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Watchdog says its lack of funding is compromising safety

The patient safety commissioner has complained to MPs that she does not have enough staff to cope with her ‘significant workload’, it has emerged.

Henrietta Hughes’ concerns are revealed in a letter from Commons health and social care committee chair Steve Brine to health and social care secretary Steve Barclay.

Mr Brine asks for assurances over the commissioner’s resources and says he was “concerned” Dr Hughes had told him her current funding was “too little to make the necessary improvements” to safety oversight.

Mr Brine wrote on 6 March: “I am in regular contact with Dr Hughes and the matter of resources for her office is something that she has raised with me. She tells me that her office is under extreme pressure, with a significant workload, including correspondence from patients.”

Mr Brine told Mr Barclay he shared Dr Hughes’ concerns that without “sufficient resourcing” there was a risk that the safety commissioner role would – according to Dr Hughes – “let down the hopes of patients that were raised by the publication of Baroness Cumberlege’s report”.

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Source: HSJ, 14 March 2023

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Watchdog repeatedly told about private NHS medicines courier

The watchdog responsible for investigating unresolved healthcare complaints has been warned repeatedly for nine months about problems with Sciensus, a private company paid millions to deliver vital medicines to NHS patients, the Guardian can reveal.

The Parliamentary and Health Service Ombudsman (PHSO) has received 18 official requests to examine grievances against Sciensus since August last year, but has not begun any investigations, according to a person familiar with the matter.

The revelation comes after a Guardian investigation exposed serious and significant concerns raised by patients, clinicians and health groups about Sciensus.

The investigation revealed that the company has struggled to provide a safe or reliable service. Patients persistently complain about delayed or missed home deliveries of medication, the Guardian found, with clinicians warning that the health of some has deteriorated as a result.

The investigation also uncovered how some NHS staff experience “daily issues” with Sciensus. Others reported an increase in patients “flaring” as a result of missed or delayed medication. Some have seen a rise in hospital admissions.

In the wake of the investigation, the Care Quality Commission, the care regulator, said it was “aware of concerns raised” about Sciensus, and was reviewing them.

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Source: The Guardian, 1 May 2023

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Watchdog investigating national rise in stillbirths

A national review has been launched by regulators because of an increased number of stillbirths during the first wave of covid, HSJ can reveal.

The Healthcare Safety Investigation Branch (HSIB) is investigating 40 intrapartum stillbirths which took place between April and June this year, when the country experienced the first wave of COVID-19. During the same three months in the previous year, 24 stillbirths were reported to HSIB.

The HSIB has told HSJ it has now launched a thematic review into the stillbirths, which will investigate stillbirths in all settings across England during that time period.

The Royal College of Obstetricians and Gynaecologists, which has also launched a national review into perinatal outcomes during the pandemic, estimates that 86 per cent of maternity units reported a reduction in emergency antenatal presentations in April, “suggesting women may have delayed seeking care”.

HSIB is aiming to complete the thematic review early next year. It said the stillbirths being investigated are not concentrated on any geographical area or trust.

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Source: HSJ, 2 November 2020

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Watchdog investigates possible failures at mental health hospital after 24 alleged rapes

The care watchdog is investigating possible safeguarding failures at an NHS trust after a documentary uncovered figures showing there were 24 alleged rapes and 18 alleged sexual offences in just three years at one of its mental health hospitals.

The Care Quality Commission (CQC) told Disability News Service (DNS) that it had suspended the trust’s ratings for wards for people with learning difficulties and autistic people while it carried out checks.

The figures were secured by the team behind Locked Away: Our Autism Scandal, a film for Channel 4’s Dispatches, which revealed the poor and inappropriate treatment and abuse experienced by autistic people in mental health units.

None of the alleged rapes at Littlebrook Hospital in Dartford, Kent, led to a prosecution, with allegations of 12 rapes and 15 further sexual offences dropped because of “evidential difficulties” and investigations into 12 other alleged rapes and two sexual offences failing to identify a suspect.

A CQC spokesperson said: “Sexual offences are a matter for the police in the first instance.

“However, we take reports of sexual offences seriously and review them all, and raise these issues directly with the trust.

“We do this alongside involvement from police and local authority safeguarding teams’ own investigations and monitor any actions and outcomes taken by the trust to ensure people are kept safe."

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Source: 30 March 2023

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Watchdog hits out at DHSC ‘ambiguity and delay’

The national patient safety commissioner has hit out at government for failing to confirm her budget a month into the financial year, warning that she is ‘incredibly limited’ in what she can achieve.

In an strongly worded letter released today, Henrietta Hughes states: “Despite it now being the end of April the Department has still not provided me with a budget for this financial year.”

