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    Professor Steven Yule, and the Surgical Sabermetrics Lab Group, invite you to a research seminar from Professor Denny Yu on: Innovative Approaches for Assessment of Non-Technical Skills in Surgery - Objective Metrics and Sensing. The seminar will take place on Friday, 10th of May at the Usher Institute (and virtual), from 2-3pm Edinburgh time (9-10am EST). This promises to be a fascinating talk. Please see the attached poster for further detail, and Professor Yu's bio. For those joining virtually, please find the meeting link below: https://ed-ac-uk.zoom.us/j/83539499634 Meeting ID: 835 3949 9634 Passcode: s7hs8fSq Surgical Sabermetrics Research Seminar Invite - Prof Denny Yu.pdf
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  8. Content Article
    In March 2024, the Professional Standards Authority (PSA) convened a roundtable discussion entitled ‘Accountability, fear and public safety’ to explore some of the recent NHS safety culture initiatives in England and their relationship with professional health regulation. In this blog, Anna van der Gaag, Visiting Professor in Ethics & Regulation at the University of Surrey, reflects on this discussion and how to bring the best of safety culture initiatives and the best of regulatory processes together to do more for patient safety.
  9. News Article
    The safety of a teaching hospital’s out-of-hours supervision has been questioned, including reports trainees were told not to ask for help “unless your patient is dying”. The General Medical Council put University Hospital Southampton Foundation Trust’s general surgery training under enhanced monitoring at the end of 2023 following a referral and quality management visit by NHS England South East, Workforce Training and Education – Wessex. The NHSE team’s visit and subsequent report said doctors in training had claimed senior staff were “not contactable” out of hours and there was “difficulty” in securing senior clinical advice, particularly on Sundays. The report added foundation year doctors were “discouraged” from contacting senior staff out of hours by “inappropriate” and “belittling” comments and behaviours, such as being told not to ask for help “unless your patient is dying”. Foundation doctors also reported starting rotation on call and conducting ward rounds without appropriate supervision. While the GMC open case is centred on patient safety concerns relating to supervising trainee doctors, the workforce and training directorate report also raised concerns about bullying, inappropriate sexual comments made by consultants, and a feeling that foundation doctors were unable to speak up. Read full story (paywalled) Source: HSJ, 1 May 2024
  10. Patient_Safety_Learning started following Lost in the system? NHS referrals
  11. News Article
    Increased reliance on imaging for diagnosis and efficient patient care mixed with higher volumes of patients has left US hospitals scrambling to meet demand with the few radiologists they have. There are over 1,400 vacant radiologist positions posted on the American College of Radiology's job board, according to a bulletin posted on its website. The total number of active radiology and diagnostic radiology physicians has dropped by 1% between 2007 and 2021, but the number of people in the U.S. per active physician in radiology grew nearly 10%, according to the Association of American Medical Colleges. An increase in the Medicare population and a declining number of people with health insurance adds to the problem. "Demand for imaging services is increasing across the country, creating longer worklists for radiology staff at the same time the healthcare system is experiencing a workforce shortage in radiology," Michigan Hospital Association CEO Brian Peters told The Detroit News in an April 28 report. "The combination of vacancies and increased demand can force imaging delays measured from days to upwards of two weeks." CMS also cut fees for both diagnostic (3%) and interventional radiology (4%) this year, according to an article published on healthcare technology company XiFin's website. This leaves many hospitals having to use external groups to stay on top of demand. Mr. Peters told Detroit News, "Hospitals and health systems are also competing with practices offering remote-only positions, which allows Michigan radiologists to work for out-of-state providers at higher rates." Read full story Source: Becker's Hospital Review, 29 April 2024
  12. News Article
    Medical devices should be judged more on the value they bring to a wider health economy than just the price of the items, according to draft Department of Health and Social Care procurement guidance seen by HSJ. The draft methodology, produced by Department of Health and Social Care’s MedTech directorate, outlines how “value” should be given a minimum weighting of 60 per cent while price should have a maximum weighting of 40 per cent when procurement teams are evaluating which products to buy. The “value” weighting will include a minimum of 10 per cent which must be applied to social value, which is already a requirement for all public procurements. This would reverse established practice across many procurements that sets the price of products or services as the most important factor, at times to the detriment of products that provide greater value to a health economy. It is intended to be used for all procurements of medical devices. It came from the 2023 MedTech strategy, which “identified that the value of medtech products should not be considered in isolation but across the whole patient pathway and that lowest price does not always translate to best value,” it said. The plan is for it to become one of a set of commercial ”playbooks” produced by NHS England as part of the implementation of its national commercial strategic framework, which it published in November 2023. The draft methodology should bring consistency to how the NHS judges value in a procurement and to the evidence suppliers produce to support their offering. This should mean effective products are adopted more widely and their system-wide benefits to patient pathways are realised at scale. Read full story (paywalled) Source: HSJ, 30 April 2024
