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When GP practices have a patient who is violent or exhibiting behaviour that makes them fear for their safety, the patient should immediately be removed from the practice list. This guidance from the BMA explains how to do this as well as outlining the special allocation scheme (SAS), which provides primary care medical services in a secure environment to patients who meet the criteria. In the SAS, designated GP practices provide services to patients by appointment at specific locations and times as detailed in individually agreed contracts. Patients join the scheme after being immediately removed as a result of an incident that was reported to the police. It aims to protect GPs, practice staff and patients who have the right to be in the practice without fear of intimidating behaviour. 

The National Association for Healthcare Security (NAHS) was formed in 1994 as a UK non profit-making professional organisation. The NAHS operates in a single national network and aims to support and enable healthcare provision through the delivery of professional security management; promoting and ensuring members are best placed and equipped to provide a safe and secure environment for their organisations staff, patients and visitors. This process ultimately enhances and improves staff wellbeing and the healthcare environment along with improving the quality of a patient’s treatment journey. The website includes a library of resources relating to security in healthcare settings.

Accurate and accessible medical information is key to successful patient-centred care, which can be supported by the availability of easy-to-understand summaries of articles published in medical journals. In this short Lancet article, Mohamed Seghier of Khalifa University of Science and Technology, makes the case for plain language summaries that enable clinically useful research to be understood by the general public.

In January 2024, the Institute for Healthcare Improvement (IHI) Lucian Leape Institute convened an expert panel to explore the promise and potential risks for patient safety from generative artificial intelligence (genAI). This report is based on the expert panel’s review and discussion.

This cohort study in JAMA Network Open aimed to determine whether US Food and Drug Administration (FDA) warnings to prevent prenatal exposure to valproic acid are associated with changes in pregnancy risk and contraceptive use. The study examined 165 772 valproic acid treatment episodes among 69 390 women and found that pregnancy rates during treatment remained unchanged during the 15-year study, and were more than doubled among users with mood disorder or migraine compared with epilepsy. Contraception use among users was uncommon, with only 22.3% of treatment episodes having a 1-day overlap of valproic acid and contraception use. The authors argue that these findings suggest a need to review efforts to prevent prenatal exposure to valproic acid, especially for clinical indications where risk of use during pregnancy outweighs therapeutic benefit and safer alternatives are available.

This US cross-sectional study in JAMA Network Open aimed to find out whether there is a difference in reported inappropriate antipsychotic medication use between severely and less severely deprived neighbourhoods, and whether this difference is modified by greater total nurse staffing hours. The study included 10,966 nursing homes and found that nursing homes that fell below critical levels of staffing (less than three hours of nurse staffing per resident-day), were associated with higher inappropriate antipsychotic medication use among nursing homes in severely deprived neighbourhoods (19.2%) compared with nursing homes in less deprived neighbourhoods (17.1%). These findings suggest that addressing staffing deficiencies in nursing homes, particularly those located in severely deprived neighbourhoods, is crucial in mitigating inappropriate antipsychotic medication use.

According to the United Nations Convention on the Rights of the Child, all children have the right to the highest attainable standard of health “without discrimination of any kind”. The UK has committed to upholding this right—but not all children in the UK are equally protected. Racism is a known risk factor for health in children, ranging from preterm birth and low birthweight, to major depression and asthma, and childhood is a vital period that can shape health throughout the life course. The authors of this Lancet article report on a roundtable discussion convened by Race & Health and the Race Equality Foundation in October 2023. The discussion focused on racism in the UK health system, with the aims of identifying key areas of exposure to racism in the UK health system for children, and the main barriers to uprooting racist structures and practices in the health system. The roundtable recommended the following immediate actions: Adopt a human rights-based approach that upholds children's rights to the highest attainable standard of health without discrimination and abolish policies that undermine these rights for minoritised children. Incorporate anti-racist health and research practice into the health system's functioning and commissioning, including by increasing engagement during decision making, and co-creation of processes, policies, and procedures with minoritised communities to foster greater trust. Integrate anti-racist training within health-care curricula to ensure that the next generation of health workers have the information and skills to recognise and combat racism in the health system. Embed professional accountability to uphold anti-racist principles and practice into the health system, including by embedding anti-racism within the annual appraisal process as a professional requirement. Ensure that data and evidence collected and valued by the health system incorporate the voices and inputs of communities, delivering epistemic justice. End structural discrimination in institutions and systems that shape children's interactions with the health system, including social care systems, and separate policing and prison systems from health care. Uphold equality, diversity, and inclusion commitments and funding and allocate funding to dismantle racism and white supremacy in the UK health system. Co-create anti-racist and anti-oppressive services with minoritised communities, providing a viable alternative to oppressive systems and structures.

This Lancet study examines the discrepancy between occurrence of Long Covid as perceived and reported by participants in longitudinal population-based studies and evidence of Long Covid recorded in their EHRs. The authors argue that this discrepancy might reflect substantial unmet clinical need, particularly amongst patients of non-White ethnicity. This is in keeping with reports from individuals with Long Covid of difficulties accessing healthcare, and poor recognition of and response to their illness when they do.

The last two decades have seen substantial advancement in the practice of team-based, safe care delivery. In parallel, burnout has been recognised as prevalent among US doctors and influenced by workplace structure and experiences. This study assessed US doctors’ perceptions of team-based care delivery and safety climate within their institutions and how these domains were associated with burnout.

This cross-sectional study in JAMA Network Open aimed to explore whether prescribing of psychotropic medications for children and adolescents changes in the two years following the onset of the Covid-19 pandemic. The authors retrieved and analysed all 8,839,143 psychotropic medication prescriptions dispensed to individuals aged from 6 to 17 years in France between 2016 and 2022. They found steady increases in prescription trends for all psychotropic medications after the pandemic onset, with prescription rates of all psychotropic medication classes except psychostimulants higher than expected rates.

This investigation by the Health Services Safety Investigations Body (HSSIB) considers how patient safety can be improved in relation to children and young people with mental health needs while they stay on an acute paediatric ward—a ward for children and young people in a hospital that typically treats physical health conditions. It focuses on the risk factors associated with the design of these wards in acute hospitals.