5430
875
446
120
58
Hundreds of patients, including children, dependent on intravenous nutrition to keep them alive are experiencing delays in vital deliveries, because of restrictions placed on the manufacturer by the MHRA. Clinicians warn patients may need to be admitted to hospital, rather than stay at home, if delays continue.
Read full story (paywalled)
Source: HSJ, 23 July 2019
A type of anaesthetic machine that has been used in NHS hospitals can be hacked and controlled from afar if left accessible on a hospital computer network, says CyberMDX, a cyber-security company. For example, a successful attacker would be able to change the amount of anaesthetic delivered to a patient or alarms designed to alert anaesthetists to any danger could be silenced.
GE Healthcare, which makes the machines, said there was no "direct patient risk". But CyberMDX's research suggested the Aespire and Aestiva 7100 and 7900 devices could be targeted by hackers if left accessible on hospital computer networks.
Source: BBC News, 10 July 2019
The Care Quality Commission (CQC) has been found guilty of maladministration over its handling of a fit and proper person test complaint which led to a £200,000 investigation by an NHS trust. A Parliamentary and Health Service Ombudsman (PHSO) investigation identified “several instances of maladministration” in the CQC’s handling of a complaint by former consultant paediatrician David Drew.
Ombudsman Rob Behrens has now written to the Health Secretary, NHS England, Chair of the Commons Health Committee Sarah Wollaston, and Chair of the Parliamentary and Constitutional Affairs Committee Bernard Jenkin with a copy of the PHSO investigation. In his letter. Mr Behrens said: “I believe this case exemplifies the damaging impact that poor handling of allegations can have on people’s faith in the ability of the CQC to identify and act on misconduct when whistleblowers come forward. This underlines the need for reform to the [fit and proper person] system and the recommendations from the Kark review to be swiftly implemented.”
Read full story (paywalled)
Source: HSJ, 24 July 2019
Dr Max Pemberton, columnist for the Daily Mail, gives his opinion of the app that offers patients a GP consultation via their mobile phone. In theory, it sounds great: the patient can dial up, speak to and (via phone camera) see a doctor, who could be anywhere. However, how effective can such consultations be? "I have been able to test this service for myself — and what I have experienced left me worried", says Dr Pemberton.
Source: The Spectator, 20 July 2019
A response from Tom Kark, QC, in relation to some of the issues raised recently in the HSJ relating to the Fit and Proper Person Test (FPPT)
Source: HSJ, 12 June 2019
Nurses from Northwest Pennsylvania convened at a billboard calling for greater limitations on the number of patients a nurse can attend to during a shift. The advertisement, located on state Route 8 outside of Centerville, is one of two billboards that Nurses of Pennsylvania, a non-profit advocacy group in the US for nurses and patients, crowd funded in order to raise awareness about the issue of safe staffing and possible legislation.
Registered nurse Kimberly Aldrich, said: “What gets me is that this is not an unprecedented idea in Pennsylvania... When we drop our kids off at daycare, we can rest assured that the facility is legally required to adhere to limits on the number of kids a childcare worker can be assigned. Why should we accept less if our kids are in the hospital?”
Source: The Titusville Herald, USA, 24 July 2019
GPs say they are misdiagnosing patients because appointment slots are too short. A survey of family doctors found more than one in three said they had failed to properly diagnose cases because they did not have enough time to fully assess them. Typically, the time slot to see a patient is around 10 minutes. The poll of 200 GPs found that 95 per cent of those surveyed said such slots were too short to do their jobs safely.
Source: The Telegraph, 25 July 2019
Unlike many research lab, the Surgical Simulation Research Lab (SSRL) at the University of Alberta in Canada is focusing on healthcare providers; specifically, they aim to know capacities and limitations of physicians and surgeons, and design a system to support them.
"Our goal is to create a simulation system for young physicians and surgeons to practice surgical skills without harming the patient..." said Bin Zheng, Associate Professor and the Director of SSRL. "This includes a better simulation programme for their skills training. We do everything to create a simulation model to replace patients being used as a training model".
Source: Xinhua News, 21 July 2019
A deceased NHS consultant could have been charged with manslaughter over the deaths of haemophiliac patients given blood infected with HIV and hepatitis C, a lawyer for families has claimed. Des Collins said the reputation of Prof Arthur Bloom "cannot remain intact". The role of Prof Bloom has been mentioned by families of a number of victims giving evidence to the ongoing contaminated blood inquiry in Cardiff.
Cardiff and Vale University Health Board said it was co-operating fully with the inquiry. It added: "We cannot comment on historical allegations at this stage and will await the findings of the inquiry and then take any necessary steps. "We are committed to an open and transparent approach and have been working with Haemophilia Wales to support patients and families who are likely to be involved in the inquiry."
Source: BBC News, 26 July 2019
Almost half (47%) of patients with cancer do not think that they have been sufficiently involved in deciding which treatment option is best for them, a new survey shows. The survey of nearly 4000 patients across 10 countries also found that around four in 10 (39%) said that they were never or only sometimes given enough support to deal with symptoms and side effects.
