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Healthgrades recognised 864 US hospitals with its 2023 Patient Safety Excellence Awards and Outstanding Patient Experience Award. Only 83 of those hospitals received both awards.
The dual recipients spanned 28 states. Texas had the most dual recipients with 12 honorees — including three Baylor Scott and White Health hospitals.
Source; Becker's Hospital Review, 14 March 2023
Deliberate attempts were made to “conceal the extent of racial discrimination” at a national NHS agency, according to a report leaked to HSJ.
A highly critical internal report at NHS Blood and Transplant (NHSBT) also said fewer than half the recommendations made in 2020 by external mediation experts, around issues of racism, had so far been actioned.
A review conducted by Globis Mediation Group in 2020 found “systemic racism” among management at the agency’s large Colindale site in north London, with ethnic minority staff being “ignored, being viewed as ineligible for promotion and enduring low levels of empathy”.
It made nine recommendations, including exploring whether similar issues existed at the other 15 NHSBT sites.
Source: HSJ, 16 March 2023
Following the Advanced cyber attack in August 2022, Phil Huggins has revealed to a Digital Health Rewired audience that the NHS has “seen no clinical impact or significant clinical harm”, after a review to be released in the near future.
The national chief information security officer for health and care at NHS England was speaking alongside a panel on the Cyber Security Stage on day two of Digital Health Rewired 2023 in London.
Huggins explained that although the impact of the Advanced attack was big on the system, in a clinical sense it was not particularly damaging, despite the fact that client data was confirmed to have been exfiltrated.
However, Ayesha Rahim, clinical lead for digital mental health at NHS England and chief medical information officer at Surrey and Borders Partnership Foundation Trust, was also on the panel, and spoke of the huge impact the attack had on staff.
“The date 4th August is imprinted in my brain”, Rahim said, which is when the attack first happened and was first reported. She explained that it is “quite difficult to fully convey the chaos this caused”, giving examples of staff having no idea what a patient’s background was and therefore having to do everything “blindfolded”.
Rahim said staff could not tell if it was safe to go out on visits to mental health patients due to the lack of data and information on them, and every time a person saw a staff member they were retraumatised having to explain their past over and over, including experiences of sexual abuse.
Source: Digital Health, 15 March 2023
Some hospitals are suspending supplies of gas and air, after it was found to pose health risks to midwives. What can be done to ensure pregnant women still get the help they need?
When Leigh Milner was expecting her first baby, she knew exactly how she wanted her labour to go. Her birth plan included an epidural for the pain and she was hoping, she says ruefully, for “all the drugs”. But that is not how things worked out. Milner, 33, a BBC presenter, ended up giving birth to Theo at Princess Alexandra hospital in Harlow last month with nothing but paracetamol for pain relief, in what she calls a positively “Victorian” experience.
“I kept begging over and over again – ‘I need something for pain relief’ – and the only thing they could give me was paracetamol because they didn’t have gas and air. I was quite frightened, I didn’t know what else to do,” says Milner.
"Birth is painful, but it shouldn’t be traumatic.”
Source: The Guardian, 16 March 2023
Gonorrhoea cases in England have resurged since the easing of Covid restrictions, health officials are warning people who are sexually active.
The disease is caused by the bacterium Neisseria gonorrhoeae. The infection is spread by unprotected vaginal, oral and anal sex.
Symptoms can include a thick green or yellow discharge from sexual organs, pain when urinating and bleeding between periods, but some people will have no symptoms.
Condoms can stop the spread of this and other sexually transmitted infections.
Experts say people should practise safe sex and get tested regularly if they are having sex with new or casual partners. Testing is simple, free and discreet, they advise.
Provisional data shows diagnoses in the first half of 2022 hit 56,327 - 21% higher than for the same period in 2019.
An untreated infection can lead to infertility, pelvic inflammatory disease and can be passed on to a child during pregnancy.
Source: BBC News, 16 March 2023
Life expectancy in the UK has grown at a slower rate than comparable countries over the past seven decades, according to researchers, who say this is the result of widening inequality.
