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NHS mix-up led to female patient having unnecessary cervical examination

A woman was subjected to an unnecessary invasive procedure in an NHS outpatient clinic after she was confused for another patient, a safety watchdog has found.

The Healthcare Safety Investigation Branch has called for a review of how the NHS can avoid the mishap happening again after investigating the case of a 39-year-old woman who was subjected to an unnecessary cervical examination.

HSIB said a better system was needed as the number of outpatient appointments has increased from 54 million to 94 million during the last 10 years with many clinics carrying out more invasive procedures.

According to its latest investigation, the female patient was attending a gynaecological outpatient clinic for a fertility treatment assessment.

The error happened when she was called through from the waiting room as another patient had a similar sounding name.

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Source: The Independent, 2 June 2021

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Self-harm in over-65s ‘needs post-pandemic focus’

Self-harm among the over-65s must receive greater focus because of the increased risks associated with the pandemic, a leading expert has said.

Loneliness, bereavement and reluctance to access GPs can all be causes in older adults, said Prof Nav Kapur, who has produced guidelines on the subject.

He warned that in over-65s, without the right help, self-harm can also be a predictor of later suicide attempts.

The NHS's mental health director said it had expanded its community support.

Claire Murdoch added that its services, including face-to-face appointments, had "continued for all who needed them", and 24/7 crisis lines had been established.

Over-65s are hospitalised more than 5,000 times a year in England because of self-harm and self-poisoning, figures obtained from NHS Digital show.

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Source: BBC News, 3 June 2021

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‘Devastating, tragic, and deadly’: VA leaders in Arkansas allowed impaired pathologist to harm hundreds of veterans, watchdog finds

Oversight failures, a fearful workplace culture and lax quality standards for years at a Veterans Affairs hospital in Arkansas, USA, allowed a pathologist who was routinely drunk on the job to misdiagnose thousands of veterans — sometimes with dire or deadly consequences, a new investigation has found.

Hospital leaders “failed to promote a culture of accountability” that would have led more of the doctor’s colleagues to come forward with accounts that his behavior was putting patients at risk, according to the report released Wednesday by VA’s Office of Inspector General. But the staff members at the Veterans Health Care System of the Ozarks in Fayetteville feared that reporting their concerns would lead to retaliation from their bosses.

“Any one of these breakdowns could cause harmful results,” Inspector General Michael Missal’s staff wrote in an 86-page report about the failures to stop the pathologist, Robert Morris Levy. “Together and over an extended period of time, the consequences were devastating, tragic, and deadly.”

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Source: The Washington Post, 2 June 2021

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COVID-19: Health staff in plea for better protection

More than 20 healthcare organisations, including those representing nurses, doctors, surgeons and therapists, are calling for stricter UK guidelines to be introduced on face masks and other personal protective equipment (PPE).

In a virtual meeting with officials, they will say existing rules leave them vulnerable to infection through the air, especially by new Covid variants.

The unprecedented appeal will see them argue that other countries, such as the United States, protect their health workers with higher-grade equipment.

It is thought to be the first time health and care organisations have united on a single issue in this way - a sign of the desperation many feel about the need for staff to be kept safe.

The delegation will include representatives of the British Medical Association, the Royal College of Nursing and many other professional organisations and unions.

On the government side will be about 20 of the most senior officials from all four UK nations, many involved in setting the guidelines on personal protective equipment (PPE).

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Source: BBC News, 3 June 2021

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‘Secretive’ safety findings set to be revealed direct to CQC

The Care Quality Commission may in future be notified when ‘secretive’ external reviews have looked at patient safety issues within trusts.

Last summer, HSJ revealed guidance for trusts to publish summaries of royal colleges’ reviews was being widely ignored, with some even failing to inform the CQC.

A recent BBC Panorama programme has again raised the issue, with Academy of Medical Royal Colleges chair Helen Stokes-Lampard saying she was “dismayed” the body’s guidance was not being followed.

But she has now told HSJ of “advanced discussions” with the CQC about changes which would see the royal colleges routinely inform the regulator when reviews raise patient safety issues.

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Source: HSJ, 3 June 2021

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Annual checks can lengthen life

A group set-up following the Winterbourne View scandal is urging more people with learning disabilities to attend their annual health check-up.

Healthwatch South Gloucestershire said regular health checks could prevent people from dying unnecessarily.

It formed after BBC Panorama exposed abuse of patients at Winterbourne View hospital 10 years ago. Only about 36% of people with learning difficulties are believed to have an annual GP health check-up.

