amid calls for the Government to appoint a minister to deal with the growing crisis. 
    In an essay in The Lancet Oncology, campaigners and medics said the upward trend of cancer deaths is likely to continue, with 3,327 in the last six months alone. 
    They urged the Government to tackle the crisis with the same focus and urgency given to the Covid vaccine rollout, and called for a cancer minister to get on top of the backlog.
    NHS data from November showed that in the last 12 months, 69,000 patients in the UK have waited longer than the recommended 62-day wait from suspected cancer referral to start of treatment.
    Professor Gordon Wishart, a former cancer surgeon and chief medical officer of Check4Cancer, said: “The Covid-induced cancer backlog is one of the deadliest backlogs and has served to widen the cracks in our cancer services". 
    “Now we face a deadly cancer timebomb of treatment delays that get worse every month because we don’t have a sufficiently ambitious plan from policymakers. I urge the Government to work with us.”
    Read full story (paywalled)
    Source: The Telegraph, 15 December 2022
  15. Sam
    The Royal College of Midwives (RCM) has not met thresholds required to strike in its vote, it announced today, but physiotherapy staff are set to strike at more than 100 trusts in their first ever action ballot over pay.
    The trade union announced this afternoon that its ballot had not reached the turnout required to take strike action. 88& of those who voted said they supported strike action, but only about 47% of eligible members voted. Law requires a turnout of at least 50%, the RCM said.
    It comes as nurses prepare to take industrial action on 15 and 20 December, over pay and safety concerns, with ambulance staff across the GMB Union, Unison and Unite set to walk out on 21 December (and GMB also on 28 December).
    Read full story (paywalled)
    Source: HSJ, 13 December 2022
  16. Sam
    The government is setting up 19 more diagnostic centres in communities across England to help tackle the Covid backlog.
    Ninety one are already open and have delivered more than 2.4 million tests, checks and scans since last summer, ministers say.
    It is hoped the centres will speed up access to services for patients, thereby reducing waiting times.
    Seven million people in England are now waiting for hospital treatment.
    GPs can refer patients to community diagnostic centres so that they can access life-saving checks and scans, and be diagnosed for a range of conditions, without travelling to hospital.
    Some are located in football stadiums and shopping centres and can offer MRI and CT scans, as well as x-rays.
    In September, according to the government, the hubs delivered 11% of all diagnostic activity - and its ambition is for 40% to be achieved by 2025.
    Read full story
    Source: BBC News, 7 December 2022
  17. Sam
    Ministers have been urged to launch a public inquiry into the care of mental health patients after The Independent revealed allegations that patients had suffered “systemic abuse” in inpatient units.
    A joint investigation with Sky News found that teenagers at facilities run by The Huntercombe Group had been left with post-traumatic stress disorder by their treatment despite hundreds of warnings to regulators and the NHS.
    Now the government is facing calls to review all mental health care services over fears that these cases are “the tip of the iceberg”.
    Labour’s shadow mental health minister Dr Rosena Allin-Khan has called for a “rapid review” by the government into inpatient mental health services, while Deborah Coles, the chief executive of charity Inquest, has called on the new health secretary Steve Barclay to launch a statutory public inquiry.
    Read full story
    Source: The Independent, 28 October 2022
  18. Sam
    Parents are being urged to get their young children vaccinated against flu as data suggests hospitalisation rates among under-fives have almost doubled in England in the space of two weeks.
    Data suggests the UK could face a triple whammy of respiratory illness this winter. While experts are concerned there could be another Covid wave, levels of both flu and respiratory syncytial virus (RSV) are increasing. The latter is a common winter virus that typically affects young children and can cause bronchiolitis.
    Dr Conall Watson, consultant epidemiologist for the UK Health Security Agency (UKHSA), said hospital admission rates for flu had risen in recent weeks and were highest in children under five.
    “Already this year a small number of young children have needed intensive care. Please book your preschooler in for flu vaccine at your GP surgery as soon as you can,” he said. “Flu nasal spray vaccine is also currently being offered to all primary school children and will be available for some secondary school years later this season.”