The UK lags behind all other countries in the group of G7 advanced economies except the US, according to a new analysis of global life expectancy rankings published in the Journal of the Royal Society of Medicine.
While life expectancy has increased in absolute terms, similar countries have experienced larger increases, they wrote. In the 1950s, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Denmark, Norway and Sweden, but in 2021 the UK was ranked 29th.
The researchers said this was partly due to income inequality, which rose considerably in the UK during and after the 1980s.
Prof Martin McKee, of the London School of Hygiene & Tropical Medicine, said: “That rise also saw an increase in the variation in life expectancy between different social groups. One reason why the overall increase in life expectancy has been so sluggish in the UK is that in recent years it has fallen for poorer groups".
Source: The Guardian, 16 March 2023
NHS staff have accused Steve Barclay of breaking a pledge to publish details of how many of them are abused and assaulted in the course of their work.
In 2018, when Barclay was a junior minister in the Department of Health and Social Care (DHSC), he promised he would resume publication of those statistics in the following year.
However, five years later, Barclay has not fulfilled his pledge, despite being in his second stint as health secretary.
Health unions and NHS leaders have warned that frontline staff have been on the receiving end of increased abuse, threats, aggression and assaults since the first outbreak of Covid. Long waiting times for care appear to be a particular source of frustration for some patients or their relatives.
The disruption caused by the junior doctors' strike in England could take weeks to resolve, health bosses say.
Tens of thousands of appointments and treatments, including cancer care, had to be cancelled during the three-day walkout.
Patients with appointments coming up may see them cancelled to make room for high-priority cases hit by the strike.
Hospitals are also reporting problems discharging patients from wards, as consultants were sent to cover A&E.
Saffron Cordery, of NHS Providers, which represents NHS trusts, said the scale and length of the walkout, coupled with the fact it started on a Monday - traditionally the busiest day of the week - had made it more difficult than previous strikes by nurses and ambulance staff.
"It will take weeks to recover - just rebooking patients who have treatments and appointments cancelled is a big job," she said.
"Patients have to be individually prioritised - it may mean some patients with bookings in the coming weeks being pushed further back."
Source: BBC News, 16 March 2023
A chief executive has apologised after a survey of his trust’s staff from minority ethnic backgrounds found many had been subjected to racist behaviour by colleagues.
The staff at East of England Ambulance Service Trust said peers had made monkey noises and referred to banana boats in front of them, excluded them from social events, and assumed they could speak Middle Eastern and Asian languages just because of their skin colour, they told researchers.
The trust has had substantial cultural problems for several years, and commissioned the survey to “better understand the experience, perceptions and realities of the trust BME staff”, a board paper said.
The report on its findings, published this week in trust board papers, warns: “There are risks that a minority of EEAST employees are demonstrating behaviours or using language which could be perceived as racist. Reports of subsequent inaction by managers further risk this behaviour being normalised.”
Read full story (paywalled)
Source: HSJ, 15 March 2023
The US Emergency Care Research Institute (ECRI) has said the paediatric mental health crisis is the most pressing patient safety concern in 2023.
ECRI, which conducts independent medical device evaluations, annually compiles scientific literature and patient safety events, concerns reported to or investigated by the organization, and other data sources to create its top 10 list.
Here are the 10 patient safety concerns for 2023, according to the report:
1. The pediatric mental health crisis
2. Physical and verbal violence against healthcare staff
3. Clinician needs in times of uncertainty surrounding maternal-fetal medicine
4. Impact on clinicians expected to work outside their scope of practice and competencies
5. Delayed identification and treatment of sepsis
6. Consequences of poor care coordination for patients with complex medical conditions
7. Risks of not looking beyond the "five rights" to achieve medication safety
8. Medication errors resulting from inaccurate patient medication lists
9. Accidental administration of neuromuscular blocking agents
10. Preventable harm due to omitted care or treatment
For the number one spot, ECRI said the COVID-19 pandemic raised the situation, which includes high rates of depression and anxiety among children, to crisis levels.
ECRI President and CEO Marcus Schabacker, MD, PhD, said social media, gun violence and other socioeconomic factors were fueling the issue, but COVID-19 pushed it into a crisis.
