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Patient Safety Learning Awards 2019 now open

The Patient Safety Learning Awards 2019 are here!

The Patient Safety Learning Awards publicly acknowledge and celebrate important work in patient safety, while sharing learning and successes to improve patient safety. This year, our Awards are inspired by our latest report, A Blueprint for Action. A Blueprint for Action sets out actions needed to progress towards a patient-safe future. These address six foundations of safer care for patients - one of these foundations is shared learning.

The Awards this year have six different categories, based on our foundations for safer care:

  • shared learning for patient safety
  • leadership for patient safety
  • professionalising patient safety
  • patient engagement for patient safety
  • data and insight for patient safety
  • patient safety culture.

A seventh award, the Patient Safety Learning Award, will be made to the individual, team or organisation who our judges believe has gone above and beyond. Each winning entry will receive a cash prize to enable them to visit another team or organisation to learn more about patient safety. As well as this prize, winners will receive two complimentary tickets to our annual conference, awards and drinks reception, held in London on 2 October 2019.

Enter now

The deadline for entries is midnight on Friday 30 August.

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NHS regulator ‘not fit for purpose’ for dismissing baby deaths scandal warnings

The healthcare regulator has been branded “not fit for purpose” after dismissing warnings of the biggest maternity scandal in NHS history, The Telegraph can reveal.

Letters seen by this newspaper show that the Care Quality Commission (CQC) told grieving parents it would not support an independent inquiry into baby deaths, just months before such an investigation was ordered.

Rhiannon Davies wrote to the watchdog in Dec 2016, alerting the regulator to 19 avoidable deaths of mothers and babies at the Shrewsbury and Telford Hospital NHS Trust, as well as a string of cases where lives were put at risk.

However, the head of the CQC at the time assured Ms Davies that the culture was “changing for the positive”, rebuffing her calls for an independent inquiry.

Ms Davies had provided the watchdog with details of a string of deaths, which she and fellow bereaved parents had found from publicly available information.

The information was contained in a letter to Jeremy Hunt, the health secretary at the time, and shared with the regulator, setting out why families believed an inquiry was required.

On Tuesday night, Ms Davies said that the refusal of the CQC to back an investigation, and the false assurances given by its most senior figure, showed how it “never scratched beneath the surface” despite death after death.

Ms Davies said that she had “absolutely no faith” in its current ability to regulate and spot future scandals, saying it had “pushed back” every effort made by families to expose the failings at Shrewsbury.

“They are not fit for purpose because we cannot trust them to be doing their job properly,” she told The Telegraph.

Read full story (paywalled)

Source: The Telegraph, 5 April 2022

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My daughter took her own life after pain caused by mesh surgery

A woman whose daughter took her own life after being left in chronic pain caused by giving birth has spoken of her family's heartbreak.

Sara Baines, 34, from Flintshire, died in September last year leaving her family devastated.

This week an inquest heard Sara suffered from chronic pain due to complications resulting from surgical mesh that was implanted after she gave birth in 2011.

Her mother, Alison Sharrock, says Sara was failed by the health system on multiple occasions.

Sara bled heavily whilst giving birth and suffered a second-degree tear. She had to have two surgeries to repair the tear, neither of which was completely successful. Sara found herself completely incontinent, at the age of 24.

In 2015, Sara was advised to have mesh fitted.

Alison said: "We were told the mesh was a 'quick-fix'. It felt like the answer to all her problems and she was thrilled. She had surgery but afterwards, though the incontinence improved, she had terrible abdominal pain."

The pain became so severe that Sara was offered a hysterectomy, aged 28. Afterwards, the pain only intensified, and her general health deteriorated. She suffered water infections, skin rashes, gum disease and unexplained pain. Unable to eat or sleep, she became depressed and anxious.

"She felt nobody was really listening to her. She felt she was gaslighted and fobbed off," said Alison.

Kath Sansom, founder of Sling The Mesh which has almost 10,000 members suffering irreversible pan and complications from surgical mesh implants, said: "Our hearts go out to Sara's family. Nine out of 10 people in our support group were not told any risks of having a plastic mesh permanently implanted."

