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Content ArticleThe Health Research Authority, the National Institute for Health and Care Research and a host of organisations across the UK have been working together to bring about changes which will drive up standards in health and social care research. Together they have signed up to a Shared Commitment to public involvement.
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- Person-centred care
- Patient engagement
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(and 3 more)
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Content ArticleThis episode of the Business of Healthcare podcast delves into the complex and sensitive topic of the mesh scandal which has impacted countless women's lives. Host Tara Humphrey welcomes Consultant Gynecologist and Urogynecology subspecialist Dr Wael Agur to share his expert insights on the rise and fall of mesh devices in surgical procedures. Wael offers a candid look at the multifaceted issues surrounding patient consent, the role of manufacturers, aggressive marketing strategies, and the ethical dilemmas faced by medical professionals.
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- Medical device
- Pain
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Content ArticleNottingham University Hospitals Trust has produced a leaflet for pregnant people who have experienced vaginal bleeding in later pregnancy. The leaflet aims to give women and families more information about possible causes of bleeding and recommendations that might be made for changes in pregnancy care. The leaflet has been produced in partnership with the parents of baby Quinn Parker, who tragically died in July 2021 after suffering oxygen starvation in the womb.
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- Information sharing
- Patient engagement
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Michelle Harrod joined the community
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Patient Safety Learning started following Clutching morphine and sheltering in a bus stop: the NHS patients sent from hospital to the street , Disputed medical terms used to explain dozens of deaths after police restraint in UK , NHS ombudsman warns hospitals are cynically burying evidence of poor care and 3 others
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News ArticleA controversial unproven medical condition which is rooted in pseudoscience and disputed by doctors is routinely being used in Britain to explain deaths after police restraint, the Observer has found. “Acute behavioural disturbance” (ABD) and “excited delirium” are used to describe people who are agitated or acting bizarrely, usually due to mental illness, drug use or both. Symptoms are said to include insensitivity to pain, aggression, “superhuman” strength and elevated heart rate. Police and other emergency services say the labels, often used interchangeably, are a helpful shorthand used to identify when a person who might need medical help and restraint may be dangerous. But the terms are not recognised by the World Health Organization and have been condemned as “spurious” by campaigners who say they are used to “explain away” the police role in deaths. The American Medical Association rejected “excited delirium” after it was used by police lawyers in the case of George Floyd. California lawmakers banned it as a diagnosis or cause of death in October, saying it had been “used for decades to explain away mysterious deaths of mostly black and brown people in police custody”. The Royal College of Psychiatrists has also warned that the current definition of ABD, as it is now more commonly known in the UK, could be leading to people “being subjected to avoidable and potentially harmful interventions”. In 2017, a Home Office-commissioned review into deaths in police custody said the terms were “strongly disputed amongst medical professionals”. The Royal College of Psychiatrists has also warned that the current definition of ABD, as it is now more commonly known in the UK, could be leading to people “being subjected to avoidable and potentially harmful interventions”. In 2017, a Home Office-commissioned review into deaths in police custody said the terms were “strongly disputed amongst medical professionals”. Read full story Source: The Guardian, 17 March 2024
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- Restrictive practice
- Mental health
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News Article
NHS ombudsman warns hospitals are cynically burying evidence of poor care
Patient Safety Learning posted a news article in News
Hospitals are cynically burying evidence about poor care in a “cover-up culture” that leads to avoidable deaths, and families being denied the truth about their loved ones, the NHS ombudsman has warned. Ministers, NHS leaders and hospital boards are doing too little to end the health service’s deeply ingrained “cover-up culture” and victimisation of staff who turn whistleblower, he added. In an interview with the Guardian as he prepares to step down after seven years in the post, Rob Behrens claimed many parts of the NHS still put “reputation management” ahead of being open with relatives who have lost a loved one due to medical negligence. The ombudsman for England said that although the NHS was staffed by “brilliant people” working under intense pressures, too often his investigations into patients’ complaints had revealed cover-ups, “including the altering of care plans and the disappearance of crucial documents after patients have died and robust denial in the face of documentary evidence”. Read full story Source: The Guardian, 17 March 2024- Posted
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- Investigation
- Patient death
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News Article
£6bn deficit warning sparks ‘horrible’ demands for nationwide cuts
Patient Safety Learning posted a news article in News
