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  1. Today
  2. Content Article
    This paper was presented to the NHS England board at its public session on 16 May 2024. It discusses the effect the pandemic has had on NHS productivity with details of NHS England’s estimates for the drivers of the loss of productivity observed. It also discusses the emerging plan to improve productivity in the coming years.
  3. Content Article
    The Royal Pharmaceutical Society want to hear from patients and/or their carers about the impact that medicines shortages have had on your lives. They would appreciate you taking the time to tell them of your experiences, by completing the following questionnaire. The questionnaire should take approximately 15-20 minutes to complete.
  4. Content Article
    This audit tool is designed to assess theatre compliance with the five steps to safer surgery, which includes the World Health Organization (WHO) Surgical Safety Checklist. The checks included in the five steps are designed to reduce the number of errors and complications resulting from surgical procedures by improving team communication and by verifying and checking essential care interventions. The tool features a monthly observation audit and documentation audit and presents recorded data in a results tab which tracks progress by month, providing more timely data locally than the clinical scorecard.
  5. Content Article
    This study, published in Human Factors in Healthcare, applied a human factors approach through the Systems Engineering Initiative for Patient Safety (SEIPS) model to inform the design of community cardiac diagnostic services, focusing on workforce design and the potential role of cardiac physiologists. The study setting was a cardiology department at a community hospital. Data were collected through observations, interviews and focus groups. Data were analysed using SEIPS and Thematic Analysis.The analysis revealed three overarching design considerations: (1) Promoting professional growth and autonomy for the cardiac workforce in the community. (2) Focusing on the needs of patients in the community, including accessibility and communication. (3) Facilitating communication across organisational boundaries, particularly between CDCs and General Practitioners (GPs).
  6. Content Article
    Medtech companies are continually developing new medical devices and products for use in healthcare, and ensuring that each one is safe to use should be the top priority of every company. In this anonymous blog, a nurse shares their experience of being employed by a start-up producing a new piece of equipment for use in cardiac surgery. They soon discovered their values did not match up, as the company prioritised getting their new product to market above patient safety. The writer talks about the personal cost of repeatedly speaking up for safety and describes the importance of working for an employer that sees patient safety as the top priority and recognises that it goes hand in hand with commercial success.
  7. Yesterday
  8. Content Article
    In Birmingham, eight out of 10 Somali children live in ‘poor’ households with low levels of economic activity and high rates of mental health issues, such as PTSD. In the UK, six in 10 (59%) people in the Somali community live in overcrowded accommodation, compared to fewer than one in 10 (8%) of the overall population. Meanwhile, studies show that many Somali people find it difficult to access health and social care services, due to language and socio-economic barriers. Suad Duale is a community activist, clinician, mother and researcher who grew up as a Somali refugee in Birmingham. In this blog for The King's Fund, she describes how unfair treatment of the Somali community leads to a collective lack of trust in professionals, particularly in the health system. She describes the issues contributing to the disparities faced by the community, including a lack of people from the Somali community in leadership roles who are able to advocate for the needs of the community. She describes the work of Dream Chaser Youth Club in Birmingham, where she volunteers by acting as a link to help people from the Somali community connect with health and care services.
  9. Last week
  10. Content Article
    This article by Saoirse Mallorie, Senior Policy Analyst at The King's Fund, looks at the detail behind the results of the 2023 NHS Staff Survey. She highlights that although it looks as though there has been improvement in some areas, staff satisfaction is not where it should be. The article also looks at variation between staff groups in terms of work-related stress, autonomy, belonging and workload, representing these differences visually in graphical form.
  11. Content Article
    NHS bosses are destroying the careers of whistleblowers who stand up to protect patients’ lives, according to an exclusive investigation by The Telegraph. More than 50 doctors and nurses told us they have been targeted after raising concerns about upwards of 170 patient deaths and nearly 700 cases of poor care. In this episode of The Daily T podcast, Kamal Ahmed and Camilla Tominey are joined by the journalists behind the story, Janet Eastham and Gordon Rayner. This discussion takes in the video from 2 minutes 52 seconds to 16 minutes 40 seconds.
  12. Content Article
    In this interview, Patrick Christys from GB News speaks to former Consultant Urological Surgeon, Peter Duffy, about the treatment of whistleblowers in the NHS who raise patient safety concerns. You can find out more about Peter’s experiences in his books Whistle in the Wind and Smoke and Mirrors. To watch the interview, click on the link below.
