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International trial aims to improve the quality of life for Long Covid patients

Researchers at the University of Derby and their regional, national and international partners are working collaboratively to develop bespoke support pathways for patients with Long Covid. 

Led by Dr Mark Faghy, they are currently running a series of projects to understand the determinants of recovery which captures the lived experience and informs a bigger piece of work to develop a holistic view of the key stakeholders that are required to develop pathways that can improve patient outcomes.

One part of this is the launch of a new Delphi Consensus statement which seeks to obtain input from patients, researchers and any healthcare professionals to inform the approaches to support people living with long COVID.  If you have an interest in this study, please click here.

For more information on the current work, please contact Dr Mark Faghy (@DrMark_Faghy and M.Faghy@Derby.ac.uk) and also see:

https://www.derby.ac.uk/news/2022/international-trial-aims-to-improve-the-quality-of-life-for-long-covid-patients/ “

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Vaginal mesh and Gardasil: Approval for general indemnity cover and product liability cover

The Irish Cabinet has approved general indemnity cover and product liability cover for claims to two public sector bodies relating to transvaginal mesh products and the Gardasil HPV vaccine. 

The Health Minister Stephen Donnelly brought forward a proposal to Cabinet Wednesday for the provision of this cover to the Irish Blood Transfusion Service (IBTS) and the Mental Health Commission (MHC) for claims relating to the mesh products or Gardasil. 

Gardasil is a type of vaccine used to protect against HPV. Vaginal mesh devices have been used in operations to treat stress urinary incontinence and pelvic organ prolapse; two conditions that can impact women after natural childbirth or in their later years.

Including the bodies in the State’s general indemnity scheme for these claims will eliminate the requirement for them to carry private insurance.

The State Claims Agency was consulted and indicated that it supports the inclusion of both bodies under the scheme.  

The clinical indemnity scheme indemnifies hospitals but is confined to clinical acts and/or omissions and doesn’t cover product liability matters.

Current legal cases around transvaginal mesh products involve allegations in relation to the product itself and allegations of clinical negligence. It has now been proposed to delegate the product liability claims for mesh products to the State Claims Agency to ensure hospitals aren’t exposed to uninsured liability. 

Thousands of women across the world have suffered complications after having a vaginal mesh device implanted. These complications include chronic pain and recurrent urinary tract infections and have been life-changing in many cases.

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Source: thejournal.ie, 19 January 2022

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Bullying, sexism and racism ‘prevalent and tolerated’ at national regulator

An external review into the Healthcare Safety Investigations Branch (HSIB), the national safety watchdog, has revealed ‘damaging’ cultural problems, including bullying, sexism and racism which go ‘right to the top of the organisation’.

The King’s Fund was commissioned by NHS England to undertake a review of the HSIB’s leadership and culture, as it prepares to be an independent organisation.

The review, seen by HSJ, concluded: “Bullying, sexism, racism and other forms of discrimination and unprofessional behaviours appear to be prevalent and tolerated – this goes right to the top of the organisation.”

The result of this was found to be “very damaging to the health and wellbeing of staff, diminished the culture and undermines the potential of the organisation”

The review also described a “perceived command-and-control approach to leadership, lack of openness to challenge, hierarchical approaches to management and behaviour that is out of step with the organisation’s values”.

The reviewers also identified a “strong voice from staff”, which felt that senior maternity investigation team leaders were “not being held accountable for behaviours that had a very negative impact on staff”.

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Source: HSJ, 21 January 2022

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Babies at risk’ as NHS faces losing nearly one in 10 midwives over mandatory jabs

The NHS could be forced to dismiss almost 2,000 midwives by the government’s mandatory vaccination policy, amid warnings from a former chief nurse of England that mothers and babies will be put at risk.

Well-placed senior sources have told HSJ around 1,700 midwives remain unvaccinated nationally, according to the latest data from trusts.

Based on official headcount data that would amount to between 6.5-8% of the workforce, depending on whether it counts full time equivalent or total staff numbers.

However, they are mostly in London, with the latest estimate in the city said to be about 680 (representing between 12 and 14% of the workforce), several well placed sources told HSJ, meaning its maternity services could be seriously destabilised.

A former chief nurse of England, Sarah Mullally, who now sits in the House of Lords as the Bishop of London, said she believed about 12.5% of London’s midwives were unvaccinated, and called on the government to delay the mandatory health worker vaccination policy.

