First ever Patient Safety Commissioner appointed

  • The independent Commissioner will act as a champion for patients and lead a drive to improve the safety of medicines and medical devices
  • Dr Hughes will improve how the healthcare system listens to patients, the government and the NHS to put patients first

The Health and Social Care Secretary Steve Barclay has today appointed Dr Henrietta Hughes OBE as the first ever Patient Safety Commissioner for England.

Adding to and enhancing existing work to improve the safety of medicines and medical devices, the appointment of a Commissioner is in response to the recommendations from Baroness Cumberlege’s review into patient safety, published in 2020.

Dr Hughes will be an independent point of contact for patients, giving a voice to their concerns to make sure they are heard. She will help the NHS and government better understand what they can do to put patients first, promote the safety of patients, and the importance of the views of patients and other members of the public.

Bringing with her a wealth of experience in patient care as the National Guardian for the NHS, where she encouraged staff to speak up and supported whistle-blowers, Dr Hughes will be a champion for patients. She will continue to practice as a GP and chair of Childhood First, a charity that promotes and furthers the care, treatment and rehabilitation of children and adolescents.

Health and Social Care Secretary Steve Barclay said:

It is essential that we put patient safety first and continue to listen to and champion patients’ voices.

Dr Henrietta Hughes brings a wealth of experience with her as the first ever Patient Safety Commissioner to improve the safety of medicines and medical devices and her work will help support NHS staff as we work hard to beat the Covid backlogs.

Patient Safety Commissioner Henrietta Hughes said:

I am humbled and honoured to be appointed as the first Patient Safety Commissioner. This vital role, recommended in First Do No Harm, will make a difference to the safety of patients in relation to medicines and medical devices.

Patients’ voices need to be at the heart of the design and delivery of healthcare. I would like to pay tribute to the incredible courage, persistence and compassion of all those who gave evidence to the report, their families and everyone who continues to campaign tirelessly for safer treatments.

I will work collaboratively with patients, the healthcare system and others so that all patients receive the information they need, all patients’ voices are heard and the system responds quickly to keep people safe.

The First Do No Harm report, led by Baroness Cumberlege and published in 2020 explored issues relating to the use of Primodos, sodium valproate and pelvic mesh, and was commissioned because women did not feel listened to or their concerns acknowledged.

It highlighted the need to better protect and listen to patients and recommended the creation of an independent Patient Safety Commissioner. In July 2021, the government published its formal response to the recommendations set out in this report including a commitment to appoint a Patient Safety Commissioner with a remit covering medicines and medical devices.

The government continues to take action to improve patient safety. A statutory duty of candour has been implemented that requires Trusts to inform patients if their safety has been compromised, legal protections for whistle-blowers have been put in place, and a NHS Patient Safety Strategy was published in 2019 to create a safety, learning culture across the NHS. The Health and Care Act 2022 also established the Health Services Safety Investigations Body to investigate patient safety incidents in England.

This appointment was made following an open competition, in line with the Governance Code for Public Appointments, and following a pre-appointment scrutiny hearing with the Health and Social Care Committee.




Designs framework call for views

The designs framework enables rights holders to protect designs and enforce their rights. The call for views sought views and evidence on opportunities to improve the designs framework in the UK. This will help the government ensure the UK’s designs framework works for the designers, businesses and consumers that use it.

Responses to the call for views were received on three broad areas – new opportunities, future technologies, and better regulation. The government response provides a summary of the responses received. It sets out issues for further consideration, including areas for future consultation. These issues include:

  • how to simplify the designs regime, in particular for unregistered designs
  • how to improve guidance for designers, including those who do not normally engage with government directly
  • options around search and examination
  • the relationship between design and copyright law, and if there is a need for reform or guidance
  • concerns about disclosure requirements for supplementary unregistered designs, including uncertainty in relation to simultaneous disclosure
  • if the current format requirements for how designs are represented should be updated
  • how to ensure the designs system is flexible enough to support developments in technology
  • options for a possible deferment provision
  • measures that could be introduced to make enforcement easier for all rights owners
  • evidence to support views on the extension of criminal sanctions for unregistered design infringement

The UK has a vibrant design industry. A designs framework that supports designers, and encourages overseas investment, will help give the UK a competitive edge. Following the UK’s departure from the European Union (EU), we have new flexibilities to define the domestic designs regime. As the UK negotiates trade deals with international partners, a modern and flexible designs framework will help make the most of these new opportunities and help our design industry flourish.