Local NHS organisations are facing intense “pressure” from NHS England’s national and regional teams to cut staffing numbers to improve the service’s financial outlook for 2024-25. Multiple sources have told HSJ that first draft financial returns submitted by the 42 integrated care systems indicate a combined deficit of around £6bn for the service. The £6bn figure is likely to fall substantially as NHS England meets individually with integrated care systems with the worst numbers. The need to reduce the number is prompting “horrible” conversations about service cuts, according to HSJ sources. One local leader in the South East region said the need to reduce staffing numbers constituted a “very significant part of the pushback on first-cut numbers”. A senior source in the Midlands added: “We’ve got virtually no workforce growth in our plan now… and we’ve still got a deficit. To get to breakeven we’d have to be looking at quite a significant workforce reduction.” Another leader in the South of the country said there was “big pressure” to get down to pre-pandemic staff numbers, “despite [the] increases in acuity, demand and backlogs as a consequence of covid”. Read full story (paywalled) Source: HSJ, 18 March 2024- Posted
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- Funding
- Organisation / service factors
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Content ArticleThe Children and Young People’s Health Equity Collaborative (CHEC) is a partnership between the UCL Institute of Health Equity (IHE), Barnardo’s and three Integrated Care Systems (ICSs), Birmingham and Solihull, Cheshire and Merseyside, and South Yorkshire. The CHEC sees action on the social determinants of health as essential in improving health outcomes among children and young people and reducing inequalities in health. The CHEC recognises that social determinants of health are generally not sufficiently addressed in policies, services and interventions that aim to support better health among children and young people. This framework has been developed by the CHEC with direct input from children and young people local to the three ICSs. The CHEC Board were also involved in its development. The framework’s main purpose is to underpin action for achieving greater equity in children and young people’s health and wellbeing and will be used to support the development of pilot interventions in the three partner ICS areas. There is an ambition for the framework also to be used more widely, encouraging other ICSs to take action on the social determinants of health among children and young people.
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- Children and Young People
- Health inequalities
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Content ArticleGetting a diagnosis for endometriosis now takes almost a year longer than before the pandemic, according to new research published by Endometriosis UK during Endometriosis Action Month 2024. The new study shows that diagnosis times in the UK have significantly worsened over the last 3 years, increasing to an average of 8 years and 10 months, an increase of 10 months since 2020. This lengthy wait means a delay in accessing treatment, during which the disease may progress, leading to worsening physical symptoms and a risk of permanent organ damage. Endometriosis impacts the physical and mental health of 1 in 10 women and those assigned female at birth in the UK from puberty to menopause, although the impact may be felt for life.
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- Endometriosis
- Womens health
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News Article
Endometriosis: Women in Wales waiting 10 years for diagnosis
Patient Safety Learning posted a news article in News
The wait to be diagnosed with endometriosis has increased to almost ten years, a "devastating" milestone say women with the condition. It now takes almost a year more than before 2020 to be diagnosed, according to research published by Endometriosis UK, which is setting up new volunteer-led support groups in Wales. The wait in Wales is also the longest in the UK, the research found. The Welsh government said it knew there was "room for improvement". "Nobody listened to me, and to feel like women are still going through that 20 years after my diagnosis is horrific," said Michelle Bates. The 48-year old from Cardiff was diagnosed aged 25 after suffering with "harrowing" pain from age 13 onwards - a 12-year wait. "I went back and forth to the GP with my mum, who was the only one who believed in my pain," she said. The study by Endometriosis UK, which is based on a survey of 4,371 people who received a diagnosis of endometriosis, showed almost half of all respondents (47%) had visited their GP 10 or more times with symptoms prior to receiving a diagnosis, and 70% had visited five times or more. It also found 78% of people who later went on to receive a diagnosis of endometriosis - up from 69% in 2020 - were told by doctors they were making a "fuss about nothing", or comments to that effect. Read full story Source: BBC News, 18 March 2024- Posted
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- Endometriosis
- Womens health
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(and 4 more)
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RuthMcDonald joined the community
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Content ArticleIn this Guardian interview, Rob Behrens, the outgoing NHS Ombudsman for England, says that too much unsafe care is still happening in the health service and that a culture of cover up makes it hard for bereaved families to find out the truth about their loved one's death. He describes the NHS as a complex institution run by mostly excellent, committed staff that is beset by cultural issues and a focus on limiting reputational damage at the expense of transparency and fair treatment of staff who speak up.
