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Keep up to date with the latest news, research and activity in patient safety.

Poorer families denied millions in compensation over maternity failings

Poorer families are being denied millions of pounds in compensation from the NHS for maternity care failings compared with wealthier families, The Independent can reveal.
Families whose babies experience brain damage due to negligent maternity care can receive multimillion-pound payouts to cover costs relating to the child’s future care and accommodation, based on their medical need.
But a separate element covering the child’s predicted “loss of future earnings” is calculated on the basis of their family’s existing income and education levels, meaning that more affluent families get more cash.
Critics have condemned the system as “unfair”, highlighting the fact that it gives the least financial support to the families who “need it the most”, and have called for earnings payments to be linked to the average wage.
Two-thirds of NHS spending on compensation cases goes on maternity claims, according to NHS Resolution, the body that deals with compensation awards. Payouts for maternity negligence cost the taxpayer £2.6bn in 2022-23, the latest figures show, with the total cost of harm, including loss of earnings, valued at £6.6bn. Both figures were up on the previous year.
The Medical Defence Union (MDU), which represents doctors in negligence cases, has described the system as “flawed”. It believes loss of earnings payments should be capped at three times the average wage, annually – and that “parental education, earnings or wealth should play no part in the assessment of damages awarded to minors”.
Read full story
Source: The Independent, 22 February 2025
Patient Safety Learning

New mum says maternity treatment was 'humiliating'

More than 250 people have come together in a Facebook group to share stories of issues they have experienced with maternity care.
All of the women were treated at Oxford's John Radcliffe (JR) Hospital, which is run by Oxford University Hospitals NHS Foundation Trust (OUH).
Among them is Oria Malik, who told the BBC that following a "tough" labour her aftercare was "humiliating" and left her feeling "very vulnerable".
Ms Malik gave birth at the JR seven months ago, and said what began as a positive experience "quickly turned" after her pain levels were ignored.
"I just felt really isolated because I couldn't communicate to anyone how much pain I was in," Ms Malik said.
"I told the midwife that I felt the need to push at 7am, and she said 'oh no, you're not in labour, you're fine' - but my body needed to push a baby out at that point."
While inserting a cannula into Ms Malik's arm following the birth, one nurse was "so rough" with her hand that she "ended up with a blood clot" in her vein that has "still not really healed".
Separately, Ms Malik said a maternity support worker consistently left the curtain open to her space on the ward.
She said: "There were people and families in the bed's opposite who could see me laying in a bed - I didn't have any clothes on."
"There was no privacy - I found it really humiliating and [it made me feel] very vulnerable."
Read full story
Source: BBC News, 24 February 2025
Patient Safety Learning

Measles, once eliminated in the USA, rises in Texas and New Mexico

Nearly 100 people across Texas and New Mexico have caught measles, state officials said, escalating anxiety over the spread of a potentially life-threatening illness that was declared eliminated in the United States more than two decades ago.
Ninety cases of measles — the majority affecting children under age 17 — were detected in Texas’s South Plains, a sprawling region in the state’s northwest, the Texas Department of State Health Services said Friday. The spread marks a significant jump from the 24 cases reported earlier this month. The DSHS warned that “additional cases are likely to occur in the outbreak area and the surrounding communities.”
The United States had declared measles eliminated in 2000, meaning the disease had not spread domestically for more than 12 months. It credited the achievement to widespread inoculation campaigns after the vaccine became available in 1963.
However, the national vaccination rate for measles has dropped in recent years, particularly during and after the coronavirus pandemic. 
Most cases recorded this year have occurred in people who were unvaccinated or whose vaccination status was unknown, the CDC said.
The disease’s comeback has occurred in tandem with the rise of anti-vaccine rhetoric propagated on social media and among some public officials.
Read full story (paywalled)
Source: The Washington Post, 24 February 2025
Patient Safety Learning

