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NHS casualty bungles cost £400m

Accident and emergency has become the top source of negligence claims by patients. Delays, misdiagnosis and poor treatment in accident and emergency (A&E) departments are now the top cause of NHS negligence claims, overtaking orthopaedic surgery for the first time. Bungled operations on backs, bones, joints, ligaments, nerves and muscles usually lead to the most claims, but a 41-page NHS strategy document for the next 12 months reveals that emergency units have become the main source of litigation against the service.

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Source: The Times, 7 July 2019

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NHS operations cancelled as consultants work to rule in pensions standoff

Hospitals are having to cancel operations and cancer scans are going unread for weeks because consultant doctors have suddenly begun working to rule in a standoff over NHS pensions. Doctors say the dispute is escalating so quickly that it will send NHS services “into meltdown” and is so serious that it poses “an existential threat” to the health service’s survival.

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Source: The Guardian, 8 July 2019

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Caring GPs do more to prolong life than medication, study shows

Researchers at the University of Cambridge discovered that patients who had been diagnosed with Type 2 diabetes were up to 50 per cent less likely to die within a decade if their doctor showed empathy. In healthcare, empathy is defined as understanding the patient’s perspective, shared decision making between patient and doctor, and consideration how the illness may impact other areas of their life. But with financial and time pressures plaguing the NHS, doctors increasingly complain they do not have enough time to carry out the softer side of medicine. Now research, published in the Annals of Family Medicine, shows that showing care for a patient can be far more effective at prolonging life than giving drugs to lower cholesterol or blood pressure and so should be prioritised.

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Source: The Telegraph, 8 July 2019

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NHS health information available through Amazon's Alexa

The NHS has teamed up with Amazon to allow elderly people, blind people and other patients who cannot easily search for health advice on the internet to access the information through the AI-powered voice assistant Alexa. The health service hopes patients asking Alexa for health advice will ease pressure on the NHS, with Amazon’s algorithm using information from the NHS website to provide answers to health questions. Matt Hancock, Health Secretary, said the move will help patients, especially the elderly, blind and those who are unable to access the internet in other ways, take more control of their healthcare and help reduce the burden on the NHS.

However, despite welcoming the move, the Royal College of GPs warned that independent research must be carried out to ensure the advice given is safe. Professor Helen Stokes-Lampard, Chairwoman of the Royal College of GPs, said: “This idea is certainly interesting and it has the potential to help some patients work out what kind of care they need before considering whether to seek face-to-face medical help... However, it is vital that independent research is done to ensure that the advice given is safe, otherwise it could prevent people seeking proper medical help and create even more pressure on our overstretched GP service.”

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Source: The Independent, 10 July 2019

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Patient Safety Learning's response to the AHSN Network Strategy for Patient Safety

In June 2019, the Academic Health Science Network (AHSN), established by NHS England in 2013 and re-licensed from April 2018 to operate as the key innovation arm of the NHS, invited comment on its proposed patient safety strategy. The strategy aims to demonstrate the added value that AHSNs and Patient Safety Collaboratives can bring to patient safety by working much more collaboratively.

Chief Executive of Patient Safety Learning, Helen Hughes, has responded to the strategy. Helen comments: "We see the potential of the AHSNs: the capability and expertise, the desire to make a real difference and a belief in collaboration. We want to see this potential realised, and Patient Safety Learning wants to help."

See Helen's response in full

AHSN will launch its strategy at NHS Expo in September.

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Warning issued over adrenaline pen fault

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

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

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Source: BBC News, 12 July 2019

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Patients who suffer from medical errors in Canada face 'rigged system,' critics say

Medical errors aren’t uncommon in Canada. In 2013, 28,000 people died from safety incidents in acute and home care settings, according to the Canadian Patient Safety Institute. Those preventable incidents may include errors with medication, preventable infections and injurious falls. Last year, more than 900 new medical lawsuits were filed in Canadian courts. About half of all medical mistakes are considered preventable, researchers say. In many cases, injured patients are unable to work and require financial assistance to pay the bills. 

The widespread problem has grown to epidemic levels in Canada, according to Kathleen Findlay, CEO and Founder of the Center for Patient Protection. “I think it is a national health care crisis and it’s not getting nearly the attention it deserves,” said Findlay, who founded the advocacy group after her mother suffered a series of medical errors during a six-month hospitalisation.

What’s worse, critics say, is that the system in place to hold doctors accountable is unfairly stacked against patients, who can only get compensation by taking legal action against their doctor. Critics say that doctors often have a financial leg up over patients thanks to the Canadian Medical Protective Association (CMPA), which has access to more than $3 billion to cover legal defense.

“I believe we have a rigged system that does more to help doctors than the patients they have harmed,” said Findlay, who described the CMPA as a Frankenstein-like creation designed specifically to help doctors. “We are paying as taxpayers for a healthcare system that harms us, and the perversity of it is that we have to pay again to defend the doctors who have done the harm. If that isn't perverse I don't know what is.”