  13. Content Article
    Medicines waste is a significant problem in the NHS, with an estimated £300m wasted annually on unused or partially used medicines. In hospitals, this waste is added to when patients do not take their medicines home or when their medicines are not transferred with them as they change wards. In this blog for The Pharmaceutical Journal, Claire Williams, deputy clinical pharmacy manager at Hampshire Hospitals NHS Foundation Trust describes how her Trust reduced its medicines waste by moving patients’ medication with them and returning unused medication to the pharmacy in a timely manner. The Trust was participating in the Centre for Sustainable Healthcare ‘Green Team’ competition, and Claire and her colleagues saw it as an opportunity to showcase the impact that pharmacy can have in supporting the green agenda. This article is free to read but you will need to sign up for a Pharmaceutical Journal account to access it.
  14. Content Article
    This report commissioned by the US Agency for Healthcare Research and Quality aims to identify major themes related to the current state of diagnostic safety and highlight key gaps in knowledge. Through a rapid narrative review methodology to evaluate multiple resources in the literature and interviews with experts, it presents several findings that have implications for future resource investments to reduce harm from diagnostic errors. The report looks at the following key themes: Incidence and Contributing Factors Measurement: Data and Methods Cognitive Processes Culture, Workflow, and Work System Issues Disparities Health Information Technology Patients and Families Testing Interventions Implementation
  15. Content Article
    Large language models (LLMs) are a form of artificial intelligence that can generate human-like text and functions as a form of an input–output machine. They bring great potential to help the healthcare industry centre care around patients’ needs by improving communication, access and engagement. However, LLMs also present significant challenges associated with privacy and bias that also must be considered. This blog looks at three major patient-care advantages of LLMs, as well as the potential risks associated with using them in healthcare.
  16. Content Article
    FebriDx® is a single-use, analyser-free, point-of-care test with markers for bacterial and viral infection, measured on a finger-prick blood sample. As part of a larger feasibility study, this study explored the views of healthcare professionals (HCPs) and patients on the use of FebriDx® to safely reduce antibiotic prescriptions for lower respiratory tract infections (LRTI) in primary care. The authors concluded that the tool was perceived as a useful in guiding antibiotic prescribing and supporting shared decision making. Initial practical problems with testing and communicating results are potential barriers to use. Training and practice on using the test and effective communication are likely to be important elements in ensuring patient understanding and satisfaction and successful adoption.
  17. Content Article
    In this blog, Kristy Widdicombe-Dutch shares her decades-long experience of harmful healthcare that has left her with a complete loss of trust in the system. She describes how, starting in her 20s, she has experienced disbelief, gaslighting and poor care in relation to her vascular issues, which has left her with long-term physical harm and psychological trauma.
  18. Content Article
    Despite growing awareness of diagnostic error, most healthcare systems do not track or record diagnostic quality, and many diagnostic safety events are not recognised. Without methods to identify, measure, investigate and analyse events, healthcare organisations cannot understand causes of diagnostic errors, identify contributing factors or create solutions. One of the best ways to collect information about diagnostic errors is through self-reporting by patients and healthcare professionals. This issue brief from the Agency for Healthcare Research and Quality looks at how to foster psychological safety and organisational safety culture in order to reduce harm from diagnostic error. 
  19. Content Article
    Suicide and non-fatal self-harm represent key patient safety events in mental healthcare services. However, examples of optimal practice that help to keep patients safe also often important learning for organisations and healthcare professionals. This study in BMC Psychiatry aimed to explore clinicians’ views of what constitutes good practice in mental healthcare services in the context of suicide prevention. The study highlighted clinicians’ views on good practice specific to mental health services that focus on enhancing patient safety via prevention of self-harm and suicide. The authors concluded that clinicians possess important understanding of optimal practice, but there are few opportunities to share such insight on a broader scale. A further challenge is to implement optimal practice into routine, daily care to improve patient safety and reduce suicide risk.
  20. Content Article
    This report, commissioned by Alzheimer’s Society from Carnall Farrar, sets out estimates of current and future economic and healthcare costs of dementia in the UK. It breaks down this data by cost type, dementia severity and the regions of England and the devolved nations.
  21. Content Article
    This BMJ long-read article argues that health is going in the wrong direction in the UK, and reversing the trend requires political and societal commitment to deal with the underlying causes. It proposes evidence-based solutions to the worsening health and widening inequalities in the UK through action on the social determinants of health.
  22. Content Article
    The Safe Learning Environment Charter supports the development of positive safety cultures and continuous learning across all learning environments in the NHS. It is underpinned by principles of equality, diversity and inclusion. It has been developed by over 2482 learners, educators and key stakeholders in health education. The Charter was created by NHS England in response to healthcare learners’ feedback on their clinical experiences in maternity services, set out in the Kirkup (2015 and 2022) and Ockenden (2020 and 2022) reports. The Charter is designed for learners and those responsible for supporting placement learning across all learning environments and all professions within them. It is aligned to the NHS People Promise in recognition that learners are vital to the workforce and are included in the promises NHS staff and leaders must all make to each other, to improve everyone’s experience of working in the NHS. The Charter sets out the supportive learning environment required to allow learners to become well-rounded professionals with the right skills and knowledge to provide safe and compassionate care of the highest quality.
