Jump to content
Sign in to follow this  
  • articles
  • comments
  • views

Contributors to this article

About this News

Articles in the news


Kent and Medway: Review into patient harm after DMC 'failure'

At least 18 serious cases are being investigated by NHS bosses after GP and dermatology services were stripped from private medical company.

The Kent and Medway Clinical Commissioning Group (CCG) confirmed on Monday an independent review was taking place. It will see if delays to treatment for thousands of patients using DMC Healthcare services "caused harm".

The NHS removed contracts worth £4.1m a year from the private firm in July.

DMC was responsible for nearly 60,000 patients at nine surgeries in Medway, and skin condition services in other parts of Kent, the Local Democracy Reporting Service said.

In north Kent, there were 1,855 patients needing urgent treatment and a further 7,500 on the dermatology service waiting list. Of those, 700 had been waiting more than a year.

Nikki Teesdale, from Kent and Medway's CCG, said it was "too early" to reach definitive conclusions around the 18 serious cases. Speaking to Kent and Medway's joint health scrutiny committee on Monday she said of the 18, five had been waiting "significant periods of time" for cancer services.

"Until we have got those patients through those treatment programmes, we are not able to determine what the level of harm has been," she added.

Read full story

Source: BBC News, 29 September 2020

Read more

Post-covid clinics in the US get jump-start from patients with lingering illness

Clarence Troutman survived a two-month hospital stay with COVID-19, and then went home in early June. But he's far from over the disease, still suffering from limited endurance, shortness of breath and hands that can be stiff and swollen.

"Before Covid, I was a 59-year-old, relatively healthy man," said the broadband technician from Denver. "If I had to say where I'm at now, I'd say about 50% of where I was, but when I first went home, I was at 20%."

He credits much of his progress to the "motivation and education" gleaned from a new programme for post-covid patients at the University of Colorado, one of a small but growing number of clinics aimed at treating and studying those who have had the unpredictable disease caused by this coronavirus.

As the US general election nears, much attention is focused on daily infection numbers or the climbing death toll, but another measure matters: Patients who survive but continue to wrestle with a range of physical or mental effects, including lung damage, heart or neurological concerns, anxiety and depression.

"We need to think about how we're going to provide care for patients who may be recovering for years after the virus," said Dr Sarah Jolley, a pulmonologist with UCHealth University of Colorado Hospital and director of UCHealth's Post-Covid Clinic, where Troutman is seen.

That need has jump-started post-covid clinics in the US, which bring together a range of specialists into a one-stop shop.

One of the first and largest such clinics is at Mount Sinai in New York City, but programmes have also launched at the University of California-San Francisco, Stanford University Medical Center and the University of Pennsylvania. The Cleveland Clinic plans to open one early next year.

And it's not just academic medical centres: St. John's Well Child and Family Center, part of a network of community clinics in South Central Los Angeles, said this month it aims to test thousands of its patients who were diagnosed with covid since March for long-term effects.

The general idea is to bring together medical professionals across a broad spectrum, including physicians who specialize in lung disorders, heart issues and brain and spinal cord problems. Mental health specialists are also involved, along with social workers and pharmacists.

Read full story

Source: CNN Health, 28 September 2020

Read more

'Frail' people like me should not be denied lifesaving Covid care

A frailty index is rationing treatment for older and disabled people who catch coronavirus, says Patience Owen. Patience has has a debilitating connective tissue disorder and, like thousands of others with rare conditions, is already in a minority within a minority, marginalised by our NHS, battling increasing disability day by day.

Back in March, without consultation and days before the first lockdown, the Clinical Frailty Scale (CFS), a worldwide tool used to swiftly identify frailty in older patients to improve acute care, was adapted by the National Institute for Health and Care Excellence (NICE). It asked NHS staff in England to score the frailty of Covid patients. Rather than aiming to improve care, it seems the CFS – a fitness-to-frailty sheet using scores from one to nine – was used to work out which patients should be denied acute care. Nice’s new guidelines advised NHS trusts to “sensitively discuss a possible ‘do not attempt cardiopulmonary resuscitation’ decision with all adults with capacity and an assessment suggestive of increased frailty”.

"Checking the scale, I found I would score five, the 'mildly frail' category, and therefore should I get Covid I could be steered towards end-of-life care. Bluntly, if I catch the virus, the NHS may help me to die, not live," says Patience.

By early April, there was a proliferation of illegal “do not resuscitate” (DNR) notices in care homes for people with learning disabilities, and for older people in care homes and in hospitals. Many acutely ill patients stayed at home with Covid symptoms in the belief that they risked being denied care in hospital. Following warnings by the healthcare regulator, the Care Quality Commission, and other medical bodies, that the blanket application of the notices must stop, and legal challenges by charities, exclusions were made to the NICE guidelines.

These included “younger people, people with stable long-term disabilities, learning disabilities or autism”. Yet the guidelines remain in place, in spite of the fact that they appear to contravene the Human Rights Act (including the right to life, article 2, and the right to non-discrimination, article 14). 

