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NHS sets out 'safer' child gender services model

Six new regional centres created to support under 18s struggling with their gender identity will open over the next two years, NHS England has confirmed.

They will join two existing clinics, as part of an overhaul of gender services for children and young people.

The emphasis will be on providing a more holistic approach, with a particular focus on supporting mental health and those with conditions such as autism.

It follows a ban earlier this year on the routine prescription of puberty blockers for children with gender dysphoria. The changes come in response to a landmark review published in April, which was critical of the way young people had been supported.

NHS England has also announced details of how the clinics will work.

GPs will no longer be able to refer patients directly. Instead, referrals will have to come via children and young people’s mental health services and hospital child health specialists.

The move is designed to ensure the wider needs of these children are assessed before they are sent to a specialist centre, and follows a sharp rise in referrals in recent years.

NHS England medical director Prof Stephen Powis said the new system was about establishing a “fundamentally different and safer model of care for children and young people”.

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Source: BBC News, 7 August 2024

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Opioid painkillers put millions at risk of addiction or dependency

Millions of people are addicted to, or at risk of becoming dependent on, prescription opioid painkillers, according to international research.

The study found that one in three people taking prescribed opioid analgesics, which include codeine, tramadol, oxycodone and morphine, show symptoms of being dependent on them, while one in 10 become fully dependent on the drugs.

The research, led by academics from the University of Bristol and published in the journal Addiction, also showed that one in eight people are at risk of prescription opioid misuse.

It examined data from 148 international studies involving more than 4.3 million patients aged 12 and over who had non-cancer pain for three months or longer and who were prescribed the medicines.

While they are useful for short-term acute pain and managing end-of-life care, “opioid painkillers are not effective in the management of long-term pain,” said Kyla Thomas, a professor of public health medicine at the University of Bristol and lead author of the study. “They are associated with many harms. Our findings show that opioid misuse is much more common among patients taking them for long-term pain than perhaps people imagine.”

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Source: The Guardian, 7 August 2024

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Third of NHS doctors struggling as GMC warns health services in critical state

NHS doctors are “at breaking point”, with almost a fifth cutting their hours and two in five refusing to take on extra work to avoid becoming burnt out, new research has found.

A third of medics are “struggling” and unable to cope with heavy workloads that force them to regularly work extra hours to keep up with the demands for care, the General Medical Council (GMC) said.

Its findings paint a grim picture of the working lives, morale and wellbeing of doctors in the UK.

The GMC, which regulates the medical profession, warned that exhausted, overworked doctors could pose a threat to patients’ safety. “UK health services are in a critical state and those who work within them are at breaking point,” said Charlie Massey, the GMC’s chief executive.

Prof Dame Carrie MacEwen, its chair, also described doctors’ experiences in the annual report.

“Seeking to protect their wellbeing, doctors are taking matters into their own hands. Many are reducing their hours and declining additional work,” she said. “A concerning proportion are taking time off due to stress.”

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Source: The Guardian, 8 August 2024

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‘Hierarchical cultures’ reported at trust after doctor jailed

A trust has been told to improve its culture of speaking up and sexual safety by a review of its handling of a doctor who was later convicted of downloading child abuse images.

The review, commissioned and published by Royal Devon University Hospital Foundation Trust, examined the trust’s handling of its former consultant anaesthetist Alexander Knight (Grice), who in March was convicted of five charges of downloading and viewing indecent images of children.

The external review, carried out by consultant forensic psychiatrist Helen Smith and published by RDUH in July, praised the trust for “contain[ing] the situation” when Dr Knight was arrested, and for working closely with the police and other agencies to enable the investigation and ultimately his conviction.

But it also found some staff had found it difficult to speak up about previous incidents involving the doctor, in which he had acted “inappropriately”.

It said the trust should address “hierarchical” cultures in some teams which prevent staff from being able to speak up about sexual safety. The trust said it has begun work to address this.