"We're approaching a national public health emergency," Dr. Schabacker said in a statement.
Source: Becker's Hospital Review, 13 March 2023
A scandal-hit hospital group has been sanctioned by inspectors after The Independent revealed “systemic abuse” at a string of children’s mental health units.
England’s safety watchdog issued an official warning to Ivetsey Bank Hospital in Staffordshire, run by The Huntercombe Group, after an extensive investigation by this newspaper found the private hospital had put the safety of young mental health patients at risk.
The Care Quality Commission also downgraded the hospital’s rating to “inadequate”. If improvements are not made in line with the warning notice, the hospital could be forced to close.
An inspection was carried out two weeks after The Independent revealed widespread allegations of abuse and excessive restraint across The Huntercombe Group’s hospitals.
The investigation revealed the provider, which also runs Taplow Manor children’s hospital in Maidenhead, was facing allegations from more than 50 former patients as well as claims of poor care from staff whistleblowers and dozens of negligence claims.
Source: The Independent, 15 March 2023
Certain cough medicines sold behind the counter at pharmacies are being withdrawn over safety concerns.
Health experts say there is a very rare chance that some people could experience an allergic reaction linked to an ingredient called pholcodine.
People should check the packaging of any cough tablets or syrups they have at home to see if pholcodine is listed among the ingredients. If it is, talk to your pharmacist about taking a different medicine.
Products containing pholcodine do not need a prescription, but cannot be bought without consultation with the pharmacist as they are kept behind the counter.
The Medicines and Healthcare Products Regulatory Agency (MHRA) described removing the products from sale as a precautionary measure.
Source: BBC News. 15 March 2023
Acute trusts are reporting high demand at emergency departments (EDs) despite junior doctor strikes, which in some cases threaten to lead to overflowing wards and long ambulance handover delays.
Chief executives and directors from trusts around England told HSJ their EDs had been as busy or busier than usual.
Many had hoped prominent media coverage and NHS announcements about the strikes would lead to reduced demand, helping them cope with fewer doctors on duty. Several claimed it showed national communications about the strikes were lacking.
NHS England has said some hospitals saw their busiest Monday of the year so far yesterday, which it said “presents a major challenge as our staff continue to do all they can to mitigate the impact of the industrial action for patients.”
Read full story (paywalled)
Source: HSJ, 14 March 2023
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”.
Read full story (paywalled)
Source: HSJ, 14 March 2023
A new US study highlights a striking racial disparity in infant deaths: Black babies experienced the highest rate of sudden unexpected deaths (SIDS) in 2020, dying at almost three times the rate of White infants.
The findings were part of research by the Centers for Disease Control and Prevention, which also found a 15% increase in sudden infant deaths among babies of all races from 2019 to 2020, making SIDS the third leading cause of infant death in the United States after congenital abnormalities and the complications of premature birth.
“In minority communities, the rates are going in the wrong direction,” said Scott Krugman, vice chair of the department of pediatrics and an expert on SIDS at Sinai Hospital in Baltimore.
The study found that rising SIDS rates in 2020 was likely attributable to diagnostic shifting — or reclassifying the cause of death. The causes of the rise in sleep-related deaths of Black infants remain unclear but it coincided with the arrival of the coronavirus pandemic, which disproportionately affected the health and wealth of Black communities.
Read full story (paywalled)
Source: The Washington Post, 13 March 2023
Data revealed for the first time shows nearly three-quarters of adult patients needing community mental health care are waiting more than four weeks for treatment to start, which is the timeframe that NHS England wants to introduce as a national standard.
Figures shared with HSJ also show two-thirds of children needing community care are waiting more than four weeks from referral to treatment.
In 2021, NHS England proposed a series of new waiting time standards in mental health, including a four-week standard for non-urgent community care.
A lack of new funding, as well as data recording problems, mean the new standards have not so far been introduced, and no timeline set for implementation.
Read full story (paywalled)
Source: HSJ, 14 March 2023
A couple whose baby died after he was starved of oxygen during a home birth are campaigning for risky breech deliveries to be spotted earlier.
Arthur Trott was an undiagnosed breech baby, born after a planned home birth in Burgess Hill on 24 May 2021.