She added: “This ambiguity and delay is impacting on my ability to arrange patient engagement events as these require a budget”.

It appears to be an almost unprecedented public intervention from an official who is appointed and hosted by the DHSC.

In the letter to Commons Health and Social Care Committee chair Steve Brine, she also says she does not have enough resources to fulfil the role, and is only able to employ four members of staff.

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Source: HSJ, 3 May 2023

 

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Watchdog forced to hand over NHS staff names in safety failure cases

A national safety watchdog has been forced to release almost 100 pieces of evidence, including names of NHS staff, after being ordered to by courts.

A freedom of information request, submitted by HSJ, has revealed the Healthcare Safety Investigation Branch (HSIB) has been required to release 93 interviews with staff, family members and external experts, along with their identities, over the last two years. 

The interviews, which relate to HSIB investigations involving hospital trusts across England, were released to coroner’s courts through eight separate orders dating from February 2019.

A further four court orders compelled HSIB to release other information to coroners, including reports into trusts, findings of internal panel reviews, and evidence from external experts. The orders were made under the Coroners and Justice Act 2009.

When HSJ asked whether any NHS staff or family members were named in open court, HSIB said it was “not able to comment on specific instances”, but added that all those whose evidence was shared with the coroners were notified in advance.

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Source: HSJ, 23 February 2021

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Watchdog finds 'toxic' culture in Manx hospital A&E

There is a "toxic" culture of bullying and blame in the Isle of Man's emergency department at Noble's Hospital, an inspection has found.

The Care Quality Commission's report said it was a "significant concern" along with "ineffective" staff training and medicine storage systems.

It found a "significant disconnect" between nursing and medical staff had the potential to "cause or contribute to patient harm".

During inspectors' four-day visit in June, some staff said the attitude and behaviour of senior medics was "feral".

Manx Care's director of nursing Paul Moore said the understaffed department had been "really struggling" at times.

He warned efforts to change governance and culture would take time.

Mr Moore said on average the emergency department had about 50% of the required staff over a given month, and recruitment was the "number one priority" to help make lasting changes.

"The bottom line is I have to put staff in front of patients before other considerations, especially when we're short", he added.

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Source: BBC News, 8 September 2022

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Watchdog calls for review of menopause link to poor mental health after woman’s suicide

The link between menopause and poor mental health should be reviewed, the health watchdog has said, after an inquiry into a woman’s suicide found staff lack training to spot the risks.

Frances Wellburn, 56, took her own life in 2020 after she was incorrectly assessed as being a “medium risk” of suicide by Tees, Esk and Wear NHS Trust (TEWV).

A national study by the Health and Safety Investigation Branch (HSIB), prompted by her death, warned that this was a national problem, with funding and capacity problems driving staff to use ineffective “checklist” tools when assessing suicidal patients.

HSIB also found staff were not trained to spot mental health risks associated with menopause, and menopause is not routinely considered a contributing factor among women with low mood who need help.

It said that women are often prescribed antidepressants when hormone replacement therapy (HRT) would be more appropriate.

In Ms Wellburn’s case, HSIB found TEWV staff had failed to take into account that she was going through menopause when they assessed her as being at medium risk of self-harm. This went against national guidance, which states scales should not be used to predict future suicide or self-harm.

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Source: The Independent, 23 March 2023

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Watchdog 'very concerned' about safety of patients at Greater Manchester Mental Health Trust where 3 young people died

A watchdog is "very concerned" about the safety of people using the services of Greater Manchester Mental Health NHS Trust.

The damning report says inspectors found there was not always enough nursing staff and that permanent staff did not feel safe if bank or agency workers were used as they didn't have the relevant training.

It follows an unannounced inspection in September by the Care Quality Commission "due to on-going concerns about the safety of services".

Three young patients died in nine months at Prestwich Hospital, one of the Trust's units.

A campaign group and the families are campaigning for a full investigation into those cases by NHS England.

The CQC's two-day inspection of eight wards across five of the the Trust's seven sites found:

  • The service did not always have enough nursing staff, who knew the patients or received basic and essential training to keep patients safe from avoidable harm.
  • The environment on Poplar ward (Park House) was not clean on the first day of inspection and space on the ward was limited for patients.
  • It was not clear that immediate concerns or learning from incidents was shared across the locations, although local learning and reviews were taking place.
  • The wards did not all have up to date and recently reviewed ligature risk assessments. Staff on two wards could not locate the ligature risk assessments at the time of the inspection.