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Source: Mail Online, 24 March 2023

Further reading on the hub:

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Coronavirus: PM says everyone should avoid office, pubs and travelling

The Prime Minister has said everyone in the UK should avoid "non-essential" travel and contact with others to curb coronavirus as the country's death toll hit 55.

Boris Johnson said people should work from home where possible as part of a range of stringent new measures, which include:

1. Everyone of every age should avoid any non-essential social contact and travel.

2. Everyone to avoid pubs, clubs, cinemas, theatres and restaurants etc.

3. Everyone to avoid large gatherings - including sports events.

4. Everyone should work from home where possible.

5. If anyone in a house has CV19 symptoms, everyone in that house has to isolate for at least 14 days

6. Over 70s and those at risk (including pregnant women) to stay home for 12 weeks, which means no going out to shops or collect anything etc., unless there is no other option.

Schools will not close for the moment. 

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Source: BBC News, 16 March 2020

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Pandemic is having “severe” impact on non-communicable disease care, WHO survey finds

The COVID-19 pandemic has dramatically curtailed the provision of health services for non-communicable diseases, says a survey of 155 countries by the World Health Organization conducted over three weeks in May.

In the survey poorer countries were the most likely to report disrupted services, but some 94% of responding countries had reassigned health ministry staff from work on NCDs to dealing with the pandemic. Hypertension treatment has been partially or completely disrupted in 53% of the countries surveyed, diabetes treatment in 49%, cancer treatment in 42%, and cardiovascular emergency responses in 31% of countries, the survey found.

In the Netherlands, new cancer diagnoses have fallen by 25% since the pandemic lockdown began. In rural India, 30% fewer cardiac emergencies reached health facilities in March 2020 than the previous year.

Rehabilitation services, which are often key to a healthy recovery after severe COVID-19, have been disrupted in 63% of countries surveyed. Screening campaigns have been put on hold in more than half.

WHO’s director general, Tedros Adhanom Ghebreyesus, said, “The results of this survey confirm what we’ve been hearing from countries for a number of weeks now. Many people who need treatment for diseases like cancer, cardiovascular disease, and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

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Source: BMJ, 3 June 2020

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Trust declares critical incident over ‘relentless demand’

  • Gloucestershire Hospitals FT declares critical incident after ‘relentless demand’ on emergency care
  • Pressure comes two months after trust downgraded one of its A&Es
  • ‘Tired’ staff warned a ’Herculean effort’ is needed to reset emergency system
  • NHS 111 cited as pinch point

A trust has declared a critical incident after experiencing “relentless demand” on urgent and emergency care, months after downgrading one of its emergency departments.

The internal critical incident was raised by Gloucestershire Hospitals Foundation Trust yesterday. An internal memo said the previous three days “have seen unprecedented demand fall on the Gloucestershire urgent and emergency care system”.

Clinicians have been told that early discharges need to be identified on both its Cheltenham General and Gloucestershire Royal hospital sites, to try to free up bed-space, and that all non-essential meetings, besides those at executive level, should be cancelled.

The incident comes after the trust decided in June to downgrade the A&E department at Cheltenham General to a minor injuries unit, operating from 8am to 8pm. Previously, the unit offered a full A&E service between 8am and 8pm, with a “nurse-led” minor injuries service outside these hours.

The problems appear to be unrelated to covid-19, although infection control measures are known to have reduced capacity in many A&Es and wards.

HSJ understands that local managers believe NHS 111, run by Care UK Health Care, has been a particular cause of the problems in recent days, because it has not been directing enough people to alternative services; as well as workforce pressures and the hot weather.

Read full (paywalled) article here in the HSJ.

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English NHS breaches 52 weeks

The NHS in England is required by legislation to ensure that at least 92 per cent of patients on the waiting list have been waiting no longer than 18 weeks from referral to treatment. At the end of February, following a year of covid restrictions, that waiting time measure exceeded 52 weeks.

How much longer than 52 weeks? We don’t know, because the data stops at “52 plus”. But there is good news, because this is about to change.

Guidance was issued during March requiring two major improvements to the published RTT data.

Firstly, instead of stopping at 52 weeks plus, the weekly waiting time cohorts will continue up to 104 weeks plus.