A breech delivery is when a baby's bottom or feet will emerge first.
An inquest into his death found a delay in transfer to hospital "materially contributed" to his brain injury.
The South East Coast Ambulance Service Trust said it welcomed "any changes to national breech birth guidance".
Arthur's parents believe a breakdown in communication between the paramedics who attended and their control room meant Mrs Trott was kept at home too long.
Arthur's father, Matt Trott, said: "You could hear the panic and confusion in everyone's voices. One minute they were told to go to hospital, the next minute to stay."
As a result of Arthur's death, all planned home births in Sussex are being offered a presentation scan at 38 weeks.
Source: BBC News, 14 March 2023
NHS England was aware of concerns about upper gastrointestinal surgery at a hospital nearly three years before the Care Quality Commission intervened to stop it being carried out, HSJ can reveal.
NHSE in the South East commissioned a report into upper GI cancer services in parts of the region in January 2020. In particular, HSJ understands the review was prompted by concerns the small number of surgeries carried out at the Royal Sussex County Hospital in Brighton meant it may be unable to comply with parts of the service specification and face difficulties maintaining an adequate surgical workforce rota.
Despite these concerns, Brighton continued to carry out upper GI surgery until the CQC suspended planned oesophagic-gastric resections last August.
Read full story (paywalled)
Source: HSJ, 14 March 2023
An NHS England investigation into claims of a toxic culture at a hospital trust has been described as lacking transparency and undermining trust.
The Parliamentary Health Service Ombudsman also said there were "very serious" patient safety issues at University Hospitals Birmingham (UHB).
Criticism is contained in letters seen by the BBC between the ombudsman, the trust and NHS England.
The inquiries, commissioned by the Birmingham and Solihull Integrated Care Board and the local NHS, were begun in response to an investigation by BBC Newsnight and BBC West Midlands which heard from current and former clinicians from the trust, who accused it of being "mafia-like".
One of England's biggest hospital trusts, UHB has been in the spotlight for months after three probes were started following allegations doctors there were threatened for raising safety concerns.
The trust denies this and says its "first priority is patient safety".
The ombudsman, however, said he was sceptical about the reviews' transparency and independence.
His finding of "very serious" patient safety issues at UHB is based on the trust's response to the ombudsman's recommendations and findings, including a case of an avoidable patient death.
Source; BBC News, 14 March 2023
The patient lay slumped next to a pile of pills and a personally signed note reading: 'do not resuscitate me'. His breathing was agonal, his skin mottled, his pupils fixed, no pulse discernible. The attending doctor, in agreement with both paramedics and family member, decided to respect his wishes. Yet, this GP was placed under investigation for gross negligence manslaughter by the Crown Prosecution Service (CPS) for not resuscitating the patient, setting in motion a sequence of investigations, including by the coroner and the General Medical Council (GMC), that were triggered by the statement of one policeman at the scene.
All investigations and allegations were eventually dismissed but not until the GP had been through years of significant physical and mental stress. Still today, questions remain unanswered – in particular, concerning the actions of the police and the CPS.
Speaking under the condition of anonymity, the GP spoke to Medscape News UK, and said that now, over 7 years after that fateful home visit, she remained resolute that she made the correct clinical decisions at the time.
"It has all been very stressful for me. What was behind this case? What was driving this potential prosecution? And throughout, the patient, the family and their concerns were completely forgotten in the pursuit of so-called justice," she pointed out.
Source: Medscape News, 9 March 2023
Hospitals are being asked to offer a wider range of gown sizes to better protect patients' dignity.
It follows the experience of a patient from Wiltshire who said she was offered a gown that was "far too small" during a hospital stay in Bristol.
Barbara Gale said it gaped at the back and made her feel "embarrassed".
The experience sparked calls for more sizing options..
An independent study conducted by the University of Strathclyde in Glasgow in 2019 asked patients across the UK for their thoughts on the issue of hospital gowns.
Consultant clinical psychologist for the NHS, Nicola Cogan, led the research and said the findings showed Ms Gale's experience was not an isolated case.