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Source: Greater Manchester News, 26 November 2021

 

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Watch for measles, UK doctors told, as vaccine rate dips

Doctors must be on high alert for measles as vaccine rates among young children have dipped to a 10-year low, leaving some unprotected and risking outbreaks of the highly infectious and dangerous virus, experts say.

It is the first time in decades the Royal College of Paediatrics and Child Health (RCPCH) has issued national guidance such as this.

At least 95% of children should be double vaccinated by the age of five. But the UK is well below that target.

Latest figures show only 84.5% had received a second shot of the protective measles, mumps and rubella (MMR) jab - the lowest level since 2010-11.

Measles can make children very sick. The main symptoms are a fever and a rash but it can cause serious complications including meningitis. For some, it is fatal.

The RCPCH is worried the UK is now seeing a "devastating resurgence" of virtually eliminated life-threatening diseases such as measles, because of low vaccine uptake.

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Source: BBC News, 22 November 2023

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Washington State Nurses Association: Joint statement on the conviction of RaDonda Vaught

On 25 March2022, a Tennessee jury convicted RaDonda Vaught, a nurse at Vanderbilt University Medical Center, of criminally negligent homicide and impaired adult abuse in a 2017 medication administration error that tragically resulted in a patient death. The Washington State Nurses Association have issued a joint statement adamantly opposed to criminalization of patient care errors. 

"Focusing on blame and punishment solves nothing. It can only discourage reporting and drive errors underground. It not only undermines patient safety; it fosters an environment of fear and lack of respect for health care workers."

"The Vaught case has drawn intense national attention and concern. We join with health care workers and patient safety experts around the country and the world in rejecting the criminalization of medical errors. Further, we are committed to redoubling our efforts to achieve health care environments that are safe for patients and health care workers alike. This includes the ongoing, critical fight to achieve safe staffing standards in Washington state."

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Source: Washington State Nurses Association, 8 April 2022

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Warrington cancer patient died after "unacceptable delay"

Serious failings have been found at an NHS trust which performed "unacceptably delayed" and unnecessary surgery on a bladder cancer patient.

Denis Harrison, 62, died in August 2017 after waiting six months for surgery at Warrington and Halton Hospitals NHS Foundation Trust. The Parliamentary and Health Service Ombudsman (PHSO) said the trust had "failed to act with any urgency".

Mr Harrison's wife said the couple faced "severe mental anguish" waiting.

The PHSO said it was not possible to know whether earlier surgery would have saved his life, but he "was not given the best possible chance of survival".

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Source: BBC News, 25 September 2019

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Warnings over NHS mental health care issued in 14 young deaths in five years

Children with mental health problems are dying because of failings in NHS treatment, coroners across England have said in what psychiatrists and campaigners have called “deeply concerning” findings.

In the last five years coroners have issued reports to prevent future deaths in at least 14 cases in which under-18s have died while being treated by children’s and adolescent mental health services (CAMHS).

The most common issues that arise are delays in treatment and a lack of support in helping patients transition to adult services when they turn 18.

Coroners issue reports to prevent future deaths in extreme cases when it is decided that if changes are not made then another person could die.

Dr Elaine Lockhart, the chair of the Royal College of Psychiatrists’ faculty of child and adolescent psychiatry, said the findings were “deeply concerning” and every death was a tragedy.

She said there were too often lengthy delays and services were under strain as demand rises and the NHS faces workforce shortages.

“In child and adolescent mental health services in England, 15% of consultant psychiatrist posts are vacant,” Lockhart said, calling for more support, investment and planning to grow staff levels.

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Source: The Guardian, 3 February 2022

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Warnings over NHS data privacy after ‘stalker’ doctor shares woman’s records

The confidentiality of NHS medical records has been thrown into doubt after a “stalker” hospital doctor accessed and shared highly sensitive information about a woman who had started dating her ex-boyfriend, despite not being involved in her care.

The victim was left in “fear, shock and horror” when she learned that the doctor had used her hospital’s medical records system to look at the woman’s GP records and read – and share – intimate details, known only to a few people, about her and her children.

“I felt violated when I learned that this woman, who I didn’t know, had managed to access on a number of occasions details of my life that I had shared with my GP and only my family and very closest friends. It was about something sensitive involving myself and my children, about a family tragedy,” the woman said.

The case has prompted warnings that any doctor in England could abuse their privileged access to private medical records for personal rather than clinical reasons.

Sam Smith, of the health data privacy group MedConfidential, said: “This is an utterly appalling case. It’s an individual problem that the doctor did this. But it’s a systemic problem that they could do it, and that flaws in the way the NHS’s data management systems work meant that any doctor can do something like this to any patient.

