Thursday 31 August 2017

NHS hospitals deeper in the red than reported, new analysis shows

NHS hospitals deeper in the red than reported, new analysis shows NHS trusts ended last year with an underlying overspend almost £3 billion more than was reported in their official accounts, according to new analysis by the Nuffield Trust think tank. Without more funding for the NHS, hospitals are unlikely to recover any time soon from a mismatch between the money they receive and the cost of providing patient care, the research shows.

The briefing, is based on analysing the accounts and financial data published by NHS regulators. By stripping out temporary funding boosts and one-off savings, it finds that NHS trusts ended last year (2016/17) with an underlying overspend of £3.7 billion. This was far higher than the £791 million reported by NHS regulators.

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Clinical artificial intelligence: on the brink of a digital revolution?

Clinical artificial intelligence: on the brink of a digital revolution? Ahead of The King’s Fund’s festival of ideas to inspire and challenge the future of health care, Hugh Harvey, Clinical Artificial Intelligence and Predictive Analysis Researcher at King's College London, imagines a world in which artificial intelligence has transformed frontline care.

Only 1 in 10 MPs in England believe the social care system is fit for purpose for the UK’s ageing population

Only 1 in 10 MPs in England believe the social care system is fit for purpose for the UK’s ageing population Only 1 in 10 MPs in England (10%) believe that the current social care system is suitable for the UK’s ageing population. And 86% of MPs in England believe a cross-party consensus is needed for a lasting settlement on health and social care. That’s according to a new poll of 101 MPs of all parties representing constituencies in England commissioned by Independent Age, the older people’s charity.

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Guidance: Prevention concordat for better mental health: planning resource

Guidance: Prevention concordat for better mental health: planning resource The Prevention Concordat for Better Mental Health is underpinned by an understanding that taking a prevention-focused approach to improving the public’s mental health is shown to make a valuable contribution to achieving a fairer and more equitable society.

This resource has been developed to help local areas put in place effective arrangements to promote good mental health and prevent mental health problems. It does so by offering a 5-part framework of focus for effective planning for better mental health.

It also highlights a range of actions and interventions that local areas can take to improve mental health and tailor their approach. This includes illustration through practice examples and links to further supporting resources. Public Health England

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Acid attacks: NHS offers public advice on how to respond

Acid attacks: NHS offers public advice on how to respond The NHS and burns specialists are giving official advice to the public on how to provide first aid after an acid attack.

While still rare, the number of attacks using corrosive substances is rising.

The health service said the assaults were medical emergencies and people should call 999 immediately.

Contaminated clothing should be carefully removed and affected skin rinsed in running water until help arrives. BBC News

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Serious ambulance incidents include rape allegation and 'lost keys' death

Serious ambulance incidents include rape allegation and 'lost keys' death "Serious incidents" involving ambulances - including an alleged rape and a patient dying after vehicle keys were "lost" - have risen by 16% in five years.

The number of such events rose in seven of England's 10 ambulance areas.

Unison said the rise reflected "intolerable pressures" facing ambulance workers.

The Association of Ambulance Chief Executives said the incidents amounted to a "tiny" number of patient journeys.

"Serious incidents" (SIs) are defined by the NHS as "adverse events" needing a "heightened level of response". BBC News

US approves breakthrough leukaemia treatment that 'weaponises' blood cells to attack cancer

US approves breakthrough leukaemia treatment that 'weaponises' blood cells to attack cancer Opening a new era in cancer care, US health officials have approved a breakthrough treatment that genetically engineers patients' own blood cells into an army of assassins to seek and destroy childhood leukaemia.

The Food and Drug Administration called the approval historic, the first gene therapy to hit the US market. Made from scratch for every patient, it's one of a wave of “living drugs” under development to fight additional blood cancers and other tumours, too.

Novartis Pharmaceuticals set the price for its one-time infusion of so-called “CAR-T cells” at $475,000, but said there would be no charge for patients who didn't show a response within a month. The Independent

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We need action to address the mental health crisis, not more empty words

We need action to address the mental health crisis, not more empty words Theresa May and her ministers now talk the talk. But government policies helped to fuel a problem they can no longer ignore

Front page articles on mental health have become a regular occurrence. This week we learned that Britain’s biggest police force received a phone call relating to mental health every five minutes last year. And James Munby, head of the high court’s family division, hit the headlines this month referring to the case of girl X – a suicidal teenager for whom no secure bed was available. Munby wrote: “If this is the best we can do for X, and others in similar crisis, what right do we, what right do the system, our society and indeed the state itself, have to call ourselves civilised?”

We cannot afford to ignore the well-established link between social inequality and mental ill health Continue reading... The Guardian

UK needs to act urgently to secure NHS data for British public, report warns

UK needs to act urgently to secure NHS data for British public, report warns Algorithms based on NHS records could seed an ‘entirely new industry’ in AI-based diagnostics and mint billions for tech companies, strategic review reveals

The government must act urgently to ensure that patients and UK taxpayers – not tech companies – gain most from new commercial applications of NHS data, an independent review of the UK life sciences industry has said.

Sir John Bell, a professor of medicine at Oxford university who led the government-commissioned review, said that NHS patient records are uniquely suited for driving the development of powerful algorithms that could transform healthcare and seed an “entirely new industry” in AI-based diagnostics. Continue reading... The Guardian

Life-saving flu vaccines at heart of 160 million boost for life sciences

Life-saving flu vaccines at heart of 160 million boost for life sciences A new national centre to investigate cures for influenza will be at the heart of a £160 million Government boost for the UK’s research sector, ministers will announced.

The facility is also expected to manufacture large-scale vaccines to tackle polio and a host of other illnesses.

The announcement coincides with the publication of a review recommending the future strategy for Britain’s £64 billion life sciences industry as the UK prepares to leave the EU. The Daily Telegraph

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New national database for all child deaths planned

New national database for all child deaths planned A ll child deaths will be recorded onto a new national database in a bid to share information aimed at saving young lives, officials are reportedly planning.

The shake-up is being designed to overhaul the current system of local review panels which critics say squander the opportunity to learn lessons.