Secondly, we are going to get a lot more information about mental health and other RTT waiting times, because the catch-all “Other” specialty is going to be broken down into medical, surgical, mental health, paediatric and the rest.

Read full story (paywalled)

Source: HSJ, 16 April 2021

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Ways to identify EHR usability issues and reduce patient harm

An electronic health record (EHR) bug that transmits and medication order for 25 mg of a drug – not the prescribed 2.5 mg – could be the difference between life and death. And it’s that seemingly impossible reality that’s bringing more industry stakeholders to the table working to better understand EHR usability and its effects on patient safety.

“Often times when people think about usability, they think about design and then they think about the EHR vendor,” Raj Ratwani, PhD, Director of MedStar Health Human Factors Center, said in an interview with EHRIntelligence.

“In reality, it's a very complex space. The products that are being used by frontline clinicians are shaped by the vendor. But they are also shaped by how that product is implemented at that provider site, how it's customized, and how it’s configured. All of those things shape usability.”

EHR usability issues are an exceptionally common issue, Ratwani reported in a recent JAMA article. About 40% EHRs reported having an issue that can potentially lead to patient harm and about 786 hospitals and 37,365 individual providers may have used EHRs with potential safety issues based on required product use reporting.

Direct safety challenges typically come from EHR products that are sub-optimally designed, developed, or implemented. Usability issues stem from a very cluttered interface or a complex medication list. Seeing a cluttered list can lead to a clinician selecting the wrong medication.  

A major usability issue also comes from data entry. EHR users want that process to be as clean as possible. Consistency in the way information is entered is also key, Ratwani explained.

Ratwani also wants to ensure that certification testing is as realistic as possible.

He compared it to when a vehicle is certified to meet certain safety standards each year. This type of mechanism does not exist when it comes to EHRs because right when the product is certified, it then gets implemented, and there is no further certification of safety done at all after the initial testing.

“One way to do that, at least for hospitals, is to have that process be something that the Joint Commission looks to do as part of their accreditation standards,” Ratwani said.

“They could introduce some very basic accreditation standards that promote hospitals to do some very basic safety testing.”

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Source: EHR Intelligence, 13 January 2020

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Virtual wards and at-home antibiotic kits part of £160m funding to cut NHS waiting lists

Virtual wards, at-home antibiotic kits and using artificial intelligence in GP surgeries are among new initiatives to be trialled as part £160m funding to tackle waiting lists in the NHS.

NHS England announced the funding to aid in the health service’s recovery after the pandemic, after figures last month revealed the number of people waiting to begin hospital treatment in England had risen to a new record.

A total of 4.7 million people were waiting to start treatment at the end of February - the highest figure since records began in August 2007. But NHS England said indicators suggest operations and other elective activity were at four-fifths of pre-pandemic levels in April, which is "well ahead" of the 70% threshold set out in official guidance.

It said it is working to speed up the health service's recovery by trialling new ways of working in 12 areas and five specialist children's hospitals.

The so-called "elective accelerators" will each get some of the £160m as well as extra support for new ways to increase the number of elective operations, NHS England said.

Tens of thousands of patients in the trial areas will be part of initiatives including a high-volume cataract service, one-stop testing facilities and pop-up clinics to allow patients to be seen and discharged closer to home.

Other trials over the next three months include virtual wards and home assessments, 3D eye scanners, at-home antibiotic kits, "pre-hab" for patients ahead of surgery, artificial intelligence in GP surgeries and so-called "Super Saturday" clinics, bringing multi-disciplinary teams together at the weekend to offer more specialist appointments.

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Source: The Independent, 

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Father calls for overhaul of 'flawed' suicide assessments

A father whose son took his own life in July 2020 is calling for an "urgent overhaul" of the way some counsellors and therapists assess suicide risk.

His son Tom had died a day after being judged "low risk", in a final counselling session, Philip Pirie said.

A group of charities has written to the health secretary, saying the use of a checklist-type questionnaire to predict suicide risk is "fundamentally flawed".

The government says it is now drawing up a new suicide-prevention strategy.

According to the latest official data, 6,211 people in the UK killed themselves in 2020. It is the most common cause of death in 20-34-year-olds.