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Source: The Guardian, 14 May 2023

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Warnings against 'reckless' weight loss surgery abroad

Seven British patients who travelled to Turkey for weight loss surgery died after operations there, a BBC investigation into the trend has found.

Others have returned home with serious health issues after having had gastric sleeve operations, during which more than 70% of the stomach is removed.

The operations, used to treat morbid obesity, are carried out in the UK, but, because it can take years to get one through the NHS, some people are looking abroad for treatment.

British doctors say that they're treating an increasing number of patients who have travelled to Turkey and returned with serious complications.

Dr Ahmed Ahmed, a leading surgeon and member of council at the British Obesity and Metabolic Surgery Society, says he's treated patients returning from Turkey who have had an entirely different operation to the one they understood they had paid for.

The BBC has also been told that some people are being accepted for surgery who do not have a medical need for it. The BBC contacted 27 Turkish clinics to see if they would accept someone for treatment who was considered to have a normal BMI. Six of the clinics we approached were happy to accept someone with a BMI of 24.5 for extreme weight loss surgery.

Separately, the BBC also found that some clinics who refused the treatment actually then encouraged patients to put on weight, to enable them to be accepted for surgery.

One said: "You need to gain 6.7kg to have sleeve surgery. I think you can easily eat some food and then lose weight easily." Another asked: "How soon can you gain weight?"

Dr Ahmed says the practices are "reckless" and "unethical".

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Source: BBC News, 21 March 2023

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Warning over warring Great Ormond Street surgeons

Warring between two surgeons at Great Ormond Street Hospital could put patients at risk, a review suggests.

A board paper released by the leading children's hospital said a "fractured" relationship between two consultants in the paediatric surgical urology team was affecting the service last year.

The London hospital said steps were being taken to resolve the problems. This has included mediation, mentoring and away days.

The board paper from a meeting in November set out the findings of a two-day inspection by the Royal College of Surgeons last May. The college was invited in by the trust itself after reports of problems. The summary of the report said there were "significant difficulties" between two surgeons in the team. It described a "lack of trust and respect" which meant they did not work collaboratively and led to significant competition for work.

If this continued it would have the "potential to affect patient care and safety" as well as longer waits for surgery, it said. The "dysfunction" between the two senior doctors caused problems for the wider team with evidence support staff had also been treated inappropriately.

Great Ormond Street said it took the issue "extremely seriously" and good progress was being made.

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Source: BBC News, 15 January 2020

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Warning over use in UK of unregulated AI chatbots to create social care plans

Britain’s hard-pressed carers need all the help they can get. But that should not include using unregulated AI bots, according to researchers who say the AI revolution in social care needs a hard ethical edge.

A pilot study by academics at the University of Oxford found some care providers had been using generative AI chatbots such as ChatGPT and Bard to create care plans for people receiving care.

That presents a potential risk to patient confidentiality, according to Dr Caroline Green, an early career research fellow at the Institute for Ethics in AI at Oxford, who surveyed care organisations for the study.

“If you put any type of personal data into [a generative AI chatbot], that data is used to train the language model,” Green said. “That personal data could be generated and revealed to somebody else.”

She said carers might act on faulty or biased information and inadvertently cause harm, and an AI-generated care plan might be substandard.

But there were also potential benefits to AI, Green added. “It could help with this administrative heavy work and allow people to revisit care plans more often. At the moment, I wouldn’t encourage anyone to do that, but there are organisations working on creating apps and websites to do exactly that.”

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Source: The Guardian, 10 March 2024

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Warning over medical clinics using fake Google reviews

Medical clinics are using fake Google reviews to boost their profiles online, a BBC investigation has found.

Consumer groups say fake reviews are a "significant and persistent problem" and have called on internet firms to do more to remove them and fine companies.

Which? has warned it could be a serious issue if someone chooses a treatment clinic based on reading a fake review.

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Source: BBC 2 August 2023

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Warning over cuts to NHS services without £10bn extra funding

Groups representing the NHS have warned services may have to be cut unless NHS England receives an extra £10bn in funding next year, which may put patients at risk. 

The NHS Confederation and NHS Providers said the money was needed to cover pandemic-related costs and reduce the backlog in operations and treatments, but the government said it had already provided additional money to tackle backlogs.

"We are committed to making sure the NHS has everything it needs to continue providing excellent care to the public as we tackle the backlogs that have built up during the pandemic. This year alone we have already provided a further £29bn to support health and care services, including an extra £1bn to tackle the backlog. This is on top of our historic settlement for the NHS in 2018, which will see its budget rise by £33.9bn by 2023-24." Said a government statement. 