She said: "We spoke to a 1,000 patients and found over two thirds reported they struggled to get a gown on themselves and 70% reported the gown did not fit".
"It's not cost effective for the NHS, but also it shows that the gown is currently not fit for purpose."
Source: BBC News, 13 March 2023
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More than 100,000 patients, including children, have been treated in so-called virtual wards over the last year, NHS officials have said.
Leading medics said that the use of the system to monitor patients at home has been a “real game changer”.
Officials say virtual wards can help patients avoid unnecessary hospital trips altogether, or enable them to be sent home from hospital sooner.
Using various equipment and technology, clinicians can monitor vital signs such as a patients’ heart rate, oxygen levels and temperature remotely.
NHS England’s national medical director, Professor Sir Stephen Powis, said: “The advantages of virtual wards for both staff and patients have been a real game-changer for the way hospital care is delivered and so it is a huge achievement that more than 100,000 patients have been able to benefit in the last year alone, with the number of beds up by nearly two thirds in less than a year.
“With up to a fifth of emergency hospital admissions estimated to be avoided through better supporting vulnerable patients at home and in the community, these world-leading programmes are making a real difference not just to the people they directly benefit but also in reducing pressure on wider services.”
Source: The Independent. 11 March 2023
MPs from across the political spectrum have called for a ban on electroconvulsive therapy (ECT) as a treatment for mental illness in England, and want the practice to be subject to an urgent inquiry.
MPs told The Independent they have serious concerns that women are disproportionally given electroconvulsive therapy, and argued that patients are not properly notified of the treatment’s potential side effects. Some patients have also reported that they weren’t asked to provide consent before it was administered.
Dr Pallavi Devulapalli, a GP, called for the government to undertake an “urgent and comprehensive review” of the treatment as she warned that patients’ wellbeing was “at stake”.
The calls come after The Independent previously reported that thousands of women were being given ECT despite concerns that it can cause irreversible brain damage.
It comes after Dr Sue Cunliffe, who began receiving ECT in 2004, previously told The Independent that the treatment had “completely destroyed” her life despite a psychiatrist having told her there would be no long-term side effects.
Dr Cunliffe, a former children’s doctor, said: “By the end of it, I couldn’t recognise relatives or friends. I couldn’t count money out. I couldn’t do my two times table. I couldn’t navigate anywhere. I couldn’t remember what I’d done from one minute to another.”
Source: The Independent, 12 March 2023
Bereaved families are having to report maternity blunders because watchdogs and hospitals are unable to spot failings, an expert has warned.
Bill Kirkup said avoidable deaths were "a badge of shame" but would continue without urgent change.
Eight years on from his report into the Morecambe Bay maternity scandal, he said the failure of officials to act had needlessly cost more lives.
"I am very disappointed – and surprised – that we're still where we are", he said. "That's a terrible badge of shame for the health service that it takes families to come and tell us what's wrong.
"Yet just about every tragedy that I've ever been involved with investigating has come to light when there's a group of families who say 'You've got a problem here'.
"People are lying, they're not being open and they're concealing what's happening.
"If we can't bring this change, I'm not confident that there won't be another East Kent, Morecambe Bay or Nottingham, somewhere else."
Source: Mail Online, 10 March 2023
A cross-border trial has improved care for patients prescribed multiple medicines.
The iSIMPATHY project, funded by the European Union's INTERREG VA Programme, worked with professionals in Scotland, the Republic of Ireland and Northern Ireland to comprehensively review patient medication.
Taking multiple medicines can be problematic if the increased risk of harm from interactions between drugs, or between drugs and diseases, outweighs the intended benefits.
Interim findings showed these interventions potentially prevented major organ failure, adverse drug reactions, avoided hospital admissions and saw patients moved to more appropriate medication.
Scotland’s Public Health Minister Maree Todd said: “This project looked at some of our most vulnerable patients taking more than five medications. The reviews have avoided adverse combinations of drugs and hospitalisations while also reducing prescriptions and drugs costs.
“We will know more when the full evaluation is published in June, we will work with partners to see how we can these improvements can be applied more widely, potentially saving lives and money.”
Source: Scottish Government, 10 March 2023
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