According to documents seen by the Health Service Journal, the Department for Education, which oversees the current system, will be stripped of its role and a new national database established by the Department of Health. The Daily Telegraph

Wednesday 30 August 2017

Guidance: Health matters: making cervical screening more accessible

Guidance: Health matters: making cervical screening more accessible Attendance for cervical screening has been falling year on year. This professional resource aims to address this decline in attendance by presenting recommendations that can help increase access to screening and awareness of cervical cancer. Public Health England

P.F.I. - Profiting From Infirmaries

P.F.I. - Profiting From Infirmaries This report looks at the significant profits made by PFI companies from NHS contracts over the last 6 years. Centre for Health and the Public Interest

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Divided by choice? Private providers, patient choice and hospital sorting in the English National Health service

Divided by choice? Private providers, patient choice and hospital sorting in the English National Health service This study examines the impact of the NHS reforms of the 2000s which enabled privately-owned hospitals to enter the NHS market. It finds that post-reform, poor and ethnic minority patients were much less likely to choose private hospitals; and that the key factors in choice related to the geographic distribution of hospitals and health-based criteria for treatment from private providers. Institute for Fiscal Studies

Two thirds of GPs say revalidation has not benefited their clinical practice

Two thirds of GPs say revalidation has not benefited their clinical practice Two in three GPs do not believe that revalidation has had a positive impact on their clinical practice, a GPonline poll has found.

Mental health patients should have more rights to refuse treatment, senior judge suggests

Mental health patients should have more rights to refuse treatment, senior judge suggests Mentally ill people should have more power to decide whether or not they want to receive treatment, one of Britain's most senior judges has said.

Judge Mark Hinchliffe, who oversees England's mental health tribunals, said patients should have the "right to self-determination, even if their decisions seem unwise".

He suggested that those who had the capacity should be able to refuse treatment, even if they have been diagnosed with mental health problems which currently mean they can be treated without their agreement. The Daily Telegraph

Metal sterilisation implant leaves women in 'suicidal' pain and some requiring hysterectomies

Metal sterilisation implant leaves women in 'suicidal' pain and some requiring hysterectomies Hospitals have been warned to stop using a metal implant to sterilise women after patients were left in agony and required hysterectomies to remove the devices.

Recipients of the Essure implant have reported “suicidal” desperation and significant hair loss, as it emerged the product’s manufacturer has asked doctors to suspend its use.

UK regulators have also faced criticism for failing to ban the device and refusing to reveal how many women have reported problems. The Daily Telegraph

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Tuesday 29 August 2017

Corby Mind opens ‘crisis cafe’ for those with mental health conditions

Corby Mind opens ‘crisis cafe’ for those with mental health conditions A new project aiming to support people with mental health conditions has opened in Corby.

The Sanctuary @ Corby Mind has opened The Sanctuary Crisis Cafe, at 18 Argyle Street, Corby, which will be open for three evenings a week (Thursdays 6pm to 10pm, Fridays and Saturdays 7pm to 11pm) and a Sunday late afternoon (3pm to 7pm).

During these hours residents are free to drop in and sit and chat with the Mind team over a hot drink. Northamptonshire Telegraph

Learning from human guinea pigs: creating open, supportive organisational cultures

Learning from human guinea pigs: creating open, supportive organisational cultures As well as being the 50th anniversary of Sgt Pepper’s Lonely Hearts Club Band, the legalisation of abortion and the partial de-criminalisation of homosexuality, 2017 marks 50 years since the publication of Human guinea pigs: experimentation on man, which lifted the lid on unethical medical research. The King's Fund

Measuring quality of health care in the NHS: Giving a voice to the patients

Measuring quality of health care in the NHS: Giving a voice to the patients The high profile role that the NHS played in Brexit and recent general election campaigns demonstrates that the health care system remains foremost in the minds of all political parties when considering how to present their policies.

These campaigns put a spotlight on the sustainability of the health care system, but may have also fuelled a fear over deteriorating health system performance. The Health Foundation

Guidance: NHS funds held on trust

Guidance: NHS funds held on trust This guidance gives an introduction to the general principles determining the financial responsibilities of trustees of NHS charities. It outlines how funds held on trust are handled and managed, including the processes for transferring funds to other bodies. Department of Health

A toolkit for school nurses

A toolkit for school nurses This toolkit provides school nurses with information, examples of good practice, templates and useful websites to support and develop professional practice. It considers varying policy and practice which applies across the UK and the range of settings in which school nurses work. Royal College of Nursing

Virtual reality game takes on dementia

Virtual reality game takes on dementia Scientists have developed a virtual reality computer game as part of the world's biggest dementia research experiment.

It is designed to test one of the first things to go with dementia - the ability to navigate.

The original smartphone app had 3 million players, but the move to virtual reality should allow scientists to investigate in greater detail.

Alzheimer's Research UK says the goal is a new way of diagnosing the disease. BBC News

Operations cancelled as cyber attack hits NHS Lanarkshire hospitals and GPs

Operations cancelled as cyber attack hits NHS Lanarkshire hospitals and GPs Operations have been cancelled after hospitals and GP practices run by NHS Lanarkshire were hit by a cyber-attack.

The health board confirmed malicious software had been detected in IT systems, causing appointments and procedures to be postponed.

It said it "took immediate action" to put a solution in place and minimise disruption. Patients are asked not to attend hospital unless it is essential.

It is unclear whether the health board was deliberately targeted. BBC News

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Police dealing with record level of phone calls on mental health

Police dealing with record level of phone calls on mental health Forces left to pick up pieces, with senior officer saying cuts and rising demand mean NHS is struggling to cope

Britain’s biggest police force received a phone call relating to mental health every five minutes last year, an escalating level of demand caused by NHS services struggling to cope.

The number of calls handled by the Metropolitan police in which someone was concerned about a person’s mental health hit a record 115,000 in the last year: on average 315 a day, or about 13 an hour.

A woman on crutches walked a mile to smash a shop window in Hereford, then called the police herself, believing that was the best way to get access to mental health services. Continue reading... The Guardian

Jeremy Hunt continues war of words with Stephen Hawking over NHS

Jeremy Hunt continues war of words with Stephen Hawking over NHS Health secretary says scientist is ‘once again wrong in his characterisation of policy’ after Hawking’s latest criticism

The battle of words between the scientist Stephen Hawking and the health secretary, Jeremy Hunt, over the health of the NHS has continued with Hunt writing that Hawking “is once again wrong in his characterisation of government policy towards the NHS”.