And of the 17 people each day, on average, who kill themselves, five are in touch with mental health services and four of those five are assessed as "low" or "no risk", campaigners say.

Tom Pirie, a young teacher from Fulham, west London, had been receiving help for mental-health issues.

He had repeatedly told counsellors about his suicidal thoughts - but the day before he had killed himself, a psychotherapist had judged him low risk, his father said.

Tom's assessment had been based on "inadequate" questionnaires widely used despite guidelines saying they should not be to predict suicidal behaviour, Philip said.

The checklists, which differ depending on the clinicians and NHS trusts involved, typically ask patients questions about their mental health, such as "Do you have suicidal thoughts?" or "Do you have suicidal intentions?"

At the end of the session, a score can be generated - placing the individual at low, medium or high risk of suicide, or rating the danger on a scale between 1 and 10.

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Source: BBC News, 20 April 2022

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NHS spent more than two billion on private mental health hospitals last year

NHS spent more than two billion sending patients to psychiatric units last year, following decades of cuts to beds, new analysis reveals.

The huge sum on private mental health hospitals in 2023 was a £279 million increase on the year before. A report by Laignbuisson, shared exclusively with The Independent, said the lack of beds within the NHS is a major driver of spending on private hospitals, warning healthcare leaders are “stuck between a rock and a hard place.”

The two biggest private providers, Priory Group and Cygnet Health Care, took 509 million and 560 million in profits last year They account for more than 68% of the market, according to the report.

Almost £200 million was spent on private children’s hospitals by the NHS in the same year, figures show.

Tim Read, author of the report, said private mental health hospitals face stable conditions despite the move to more community care due to the “limited capacity” in NHS beds.

“Despite being a policy priority, it is clear the system is struggling to get a grip on out-of-area placements. With NHS Mental Health Trusts’ seeing occupancy rates climb to nearly 90 per cent, commissioners are stuck between a rock and hard place – either admit locally to an overcrowded ward or place a vulnerable person a long way from the local support networks.

“The NHS has seen its own bed capacity dwindle over decades and with significant re-investment unlikely given other priorities, the way that local areas engage collaboratively with the independent sector on how to best meet local need becomes ever more important.”

Read full story

Source: The Independent, 20 December 2024

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CQC orders ‘significant improvements’ at trust criticised over deaths

The Care Quality Commission (CQC) has ordered ‘significant improvements’ from a mental health trust which has been criticised over the deaths of vulnerable patients.

The watchdog has warned Tees, Esk and Wear Valleys Foundation Trust (TEWV FT) it has “serious concerns” about risk management processes at its inpatient wards following inspections of three of its hospitals in January. It follows a string of severe problems in child and adolescent services run by the trust. 

In a formal letter and a separate warning notice to TEWV FT, the CQC ordered the trust to carry out “significant improvements” to the safety of adult acute wards, and psychiatric intensive care, after a visit to Roseberry Park, West Park and Cross Lane hospitals on the week of 18 January.

Sources have told HSJ the trust’s leadership is working towards a May deadline to make sufficient improvements or it could potentially risk further enforcement action. However, neither the trust nor the CQC have confirmed this.

Families and campaigners — including Labour MP Andy McDonald, who represents Middlesbrough — have called for a public inquiry into alleged “systematic failures” at the trust following the deaths of around 14 patients under the trust’s care within two years.

Read full story (paywalled)

Source: HSJ, 12 March 2021

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Trust given warning notice over rapid tranquillisation

A mental health trust has been served with a warning notice ordering improvements in its processes around rapid tranquillisation of patients.

The Care Quality Commission said the trust needed to ensure all staff at Kent and Medway NHS and Social Care Partnership Trust followed local and national recommendations to monitor and record a patient’s physical health when rapid tranquillisation was administered. Inspectors were concerned staff were not always aware of the potential impact of these medications.

Serena Coleman, CQC deputy director of operations in the south, said: “We found some staff weren’t always using the least restrictive options to make sure that people’s behaviour wasn’t controlled by an excessive use of medicines.

“As required medication, such as lorazepam and promethazine, was being used quite frequently but we couldn’t always find records to explain why these medications were necessary. There were examples where reviews hadn’t happened for long periods, meaning staff couldn’t be sure it was still appropriate to administer to people."