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Source: CTV News, Canada, 14 July 2019

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Patients die after multiple warnings about national 999 IT system dismissed

Patients have died after the government overruled multiple safety concerns raised about an IT system used to triage 16 million NHS patients a year. An HSJ investigation has uncovered at least three instances where patients triaged by the NHS Pathways software died months, sometimes years, after central agencies were alerted to safety concerns by ambulance trusts, but declined to make changes requested.

NHS Digital, the organisation that oversees NHS Pathways, told HSJ it had assessed the complaints but made changes only where “clinically necessary”. It has repeatedly asked coroners to “strike from the record” concerns raised about the safety of NHS Pathways’ advice.

Since 2015, coroners investigating 11 patient deaths have called for changes to the NHS Pathways software, used by NHS 111 and 999 services to triage patient calls, to prevent future deaths. Coroners have raised these concerns with health and social care secretary Matt Hancock, his predecessor Jeremy Hunt, NHS England, NHS Digital, the Care Quality Commission and service providers. Although NHS Pathways is run by NHS Digital, overall responsibility rests with NHS England.

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Source: HSJ, 15 July 2019

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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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Cuts to investigations of killings by mental health patients ‘put people at risk’

People have been put at risk because the NHS has stopped funding the automatic investigation of all killings by mental health patients, according to psychiatrists and victims’ families. Experts who had looked into every such homicide for 20 years had to stop doing so last year after NHS England stopped paying the £100,000-a-year cost involved, the Guardian has reported.

Previously, for 26 years until last year, researchers from Manchester University had looked into the mental health history and NHS care received by the perpetrator of every such homicide to try to identify patterns and flaws which could be tackled to reduce the risk of similar attacks in the future. Their findings had led to improved care of potentially dangerous mental health patients.

“This is a risky and reckless decision.... It’s outrageous,” said Julian Hendy, the founder of Hundred Families, a charity that helps bereaved families. 

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Source: The Guardian, 17 July 2019

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Majority of avoidable patient deaths in the US occur in hospitals with 'C' grade or below according to Leapfrog report

Patients treated at US hospitals that earned 'D' or 'F' grades when it comes to patient safety face a 92% higher risk of death from avoidable medical errors than at hospitals with an 'A' grade, according to a new report from The Leapfrog Group, a national nonprofit healthcare watchdog. In Leapfrog's Annual Hospital Safety Grades, about 32% of the 2,600 hospitals evaluated received an 'A' grade for safety, 26% earned a 'B' grade and 36% earned a 'C' grade. The hospital safety group awarded a 'D' or an 'F' grade to about 7% of the hospitals it examined. Patients at hospitals with a "C" grade when it came to safety were 88% more likely to die from an avoidable error compared with patients treated at hospitals that received an 'A'.

"It was pretty shocking to us and should be pretty sobering to hospitals that are not getting an 'A.' It's really time to take this seriously. You know you can do better," said Leah Binder, president and CEO of The Leapfrog Group.

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Source: FierceHealthcare, 15 May 2019

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Majority of US hospitals not meeting surgical safety standards, survey shows

The Leapfrog Group, an independent national healthcare watchdog organisation, today released Safety In Numbers: The Leapfrog Group’s Report on High-Risk Surgeries Performed at American Hospitals. The report analyses eight high-risk procedures to determine which hospitals and surgeons perform enough of them to minimise patient harm or death, and whether hospitals actively monitor to assure that each surgery is necessary. Findings on these measures pointed to alarmingly poor performance across the board and red flags for patient safety. The voluntary survey found that the vast majority of participating hospitals do not meet The Leapfrog Group’s minimum hospital or surgeon volume standards for safety. Rural hospitals are particularly challenged in meeting the standards. 

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Source: The Leapfrog Group, 18 July 2019

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Patients could receive notifications following abnormal scan results

NHS patients could be sent text messages or emails urging them to call their doctor if X-rays or scans show abnormal results. Under plans put forward to prevent delays in treatment, patients with worrying results would receive an automated message saying they need to speak to their GP. The idea is that this would act as a safety net in case results go missing in NHS systems, or if a doctor fails to act on results.The move comes after the Healthcare Safety Investigation Branch (HSIB) investigated a case where a 76-year old woman had a chest X-ray showing possible lung cancer which was not followed up. Her findings were sent to two hospital departments as well as her GP, but nobody acted on them. She died just over two months later but could have received treatment earlier.

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Source: Yahoo UK, 18 July 2019

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New standard to make joined-up care a reality

The Professional Records Standard Body (PRSB) has published a new standard for shared care records that determines the vital information about a person that should be shared between health and care systems so care is safer, timely and more effective. Working with NHS England, the PRSB has asked citizens and health and care professionals to help produce a ‘core information standard’ that defines exactly what information should be shared in a person’s care record throughout their life. 