A spokeswoman for NICE says it is “very aware of the concerns of some patient groups about access to critical care, and we understand how difficult this feels. Our COVID-19 rapid guideline on critical care was developed to support critical care teams in their management of patients during a very difficult period of intense pressure."

“'Difficult' is a hollow word for the feeling of being selected to die," says Patience. "It’s difficult not to conclude that those with long-term conditions and disabilities, like myself, have become viewed as a sacrificial herd."

Read full story

Source: The Guardian, 29 September 2020

Read more

COVID-19: Government poised to amend regulations to allow use of unlicensed vaccine

Experts say robust legal protections are needed to inspire public confidence. The UK government has set out plans to amend drug regulations in case it decides that COVID-19 vaccines should be used before they are licensed, in a bid to roll them out more quickly.

In a consultation on the proposals that ran from 28 August to 18 September the Department of Health and Social Care for England explained that if a suitable vaccine emerged with strong evidence of safety, quality, and efficacy the government would seek to license it through the usual route but could supply it in the meantime.

The document added, “A COVID-19 vaccine would only be authorised in this way if the UK’s licensing authority was satisfied that there is sufficient evidence to demonstrate the safety, quality, and efficacy of the vaccine. ‘Unlicensed’ does not mean ‘untested.”

The consultation, and the timeframe in which it was conducted, prompted some people to post their concerns on social media. 

However, the Human Medicine Regulations 2012 already allow the licensing authority to temporarily authorise the supply of an unlicensed product in response to certain public health threats, including the suspected spread of pathogens. The proposed change would allow conditions to be attached “to ensure product safety, quality, and efficacy”

The 2012 regulations also give healthcare professionals and manufacturers immunity from being sued in the civil courts for the use of some unlicensed products recommended by the licensing authority in response to a public health threat. The new regulations would extend the immunity to drug companies that have not manufactured the product but placed it on the market with the approval of the licensing authority, and they clarify the consequences for a breach of conditions imposed by the authority.

Social media posts play into existing concerns that many people might not accept the vaccine, as surveys indicate. Lawyers have told the Department for Health and Social Care that to inspire public confidence it must provide redress for the few people who might experience adverse effects.

Bozena Michalowska, a partner specialising in product liability at the law firm Leigh Day, said, “I do not believe that people will want to play Russian roulette with their health by taking a vaccine which they know nothing about, especially when they know that the risks they take are just taken by them and not a shared risk and they will not have sufficient protection should things go wrong.”

Read full story

Source: The BMJ, 28 September 2020

Read more

Covid ICU survivor: 'I have come out the other end'

Covid survivor Tam McCue is one of the lucky ones. Earlier in the year he was in intensive care in the Royal Alexandra Hospital in Paisley where he had been on a ventilator for nearly two weeks.

At one point Mr McCue, who could barely speak, didn't think he would live. 

Fast forward five months and Mr McCue, of Barrhead, East Renfrewshire, is back from the brink.

He became desperately ill but, thankfully, it only went as far as his lungs. With coronavirus some patients have have suffered multiple organ failure which also affected their heart, kidneys, brain and gut.

Mr McCue describes his recovery as a "rollercoaster".

He added: "It's a slow process. You think you can do things then the tiredness and fatigue sets in."

He said: "It lies in the back of your mind. As years go on, how are you going to be? Is it going to get you again? It does play on you. It definitely does."

As part of his recovery Mr McCue is attending the Ins:pire clinic online. It is normally a face-to-face rehabilitation clinic which involves multiple specialties, including pharmacists, physiotherapists and psychologists. Mr McCue is one of the first Covid survivors to take part in the five-week programme, which started earlier this month.

Read full story

Source: BBC Scotland News, 29 September 2020

Read more

Leaked data gives first view of growing cancer waiting list post covid peak

Official data from mid-September shows that nearly 6,400 people had waited more than 100 days following a referral to cancer services.

The leaked data reveals for the first time the length of the cancer waiting list in the wake of the first pandemic peak, during which much diagnostic and elective cancer care was paused.

The list consists of those waiting for a test, the outcome of a test, or for treatment. NHS England and Improvement only publish waiting times for patients who have been treated – not the number still waiting – so this information has been secret.

The data, obtained from official emails seen by HSJ, showed the total number of people on the cancer waiting list grew substantially, from 50,000 to around 58,000, between the start of August and the middle of September. 

Of the 6,400 people recorded to be waiting more than 104 days on 13 September, 472 had a “decision to treat classification”, meaning they have cancer and are awaiting treatment. 

NHS England has said reducing the cancer waiting list would be overseen by a national “taskforce”, which is being chaired by national director for cancer Peter Johnson.

Experts have warned the delays already stored up in the system could cost tens of thousands of lives as patients go undiagnosed or have their diagnosis and treatment later than they otherwise would.

HSJ asked NHS England if harm reviews had been carried out for those on the waiting list and whether it had discovered if those waiting longer than104 days had been harmed, but did not receive an answer.