Speaking in Parliament yesterday, she warned mothers and babies would be put at risk, “in order to implement a policy that has been superseded by the evolution of the virus”.

She added: “I would strongly encourage everyone, including NHS staff and health care workers, to get fully vaccinated. However, having heard from midwives myself this week, I can see the anxiety that the requirement for mandatory vaccination is causing, as well as the potential risks to the heath service and its patients.

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Source: HSJ, 21 January 2022

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Ministers and NHS bosses clash over surgery waiting list targets in England

A “very tense” behind-the-scenes row over how quickly hospitals in England can be expected to reduce the massive backlog of surgery has broken out between NHS bosses and ministers.

The dispute has delayed publication of the government’s “elective recovery plan”, which Downing Street had indicated would be part of Boris Johnson’s “Operation Red Meat” political fightback this week.

No 10, the Treasury and Department of Health and Social Care are pressing NHS England to ensure that hospitals do as many operations as they can, as quickly as possible, in order to tackle the backlog, which now stands at a record 6 million patients.

They want to impose “stretching and demanding” targets on hospitals, sources with knowledge of the discussions said.

However, NHS trust bosses say the ongoing impact of treating patients sick with Covid, due to the current Omicron surge, longstanding gaps in their workforce, exhaustion at the frontline and record levels of staff sickness, mean they need time to get back to doing as much surgery as they did before the pandemic.

The Treasury is said to be frustrated with NHS England and privately believes it is “foot-dragging” over the targets. NHS bosses for their part fear the plan is being driven by “political expediency”, given the growing concern at the sheer number of people facing long delays for care.

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Source: The Guardian, 20 January 2022

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Covid rule changes leave clinically vulnerable as ‘collateral damage’, charities warn

Leading charities have spoken out against the government’s scrapping of COVID-19 measures warning that clinically vulnerable people have been made “collateral damage for political considerations.”

Those representing thousands of clinically vulnerable people have warned the government’s decisions to scrap COVID-19 restrictions leaves people “marginalised” and warned there was a risk to 5-11 year old vulnerable children who are yet to be vaccinated.

The removal of COVID-19 restrictions next week will mean masks are no longer mandatory and the government will no longer ask people to work from home. Blood Cancer UK has called for the government to do more to support immunocompromised people such as giving them priority testing.

Alzheimer's Society has said it is too early to drop basic measures, such as mask wearing, which help protect vulnerable members of society.

Charlotte Augst, chief executive for the charity National Voices said clinically vulnerable people had now become “collateral damage in political considerations.”

She said: “The pandemic has obviously been difficult for everyone, but it’s been the most difficult for people who are vulnerable to the virus, and some of these people have never really come out of 22 months of lockdowns.

“There are obviously infection control measures that are harmful to society and lockdown is one of them - it causes harm. But there are some infection control measures which are not and which enable people to get on with their lives - wearing masks, improving ventilation.

“Why would we not do this? When we understood that dirty water caused illness, we cleaned up the water. It cannot be a political statement to say we should clean up the air this is just fact-based decision making, but the situation] has now become all about politics.

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Source: The Independent. 21 January 2022

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Hundreds of nurses and other health workers disciplined over sex assaults or abuse

Hundreds of nurses, paramedics, health and care workers have been disciplined over allegations of sexual assault, including incidents involving child sexual abuse, The Independent can reveal.

It comes as the government begins a year-long inquiry into the sexual abuse of dead patients by “morgue monster” David Fuller.

Charities claim the true scale of the issue is likely to be hidden by “vast underreporting” while safeguarding experts say there is no “uniformity” in how NHS trusts handle such cases.

The Health and Care Professions Council (HCPC), which regulates just under 300,000 workers including paramedics, occupational therapists, psychologists and physiotherapists, has taken action on 154 occasions following 293 investigations carried out into allegations of sexual assault or abuse since 2012, according to figures obtained by The Independent.

Fifty-three clinicians were struck off, 20 were cautioned and a further 29 were either suspended, had restrictions placed on their practice or agreed to be removed from registration. More than half of the actions followed allegations of sexual abuse of a child patient.

Separate data from Nursing and Midwifery Council (NMC), which has more than 700,000 registered nurses and midwives. shows action was taken 113 times in the past four years against nurses and midwives who did not maintain professional boundaries; in more than 80 per cent of those cases, the clinician was struck off.

