Jump to content

All content

Showing all content.

To sort the content by type, date or tags you will need to be logged into the hub. Join the hub today to enjoy full member benefits.

This stream auto-updates

  1. Past hour
  2. Content Article
    Currently, it is estimated that more than one in five people in the UK are living in poverty. This King's Fund analysis reveals that people living in poverty find it harder to live a healthy life, live with greater illness, face barriers to accessing timely treatment, and die earlier than the rest of the population. The analysis looks at the link between poverty and each of the following: prevalence of ill health difficulties accessing health care late or delayed treatment poorer health outcomes. The long read argues that while the NHS can, and should, do more to make timely care accessible to deprived communities, wider government and societal action is needed to address the root causes of poverty.
  3. Today
  4. Content Article
    The Government is in the process of reforming the way that health and care professionals are regulated. It is planning to change the legislation for 9 out of the 10 healthcare professional regulators that the Professional Standards Authority (PSA) oversees, giving them a range of new powers and allowing them to operate in a very different way. The changes the Government intends to roll out will give regulators greater freedom to decide how they operate, including introducing the flexibility to set and amend their own rules. There will also be changes to regulators’ powers and governance arrangements. The changes will also create an entirely new process for handling fitness to practise (the process by which concerns about healthcare professionals are dealt with). The PSA support the reforms to healthcare professional regulation but have also identified certain risks that may arise from the new ways of working. PSA has developed guidance that they are now consulting on. The presentation slides attached are from a recent PSA roundtable and give further information on the changes, PSA guidance and the consultation. PSA are seeking views from everybody with an interest in healthcare professional regulation, including patients, the public, registrants, regulators, professional bodies and employers. The consultation is open until 5.00 pm on Monday 15 April 2024.
  5. News Article
    The BMA has called for an independent inquiry into the use of physician associates (PAs) on medical rotas in place of doctors. The union said that health secretary Victoria Atkins must launch the investigation ‘to get to the bottom of the scale’ of the issue across the NHS, as doctors have been reporting instances where gaps in medical rotas are being filled by PAs. This is happening on top of NHS England ‘investing heavily’ in the use of PAs in primary care, ‘instead of qualified experienced doctors’, the BMA added. On Friday The Telegraph reported on leaked rotas from more than 30 hospitals showing physician associates taking on doctors’ shifts. This coincided with new NHS England guidance to ‘emphasise that PAs are not substitutes for doctors’, as they are ‘supplementary members’ of the team and they ‘should not be used as replacements for doctors on a rota’. BMA chair of council Professor Philip Banfield said: ‘We know from our members’ experiences that hospitals are putting physician assistants on medical rotas, in place of medically qualified doctors. ‘This is on top of NHS England investing heavily in the use of physician associates in primary care, instead of qualified experienced doctors. "In our view, Victoria Atkins now has a duty to patients and a duty to medically qualified staff – doctors – to establish how widespread this practice is and more importantly, stop it." Read full story Source: Pulse, 18 March 2024 Further reading on the hub: Partha Kar: We need a pause to assess safety concerns surrounding Physician Associates
  6. News Article
    A secret report has warned that the NHS is failing to protect trainee paramedics from widespread sexual harassment and racism at work, The Independent has revealed. A confidential NHS England report uncovered by The Independent has found that “extremely alarming” conduct and undermining behaviour are rife in ambulance trusts across the country, with trainees subjected to derogatory comments about their age, ethnicity and appearance in front of patients. There is a “worrying acceptance” that this is “part of the job”, with students hesitant to raise complaints about sexual behaviour by male colleagues in case it gives them a reputation as “annoying snowflakes”, the report says. The revelations come after a recent NHS staff survey revealed that thousands of ambulance staff had reported unwanted sexual behaviour from colleagues and patients last year. One healthcare leader described the findings as “harrowing”, warning that much more needs to be done to protect junior staff. The national report, which is understood to have gone through several edited versions and is marked commercially sensitive, was not due to be released until The Independent obtained the document through a freedom of information request. It found an “undercurrent” of bullying in some areas, with examples of students leaving their jobs as a result of inappropriate behaviour. Trainees reported feeling undervalued and unwanted while on the job, with one apparently told: “Your concerns don’t matter – we have to meet patient demands.” Ambulance handover delays have also led to student paramedics having less experience and training on the job, prompting fears that newly qualified paramedics do not have sufficient levels of experience in life-critical situations. Read full story Source: The Independent, 19 March 2024
  7. Content Article
    Nottingham 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.
  8. Content Article
    This 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.
  9. Content Article
    In this opinion piece, Partha Kar describes patient safety issues relating to a planned increase in the number of Physician Associates (PAs) working in the NHS in England. Highlighting safety concerns being raised by healthcare professionals and members of the public, he calls for a pause to the planned expansion to allow these issues to be investigated. He outlines the need for a clear scope of practice, standardised training, full regulation and clear communication with all stakeholders, including the public.
  10. News Article
    NHS doctor Chris Day has won the right to challenge a tribunal decision which raises questions about information governance in NHS hospital trusts and the use of digital evidence by employment tribunals. Day blew the whistle on acute understaffing at a South London intensive care unit linked to two patient deaths in 2013. His decade-long legal campaign has since exposed the lack of statutory whistleblowing protections for nearly 50,000 doctors below consultant level in England. An appeal tribunal in February refused Day the right to challenge key aspects of an earlier tribunal ruling that cleared Lewisham and Greenwich NHS Trust (LGT) of deliberately concealing evidence and perverting the course of justice when one of the trust’s directors “deliberately” deleted up to 90,000 emails midway through a tribunal hearing in July 2022. Day’s high-profile case nevertheless continues to raise questions about information governance practices in NHS hospital trusts and the degree of scrutiny applied to digital evidence retention and disclosure practices at UK employment tribunals. The 2022 tribunal heard that LGT communications director David Cocke had attempted to destroy up to 90,000 emails and other electronic archives that were potentially critical to the case as the hearing progressed. However, any remaining documents among the tens of thousands of emails and electronic archives, which NHS trust lawyers told the tribunal had been “permanently” destroyed, are likely still to exist and be recoverable, according to an expert consulted by Computer Weekly. Read full story Source: Computer Weekly, 19 March 2024
  11. Yesterday
  12. Content Article
    The 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.
  13. Content Article
    The 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.
  14. News Article
    A 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
  15. News Article
    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
  16. News Article
    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
  17. Content Article
    The 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.
  18. News Article
    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
  19. Content Article
    Getting 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.
  20. Content Article
    In 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.
  21. News Article
    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
  22. Content Article
    The 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.
  23. News Article
    Gripping 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
  24. Content Article
    Serious 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.
  25. News Article
    The 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
  26. Last week
  27. Content Article
    This 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.
  28. Content Article
    Peripheral 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.
  29. Content Article
    NHS 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.
  1. Load more activity
×
×
  • Create New...