The review said: “Many people who took part in this review describe feeling unable to speak up, or if they did speak up, an experience of not being heard, their concerns not being valued, or being dismissed, not understood.”

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Source: HSJ, 7 August 2024

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‘Scrap single-word CQC ratings’, say trust bosses

Most trust leaders want the Care Quality Commission’s single-word ratings scrapped, NHS Providers has said based on survey feedback.

NHS Providers said written feedback from its annual regulation and oversight survey showed leaders thought the ratings – of “outstanding”, “good”, “requires improvement”, and “inadequate” – were “too simplistic”. They are currently used to rate providers overall quality, sites, services, and performance on particular domains such as safety.

Staff often found the ratings “demoralising” while patients thought they were “confusing”, according to the findings, shared with HSJ ahead of publication.

NHSP, which represents trusts and foundation trusts, also told HSJ it backed scrapping the single-word rating approach.

The findings come with an overhaul of the CQC’s regulation approach highly likely to be instigated later this year. Wes Streeting, the new health and social care secretary last month published a damning interim report by integrated care board chair Penny Dash, which found major flaws across its processes, methodology, staffing, and systems.

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Source: HSJ, 8 August 2024

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Falsified patient records linked to 12 deaths

A mental health trust may have falsified records of up to 12 deceased patients, according to a coroner’s report.

Saba Naqshbandi KC, assistant coroner for Inner North London, said staff at East London Foundation Trust had faked observation records, claiming to have checked on patients when they had not. 

A member of the trust’s staff admitted to falsifying records in the case of 40-year-old patient Mahamoud Hussain Ali.

In a prevention of future deaths report published last week, the coroner said investigations commissioned by ELFT following Mr Ali’s death uncovered 11 further “fatal incidents” where records may have been fabricated. 

In a message to staff in October 2023, seen by the coroner, ELFT admitted that instances of records being fabricated were increasing.

It said: “We have seen an increase in occasions where observation records have not been completed but records falsified to reflect that they had been done.” 

Ms Naqshbandi wrote in the PFD report: “I am concerned that action undertaken thus far by the trust has not been sufficient to ensure that observations are being conducted and/or recorded as required, which in my opinion gives rise to a concern that future deaths will occur.”

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Source: HSJ, 8 August 2024

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USA: New CMS rule incentivises safety practices and strategies

A new federal rule calls on acute care hospitals to attest to supporting patient safety with strategies and best practices in five areas:

  • Leadership commitment to eliminating preventable harm.
  • Strategic planning and organizational policy.
  • Culture of safety and learning health system.
  • Accountability and transparency
  • Patient and family engagement.

The new requirement — the Patient Safety Structural Measure (PSSM) — was published by the Centers for Medicare & Medicaid Services in final form last week and is part of the Hospital Inpatient Quality Reporting (IQR) programme.

Barbara Fain, Executive Director of the Betsy Lehman Center, notes that the new measure closely parallels the Massachusetts Roadmap. “Through financial incentives and transparency, CMS is using its platform to motivate greater hospital investment in the same approaches endorsed by the Roadmap because they are known to reduce preventable patient harm,” she says. 

With the Roadmap and continued guidance from the Massachusetts Health Care Safety and Quality Consortium, the Betsy Lehman Center is already developing resources that the state’s hospitals can use to excel in each of the measure’s five domains.

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Source: Betsy Lehman Center, 8 August 2024

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AI in healthcare: what are the risks for the NHS?

Generative AI - a type of artificial intelligence that can produce various types of content, including text and images - will be transformative for patient outcomes, according to Sir John Bell, a senior government advisor on life sciences.

Sir John is president of the Ellinson Institute of Technology in Oxford - a major new research and development facility investigating global issues, including the use of AI in healthcare.

He says generative AI will improve the accuracy of diagnostic scans and generate forecasts of patient outcomes under different medical interventions, leading to more informed, personalised treatment decisions.

But he warns researchers should not work in isolation, instead innovation should be shared fairly around the country to avoid some communities missing out.