On Saturday, after a week of angry exchanges, Hawking wrote in the Guardian: “Hunt’s statement that funding and the number of doctors and nurses are at an all-time high is a distraction. Record funding is not the same thing as adequate funding. There is overwhelming evidence that NHS funding and the numbers of doctors and nurses are inadequate, and it is getting worse.” Continue reading... The Guardian

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Online pharmacy targets patients with 'confusing' marketing blitz

Online pharmacy targets patients with 'confusing' marketing blitz Britain’s largest online pharmacy has been accused of “blitzing” people with unsolicited marketing material which some patients may confuse for official NHS correspondence.

Patients have reported mistakenly signing up to Pharmacy2U’s repeat prescription service thinking they have been contacted by their local GP surgery or high street chemist, meaning longstanding prescription arrangements are automatically cancelled.

The Sunday Telegraph understands that in some cases, people have received up to four letters in a matter of weeks, making them believe they must act urgently to avoid losing access to medication.

Hospital to screen all newborns for genetic diseases

Hospital to screen all newborns for genetic diseases A major project at Liverpool Women's NHS Foundation Trust will screen the newborns for inherited conditions or illnesses and provide early treatment. The Daily Mail

Friday 25 August 2017

REVEALED: The best and worst GP surgeries in East Northamptonshire as rated by you

REVEALED: The best and worst GP surgeries in East Northamptonshire as rated by you Irthlingborough’s Spinney Brook Medical Centre is the best GP surgery in East Northamptonshire, according to the results of a patient survey.

The High Street practice came out on top with 95 per cent of patients who go there saying they had a ‘good’ experience.

Nene Valley Surgery in Thrapston came second with 92 per cent echoing the good impression. Northamptonshire Telegraph

Yarn bombers cover Corby Urgent Care Centre

Yarn bombers cover Corby Urgent Care Centre Staff and visitors at Corby’s Urgent Care Centre were given a surprise this morning after turning up to see it covered in knitted decorations. Northamptonshire Telegraph

Developing accountable care systems Lessons from Canterbury, New Zealand

Developing accountable care systems Lessons from Canterbury, New Zealand Canterbury District Health Board (DHB) is responsible for planning, organising, purchasing and providing health and care services for the largest and most highly populated region of New Zealand’s South Island. Like other health systems around the world, Canterbury has faced growing demand for hospital care, and a review in 2007 highlighted unaffordable projections for future hospital demand, poor performance in emergency and elective care, and financial deficits. To address these pressures, Canterbury DHB set out to transform the health system, fundamentally redesigning ways of working. The King's Fund

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Primary Care Home: Evaluating a new model of primary care

Primary Care Home: Evaluating a new model of primary care This is an evaluation report for the Primary Care Home (PCH) model – a way of organising care for groups of 30,000 to 50,000 patients. It was developed by the National Association of Primary Care (NAPC), which commissioned this report.

Established last year, the model seeks to link staff from general practice, community-based services, hospitals, mental health services, social care and voluntary organisations to deliver joined-up care. The model was piloted in 15 rapid test sites, each of which qualified for £40,000 of start-up funding from NHS England. Since then another 170 sites have signed up.

Our formative evaluation was based on reviews in 2016/17 of 13 rapid test sites’ plans and priorities for building the PCH model, and an in-depth look at the progress and early successes in three case study areas.

The report looks at how sites can make early progress with implementing and evaluating their local PCH models, examines what might stand in the way of change and offers a number of broader lessons for the NHS as a whole. The Nuffield Trust

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On the road to Health 2020 policy targets: monitoring qualitative indicators - an update

On the road to Health 2020 policy targets: monitoring qualitative indicators - an update This report shows an overall improvement in the implementation of Health 2020 values and principles in the countries of the WHO European Region. Between 2010 and 2016, the share of responding countries that had policies addressing inequalities increased from 88 per cent to 98 per cent. Those that aligned national policies with Health 2020 also increased during this period, from 58 per cent to 92 per cent. World Health Organization

Home Care: what people told Healthwatch about their experiences

Home Care: what people told Healthwatch about their experiences Over the last year, the number of local Healthwatch citing improvements to home care services as a priority for their community has doubled. The new report explains what people have told Healthwatch about their experience of home care.

Stopping conflict 'boiling over' at children's hospitals

Stopping conflict 'boiling over' at children's hospitals In his final ruling on the distressing and tortuous legal case of baby Charlie Gard, the High Court judge said last month that mediation should be tried in all such cases.

Is it possible to defuse conflict between parents and hospital staff in these highly charged situations?

A project that began at Evelina Children's Hospital, in London, might hold some answers.

It has also been applied in Southampton, where the children's hospital was at the centre of a political and media firestorm three years ago. BBC News

Female veterans' mental health 'overlooked'

Female veterans' mental health 'overlooked' A much smaller proportion of female veterans are accessing mental health support than their male counterparts, the charity Forward Assist has said.

It says there is a "hidden population" of ex-servicewomen with mental health issues, which it is looking to support. BBC News

Portsmouth hospital 'fed patients pills in ice cream'

Portsmouth hospital 'fed patients pills in ice cream' Hospital staff secretly fed pills to patients by hiding them in their meals and in ice cream, the health watchdog has found.

Queen Alexandra Hospital in Portsmouth has been given a formal warning by the Care Quality Commission over its "very poor care".

In a separate incident, inspectors had to intervene and help a choking patient when two staff members failed to act.

The hospital said it was confident it would be able to improve.

Inspectors, who visited in February, rated medical care at the hospital as "inadequate". BBC News

Government cuts have caused 'human catastrophe' for disabled, UN committee says

Government cuts have caused 'human catastrophe' for disabled, UN committee says Government welfare cuts have created a “human catastrophe” for disabled people in the UK, the chairwoman of an influential United Nations committee has said.

Theresia Degener, who leads the UN's Committee on the Rights of Persons with Disabilities (CRPD), said the UK Government has “totally neglected” disabled people.

Ministers are also accused of misleading the public about the impact of Government policies by refusing to answer questions and using statistics in an unclear way. The Independent

NHS accused of keeping secret its plans to cut services

NHS accused of keeping secret its plans to cut services Campaigners say freedom of information requests to NHS trusts and government have been turned down

The NHS has been accused of keeping the public in the dark about controversial plans to plug a £250m funding gap by rationing services.

The crowdfunded campaign group 38 Degrees submitted freedom of information (FOI) requests to the government, NHS leaders as well as trusts and clinical commissioning groups in the 13 areas affected but all except two refused to release details of planned changes. Continue reading... The Guardian

The NHS saved my little sister – so I decided to become a doctor

The NHS saved my little sister – so I decided to become a doctor A trip to accident and emergency as an eight-year-old 32 years ago was the inspiration for my career

For many doctors in the UK, this time of the year is the anniversary of the start of our careers. For me, 2017 is also the 32nd anniversary of the event that determined why I became a doctor.

