Several stories this week demonstrate the continuing impact of increasing pressures on the NHS: a dramatic increase in people with eating disorders; a failure in Wales to deliver appropriate eye care in time to those at risk of blindness; and a warning from coroners that people are dying as a result of ambulance and A&E delays. More positively, a new study shows the potential of artificial intelligence to detect breast cancer in mammograms and halve radiologists’ workload.
Artificial intelligence (AI) is as effective in detecting breast cancer as two radiologists, a large-scale trial has found.
The randomised controlled trial, which followed 80,000 women in Sweden, compared the use of AI software to read mammograms with the standard protocol of two radiologists reviewing the scans. The preliminary results suggest that the AI software is as good as the standard protocol, does not increase false positives and could, if implemented, almost halve the radiologist workload.
Half the scans were assessed by two radiologists, while the other half were assessed by AI-supported screening followed by interpretation by one or two radiologists.
In total, 244 women (28%) recalled from AI-supported screening were found to have cancer compared with 203 women (25%) recalled from standard screening. This resulted in 41 more cancers being detected with the support of AI, of which 19 were invasive and 22 were in situ cancers. The false-positive rate was 1.5% in both groups.
Wales faces a “tidal wave of blindness” unless urgent improvements are made to the delivery of eye care, the president of the Royal College of Ophthalmologists in Wales, Gwyn Williams, has warned.
New figures from the Welsh government show that 75,000 people at greatest risk of losing their sight are waiting too long for treatment. This number has almost doubled in just four years.
Diseases such as glaucoma and macular degeneration can lead quickly to blindness if not detected and treated early.
Williams called on the health minister to act on a 2021 external review of eye care, which found Wales had some of the lowest numbers of specialists anywhere in the UK. He said: “In truth we were barely coping when Covid came along and now we have no hope without innovative ideas and substantial investment in services infrastructure and new ways of working.” Without reorganisation, he added, there would be “a tidal wave, a tsunami of blindness across the whole country.”
Coroners have said there are increasing numbers of deaths caused by problems in the emergency pathway, including severe staffing shortages.
At least 24 “prevention of future death” reports were sent to NHS organisations in England and Wales in the first half of 2023, noting shortcomings within emergency services, HSJ has reported.
In six of the 24 cases, coroners found that ambulance, emergency room and other delays caused or contributed to patient deaths. Even where delays were not thought to have contributed, coroners warned the NHS and government that intense emergency pressures were costing lives. The most extreme reports involved patients waiting 16 hours before they were allocated hospital beds.
People with eating disorders are being refused NHS treatment because they are not thin enough.
The number of people diagnosed with an eating disorder is growing sharply, new figures show. The Independent reports that at least 5,385 patients, the majority of whom were children, were admitted to general wards for conditions such as anorexia and bulimia in 2021-22. This is more than double the number in 2017-18. Campaigners told the paper, however, that patients are being refused treatment because their weight isn’t low enough.
Rachel de Souza, the children’s commissioner for England, also highlighted a increase in the proportion of young people waiting more than three months to begin treatment, from 16% 2016-17 to 45% in 2022-23.
Medical clinics are using fake Google reviews to boost their profiles online, according to a BBC investigation
One of the companies the BBC’s investigation examined was the Ipswich Spine Clinic, which had a 4.9 star rating on Google reviews. The BBC found that a number of people who had given this clinic five stars on Google had also reviewed 16 of the same businesses in the US, Australia, Austria and Canada, for products as diverse as property conveyancing, car repairs, and hookah pipe
The consumer publication Which? has warned that it could be a serious issue if someone chose a treatment clinic based on reading a fake review.
The government said it was toughening the law to protect consumers, while Google said it removed fake reviews.
Patients in all but one integrated care system (ICS) found it more difficult to contact their GP practice by phone this year compared to last year.
GP patient survey data, published this month, showed that the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53% to 50%. Those with the biggest drop in performance included Cambridgeshire and Peterborough, Sussex, and Suffolk and North East Essex.
Several ICSs said the drop was the consequence of high patient demand. The number of general practice appointment bookings nationally reached a record 36 million in October 2022.