"To achieve these benefits the NHS must unlock the enormous value currently trapped within data silos, to do good while safeguarding against harm," Sir John says.

"Allowing AI access to all the data, within safe and secure research environments, will improve the representativeness, accuracy and equality of AI tools to benefit all walks of society, reducing the financial and economic burden of running a world-leading National Health Service and leading to a healthier nation."

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Source: BBC News, 7 August 2024

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Ditching two-child benefit cap would cut deaths and A&E admissions, study says

Curbing child poverty by scrapping the two-child benefit cap would save hundreds of lives a year and avoid thousands of admissions to hospital, the largest study of its kind suggests.

Keir Starmer has faced repeated demands from within Labour ranks and opposition leaders to abolish the policy, which was announced in 2015 by George Osborne, then chancellor. Almost half of all children in some towns and cities now live below the breadline.

Now researchers from the universities of Glasgow, Liverpool and Newcastle have shown for the first time the extraordinary impact that reducing child poverty with measures such as ditching the two-child benefit cap could have in England.

Tackling it would substantially cut the number of infant deaths and children in care, as well as rates of childhood nutritional anaemia and emergency admissions, with the most deprived regions, especially in north-east England, likely to benefit the most, the projections indicate.

Changes were likely to have huge beneficial knock-on effects on local authorities and the NHS, the research concluded.

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Firm fined £6m after hackers stole 83,000 patients’ details

The personal details of nearly 83,000 people were stolen during a cyber attack in 2022 that caused a “total system outage” of 111 services and left several trusts without access to their electronic patient records, regulators have revealed.

Software supplier Advanced — now known as OneAdvanced — was targeted by a criminal hacker group in August 2022. It supplies its Adastra system to 85% of NHS 111 providers, while its Careflow EPR is used by around a dozen community and mental health trusts.

On Wednesday, the Information Commissioner’s Office announced it had concluded its provisional findings into the attack and had issued a £6m fine to OneAdvanced, which it said had “failed to implement measures to protect” personal patient information.

According to the ICO, sensitive information such as phone numbers and medical records belonging to 82,946 people was stolen during the attack. Details about how to gain entry to the homes of 890 people who were receiving care at home were also stolen.

In the wake of the attack, NHS England said it had received assurances from OneAdvanced that no data held by mental health trusts had been “breached” from its Careflow system. 

The supplier said that none of the stolen information was ever made public or released on the dark web.

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Source: HSJ, 7 August 2024

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Vulnerable and alone in a hospital 200 miles from home

For 21-year-old university student Cassandra, the isolation of the coronavirus lockdown was unbearable.

But when she was admitted to hospital for mental health treatment, that sense of isolation was compounded.

She was one of 1140 people from Greater Manchester who last year found themselves staying in hospitals that were, in some cases, hundreds of miles from home.

And this was despite the fact so-called ‘out-of-area placements’ were supposed to have stopped in 2021.

Cassandra was sent to a hospital 200 miles (321km) away in Norwich. “I was completely shut out from the world around me,” she says.

Out-of-area placements happen because hospitals do not have enough beds for their patients. The 1000-plus patients from Greater Manchester who were sent to another county represent more than a fifth of the national total of out-of-area placements last year.

Some placements are at a relatively short distance, but most Greater Manchester patients were sent more than 62 miles (100km) away, at a total cost of £25.6m.

Cassandra’s situation was made worse by the cost-of-living crisis, which meant her family was unable to visit her.

“I had no physical affection in terms of hugs from my mum. I had no comfort from when the hospital got too much,” says Cassandra. “I had no escape, in a sense.”