In 1981, when my sister wasn’t even one year old, she contracted epiglottitis. She was very sick and was treated at Raigmore hospital in Inverness. She recovered but, four years later, in August 1985, she became sick again with a runny nose, fever, and raspy breathing. I was eight, but I remember that she looked toxic. Continue reading... The Guardian

School nurse shortage 'putting children's lives at risk'

School nurse shortage 'putting children's lives at risk' Royal College of Nursing calls on government and local authorities to properly fund school nursing services

Children’s lives are being put at risk because of the shortages of school nurses, experts have warned.

Austerity measures have resulted in more than 500 school nurses leaving the profession without being replaced. Continue reading... The Guardian

Half of hospital admissions for alcohol are baby boomers

Half of hospital admissions for alcohol are baby boomers Younger Britons are drinking far less than previous generations but alcohol is still a key part in the lives of their parents, they say. The Daily Mail

Thursday 24 August 2017

NSPCC refers four children a week to Northamptonshire authorities due to concerns over neglect

NSPCC refers four children a week to Northamptonshire authorities due to concerns over neglect The NSPCC refers an average of four reports of child neglect every week to police and social services in Northamptonshire.

Between 2016 and 2017 the NSPCC Helpline dealt with 224 reports in this way following calls or emails from concerned adults about children in Northamptonshire. There were a further 19 contacts requesting advice about a child possibly facing neglect in the county during 2016 and 2017. Northamptonshire Telegraph

A&E warning after KGH has busiest day of year

A&E warning after KGH has busiest day of year KGH has warned people not to use A&E unless it is an absolute emergency over the bank holiday after medics had their busiest day of the year. Northamptonshire Telegraph

Tearing up the rulebook: legislation and new care models

Tearing up the rulebook: legislation and new care models Over the past five years, the government and national NHS bodies have conducted a unique experiment: running health services as a planned system against the backdrop of a contradictory legislative framework, one that envisages arm’s length contracting relationships between purchasers and providers, independent provider organisations, and a significant role for competition. In doing so, they have turned their backs not just on the Health and Social Care Act 2012, but on almost three decades of reforms: separate commissioners, foundation trusts, payment for activity and patient choice among others. The King's Fund

Community health creation in Cliftonville West

Community health creation in Cliftonville West A group of residents in Cliftonville West, one of the poorest areas of Kent and the UK, has shown how engaging communities in their own development can achieve significant improvements in residents’ lives and wellbeing in just a few years.

The creation of residents group A Better Cliftonville (ABC) in 2013 has enabled the community to take ownership of problems impacting on their quality of life, and provided a framework for them to work together with local agencies to address these. The Health Foundation

Guidance: Regenerative medicine: government response to Science and Technology Committee inquiry

Guidance: Regenerative medicine: government response to Science and Technology Committee inquiry This document is the government’s response to the House of Commons Science and Technology Committee report of 28 April 2017

Regenerative medicine involves replacing or regenerating tissues or organs in the human body, in order to restore or establish normal function. Examples include stem cell therapy, gene therapy and tissue engineering.

The response shows how the government is working to create an integrated environment that allows the delivery of therapies and supports the development of a world-leading regenerative medicine industry industry in the UK. Department of Health

Can Transparency and Technology Make Us Healthier?

Can Transparency and Technology Make Us Healthier? There are many factors driving the recent push for greater transparency in health care, from the desire to identify waste and reward high-quality, low-cost care to an attempt to close the information gap between patients and physicians. For more than 15 years the Transparency Policy Project, an interdisciplinary group based at the Harvard Kennedy School, has been studying policies that mandate information disclosure as a tool to curb risks to the public, such as exposure to pollutants, and to improve public services. The Commonwealth Fund

Middle-aged told to walk faster

Middle-aged told to walk faster Middle-aged people are being urged to walk faster to help stay healthy, amid concern high levels of inactivity may be harming their health.

Officials at Public Health England said the amount of activity people did started to tail off from the age of 40.

They are urging those between the ages of 40 and 60 to start doing regular brisk walks.

They say just 10 minutes a day could have a major impact, reducing the risk of early death by 15%.

But PHE estimates four out of every 10 40- to 60-year-olds take a brisk 10-minute walk less frequently than once a month. BBC News

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'Lack of publicity' leaves GPs unaware of government's Fit for Work scheme

'Lack of publicity' leaves GPs unaware of government's Fit for Work scheme Around two-thirds of GPs have not referred a single person under the government's flagship Fit for Work programme in the past year, a survey by GPonline suggests.

Every extra patient on a nurse's caseload increases death risks 

Every extra patient on a nurse's caseload increases death risks Patients are 14 per cent more likely to die on wards with just two extra cases per nurse, a major study warns.

The research by Southampton University found far higher death risks in understaffed hospitals.

The average hospital has around eight patients per nurse, but some have to cope with as many as 18 patients at a time, the study shows.

The research, involving 31 NHS trusts, found that every extra patient on a nurse’s caseload increased mortality rates by seven per cent.

It found that short-staffing meant that crucial tasks - such as administering medicines, and detecting that patients were deteriorating - went undone. The Daily Telegraph

NHS hospital dispenses baby medicine six months out of date

NHS hospital dispenses baby medicine six months out of date An NHS hospital has apologised after dispensing medicine for a baby that was six months beyond its use-by date.

Kent and Canterbury Hospital also admitted it had other out-of-date boxes of the same medication, Gaviscon, on its shelves.

Four-month-old Phoebe Nightingale was given the expired medication to treat severe reflux earlier this month.

An internal investigation was sparked when her furious mother pointed out to staff that the medicine’s use-by date expired two months before her daughter was even born. The Daily Telegraph

Safety concerns at hospital favoured by Royal Family after four deaths from 'clinical incidents'

Safety concerns at hospital favoured by Royal Family after four deaths from 'clinical incidents' Watchdogs have raised safety concerns about the private hospital favoured by the Royal Family after it emerged four people died due to “clinical incidents”.

King Edward VII hospital, in Marylebone, London, has been ordered to improve following inspections by the Care Quality Commission.

The regulator found the hospital kept no medical records of its outpatients and that doctors were failing to follow basic cleanliness rules to prevent infections.