The Intellectual Property Office’s Chief Executive, Tim Moss, said:

In a competitive global marketplace, great design helps UK products stand out, demonstrate quality and reach new customers all over the world.

The designs framework is a crucial element of our IP system. Through this review, we want to ensure it remains fit to embrace the challenges of an increasingly digital future, helping to unleash the potential of the UK’s creative and innovative industries.

Matthew Ridley, Chair of Chartered Institute of Patent Attorneys’ Designs and Copyright Committee, said:

We have appreciated the opportunity to respond to the call for views, and look forward to providing further input at consultation.  We are pleased that the government response acknowledges the benefits of the existing speed and value of the UK designs registration system.

Further consultation will provide further opportunity to identify improvements to the UK design framework – particularly in the areas of simplifying the unregistered design and copyright systems, considering the searching and examination of registered designs and implementing a harmonised deferment provision under UK law. We look forward to further engagement with government on these important areas.

Cat Drew, Chief Design Officer at the Design Council said:

The design economy is a significant and growing contributor to economic growth. Our departure from the EU, the disruption of the Covid pandemic and the climate emergency are seeing us reconfigure and re-establish global trade routes. An IP framework that supports all designers, and protects sustainable and equitable innovation will help ensure the design economy remains a major driver of exports.

The climate emergency requires us to redesign almost every aspect of our lives. Global collaboration is crucial. We need an IP system that allows ideas to be shared and spread, protecting and rewarding imagination and creativity.

We welcome the IPO’s recognition that these are complex issues, and look forward to working with them on further consultation to get this challenge right.

Notes to editors:

  • the Intellectual Property Office (IPO) is the government agency responsible for ensuring the designs framework supports rights holders to protect designs and enforce their rights
  • the call for views ran for 8 weeks between January and March 2022 and received 57 responses. The IPO also held a number of round-table events
  • in addition to the call for views, the IPO published a survey aimed at people with an interest in designs and how they are protected, but who do not consider themselves experts on IP. The survey received 288 responses
  • responses to the call for views were received from designers (5), design consultants (2), academics (2), legal firms and professionals (17), legal trade bodies and professional bodies (7), other trade bodies (10), small and medium enterprises (SMEs) (9), large enterprises (4) and other (1)
  • responses to the designs survey came predominantly from lone designers (58%) and small businesses employing fewer than 10 people (22%). This provides additional insight into how these groups use design protection in the UK



Environment Agency report sets out urgent need to work with nature

An Environment Agency report that lays bare the scale of change needed to halt England’s biodiversity and climate crisis has been published today.

It sets out how significant changes will be needed to how land is used in England, with the need for significant landscape scale interventions and the use of nature-based solutions to help wildlife recover, and for humans to mitigate and adapt to the effects of climate change.

The ‘Working with Nature’ report compiled by Environment Agency scientists sets out the global challenges facing the basics for life on Earth – clean water, climate regulation and food. It describes the potential loss of complex natural ecosystems that provide such essentials as an existential risk to human survival.

Referencing Rachel Carson’s 1962 book Silent Spring, considered by many to be the most important piece of environmental writing of the 20th century, Environment Agency chief executive Sir James Bevan today spoke about the ‘silent spring’ that awaits humanity unless action is taken by businesses, government and individuals to prevent further damage and rebuild the natural environment.

The report was unveiled at event today hosted by the Green Alliance, ahead of the COP15 Biodiversity Conference taking place later this year.

Internationally, the G7 leaders have committed to the global mission to halt and reverse biodiversity loss by 2030. The COP 15 meeting of the UN Convention on Biological Diversity (CBD) in 2022 will review the progress towards previously agreed Biodiversity targets.

Sir James Bevan, Environment Agency Chief Executive, said:

The biodiversity crisis joins the climate crisis as an existential risk to our survival, but as this report sets out the solution is not to retreat but to work together to build a nature-positive response.

