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  1. Today
  2. Content Article
    Children being subjected to lethal medical experiments sounds like the plot of a dystopian horror film. Yet that is exactly what happened in the UK in the 1970s and 80s. New documents seen last week by the BBC reveal the extent to which children with haemophilia and other blood clotting disorders were enrolled in clinical trials, often without their parents’ consent. Most of them were infected with HIV or hepatitis C as a result of being treated with blood products that doctors knew could kill them. At one boarding school for boys with haemophilia used by the doctors conducting these trials, Treloar College in Hampshire, 75 out of the 122 pupils who attended between 1974 and 1987 have died as a result of their HIV or hepatitis C infections. The independent inquiry on the contaminated blood scandal estimated that 1,250 people contracted both HIV and hepatitis C as a result of these agents, and between 2,400 and 5,000 people hepatitis C alone. Others contracted these viruses after receiving blood transfusions following surgery or childbirth; it is thought that up to 100 people were infected with HIV this way, and 27,000 people with hepatitis C. Around 2,900 people have died so far. One gets a sense of the horrific trauma the state inflicted on people by reading the evidence those affected gave the inquiry.
  3. News Article
    Medical device companies are paying millions of pounds to hospitals in the UK to fund staff places, as well as training and awareness campaigns, while pushing sales of their products, including implants, heart valves and diagnostic equipment, a new report reveals. An analysis of disclosures by medical device companies found that between 2017 and 2019 they reported €425m (£367m at today’s rates) in payments to healthcare organisations in Europe, according to the study in the journal Health Policy and Technology. The businesses reported paying more than €37m to hospitals and other healthcare bodies in the UK over the three-year period. The disclosures include payments to some of the biggest hospital trusts in England. James Larkin, one of the authors of the study and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the filings did not include consultancy fees for medical staff and many companies did not register their payments. “This is just the tip of the iceberg,” he said. “There is a huge number of payments that are not being disclosed. The descriptions for payments which are disclosed are very vague and it is not completely clear what they are for.” Read full story Source: The Guardian, 20 April 2024
  4. News Article
    A failure to share medical information between IT systems contributed to the death of a man in prison custody, a coroner has concluded. In a newly published report on the death of Finlay Finlayson at HMP Lewes in 2019, the coroner highlighted “information sharing” problems and “permissions issues” between the prison IT system and that of the man’s GP surgery. Mr Finlayson died from blood clots in his lungs, having suffered from multiple long-term health conditions including cancer during his life. At the time of his death in 2019, health services at HMP Lewes were provided by Sussex Partnership Foundation Trust, though they are now provided by the Practice Plus Group. According to the Prevention of Future Deaths report issued last month, coroner Laura Bradford heard evidence that Mr Finlayson’s care was affected by “confusion and uncertainty about his medical conditions caused by information sharing and permissions issues with SystmOne”. It appears the GP practice had not enabled sharing of the data, which would have been required for it to be accessed in the prison. Read full story (paywalled) Source: HSJ, 22 April 2024 Further reading on the hub: NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn? The digitalising of patient records — why patients MUST be involved
  5. Content Article
    In this blog Dr Henrietta Hughes, Patient Safety Commissioner for England, outlines the activities included in the Patient Safety Commissioner Business Plan 2024-25.
  6. Content Article Comment
    Thank you very much for writing this account. I too admire your tenacity and courage in doing what is right. Being so transparent and open is new and scary for some organisations and people still so we need pioneers like yourself. The reactions I get around the country in response to using After Action Review with patients and families participating illustrates the same concerns. Some trusts are all for it, others, are very hesitant.
  7. Content Article
    'Vinney' died of pulmonary thromboemboli due to deep vein thrombosis with a background of metastatic carcinoma of the base of the tongue following cardiac arrest on 25 January 2019 at HMP Lewes (Cell 216 on C-Wing), whilst on remand. He was pronounced dead at 9.16 am. The jury considered that Vinney’s care was affected by the following issues, the absence of which may have delayed or changed the circumstances of his death. There was confusion and uncertainty about his medical conditions caused by information sharing and permissions issues with SystmOne, leading to an over reliance on Vinney’s own statements. Some poor record keeping on SystmOne and confusion over when to reference the system. This affected both plans and reporting of interactions. Failures in communication between agencies and shifts, not helped by the numbers of different staff and agencies involved, high demand and challenging workloads and associated delays in accessing healthcare. This was particularly relevant between 21 and 24 January 19. In particular a lack of quantifiable evidence, e.g. NEWS scores or notes of proportionate follow-ups and recorded observations between 21 and 24/1/19 which may have allowed any deterioration in Vinney’s condition to be missed. On 25/1/19, there was a grave and unacceptable failure in communications with two or three emergency radios switched off in contravention of prison rules and protocols. This was then compounded by a delay in timely response, i.e. the proposal of a phone call rather than an in-person response, which may have been longer had it not been for decisive intervention from comms. This was followed by unacceptable indecision on calling an ambulance, in which perceptions of Vinney’s mental health were a factor, and should have been automatic on account of his head injury.
