Manchester North

Noted (AI summary) North West Ambulance Service has revised its 111 policy to remove exclusions for self-conveyance to hospital, save for Category 1 incidents, and to directly confirm patient refusal of an ambulance where possible. The updated SOP went live on 5th September 2023 and staff were informed. The Department for Levelling Up, Housing and Communities will pilot measures to improve enforcement of damp and mould with £10m funding and intends to introduce the Decent Homes Standard to the private rented sector. They will also introduce new regulations following a review of the Housing Health and Safety Rating System (HHSRS). The Department of Health and Social Care states that NHS England has confirmed with ambulance trusts that no blanket policies are in place advising patients with chest pain not to travel to A&E. NHS111 calls are dealt with on a case-by-case basis, and patients are provided with interim advice.

Noted (AI summary) NICE acknowledges the concerns but states that existing guidelines on fever, sepsis, and sore throat should be considered. They highlight that a specific guideline on Group A streptococcus has not been requested and that rapid tests were not recommended for routine adoption. MFT expresses concern for better clinician awareness of GAS and its management, and has liaised with relevant bodies to raise their concerns. They recommend the development of comprehensive, nationwide guidance for clinicians on GAS, similar to existing guidance for meningococcal disease. The Department of Health and Social Care highlights NHS England's interim clinical guidance on Group A Streptococcus and a public campaign to inform parents about symptoms. They also mention plans to implement Martha's Rule to allow rapid review of deteriorating patients. The RCPCH has shared information and suggestions for local improvement from the report with its paediatric members via its patient safety portal and will share the information for discussion with the RCPCH Clinical Quality in Practice group in October.

Noted (AI summary) The MHRA convened the Isotretinoin Expert Working Group (IEWG) to evaluate data on risks associated with isotretinoin and the Implementation Working Group has had two meetings in March 2023 and is making good progress with a further meeting planned in mid May 2023; the report of this review will be published shortly. The MHRA published a report on isotretinoin's side effects and issued a Drug Safety Update. An Implementation Working Group is developing recommendations for safe introduction of new measures, with outputs to be made public. The Department of Health and Social Care acknowledges concerns regarding Isotretinoin and refers to the MHRA's response; they note that the Isotretinoin Implementation Working Group has met and is drafting a report for the Commission for Human Medicines, with the aim of presenting their advice in July 2023.

Noted (AI summary) The Secretary of State requests local authorities prioritize improving housing conditions for private and social tenants, focusing on damp and mould. They request information on the number of properties with damp and mould and how enforcement of housing standards is being prioritized. The Secretary of State calls on social housing providers to treat damp and mould seriously, meet the Decent Homes Standard, and self-refer to the Regulator of Social Housing if in breach of standards. They also highlight the upcoming Social Housing Regulation Bill to hold landlords accountable. The Secretary of State asks legal representatives to direct social housing tenants with concerns about housing to the Social Housing Ombudsman, highlighting recent changes making it easier to access the Ombudsman. The government outlines actions taken to address damp and mould in social housing, including issuing guidance to landlords, suspending funding to Rochdale Boroughwide Housing, and awarding funding to areas with poor privately rented homes. They also highlight the Social Housing Regulation Bill to hold landlords accountable.

Noted (AI summary) NHS Greater Manchester Integrated Care states that the issue is a gap in acute provision rather than a commissioning gap and is being addressed by the Care Organisation via a SLA. Learning will be shared with the Greater Manchester System Quality Group and cascaded to professionals through relevant governance and learning forums.

Noted (AI summary) Oldham Council has amended the wording on licenses, added blind cord safety as a license condition (checked at every property visit), briefed enforcement officers on blind cord safety, and added related information to the Council's website. A new selective licensing scheme was also reintroduced in July 2022. The Department acknowledges the coroner's concerns but believes awareness campaigns are key. They support RoSPA's 'Make It Safe' campaign and will consider how to strengthen its reach.

Noted (AI summary) The GMCA will share learning from the case with the Greater Manchester Quality Board, communicate advice and guidance to relevant providers to increase staff awareness, cascade shared learning to professionals through relevant governance and learning forums, and subject potential safeguarding issues/care concerns to further review. The practice participates in monthly multidisciplinary team meetings. Standardised medication review template will be introduced that includes a prompt to routinely trigger an enquiry as to whether the patient is taking any over-the-counter medicine. High risk mental health patients will be invited for a health check and medication review, all patients with known mental health conditions will complete by March 2022. The response acknowledges the concerns raised and mentions existing guidance and requirements for medication reviews within GP practices and Primary Care Networks, and notes that the Uplands Medical Practice has introduced a standardised medication review template.