Read full story (paywalled)
Source: BMJ, 25 July 2019
An independent investigation is to be launched into a deadly outbreak of an infection which has claimed 13 lives in Essex. The Mid Essex Clinical Commissioning Group (CCG) has called in a team to probe the spread of the invasive Group A Streptococcus (iGAS) bacterium. The strain has been linked to at least 31 confirmed cases, including the 13 fatalities. The investigation will take about six months and results "will be shared and implemented," said the CCG. It has been ordered through the NHS Serious Incident Framework.
Source: BBC News, 25 July 2019
The response to physician burnout often overlooks a potentially life-threatening condition, major depressive disorder (MDD), researchers in the US found.
Research indicates that nearly half of physicians nationwide are experiencing burnout symptoms, and a study published last year found that burnout increases the odds of physician involvement in patient safety incidents, unprofessionalism and lower patient satisfaction. In fact, researchers estimate that a physician commits suicide every day.
In an article published this month in JAMA Psychiatry, a trio of physicians led by Maria Oquendo of the University of Pennsylvania's Perelman School of Medicine in Philadelphia, wrote that the widespread focus on burnout could lead to missed diagnoses of serious mental illnesses among clinicians.
Symptoms of burnout such as exhaustion overlap with symptoms of MDD, and signs of MDD in clinicians should prompt a thorough psychiatric evaluation.
Source: MEDPAGE Today, 28 July 2019
Prosecutions and other criminal enforcement actions against unsafe care homes and NHS hospitals have risen a third in a year, amid warnings of a growing crisis. Charities said older people were being put at risk by “a broken social care system and an overstretched NHS” as they urged ministers to act. Official figures show that last year, watch dogs enforced 211 criminal enforcement actions against failing providers - a rise from 159 the year before. The statistics from the Care Quality Commission, covering prosecutions, cautions and fixed penalty notices, come along side a sharp rise in civil actions taken against providers. There were 906 such cases in 2018/19, compared with 781 the year before.
Caroline Abrahams, Charity Director at Age UK, said: “The fact that the CQC felt the need to use their enforcement powers a lot more often last year than the year before is a worry, and given all we know about the pressures in the system it is hard to avoid the conclusion that this reflects an overall decline in care standards, as providers struggle to make ends meet and the temptation to cut corners in terms of quality and safety inexorably grows.”
Source: The Telegraph, 26 July 2019
For too long, medicine has been a cult that deifies workaholism and mocks those who “fuss” about sleep, say Matt Morgan, Honorary Senior Research Fellow at Cardiff University, Consultant in Intensive Care Medicine and Head of Research and Development at University Hospital of Wales, and Peter Brindley, Professor of Critical Care Medicine, Medical Ethics, Anesthesiology at the University of Alberta, Canada. But we know that lack of sleep kills. Data have consistently shown how it kills slowly and silently by increasing the likelihood of cancer, heart disease, immunosuppression and weight gain. Poor sleep also kills suddenly and loudly through motor vehicle crashes and workplace trauma. More and better sleep is needed for all but the question is do we care enough to do the right thing?
Regardless of whether insomnia is limited to medicine or is, instead, a society wide issue, we can likely all agree that we need a cultural shift. This starts by senior folks speaking up and standing side by side with junior colleagues. We should not, cannot, and need not stand by as doctors work hours that we would never condone for pilots or bus drivers. Lessons must be heeded. Fortunately, these are lessons that we have known for decades. Patient safety matters, and so does practitioner safety.
Source: BMJ Opinion, 28 July 2019
Hundreds of mothers-to-be have lost access to their midwives after a community service was forced to close. Women across the north-west of England and in Essex have been affected after One to One announced it was withdrawing the services it provided for the NHS.
One to One specialises in home births, which means some women may have to give birth in hospital against their wishes. A spokesman for the NHS said emergency protocols had been put in place and women affected would be contacted by a dedicated team. He said the "priority" was ensuring those affected were provided with support, but he said he could not guarantee that they would be able to have a home birth.
Source: BBC News, 31 July 2019
Croydon Health Services NHS Trust has rolled out an app from Ryalto designed to improve the working and professional lives of its healthcare staff. Croydon NHS Trust is now offering all of its 3,800 workers access to Ryalto – a platform that enables healthcare professionals to manage their working day and acts as a safe and singular source of communication for all employees. Secretary of State for Health and Social Care, Matt Hancock, was present at the launch, and talked about the positive impact apps can have on the way health care staff manage their working lives.
Matthew Kershaw, interim CEO, Croydon Health Services NHS Trust, said: "The app is reflective of how we live our lives today – on mobiles, with flexibility and in real-time. It offers a key digital channel for us to communicate with each other instantly, through the chat and news feed features, increasing opportunities for engagement and fostering a closer working environment where we work together to provide the best care for our patients.
Source: Health Tech Digital
A mobile phone app has speeded up the detection of a potentially fatal kidney condition in hospital patients. Acute kidney injury is caused by serious health conditions, including sepsis, and affects one in five people admitted to hospital. It accounts for around 100,000 deaths every year in the UK.