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Source: The Independent, 21 January 2022

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Surrey hospital uses AI to treat cervical cancer in UK first

A cervical cancer patient has been treated with the aid of artificial intelligence (AI) for the first time in the UK.

Emma McCormick, 44, was treated at the St Luke's Cancer Centre in Guildford, Surrey.

The Royal Surrey NHS Foundation Trust treated Ms McCormick, who is from West Sussex, using adaptive radiotherapy.

The AI technology uses daily CT scans to target the specific areas that need radiotherapy.

This helps to avoid damage to healthy tissue and limit side-effects, the hospital said.

Patients are given treatments lasting between 20 and 25 minutes, although Ms McCormick's was slightly longer as she was the first patient, a hospital spokesman said.

Ms McCormick received five AI-guided treatments per week for five weeks before having a further two weeks of brachytherapy.

She said: "If it works for me, and they get information from me, it can help somebody else. It definitely worked and did what it was meant to do and so hopefully that helps others."

Dr Alex Stewart, who treated Ms McCormick, said one of the benefits of the treatment was that it allowed for more precision, meaning there were fewer side-effects for the patients.

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Source: BBC News, 21 January 2022

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Public told not to delay cancer check-ups

The public are being urged not to put off seeking help for worrying cancer symptoms because of NHS pressures.

NHS England chiefs said record numbers were being seen for check-ups before Omicron hit - and despite the current situation cancer was being prioritised.

There have been nearly 50,000 fewer cancer diagnoses across the UK since the start of the pandemic, Macmillan Cancer Support say.

This risks an increase in late-stage diagnoses, reducing survival chances.

Past surveys have suggested people are reluctant to come forward during surges in Covid cases because they did not want to be a burden to the health service.

NHS England said record numbers had had urgent cancer check-ups in November when 246,000 saw a consultant after a referral by a GP - although just over three quarters of these were seen in the target time of two weeks.

NHS England cancer director Dame Cally Palmer added it was vital people did not delay now even though hospitals were under huge strain.

"NHS staff are working hard to ensure that those who are coming forward for checks can be seen quickly so that cancer can be caught at an earlier stage."

She said common symptoms to look out for included diarrhoea that lasts for three weeks or more, new lumps or bumps and unexplained weight loss or fatigue.

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Source: BBC News, 2o January 2022

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GP’s ethnicity ‘affects level of support they get’

A GP’s ethnicity has an impact on the level of leadership support it gets from regulators and external bodies, a new Care Quality Commission (CQC) report has suggested.

In 2021, the CQC conducted research looking at concerns raised by some doctors that ethnic minority-led GP practices were “more likely to have a poorer experience or outcomes” from regulation.

In a final report, the CQC has admitted ethnic minority-led practices are “not operating on a level playing field”, due to several factors including the fact they are more likely to care for populations with higher levels of socio-economic deprivation and poorer health.

This can affect their ability to achieve some national targets used in assessments of quality, and increase challenges around recruitment and funding.

The evidence gathered by the CQC also suggested that practices led by ethnic minority doctors “often lacked leadership support from other bodies and suffered from low morale”.

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Source: HSJ, 19 January 2022

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Concern over ‘disgraceful’ nurse staffing levels planned for mini Nightingales

NHS leaders have raised concerns over the “new mini Nightingales” as hospitals draw up plans for use with “minimal” nursing levels, The Independent has learned.

In December the NHS announced it would be launching eight “surge” hubs dubbed “mini Nightingales” to help hospitals manage increased admissions amid the Omicron wave.

These facilities would be able to admit about 100 patients and have been set up as temporary sites across eight NHS hospitals.

Details around the safety requirements and required staffing levels have yet to be published, however several NHS sources have said some hubs are planning to use a “low” ratio of 1:15 nurses to patients within the units.

One trust chief has called the staffing models a “disgrace” and says the hospitals should never be used.

Senior sources have questioned the safety of using a 1:15 ratio, although they said the risk would depend on how ill the patients being sent to the units are and whether there would be sufficient health care assistant support. However, sources have said the staffing models have yet to be finalised and so could change.

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Source: The Independent, 20 January 2022

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Health department warning over vaccine mandate for NHS staff in England

Ministers have been issued with a stark warning over mandatory Covid vaccines for NHS workers in England, with a leaked document saying growing evidence on the Omicron variant casts doubts over the new law’s “rationality” and “proportionality”.