Read full story (paywalled)

Source: HSJ, 3 August 2023

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NHS coronavirus tracing app ‘will have unintended consequences’, senior official says

An NHS app that aims to track the spread of coronavirus is being rolled out for the first time, as part of a trial on the Isle of Wight.

Council and healthcare workers will be the first to try the contact-tracing app, with the rest of the island able to download it from Thursday. The app aims to quickly trace recent contacts of anyone who tests positive for the virus.

However, the new NHS coronavirus app will have “unintended consequences”, according to the head of the unit developing it.

Officials do not know “exactly how it will work”, Matthew Gould, chief executive of NHSX, told a parliamentary committee. “There will be unintended consequences, there will for sure be some things we have to evolve,” he said.

Privacy campaigners have raised concern over the potential for “mission creep” with the data that will be gathered on people’s movements and contact with others.

The Health Service Journal reported that it has not yet passed tests on cyber security, performance and clinical safety needed to be included in the NHS app library.

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Source: The Independent, 4 May 2020

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Failure to act on sepsis led to man’s death

A man died after an NHS trust failed to diagnose and treat sepsis quickly enough, a Parliamentary and Health Service Ombudsman investigation has found.

Stephen Durkin died after suffering organ failure from sepsis. Stephen’s wife Michelle made a complaint to the Ombudsman after she was left floored by his sudden death which she believed was avoidable.

Stephen was an otherwise healthy 56-year-old when he attended Wye Valley Trust A&E in July 2017 with chest pain. Hospital staff suspected he had a major blood vessel blockage and admitted him to a ward overnight. The next morning his overall condition had worsened but staff did not monitor him more closely, as national guidance advises, and he continued to deteriorate throughout the day.

The next day Stephen was admitted to intensive care and treated for sepsis but tragically died later that evening. In the space of 48-hours his condition deteriorated rapidly but staff did not act quickly enough and the critical care team attended Stephen ten hours too late.

His wife Michelle arrived at the hospital to visit Stephen, only to find that he was critically ill and unresponsive. She was left devastated by his death and turned to the Ombudsman to look into what had happened with his care.

Ombudsman Rob Behrens said: "Stephen’s tragic death could so easily have been avoided. His case shows why early detection of sepsis, as set out in national guidelines, is crucial."

"Sadly, this is not the first time we have had to highlight this issue. There is clearly more the NHS needs to do. It is vital that NHS trusts ensure their staff are sepsis-aware to reduce the number of avoidable deaths from this life-threatening condition."

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Source: PHSO, 3 March 2022

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Three hundred babies lost to a fixation on natural births

When Debbie Greenaway was told by doctors that she should try to deliver her twin babies naturally, she was nervous. 

But the doctor was adamant, she recalls. “He said: ‘We’ve got the lowest caesarean rates in the country and we are proud of it and we plan to keep it that way'."

For Greenaway, labour was seemingly endless. She was given repeated doses of syntocinon, a drug used to bring on contractions. By the second day, the midwife was worried for one of the babies, whom the couple had named John. “She was getting really concerned that they couldn’t find John’s heartbeat.”

Her husband remembers “the midwife shaking her head”. “She said a number of times that we should be having a caesarean.”

By the time doctors finally decided to perform an emergency C-section, it was too late. Starved of oxygen, baby John had suffered a catastrophic brain injury. When he was delivered at 3am, he had no pulse. Efforts to resuscitate him failed.

Their son’s death was part of what is now recognised as the largest maternity scandal in NHS history. 

The five-year investigation will reveal that the experiences of 1,500 families at Shrewsbury and Telford Hospital Trust between 2000 and 2019 were examined. At least 12 mothers died while giving birth, and some families lost more than one child in separate incidents, the report is expected to show.

The expert midwife Donna Ockenden and a team of more than 90 midwives and doctors will deliver a damning verdict on the Shrewsbury trust, its culture and leadership — and failure to learn from mistakes or listen to families.

At its heart is how a toxic obsession with “normal birth” — fuelled by targets and pressure from the NHS to reduce caesarean rates — became so pervasive that life-or-death decisions on the maternity ward became dangerously distorted for nearly two decades.