Nature provides the basics for life – clean water, clean air and food. With major pressures on land use across England, nature-based solutions must be a major part in our response to protect these essentials whilst rebuilding our natural world.

England is one of the most nature-depleted countries in the world due to its long history of industrialisation and land use changes over millennia. Large areas of habitats have been lost with 99.7% of fens, 97% of species-rich grasslands, 80% of lowland heathlands, up to 70% of ancient woodlands and up to 85% of saltmarshes destroyed or degraded.

The impacts on species have also been severe, with a quarter of mammals in England and almost a fifth of UK plants threatened with extinction.

Nature in England has also been impacted by pressures on land use. The report sets out the impact of the last 50 years of agricultural production and points to the likelihood of a need of further intensification and increased yields from agricultural land. It also charts the impacts of urbanisation, forestry and the need for large areas of land for climate change mitigation.

To address the major declines in biodiversity that will only be accelerated by a changing climate, the report sets out a need for more land to be dedicated to nature conservation to act as refuges for nature and to mitigate against climate change – such as coastal wetlands to combat flood risks.  However, with such demand on land, it will need to provide multiple benefits to people and nature.

The Environment Agency has a leading role to play in restoring or recreating new wildlife-rich habitat in England. Recent projects include peat restoration at Great Fen, Cambridgeshire, which will save 325,000 tonnes of CO2 from being released each year while restoring habitats for threatened fenland species and protecting surrounding towns, villages and farmland from the risk of flooding after heavy rainfall.

The report identifies such nature-based solutions as a crucial tool in restoring nature and achieving multiple other benefits. By working with nature, including tree planting, peat restoration, species reintroductions and natural flood management, it suggests there are opportunities to restore biodiversity, whilst providing other benefits such as carbon sequestration, flood protection and clean and plentiful water.

The report also says action will also be required to address the levels of consumption in wealthy countries, which contribute to the loss of biodiversity, and that sustained effort will be required from many people and organisations at forums like the COP 15 meeting of the UN Convention on Biological Diversity to tackle the effects of global consumption, production and supply chains.




Strengthened controls to protect the public from medically unfit gun holders

Strengthened controls for licensed gun owners will be in place from this week to better protect the public from those who are medically unfit to own a firearm.

A new digital marker is being rolled out across GP surgeries in England which, once applied to a patient’s record, will flag that they have a firearms licence and automatically alert doctors if there has been a relevant change in their medical situation.

This could include a change in their mental health, diagnosis of a neurological condition or evidence of substance abuse.

The new system will mean GPs can alert the relevant police force, who can then ensure licensed gun holders who may no longer be fit to own a firearm are swiftly identified, their licence reviewed and, if deemed appropriate, their firearm seized.

Minister for Crime, Policing and Probation, Kit Malthouse said:

We have some of the strictest gun control laws in the world and we will not hesitate to bring in even stronger processes where we see the need for them.

The imminent inquest into the tragic shootings in Sussex and impending first anniversary of the horrific shootings in Plymouth are a stark reminder of how much we owe it to the public to take these matters seriously.

We are focused on making our streets safer and it is absolutely right that the police be told about changes in the medical circumstances of anyone licensed to own a gun. This move is yet another example of us giving the police the tools they require to protect the public.

The digital marker system bolsters recent statutory guidance, brought into force last November, that set outs that the police cannot grant a firearms licence until they have reviewed information from a suitably qualified doctor regarding the applicant’s medical history.

The digital marker will streamline the way doctors can keep track of patients who have applied for, or been granted, a firearms certificate – which was previously something done manually. The marker has been developed by NHS Digital and is being rolled out in GP practices across England, with 98% of practices able to access it from this week.

Minister for Patient Safety and Primary Care, Maria Caulfield, said:

These new measures make it easier for GPs to identify any concerning medical issues with gun holders or applicants, before passing this vital information on to relevant police forces, helping ensure public safety.

The new system was agreed following extensive cooperation with the British Medical Association (BMA) and comes after they agreed a Memorandum of Understanding in July 2019 with the Home Office and the National Police Chiefs Council about the role of doctors in the firearms licensing system.

NHS Digital CEO, Simon Bolton, said:

The addition of this marker to GP records is a prime example of how a digitally enabled healthcare service benefits patients and the public.