Two jabs will become compulsory for frontline NHS staff from 1 April after MPs voted on the legislation last month.

But the document, drawn up by Department of Health and Social Care (DHSC) officials and seen by the Guardian, said the evidence base on which MPs voted “has changed”, creating a higher chance of objections and judicial review.

The effectiveness of only two vaccine doses against Omicron, and the lower likelihood of hospitalisations from the milder variant, are cited.

More than 70,000 NHS staff – 4.9% – could remain unvaccinated by 1 April, the document says. NHS trusts in England are preparing to start sending dismissal letters from 3 February to any member of staff who has not had their first dose by then.

Amid significant pressures on the NHS, last week groups including the Royal College of Nursing urged Sajid Javid, the health secretary, to delay the legislation, known as “vaccination as a condition of deployment” (VCOD2).

On Tuesday the Royal College of Nursing said the leaked memo should prompt ministers to call a halt to the imposition of compulsory jabs, which it called “reckless”.

“The government should now instigate a major rethink”, said Patricia Marquis, the RCN’s England director. “Mandation is not the answer and sacking valued nursing staff during a workforce crisis is reckless.”

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Source: The Guardian, 18 January 2022

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Patients 'wait two years' for check-ups as dentists drop NHS work

NHS dentistry is "hanging by a thread" with some patients facing two-year waits for check-ups, the British Dental Association has said.

Department of Health data analysed by the BBC shows almost 1,000 dentists working in 2,500 roles across England and Wales left the NHS last year.

One woman told how she had been in pain for more than a year while waiting to have root canal surgery.

NHS England said patients who most needed care should be prioritised.

Pamela Carr, 58, from Carlisle, has been looking for an NHS dentist to fix her root canal since November 2020.

"I've become used to the pain," she said. "I can't afford the private care, and I've tried every practice within 30 miles. I phoned NHS England too."

"They said there's nothing they can do because there are no NHS dentists. That was the end of the conversation."

Clinical Commissioning Group North Cumbria, which covers the area, lost 4% of its dentists in the last year. The worst-affected area was NHS Portsmouth CCG, which lost 26% of its NHS dentists over 12 months. At least 10% of NHS dentists were lost in 28 other English CCGs.

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Source: BBC News, 19 January 2022

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Antimicrobial resistance now a leading cause of death worldwide, study finds

Antimicrobial resistance poses a significant threat to humanity, health leaders have warned, as a study reveals it has become a leading cause of death worldwide and is killing about 3,500 people every day.

More than 1.2 million – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, according to the most comprehensive estimate to date of the global impact of antimicrobial resistance (AMR).

The stark analysis covering more than 200 countries and territories was published in the Lancet. It says AMR is killing more people than HIV/Aids or malaria. Many hundreds of thousands of deaths are occurring due to common, previously treatable infections, the study says, because bacteria that cause them have become resistant to treatment.

“These new data reveal the true scale of antimicrobial resistance worldwide, and are a clear signal that we must act now to combat the threat,” said the report’s co-author Prof Chris Murray, of the Institute for Health Metrics and Evaluation at the University of Washington.

“We need to leverage this data to course-correct action and drive innovation if we want to stay ahead in the race against antimicrobial resistance.”

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Source: The Guardian, 20 January 2022

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Hundreds of dementia care homes found to be substandard in England

Hundreds of care homes in England are providing substandard care to dementia patients, analysis by the Guardian has found.

One in five homes specialising in dementia are rated “inadequate” or “requires improvement” by the Care Quality Commission (CQC), inspection reports show. Some pose such a serious risk to people with dementia – including filthy conditions, poor infection control and untrained staff – that inspectors have ordered them to be placed into special measures.

Altogether, 1,636 care homes are failing patients in findings described by charities and campaigners as “appalling”. They said urgent action was needed to tackle the “unacceptable” state of dementia care across the country.

Zoe Campbell, the director of operations at the Alzheimer’s Society, said: “It’s appalling to hear that one in five care homes specialising in dementia are delivering substandard care. Every person with dementia deserves to live in a safe, secure place and to be treated with compassion and respect.”

Campbell said the revelations meant staff recruitment and dementia training must be prioritised in the government’s social care proposals.