  23. Content Article
    In this blog, Miqdad Asaria, Assistant Professor at the Department of Health Policy at LSE, argues that AI could lead to a paradigm-shift in healthcare systems likes the NHS. He outlines how AI could help personalise medical treatments, enhance research and development of new drugs and help with the administrative burden currently undermining the productivity and efficiency of healthcare providers.
  24. Content Article
    This is the second ‘saving babies’ lives’ progress report from the Joint Policy Unit. When the first report was published in May 2023, the Unit committed to reassessing progress each year. Through this process it aims to hold government and decisionmakers to account, helping to ensure that saving babies’ lives and tackling inequalities in pregnancy and baby loss are the political priorities they deserve to be. This years report highlights that maternity services need a much more transformative approach from government, that matches the scale and impact of the issue. Maternity services are not on course to meet government ambitions to reduce rates of stillbirth, neonatal death or preterm birth, and there continue to be stark and persistent inequalities in rates of pregnancy and baby loss by ethnicity and deprivation. View a summary version of the report
  25. Content Article
    Kerri Mothersole was a 44 year old woman who had a past medical history of asthma, labyrinthitis, depression and back pain. In May 2020 she was seen with symptoms of possible early menopause and blood tests requested. In October 2020 she was noted to be suffering from tiredness and had irregular periods and again blood tests were requested. Blood tests taken in January 2021 noted a low haemoglobin and ferritin so iron was prescribed as well as follow up in two months. In March 2021 she complained of having per vaginal bleeding for six weeks and she was referred for an ultrasound. Due to her underlying ill health, she had difficulty in attending appointments and missed a number of different appointments. She was seen in the surgery on 21 June 2021 by her General Practitioner who noted abdominal tenderness and weight loss and he again referred her for an ultrasound. An ultrasound was undertaken by a private firm HEM Clinical Ultrasound on 28 June 2021 but the report was never sent to her General Practitioner. A second ultrasound on the 1 July 2021suggested a diagnosis of adenomyosis but noting that serious pathology could not be ruled out. Only the second report was sent to the General Practitioner which led to a routine gynaecology referral, she had however already been referred to the colorectal team on the urgent two week wait pathway. Had the earlier scan report been seen this would have led to an urgent referral to gynaecology. There were a number of missed appointments and a colonoscopy took place on 20 October 2021. The procedure was negative but the endoscopist thought he could feel something in the pelvis and a CT scan was arranged. The CT scan on 28 October 2021 demonstrated a large pelvic mass and she was referred to the gynaecology team in early December and a multidisciplinary team meeting discussion on 17 December 2021 led to a request for an MRI scan. Appointments were made for 31 December 2021, 25 January 2022 and again in February but not attended and she eventually underwent an MRI on 1 May 2022 which revealed a large mass. She was again discussed at the multidisciplinary team meeting on 6 May 2022 and referred to the gynae-oncology surgeons at Maidstone hospital. She was seen on 1 June 2022 and booked for surgery on 27 June 2022. She was, however, far too unwell for surgery on 27 June 2022 and further investigations revealed brain metastases. She was admitted to hospital and treated with steroids and referred to the Oncologists as surgery was deemed no longer appropriate. She was prescribed hormone treatment but she was, by now, too unwell to receive even palliative radiotherapy. She was taken to Medway Maritime hospital on 19 August 2022 and was struggling as she had been so unwell at home. Whilst plans were being made to provide some care at home she remained overnight but sadly died on 20 August 2022 as she was so unwell she could not return home.
  26. Content Article
    This report from Public Policy Projects (PPP) calls for changes in the use of approved medicines to improve diabetes care in the UK. It is the first in a series looking at specific areas of diabetes care in the UK.
  27. Content Article
    In April 2024 the World Health Organization published the Patient Safety Rights charter, outlining patients’ rights in the context of safety in healthcare. In this blog, Assistant Professor John Tingle and Teaching Fellow Angela Eggleton from Birmingham Law School at the University of Birmingham, consider the rights included in the Charter and applying this to the NHS.
  28. Content Article
    Diagnostic errors are associated with patient harm and suboptimal outcomes. However, despite efforts to advance definition, measurement and interventions for diagnostic error, diagnosis in mental health is not well represented in this ongoing work. The authors of this article, published in BMJ Safety & Quality, summarise the current state of research on diagnostic errors in mental health and identify opportunities to align future research with the emerging science of diagnostic safety.
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