    Read full story
    Source: The Guardian, 28 October 2022
  19. Sam
    Researchers in the US have found a genetic link between people with African ancestry and the aggressive type of breast cancer. They hope their findings will encourage more black people to get involved in clinical trials in a bid to improve survival rates for people with the disease.
    Triple negative breast cancer (TNBC) is more common in women under 40 and disproportionately affects black women.
    A study published in the journal JAMA Oncology found that black women diagnosed with TNBC are 28% more likely to die from it than white women with the same diagnosis.
    Now a new study has confirmed a definitive genetic link between African ancestry and TNBC. Lisa Newman, of Weill Cornell Medicine, has been part of an international project studying breast cancer in women in different regions of Africa for 20 years.
    She says representation of women with diverse backgrounds on clinical trials is absolutely critical.
    "Unfortunately, African-American women are disproportionately under-represented in cancer clinical trials and we see this in the breast cancer clinical trials as well," says Dr Newman.
    "If you don't have diverse representation, you don't understand how to apply these advances in treatment.
    "Part of it is because there is some historic mistrust of the healthcare system.
    "We do continue to see systemic racism in the healthcare delivery system where it has been documented, tragically, that many cancer care providers are less likely to offer clinical trials to their black patients compared with their white patients."
  20. Sam
    More than 900 invitees converged on Manchester Central last night to find out which projects would emerge winners in the latest edition of our Patient Safety Awards.
    The awards recognise and reward the hard-working teams and individuals who, in these times of austerity, pay restraints and workforce shortages, are striving to deliver improved patient care.
    HSJ correspondent Annabelle Collins gave a welcome speech before comedian and writer Justin Moorhouse hosted the event, which was held at the end of the first day of the Patient Safety Congress.
    Ms Collins said: “Not only are you treating more and more patients, in difficult circumstances, you’re treating them safely and innovating during a time when the health service is being told by the government to be more efficient. To do more, with less. I think this makes your work and achievements even more special.
    This year, the awards were presented under four key areas:
    Clinical and specialist excellence; Enacting organisation-wide change; Proactive prevention and harm avoidance; and Service/system innovation. Read about the winners
    Source: HSJ, 25 October 2022
  21. Sam
    An endometriosis sufferer has said her reproductive organs are so damaged by a three-year delay for surgery, it has affected her ability to have children.
    Claire Nicholls, 29, has been in pain for years with the condition - which involves tissue similar to the lining of the womb growing elsewhere.
    Ms Nicholls said she was passed from "pillar to post" and for 10 years, medical professionals did not seem to believe how much pain she was actually in.
    She has stage four endometriosis, which is the most severe and widespread.
    "The pain can be excruciating, at times I can't get out of bed and I have also had to attend the emergency department," she said.
    After opting to go private, her surgeon said he was unable to see many of her organs due to the amount of scarred tissue caused by the delay in surgery.
    "He told me the scarred tissue and adhesions were all around my organs... they couldn't remove it all as it could have damaged other organs including my bladder - it was just too severe," she said.
    Northern Ireland has the longest gynaecological waiting lists in the UK, according to a professional body. It is calling for two regional endometriosis centres.
    The report from the Royal College of Obstetricians and Gynaecologists found 36,900 women in Northern Ireland are on a gynaecology waiting list - a 42% increase since the start of the pandemic.
    Read full story
    Source: BBC News, 25 October 2022
  22. Sam
    Hospitals “desperate” to free up beds could be putting patients in danger, The Independent has been told.
    NHS trusts are being forced into “risky behaviours” in the push to free up hospital beds and A&E departments, experts have warned.
    It comes as new data reveals that waits for ambulance crews outside hospitals hit 26 hours in September, with more than 4,000 patients likely to have experienced severe harm due to delays.
    In documents leaked to The Independent, hospital leaders in Cornwall warned staff that current pressures in its emergency care system combined with ambulance delays have “tragically resulted in deaths”.
