News round-up (27 October 2023)

Several stories highlight concerns about the NHS. A newspaper investigation finds that GPs are continuing to prescribe a dangerous antidepressant, while the ombudsman has warned that too many people are dying from sepsis as a result of NHS mistakes, and the regulator has noted a rise in people using private health care to avoid long waiting lists. There is good news, however, for anyone worried about their sedentary lifestyle – a brisk walk of 22 minutes a day can counteract the increased health risks caused by spending too much time sitting down.

Too many people dying from sepsis, says ombudsman

Too many people are dying from sepsis because the NHS hasn’t learnt from the mistakes of the past, according to Rob Behrens, the UK’s health ombudsman.

In 2013, the ombudsman carried out an investigation into sepsis deaths and concluded that patients were not being diagnosed or treated quickly enough. The report made a series of recommendations to improve the NHS’s response.

A new report from the ombudsman, however, has found that, although some improvements have been made, there is much that still needs to be done.

Sepsis is a condition that develops when the body’s immune system overreacts to an infection and starts attacking its own tissues and organs.

The UK Sepsis Trust estimates that about 48,000 people die each year from sepsis-related illnesses, of which thousands are preventable.

GPs prescribe dangerous antidepressant blacklisted by NHS

A dangerous antidepressant blacklisted by the NHS because of concerns about its safety is still being prescribed to tens of thousands of patients every year, the Telegraph found.

In 2017, the NHS told GPs to stop prescribing dosulepin – previously known as dothiepin – after research linked it to 160 suicides and 40 accidental overdoses in the UK each year.

In 2019, NHS England issued further warnings, telling GPs they must transfer existing patients on to alternative medication. An analysis of official prescription data shows that doctors have prescribed 1.28 million courses of the drug since then.

Last year, GPs in England prescribed more than 370,000 courses of dosulepin. The Telegraph estimates that about 50,000 patients a year remain on the drug.

CQC warns of two-tier health system

Failings in the NHS are in danger of creating a two-tier health system, the Care Quality Commission (CQC) has warned.

The CQC, which regulates health care in England, said that there had been a rise in people paying for their own healthcare, driven by record waiting lists and poor access to services.

Strike action and staff shortages had exacerbated problems in a health care system already “in gridlock,” according to the CQC’s annual state of care report.

The CQC said that that patients who could not afford to pay faced long waits or going without care. Eight in 10 of those who used private healthcare last year would previously have used the NHS, the CQC said.

Rise in pupil absence is down to anxiety

A quarter of all children who were absent from school in June were off as a result of anxiety or mental health problems, a Department for Education survey of parents has found.

This has increased from 16% found in a similar survey in March 2022.

The problem was more marked in secondary schools, where 29% of respondents cited their children’s anxiety or mental ill health as a reason for absence, compared with 19% of parents of primary school pupils.

Parents of pupils eligible for free school meals were also more like to cite anxiety or mental health problems as a reason for absence (35% compared with 20% for those parents of pupils who were not eligible for free school meals).

Brisk 22-minute walk could offset effects of sitting

Going for a brisk walk for just 22 minutes once a day could be enough to counteract the negative health effects of sitting too much, according to new research.

Sedentary lifestyles are among the leading causes of ill health – but a new study, published in the British Journal of Sports Medicine, suggests that moderate-to-vigorous physical activity can eliminate the risk.

The researchers looked at data for 11,989 people aged over 50, from Norway, Sweden and the US. People in the study wore activity trackers that measured their moderate-to-vigorous physical activity (MPVA). Examples of moderate activity include very brisk walking, heavy cleaning or playing badminton. Vigorous activity includes hiking, jogging at 6mph or faster, fast cycling, or playing football.

Every minute higher MVPA showed a lower risk of death, so even doing 10 minutes a day lowered the risk. Doing just 22 minutes a day completely eliminated the higher risk of death caused by sedentary behaviour, however.

Generative AI in health requires rigorous oversight, NHS executive says

Generative artificial intelligence (AI) – that is AI such as ChatGPT that can generate content – needs more rigorous regulation, NHS England’s director of AI has said.

Don Cushnan told the publication Digital Health that digital tools should undergo a rigorous process before they can be integrated into clinical practice. This will include navigating UK regulators such as the Information Commissioner’s Office (ICO) to the Care Quality Commission (CQC).  

“Getting your way through that is difficult, and also for us as commissioners, it can be hard for us to understand what the things are that we want to do to make sure that we methodologically test whether these products work,” Cushnan said.

He added that efforts from NHS England and the NHS AI Lab are geared towards AI tools that are suitable for clinical environments and use straightforward statistical models for their decision-making. 

Cushnan confirmed that there are also discussions about the potential for generative AI taking place in the NHS, but that decisions had not yet been made.