  8. Content Article
    This podcast looks at preventing respiratory syncytial virus (RSV) outbreaks within healthcare facilities and strategies to minimise transmission of RSV among healthcare workers and patients during an outbreak. 
  9. News Article
    New figures have quantified what the pandemic has meant for cancer waiting lists—and the impact is stark. Official data show that 15,971 cancer patients in the UK have had to wait more than 124 days, or four months, after diagnosis for their treatment to start since 2020 as the pandemic sends waiting lists soaring. The statistics show that the number of untreated patients has more than doubled since Covid began, with one patient waiting for more than two years, according to data released following a freedom of information request from the Liberal Democrats. This is despite an NHS target for patients to receive cancer treatments within two months of an urgent referral. Last year, 6,334 patients waited more than 124 days, compared to 2,922 in 2022, the figures show. Data was received from 69 out of 137 acute health trusts in the UK, meaning the true number of people waiting long periods for treatment is likely to be much higher. Over 1,100 cancer patients last year were left waiting more than six months to receive treatment, triple the NHS target time. Liberal Democrat Leader, Ed Davey, said: “Every single one of these figures is a tragedy. Long delays for treatment can have a devastating impact on cancer patients and their families, and in certain cases can even cost lives." Read full story Source: inews, 22 April 2024
  10. News Article
    Hospital patients who are treated by women doctors are less likely to die and to be readmitted, a new study has found. Research, by UCLA, discovered the health of female patients is more advantaged by treatment from women doctors than it is for men. The study, published in the journal Annals of Internal Medicine, found the mortality rate for female patients was 8.15 per cent when treated by women physicians in comparison to 8.38 per cent when the doctor was male - which researchers deem a “clinically significant” difference. Meanwhile, the mortality rate for male patients treated by female doctors was 10.15 per cent - less than the 10.23 per cent rate for male physicians. Researchers unearthed the same pattern for hospital readmission rates. Professor Yusuke Tsugawa, one of the authors, said patient outcomes between male and female physicians would not be different if the professionals practiced medicine in the same way. “What our findings indicate is that female and male physicians practice medicine differently, and these differences have a meaningful impact on patients’ health outcomes,” he said. Read full story Source: The Independent, 22 April 2024
  11. Content Article
    Little is known as to whether the effects of physician sex on patients’ clinical outcomes vary by patient sex. This study examined whether the association between physician sex and hospital outcomes varied between female and male patients hospitalised with medical conditions. The findings indicate that patients have lower mortality and readmission rates when treated by female physicians, and the benefit of receiving treatments from female physicians is larger for female patients than for male patients.
  12. News Article
    The government has been accused of “deprioritising women’s health” as analysis shows that almost 600,000 women in England are waiting for gynaecological treatment, an increase of a third over two years. There are 33,000 women waiting more than a year for such treatment, an increase of 43%, according to Labour analysis of data from the House of Commons library. It found that there is no region in England that meets the government’s target for cervical cancer screening of 80% coverage, with just over two-thirds of women (68.7%) having been screened in the past five and a half years. Also, one in four women (26%) with suspected breast cancer waited more than a fortnight to see a specialist in the year to September 2023. Under two-thirds (66.4%) of eligible women have been screened for breast cancer in the last three years, with just two English regions meeting the 70% coverage target. The NHS target in England is that 92% of patients have a referral-to-treatment time of less than 18 weeks. The figures come after the government pledged to end decades of gender-based health inequalities through a new women’s health strategy for England. Read full story Source: The Guardian, 22 April 2024
  13. News Article
    Leaders of an integrated care system in the Midlands have warned they cannot make the scale of staffing cuts required to balance the books without putting patients at risk. Indicative analysis produced by Staffordshire and Stoke-on-Trent Integrated Care Board also found its provider trusts would have to cut 10 per cent of their workforce to break even. This would equate to 2,300 posts across University Hospitals North Midlands, Midlands Partnership Foundation Trust and North Staffordshire Combined Healthcare, while the ICB would have to cancel a “very high proportion” of third-sector contracts. The document says this “would bring our teams below safe staffing levels” and have a “profound effect on our ability to deliver safe services”. Read full story (paywalled) Source: HSJ, 23 April 2024
  14. Content Article
    Medical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. MedTech Europe, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system.