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Source: BBC News, 7 August 2024

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Parkinson’s Excellence Network: New time critical medication resources for health professionals launched

Three new resources have been launched by the Parkinson’s Excellence Network to support UK healthcare professionals in hospitals to improve the delivery of time critical medication for people with Parkinson’s: 

  1. Self administration of Parkinson’s medication: a guide for hospital staff. This guide supports senior pharmacists and nurses who are working to develop a self administration policy or better utilise an existing policy to support the delivery of time critical medication. Read the guide.
  2. Time critical medication patients' stories: in their own words. In these short films, people with Parkinson’s share their experiences of receiving their Parkinson's medication in hospital and how this impacted on their health and well being. These films have been developed to raise awareness and support education and training of health professionals. Watch Barrie and Margot’s films now.
  3. Time critical medication: hospital awareness kit. This new collection of interactive posters, vibrant screensavers and social media graphics will help you to raise awareness of time critical Parkinson’s medication in your hospital. Access the toolkit.

Access all of the time critical medication resources.

Related resources on the hub:

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GPs seeing 'unsafe number of patients per day'

Some GPs are carrying out an "unsustainable" number of consultations, seeing up to 70 patients in a single day, it has been claimed.

This is more than double the number deemed "safe" by the European Union of General Practitioners, which sets a maximum level of 25 patients per day.

The Consortium of Lancashire and Cumbria Local Medical Committees (LMCs) revealed the figure at the end of a week in which GPs nationwide began an indefinite work-to-rule over funding for their practices.

Ms Tomlinson, chief operating officer of Consortium of LMCs, said prior to the work-to-rule beginning some Lancashire GPs were seeing more than double the safe number of patients in a shift.

"The demand is huge now – we’re hearing of GPs seeing 60 to 70 patients a day, which is not sustainable at all.

She said limiting the number to 25 would mean patients get "better, safer clinical time with a GP".

She said it would not deprive patients of the care they need and advised people "not to worry about phoning" their surgery if they were unwell.

"GPs are still wanting to see you. If [those choosing to cap daily patient numbers] reach that level, you will be diverted to out-of-hours [services], urgent treatment centres or 111 – so you will still be seen in a healthcare setting."

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Source: BBC News, 6 August 2024

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At least 70 ‘Never Events’ at hospitals in Northern Ireland in last five years

At least 70 incidents that ‘should never be allowed to happen’ have taken place at hospitals in the north in the last five years.

As severe pressure on the health service continues to grow, figures obtained by The Irish News through Freedom of Information requests show that 70 so-called ‘Never Events’ have occured since 2019.

The data also shows that two deaths were caused as a result of such incidents in the last five years, one in the Belfast trust area and one in the South Eastern trust area.

‘Never Events’ in the NHS are defined as ‘wholly preventable’ incidents where there are ‘strong systemic protective barriers’ in place to avoid them. Each incident has the potential to cause serious harm or death.

The data provided to The Irish News from the five health and social care trusts in the North show that the Belfast Trust alone was responsible for 37 Never Events.

SDLP MLA Colin McGrath says the figures are “extremely worrying” and that he has written to Health Minister Mike Nesbitt for an “urgent assessment” of the number of incidents.

“’Never Events’ by their very title should never occur but the sheer scale of them is worrying,” the South Down MLA said.

“It is most concerning too to hear that people have died as a result of these events - underlying the serious nature of them.

“I have written to the Minister on the back of these figures secured by the Irish News and have asked for an urgent assessment of them to ensure learning from the incidents is achieved to reduce their occurrence in the future.”

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Source: The Irish News, 5 August 2024

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BMA calls for ban on puberty blockers to be lifted

The British Medical Association (BMA) has called for the ban on puberty blockers for under-18s to be lifted.

The doctors’ union also wants a pause on the implementation of a landmark review into gender care for children and young people.

It said it wanted to undertake an evaluation of the Cass Review after academics expressed concern about its approach.

The review, commissioned by NHS England, called for a move away from medical interventions for children struggling with their gender identity and advocated a more holistic model incorporating better mental health support.

The review was led by leading paediatrician Dr Hilary Cass and prompted the last government to ban the use of puberty blockers for under-18s questioning their gender – a move which was then supported by Labour when they won the election.