This new system will also reduce the administrative burden for GPs, giving them more time to deliver care.

Dr Peter Holden, BMA lead for firearms licensing policy and a GP in Matlock, Derbyshire, said:

As advocates for their patients and communities, family doctors support the need for scrutiny and proper safeguards when it comes to owning a weapon that can be used with lethal outcomes.

For decades now, the BMA has been pushing for an active flagging system within patients’ records that is robust, clear and standardised across the country, and the new digital marker is a positive step in the right direction of improving the contribution GPs make to the licensing process.

However, the public should be under no illusion that this will be an overnight solution. This new scheme will apply only to new applicants or people renewing their licences, so it will take up to five years before all licensed gun owners are included within this framework.

Of course, when there is a diagnosis of concern, GPs will continue to use all of the information in front of them and where there is a danger to the wider public or the patient themselves, they will alert authorities.

The introduction of the marker though must not imply that the buck for public safety stops with the GP; as the police have acknowledged, they themselves are ultimately responsible for firearms licensing.

But as this new marker is rolled out, we encourage GPs to build on existing relationships with local forces to help further protect public safety.




Reversing the Nature Crisis: Silent spring or Adlestrop?

Introduction: Silent Spring

“There was once a town in the heart of America where all life seemed to live in harmony with its surroundings. Then a strange blight crept over the area. Everywhere was a shadow of death. It was a spring without voices. On the mornings that had once throbbed with the dawn chorus of robins, doves, jays, wrens, and scores of other bird voices there was now no sound; only silence lay over the fields and woods and marsh. No witchcraft, no enemy action had silenced the rebirth of new life in this stricken world. The people had done it themselves.”

Those are the opening lines of Rachel Carson’s Silent Spring, the 1962 book that sparked the modern environmental movement. Sixty years on we are closer than ever to that silent spring happening. Since we humans and everything we cherish depends on nature, we have the strongest possible interest in avoiding that outcome.

But if we are going to fix the problem, we need to start by understanding what the problem is, its magnitude, and what’s causing it.

That is why the Environment Agency has today published a major new report on the state of our nature. It looks in particular at what is happening to our plants and animals (trigger warning: it’s shocking), explains what these do for us (apart from bringing us joy at their beauty), and sets out how we can turn things around.

Our report focuses on England, but you could write this report about almost any other country in the world right now and while the details would all be different, the underlying picture would be the same – awful.

What’s happening: the story so far

People have affected the environment in England for millennia. Most of our untouched natural wilderness had probably already vanished from Britain by the time the Romans arrived. Even then our forebears were not living sustainably, cutting down forests and starting to degrade nature. The Industrial Revolution made things worse, by trigging the start of climate change as coal was burned to power machines, and by starting to put much more pollution into environment. That accelerated the degradation of nature on which our plants, our wildlife and all of us ultimately depend.

But it wasn’t until the second half of the 20th century and our own lifetimes that things really started to go downhill. Our report collects the evidence. Species-rich grasslands such as meadows have decreased in extent by around 97% since 1930. Lowland heathlands now cover only 20% of the area they did in the 19th century. The loss of wetlands, one of the richest habitats, has also been severe: we have lost 99.7% of our fens, 81% of our grazing marshes and 44% of our lowland bogs. Almost all our ancient trees have gone too: up to 70% of our remaining ancient woodlands have been deforested or damaged, mostly during the past century.

The loss of meadows, wetlands, woods – the decline in those precious habitats has had its inevitable consequence: an equally shocking decline in the plants and animals that depend on them. Since 1970, 41% of our species have decreased in abundance and 15% of all our native species in the island of Britain are now threatened with extinction.

The position is even worse for the mammals, birds, butterflies and moths designated as priority species – those about which we have the greatest concern. They have declined in abundance overall by 61% since 1970.

Since that date butterflies and moths have decreased in average abundance by 16% and 25% respectively; a third of pollinator species have declined; water and wetland birds have declined by 14%, woodland birds by 25%, and farmland birds by 55%. A third of farmland specialist species – those that depend on a narrow ecological niche, like grey partridge, turtle doves, tree sparrows and corn buntings – have declined by more than 90% since 1970.