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- Culture of fear
- Whistleblowing
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News Article
Nurse reveals sexual harassment and whistleblowing ‘nightmare’
Patient Safety Learning posted a news article in News
A nurse has warned that she has been “crushed and silenced” over a battle with the NHS and the nursing regulator to investigate claims that she was sexually harassed by a colleague at work. Michelle Russell told Nursing Times of the “eight-year nightmare” she has endured since coming forward about her experiences and that she said had recently led her nursing career to come to an end. “Knowing what’s happened to me is not going to make it easier for anybody else to speak out" She has argued that “speaking up is not encouraged” in the NHS and that her case would discourage other nurses from coming forward about sexual harassment. Ms Russell said: “Anybody who has been around me would be able to see the emotional impact of all of this on me. “I’ve lost my job for highlighting a public safety concern.” The national guardian for the NHS told Nursing Times sexual harassment was a “patient safety issue” and warned that staff continued to face difficulties when speaking out. It comes as the latest NHS Staff Survey this month revealed that almost 4% of nurses and midwives had been the target of unwanted sexual behaviour in the workplace by another member of staff in the last 12 months. Read full story Source: Nursing Times, 15 March 2024- Posted
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- Nurse
- Staff safety
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Content ArticleThe National Safety Standards for Invasive Procedures (NatSSIPs) 2 are intended to help share learning and best practice to support multidisciplinary teams and organisations to deliver safer care. This two-page summary document, published by the Centre for Perioperative Care, provides a concise overview of NatSSIPs for anyone who does interventional procedures and the teams who support them.
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- Operating theatre / recovery
- Surgery - General
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News ArticleGripping a bag of morphine handed to him by hospital staff, Antonio sheltered at a bus stop, cold and shivering, as he tried to work out what to do. It was three days after undergoing gruelling surgery to remove his testicular cancer and the 36-year-old had been discharged from NHS care with nowhere to go. He was clutching a referral letter for the council’s housing team, given to him by hospital staff. When he arrived at the council office, he explained he had been homeless for the past few months – but was told they could not house him. “They asked me: ‘If you are in so much pain and trouble, why did they send you here?’ and I didn’t know what to say,” Antonio, whose name has been changed, tells The Independent. He was given a piece of paper with a phone number on it and told to call the next day. It was now late in the afternoon and the Salvation Army’s homeless day centre, where he would usually go for help, was closed. He had no option but to turn around and ready himself for a night on the streets. Antonio’s story is, tragically, not unique. He is one of thousands of people across England who have been discharged from NHS hospitals into homelessness in recent years, many while still battling serious health conditions. Data obtained by The Independent, in collaboration with the Salvation Army, shows at least 4,200 people were discharged from wards to “no fixed abode” in 2022/23. Read full story Source: The Independent, 17 March 2024
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- Discharge
- Patient suffering
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Content ArticleSerious incident management and organisational learning are international patient safety priorities. However, little is known about the quality of suicide investigations and the potential for organisational learning. Suicide risk assessment is acknowledged as a complex phenomenon, particularly in the context of adult community mental health services. Root cause analysis (RCA) is the dominant investigative approach, although the evidence base underpinning RCA is contested, with little attention paid to the patient in context and their cumulative risk over time. This study reviewed research in this area and found that recent literature proposes a Safety-II approach in response to the limitations of RCA.
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- Investigation
- Mental health - adult
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News ArticleThe ceiling of an intensive care ward collapsed onto a patient on life support and hours later a falling lift broke a doctor’s leg in a 24-hour snapshot of Britain’s crumbling NHS hospitals last week. Staff rushed to evacuate the ten-bed unit at the Princess Alexandra Hospital, in Harlow, Essex, and the local trust declared a major incident on Thursday morning as engineers carried out urgent safety checks and patients were moved to other wards. The next day, a surgeon was in a lift at the Royal London Hospital, in Whitechapel, east London, when the lift plummeted four floors. His leg was broken when the lift’s emergency brakes activated. Hospital managers shut down four other lifts pending a safety investigation. The day before, another lift in the hospital had also fallen. The incidents signify that “chickens are coming home to roost” after years of underinvestment in NHS facilities, Dame Meg Hillier, chairwoman of the Commons public accounts committee, said. “It’s a sign of the crumbling infrastructure, not just of our hospitals but of the whole country,” she said. “These are not conditions that patients or hospital staff should have to work in.” Read full story (paywalled) Source: The Times, 17 March 2024
- Last week
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Content ArticleThis Twitter thread summarises the views of Dr Ian Jackson, a retired consultant anaesthetist and former Foundation Training Programme Director, on the patient safety and training issues relating to Anaesthesia Associates (AAs). He highlights issues with the length of training AAs receive compared with anaesthetists, the difference in training individuals who have experience in healthcare and theatre roles and those who have not and the supervision model in the current AA scope of practice.