    Royal Cornwall Hospitals Trust and the Cornwall Partnership NHS Foundation Trust said in the document that ambulance delays and waits in A&E were causing a “risk to life”, and that as a result they were planning to begin discharging patients into the care of the voluntary sector.
    The document said: “It is likely that the risk of such support not meeting all the patients’ individual requirements is less than the risk to life currently experienced in the community when there are significant handover delays at the hospital front doors.”
    It comes as North West Ambulance Service launched an investigation after a patient died waiting in the back of an ambulance outside A&E, the Manchester Evening News reported.
    Read full story
    Source: The Independent, 24 October 2022
  23. Sam
    Trust chief executives risk becoming “prisoners” of organisations with poor cultures if they do not “step back and see the bigger picture”, a former chief inspector of hospitals has said.
    Ted Baker said he was “tired” of people getting angry about cultural problems in the NHS while doing nothing to change it, amid an appeal for “less anger and more thoughtful interventions”.
    He told HSJ’s Patient Safety Congress greater understanding was needed about what will change culture, and working to do so, rather than “rail against the culture in the way people do all the time”.
    Professor Baker said: “One of my real concerns is that we often end up criticising individuals in organisations because they, if you like, embody the ‘wrong’ culture.
    “But many individuals are often prisoners of the culture themselves, but we don’t see that.
    “You put a chief executive into an organisation with a poor culture, if they don’t have the wisdom and the vision to step back and see the bigger picture, they could become trapped in the culture themselves.”
    Read full story (paywalled)
    Source: HSJ, 24 October 2022
  24. Sam
    The NHS in Wales needs to "speed up the process" of treating people waiting over two years for hospital treatment, the health minister said.
    Eluned Morgan said health boards need to prioritise the "longest waiters and they're not always doing that".
    There are 59,350 people waiting over two years in Wales, although the number has fallen for a fifth month in a row.
    The Welsh NHS Confederation, which represents NHS health organisations, has been asked to comment.
    In Wales, there are 183,450 operations and procedures waiting more than a year.
    Overall waits - from referral to treatment - have passed 750,000.
    Scotland has 7,650 patients waiting more than two years, England has 2,646.
    Asked on BBC Politics Wales why so many more people are waiting longer in Wales, Ms Morgan said: "Our health boards need to make sure that they're taking people from the longest waiters and they're not always doing that."
    Read full story
    Source: BBC News, 23 October 2022
  25. Sam
    Research led by Trinity College in Ireland has found that a regulation which came into effect in May 2021 with the aim of improving the oversight of medical devices in Ireland is leading to unintended consequences which may put some surgeries for children, and the treatment of rare diseases, at risk. The study has been published in the journal Pediatric Cardiology.
    Medical devices include a great diversity of technologies, which are evaluated and approved in the European Union (EU) according to a revised law that came into effect on 26 May 2021, known as the Medical Device Regulation or MDR (EU 745/2017). It has a transition period that allows products that were approved under the previous rules (the EU Medical Device Directives) to continue to be marketed until 26 May 2024 at the latest. As a result of a series of unforeseen factors, there is a possibility that the MDR may result in products becoming unavailable, with the consequent risk of a loss of some interventions that are reliant upon those devices. Devices that are used for orphan or paediatric indications are particularly vulnerable to this.
    The paper provides an example of one device, the Rashkind balloon catheter, first developed by Dr William Rashkind in 1966 to open the upper chambers in the heart in neonates with congenital heart disease. A number of these balloons were once available in Europe and now there is only one. This device may become unavailable next year. If this happens, it will not be possible to continue this procedure, and alternative surgeries or treatments are far less optimal. The paper also describes the timeline and cost of bringing the device to market in the EU, the US and Canada, and the cost and time needed to access the EU market has become much greater. 
    Researchers believe there is now an urgent need for policy to be developed to protect essential medical devices for orphan indications and for use in children, to ensure that necessary interventions can continue, and to ensure a more sustainable system in Europe over the longer term.
    Read full story
    Source: Trinity College Dublin, 20 October 2022
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