Read full story (paywalled)

Source: HSJ, 29 September 2020

Read more

Coronavirus: NHS faces pandemic 'triple whammy' this winter

The NHS is facing a "triple whammy" of rising COVID-19 cases, a major backlog in treatment and reduced capacity due to infection-control measures, according to health bosses. 

The NHS Confederation report on the English NHS said more investment was desperately needed. The NHS bosses also called on ministers to be "honest and realistic" about waiting lists for treatment.

It comes despite the government promising an extra £3bn this winter. That money - announced over the summer - was intended to help hospitals cope with the extra-infection control measures required and to pay for patients to be treated privately for routine treatment, such as knee and hip replacements. 

But hospitals are still performing only half the number of routine operations they normally would. Two million patients have already waited longer than 18 weeks for treatment, the highest number since records began, in 2007.

And services in other areas, such as cancer care, are running at about three-quarters capacity. 

Of the more than 250 bosses who responded to the confederation's survey:

  • fewer than one in 10 said the current level of funding allowed them to deliver safe and effective care
  • nearly nine in 10 said a lack of funding would be a significant barrier to achieving waiting-time targets for everything from mental-health care to cancer treatment and routine operations.

Read full story

Source: BBC News, 29 September 2020

Read more

'A one-off test is a folly': The truth behind covid false negative covid results

When Sarah found herself suffering sudden bouts of breathlessness in May, she took herself to hospital. But after her COVID-19 swab test came back negative, doctors said she was probably anxious, and sent her home.

Despite this, Sarah’s symptoms continued to worsen. A week later, she was rushed to hospital in an ambulance. Paramedics told her that based on her clinic observations, she should be in a coma.

Then came more surprising news: She had tested positive for coronavirus

Sarah’s story – given to a patient safety charity under a pseudonym – is one that resonates with Dr Claudia Paoloni, president of the Hospital Consultants and Specialists Association. She detailed another case in which a patient tested negative twice: once when she was first admitted to hospital and once later in her hospital stay. She finally tested positive on her third test – by which time she was on a ventilator in intensive care.

Paolini believes COVID-19 swab tests produce a troublingly high rate of false negative results, and the problem lies in the reliance on a single test.

“To use as a one-off test in any capacity to exclude someone from having COVID-19 is a folly.” 

If you want to exclude someone from having the virus, Paoloni said, you must do multiple tests and collect multiple negative results. “If the test and tracing system is not working, which is the case here, transmission will continue unabated in the community.”

The most recent data published by the Office for National Statistics says the test’s sensitivity - which it says can tell us how likely it is to return a false-negative result, may be somewhere between 85% and 98%. 

Dr Deenan Pillay, Professor of Virology at University College London and member of Independent Sage, a group of scientists providing transparent advice during the crisis, said a significant number of self-administered tests could be coming back negative for people who do in fact have the virus.

“The single biggest reason why a swab from someone who has COVID-19 comes up as negative is the quality of the swab that is taken,” Dr Pillay said. “Swabbing your nose and throat in a way that will pick up the virus means really scraping down the side of the wall of the nose or back of the throat to get cells from the lining of the throat. That’s not a pleasant thing to do.”

This is of course true for at-home testing, which relies on the patient or a family member to collect the swab. But it could be true at testing centres, too.

Tom, a 29-year-old from London whose name has been changed for this story, said there were no medical staff on site when he visited a Covid testing centre in London. The only people he interacted with were staff from a third-party contractor paid to carry out testing.

“The man simply handed me a test, read out the instructions to self-administer the test, and asked me to do it myself,” he said.

Pillay agrees that testing methods are likely to have an impact on false negative results. “I have seen the documentation given out at testing centres and it is very confusing,” he said. “Centres often expect you to administer the test yourself or get someone else in your car to administer it for you, all of which creates difficulties.” 

Pillay believes the solution lies in having medically trained staff at testing centres. “The way the system is developed at the moment, outsourced to private companies like Deloitte and Lighthouse Labs, is just woeful,” he said.

“The whole system is failing at the moment. And it’s happening just as the numbers of infections are starting to rise,” Dr Pillay said.

Read full story

Source: Huffpost, 27 September 2020

Read more

Cwm Taf maternity: Mothers to be told of service failings

Parents affected by serious failings in maternity units at a Welsh health board will be told of the findings of an independent investigation this autumn. Ten more cases at units run by Cwm Taf Morgannwg in the south Wales valleys have been found by a review, bringing the total number to 160.

Maternity services at hospitals in Merthyr Tydfil and Llantrisant were placed in special measures last year. Failings at the maternity units were discovered after an investigation by two Royal Colleges, which found mothers faced "distressing experiences and poor care" between 2016 and 2018.

The services at the Royal Glamorgan Hospital in Llantrisant and Prince Charles Hospital in Merthyr Tydfil were also found to be "extremely dysfunctional" and under extreme pressure.