The institution was rated as “requires improvement”, the second lowest of four possible categories, and issued two formal notices for breach of regulations. The Daily Telegraph

Students must get meningitis vaccination before university

Students must get meningitis vaccination before university Public Health England (PHE) said cases of meningitis caused by the meningococcal W strain are still rising in the UK - as the disease spreads across the world. The Daily Mail

Wednesday 23 August 2017

Jeremy Hunt 'hugely disappointed' to learn about concerns amid volunteer service calling time at Northampton General Hospital

Jeremy Hunt 'hugely disappointed' to learn about concerns amid volunteer service calling time at Northampton General Hospital The secretary of state for health has called disruption to 'vital' hospital volunteers 'highly regrettable' following a parking dispute with a charity group and Northampton General Hospital.

The Friends of Northampton General Hospital (NGH) - a service who man three reception desks and assist outpatients - are winding up their 28-year-strong volunteer group on August 31 after the group had their free parking privileges withdrawn by the hospital in a recent review. Northampton Chronicle and Echo

Northampton hospital hit by delays in diagnosing cancer inside 'crucial' 62-day target

Northampton hospital hit by delays in diagnosing cancer inside 'crucial' 62-day target Recruitment problems at Northampton General Hospital is delaying "critical" treatment for cancer patients, a report shows.

In June, the hospital missed all-but-one of their targets set by NHS guidelines for diagnosing or referring cancer patients within a 62-day standard. Northampton Chronicle and Echo

Corby Urgent Care Centre action group launches judicial review

Corby Urgent Care Centre action group launches judicial review An action group set up by people hoping to save the Corby Urgent Care Centre has begun a judicial review over the CCG’s lack of consultation.

The review, made by the Save Our Urgent Care Action Group, says residents have not been lawfully involved in any planned changes to healthcare or the potential closure of the Urgent Care Centre, run by Lakeside+. Northamptonshire Telegraph

New scheme launched to help NHS whistleblowers

New scheme launched to help NHS whistleblowers A nationwide pilot to help NHS whistleblowers back into work is being launched by NHS England. The Whistleblowers Support Scheme will offer a range of services including career coaching, financial advice and mediation for primary care staff who have suffered as a result of raising concerns about NHS practice.

Expansion of the GP international recruitment programme

Expansion of the GP international recruitment programme This guidance describes how NHS England is working with partner organisations to expand the GP international recruitment programme. In order to meet targets for GP recruitment set out in the General practice forward view, the programme is being brought forward two years and proposals for the recruitment of an extra 601 doctors has been approved. NHS England

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Language tests

Language tests Polina Ralutin was an experienced nurse in the Philippines and keen to take up a post in the NHS, at the Lister hospital, in Stevenage.

First, she had to pass an exam testing her knowledge of the English language. But she was surprised to find she had to analyse a text on jam-making for the exam.

She told the BBC's World Tonight programme: "I had to look at a diagram of the process and describe how to make it - there was a time limit, and it was very difficult to achieve in almost perfect English - how to make jam."

Polina passed the exam and took up her post in April 2016. But she knows several other nurses who failed, and she believes the test is too difficult.

"I have good friends who had to take it three times," she says. "I know plenty of others who struggled so much with it." BBC News

Prison healthcare so bad it would be shut down on outside, say doctors

Prison healthcare so bad it would be shut down on outside, say doctors Doctors tell of understaffed services, with patients missing hospital appointments due to clerical errors or lack of escort

NHS doctors working in prisons have warned that the conditions in which they operate are so unsafe that the services would be closed down had they been outside the prison system, the Guardian has learned.

The warnings have been issued in emails from an internal prison doctors’ email group seen by the Guardian. The fears about failures in prison healthcare come at a time when prisons are under huge pressure as a result of violence, overcrowding, drug use and high suicide rates. Continue reading... The Guardian

UK medicines agency seizes HIV home-test kits over false result risk

UK medicines agency seizes HIV home-test kits over false result risk Over 100 Hightop test kits, which have not met EU regulations, seized as agency warns consumers against using them

More than 100 HIV home-testing kits have been seized by the UK Medicines and Healthcare products Regulatory Agency (MHRA) amid fears over their reliability.

The agency believes it has seized all stock of the Hightop HIV/Aids home-test kit from UK suppliers but is warning consumers against purchasing the product online or using it, if already purchased, because of the potential for false results. Continue reading... The Guardian

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Hospital turns down donation from men who wore 'demeaning' nurse costumes 

Hospital turns down donation from men who wore 'demeaning' nurse costumes A hospital has turned down a donation from a group of men who raised money by dressing up as nurses, claiming their behaviour was "highly-sexualised" and "demeaning".

The men raised £2,500 in the event in Ludlow, Shropshire, which sees them dress up as female nurses and take to the streets with collection buckets.

The fundraising drive for Shropshire Community Health NHS Trust has been taking place without complaint for 30 years, raising around £90,000 in total.

Jan Ditheridge, chief executive of the trust, said she is not comfortable with how the event portrays medical staff and refused the donation. The Daily Telegraph

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More dementia patients in A&E over lack of care home beds

More dementia patients in A&E over lack of care home beds A lack of care home beds means more than three in four dying dementia patients end up in A&E, shocking new figures show.

The number of later-stage patients making emergency visits to hospital jumped by 62 per cent in just five years between 2008/09 and 2012/13, research by King’s College London found.

Doctors warned many of the visits were preventable, unnecessary and distressing for patients and their families – as well as putting greater strain on overstretched emergency departments.

They blamed falling numbers of care home beds for the problem as the study found people in care homes were much less likely to go to A&E. The Daily Mail

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Tuesday 22 August 2017

Delivering high quality end of life care for people who have a learning disability

Delivering high quality end of life care for people who have a learning disability This guidance document provide resources and tips for commissioners, service providers and health and social care staff providing, or delivering care to people with a learning disability at the end of their lives. NHS England

Position statement on children and young peoples' mental health

Position statement on children and young peoples' mental health This intercollegiate statement, produced in conjunction with the Royal College of Paediatrics and Child Health and the Royal College of Psychiatrists, outlines five principles to improve the care and support of children and young people (CYP) with mental health problems. The guidance highlights the need for a shared vision for CYP mental health across all professions and agencies. Royal College of General Practitioners

Hunt vs. Hawking: who's right about the NHS?

Hunt vs. Hawking: who's right about the NHS? The health secretary, Jeremy Hunt, clashed with Professor Stephen Hawking over the weekend about the NHS.