  13. News Article
    A new trial to gather evidence on screening methods to detect prostate cancer is set to be led by researchers at Imperial College London, working alongside UCL, Queen Mary University of London and the Institute of Cancer Research. The £42million TRANSFORM screening trial, backed by charity Prostate Cancer UK, aims to find the best way to screen for prostate cancer and double the number of lives it could save. Previous trials using PSA blood tests and biopsies have shown that it is possible to prevent between 8% and 20% of prostate cancer deaths depending on how regularly patients are screened. But healthy people can potentially be harmed by this approach. Currently, there are more than 12,000 prostate cancer deaths in the UK alone, and this could mean thousands of lives saved each year in the UK. TRANSFORM will bring together leading prostate cancer researchers to test new approaches that have the potential to more than double the impact of screening, and ultimately reduce prostate cancer deaths by up to 40%. Read full story Source: Imperial College, 1 May 2024
  14. News Article
    Transgender women should not be put on single-sex female NHS wards, the government is proposing. The measure is part of a raft of changes to the NHS Constitution for England, the charter of rights for patients. The proposals stress the importance of biological sex for the first time when it comes to same-sex accommodation and intimate care. In both cases, the rights are available only where possible. For example, same-sex accommodation rights, which have existed for years, can and are breached where there is a clinically urgent need to admit and treat a patient and do not extend to areas such as critical care or accident and emergency. The guidance also means that trans men should not be housed on single-sex male wards. Under the proposals: transgender people, whose gender identity differs from their biological sex, may be provided single rooms, where appropriate patients will have the right to request a person of the same biological sex delivers any intimate care Health Secretary Victoria Atkins said it was about making it clear that "sex matters." She said, "We want to make it abundantly clear that if a patient wants same-sex care, they should have access to it wherever reasonably possible. By putting this in the NHS Constitution, we're highlighting the importance of balancing the rights and needs of all patients, to make a healthcare system that is faster, simpler and fairer to all." Labour's shadow health secretary Wes Streeting said: "Rights on paper are worthless unless they are delivered in practice. "The NHS constitution already pledges that no patient will have to share an overnight ward with patients of the opposite sex, but that is not the case for too many patients." Read full story Source: BBC News, 30 April 2024
  15. News Article
    Healthcare providers are failing to protect the privacy of people living with HIV, the UK’s data watchdog has warned. The Information Commissioner’s Office said it has been forced to hand fines worth thousands to organisations which have released the details of those living with HIV. Speaking with The Independent, Information Commissioner John Edwards, said: “It is a huge problem [within healthcare] and it’s a disproportionate amount of our business. “That’s partly because of the seriousness and the sensitivity of health information, the huge scale of the health sector and very many moving parts, with many opportunities for information to slip out as it moves from one place to another, and frankly, they’re just not doing well enough.” In a warning on Tuesday the watchdog highlighted specific concerns over HIV patients’ data being breached through the use of bulk emails in which staff have not used the blind copy function. The Information Commissioner said: “People living with HIV are being failed across the board when it comes to their privacy and urgent improvements are needed across the UK. We have seen repeated basic failures to keep their personal information safe - mistakes that are clear and easy to avoid." Read full story Source: Independent, 30 April 2024
  16. Content Article
    This narrative review aimed to investigate adverse events in trauma resuscitation, evaluate contributing factors and assess methods, such as trauma video review (TVR), to mitigate adverse events. The authors found that, when integrated with standardised tools, TVR shows promise for identifying adverse events. They suggest that future research should prioritise linking trauma team performance to patient outcomes and developing sustainable TVR programs to enhance patient safety.