A number of recommendations were set to make the service safe for pregnant women and those giving birth at the hospitals.

The Welsh Government then appointed the Independent Maternity Services Oversight Panel (IMSOP) to look back at cases, including neonatal deaths.

Mick Giannasi, the chairman of IMSOP, said: "In the early autumn, we will start writing to mothers to say we have reviewed your care and this is what we found.

"That will be quite distressing for the women because they will have to revisit all those things again.

"But it's going to be a difficult period for staff as well because we know that the Royal Colleges review was very difficult for staff - some of the messages that they had to hear were very challenging and those things may be played out again."

Read full story

Source: BBC News, 28 September 2020


Read more

NHS announces independent review into gender identity services for children and young people

The NHS has announced that Dr Hilary Cass OBE, former President of the Royal College of Paediatrics and Child Health, will lead an independent review into gender identity services for children and young people.

The review will be wide-ranging in scope looking into several aspects of gender identity services, with a focus on how care can be improved for children and young people including key aspects of care such as how and when they are referred to specialist services, and clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

It will also set out workforce recommendations for specialist healthcare professionals and examine the recent rise in the number of children seeking treatment. Dr Cass will then make clear recommendations for children and young people’s gender identity services reporting back next year.

The Gender Identity Development Service for Children and Adolescents is managed by the Tavistock and Portman NHS Foundation Trust.

The Care Quality Commission (CQC) is due to carry out a focused inspection of The Tavistock and Portman NHS Foundation Trust, Gender Identity Services for children and young people, during the autumn. The inspection will cover parts of the safe, effective, caring, responsive and well-led key questions and will include feedback from people using the service, parents, relatives, carers, and staff. Separately, Dr Cass will also review the service’s clinical practice with the support of the Royal College of Paediatrics and Child Health and engagement of other professional bodies to provide multi-professional insight working closely with the CQC.

The review includes an examination of the issues surrounding children and young people who are prescribed puberty blocking and cross sex hormone drugs.

Dr Hilary Cass OBE, independent chair, said: “It is absolutely right that children and young people, who may be dealing with a complexity of issues around their gender identity, get the best possible support and expertise throughout their care.”

“This will be an inclusive process in which everyone will have the opportunity to make their views known. In particular I am looking forward to hearing from young people and their families to understand their experiences.

“This review provides an opportunity to explore the most appropriate treatment and services required.”

Read full story

Source: NHS England, 22 September 2020

Read more

Did the NHS 111 Covid helpline fail hundreds of families?

Hundreds of people believe the 111 helpline failed their relatives. Now the Guardian reports that they are demanding a full inquiry into the service.

When the coronavirus outbreak hit in March, the NHS feared hospitals could be overwhelmed and so patients with suspected symptoms were directed to call the designated 111 helpline. Call volumes were massive and waiting times were often over an hour.

The Guardian’s David Conn has spent months talking to bereaved relatives about that difficult time and during his conversations he found many were deeply unhappy about the service they felt had been provided by the 111 helpline.

Lena Vincent’s partner Patrick McManus died from the virus in April following a short period in hospital. He had called 111 three times and had not been advised to seek further medical help. Lena tells Anushka she wants to know who is accountable for the service.

Listen to the podcast

Source: The Guardian, 28 September 2020

Read more

Why India should worry about post-COVID-19 care

When 60-year-old Milind Ketkar returned home after spending nearly a month in hospital battling COVID-19, he thought the worst was over.

People had to carry him to his third-floor flat as his building didn't have a lift. He spent the next few days feeling constantly breathless and weak. When he didn't start to feel better, he contacted Dr Lancelot Pinto at Mumbai's PD Hinduja hospital, where he had been treated.

Dr Pinto told him inflammation in the lungs, caused by Covid-19, had given him deep vein thrombosis - it occurs when blood clots form in the body and it often happens in the legs.

Fragments can break off and move up the body into the lungs, blocking blood vessels and, said Dr Pinto, this can be life-threatening if not diagnosed and treated in time.

Mr Ketkar spent the next month confined to his flat, taking tablets for his condition. "I was not able to move much. My legs constantly hurt and I struggled to do even daily chores. It was a nightmare," he says.

He is still on medication, but he says he is on the road to recovery.

Mr Ketkar is not alone in this - tens of thousands of people have been reporting post-Covid health complications from across the world. Thrombosis is common - it has been found in 30% of seriously ill coronavirus patients, according to experts. These problems have been generally described as "long Covid" or "long-haul Covid".

Awareness around post-Covid care is crucial, but its not the focus in India because the country is still struggling to control the spread of the virus. It has the world's second-highest caseload and has been averaging 90,000 cases daily in recent weeks.

Dr Natalie Lambert, research professor of medicine at Indiana University in the US, was one of the early voices to warn against post-Covid complications.

She surveyed thousands of people on social media and noticed that an alarmingly high number of them were complaining about post-Covid complications such as extreme fatigue, breathlessness and even hair loss.

