This week sees a focus on some of the challenges facing the NHS. The review into failings in maternity care in Nottingham is now set to be the biggest such review in UK history, it has emerged. Statistics from Cancer Research UK show that lung cancer cases in women are overtaking those in men, while there has also been a big rise in the incidence of skin cancer, particularly among the over-55s. A new review has expressed concern that the standard checks for newborn health and detecting jaundice in babies do not adequately take into account how symptoms may present differently on darker skin.
A review into failings in maternity care in hospitals in Nottingham being carried out by midwife Donna Ockenden will be the largest ever carried out in the UK.
Ockenden has said that she will examine the cases of 1,700 families.
The review is being carried out in response to dozens of baby deaths and injuries at Nottingham University Hospital (NUH) NHS Trust. So far,1,266 families have contacted the review team themselves directly. Ockenden has called for a “radical review” to make sure that women from all communities were being contacted by the trust and felt confident to come forward.
The review methodology has also been changed from an opt-in to an opt-out approach, which means that families will have to opt out of the investigation if they do not want to participate, rather than opt in if they do.
The review focuses on the maternity units at the Queen’s Medical Centre and City Hospital, run by the trust.
The number of people in the UK diagnosed with skin cancer has hit a record high with a sharp rise among over-55s.
According to Cancer Research UK, melanoma cases across all age groups have reached 17,500 a year, the highest since records began. Amongst the over-55s, cases have risen by 195% since the 1990s. Between 1993 and 1995, 21.3 people aged 55 and over were diagnosed with melanoma out of every 100,000; this rose to 62.9 cases a 100,000 in 2017-2019.
The rise may be linked to the increase in the numbers of people holidaying abroad, the charity suggested.
A scheme in which category 2 999 calls are validated by clinicians will be extended nationally, after a pilot study found the approach reduced ambulance journeys by 4%, HSJ has reported.
While category 1 calls are those for life-threatening injuries and illnesses, category 2 calls relate to emergencies. The new scheme only involves those category 2 calls which are less urgent – patients who are suspected of having a heart attack or stroke are responded to as normal.
NHS England has confirmed that one ambulance trust in the scheme, the West Midlands, has begun delaying the dispatch of ambulances for some category 2 calls by up to 23 minutes so that the validation can take place. At three other trusts (London, South Western and the East Midlands), about 40% of category 2 calls receive clinical validation, but an ambulance is dispatched to them as soon it is available, as normal.
An NHS England spokesperson said: “Some ambulance trusts have introduced clinical validation for some category 2 ambulance calls where skilled and experienced clinicians carry out rapid assessments to determine the best response for each patient’s need, freeing up ambulances to respond to the sickest patients.”
A review by the NHS Race and Health Observatory has raised concerns about the focus on skin colour in the Apgar score, which is a series of routine health checks in newborn babies.
One element of the Apgar score assesses whether the baby is “pink all over”. The report says that the assessment is not relevant for babies with darker skin, and calls for an update of maternity guidelines.
The report also expresses concerns about the difficulty of diagnosing jaundice in babies from ethnic minorities. Current guidance relies heavily on changes in skin colour. It says there is a need for more consistent training for healthcare staff and parents on how to spot jaundice in babies belonging to ethnic minorities and recommends establishing a national image database.
New projections show that lung cancer diagnoses among women are set to outnumber those among men for the first time.
Because smoking rates peaked among men long before they did in women, male lung cancer cases are falling more rapidly. The forecasts suggest that cases among women will continue to outnumber those in men, with the gap widening until at least 2040.
For the period 2016-18 there were 25,404 male cases and 23,396 female cases. The projections by Cancer Research UK suggest that this year, there are likely to be 27,332 cases among women, and 27,172 among men.
Charities have said that women should now be as alert to potential signs of lung cancer as they are about checking for lumps in their breasts.
More than half of those diagnosed with stage one lung cancer will survive their cancer for five years or more after diagnosis. But just 5% of those diagnosed with stage four disease are still alive five years later.
More than two-thirds of people agree that digital health apps should be used within the NHS, according to a survey into public attitudes on health apps in the UK by the Organisation for the Review of Care and Health Apps (ORCHA).
The survey also found that 60% more GPs have recommended digital health apps to their patients this year than last year. London GPs were more likely to recommend health apps than GPs in any other region.