The Local Democracy Reporting Service (LDRS). said the lack of regular, medical observations contributed to them having a life expectancy of 20 years lower than in the wider population.

Healthwatch South Gloucestershire, a regional, independent health and social care champion, has created a checklist to encourage more people to attend appointments to help them improve their life expectancy.

Vicky Marriott from the group said: "It is our unrelenting mission to listen and share people's lived experience so that the information informs how health and social care services improve.

"We recently listened to people with learning disabilities and their families and developed with them an accessible info-sheet packed full of easy-to-read explanations about the lifesaving benefits of annual health checks."

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Source: BBC News, 1 June 2021

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UK rights watchdog endorses compulsory Covid jabs for care home staff

The prospect of care home workers being required to get vaccinated against COVID-19 has moved a step closer, with a crucial endorsement from the UK’s human rights watchdog.

Ministers are considering changing the law to make vaccination a condition of deployment for people in some professions that come into regular close contact with elderly and vulnerable people at high risk from the coronavirus.

In a report to the government seen by the Guardian, the Equality and Human Rights Commission (EHRC) admitted that making vaccines compulsory for care home staff would be a “significant departure from current public health policy”.

But they judged that ministers were “right to prioritise protection of the right to life for residents and staff” and said it would be reasonable for care home workers to need a jab “in order to work directly with older and disabled people, subject to some important safeguards”.

The EHRC is also likely to make a similar recommendation about healthcare workers, after the vaccines minister, Nadhim Zahawi, suggested over the weekend that NHS staff could face mandatory jabs, too, as some patients were “being infected in hospital”.

Zahawi said no decisions had been made yet, and stressed there was a precedent: surgeons were required to be vaccinated against hepatitis B. He added: “It would be incumbent on any responsible government to have the debate, to do the thinking about how we go about protecting the most vulnerable by making sure that those who look after them are vaccinated.”

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Source: The Guardian, 2 June 2021

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Ambulance crews in England to get body cameras after 30% rise in assaults

Thousands of ambulance crews in England will be given body cameras after a sharp rise in attacks on NHS staff treating patients, the government has announced. Data shows that 3,569 ambulance staff were physically assaulted by members of the public last year – 30% more than in 2016-17.

The plans come after successful trials in London and the north-east. The cameras will be given to crews in 10 ambulance trusts across the country. Medics will wear the cameras and be able to press a button to start recording if patients or the public become aggressive or abusive, and the film will be given to the police where needed.

Prerana Issar, the chief people officer for the NHS, said: “Every member of our dedicated and hardworking NHS staff has the fundamental right to be safe at work and it is our priority to eliminate violence and abuse, which we will not tolerate. As well as reducing the number of incidents towards our staff, these cameras are a vital step towards ensuring our people feel safe too.”

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Source: The Guardian, 2 June 2021

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Major trust faces bullying concerns from hundreds of senior doctors

Concerns over bullying and discrimination have been raised in a survey of hundreds of doctors at a major hospital trust, HSJ  can reveal.

University Hospitals of North Midlands Trust’s medical staff committee carried out a survey of its doctors earlier this year, after bullying concerns were raised by members of the British Association of Physicians of Indian Origin at the trust.

A summary of the survey findings, published in a newsletter sent to all doctors at the trust last week and seen by HSJ, showed more than two-thirds of the 348 respondents claimed to have experienced bullying, harassment or victimisation at work. Nearly 80% said they had witnessed bullying or harassment, while 50 per cent of respondents said the bullying and harassment was due to race or ethnicity.

Fifty-five per cent of those answering the survey also said they had not reported concerns as they had “no confidence in the investigative process within the organisation”.

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Source: HSJ, 2 June 2021

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Injured patient left in urine-soaked bed sheets and labelled ‘lazy’ by nurses after botched surgery

A second “mutilated” patient left with life-changing injuries after botched hospital surgery has described how she was left in urine-soaked bed sheets for days by nurses who called her lazy when she was unable to get out of bed.

Lucy Wilson told The Independent she believes she would have been better looked after at a veterinary practice compared to the level of care she received from nurses at Norfolk and Norwich Hospital Trust in January last year.

She was one of three patients harmed by surgeon Camilo Valero in the same week and almost died after Dr Valero and other staff failed to recognise her life-threatening injuries following the operation to remove her gall bladder.

Dr Valero is under investigation by the General Medical Council but is still practising under supervision at the trust, which has refused to say whether the third patient survived their ordeal.