‘Alarming’ data reveals high diabetes risk for pregnant women in English jails

Pregnant women in prison in England are three times more likely to be ­diagnosed with gestational ­diabetes than those on the outside, according to “alarming” new data.
Figures obtained through freedom of information (FOI) requests to NHS trusts providing healthcare to women’s prisons in England found 12% of women receiving care relating to pregnancy in 2023 were diagnosed with the condition, triple the national figure of 4%.
Laura Abbott, associate ­professor in midwifery at Hertfordshire University, said these figures were “alarming but not surprising”.
“We have known for many years that preterm birth is more common among ­incarcerated pregnant women, and this ­further highlights the severe health risks they face,” she said. “Gestational diabetes increases the risk of high blood pressure and pre-eclampsia, serious conditions that require early detection, good nutrition and careful obstetric management, which is extremely difficult in a prison setting. It can also increase the risk of stillbirth.”
There were 215 pregnant women in prison in England between April 2023 and March 2024, according to figures published by the Ministry of Justice. There were 52 births while in custody, 98% of which took place in hospital.
The NHS and Prison Ombudsman categorise all pregnancies in prison as high risk. Pregnant women in prison are seven times more likely to have a stillbirth and twice as likely to go into premature labour, according to data from FOI requests in 2022. In 2019, newborn Aisha Cleary died at HMP Bronzefield after her mother, who was in prison on remand, was left to give birth alone in her cell.
Read full story
Source: The Guardian, 23 February 2025
Sam

MS patients suffer side-effects after NHS England switches to cheaper drug

Scores of people with multiple sclerosis (MS) have suffered debilitating side-effects after being put on to a cheaper new drug as part of an NHS drive to save money.
About 170 MS patients at Charing Cross hospital in London have had complications, including a relapse of their illness, after being switched from Tysabri to a different drug called Tyruko, made by the pharmaceutical company Sandoz.
In a handful of cases, the people affected developed such serious symptoms that they had to be taken to hospital for treatment. Patients have told doctors about side-effects including an inability to use their legs, other mobility problems, fatigue, pain and sudden weight gain.
It is unclear how widespread the adverse reactions to Tyruko are. NHS England said the problem has only been seen at the London hospital. However, one of the patients there claimed to know of people with MS being treated at 15 other hospitals in England who have experienced similar setbacks to their health after being moved on to Tyruko after sometimes years taking Tysabri.
Problems have arisen since NHS England began moving patients across the country with very active relapsing remitting MS from Tysabri on to Tyruko, a “biosimilar” drug, last April. A biosimilar is a version of a drug that has fallen out of patent, allowing other pharmaceutical firms to legally make a medicine that is as safe and effective as the original but on average 72% cheaper.
The side-effects from Tyruko are causing so much concern within the health service that NHS England is in discussion with the Department of Health and Social Care (DHSC) and the Medicines and Healthcare products Regulatory Agency (MHRA) about what to do.
A spokesperson for Sandoz said: “Patient safety is our first priority. We are seeking to understand the situation at Imperial healthcare NHS trust, which appears to contrast with the experience of patients at other UK hospitals. We believe it’s premature to draw conclusions at this point. We continue to work with the NHS and regulatory authorities to resolve this.”
Read full story
Source: The Guardian, 24 May 2025
Sam

If we can’t learn from errors, families relive tragedy for nothing

It was in a coroner’s court last year, at the inquest into the death of his 27-year-old daughter Maeve, that Sean O’Neill heard the most dispiriting words. The coroner, Deborah Archer, said she was going to write a prevention of future deaths (PFD) report, highlighting to the NHS and other agencies areas of concern. Then she added: “I write a lot of these reports, and often nothing happens.”
Maeve died after suffering for half her life with myalgic encephalomyelitis (ME), a post-viral condition that is not well understood, inadequately researched and which doctors often refuses to recognise or treat.
Sean's aim was to use the media to highlight what happened to Maeve and raise awareness of the plight of the hundreds of thousands of people whose lives are limited by ME and similar conditions. His second aim was to convince the coroner to write a PFD report and point out areas in healthcare, medical research, education and training where action could be taken that might prevent further such deaths.
The written responses to Archer’s PFD report have been underwhelming. The public health minister, (the recently resigned) Andrew Gwynne, promised an NHS delivery plan. NHS England said it would do a “stocktake” of ME services, even though there had been evidence at the inquest that such services are scarce, and in the cases of severely ill patients, “non-existent”. The Medical Research Council said it “recognises the unmet clinical need for better diagnosis and treatments for people living with ME” but defended its record to date.
In 2023 there were more than 1,600 inquests that had been open for more than two years; often these are the most difficult cases, yet bereaved families face being repeatedly traumatised by every preliminary hearing and legal letter.
As in Maeve’s case, the best hope for a family is that a PFD report points the way to reform. A coroner is not allowed to recommend, only suggest. Yet only rarely are these reports written. 
Those coroners who do write reports often find their suggestions ignored. Just under 40% of the 5,532 PFD reports published since 2013 have received no responses. There is no other section of the legal system in greater need of reform. There should be a national coronial service, more PFD reports should be written and lessons should be disseminated. What is the point of investigating avoidable deaths — of making bereaved families relive their trauma, of spending millions of public pounds — unless we are prepared to learn how to avoid similar fatal errors?
Read full story (paywalled)
Source: The Times, 23 February 2025
Sam

