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Seven in 10 hospital trusts failing to meet safety standards

Patient safety is frequently at risk in NHS hospital trusts in England, with 70% of them failing to meet national safety standards, according to an Observer analysis of inspection reports, with staff shortages the biggest problem. 

Reports by the Care Quality Commission (CQC) reveal that managers at one trust failed to act on staff reports of abuse and violence, while a shortage of critical beds at another trust led to three serious incidents resulting in patient harm. Of 148 acute and general hospital trusts, safety standards at 96 are rated as “requires improvement” by the CQC; six are rated inadequate, the lowest category. The others are rated good, with none outstanding.

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Source: Guardian, 8 September 2019

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AHSN's 'Patient Safety in Partnership' plan

The Academic Health Science Network (AHSN) has published their plan for a safer future: 'Patient Safety in partnership: Our plan for a safer future 2019-2025' . Their plan supports the NHS Patient Safety Strategy and sets out how England’s 15 AHSNs, and the Patient Safety Collaboratives (PSCs) they host, will work more closely with their local health and care organisations to improve safety both in hospitals and community-based services such as care homes.

AHSN's "ambition is to support the delivery of the NHS Patient Safety Strategy and therefore our vision is aligned to the national strategy: ‘for the NHS to continuously improve patient safety'.’'

Patient Safety Learning is delighted to be working with The AHSN and Patient Safety Collaboratives and welcomes their Patient Safety in Partnership plan:

"We believe that it will make a difference for patient safety and represents a step forward from the good work that AHSNs are already doing. We believe that there is opportunity for even more to be achieved with the resources, scale and capability within the AHSN networks. We absolutely applaud the statement that patient safety is a central priority and guiding principle for all AHSNs, and we recognise the AHSNs’ distinct role as orchestrators across the healthcare system. We think that AHSNs, with PSCs, can reinforce this position by taking a powerful role in bringing, enabling and supporting systems thinking for patient safety across healthcare."

Patient Safety Learning will be sharing details of the innovation and improvement programmes on the hub.

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When parents of sick children don't get to decide

The parents of five-year-old Tafida Raqeeb, who is on life support, are going to the High Court to challenge an NHS decision which is preventing them from taking her abroad. 

Tafida Raqeeb suffered a traumatic brain injury in February as a result of a rare condition, arteriovenous malformation, where a tangle of blood vessels causes blood to bypass the brain tissue. Tafida's mother and father want to seek treatment in Italy. But the Royal London Hospital, which is caring for their daughter, says releasing her is not in her best interests.

A spokesperson for Barts Health NHS Trust, which runs the hospital, said that its clinicians and independent medical experts had found "further medical treatment would not improve her condition".

In England and Wales the concept of parental responsibility is set out in law, in the Children Act 1989. This gives parents the responsibility broadly to decide what happens to their child, including the right to consent to medical treatment. But this right is not absolute. If a public body considers that a parent's choices are not in the best interests of their child, and an agreement cannot be reached, it can challenge these choices by going to court. It comes down to a judge to make the final decision, based on the evidence available.

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Source: BBC News, 2 September

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Hundreds of thousands of people in England are getting hooked on prescription drugs

Hundreds of thousands of people in England are getting hooked on prescription drugs, health chiefs fear. 

A Public Health England (PHE) review looked at the use of strong painkillers, antidepressants and sleeping tablets - used by a quarter of adults every year. It found that at the end of March 2018, half of people using these drugs had been on them for at least 12 months. Officials said long-term use on such a scale could not be justified and was a sign of patients becoming dependent.

PHE medical director Prof Paul Cosford said he was worried. "These medicines have many vital clinical uses and can make a big difference to people's quality of life." But he added there were too many cases where patients were using them for longer than "clinically" appropriate - where the drugs would have simply stopped working effectively or where the risks could outweigh the benefits.

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Source: BBC News, 10 September 2019

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Improving safety in care homes

A new report from the AHSN Network is shining a light on ways we can do more to improve safety for residents of care homes.

The publication showcases over 30 examples of projects delivered by England’s 15 Patient Safety Collaboratives (PSCs) and the Academic Health Science Networks (AHSNs) which host them. They include case studies in medicines safety, dementia, monitoring and screening, and workforce development.

AHSN Network Patient Safety Director Dr Cheryl Crocker, said:

“Many residents have complex healthcare needs, reflecting multiple long-term conditions, significant disability and advanced frailty. All these factors make caring for residents an incredibly difficult job for care homes and their staff.