The exchange saw claims and counter-claims scattered across the pages of the weekend papers, with each accusing the other of ignoring evidence.

So, who’s right? FactCheck looks at the four biggest points of contention between the pair. Channel 4 News

BMA chair will support GPs' decision in industrial action ballot

BMA chair will support GPs' decision in industrial action ballot BMA chair Dr Chaand Nagpaul has said he would support the democratic decision of practices if they vote in favour industrial action. GPonline

Jamie is psychotic and won't go outside. Mental health services are failing him

Jamie is psychotic and won't go outside. Mental health services are failing him As a psychiatrist, I work hard to support his wish to remain in the community but there are many barriers

We’re standing in front of Jamie’s door for the second time today. It’s been 10 minutes but at least it’s stopped raining. This could be any one of the hundreds of crumbling red brick terraced houses in Leeds.

It’s not a surprise that there’s no sign of Jamie, beyond the sounds of his dogs barking and the bass music reverberating inside. The door still hasn’t been fixed since it was forced by the police prior to his last admission three months ago. Just as we’re about to leave, Jamie opens the door. Continue reading... The Guardian

Connor Sparrowhawk: no risk assessments before teenager's death, tribunal finds

Connor Sparrowhawk: no risk assessments before teenager's death, tribunal finds Dr Valerie Murphy faces sanction after tribunal finds further failings over death of 18-year-old who drowned at NHS unit

A senior psychiatrist failed to carry out any risk assessments on an epileptic teenager before he had a seizure and drowned in a bath, a medical tribunal has found.

Dr Valerie Murphy was the lead clinician responsible for treating Connor Sparrowhawk, 18, who died in an NHS care unit in Oxford on 4 July 2013. Continue reading... The Guardian

Up to 12,000 patients may have been put at risk by check-up failure 

Up to 12,000 patients may have been put at risk by check-up failure Thousands of patients may have been put at risk after failing to be given crucial hospital appointments, an independent review claims.

The investigation, ordered by Portsmouth Hospital trust, found almost 12,000 patients may have been put at “significant clinical risk” because they did not have planned check-ups, after undergoing procedures.

Worst affected treatment areas were gastroenterology, ophthalmology and cardiology, the report, seen by the Health Service Journal, found. The Daily Telegraph

Families could get supermarket discounts if they hit NHS exercise targets

milies could get supermarket discounts if they hit NHS exercise targets Families could get discounts on their supermarket shopping if they hit weekly exercise “step targets” under radical NHS proposals.

Free bikes, sprinting tracks on pavements and outdoor public gyms are also proposed as part of efforts to drive out couch potato lifestyles and reward those who try to shape up.

The head of the health service said the schemes, which will be piloted in new towns, aimed to create a “design for life” which would persuade young and old out of sedentary habits.

Under the proposals, those who meet weekly activity targets, tracked on apps, could be offered discounts on weekly supermarket shopping and sports gear, free cinema tickets, or cut-price gym membership. The Daily Telegraph

Monday 21 August 2017

Plans to improve NHS Continuing Healthcare assessment processes

Plans to improve NHS Continuing Healthcare assessment processes NHS England has published plans to improve of NHS continuing healthcare (CHC) pathways and processes, as part of the NHS contribution to the reduction of delayed transfers of care.

NHS call for equality over private hospitals' tax break

NHS call for equality over private hospitals' tax break NHS trusts are calling for equal treatment on business rates after research revealed private hospitals get discounts worth £52m over five years.

A study suggests more than one in four private hospitals are charities, giving them an 80% rebate in business rates.

But NHS trusts all have to pay in full, and will face a £300m increase in rates over the next five years. BBC News

Most GPs support ban on prescribing OTC drugs

Most GPs support ban on prescribing OTC drugs Close to two thirds of GPs support a ban on prescribing drugs that are available over the counter, a GPonline survey has revealed.

The NHS saved me. As a scientist, I must help to save it | Stephen Hawking

The NHS saved me. As a scientist, I must help to save it | Stephen Hawking The crisis in the health service has been created by politicians who want to privatise it – when public opinion, and the evidence, point in the opposite direction

Like many people, I have personal experience of the NHS. In my case, medical care, personal life and scientific life are all intertwined. I have received a large amount of high-quality NHS treatment and would not be here today if it were not for the service.

The care I have received since being diagnosed with motor neurone disease as a student in 1962 has enabled me to live my life as I want, and to contribute to major advances in our understanding of the universe. In July I celebrated my 75th birthday with an international science conference in Cambridge. I still have a full-time job as director of research at the Centre for Theoretical Cosmology and, with two colleagues, am soon to publish another scientific paper on quantum black holes.

When public figures abuse scientific argument to justify policies, it debases scientific culture Continue reading... The Guardian

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Operating on the wrong person and patients falling out of windows - NHS 'never events' at near record levels

Operating on the wrong person and patients falling out of windows - NHS 'never events' at near record levels Patients falling out of windows and equipment being left inside wounds after surgery were some of a near record number of 'never events' recorded by the NHS last year.

Campaigners have warned the same life-threatening mistakes, for which there can never be an excuse, are "disturbingly high" and often repeated, as official data reveals wrong site surgery took place 178 times in the 12 months before April.

Surgical swabs were mislaid inside patients after operations 22 times, the data shows, and in two cases broken-off drill bits were mislaid. The Daily Telegraph

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Men offered a £3,000 sweetener to induce them to train as nurses

Men offered a £3,000 sweetener to induce them to train as nurses Men are being offered a £3,000 sweetener to entice them to train as nurses.

Coventry University said the plans aim to “address a growing gender imbalance” on such courses

Men account for just 10 per cent of the total nursing students placed at UK universities, and the gender gap is growing.

Nurses said some male patients preferred to be treated by another man. The Daily Telegraph

Friday 18 August 2017

REVEALED: The best and worst GP surgeries in Kettering as rated by you

REVEALED: The best and worst GP surgeries in Kettering as rated by you Mawsley Village Surgery is the best GP practice in the Kettering district, according to the results of a patient survey. The surgery in School Road came out on top with 94 per cent of patients who go there saying they had a ‘good’ experience. Northamptonshire Telegraph

Next stage of world-leading childhood obesity plan announced

Next stage of world-leading childhood obesity plan announced As set out in the plan, PHE will now consider the evidence on children’s calorie consumption and set the ambition for the calorie reduction programme to remove excess calories from the foods children consume the most.