The Centre for Disease Control (CDC) in the US reported its own survey results a few weeks later and acknowledged that at least 35% of those surveyed had not returned to their usual state of health.

Post-Covid complications are more common among those who were seriously ill, but Dr Lambert says an increasing number of moderately ill patients - even those who didn't need to be admitted to hospital - haven't recovered fully.

Read full story

Source: BBC News, 28 September 2020

Read more

Coronavirus: Tens of thousands ‘wrongly given’ all clear by Lighthouse Labs

Tens of thousands of people infected with coronavirus were incorrectly given the all clear by England’s Lighthouse Laboratories, a High Court trial will be told next week.

Court documents seen by The Independent show the labs are accused of unfairly selecting software that was shown in a test to produce significant numbers of errors and false negatives, samples that should have been positive or classed as needing to be re-taken.

The two companies behind the Lighthouse Labs in England – Medicines Discovery Catapult Ltd and UK Biocentre Ltd – are accused of treating British company, Diagnostics.ai unfairly and giving preferential treatment to Belgian company UgenTec, despite the British firm’s software performing better in the test.

The case, first revealed by The Independent in June, also includes a judicial review of the procurement decision against health secretary Matt Hancock – one of the first court hearings over the procurement processes followed by the government since the start of the pandemic.

The Independent understands lawyers for Diagnostics.ai will accuse the laboratories of choosing a software solution that went on to produce tens of thousands of incorrect results which will have led to infected people going about their normal lives while at risk of spreading the virus.

In June, UgenTec chief executive Steven Verhoeven told The Independent the suggestion its software had made errors was “incorrect”.

The Department of Health refused to comment on the legal action but said in June that the UgenTec software had been used for several months and was subject to quality assurance processes, though it did not give any further details.

Mr Justice Fraser will hear opening arguments in the case on Monday at the High Court.

Read full story

Source: The Independent, 25 September 2020

Read more

"I’m one of the legion of long-Covid sufferers"

Hundreds of thousands who survived the virus still have side-effects that range from loss of smell to chronic fatigue.

"It started with a mild sore throat. I was in Devon at the beginning of the lockdown, and because I hadn’t been on a cruise ship, gone skiing in Italy or partying with the crowds at Cheltenham races, I didn’t think it could be COVID-19. Then I developed sinusitis. My GP was practical: “This is not a symptom of the virus,” he emailed me. But my sense of smell had disappeared. At first this wasn’t a sign but six months later, I still can’t tell the difference between the smell of an overripe banana or lavender. I can distinguish petrol but not gas, dog mess but not roses, bacon but not freshly cut grass. Everything else smells of burnt condensed milk."

Read full story (paywalled)

Source: The Times, 23 September 2020

Read more

Investigation launched after seven ‘never events’ in two years at leading trust

An external review has been launched at a leading children’s hospital after a series of “never events”.

According to local commissioners, a review by the Association for Perioperative Practitioners will look into seven incidents at Alder Hey Children’s Foundation Trust over the last two years. The probe had been delayed by the pandemic and began this month.  

Great Ormond Street Hospital for Children FT and Sheffield Children’s FT, the two other dedicated children’s trusts in England, reported one and four never events respectively, between April 2018 and July 2020, according to national data.

In a statement, Alder Hey claimed it could not provide further details of the incidents. But most have been described in its board papers over the past year. They include a 15-year-old who had the wrong tooth removed by the surgical division, a patient who had the wrong eye operated on, a swab that was left inside a patient having their adenoids and tonsils removed, and an incorrect implant being inserted into an orthopaedics patient.

Liverpool Clinical Commissioning’s group’s board papers for September said: “The trust has had a series of seven never events and there is a plan to undertake an external review that has been delayed due to the pandemic response. The trust has approached the Association for Perioperative Practitioners and have agreed the process."

“The trust also plans to work with Imperial College London on a peer review and bespoke human factors training to include simulation training and coaching. The trust also plans to produce an overarching action plan to bring together the themes and learning from the seven never events. This work is still underway and NHSE/I and CCG had requested a copy of this plan.”

Read full story (paywalled)

Source: HSJ, 24 September 2020

Read more

Great Ormond Street criticised over Arvind Jain's death

Delays at the Great Ormond Street Hospital led to a boy dying an agonising death, a health watchdog has found.

Arvind Jain, 13, who had Duchenne Muscular Dystrophy, died in August 2009 after waiting months for an operation. The ombudsman's report found he had "suffered considerable distress" and criticised referral procedures as "chaotic and substandard".

The Great Ormond Street Hospital said there were "failings in clinical care".

Arvind's sister Shushma said: "To read that he was suffering all the time, that was disgusting. He had been asking us repeatedly if he would get the operation and we would be constantly reassuring him that he would not die."

The degenerative disease Arvind, who lived in Cricklewood, north London, suffered from was not immediately life threatening but in January 2009 his condition had become acute enough for him to struggle with swallowing and feeding. He had a temporary medical solution where a tube was inserted through his nose to help him get the required nutrition. He also experienced a number of other medical complications although none of these was considered life-threatening.