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Source: The Guardian, 18 January 2022

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GPs should regularly review self-harm patients, says draft NICE guidance

GPs should regularly review self-harm patients and offer a specific CBT intervention, according to a consultation on the first new guidance for self-harm to be drawn up in 11 years.

The new draft guidance emphasises the importance of referring patients to specialist mental health services, but stresses that, for patients who are treated in primary care, continuity is crucial.

If someone who has self-harmed is being treated in primary care, GPs must ensure regular follow-up appointments and reviews of self-harm behaviour, as well as a medicines review, the draft guideline say.

They must also provide care for coexisting mental health issues, including referral to mental health services where appropriate, as well as information, social care, voluntary and non-NHS sector support and self-help resources.

The guidance says that referring people to mental health services would ‘ensure people are in the most appropriate setting’.

However, the committee agreed that ‘if people are being cared for in primary care following an episode of self-harm, there should be continuity of care and regular reviews of factors relating to their self-harm to ensure that the person who has self-harmed feels supported and engaged with services’.

The draft guidance, out for consultation until 1 March, also says ambulance staff should suggest self-harming patients see their GP to maximise the chance of engagement with services.

It says: ‘When attending a person who has self-harmed but who does not need urgent physical care, ambulance staff and paramedics should discuss with the person (and any relevant services) if it is possible for the person to be assessed or treated by an appropriate alternative service, such as a specialist mental health service or their GP.’

It notes that ‘ambulance staff often felt that the emergency department was not the preferred place that the person who had self-harmed wanted to be taken. They agreed that referral to alternative services could facilitate the person’s engagement with services’.

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Source: Pulse, 18 January 2022

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ICS told to increase help for trust that treated patients on the floor

A troubled integrated care system has been told it must provide more help to a severely under-pressure acute trust where patients were treated on the floor and in a storeroom.

The Care Quality Commission said Devon ICS must give more “input” to University Hospitals Plymouth Trust, where inspectors warned staff could “not ensure the safety of all patients” arriving at the emergency department.

During a visit to the trust’s Derriford Hospital in September, inspectors saw staff treating six patients who “lay on the floor” of the ambulatory assessment unit, while another patient who had been in the department overnight was being “treated/assessed in the ‘storeroom’” – according to the CQC’s report.

Inspectors reported: “The department was overcrowded, there was no seating available… Social distancing was not possible.”

While the CQC praised senior leaders in the ED and executive chiefs for being “open to challenge” and “understanding the problems” faced by the urgent and emergency care service, inspectors said there was only so much the trust could do alone.

Catherine Campbell, head of hospital inspection at CQC, said: “The impact of a high number of patients attending to receive care, combined with reduced staffing levels in the ED, created issues that the trust couldn’t solve alone and further support was needed from the local health and social care system."

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Source: HSJ, 19 January 2022

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Cervical cancer: New screenings will save lives, says top doctor

Changes in cervical cancer screenings will help save lives, not put them at risk, according to a top gynaecologist.

Prof Alison Fiander said people should not be worried screenings have dropped from every three to every five years in Wales as tests are "more effective".

Public Health Wales (PHW) said the new rules were for people aged 25 to 49.

More than 1.2 million people backed calls for a rethink in a UK petition and politicians in Wales will debate it after 30,000 signed a Senedd petition.

Women and people with a cervix - as it could also affect trans men too - who had not tested positive for human papillomavirus (HPV) will now wait two more years between tests.

Health chiefs in Wales said they changed the interval between screenings to the same time as those in Scotland because tests are now more accurate. Cervical screening gaps in England and Northern Ireland remain at three years.

But Wales' public health body did publicly apologise for causing "concern", and admitted health chiefs "hadn't done enough to explain the changes".

Prof Fiander, a clinical lead at the Royal College of Obstetricians and Gynaecologists, said PHW had "missed an opportunity" to help educate people but reassured the public the change was safe and not a cost-cutting exercise.

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Source: BBC News, 18 January 2022

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Doctors warn hospitals ‘not coping’ as study links A&E waits to deaths

Hospitals are not able to cope with current pressures, senior doctors have warned, as a new study links long A&E waits to an increased risk of death.

Patients waiting more than five hours within an emergency department are at an increased risk of dying, according to a study published in the Emergency Medicine Journal (EMJ).

The study’s findings come as emergency care performance across England continues to deteriorate, and as pressures across hospitals mean that more patients are waiting for more than four hours in A&E departments than ever before.