“Given this operating landscape, there are some fantastic examples of care, safety and quality improvement in care homes. The aim of this summary is to share good practice supported by the AHSN Network, and we are actively encouraging readers to get in touch with those who have shared their work for this report and discuss how we can have even greater impact on patient safety and improvement in care homes.”

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Don’t charge migrants for maternity care, say midwives

Midwives have called on the government to end the policy of charging some migrants for maternity care, saying it undermines trust and creates a climate of fear among vulnerable pregnant women.

A report by Maternity Action, backed by the Royal College of Midwives, says some women were seeking maternity care late in pregnancy, missing tests and treatments, or completely avoiding antenatal care for fear of charges and Home Office sanctions.

“Midwives should not act as gatekeepers to maternity services,” said Gill Walton, chief executive and general secretary of the Royal College of Midwives.

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Source: BMJ, 9 September 2019

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Foundation trust to seek merger to avoid ‘patient safety risks’

A mental health trust is preparing to seek a merger or acquisition by another provider in a bid to address its financial challenges, HSJ has learned. 

In a message to staff, North West Boroughs Healthcare Foundation Trust said growing financial pressures were “likely to put the quality and safety of patients at risk”.

It said various options were discussed by governors and the trust board at a meeting yesterday, and it was agreed to pursue a “merger or acquisition of the whole organisation with one or more provider trusts”.

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Source: HSJ, 12 September

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Northwest Ambulance Service case review published

The National Guardian’s Office (NGO) has published a 'Summary of speaking up learning and actions' in response to the referrals made from the review into the handling of two speaking up cases at Northwest Ambulance Service NHS Trust (NWAS). The review is the product of the NGO’s engagement process, the central feature of which is the actions the trust will take to address the issues highlighted.

These include explaining the scope of the role of the Freedom to Speak Up Guardians and the issues they can support workers to raise. The trust has also committed to consider their approach to the independence, timeliness and handling of investigations into speaking up matters. They also recognised the need to address perceived attitudes towards female workers.

“The trust has outlined significant steps it is making to ensure these issues are taken seriously, and the learning is embedded in effective improvement actions,” explained Dr Henrietta Hughes, National Guardian for the NHS.

Daren Mochrie, NWAS’ Chief Executive, said, “It’s really important for us to give our staff the confidence to be able to share any concerns and observations safely and confidentially. This creates an open and honest reporting culture within the trust. We welcome the findings of the report and are now putting the learning from this into action to even further improve our reporting system.”

Source: National Guardian's Office, 12 September 2019

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Member of EEAST staff shares sepsis story

To raise awareness of an illness estimated to kill 30 million people a year globally – and up to 44,000 people a year in the UK – East of England Ambulance Service NHS Trust (EEAST) is encouraging people to learn to spot the signs of sepsis – and know what to do.

As part of World Sepsis Day, EEAST staff have been sharing stories about how they have been affected by sepsis in their families.

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Source: East of England Ambulance Service NHS Trust, 13 September 2019

 

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Pregnancy-related deaths are rising in the US. Geisinger among 30 health systems testing digital tools to stop the trend

Pregnancy-related deaths and maternal morbidity continue to rise in the US. A major factor is large areas of the country, 'maternity deserts' have little or no proper maternity care, officials say.

So 30 health systems are teaming up to implement digital tools and new care models to help close gaps in care for mothers and infants. Those digital solutions include screening tools to identify pregnant women with comorbidities like diabetes and hypertension to intervene earlier and using telehealth to connect expectant mothers to doulas. 

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Source: FierceHealthcare, 12 September 2019

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Cancer survival in the UK improving, but lagging behind

Cancer survival in the UK is on the up, but is still lagging behind other high-income countries, analysis suggests.

Five-year survival rates for rectal and colon cancer improved the most since 1995, and pancreatic cancer the least. Advances in treatment and surgery are thought to be behind the UK's progress.

But the UK still performed worse than Australia, Canada, Denmark, Ireland, New Zealand and Norway, the study in Lancet Oncology found. Cancer Research UK said the UK could do better and called for more "investment in the NHS and the systems and innovations that support it".

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Source: BBC News, 12 September 2019

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BMA calls for legislation to stop doctors being blamed when under “unmanageable pressure”

The BMA has written to the government to call for new legislation to ensure accountability for safe staffing levels and that “individual clinicians are not blamed when the system places them under unmanageable pressure.”

The call came as the BMA published a year long study looking at the changes needed to improve care of patients and the working lives of doctors in the NHS, alongside a “manifesto for change” outlining all the recommendations.