During a trial at London's Royal Free Hospital, doctors and nurses received warning signals via a mobile phone app in an average of 14 minutes, when patients' blood tests indicated the condition. The new alerting system, known as Streams, developed by the Royal Free with technology firm DeepMind, sends results straight to front-line clinicians in the form of easy-to-read results and graphs.
This could could save the NHS an average of £2,000 per patient by alerting clinicians to acute kidney injury sooner. However, although the findings, published in the journal Nature Digital Medicine, led to earlier recognition, it did not lead to any improvements in the primary outcome measure (renal recovery) or in secondary outcomes, which included survival, length of stay in hospital, and admission to the intensive care unit.
Source: BBC News, 1 August 2019
Junior doctors have won a court case against a hospital trust over rest breaks which could have far-reaching implications for the NHS. The 21 doctors said Derby Hospitals NHS Foundation Trust failed to make sure they either took proper breaks or were paid extra for working. Lord Justice Bean said the trust's method of calculating breaks was "irrational" and a breach of contract.
Read full story (paywalled)
Source: HSJ, 31 July 2019
NHS Improvement's revised expectations of boards and board members in relation to Freedom to Speak Up plus supplementary resources and a self-review tool.
Effective speaking up arrangements protect patients and improve the experience of NHS workers. NHS Improvement's guide contributes to the need, set out by Sir Robert Francis in his Freedom to Speak Up review, to develop a more open and supportive culture that encourages staff to speak up about any issues of patient care, quality or safety.
The importance of workers having the freedom to speak up and the role that executive directors play in this has been recently reaffirmed in the review of Liverpool Community Health NHS Trust, the Kark Report and the interim NHS People Plan.
Source: NHS Improvement, 31 July 2019
About three quarters of GPs and hospital consultants have cut or are planning to cut their hours because of the doctors’ pensions crisis. About 42% of family doctors and 30 % of consultants have reduced their working times already, claiming that they are being financially penalised the more they work. A further 34% and 40 per cent respectively have confirmed that they plan to reduce their hours in the coming months because they fear losing out, according to a survey of more than 6,000 doctors by the British Medical Association.
The government has launched an urgent consultation over the issue, which is the result of changes to pension rules limiting the amount that those earning £110,000 or more can pay into their pensions before they are hit with a large tax bill.
Read full story (paywalled)
Source: The Times, 1 August 2019
Twenty hospitals in England due to receive an extra £850m funding for upgrades to outdated facilities and new equipment have been revealed. Prime Minister Boris Johnson will formally announce the plans – part of NHS spending pledges totalling £1.8bn – at a Lincolnshire hospital today. Ahead of his visit to Lincolnshire, Mr Johnson said the new money – less than 1% of the annual NHS budget – would mean "more beds, new wards, and extra life-saving equipment".
But responding to the funding announcement, the Health Foundation said "years of under-investment in the NHS's infrastructure means this extra money risks being little more than a drop in the ocean". Ben Gershlick, from the charity, added that NHS facilities in England were "in major disrepair", with a £6bn maintenance backlog.
The Healthcare Safety Investigation Branch (HSIB) has launched a new online feedback form so that anyone involved or interested in HSIB's healthcare safety investigations can "tell us what they think".
There are options to give feedback on national investigations in general, specific national investigations, maternity investigations and HSIB in general.
The feedback form is available from the HSIB website
Source: HSIB, 1 August 2019
Burnout is an occupational phenomenon and we need to look beyond the individual to find effective solutions, argue Montgomery and colleagues in a recent BMJ article
Burnout has become a big concern within healthcare and is associated with sleep deprivation, medical errors, poor quality of care and low ratings of patient satisfaction. Yet often initiatives to tackle burnout are focused on individuals rather than taking a systems approach to the problem. Evidence on the association of burnout with objective indicators of performance (as opposed to self report) is scarce in all occupations, including healthcare. But the few examples of studies using objective indicators of patient safety at a system level confirm the association between burnout and suboptimal care.
Read full article (paywalled)
Source: BMJ, 30 July 2019
In a recent BMJ 'Head to head', the authors argue whether the World Health Organization's (WHO) surgery safety checklist saves lives.
Studies show that the WHO's surgery checklist saves lives around the world, say Alex Haynes and Atul Gawande. But David Urbach and Justin Dimick argue that there’s not enough evidence to say for sure.
Read full story (paywalled)
Source: BMJ, 5 August 2019
More than 4,000 women in the Republic of Ireland were not told the results of cervical cancer smear tests due to an IT problem, a report has revealed.
It found in about 870 of the cases, results letters were not issued to the women or their GP. In the other 3,200 cases the results were issued to GPs, but not the women. The report concluded there was not proper due diligence and risk assessment in appointing a new lab as a cervical check test facility.
Quest Diagnostics Chantilly Laboratory was appointed in an effort to help clear a major backlog of cervical cancer test samples. This, the review said, was well intentioned but no testing took place to see if it could be seamlessly integrated into the way the system operated.
Source: BBC News, 6 August 2019