Newcastle

Noted (AI summary) The York & Scarborough Teaching Hospitals NHS Foundation Trust acknowledge that timely referral of patients to a transplant centre is important and have circulated this message to relevant clinicians. They state that Mr Morrell was undergoing optimisation of therapy, hence urgent referral for transplant assessment would not have materially advanced his management.

Noted (AI summary) The North East Ambulance Service emphasizes existing training and education for paramedics on stroke symptoms, including the possibility of symptoms dissipating, and highlights the strengthening of their Senior Clinical Leadership team. The General Chiropractic Council has established an expert group to review the coroner's findings and recommend actions to prevent similar deaths or harm to patients, with a final report expected by October 2025. The chiropractor states they will continue to follow the rules and guidance issued by their regulator (GCC) and looks forward to receiving any updated guidance from the GCC. The General Chiropractic Council established an Expert Group, comprised of members from within and outside of the profession, to consider the coroner's findings which resulted in an Action Plan with practical solutions for chiropractors to incorporate into their daily practice. The British Chiropractic Association held webinars to refresh the knowledge of their members on the symptoms and treatment of stroke and the Royal College of Chiropractors initiated work to review their emergency referral form.

Noted (AI summary) NHS England has engaged with Newcastle upon Tyne Hospitals NHS Foundation Trust, who have permanently suspended use of the cannula in question. All reports received are discussed by the Regulation 28 Working Group. The DHSC acknowledges the concerns, explains the roles of NHS England, MHRA and CQC, and outlines the NSDR's role in managing medical supply disruptions. They note that the supply disruption was not escalated to NSDR and that the MHRA has no evidence of excess risk with the cannula used.

Noted (AI summary) NHS England acknowledges concerns about the shortage of Paediatric Pathologists and delays to reports. They describe recruitment incentives and development of a curriculum for placental pathology reporting, but provide no timeline. They will raise the SUDIC protocol revision with the Royal Colleges and relevant government departments. The GMC acknowledges the concern about the shortage of paediatric pathologists but states it does not have a direct role in recruitment or determining training numbers. They outline their role in registration processes and efforts to streamline these for overseas-trained doctors. The Department of Health and Social Care acknowledges concerns over workforce capacity, genetic screening, and sudden death in childhood, noting that NHS England is working on these issues. They mention the NHS Long Term Workforce Plan, the NHS Genomic Medicine Service, and the NHS-Coronial-Sudden Unexpected Death pilot.

Noted (AI summary) The trust has introduced MDTs to improve communication, and changed the on-call system to ensure a dedicated colorectal surgeon is available during the week. An IBD SOP will ensure involvement of general surgery and gastroenterology teams. DAC Beachcroft clarifies the communication processes between North Cumbria and Newcastle hospitals, explaining the roles of different teams and when direct specialist advice is sought, and highlighting that North Cumbria now take part in a regular Inflammatory Bowel Disease MDT at Newcastle.

Noted (AI summary) NHS England acknowledges the concerns raised regarding the lack of automatic flags for non-responders to cervical screening in GP systems, clarifies the routine invitation process, and highlights ongoing work to improve screening uptake. TPP confirms that SystmOne has an automatic alert for cervical smears, irrespective of whether a patient has had one, but GPs are not informed when patients don't respond to invitations and that alert is not in the system. EMIS expresses condolences and states that their system already meets the recommendation of including an automatic flag/alert when a patient fails to attend for cervical screening as part of the National Screening Programme. They state that the System has an alert reading “Cervical Smear due or outstanding” that displays each time the patient’s record is opened, and also that GP practices can extract lists of patients who remain eligible but are not up to date with their cervical screening. The Department of Health and Social Care acknowledges concerns about patient record systems and alerts for non-responders for smear tests and states NHS England is creating a new IT Cervical Screening Management System (CSMS), due to go live in Quarter 1 2024/25, that will allow GPs to review a list of their non-responders.