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- Physician associate
- Anaesthesia
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Content ArticlePeripheral nerve blocks (PNB) are safe and effective alternatives or supplements to general anaesthesia. They may improve pain control both during and after surgery, thus avoiding many of the side effects of systemic opioids. PNBs may also lead to improved patient satisfaction, decreased resource utilization, and may be better for the environment by decreasing usage of aesthetic gases and other medications. With the growing use of peripheral nerve blocks in the United States, this paper examines safety issues surrounding the procedures. It examines the safety of nerve blocks as it relates to: nerve injury recognition and treatment of local anaesthetic systemic toxicity (LAST) appropriate health care professional performance of timeouts to avoid wrong-site blocks.
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- Anaesthesia
- Adminstering medication
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Content ArticleNHS strikes have become such a familiar feature of our lives over the past two years that there is a risk we can become inured to their impact. This King's Fund article looks at the different ways in which strikes can impact the NHS and the people it serves.
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- Workforce management
- Organisational Performance
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C Horsey joined the community
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Content ArticleIn this video story, Gaylene tells the story of her hospital stay in 1987 when she was very seriously ill—so ill that her doctors thought she would die. She describes how her wishes not to have her family visit when she looked so unwell were not listened to, which resulted in a traumatic visit for Gaylene, her husband and her four children under the age of 5. She highlights the ongoing impact the event had on her family and the importance of good communication between patients and healthcare staff.
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- Person-centred care
- Patient engagement
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Content ArticleThis blog looks at evidence around the impact of universal masking in healthcare settings on infection rates. Highlighting a recent study carried out at St. George’s Hospital in London that showed universal to have a negligible benefit on infection control amongst patients, the author argues that it is time to move away from universal masking to masks being worn really carefully as part of PPE for dealing with respiratory symptoms.
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- Pandemic
- Infection control
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Content ArticleThe NHS will always need whistleblowers as healthcare is complex, rapidly changing and dangerous. However, whistleblowers continue to be treated very poorly by the health service, as this Private Eye special report highlights. The report looks in detail at several whistleblowing cases and how attempts to cover up mistakes and wrongdoing have resulted in patient deaths and devastated the careers and personal lives of staff who speak up for patient safety.
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- Whistleblowing
- Speaking up
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Su Davis joined the community
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Awroe joined the community
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Hannah Tearle joined the community
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Content ArticleThe stressful nature of the medical profession is a known trigger for aggression or abuse among healthcare staff. Interprofessional incivility, defined as low-intensity negative interactions with ambiguous or unclear intent to harm, has recently become an occupational concern in healthcare. While incivility in nursing has been widely investigated, its prevalence among physicians and its impact on patient care are poorly understood. This review summarises current understanding of the effects of interprofessional incivility on medical performance, service and patient care.
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- Organisational culture
- Just Culture
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Content ArticleDiagnostic delays in the emergency department (ED) are a serious patient safety concern. This retrospective cohort study included children treated at 954 EDs across 8 states, and examined the association between ED volume and delayed diagnosis of first-time diagnosis of an acute, serious conditions (e.g., bacterial meningitis, compartment syndrome, stroke). The researchers found that EDs with lower pediatric volume had higher rates of delayed diagnosis across 23 serious conditions.
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- Paediatrics
- Emergency medicine
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Content ArticleThis study in Surgery aimed to evaluate the association between trauma team function and cardiac arrest in hypotensive trauma patients. Trauma video review was used to collect data from resuscitations of adult hypotensive trauma patients at 19 centres, and 430 patients were included in the study. The results show that better team function is independently associated with a decreased probability of cardiac arrest in trauma patients presenting with hypotension. The authors suggest that trauma team training may improve outcomes in peri-arrest patients.
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- Medicine - Cardiology
- Teamwork
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