The permanent solution recommended by his consultant paediatric neurologist was a gastrostomy insertion which would allow Arvind to feed through his stomach.

The Great Ormond Street Hospital Trust (GOSH) excels in such procedures, however, a series of communication errors meant despite repeated and urgent requests from his neurological consultant, proper investigations were not carried out into Arvind's suitability for the operation.

After five months of delays he and his family were reassured that as soon as he got the operation he would be much more comfortable. Another hospital also offered to carry out the operation in the event that the delays continued. But the surgical team that was due to carry out the operation never managed to assess Arvind.

His condition deteriorated to the point where he was not well enough to be operated on and Arvind died on 9 August 2009.

The Parliamentary and Health Service Ombudsman's report said he "suffered considerable distress and discomfort". It also describes a series of basic shortcomings in Arvind's care.

The report said: "The standard of care provided for Arvind fell so far below the applicable standards as to amount to service failure."

Read full story

Source: BBC News, 23 September 2020

Read more

True Global Solidarity: Spectacular World Patient Safety Day around the world

Dr Neelam Dhingra, Coordinator, Patient Safety and Risk Management, World Health Organization, reflects on World Patient Safety Day 2020.WPSD.png.da03fa56e160d143a1492a93e3ae8072.png

"Dear Colleagues

Congratulations. This is a moment of pride for all of us!

The WHO Patient Safety Flagship would like to express its deepest appreciation to members of the Global Patient Safety Network for an outstanding commemoration of the World Patient Safety Day 2020 around the world. The response to the call was phenomenal and we have already received great stories and truly inspiring reports from multiple countries, regions, partners and stakeholders showcasing a variety of activities. A number of global virtual events amplifying the messaging for the day. “Safe health workers, Safe patients” and “Speak up for Health worker safety!”. Moreover, hundreds, if not thousands, of iconic monuments, landmarks and health care facilities were lit up in colour orange from all over the world. We are working on a short summary and a full report illustrating all these amazing contributions. Most importantly, the day was a witness to expression of strong commitment and leadership of ministries of health for urgent and sustainable action, from countries across the world.

At WHO headquarters on 17 September 2020, a landmark Charter “Health worker Safety: A priority for patient safety”, was launched at a World Patient Safety Day Press Conference (https://twitter.com/who/status/1306496780649938944?s=24) by WHO Director General, Dr. Tedros Adhanom Ghebreyesus in the presence of International Labour Organization Director General, Dr Guy Ryder and Rt. Hon Mr Jeremy Hunt, Chair, Health and Social Care Select Committee, House of Commons of the UK, who played a key role in establishing World Patient Safety Day, an active campaigner on patient safety globally and also the Co-Chair of WHO Steering Committee on World Patient Safety Day.

WHO Member States and all relevant stakeholders are invited to support health worker safety by endorsing and signing up to the Charter.

Charter: Health worker safety: a priority for patient safety


Sign up: https://www.who.int/campaigns/world-patient-safety-day/sign-up-to-the-charter---health-worker-safety

A Global Virtual Event “One world: Global solidarity for health worker safety and patient safety” was held showcasing rich participations from members of this very network, regions and countries. WHO Deputy Director General, Dr Zsuzsanna Jakab, and also the Co-Chair of WHO Steering Committee on World Patient Safety Day, in her closing remarks emphasised 'World Patient Safety Day 2020 should not be seen only as Day but a platform for change.  WHO will work with partners to advance the themes of the Day throughout the entire year'.

A number of advocacy, policy, technical products were launched at the event including:

1. World Patient Safety Day 2020-21 Goals. From this year onwards, WHO will launch theme-related goals with the aim of achieving tangible and measurable improvements at the point of health service delivery. Ministries of health and health care organizations are encouraged to incorporate these goals into ongoing service improvement programmes and drives. As a new set of goals will be proposed each year, implementation teams at health care facilities are advised to institutionalize patient safety improvements achieved, and to take on new goals as well as sustaining action on goals from the previous year. WHO is setting up an online platform where health care facilities and organizations can report progress and learn from each other. A certificate of appreciation will be provided to the registered facilities. The World Patient Safety Day goals 2020–2021 are aimed at improving health worker safety. Please sign up to the goals.

Goals https://www.who.int/publications/i/item/who-uhl-ihs-2020.8

Sign up: https://www.who.int/campaigns/world-patient-safety-day/sign-up-for-wpsd-2020-2021-goals

2. Patient safety incident reporting and learning systems: technical report and guidance: https://www.who.int/publications/i/item/9789240010338

3. WHO-ILO joint publication "Caring for those who care: National Programmes for Occupational Health for Health Workershttps://www.who.int/publications/i/item/caring-for-those-who-care

4. Protection of health and safety of health workers: Checklist for healthcare facilities https://www.who.int/publications/i/item/protection-of-health-and-safety-of-health-workers

5. An OpenWHO course on: Occupational health and safety for health workers in the context of COVID-19

World Patient Safety Day provides a torch bearing platform, which brings spotlight on global, national and local patient safety issues. This year the World Patient Safety Day brought a spotlight on health worker safety and its impact and interaction with patient safety.