These drugs suppress the natural production of hormones and delay the onset of puberty.

The ban applied to private clinics, because the NHS had already stopped using them outside of clinical trials, and was challenged in the High Court by campaign group TransActual.

The BMA said members of its Council, its top decision-making body, voted in favour of a motion last month that was critical of the Cass Review and called on the union to "publicly critique" it.

The BMA said it was concerned about its impact on transgender healthcare provision because of its "unsubstantiated recommendations".

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Source: BBC News, 1 August 2024

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Drug shortages: 'I'm eating less and rationing pills'

Two people with cystic fibrosis have said they are having to eat less due to a shortage in a medication which helps them eat.

Charlotte Bones, 31, and Steve Horwood, 35, both take Creon to help them digest food, as the condition causes sticky mucus to build up in the lungs and digestive system.

But a long-term Europe-wide shortage of the medication, external is affecting how many capsules they can get hold of meaning they are also having to ration their pills.

The Department for Health and Social Care (DHSC) said it was "working closely with industry, the NHS and others in the supply chain" to make sure alternative products were available.

Ms Bones, from Kilburn, said the shortage had meant she had been changed to a different strength of medication.

As a result of the shortage, she said she had been having less food and reducing the number of Creon pills she took in a day to stop her from running out.

Despite contacting six or seven different pharmacies, she said none have had Creon in stock and her hospital pharmacy was not able to signpost her to anywhere with supplies.

In the interim, Ms Bones said reducing her Creon intake had led to unpleasant side-effects, including stomach aches and diarrhoea, which were "hard to juggle" alongside her job.

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Source: BBC News, 5 August 2024

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Pharmacies in England cutting services amid financial pressures, research finds

Pharmacies across England are unable to provide critical NHS and public health services owing to the overwhelming financial and operational pressures they are facing, according to research.

A poll of pharmacy owners representing more than 2,100 pharmacies found that more than 96% of respondents said they had stopped providing locally commissioned services over the past 12 months.

These include emergency contraception and products to help quit smoking.

Four in five (81%) of pharmacy owners polled said they have had to stop offering extended opening hours, while 90% have had to stop employing locum pharmacists owing to the high costs.

Of the 92 owners polled for the representative body Community Pharmacy England, more than one-fifth said they have had to end free delivery of prescription medicines to patients.

Janet Morrison, chief executive of Community Pharmacy England, said: “Across England patients and local communities are paying the price of our collapsing community pharmacy network, as thousands of pharmacies have been left with no choice but to reduce the services that they can offer. These are not decisions that any pharmacy wants to make, but with a 30% real-terms funding reduction and spiralling costs, pharmacy owners are having to make impossible decisions to try to keep their doors open."

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Source: The Guardian, 5 August 2024

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20,000 patients a year ‘warehoused’ in community beds after hospital discharge

More than 20,000 patients each year are being left to languish in care homes and community beds after discharge from hospital without any rehab support according to new data obtained by HSJ.

The findings of NHS England’s audit of NHS-funded community beds were released to HSJ after a Freedom of Information request.

The data showed that during March 2024, 1,999 of the total 13,196 beds (13.9%) did not “provide rehab, reablement and recovery services”. These beds are overwhelmingly used for short-term rehab and recovery after an acute stay.

When applied to all discharges into this kind of care over a 12-month period, the audit data suggests well over 20,000 people a year are placed in beds without rehab support.

The senior clinicians I spoke to about the data said the lack of rehab was “inhumane” and would cause patients to deteriorate and decondition, rather than recover. 

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Source: HSJ, 5 August 2024

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Support managers ‘to do the right thing’ says whistleblowers’ champion

Managers must be “supported to do the right thing” when alerted by whistleblowers to potential problems, the NHS’s national freedom to speak up guardian has told HSJ.

Jayne Chidgey-Clark was responding to pledges by new health and social care secretary Wes Streeting to sack managers who wilfully suppress concerns expressed by whistleblowers.