Ready meals, pizzas, burgers, savoury snacks and sandwiches are the kinds of foods likely to be included in the programme.

Over the past year, real progress has been made on reducing the level of sugar in many products.

The Soft Drinks Industry Levy has become law and will come into effect in April 2018 and PHE has formulated a comprehensive sugar reduction programme with the aim of a 20% reduction in sugar in key foods by 2020. Leading retailers and manufacturers have also announced they are, or already have, lowered the amount of sugar in their products as a result of these programmes. Public Health England and the Department of Health

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Joint statement on handling conflicts of interest

Joint statement on handling conflicts of interest This joint statement, produced alongside other health professions regulators, sets out expectations on how health and care professionals are expected to manage conflicts of interest. Health and Care Professions Council

Mental health services patchy, says PM

Mental health services patchy, says PM Theresa May says the UK's mental health services are "patchy" and has told Newsbeat she's going to review them.

She's pledged to support teenagers through a new strategy and better access to help.

"The National Citizens Service will build in mental health awareness," the prime minister explained.

She added that "10,000 members of staff" will be trained in "spotting issues around mental health". BBC News

Now NHS cuts are stripping basic medicines from the poor

Now NHS cuts are stripping basic medicines from the poor The government tries to deny cuts exist. But some hapless GPs are being forced to stop providing everyday medications to those unable to pay for them

The retreat of the health service is stealthy and haphazard, as a creeping postcode lottery of cuts gradually erodes the “national” in NHS. IVF, hip and knee operations are being cut back randomly in some regions. In some places patients can only get one cataract fixed: seeing with one eye is enough.

The ban on all over-the-counter medicines comes with a screed of cant about the importance of promoting 'self-care' Continue reading... The Guardian

NHS's longest serving chief executive sacked

NHS's longest serving chief executive sacked The NHS's longest serving chief executive has been sacked for gross misconduct, but he has claimed he was dismissed for suspending senior consultants who used hospital premises to have sex.

Sir Leonard Fenwick, who joined Newcastle upon Tyne Hospitals NHS Foundation Trust in 1965, said he had been the victim of an "orchestrated witch-hunt". The Telegraph

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Work hard, work hard - a quarter of modern medical students are teetotal

Work hard, work hard - a quarter of modern medical students are teetotal The ‘work hard, play hard’ medical student who burns the candle at both ends, consuming prodigious quantities of alcohol before an early morning anatomy class, has long been a staple of university life.

But a new survey carried out for the British Medical Journal suggests this stereotype is now little more than a myth.

Merely one in ten future doctors currently exceed the Government’s recommended weekly alcohol limit, and a quarter profess themselves to be completely teetotal. The Daily Telegraph

A quarter of trainee GPs want to work as stand-ins

A quarter of trainee GPs want to work as stand-ins A quarter of trainee GPs are intending to shun a full-time job in the NHS by becoming locums, research has found.

Many have been put off taking permanent posts by the long hours and intense workload and will instead seek the flexibility of working as stand-in doctors.

The study by Warwick University found that only two-thirds planned to work as GPs six months after they finished training. The remainder were intending to take a career break, move abroad or quit working for the NHS altogether. The Daily Mail

Thursday 17 August 2017

Great expectations: the changing nature of the public’s relationship with the NHS

Great expectations: the changing nature of the public’s relationship with the NHS Despite the NHS and the challenges it faces rarely being far from the headlines in recent years, there has been relatively little research done into whether – and how – the public’s priorities are changing and what people expect from the NHS in the 21st century. The King's Fund

Half of older patients’ families struggle to complain about poor hospital care

Half of older patients’ families struggle to complain about poor hospital care Older vulnerable people are often reliant on relatives to raise concerns when things go wrong in hospital, yet over half (51%) of family members with a concern say it is difficult to complain about the hospital care or treatment of an older relative, according to a new survey published by Gransnet and the Parliamentary and Health Service Ombudsman.

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Progress through partnership: involvement of people with lived experience of mental illness in CCG commissioning

Progress through partnership: involvement of people with lived experience of mental illness in CCG commissioning This report finds that despite recommendations set out over a year ago in the Five year forward view for mental health, little is known about the extent to which CCGs are involving people with experience of mental illness in the commissioning of mental health services. The research also reveals that the majority of CCGs do not have clear plans for the co-production of mental health services and that the difficulty in prioritising this is due to pressure on resources and workload. Rethink Mental Illness

NHS Health Check 40-64 dementia pilot research findings

NHS Health Check 40-64 dementia pilot research findings This report summarises the findings from a pilot project into the effectiveness of dementia risk reduction messaging in NHS Health Checks. It found that the pilot project showed promise in shifting public awareness and understanding of dementia risk with 75 per cent of the 164 participants recalling the advice on dementia risk and 80 per cent reporting that the advice would impact on their behaviour. Alzheimer's Society

Information for nurses and midwives on responding to unexpected incidents or emergencies

Information for nurses and midwives on responding to unexpected incidents or emergencies Following recent terrorist incidents, the Nursing and Midwifery Council (NMC) has provided information for nurses and midwives on responding to unexpected incidents or emergencies.

There may be occasions where you find yourself involved in an unexpected incident or emergency away from your normal place of work where people may require care.

As a healthcare professional, your first instinct is often to go to the aid of others in need. However, it is important that if you find yourself in an unclear situation you should follow official government guidance to run, hide and tell.

Medical school offers students places through clearing

Medical school offers students places through clearing A-grade students who missed out on a medical school place will be able to apply to a top medical school in London through clearing.

For the second year running, St George’s, University of London, will offer a small number of medical school places through clearing.

Tens of thousands of students use UCAS Clearing and Adjustment each year to find a university place, either because they got better or worse grades than expected, or because they changed their plans. OnMedica

The Guardian view on vaginal mesh implants: trust data and patients | Editorial

The Guardian view on vaginal mesh implants: trust data and patients | Editorial The devices have benefited a large number of women – but thousands have suffered serious adverse effects

The numbers tell their own tale. Thousands of women have undergone surgery to have vaginal mesh implants removed after suffering complications. Around one in 15 of those fitted with the most common type of mesh have required operations, according to NHS data obtained by the Guardian. In short, the problems are much more widespread than previously acknowledged. The removal rate was previously estimated at less than 1%.