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  23. News Article
    The number of young people receiving their MMR jab is up nearly a quarter from last year, official figures show. A national campaign to boost uptake was launched in January amid concern over measles rates in England, when the UK Health Security Agency (UKHSA) declared a national incident after a major outbreak in the West Midlands. The growth in infections shows no sign of abating, with a 40% increase in reported cases in England since March. The latest NHS England data shows more than 360,000 MMR jabs were administered in the 12 weeks to 24 March 2024, a 23% rise. The new campaign encourages parents and carers of children aged from six to 11 to make an appointment with their child’s GP practice so they can receive missed MMR vaccinations, and just over a million people aged 11 to 25 in London and the West Midlands have also been encouraged to catch up on missed jabs. In order to keep measles at bay, more than 95% of children should be vaccinated, but NHS figures from December suggest England is only at about 85%. With an estimated 3.4 million under-16s at risk of getting the virus, the campaign sent more than a million parents letters and emails inviting them to get their child vaccinated. Pop-up MMR clinics have been held in wellbeing buses, libraries and schools, pharmacies and outside supermarkets. But measles cases continue to rise. According to UKHSA figures released last week, there were 103 new cases in the past week. The number of laboratory confirmed cases since 1 October 2023 rose to 1,212 , an increase of 40% on March’s figures . In October 2023, there were just 17. The biggest increases in vaccination numbers were in the north-west, London and the West Midlands. Read full story Source: Guardian, 28 April 2024
  24. Content Article
    The NHS Constitution sets out the principles, values, rights and pledges underpinning the NHS as a comprehensive health service, free at the point of use for all who need it. The Department of Health and Social Care is seeking views on how best to change the NHS Constitution, as part of the process of completing its 10 year review. They are requesting feedback from patients, carers, NHS staff and the public on the proposals set out in this consultation document. This consultation closes at 11.59pm on 25 June 2024.
  25. Content Article
    This article tells the story of 61 year-old Susannah Constantine who was diagnosed with a rare neurological condition after her MRI was not looked at by her GP surgery for over a year. Susannah decided to have a private MRI when doctors couldn't diagnose why she’d been suffering from tinnitus and pins and needles in the fingers of her left hand. The results were sent to her GP, and Susannah heard no more, so struggled on for another year—she gradually became weaker and her muscles atrophied. She called her GP surgery to check if the MRI held any clues and learnt no one there had ever looked at the results—they had just been sat there for a year. She was told she needed to see a neurosurgeon immediately and was diagnosed with arteriovenous malformation (AVM), a rare neurological condition that disrupts the flow of blood and oxygen to the brain. If not spotted and treated in good time there is a one in three chance of suffering a brain haemorrhage, paralysis or stroke.
  26. Content Article
    Abbie experienced a high-risk pregnancy with her twin girls. They were born at 27 weeks gestation and weighed in at just 677g and 500g. After 150 nights in Neonatal Intensive Care Unit (NICU), both of Abbie’s daughters came safely home.  In this blog, Abbie highlights the importance of building a trauma-informed, clinical network around women whose babies have spent time in NICU. Drawing on her own experience and insights, she offers suggestions for how midwives, GPs and health visitors can support their mental health postnatally. 
  27. News Article
    People with type 1 diabetes are being forced to endure the “stress and anxiety” of insulin shortages, patients, pharmacists and health campaigners have warned. The “distressing” drug scarcity, the latest to affect the UK, is sowing uncertainty for the 400,000 people with the condition, with some products not available again until next year amid global manufacturing shortages. Britain is already contending with record numbers of medicines becoming hard or impossible to obtain, including those for attention deficit hyperactivity disorder and epilepsy. The Juvenile Diabetes Research Foundation (JDRF) said “a regular and reliable supply of insulin is essential for life” for people with type 1 diabetes. That is because their disease – an autoimmune condition unrelated to type 2 diabetes – means they cannot make insulin naturally and must inject it every day or receive it through a pump. The Department of Health and Social Care (DHSC) confirmed there were “supply issues with a limited number of insulin products” that patients might find “distressing”. One patient, an NHS doctor who puts vials of the drug into her insulin pump, said: “I spent the last two days trying to get hold of insulin to treat my type 1 diabetes. I was terrified when my usual, very reliable pharmacist told me he couldn’t get hold of my insulin. I had no idea that insulin could go out of stock. Type 1 diabetics fall ill and will die within a few days without insulin. I’m worried for fellow diabetics, not only to access the supply, to stay alive, but the stress and anxiety this causes.” Read full story Source: Guardian, 28 April 2024
  28. Content Article
    This Washington Post article looks at the lack of error and accident reporting in the US reproductive health and fertility industry. Unlike any other area of healthcare, no outside authority or agency regulates Never Events that happen at fertility providers. The authors highlight a case that allowed a glimpse into the industry, when legal action was taken against a San Francisco fertility centre where a storage tank imploded, damaging or destroying 4,000 human eggs and embryos. A jury later found that a manufacturing defect was largely to blame for the disaster but also implicated the actions taken by staff at the centre. The authors also highlight that patients are often asked to sign nondisclosure agreements as part of a legal settlement, which further restricts transparency when something goes wrong.