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Source: BMJ, 13 September 2019

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Surgeons are retiring early due to back problems brought on by modern surgical techniques, experts warn

Surgeons are retiring early because of back problems caused by modern surgical techniques, experts have warned. 

Keyhole surgery, where an operation is carried out through a small hole in the patient’s body, has become increasingly common because it helps patients recover more quickly and has less pain, complications and scarring than conventional operations.But in order to carry out the procedures through a tiny opening, surgeons often have to contort themselves into awkward positions for hours at a time.

Now a new report says one in five surgeons say they will have to retire early because they have developed back injuries from carrying out modern surgical techniques. This could mean patients face even longer waits for operations, thanks to the loss of 4,500 senior doctors, the research suggests. 

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Source: The Telegraph, 15 September 2019

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Hundreds of patients suffer due to NHS errors

Hundreds of patients have suffered due to NHS blunders so serious they should never happen, new data shows.

Some 621 'never events' occurred in NHS hospitals between April 2018 and July this year – the equivalent of nine patients every week, according to data obtained by PA news agency. The figures show doctors have operated on the wrong body parts and left surgical tools (including surgical gloves, chest drains and drill bits) inside patients many times over.

Rachel Power, Chief Executive of the Patients Association, said: “Wrong site surgery incidents are preventable safety instances that can have devastating consequences for the patient and their family." “People who suffer harm because of mistakes can suffer serious physical and psychological effects for the rest of their lives, and that should never happen to anyone who seeks treatment from the NHS."

Professor Derek Alderson, president of the Royal College of Surgeons, said: “While these cases are very rare, never should mean never."

“NHS staff are there to care for patients, so knowing you have caused harm is incredibly distressing. It is vital that all theatre staff use, and are involved in, the World Health Organisation pre- and post-operative checklist process, as these have been designed to help prevent serious incidents."

“It is also important that the NHS continues to promote a culture of openness and transparency, both in terms of publishing surgeons’ outcomes and the number of ‘never events’ that, sadly, occur."

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Source: ITV News, 16 September 2019

 

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NHS admin: how does it affect patient experience?

At one time or another, most of us have experienced feeling frustrated by bureaucratic processes, outdated IT systems or unsatisfactory interactions with administrative staff. 

As in many other parts of our lives, when the administrative aspects of a service seem poor (and when they seem good) it can have a significant impact on how we feel about our experience of using it overall. In the case of healthcare, this often comes at a time when we are already feeling anxious. In some cases, administration can also have an impact on the care we receive – for example, if an appointment is delayed. For these reasons alone (though there are many others) NHS administration is important.

Despite this, there has been very little research into NHS administration and its impact on service users, and it is not routinely captured in NHS data. The King’s Fund are kicking off a project to explore patients’ experiences of NHS administration in more detail. As a first step, they reviewed a random sample of over 300 comments written on the Care Opinion website between 2016 and 2018.

This analysis is just the beginning. Over the next few months, The King's Fund will speak to patients and NHS staff to understand the issues around NHS administration in more detail. For more information, see their project page.

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Source: The King's Fund, 13 September 2019

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WHO calls for urgent action to reduce patient harm in healthcare

Millions of patients are harmed each year due to unsafe health care worldwide resulting in 2.6 million deaths annually in low-and middle-income countries alone.  Most of these deaths are avoidable. The personal, social and economic impact of patient harm leads to losses of trillions of US dollars worldwide. The World Health Organization (WHO) is focusing global attention on the issue of patient safety and launching a campaign in solidarity with patients on the very first World Patient Safety Day on 17 September.

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Source: WHO, 13 September 2019

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Patient Safety Learning welcomes first ever WHO World Patient Safety Day

Monuments and fountains will be lit up across the globe today to herald the first ever World Patient Safety Day, organised by the World Health Organisation (WHO). 'Speak up for
patient safety' is the universal call as the spotlight is put on this global health priority. With the supporting strapline that “No one should be harmed in health care” the day brings
together patients, families, carers, communities, health workers, health care leaders and policy makers to show commitment to patient safety.

Patient Safety Learning's commitment to patient safety can be found in 'A Blueprint for Action', which we launched earlier this summer, which advocates six evidence-based foundations for action to address the causes of unsafe care. One of the six foundations is shared learning.  At the heart of our commitment to shared learning is the creation the hub, a community where people can share learning about patient safety problems, experiences and solutions.