Read full story (paywalled)

Source:  The Times, 26 March 2022

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NHSE’s improvement teams axed

NHS England’s elective, emergency care and mental health improvement support teams are being axed – and their staff and functions merged into the Getting it Right First Time programme, HSJ has learned.

An internal email from national urgent care director Sarah-Jane Marsh last week said that as part of the NHSE restructure, the improvement functions “will be moving to a single structure and brand under the clinical leadership of Tim Briggs, founder of the GIRFT Programme”.

HSJ understands around 70 people work across the improvement support teams, most of whom are in the emergency care improvement support team (ECIST). NHSE did not confirm a figure, but it said the merger would not result in redundancies.

The move follows what was previously described as a “culture battle” between ECIST’s alleged “performance management”-style approach and GIRFT, which is seen as more collaborative.

Senior emergency care figures told HSJ they hoped the move would see the end of “clipboard performance management”.

Professor Matthew Cooke, a former national clinical director of urgent and emergency care, said: “I can see positives in having one organisation… In my experience, the places that improve are the places that work with you, not beaten up by you. If the clipboard performance management disappeared it would be a great step forward.”

Read full story (paywalled)

Source: HSJ, 13 October 2025

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Frantic action to stop London ‘running out of beds in four days’

Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity.

In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak.

According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said.

The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. 

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Source: HSJ, 24 March 2020

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‘No one ever tried to contact me’: Former police chief’s anger over ‘do not resuscitate’ order for his sister

Across the country there have been reports of “do not resuscitate” (DNR) orders being imposed on patients with no consultation, as is their legal right, or after a few minutes on the phone as part of a blanket process.

Laurence Carr, a former detective chief superintendent for Merseyside Police, is still angry over the actions of doctors at Warrington Hospital who imposed an unlawful “do not resuscitate” order on his sister, Maria, aged 64.

She has mental health problems and lacks the capacity to be consulted or make decisions and has been living in a care home for 20 years. As her main relative, Mr Carr found out about the notice on her records only when she was discharged to a different hospital a week later.

Maria had been admitted for a urinary tract infection at the end of March. Although she has diabetes and an infection on her leg her condition was not life threatening.

Mr Carr said: “My sister has no capacity to effectively be consulted due to her mental illness and would not understand if they did try to explain, so I was furious that I had not been consulted."

He later learnt that the reason given by the hospital for imposing the DNR was "multiple comorbitidies".

In a statement, Warrington and Halton Teaching Hospitals Foundation Trust said it was fully aware of the law, which was reflected in its policies and regular training.

It said: “We did not follow our own policy in this case and have the requisite discussions with the family. The template form which was completed in this case indicates that discussion with the family was ‘awaiting’. Regretfully due to human error this did not occur."

Mr Carr and his sister are not alone. National charity Turning Point said it had learnt of 19 inappropriate DNARs from families, while Learning Disability England said almost one-fifth of its members had reported DNARs placed in people’s medical records without consultation during March and April.

Read full story

Source: The Independent, 14 July 2020

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Poor nursing pay is a ‘patient safety issue’ say campaigners

Over 60 demonstrations took place on 3 July 2021 to protest over pay. 

Figures have suggested that a band 5 nurse takes home around £5,000 less per year than they did a couple years ago due to austerity measures and a public sector pay cap. 

The protest as arranged by groups Keep Our NHS Public, Health Campaigns Together, NHS Workers Say No and NHS Staff Voices with a separate demonstration by Nurses United UK have raised concerns for patient safety, arguing that the pay issue has a direct impact on recruitment and retention of nurses.

Read full story.

Source: Nursing Notes, 3 July 2021

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COVID-19: Vaccines to be compulsory for frontline NHS staff in England

Frontline NHS staff in England will have to be fully vaccinated against Covid, the health secretary has announced.

A deadline is expected to be set for 1 April next year to give unvaccinated staff time to get both doses, Sajid Javid told the Commons.

Between 80,000 and 100,000 NHS workers in England were unvaccinated, said Chris Hopson, head of NHS Providers.

Thursday is the deadline for care home workers in England to get vaccinated.

The government's decision follows a consultation which began in September and considered whether both the Covid and flu jabs should be compulsory for frontline NHS and care workers. Mr Javid said the flu vaccine would not be made mandatory.