After requests by The Independent, bosses at the NHS trust have now committed to publishing details of a secret review carried out by the Royal College of Surgeons into Dr Valero’s work and the wider surgical services at the trust.

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Source: The Independent, 31 May 2021

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NHS Scotland Assure: New service for healthcare facilities

A new national service has been established to improve the quality and management of healthcare construction and refurbishment projects across NHS Scotland.

NHS Scotland Assure brings together experts to improve quality and support the design, construction and maintenance of major healthcare developments. This world first interdisciplinary team will include microbiologists, infection prevention and control nurses, architects, planners, and engineers.

Commissioned by the Scottish Government and established by NHS National Services Scotland, the service will work with Health Boards to ensure healthcare buildings are designed with infection prevention and control practice in mind, protecting patients and improving safety.

Cabinet Secretary for Health and Social Care Humza Yousaf said:

“NHS Scotland Assure will support a culture of collaboration and transparency to provide the reassurance patients and their families deserve to feel safe in our hospitals. This service is unique to Scotland and is leading the way in risk and quality management across healthcare facilities.

“With services designed with patients in mind, we can make a real, positive difference to people’s lives.”

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Source: Scottish Government, 1 June 2021

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Patients were sent back to care homes without Covid test despite bosses’ plea

Thousands of hospital patients were allowed to return to their care homes without a Covid test despite a direct plea to the government from major care providers not to allow the practice, the Observer has been told.

As the crisis began to unfold in early March 2020, providers held an emergency meeting with department of health officials in which they urged the government not to force them to accept untested residents. However, weeks later, official advice remained that tests were not mandatory and thousands of residents are thought to have returned to their homes without a negative Covid result.

The revelation will heap further pressure on the health secretary, Matt Hancock, who has admitted some care residents returned from hospital without a test. It comes after Dominic Cummings, the prime minister’s former senior adviser, last week accused Hancock of misleading the prime minister over the policy, during his unprecedented evidence in parliament.

Some 25,000 people were discharged to care homes between 17 March and 15 April, and there is widespread belief among social care workers and leaders that this allowed the virus to get into the homes.

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Source: The Guardian, 29 May 2021

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NHS calls for ban on toy neodymium magnets amid child safety fears

An online trend that involves using tiny magnets as fake tongue piercings has led the NHS to call for them to be banned amid people swallowing them.

Ingesting more than one of them can be life-threatening and cause significant damage within hours.

In England, 65 children have required urgent surgery after swallowing magnets in the last three years.

The NHS issued a patient safety alert earlier this month and is now calling for the small metal balls to be banned.

It said the "neodymium or 'super strong' rare-earth magnets are sold as toys, decorative items and fake piercings, and are becoming increasingly popular". It added that unlike traditional ones, "these 'super strong' magnets are small in volume but powerful in magnetism and easily swallowed".

The online trend sees people placing two such magnets on either side of their tongue to create the illusion that the supposed piercing is real.

But when accidentally swallowed, the small magnetic ball bearings are forced together in the intestines or bowels, squeezing the tissue so that the blood supply is cut off.

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Source: BBC News, 30 May 2021

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Some long Covid sufferers in England waiting months for treatment

People who remain chronically ill after Covid infections in England have had to wait months for appointments and treatment at specialist clinics set up to handle the surge in patients with long Covid.

MPs called on Matt Hancock, the health secretary, to explain the lengthy waiting times and what they described as a “shameful postcode lottery” which left some patients facing delays of more than four months before being assessed at a specialist centre while others were seen within days.

NHS England announced in December that people with long Covid, or post-Covid syndrome, could seek help at more than 60 specialist clinics. But despite government assertions in January that the network of 69 centres was already operating, the all-party parliamentary group on coronavirus found that some clinics were still not up and running three months later.

Freedom of information requests submitted to NHS trusts revealed that while some clinics had opened and were seeing patients, others had been delayed by the second wave of infections in January. 

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Source: The Guardian, 30 May 2021

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Ambulance trust reveals patient’s death amid handover delays row

An ambulance trust has highlighted the death of a woman which it says was due to “being delayed on the back of an ambulance”, just two days after it warned that lives were ‘at risk’ from long handovers.

West Midlands Ambulance Service University Foundation Trust’s board papers this month reveal the woman in her 90s — who has not been named — was taken to hospital because a severe nose bleed would not stop.

Its clinical quality board paper says the “patient story” showed ”how a patient being delayed on the back of an ambulance resulted in significant deterioration and ultimately the death of a patient”.