  29. Event
    The second Healthcare Fatigue Forum is being held on Tuesday 5th November 2024 at the Hyatt in Birmingham. Registration will open soon. This event will cover topics including the current state of fatigue risk management in the NHS, relevant and ongoing research, countermeasures and tools to mitigate fatigue. Attendees are invited to submit posters of research that is, or has, been undertaken in the field of fatigue management in health and social care workers.
  30. Content Article
    The health needs of the population are changing as it ages. Health services, particularly in secondary care, have traditionally been designed to deal with patients with a single disease, but for a growing number this is no longer a suitable model of care. Primary care has been at the vanguard of delivering more person centred and whole-person care, but many of the existing policy measures and incentives within it are outdated and aimed at managing single diseases. This report by Future Health sets out a series of recommendations for developing the Major Conditions Strategy to encompass a wider range of long-term and multiple conditions, putting patients rather than specific conditions at the centre. It also provides new data on the rising challenge of long-term conditions and in particular multiple long-term conditions.
  31. News Article
    Inga Rublite died after being found unconscious under her coat in an A&E waiting room more than eight hours after arriving. Learning what happened to Rublite in the hours before her death has been gut-wrenching for her friends and family. She sat through the night at Queen’s Medical Centre (QMC) in Nottingham after arriving at 10.30pm on 19 January with severe headache, dizziness, high blood pressure and vomiting. When her name was called seven hours later, at about 5.30am, she did not respond and staff discharged her believing she had tired of waiting and gone home. But over an hour later she was discovered having a seizure after falling asleep, and then unconscious, under her coat. She was rushed to intensive care but had suffered a brain haemorrhage, and the bleeding was so severe it was inoperable. She was declared dead two days later on 22 January, when her life support was switched off. Inga's twin sister said, “In all those years, the one time she went to the hospital to ask for help, no one was looking at her. I can’t describe how that feels. That you can’t get help in the place where you’re supposed to go for help.” Read full story Source: Guardian, 26 April 2024
  32. Content Article
    In this HSJ blog, Ken Jarrold highlights three key things he learned during his ten years as chair of NHS trusts: Focus on the people that matter—service users and frontline staff Keep an appropriate level of contact and relationship with the chief executive Live the values of the trust. He emphasises chairs keeping their focus on the people they serve and ensuring they feel at home interacting with staff and service users, as well as other leaders. He also states his hope that the Leadership Competency Framework for conducting annual appraisals of NHS chairs published by NHS England in February 2024, if applied appropriately, will result in improvements in how chairs serve their organisations.
  33. Content Article
    Fatigue is a perpetual risk in safety-critical industries. If that risk is not managed appropriately, it can result in a significant reduction in human performance, with associated impacts on safety. This paper from the Chartered Institute of Ergonomics & Human Factors (CIEHF) aims to present a roadmap for improving fatigue risk management in health and social care to improve patient safety and individual health workers' health and wellbeing. It makes a case for UK health and social care national bodies and organisations managing fatigue as a systemic risk.