This year’s WPSD came as a result of close collaboration between WHO and all stakeholders.  We strongly believe that the amazing sense of ownership was the key factor for success. For that, we thank you all.

Thanks and best regards,"

Dr Neelam Dhingra

Read more

10,000 more deaths than usual occurred in UK homes since June

Some 10,000 more deaths than usual have occurred in peoples’ private homes since mid June, long after the peak in Covid deaths, prompting fears that people may still be avoiding health services and delaying sending their loved ones to care homes.

It brings to more than 30,000 the total number of excess deaths happening in people’s homes across the UK since the start of the pandemic.

Excess deaths are a count of those deaths which are over and above a “normal” year, based on the average number of deaths that occurred in the past five years.

In the past three months the number of excess deaths across all settings, has, in the main been lower than that of previous years. However, deaths in private homes buck the trend with an average of 824 excess deaths per week in people’s homes in the 13 weeks to mid-September.

Experts are citing resistance from the public to enter hospitals or home care settings and “deconditioning” caused by decreased physical activity among older people shielding at home, for example not walking around a supermarket or garden centre as they might normally.

Read full story

Source: The Guardian, 24 September 2020

Read more

Maternity units told to allow partners and visitors so mothers are not left to give birth alone

Hospitals have been ordered to allow partners and visitors onto maternity wards so pregnant women are not forced to give birth on their own.

NHS England and NHS Improvement have written to all of the directors of nursing and heads of midwifery to ask them to urgently change the rules around visiting.

The letter, which is dated 19 September and seen by The Independent, says NHS guidance was released on 8 September so partners and visitors can attend maternity units now “the peak of the first wave has passed”.

“We thank you and are grateful the majority of services have quickly implemented this guidance and relaxed visiting restrictions,” it reads. “To those that are still working through the guidance, this must happen now so that partners are able to attend maternity units for appointments and births.”

The letter adds: “Pregnancy can be a stressful time for women and their families, and all the more so during a pandemic, so it is vital that everything possible is done to support them through this time.”

Make Birth Better, a campaign group which polled 458 pregnant women for a new study they shared exclusively, said mothers-to-be have been forced to give birth without partners and have had less access to pain relief in the wake of the public health crisis.

Half of those polled were forced to alter their own childbirth plans as a result of the COVID-19 outbreak – while almost half of those who were dependant on support from a specialist mental health midwife said help had stopped.

Read full story

Source: The Independent, 23 September 2020

Read more

Hundreds of hospital ventilators could stop working, NHS warned

Hospitals have been warned hundreds of ventilators used to keep sedated patients alive are at risk of suddenly shutting down because of a fault, in some cases without warning.

The Medicines and Healthcare products Regulatory Agency, which said there were approximately 303 Philips Respironics V60 ventilators used in the UK, has warned hospitals over a delay in replacement parts arriving in the UK to fix the problem.

It has issued a safety alert to hospitals to make them aware of the increased risk.

The regulator said it had received one report of a ventilator suddenly shutting down but said there was no report of any injury to patients.

Read full story

Source: The Independent, 23 September 2020

Read more

NHS trust fined for lack of candour in first prosecution of its kind

A hospital trust has been fined for failing to be open and transparent with the bereaved family of a 91-year-old woman in the first prosecution of its kind.

Elsie Woodfield died at Derriford hospital in Plymouth after suffering a perforated oesophagus during an endoscopy.

The Care Quality Commission (CQC) took University Hospitals Plymouth NHS trust to court under duty of candour regulations, accusing it of not being open with Woodfield’s family about her death and not apologising in a timely way.

Judge Joanna Matson was told Woodfield’s daughter Anna Davidson eventually received a letter apologising over her mother’s death, which happened in December 2017, but she felt it lacked remorse.

Davidson said she still had many unanswered questions and found it “impossible to grieve”.

The judge said: “This offence is a very good example of why these regulatory offences are very important. Not only have [the family] had to come to terms with their tragic death, but their loss has been compounded by the trust’s lack of candour.”

Speaking afterwards, Nigel Acheson, the CQC’s deputy chief inspector of hospitals, said: “All care providers have a duty to be open and transparent with patients and their loved ones, particularly when something goes wrong, and this case sends a clear message that we will not hesitate to take action when that does not happen."

Lenny Byrne, the trust’s chief nurse, issued a “wholehearted apology” to Woodfield’s family. “We pleaded guilty to failure to comply with the duty of candour and fully accept the court’s decision. We have made significant changes in our processes.”

Read full story

Source: The Guardian, 23 September 2020

Read more

‘Long covid’ clinics still not operating despite Hancock claim

The government and NHS England appear unable to identify units set up to treat ‘long covid’, contrary to a claim by Matt Hancock in Parliament that the NHS had ‘set up clinics and announced them in July’. 