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Source: BBC News, 02 August 2021

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Warning over 'nursing staffing crisis' after NHS trust told to improve

The Royal College of Nursing (RCN) has issued a warning about insufficient staffing in the NHS in the wake of a mental health trust being downgraded.

Earlier this week, Tees, Esk and Wear Valleys (TEVW) NHS Foundation Trust being rated as "requiring improvement" by the Care Quality Commission. It had previously been rated as "good" but inspectors said some services had deteriorated. Among the concerns raised were ones over staffing, workload and delays. 

Glenn Turp, Northern Regional Director of the RCN: "The CQC has rightly highlighted some very serious concerns and failings which call into question whether this trust can provide safe patient care. After the very tragic and sad deaths of two vulnerable patients last year and the findings of the CQC, the trust and NHS commissioners must take immediate action to ensure patient and staff safety."

"They have a responsibility not to commission and open new beds with insufficient nursing staff to provide safe patient care. Having the right number of nursing staff with the right skills in the right place at the right time is critical to protecting patients. It also protects those staff who too often find themselves struggling to maintain services in the face of nursing vacancies."

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Source: The Northern Echo, 7 March 2020

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Warning of suicide risk side effect over common NHS antibiotic after doctor's death

A warning has been made over the possible side effects of a common NHS antibiotic by a coroner after a newly retired senior doctor died by suicide.

"Respected and experienced" consultant cardiologist Robert Stevenson had no history of depression or mental health problems before he started a course of ciprofloxacin.

But just over a week later, the 63-year-old went for a walk and messaged his wife to tell her he had left a note under his pillow.

He was later found dead in a nearby wood.

The note he had left was said to be "uncharacteristically confused and illogical" with "baseless concerns" that he might have AIDS after taking an online HIV tester kit, an inquest heard.

The hearing was told Dr Stevenson hadn't been told about a "potential rare link" to suicidal behaviour in patients who took the drug, as this wasn't in line with medical guidance.

Now, coroner Martin Fleming issued a warning to highlight the risk of taking the antibiotic, which is prescribed by the health service for serious conditions.

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Source: The Mirror, 20 June 2023

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Warning of serious brain disorders in people with mild coronavirus symptoms

Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned.

Neurologists are on Wednesday publishing details of more than 40 UK COVID-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom.

The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication.

“We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust.

“What we’ve seen with some of these Adem patients, and in other patients, is you can have severe neurology, you can be quite sick, but actually have trivial lung disease,” he added.

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Source: The Guardian, 8 July 2020

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Warning lack of line flushing leading to ‘under delivery’ of IV antibiotics

The under delivery of intravenous antibiotics in some NHS hospitals due to lack of polices and compliance may be contributing to antimicrobial resistance (AMR), according to a parliamentary report.

Findings in the report indicated that many health service organisations do not have policies in place to reduce the risk of under delivery and those that do can struggle to comply fully with them.

The report’s authors warned that the residual volume of antibiotic remaining in the line of the IV administration set can result in under delivery of up to 30% of the prescribed dose.

They said that, as a result, this could be leading to possible resistance within patients, owing to the accumulative effect. Nurses involved with compiling the document have called for action.

Based on the findings, the report recommended that all NHS organisations implement line flushing policies by late 2024, with support from the Department for Health and Social Care.

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Source: Nursing Times, 9 December 2023

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Warning issued over adrenaline pen fault

Allergy patients are being warned of a potential fault with Emerade adrenaline pens. The Medicines and Healthcare products Regulatory Agency (MHRA) said some have blocked needles, so cannot deliver adrenaline. Around two in every 1,000 pens are thought to be affected and patients are advised to follow the existing advice to carry two pens at all times. If patients follow the advice to carry two pens at all times, the risk of not being able to deliver a dose of adrenaline falls to virtually nothing - 0.23% to 0.000529%.

The MHRA added: "Healthcare professionals should contact all patients, and their carers, who have been supplied with an Emerade device to inform them of the potential defect and reinforce the advice to always carry two in-date adrenaline auto-injectors with them at all times."

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Source: BBC News, 12 July 2019

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Warning issued for staff wearing PPE during warm weather

NHS hospitals have been advised to protect all staff wearing PPE during the warmer weather amid concerns the higher temperatures could increase the risk of heat stress. 

A letter from Public Health England sent across GP surgeries, pharmacies and hospitals, have recommended that staff wearing PPE should be given regular breaks and have a buddy system so that signs of heat stress can be spotted early on. 

The letter describes how PPE may need to be changed more frequently which may increase demand. 

Symptoms of heat stress are similar to heat exhaustion and the necessary actions should be taken to help avoid overheating. 

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Source: The Independent, 10 June 2021

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