  34. News Article
    NHS England is floating proposals to cut the elective waiting list by nearly 50 per cent to under 4 million over the next five years. HSJ understands this scenario is being discussed among system leaders as they brace themselves for the next government, whoever wins the general election, demanding a radical reduction in the waiting list. The list stood at 7.5 million as of the last official figures. The figure of just under 4 million is in part being targeted because this is the level NHS bosses estimate the list would need to be reduced to if the service is to return to meeting the standard that 92 per cent of patients referred are treated within 18 weeks, which has not been met since February 2016. Waiting list expert Rob Findlay estimated the required level would need to be closer to 3.5 million if the 92 per cent target is to be met. He told HSJ the list “would need to shrink to around 3.6 million before the statutory 18-week target became achievable again”. HSJ understands NHSE’s leadership believes a target of under 4 million could be credible—albeit likely dependent on targeted extra capacity, technology, resolution of strikes and on which other targets are set, especially around emergency waiting times. Progress could be accelerated by, for example, major outpatient reform to remove many appointments deemed unnecessary and use of technology to overhaul some pathways, officials believe. These could have a similar impact to the likes of faecal immunochemical testing, known as FIT, which is said to be playing a big role in reducing the cancer backlog. Read full story (paywalled) Source: HSJ, 26 April 2024
  35. News Article
    On Tuesday, the UK Covid inquiry which is sitting in Belfast for three weeks will start hearing from the most senior politicians and health advisors in Northern Ireland about why decisions were taken and by whom. This is module 2c of the inquiry, which is focusing on decision-making and political governance. This module will investigate Northern Ireland specifically and will include the initial response, central government decision making, and political and civil service performance. It will also probe whether Northern Ireland's political nuances had any affect on the effectiveness of the response. There were tensions between the political parties when senior Sinn Féin figures attended the funeral of ex-IRA leader Bobby Storey and when the DUP's Edwin Poots, then minister for Agriculture, Environment and Rural Affairs, said coronavirus was more common in nationalist areas. The hearings begin with opening statements and evidence from Covid-19 Bereaved Families and Disability Action. Core participants who have been named in advance include the former first ministers, Dame Arlene Foster and Paul Givan, and Michelle O'Neill, who was deputy first minster during the pandemic. Senior representatives from the departments of health, finance, the Executive Office, and the civil service will also be questioned. Read full story Source: BBC, 29 April 2024
  36. News Article
    The use of mixed-sex wards has gone “through the roof” after the number of men and women being put in beds next to each other soared to nearly its highest level in a decade. Official figures from NHS England show the government’s strict rules against doing so were broken nearly 5,000 times in February alone. NHS leaders voiced concerns over the high number of breaches and warned that care that was “unthinkable a decade ago is at risk of becoming the new normal”. Shadow health secretary Wes Streeting said patients were left feeling humiliated and at risk, adding: “The use of mixed-sex wards has gone through the roof under the Tories.” The government outlawed mixed wards in the NHS in 2010. Under the guidance, patients should not share wards overnight, share bathroom facilities or have to walk through areas occupied by patients of the opposite sex to get to the toilets. Despite promises more than a decade ago to eliminate mixed wards, The Independent found: 4,811 reported breaches in February, up from 3,789 last November Nurses warning “sky-high breaches” are the tip of the iceberg Evidence that patients are suffering sexual assaults while on mixed mental health wards Under the guidance, no mental health units should have mixed wards. However, earlier this year, The Independent revealed the practice is widespread, with more than 500 sexual assaults reported across almost half of the NHS mental health hospitals in England. Read full story Source: Independent, 28 April 2024
  37. Content Article
    A growing number of patients with eating disorders are reporting having treatment withdrawn by services, often without notice and without their consent. We spoke to eating disorder campaigner Hope Virgo about how pressures on services, enduring stigma around eating disorders and dangerous new narratives are leading to the practice of treatment withdrawal. Hope explains how this is affecting vulnerable patients and highlights that as the number of people developing eating disorders increases, the risks to patient safety will only get worse.
  38. News Article
    Sexual harassment levels in the NHS are “shameful”, with incidents happening all the time, one of the country’s top health chiefs has admitted. Dr Navina Evans, chief workforce officer at NHS England, urged leaders to act on shocking levels of sexual harassment, following exposes by The Independent. Asked about the one in eight workers who have reported unwanted sexual behaviour, she said: “It is shameful... I could tell you stories from my own experience from when I was a trainee right up to last year. Last year, the NHS published its “sexual safety charter” which requires organisations to commit to eliminating sexual harassment and assault among staff and patients. However, not all 240 NHS trusts have signed up to the charter yet, according to Dr Evans. She said: “It is really important that every organisation signs up.” The NHS staff survey this year found one in eight workers – around 58,000 – had reported experiencing unwanted sexual behaviour in the last 12 months, while one in 26 reported experiencing similar harassment from a work colleague. Read full story Source: Independent, 27 April 2024
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