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Source: HSJ, 28 May 2021

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Cumberland Infirmary patient 'dropped' from operating table dies within weeks

A woman has died after being "dropped" on the floor during surgery on her hip, which she had broken while in hospital.

Jeannette Shields, 70, had been receiving treatment for gall stones in Cumberland Infirmary in Carlisle.

North Cumbria Integrated Care NHS Trust said an investigation was under way "in relation to an incident involving a patient in one of our theatres".

Mrs Shields' husband, John, said he told the hospital he would not be "pushing this thing under the carpet".

His wife left her bed to go to the toilet by herself after getting no response to her buzzer, Mr Shields said. She felt dizzy, fell and broke her hip, he told the BBC.

Two days later she had surgery to repair it, after which the hospital called Mr Shields to say the operation had been successful but that "unfortunately they dropped her off the operating [table] after the surgery", he said.

"Then they had to use the sliding board to pick her up and rush her in and do scans on her," he said. 

"She had a great big bump on the back of her head and she just deteriorated and then she just passed away, just died.

It is not clear what happened or how Mrs Shields ended up falling from the operating table.

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Source: BBC News, 28 May 2021

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Staff at UK GP surgeries facing abuse and ‘tsunami of demand’

NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed.

The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse.

"Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue," says Jan Crowshaw, a GP manager

It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism.

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Source: The Guardian, 28 May 2021

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'More work to do' to improve Nottingham maternity units

More needs to be done to bring maternity units at a city's two main hospitals up to scratch, inspectors have said.

In 2020 the Care Quality Commission (CQC) found serious concerns at Nottingham University Hospitals NHS Trust and labelled the units "inadequate".

A new report concluded the trust still has "some areas to address".

In October a coroner said the death of Wynter Andrews minutes after she was born was "a clear and obvious case of neglect".

Nottinghamshire assistant coroner Laurinda Bower also revealed a 2018 whistle-blowing letter from midwives to trust bosses outlining concerns over staffing levels as "the cause of a potential disaster".

In the same month "in response to concerns raised... and coronial inquests", the CQC carried out an unannounced inspection at the hospital and found some staff had not completed training and "did not always understand how to keep women and babies safe", and issued a warning notice over its concerns.

Its latest report, based on an inspection in April, found improvements in the way women at risk of deterioration were identified and found documentation and monitoring had improved.

However the CQC found a disconnect between online and paper record-keeping and said there were multiple systems in place that led to duplication and errors at times.

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Source: BBC News, 28 May 2021

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Call for surgery hubs to tackle NHS backlog

Surgeons are calling for specialist hubs in England to help tackle what they call a "colossal backlog" of non-urgent operations because of COVID-19.

The Royal College of Surgeons (RCS) wants a network of hospital sites focused on routine surgery, such as hip and knee replacements.

The government says it is working "to accelerate the recovery of services".

In March, around five million patients were waiting for surgery - the highest number since modern records began.

Prof Neil Mortensen, president of the RCS, said the pandemic has had a devastating impact on surgical services - and that it must not be allowed to happen again.

"Surgery must be available on the NHS all year round, not stop and start," he said, adding that a "New Deal for Surgery" was required to help weather future pandemics. If a dangerous new variant of COVID-19 takes hold, or another bad flu arrives in the autumn, we cannot allow surgery to grind to a halt again or waiting lists will become insurmountable."

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Source: BBC News, 28 May 2021

 

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CQC to focus on services where there is a ‘greater risk of a poor culture going undetected’

The Care Quality Commission (CQC) has revealed a new strategy that will place more emphasis on a patient’s experience of care and seek to get a better grip on ”care settings where there’s a greater risk of a poor culture going undetected”.

Ian Trenholm, chief executive of the CQC told HSJ the CQC’s new approach would be informed by the belief that ”people’s experience of care is driven as much from the way different providers will interact with each other – both public sector, private sector, third sector - in a place as much as it by the individual performance of individual providers.”

He repeated his pledge, made to HSJ in August, that the CQC would endeavour to make inspections less time consuming for providers.

An important part of the CQC’s increased focus on patients’ experience of care would be taking more effort to determine the quality of services whose users may have trouble expressing their views, said Mr Trenholm.

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Source: HSJ, 27 May 2021

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Covid hospital admissions rising with most patients younger people, says NHS leader

The number of people being admitted to hospital with COVID-19 is rising in some regions but "few, if any" are from care homes, according to an NHS leader.

Younger people are making up most of coronavirus hospital admissions, with 70% of admissions in one hospital consisting of under-45s, NHS Providers chief executive Chris Hopson said.