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Source: PRSB, 17 July 2019

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GP Patient Survey 2019

NHS England together with Ipsos MORI, have published the latest Official Statistics from the GP Patient Survey. The survey provides information on patients’ overall experience of primary care services and their overall experience of accessing these services.

Read results of the survey

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Hospital admissions for deadly sepsis have doubled in three years

Hospital admissions for sepsis in England have more than doubled in three years, according to new figures that shows a rise in recorded admissions among all age groups, including the very young.

The NHS Digital data shows there were 350,344 recorded hospital admissions with a first or second diagnosis of sepsis in 2017/18, up from 169,125 three years earlier. This includes 38,401 admissions among those aged four years and under, up from 30,981 in 2015/16. For all children and young people aged 24 years and under, there were 48,647 admissions in 2017/18.

Dr Ron Daniels, Chief Executive of the UK Sepsis Trust, and Patient Safety Learning topic leader, said the scale of the problem in children looks “alarming”, adding: “What this means is that parents need to continue to be aware of meningitis, but to arguably be even more aware of sepsis as it affects far more children and can be equally deadly.” He said: “These potentially alarming data show that the number of recorded episodes of sepsis has more than doubled in just three years, a period coinciding with the recent focus on sepsis by the NHS in England."

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Source: Mirror, 22 July 2019

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AfPP launches new clinical audit tool to enhance patient safety

The Association for Perioperative Practice (AfPP), has launched the AfPP Perioperative Audit Tool; 2019 Edition, a robust audit tool that will assist both private sector and NHS theatre practitioners in creating a safer perioperative environment.

The tool comprises peer-reviewed standards and recommendations for safe perioperative practice and forms a ‘gold standard’ framework for operating theatre departments to examine service performance and identify potential improvements in patient care.

As the UK’s leading membership organization for operating theatre practitioners who put patient safety at the heart of all they do, AfPP created the tool for the theatre practitioners to review their current policies and processes to invest in the safety of their patients.

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Source: News Medical Life Sciences, 19 July 2019

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‘Drug policy isn’t working... we need to try a completely different approach’

In a recent interview in The Times, former Chief Medical Officer, Professor Sir Harry Burns considers the symptoms of the country’s drug deaths epidemic. The total of 1,187 fatalities in 2018 represents 218 drug deaths per million of the population and a 27% year-on-year rise. The death rate is three times higher than in the UK as a whole and worse than that of the United States. Politicians should listen to people working on the front line to tackle rising deaths, according to Sir Harry. The trouble is, he says, “public policy tends to be made because someone has a clever idea which then gets picked up by a politician. Very few outcomes in society are determined by one thing.” He believes that health and social benefit on a national scale comes with incremental change over an extended period of time. 

When asked what one thing would you do to improve the health of the nation, Sir Harry said "Scotland has made enormous strides in improving patient safety using the concepts of improvement science in which front line staff have tested many different ideas and applied at scale the changes which they have seen work. It’s the principle of marginal gains that has been successful in sport. I would use this approach to improve wellbeing across society."

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Source: The Times, 20 July 2019

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UK newborn baby screening 'not good enough'

UK babies are missing out on checks for rare but serious health conditions, putting lives at risk, according to a report from the charity Genetic Alliance UK. The NHS offers newborns a blood test to screen for up to nine conditions, whereas many other European countries look for 20 or more illnesses and the US screens for more than 50, the charity says. 

The UK National Screening Committee says its recommendations are based on evidence and are regularly reviewed. It is up to the governments in England, Scotland, Wales and Northern Ireland to decide which tests to provide. Genetic Alliance UK says affordable ways to expand the screening exist, but are not being used.

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Source: BBC News, 23 July 2019

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GP receptionists will offer patients appointments at chemists, in bid to take pressure off family doctors

GPs’ receptionists will divert patients to see pharmacists in a bid to relieve pressure on family doctors. The NHS plan aims to prevent 20 million GP appointments, with many of those telephoning for help instead offered a "same day” slot at a local chemist. Health officials said the moves would mean more accessible and convenient access to services. But patients’ groups said the measures were “worrying”, with fears that critical decisions could end up being taken by those with little training in how to assess patients. 

From October, those calling 111 will be offered appointments at their local pharmacists if call handlers believe they are suffering from a minor ailment. Meanwhile, the NHS will pilot the same system for patients trying to make a GP appointment - with hopes to introduce the system nationally within nine months. 

Health Secretary Matt Hancock said the moves were similar to “the French model” where pharmacists have a stronger role providing healthcare. Officials said the plans may be extended still further, to divert patients attempting to seek help from Accident & Emergency departments. 

The changes are part of a five-year contract with pharmacists. 

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Source: The Telegraph, 22 July 2019

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