The Labour manifesto also said it would “implement professional standards and regulate NHS managers, ensuring those who commit serious misconduct can never do so again.”

Ms Chidgey-Clark said: “We all need to be accountable for our actions as managers… and if professional regulation of managers is brought in, I [would] support that. However, I’m also a huge believer in the carrot approach, not just sticks.”

She continued: “There has to be accountability… if there’s been wilful suppression of speaking up, or wilful detriment to someone who has spoken up.

“Because when there isn’t [accountability], some people lose faith in the system, they’re not going to speak up, because it’s been brushed under the carpet, and [they feel], what’s the point?

“Managers need to [listen and take action] because it’s the right thing to do, not just because if they don’t do it, they’re going to get punished.”

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Source: HSJ, 5 August 2024

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Patient safety champion role unfilled a year on

The newly-created role of Scotland's Patient Safety Commissioner has not yet been filled, almost a year after a bill was passed creating the post, the BBC has learned.

Campaigners are frustrated by the lack of progress in appointing the independent watchdog with the power to hold healthcare providers to account and prevent future scandals.

The law to create the role was passed in September last year and interviews were held in April.

However, a spokesperson for the Scottish Parliament, which is handling the recruitment process, said a cross-party panel had decided not to nominate any of the candidates and their preference was to readvertise the post.

Henrietta Hughes was appointed as England's public safety commissioner two years ago.

Her role was created to look into the scandals surrounding the epilepsy drug sodium valproate, vaginal mesh implants and the pregnancy test Primodos.

Charlie Bethune has been campaigning for the recommendations of the Cumberledge report to be implemented in Scotland.

Mr Bethune, who founded the First Do No Harm group, said it was frustrating that Scotland had not yet appointed a safety commissioner.

"It's been four years since the Cumberledge report which recommended this role," he said.

"It should have been the easiest recommendation to fulfil so it doesn't give us much hope for any of the others getting done.

"Meanwhile my daughter continues to be affected from her exposure to valproate without any specialist support being available in Scotland."

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Source: BBC News, 5 August 2024

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Cleveland-based University Hospitals' spin on virtual nursing

Many virtual nursing models involve separate teams where nurses work as either a bedside nurse or a virtual nurse. But Cleveland-based University Hospitals in the USA is taking a different approach. 

In May, the health system introduced a model in which nurses can work a hybrid schedule, with several days spent at the bedside and the remainder of their schedule at a remote care hub as a virtual nurse. The model is in place across five hospital units, with 23 staff nurses on these units working some of their weekly shifts at the remote hub in an administrative building, health system leaders told Becker's. 

"We have hardwired all patient rooms in five hospital units with the technology for remote nursing," Michelle Hereford, MSHA, RN, FACHE, chief nurse executive at University Hospitals and the Ethel Morikis Endowed Chair in Nursing Leadership, told Becker's. "Each day, a nurse from each of the five units works in the remote hub in collaboration with their home units and each other." 

The approach has been a way to deliver on nurses' flexibility demands and allow members of the same team to continue working together. When working a remote shift, nurses are often caring for the same patients with whom they established a connection during a bedside shift at the hospital, making patients more comfortable when a nurse dials in virtually. 

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Source: Becker's, 30 July 2024

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Twin 'let down' over death of sister found in A&E

The twin sister of a woman who died after being found under a coat while waiting for hours at an overcrowded A&E department says she cannot accept what happened to her.

Mother of two Inga Rublite was discovered slumped on the floor of the Queen's Medical Centre (QMC) in Nottingham on 20 January and died from a brain aneurysm two days later.

An inquest into Ms Rublite's death, which concluded on 25 July, heard that while "opportunities were missed" to diagnose the 39-year-old, she still would have suffered a "devastating" second bleed on the brain, which caused her death.

Inese Briede said questions around her sister's death remained unanswered and said she would continue to "fight" for her.

Ms Briede, who travelled to the inquest from her home in Latvia, said although it was the outcome she expected, she could not accept it.