Although the number of hospital admissions is "ticking up" in areas most affected by the Indian Covid variant, the rise is small compared with the levels seen earlier in the year.

Speaking to Times Radio, Mr Hopson said most hospitalisations were among younger people and those who have been offered the vaccine but have yet to take up the offer.

A number are among those who have only had their first dose of a COVID-19 vaccine, while “a very small number” are fully vaccinated with both doses.

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Source: The Independent, 26 May 2021

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NHS England gives green light to scrap four-hour A&E target

NHS England is pushing ahead with plans to replace the NHS’s four-hour emergency target with a new set of 10 metrics, it has announced today.

The announcement follows a consultation launched in December on its latest proposals, although any final plans will still require government signoff (see box below for the 10 new metrics).

NHSE/I said in a press release: “In an NHS consultation four out of five respondents said they would welcome a bundle of measures. The specific proposals were endorsed by two thirds, 67%, of respondents and opposed by just 13%.”

However, NHSE/I said in a report on the proposals that it had not yet been established how the new basket of metrics would be used as a performance measure and that the proposals still needed government sign-off.

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Source: HSJ, 26 May 2021

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Rising patient numbers threaten to overwhelm GPs

Rising numbers of patients needing care and a shortage of GPs is threatening to overwhelm the system, doctors and patient groups are warning.

It comes after the pandemic has caused severe disruption to GP practices for more than a year.

Analysis of NHS England data by the Health Foundation found more than 28 million appointments were booked in March, among the highest recorded.

Doctor's leaders say what they are being asked to achieve is "undoable".

The analysis of NHS data in England carried out by the Health Foundation for the BBC also that that between 2019-20 and 2020-21:

  • The total number of appointments dropped by 10% - meaning 31 million fewer consultations with GPs and practice nurses
  • Major shift from face-to-face to remote consultation, with the proportion seen in practices dropping from 79% to 54%
  • The number of patients referred by GPs for urgent cancer check-ups dropped by 15%, putting lives at risk

The escalating situation has prompted patient groups to call for an urgent review of access to services, amid reports that patients are struggling to get through.

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Source: BBC News, 27 May 2021

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GPs stricken by long Covid ‘shocked and betrayed’ at being forced from jobs

Family doctors are being forced out of their jobs after developing long Covid, prompting demands for the government to compensate NHS staff with the debilitating condition who cannot work.

GPs struggling with the condition have told the Observer they felt “shocked and betrayed” when their colleagues removed them from their posts because of prolonged sick leave.

“I received a lawyer’s letter on behalf of the other partners in the GP surgery telling me that they were ending my partnership. I understood why they did what they did, because I was too sick to work at the time. But it was also callous and mercenary,” said one doctor who lost her job.

“It was hard on me, as one of the partners was also my best friend. The partners were worried I’d be a ‘disabled partner’ and wouldn’t be able to pull my weight. Long Covid meant I simply couldn’t function normally and so couldn’t meet the return to work date they gave me, so they exercised their right under our partnership agreement to end my partnership at the surgery,” added the GP, who asked to remain anonymous.

The issue has prompted soul-searching within the medical profession about what duty of care family doctors owe each other when they cannot work because they have been laid low with exhaustion, brain fog, breathlessness and other symptoms of long Covid.

Locum medics and hospital doctors with the condition are also having problems including loss of income, trouble accessing sick pay, contractual difficulties and getting employers to accept that they cannot work normally, sometimes for months.

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Source: The Guardian, 23 May 2021

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New research calls for better care for people who seek emergency help following self-harm

Research has found that people who go to A&E following self-harm receive varying quality of care and this has a significant impact on what they experience subsequently.

The study in BMJ Open, which was codesigned and co-authored with people who have lived experience of self-harm and mental health services, found negative experiences were common, and revealed stigmatising comments about injuries from some hospital staff. Some participants reported being refused medical care or an anaesthetic because they had harmed themselves. This had a direct impact on their risk of repeat self-harm and suicide risk, as well as their general mental health.

According to the research, the participants who received supportive assessments with healthcare staff reported feeling better, less suicidal and were less likely to repeat self- harm.

"This research highlights the importance of learning from the experiences of individuals to help improve care for people who have harmed themselves. We involved patients and carers throughout the entire process and this enabled us to gain a greater insight into what patients want after they present to hospital having harmed themselves", said Dr Leah Quinlivan.

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Source: University of Manchester, 25 May 2021

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