  15. Content Article
    In healthcare, an insidious epidemic lurks beneath the surface, affecting the very individuals tasked with providing care: vicarious trauma by empathy. Despite its profound impact, this phenomenon remains largely unrecognised and under-discussed within the sector. As leaders, it is imperative that we shed light on this invisible trauma and acknowledge it as one of the greatest challenges facing our industry, as Margarida Pacheco explains in her blog.
  16. Yesterday
  17. Event
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    This Safety for All webinar will present findings from a survey to investigate violence and aggression sustained by nursing and midwifery students in a UK university. The survey was conducted by the University of Plymouth and asked 37 questions to a sample of nursing students. The results of the survey highlight some worrying trends and in this webinar attendees will have the opportunity to find out what the concerning statistics were and what should be done to address them. The webinar will be presented by Dr Kevin Hambridge, Lecturer in Adult Nursing (Education), Francis Thompson, Associate Professor in Mental Health Nursing (Education) and Dr Matt Carey, Associate Professor in Child Health Nursing - Acute Care, all from the University of Plymouth. Register
  18. Event
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    Good health should be shared with all. It should not be damaged by social or economic disadvantage. Shared Health Foundation is inviting any GP or clinical lead who is working in the deep end of medicine to join its annual Doctors in Deprivation Training Day. The day aims to inspire, challenge, encourage and most importantly help participants find their tribe of other clinicians working in areas of deprivation. The training day will explore the challenges faced by those working in areas of deprivation and disadvantaged communities and share the hopeful work organisations in Greater Manchester and beyond are doing to reduce health inequalities and the impact of poverty on health. Attendees will: get to grips with the health inequalities that many people face, and how they can help put things right. learn about the causes and effects of health inequalities find out about the ways in which GPs and healthcare staff can do their bit to make a difference. Tickets to the training day are free of charge. Sign up for the training day
  19. Content Article
    Public confidence in the NHS is at an all time low and even when people can access the service, national surveys tell us that their experiences of NHS services are deteriorating. The authors of this blog—Patients Association Trustee Alf Collins and Health Consultant Richard Sloggett—make a simple plea: that all aspects of patient experience is taken seriously. They argue that the care backlogs and levels of unmet need require a radical re-orientation of the relationship between the Government, the health system and the public, and that this needs to involve a complete step-change in how patients are engaged in their care.
  20. News Article
    The shocking number of patients who are dying while under the care of stretched community mental health services can be revealed for the first time after a major NHS report was leaked to The Independent. More than 15,000 people are estimated to have died in a single year while being cared for by community mental health teams – as trusts scramble for staff and funding while the demand for care is at an all-time high. The figures, which relate to deaths between March 2022 and March 2023, can be revealed after a concerned insider handed the secret report to this publication. Health officials admitted the statistics had been collated for the first time last year in a bid to reduce deaths – but have not made them public. The leaked report reveals that: At least 137 women died between 2022 and 2023 while under the care of services for pregnant women at one unnamed trust. Nearly one in 10 of the patients treated by a crisis service – designed to help those with the most severe mental health conditions – died while under that care. One unnamed mental health trust recorded more than 500 deaths in that year-long period. Read full story Source: The Independent, 22 April 2024
  21. News Article
    The amount of time doctors have to spend doing compulsory training will be cut as part of an NHS drive to improve medics’ working lives, the Guardian can reveal. Concern that doctors have too heavy a burden of mandatory training has prompted NHS England to commission a review, which it is expected to announce imminently. It is aimed at reducing the need for doctors to undertake what for some can be up to as many as 33 sessions of training every year, depending on what stage of their career they are at. Each lasts between 30 minutes and several hours and together take about a day to complete. NHS bosses have briefed medical groups and health service care providers on the plan, which they hope will address one of the many frustrations that some doctors – especially recently qualified doctors – have about working in the service, alongside pay, constant pressure and poor working environments. Prof Sir Stephen Powis, NHS England’s national medical director, confirmed the review. “While statutory and mandatory training provides NHS staff with core knowledge and skills that support safe and effective working, we know that needing to repeat the same training courses every year isn’t the best use of a clinician’s time. So it’s right that we look to find ways to cut back on this, while still considering our legal obligations,” he said. “Cutting red tape and ensuring this type of training is only carried out when necessary – for example, when junior doctors move between hospitals – will not only be better for our staff, who will spend less time worrying about training to adhere to legal requirements, but will also benefit patients by freeing up clinicians’ time for care and treatment." Read full story Source: The Guardian, 22 April 2024