According to the research, death rates for patients waiting between six and eight hours before admission to hospital were 8% higher, and they were 10% higher for those waiting eight to 12 hours. The study was based on data collected prior to the pandemic, and national A&E waiting times have since deteriorated further.

In November last year, the Royal College of Emergency Medicine (RCEM) warned that long delays and overcrowding in A&Es may have caused thousands of deaths during the pandemic.

Researchers said that although cause and effect could not be established between longer waits and deaths after 30 days of hospital admission, they recognised a statistically significant trend.

The paper said: “Long stays in the emergency department are associated with exit block and crowding, which can delay access to vital treatments. And they are associated with an increase in subsequent hospital length of stay, especially for older patients.

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Source: The Independent, 19 January 2022

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COVID-19: Focus should be on new vaccines rather than boosters, says WHO

Giving repeated booster doses of existing CovidD-19 vaccines in developed countries is not a sustainable global strategy for tackling the pandemic, the World Health Organization has said.

Instead, WHO argues that the focus should shift towards producing new vaccines that work better against transmission of emerging variants.

In a statement, published on 11 January, the WHO Technical Advisory Group on Covid-19 Vaccine Composition said, “A vaccination strategy based on repeated booster doses of the original vaccine composition is unlikely to be appropriate or sustainable.”

The expert group, which is assessing the performance of Covid-19 vaccines, said that to deal with emerging variants such as omicron, new vaccines needed to be developed that not only protect people against serious illness but against infection. “Covid-19 vaccines that have high impact on prevention of infection and transmission, in addition to the prevention of severe disease and death, are needed and should be developed,” the group said.

Vaccines also need to be more effective at protection against infection, “thus lowering community transmission and the need for stringent and broad reaching public health and social measures,” the group said.

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Source: BMJ, 17 January 2022

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Sajid Javid plans NHS revolution modelled on academy schools

Academy-style hospitals will be set up to improve patchy NHS leadership under a shake-up planned by Sajid Javid to deal with post-pandemic waiting lists.

The health secretary is formulating the reorganisation to give well-run hospitals more freedom as well as forcing failing trusts to improve. A new class of “reform trust” will be established as Javid signals an appetite for wide-ranging changes to deal with a “huge” variation in performance across the health service.

Modelling reforms on the Blairite academies programme could lead to failing hospitals being forcibly turned into reform trusts, as happens with schools that are rated inadequate. It is possible that chains of hospitals will be run by leading NHS managers, or even outside sponsors, although this is yet to be decided.

Boris Johnson is said to want to focus on cutting NHS waiting times as part of an “operation red meat” designed to shift the focus from rows over Downing Street parties. Allies of Javid say, however, that his desire for reform long predates the prime minister’s present problems and that as the Omicron wave recedes he believes he has a “six-month window” to introduce changes before planning for next winter takes over.

His proposals raise the prospect of ministers embarking on another NHS reorganisation, even before the government’s Health and Care Bill — itself designed to reverse previous Tory reforms – becomes law.

The plans are still at an early stage but are due to feature in a white paper that will set out Javid’s plans for dealing with weak leadership and slow adoption of best practice in parts of the NHS. A Whitehall source said: “Sajid’s reform agenda is all about driving up performance across the NHS. To achieve that we are going to apply some lessons from the academies programme.”

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Source: The Times, 18 January 2022

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Coroner concerned with Barts NHS trust after woman 'unlawfully killed'

Barts Health NHS Trust has been told to take action to prevent future deaths after an elderly woman was unlawfully killed at one of its hospitals.

East London acting senior coroner Graeme Irvine sent a report to the trust in which he raised concerns over the death of 78-year-old Surekha Shivalkar in 2018.

The report follows an inquest into Mrs Shivalkar's death, which reached a narrative conclusion incorporating a finding of unlawful killing.

A Barts spokesperson said the trust had made a number of changes after carrying out an investigation.

Mrs Shivalkar underwent hip replacement revision surgery at Newham Hospital on September 28, 2018 in a procedure estimated to last between four and five hours, the coroner wrote. 

She had a number of serious conditions, including ischaemic heart disease, osteoporosis and chronic obstructive pulmonary disorder. But Mr Irvine said an inaccurate risk of death of less than 5% was given, as no formal risk assessment tool was used. 