Read more about Patient Safety Learning's commitment to patient safety in Chief Executive Helen Hughes' blog, Speaking up for patient safety on World Patient Safety Day

To mark World Patient Safety Day, Patient Safety Learning has released a series of short videos:

Patient safety is a purpose of health and social care

Shared learning for patient safety

Leadership for patient safety

On 2 October this year, we will be hosting in London our second annual conference attended by senior health and social care leaders, clinicians, patient safety experts, patients’ groups
and individuals who have experienced at first hand the traumas of losing a loved one where the quality of care has fallen down. We will also be officially launching the hub.

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BD supports World Patient Safety Day

The World Health Organization’s creation of an annual World Patient Safety Day is key to helping raise awareness and focus minds on improving the safe delivery of healthcare. BD fully supports this initiative and is partnering with care providers to ensure patient safety is prioritised, and efforts to reduce avoidable harm are enabled. 

"Patient Safety is integral to everything we do at BD and we believe it should be at the forefront of everyone’s minds when thinking about healthcare..."

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Source: BD, 17 September 2019

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NHS trust calls for police probe into deaths

NHS governors have called for a police investigation into the urology department of a health service trust following accusations that patients died and were harmed after a string of clinical errors and malpractice. 

Morecambe Bay NHS Foundation Trust (UHMBT) has now agreed to an external review after dozens of patients, relatives and staff have came forward following the publication of a book by whistleblower surgeon Peter Duffy, which exposed poor care in the unit. 

The call for a police investigation came at a meeting of the council of governors of the trust earlier this month. Governor Dave Welton told the meeting that the council had “very serious concerns about the shocking revelations.”

A former theatre nurse has also come forward claiming to have witnessed countless errors made by surgeons, while another healthcare worker said she was now speaking out to prevent further harm to patients.

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Source: BBC News, 16 September 2019

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The US Senate can save lives by removing ban on unique patient identifier

The US Senate has an unprecedented opportunity to remove a ban that has stifled efforts to establish a nationwide unique patient identifier. 

In June, the U.S. House of Representatives passed an amendment that would remove a ban that has stifled efforts to establish a nationwide unique patient identifier. Now, it is up to the US Senate to move this issue forward by rejecting inclusion of outdated rider language in their appropriations bill that prohibits the U.S. Department of Health and Human Services from spending any federal dollars to promulgate or adopt a national patient identifier.

According to a 2016 study of health care executives, misidentification costs the average health care facility $17.4 million per year in denied claims and potential lost revenue. More importantly, there are patient safety implications when data is matched to the wrong patient and when essential data is lacking from a patient’s record due to identity issues. 

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Source: The Hill, 11 September 2019

 

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BMA sets out vision for reforming ‘unsafe, underfunded’ NHS

The British Medical A has outlined its vision for an ‘unsafe’ NHS with a culture of bullying.  

According to the BMA, doctors are working in hospitals and GP Practices that are hugely understaffed, where bullying and a culture of blame is the norm and where patient care is often unsafe. These are the findings of a year-long study – ‘Caring Supportive Collaborative: Doctors Vision for Change‘ – into the state of the NHS.

The chair of the BMA Council, Dr Chaand Nagpaul said: “Nine in 10 doctors tell us that staffing levels are inadequate and that they work in environments where they fear the toxic combination of ever-increasing demand for services and lack of staff capacity will lead to mistakes."

“They tell us there is a persistent culture of fear across the NHS, where blame stifles learning, contributing to the vicious cycle of low morale so staff leave and then there’s a problem of recruitment."

“This unsafe, underfunded environment is as damaging for patients as it is for doctors. Radical change is clearly needed.”

From the report comes a manifesto, which has today been sent to MPs, as well as the secretary of state for health and social care.

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Source: Practice Business, 17 September 2019

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'Systemic' failings with 999 call-handling service criticised

A woman who died after waiting almost two hours for an ambulance was let down by "systemic" failings with a computer call-handling system, a coroner said.

Daisy Filby, 90, was one of three people who died after delays in receiving care from the South East Coast Ambulance Service (Secamb). Coroner Alan Craze said a human would have "realised what was going on" and prioritised the calls differently. 

Mrs Filby, from Seaford, died in June 2017 as a result of an "accident contributed to by neglect," Mr Craze concluded at the Hasting's Coroner's Court inquest. "If an ambulance or anybody with or without medical knowledge had been able to reach this poor lady before her death, the situation would have been different," he added.

Mr Craze said: "The problem is not the actions of any one individual in Secamb Trust. The problem is ultimately systemic and at the heart of the call-taking and decision-making system."

A spokesman for the ambulance service said: "We are very sorry for the service they received. We have listened very closely to the coroner throughout and we are committed to making further improvements where necessary."

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Source: BBC News, 18 September 2019

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