  22. News Article
    Managers at a hospital where police are investigating dozens of deaths promoted a consultant surgeon months after they allegedly assaulted junior doctors during surgery, the Guardian can reveal. Two female registrars at the University Hospitals Sussex NHS trust in Brighton sent written statements to the trust’s chief medical officer in March 2022 detailing how they were allegedly assaulted by the surgeon in separate incidents as they helped to operate on patients, leaked documents reveal. The incidents were not reported to the police and are not part of a separate Sussex police investigation into allegations of medical negligence and cover-up at the trust’s surgery and neurosurgery departments, involving at least 40 deaths and more than 60 incidents of patient harm. The consultant surgeon was alleged to have slapped one of the registrars across her face with the back of a hand. The other registrar claimed she was slapped on the hand and had surgical instruments snatched from her by the same person. The trust said its investigation found the surgeon’s actions were inappropriate but did not constitute assault and were taken in the interest of patient safety. The surgeon apologised to the registrars. The investigation concluded that, in the first incident, the registrar’s visor was blocking the consultant’s field of vision during surgery, causing them to instinctively push the visor away. In the second incident, it concluded that an instrument was taken from the registrar’s hand during a procedure for patient safety purposes. After these events, other registrars threatened to refuse to go into theatre with the consultant and pointed to other alleged examples of their bullying, sources claim. They had expected the consultant to be disciplined, given time off work and supported in changing their behaviour, the sources added. Instead, within a year of the complaints, the consultant was given a leadership role in the surgery department, despite the trust’s stated policy of zero tolerance for violence and aggression. Read full story Source: The Guardian, 22 April 2024
  23. Event
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    The theme for this year's The Private Healthcare Information Network (PHIN) forum underscores the pivotal role that advancements in AI, robotics, and data play in shaping the future of healthcare for the benefit of patients and everyone involved in the sector. The event is free to attend, but you need to book to guarantee your place. Register for the event
  24. News Article
    Lucy Letby is to apply for permission to appeal against her convictions for the murder and attempted murder of babies in her care. A panel of three judges at the Court of Appeal in London is due to consider the former nurse’s case later. The 34-year-old was handed 14 whole life terms last year. She was found guilty of murdering seven babies and attempting to murder a further six at the Countess of Chester Hospital between 2015 and 2016. Second stage Shortly after her trial ended in August, Letby applied for leave to appeal against her convictions. She lost the first stage of the process, in which a single judge reviewed her arguments as a paper exercise. Letby, originally of Hereford, now has the right to a second stage, which involves renewing her application before a panel of judges at a hearing at the Court of Appeal. Separately to the appeal, Letby is due to be re-tried on one charge of attempted murder, which the jury at her trial was unable to decide on. Read full story Source: BBC News, 2 April 2024
  25. Content Article
    This article explores the ‘the moment of patient safety’—the period around 2000 when patient safety became a key policy concern of the UK NHS and other healthcare systems. While harm caused by medical care (iatrogenic injury) had long been acknowledged by clinicians and scientists, from 2000 a new systemic language of patient safety emerged in the NHS that promoted novel managerial and regulatory approaches to patient harm. This language reflected the state’s increasing role in regulating healthcare, as well as the erosion of medical autonomy and the rise of new forms of bureaucratic management. Acknowledging a transnational, intellectual context behind the rise of policy interest in patient safety—for example, the application of insights from the industrial safety sciences—this article examines the role played by domestic cultural factors, such as medical negligence litigation and healthcare scandals, in helping to define the new language in Britain.
  26. Content Article
    Around 1.3 million people in England have a learning disability and may need more support to stay in good health. But are they able to get access to the services they are entitled to in order to prevent illness? This Nuffield Trust report looks at a set of five key preventive healthcare services and functions to understand whether they are working as they should for people with a learning disability.
  27. Last week
  28. Content Article
    The use of checklists as a tool to improve performance has proven successful in a variety of healthcare settings. For instance, checklists have been successful in preventing hospital-acquired infections and preventing errors in the surgical process. The use of checklists has also been recommended as a tool to reduce diagnostic errors. Diagnostic errors are frequent and often have severe consequences but have received little attention in the field of patient safety. Checklists are considered a promising intervention for the area of diagnosis because they can support clinicians in their diagnostic decision making by helping them take correct diagnostic steps and ensuring that possible diagnoses are not overlooked. This Agency for Health Research and Quality (AHRQ) issue brief summarises current evidence on using checklists to improve diagnostic reasoning.
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