The surgery took longer than seven and a half hours, during which time Mr Irvine said Mrs Shivalkar sustained a "prolonged and dangerous" period of hypotension, or low blood pressure.

He said the anaesthetist failed to communicate this to the surgical team and agreed to prolong surgery at the six hour point.

Mr Irvine said: "Poor communication between the orthopaedic surgical team and the anaesthetist during surgery led to a collective failure to identify a critically ill patient."

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Source: Newham Recorder, 17 January 2022

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Swedish expert praises leading work in patient safety in Scotland

Swedish expert has praised Scotland for leading work in improving patient safety, with a decade-long programme which is now expanding into social care.

Dr Pelle Gustafson (below), chief medical officer, of Swedish patient insurer Löf, said he was “particularly impressed” by the work in Scotland over the past 10 years during a meeting of the House of Commons Health and Social Care Committee.

The Scottish Patient Safety Programme (SPSP), which has been in existence for around 13 years, was set up to make patient safety a priority in NHS Scotland, drawing on lessons from the airline industry such as introducing checklists.

Gustafson was asked by Tory MP Dr Luke Evans which country he would hold at the “very top of the pillar” for preventative work during an evidence session on NHS litigation reform last week.

He responded: “If you take all preventive work as regards patient safety, I would say that I am personally very impressed by Scotland.

“In Scotland, you have a long-standing tradition of working. You have development in the right direction.

“You have a system that is fairly equal all over the place and you also have improvement activities going on. I am very impressed by Scotland.”

He added: “I am particularly impressed by the Scottish work over the last 10 years. There are a lot of things that we, in the Nordic countries, can learn from Scotland too.”

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Source: The National, 16 January 2022

 

 

 

 

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Specialist mental health unit failures exposed by patients

There are serious concerns over the standards of specialist care being provided to patients with the most complex mental health needs, a BBC investigation has found.

Patients sent by the NHS to stay in mental health rehabilitation units say they have been placed in unsafe environments, often far from home, with untrained staff.

Experts say not enough is being done to regulate the sector, which costs the NHS half a billion pounds a year.

Lissa had spent years struggling with her mental health, having experienced traumatic life events. She was diagnosed with mixed personality disorder, depression and high-functioning Asperger's. So when the NHS sent her to a unit in Coventry run by Cygnet Health Care for a specialist talking therapy, she agreed.

The hospital, however, was in special measures. There had been two deaths in the previous 20 months. In both cases there was found to be a failure to follow the patient's care plan and carry out observations correctly. Lissa says staff failed to treat her with dignity and respect.

The system in England is regulated by the Care Quality Commission, (CQC). Some rehabilitation wards haven't been inspected for four or more years.

John Chacksfield, who was a CQC inspector until late 2020, says greater scrutiny is needed.

"Sometimes the private sector provides really excellent service, but there are certain units that really do need regular inspections just to make sure staff are being trained enough, or are having enough clinical supervision. It does worry me," he says.

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Source: BBC News, 18 January 2022

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Yorkshire heart attack patient urged to take lift to York hospital

An ambulance trust has apologised after a man having a heart attack said he was advised to get a lift to hospital or face a long wait.

Graham Reagan said he was on the verge of collapsing when he finally got to York hospital after a lift from his son.

Mr Reagan said he was concerned about the impact on patients with potentially life-threatening conditions.

Speaking to BBC Yorkshire and Lincolnshire's Politics North programme, Mr Reagan described his experience as "scary".

"I'd had indigestion, or so I thought, for a couple of days, and then on 17 December I went to bed early feeling rough," he said.

In the early hours, Mr Reagan said the pains in his chest grew worse and he asked his wife to call for an ambulance. "I couldn't take it any more," he said.

Mr Reagan, from Malton in North Yorkshire, said his wife was asked "can you get to hospital" as the nearest ambulance was about 20 to 30 miles away.

"My wife doesn't drive, but fortunately my son was with us and he drove me to York hospital."

On arrival Mr Reagan said they found the entrance to A&E had also been re-routed.

"So, we then had to walk out of the hospital grounds and back in - by which time I'm collapsing," he added.

He said staff at the hospital were "absolutely brilliant" and arranged for him to be transferred to Hull for treatment after a heart attack was confirmed. However, he said he was faced with a further 35-minute delay while he waited for an ambulance to take him.

Mr Reagan said he wanted to share his experience to raise awareness.

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Source: BBC News, 16 January 2022

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