It’s no better for our mammals: several species have undergone drastic reductions in population sizes. Hedgehog numbers have fallen by approximately 66% since 1995 and water voles have done even worse, falling by 78%. Overall, a quarter of mammals in England are now threatened with extinction. Let me say that sentence again in case you missed it: a quarter of mammals in England are now threatened with extinction. If that doesn’t make you angry, you haven’t been paying attention.

The story is a bit better in our waters, partly as a result of all the work the Environment Agency has done over the last three decades to clean up our rivers. Freshwater invertebrates, on which a lot of other aquatic life depends and which had previously declined to a low in the mid-1990s, have shown a recovery in recent years. Not so some other species like salmon though: in 2019, only 16% of our rivers met the minimum population targets for salmon conservation, the lowest score since monitoring began in 1993.

Meanwhile, things aren’t any better on the ground. 18% of plants and 15% of fungi and lichens are at risk of extinction in Great Britain.

Why this is happening

Why is this happening? It’s the result of a combination of factors: unsustainable use of our resources, changes in land use, pollution, the modifications we have made to our rivers, urban development, etc, much of which has been going on for centuries but which is now having a cumulative effect.

What’s making this even worse is something relatively new – the climate emergency. Changing climate patterns are disturbing species and the warmer temperatures that climate change is bringing is threatening the existence of some of those species. Example: lakes. When the water temperature in a lake gets to 17 degrees C, they are likely to suffer from algal blooms which lead to a deterioration in water quality, less life in that water and less diversity in the life that remains.

So there are a range of factors in the nature crisis we are now witnessing. They all, however, have one thing in common: they are down to us, the humans.

Why is this a problem?

Why should we care about biodiversity? Does it really matter if the vole goes the way of the dodo? It would be a shame to live in a world without tree sparrows, but we could surely manage without them, couldn’t we? Here’s why it does matter: the biodiversity crisis is a crisis because it won’t just kill the plants and animals it is killing. It will kill us too.

That’s because nature is indivisible and interdependent. Nature provides us with a host of things we depend upon, such as clean water, clean air and food. No nature, no food. It’s vital in providing resilience to climate change by absorbing carbon dioxide, regulating local climatic conditions and providing flood protection. No nature, no climate shield. And as humans we depend on green and blue spaces for our own health and well-being. No nature, no us.

What we do about it

Are you depressed enough yet? Don’t be because we can turn this round. Just as we can successfully tackle the climate emergency by doing the right things, we can successfully tackle the biodiversity crisis too.

Nature is indivisible. What happens in one part of our blue planet affects all the other parts. So the solution to the biodiversity crisis has to start at the global level. The framework for that already exists: the international Convention on Biological Diversity, which has committed all its signatories to protect our natural diversity, and to enhance it wherever possible. At the UN Biodiversity Conference (COP 15) due to take place later this year, governments from around the world need to agree a new set of goals for the next decade with strong monitoring to measure progress on the ground in reversing nature loss.

What the government is doing

We need action at the national level. The UK government, with other leading nations, made a commitment to halt and reverse biodiversity loss by 2030: or in other words to become Nature Positive. Many organisations, the EA included, have made a commitment to be Carbon Neutral by 2030. I would (and do) get out of bed every day to achieve that. But I would leap out of bed to help the planet become Nature Positive.

We could achieve that goal in this country. We know what we need to do: nurture our protected species; sustain our protected areas; better protect wildlife habitats outside those areas; restore our damaged habitats and create new ones; start to knit together nature networks across the whole country; build a nature positive approach into our planning and development; stop the pollution which damages our habitats; tackle the climate emergency which is accelerating the biodiversity crisis and vice versa; and wherever we have a problem, employ nature based solutions as the default to solving it.

And much of this not only can be done, by governments national and local, by businesses, by landowners, by others; much of it is already being done. And what gets measured gets done. That is why we welcome the lead the UK government has given others by requiring, in the new Environment Act, the setting of a legally binding target on species abundance in England for 2030, aiming to halt the decline of nature.