There will be exemptions for the Covid vaccine requirement for medical reasons, and for those who do not have face-to-face contact with patients in their work, he added.

In a statement to MPs, Mr Javid said: "Having considered the consultation responses, the advice of my officials and NHS leaders including the chief executive of the NHS, I have concluded that all those working in the NHS and social care will have to be vaccinated."

"We must avoid preventable harm and protect patients in the NHS, protect colleagues in the NHS and of course protect the NHS itself."

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Source: BBC News, 9 November 2021

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NHS electric vehicles to help patients and the planet

The NHS is trialling a fleet of electric vehicles to help relieve pressure on ambulance services while also helping the NHS cut its carbon footprint.

The vehicles are part of a £2.1m investment as the NHS becomes the first health service in the world to commit to reaching net zero by 2040, said NHS England, with eight ambulance trusts trialling 21 zero-emission vehicles of various types.

Six of these new green vehicles are "dedicated to mental health response in the community", NHS England said. It emphasised that it hoped this development will "cut emergency response times for people with mental health needs and help reduce demand on traditional double-crewed ambulances".

The new dedicated mental health response vehicles differ in design from traditional ambulances by having fewer fluorescent markings and a much less clinical interior, to help put patients at ease. However, they still carry the equipment needed to respond to the most serious life-threatening emergencies.

NHS England highlighted that the all-electric vehicles can be deployed as a rapid response vehicle when someone is experiencing a mental health crisis, "providing a safe space for healthcare workers to support patients with mental health needs".

Claire Murdoch, national director for mental health, NHS England explained that the mental health response vehicles are an important addition to mental health care, and added: "we have a double win of being able to improve the experience of patients in crisis whilst also caring for the planet".

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Source: Medscape, 6 September 2022

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Review launched after ‘injustices suffered by BAME staff’

A clinical commissioning group (CCG) has ordered an independent review of its culture which it said was prompted by the “injustices experienced by black Asian and minority ethic colleagues” during the pandemic, HSJ has learned.

The review at Surrey Heartlands CCG, due to report in the autumn, is being led by Duncan Lewis, emeritus professor of management at Plymouth University. He has led several major reviews into culture at NHS organisations, including one into bullying and harassment at South East Coast Ambulance Service Foundation Trust in 2017 and one into workplace culture at Whittington Health Trust in 2018.

HSJ asked the CCG for the terms of reference of the review and the reasons why it felt it necessary to commission such an inquiry. It said the review’s scope would be determined by what staff felt was important regarding “our organisational culture, policy and practice – things we do well and things we need to improve”.

It added in a statement: “We will listen to the findings of the review and we will make any changes that are necessary.”

It is not yet clear if specific events within the organisation itself prompted the CCG to take the unusual step of commissioning the work. But the commissioner’s interim chief did say “feedback from staff” had been a driver.

Read full story (paywalled)

Source: HSJ, 26 August 2020

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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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Patients unwashed ‘for three days’ at trust under ‘extreme pressure’

The Care Quality Commission (CQC) has issued a trust with a warning notice following an inspection that found wards did not have enough staff to care for patients.

Staff at York hospital told inspectors they were not able to interact with individual patients and cater to their needs, with one saying: “We have to choose, do we turn, check, and make sure all patients are not soiled, or do we fully wash ten? Some of these patients haven’t been washed for two to three days.” 

York and Scarborough Teaching Hospitals CEO Simon Morritt said: “Many of the issues raised by the CQC were known to us, and reflect the extreme pressures facing the trust, the demands of covid and associated staff absence, and the well-documented recruitment challenges. The report demonstrates that, when faced with these pressures, it is not always possible to give the standard of care we would want for all of our patients all of the time.”

The CQC said there were “significant safety concerns about fundamental standards of patient care” at the hospital. 

“The service didn’t have enough nursing staff with the right skills, training and experience to keep patients safe and to provide the right care and treatment,” said Sarah Dronsfield, the CQC’s head of hospital inspection. “It was disappointing that managers didn’t regularly review the situation and change the staffing arrangements to accommodate this.”

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Source: HSJ, 9 June 2022

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