Speaking from Latvia, she told the BBC: "I think my family was thinking they would get some answers and that the anger and everything would go away - but no.

"We feel very let down by the system. I believe I've got more questions than before the inquest."

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Source: BBC News, 1 August 2024

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English hospitals brace for ‘alarming’ disruption as GPs go on strike

The NHS faces “alarming” and “dangerous” disruption until Christmas and potentially into 2025, health chiefs have said, after GPs began their first industrial action in 60 years amid a major row over funding.

Hospitals, A&E units and mental health services are already under huge pressure. They are now braced for a surge in demand from thousands of patients turning to them for help after family doctors in England launched work-to-rule action on Thursday.

A letter seen by the Guardian that was sent to senior NHS managers from the national primary care director, Dr Amanda Doyle, said the NHS was preparing for a “worst-case scenario” and that 999 services could be affected.

Speaking to the Guardian, Matthew Taylor, the chief executive of NHS Confederation, said the industrial action would probably have an immediate significant effect. “In some areas, it may take longer for patients to get an appointment with their GP, or they may have to go somewhere else for something that was previously provided in general practice.

“This will pile more pressure onto A&E, mental health and other frontline services where waiting times could grow considerably. This is an alarming situation to be in, particularly after everything the NHS has been through over the last few years, and one that health leaders understand GPs will not have entered lightly.”

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Source: The Guardian, 2 August 2024

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Tees, Esk and Wear Valleys Mental Health Trust staff says patients might be at risk after new electronic patient record system rollout

Whistleblowers at the North East's scandal-hit mental health trust have raised serious concerns about a "faulty" medical record system rolled out this year.  

Patients are being "put in danger" by the new CITO records system at Tees, Esk and Wear Valleys Mental Health Trust (TEWV), two staff members have told the Northern Echo. 

An anonymous worker, who is part of the trust's emergency mental health services, said they have had difficulty uploading and accessing next-of-kin information, allergies, triggers, risk ratings, and assessments for patients who are in the throes of a mental health crisis. 

TEWV responded, saying patient safety was their "top priority", and that "the system is stable and functional" despite "localised issues". 

Full story here

Source: The Northern Echo, 1 August 2024

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Putting patient safety at the heart of the design, development and rollout of electronic patient record systems is essential to prevent harm, says charity

Patient safety must be central to the design, development and rollout of electronic patient record (EPR) systems, says Patient Safety Learning.

An EPR system brings together different patient information in one place, making it easier to access for healthcare professionals. This information can include patients’ own notes, test results, observations by a range of different clinicians and prescribed medications.

When safely implemented, EPR systems can help to support and improve care and treatment. However, in recent years there has been growing awareness of the significant patient safety risks also associated with their implementation and use.

In a new report, Patient Safety Learning makes the case that patient safety can, and must, be put firmly at the heart of the design, development and rollout of EPR systems.

Drawing on examples from the NHS and the findings of an expert roundtable, the report sets out the key patient safety risks associated with choosing and introducing new EPR systems. It identifies ten principles to consider for safer EPR system implementation.

Commenting on the report, Patient Safety Learning Chief Executive Helen Hughes said:

“EPR systems have significant potential to improve patient care and treatment. However, we are increasingly seeing cases where poor implementation of these new systems results in direct and indirect harm to patients. If we are to fully realise their benefits, patient safety must be at the heart of their design, development and rollout.

To ensure the safety of EPR systems, it is vital that patient safety incidents associated with them are reported and acted upon. We need more transparency in reporting and sharing knowledge, of both errors and examples of good practice.

We hope that this report can kick off an informed and transparent debate about these issues, leading to action that supports the safer implementation of EPR systems and reduces avoidable harm.”

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Source: Patient Safety Learning, 31 July 2024

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© 2026 Patient Safety Learning. All rights reserved.

Patient Safety Learning is registered as a charity with the Charity Commission Registration number 1180689.

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