What the EA is doing

The Environment Agency is playing its part. We protect species and the habitats on which they depend. Example: our work to ensure that the abstraction of water (which we regulate) does not damage wildlife or habitat – and when we think it will, we are reducing or in some cases stopping that abstraction by adjusting or turning off the licences that allow it. We create and restore habitat: over 1,100 hectares last year (2021/22). We use our role as a statutory planning consultee to ensure that new developments don’t damage the environment, and we are influential: almost all planning decisions (over 98%) are in line with our advice. We are tackling the pollution that hits our wildlife, including by reducing the amount of air pollution from the industries we regulate. We are improving our waters on which so much of nature depends: we enhanced over 1,500 kilometres of rivers and streams last year. We are tackling the climate crisis, by regulating down most of the emissions that cause it, by helping people and nature become more resilient to its effects by building flood defences and by helping planners, developers and communities create better and more resilient places. And we are increasingly using nature-based solutions as the default.

Example: Steart Marshes on the Severn Estuary. If you visited Steart and didn’t know what it was, you would think it was just a beautiful bit of marshland with some nice birds. It is all of those things. But it is a lot more too. It is also the UK’s biggest coastal realignment scheme which reduces flood risk to 100,000 homes and businesses – a benefit valued at £5 billion – and has created 250 hectares of new intertidal habitat. The new marshland is home to a variety of species including great crested newts, otters, butterflies, and wintering and breeding birds. It is also a place where people can enjoy nature, a benefit to the local rural economy, and a carbon sink, locking away carbon and reducing the extent of climate change. It’s a massive success for our partners with whom we designed and built it, the Wildfowl and Wetlands Trust and local communities. And it’s a great example of how nature-based solutions can deliver multiple outcomes, including but not limited to tackling the biodiversity crisis.

Second example: Keeping Rivers Cool. If warm lakes are bad (algal bloom, as I mentioned) then warm rivers are bad too, killing off the wildlife in them. Our Keeping Rivers Cool project (the clue is in the name) uses trees to shade streams and prevent some of the warming that happens on hot sunny days, reducing the impact on trout and salmon and other species. The shade from trees can reduce temperatures in small rivers on average by 2 to 4ºC (compared to unshaded streams), sometimes by more on the hottest days: and that can make all the difference to the wildlife. Since the programme began in 2012, the Environment Agency, Rivers Trusts and Wildlife Trusts have planted more than 500,000 trees along our rivers and streams. This doesn’t just help the wildlife and tackle both the causes and consequences of climate change, though it does. It is also providing other benefits, such as reducing erosion, intercepting sediment and pollutants, and making the rivers nicer places for the humans as well as all the other forms of wildlife that benefit.

What we can all do

So the EA is doing its bit. But none of us is as good as all of us. We are all contributing in some way to the biodiversity crisis, and we all have a role to play in tackling it. There are simple steps we can all take, most or all of which will also help us address the climate crisis too. Walk, cycle or take public transport instead of driving. Have less stuff, and reuse or recycle as much of it as you can. Use water wisely. If you have a garden don’t concrete over it: keep it green and put in a pond. Only eat sustainably sourced food. Make sure your pension is not invested in businesses that are trashing the planet. Think about how your footfall resonates on this earth.

Conclusion

I started with a silent spring in which no birds sang. That is one future we can have, and will have if we fail to act. But there is another future we can have, a much brighter one, if we do choose to act. That’s a future best encapsulated by another work of literature, a famous poem about the past which is also a kind of nostalgia for a future we would all like. It’s “Adlestrop”, by Edward Thomas, written in 1917 towards the end of a war that the poet himself tragically did not survive.

Adlestrop

Yes. I remember Adlestrop—

The name, because one afternoon

Of heat the express-train drew up there

Unwontedly. It was late June.

The steam hissed. Someone cleared his throat.

No one left and no one came

On the bare platform. What I saw

Was Adlestrop—only the name

And willows, willow-herb, and grass,

And meadowsweet, and haycocks dry,

No whit less still and lonely fair

Than the high cloudlets in the sky.

And for that minute a blackbird sang

Close by, and round him, mistier,

Farther and farther, all the birds

Of Oxfordshire and Gloucestershire.

So let’s tackle the nature crisis. Let’s refuse the silent spring. Let our future be Adlestrop.

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