But numbers are not enough. Each case is a woman with a disturbing story; and listening is as important as tallying them. Carolyn Churchill had to give up work after she was left in agony, with persistent bleeding. Yet she said she was made to feel like a baby for complaining. Others describe being left unable to walk or have sex – and of being assured that the implant was not responsible. So even this data under-represents the problem. Women may not be referred for removal, or may decide against it given the risks. Continue reading... The Guardian

'Very weak' passwords put NHS hospitals at hacking risk

'Very weak' passwords put NHS hospitals at hacking risk NHS hospitals are at risk of further devastating cyber attacks because staff are using “very weak” passwords, a new report reveals.

Health chiefs warned that one in four official user accounts granting access to sensitive patient data and vital systems are inadequately protected, while many organisations are failing to update their security software.

Around 10 per cent of administrator accounts, used by those who oversee IT systems, were also using weak passwords.

The private industry briefing by NHS Digital has emerged three months after the global WannaCry attack, which pitched the health service into chaos. The Daily Telegraph

Care home assault cases double

Care home assault cases double The number of reported assaults in care homes has more than doubled in three years, shocking figures reveal today.

Police forces from across England and Wales received almost 2,500 reports of assaults in care homes in the 12 months to April – up from the 1,100 reported three years previously.

In total, officers recorded a staggering 5,400 reports of crimes in care homes last year – including reports of neglect, ill-treatment, blackmail and even a case of 'administered poison'.

Worryingly, the true toll of crime is likely to be even higher as less than half of police forces responded to the Freedom of Information request.

The figures are the latest to illustrate the scale of the crisis in the social care sector, which has been beset by funding problems, care home closures, staff shortages and allegations of ill-treatment. The Daily Mail

Lack of nurses blamed for the spread of Japanese fungus

Lack of nurses blamed for the spread of Japanese fungus Nursing shortages have been blamed for the spread of a dangerous Japanese fungus through hospital wards.

More than 200 hospital patients have contracted the drug-resistant Candida auris fungus since it arrived in the UK four years ago.

A total of 20 NHS and private hospitals have reported cases of the potentially deadly fungus, including three large outbreaks, officials state.

King's College Hospital in South London was responsible for 31 of such cases during a year-long outbreak, figures show. The Daily Mail

Wednesday 16 August 2017

'Inadequate' Northampton care home given six months to improve after inspectors find lack of 'dignity or respect'

'Inadequate' Northampton care home given six months to improve after inspectors find lack of 'dignity or respect' A pair of Northampton care homes managed by a team without "any form of quality assurance" for their patient's safety or well being has been branded "inadequate", a report says.

CQC Inspectors found a culture at St Michaels Lodge and House, in St Michaels Avenue, off Kettering Road, where residents were "not valued", with mismatched medicine records and an "uncaring" service for patients. Northampton Chronicle and Echo

The north-south NHS divide: how where you are not what you need dictates your care

The north-south NHS divide: how where you are not what you need dictates your care This report outlines the findings of an examination of data from 209 CCGs to assess patient access to medical technology. It finds wide variation in access between the north and south of England and argues that CCG performance against access indicators should be made clearer to patients. Medical Technology Group

Bridging the health care gap through telehealth: the MedicallHome and ConsejoSano models

Bridging the health care gap through telehealth: the MedicallHome and ConsejoSano models This case study looks at two telehealth models in Mexico and the U.S. targeting low- to middle-income parts of the population. Using a call centre as the point of access, these models have reduced unnecessary use of services and supported patient navigation of local health services. The Commonwealth Fund

Time spent frail in old age 'doubles'

Time spent frail in old age 'doubles' The amount of time spent needing daily care at the end of life has doubled in England over the past two decades, a study suggests.

The Newcastle University study found men spent 2.4 years on average needing regular care and women three years.

This includes everything from help with washing and dressing each day to round-the-clock care.

Researchers said it suggested there needed to be a sharp increase in the number of care home places to cope.

It comes as ministers consider a new way to fund the system.

The government has promised major reform amid reports that councils are struggling to provide enough support to cope with the ageing population. BBC News

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Maternity 'must improve' at baby-deaths hospital trust

Maternity 'must improve' at baby-deaths hospital trust Maternity services at a health trust at the centre of a baby deaths inquiry must improve, inspectors have said.

Health Secretary Jeremy Hunt ordered an investigation into the Shrewsbury and Telford Hospital NHS Trust in April.

A Care Quality Commission (CQC) report said overall care had got better but safety in maternity services "needed further improvement".

The trust said challenges needed to be resolved and it wanted to work more closely with GPs. BBC News

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Meningitis jab uptake 'worryingly low'

Meningitis jab uptake 'worryingly low' School-leavers are putting themselves at risk of deadly meningitis if they don't take up the offer to be vaccinated against the disease, nurses are warning.

People living in England who are aged 17 and 18 are eligible for the free jab.

The Royal College of Nursing says only a third took up the offer last year. BBC News

'Scandal' of vaginal mesh removal rates revealed by NHS records

'Scandal' of vaginal mesh removal rates revealed by NHS records Traumatic complications mean one in 15 women fitted with the most common type of mesh support will require surgery to extract it, figures suggest

Thousands of women have undergone surgery to have vaginal mesh implants removed during the past decade, according to NHS records that reveal the scale of traumatic complications linked to the devices.

The figures, obtained by the Guardian, suggest that around one in 15 women fitted with the most common type of mesh support later require surgery to have it extracted due to complications.

What this is showing is very high rates of removals, which are only likely to get worse

You go in vaginally and take out the mesh there, then you go in through the tummy and chisel out the mesh with some difficulty Continue reading... The Guardian

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Gender dysphoria patients deserve better treatment than I can give them

Gender dysphoria patients deserve better treatment than I can give them GPs don’t have the time or the expertise to provide the holistic treatment that transgender patients require. Proper services are required urgently

Gender identity clinics have seen a huge demand for services in recent years. Waits can vary from 12 to 18 months in most cases, but can extend to three years in some parts of the country. It is estimated that about 1% of the population is transgender, although some believe this figure to be higher. Many have a higher incidence of mental health problems, such as depression and anxiety.

Those waiting months for their first appointment can resort to buying unverified hormonal treatments on the black market, seeing private specialists (often online) or looking for support and prescriptions from their GP. Private specialists can reassure them that their GP will prescribe and monitor their treatments. This leads to some difficult conversations with patients.

Patients are faced with conflicting messages. The profession, too, remains uneasy and unsupported Continue reading... The Guardian