There are growing calls for wider services to support people who have had COVID-19 and continue to suffer serious follow-up illness for weeks or months. Hospitals run follow-up clinics for those who were previously admitted with the virus, but these are not generally open to those who were never admitted.

Earlier this month the health secretary told the Commons health committee: “The NHS set up long covid clinics and announced them in July and I am concerned by reports from Royal College of General Practitioners that not all GPs know how to get into those services.”

Asked by HSJ for details, DHSC and NHS England declined to comment on how many clinics had been set up to date, where they were located, how they were funded or how many more clinics were expected to be “rolled out”.

However, two charities and support groups — Patient Safety Learning and the Long Covid Support Group — told HSJ they were not aware of dedicated long covid clinics for community patients. An enquiry from Patient Safety Learning to NHS England has not been answered.

The number of people affected by long covid is unclear due to a lack of research but there are suggestions it could be half a million or more. Symptoms can include fatigue, sleeplessness, night-time hypoxia, “brain fog” and cardiac problems. It appears to affect more people who were not hospitalised with coronavirus than those who were were. There is some evidence that small clinics have been set up locally on a piecemeal basis, without national funding.

HSJ has only been able to identify only one genuine “long covid clinics” open to those who have never been in hospital with covid. 

Trisha Greenhalgh, an Oxford University professor of primary care health sciences who has interviewed around 100 long covid sufferers, told HSJ: “Nobody I have interviewed had been seen in a long covid clinic but there is an awful lot of people who would like to be referred and who sound like the need to be but they haven’t.”

Read full story (paywalled)

Source: HSJ, 23 September 2020

Read the letter Patient Safety Learning sent to NHS England

hub Community thread - Long Covid: Where are these clinics?


Read more

Yew Trees hospital: Ten staff suspended at mental health unit

Ten workers at a mental health unit have been suspended amid claims patients were "dragged, slapped and kicked". Inspectors said CCTV footage recorded at the Yew Trees hospital in Kirby-le-Soken, Essex, appeared to show episodes of "physical and emotional abuse".

The details emerged in a Care Quality Commission (CQC) report after the unit was inspected in July and August. A spokeswoman for the care provider said footage had been passed to police.

The unannounced inspections were prompted by managers at Cygnet Health Care, who monitored CCTV footage of an incident on 18 July.

At the time, the 10-bed hospital held eight adult female patients with autism or learning difficulties.

The CQC reviewed 21 separate pieces of footage, concluding that 40% "included examples of inappropriate staff behaviour". "People who lived there were subjected not only to poor care, but to abuse," a CQC spokesman said.

Workers were captured "physically and emotionally abusing a patient", and failing to use "appropriate restraint techniques", the report said. It identified "negative interactions where staff visibly became angry with patients" and two cases where staff "dragged patients across the floor".

"We witnessed abusive, disrespectful, intimidating, aggressive and inappropriate behaviour," the inspectors said.

Read full story

Source: BBC News, 23 September 2020

Read more

Covid ban on care home visitors risks premature deaths, experts warn

Sweeping bans on visiting at thousands of care homes risk residents dying prematurely this winter as they give up hope in the absence of loved ones, experts in elderly care have warned.

More than 2,700 care homes in England are either already shut or will be told to do so imminently by local public health officials, according to a Guardian analysis of new government rules announced to protect the most vulnerable from COVID-19.

Care groups are calling for the government to make limited visiting possible, including by designating selected family members as key workers.

Since Friday any care homes in local authority areas named by Public Health England for wider anti-Covid interventions must immediately move to stop visiting, except in exceptional circumstances such as end of life. It also halts visits to windows and gardens and follows seven months of restrictions in many care homes that closed their doors to routine visits in March.

The blanket bans will result in the “raw reality of residents going downhill fast, giving up hope and ultimately dying sooner than would otherwise be the case”, warned the charity Age UK and the National Care Forum (NCF), which represents charitable care providers.

Read full story

Source: The Guardian, 23 September 2020

Read more

Growing numbers of NHS nurses quit within three years, study finds

Gruelling 12-hour shifts, exhaustion and burnout are leading growing numbers of nurses to quit the NHS within three years of joining, new research reveals.

Stress, lack of access to food and drink while at work, and the relentless demands of caring for patients are also key factors in the exodus, the King’s Fund thinktank found.

The NHS must make it an urgent priority to tackle the worryingly poor working conditions nurses and midwives face in many hospitals or face worsening workforce shortages, it said.

“Staff stress, absenteeism and turnover in the professions have reached alarmingly high levels,” the thinktank said after investigating the working conditions faced by NHS nurses and midwives.

“This has been compounded by the Covid-19 pandemic, which has laid bare and exacerbated longer-term issues including chronic excessive workload, inadequate working conditions, staff burnout and inequalities, particularly among minority ethnic groups.”

Read full story

Source: 23 September 2020

Read more
Sign in to follow this