NHS failings and lawyers have destroyed memories of our baby, say parents

Losing Ben at the age of eight weeks in the paediatric intensive care unit of the Bristol Royal hospital for children in the spring of 2015 was traumatic and heartbreaking for Jenny and Allyn Condon.
In the 10 years since, they say their pain has not eased but, if anything, has been made more acute by the way they have been treated by a health trust as they campaigned to find out why Ben died.
“It has destroyed me,” said Jenny, who tried to kill herself and has post-traumatic stress syndrome. “I’m a broken woman. I’m in constant fight or flight.”
Speaking at the end of a two-week inquest that concluded on Friday – which laid bare failings in Ben’s care and was often contradictory, complex and, as his parents see it, adversarial – Allyn said their precious memories of Ben had been taken away by the approach of the trust that runs the hospital.
Ben was born prematurely on 17 February 2015. In April, he developed breathing difficulties and was taken to the children’s hospital, where doctors diagnosed human metapneumovirus (hMPV), a respiratory infection. He declined rapidly, had two cardiac arrests on 17 April and died.
The Condons were immediately told that no postmortem examination was needed as the cause of death was straightforward. Doctors recorded acute respiratory distress syndrome (ARDS), hMPV and prematurity on his death certificate and his body was cremated. But several weeks after Ben died his parents were told that he also had a bacterial infection.
A first inquest, in 2016, concluded that two respiratory illnesses and prematurity caused Ben’s death, but the next year, after the Condons continued to press, the University Hospitals Bristol and Weston NHS Foundation Trust admitted that a failure to give him antibiotics in a timely manner for the bacterial infection contributed to his death.
In 2021, the NHS ombudsman said Ben died after “a catalogue of failings” in his treatment and there was an attempt to “deceive” his parents. The high court quashed the conclusions of the first inquest and a new inquest has taken place at Avon coroner’s court near Bristol.
On Friday, the coroner who has heard the second inquest, Robert Sowersby, backed the Condons’ belief that the death certificate and conclusion of the first inquest were incomplete.
Sowersby, the assistant coroner for Avon, stated that between 14 and 16 April consultants decided not to give Ben antibiotics. Sowersby said: “I find Ben should have been given antibiotics by 16 April at the latest,” and added that if he had been given antibiotics it would have stopped the pseudomonas infection entering his bloodstream.
The coroner said some medics had a “patronising approach” to Ben’s parents and that Jenny and Allyn were not told what was going on or why and were not involved in important decisions. He said it was “hard” to understand a delay in telling them how sick Ben was.
Sowersby said: “A lot of mistakes were made. The actions of various employees who were involved in Ben’s care or in subsequent investigations understandably aroused suspicion and contributed to the family’s inability to believe anything they were being told.”
Read full story
Source: The Guardian, 21 February 2025
Sam

CQC must pay £500,000 after provider wins High Court challenge

The Care Quality Commission has been criticised by the High Court for failing to follow its own conflict of interest policy, after a legal challenge by a mental health provider.
Cygnet, the private inpatient mental health provider, instigated the judicial review against the regulator, accusing it of failing to follow its conflict of interest policies in its choice of inspector.
The CQC will now have to review its report into one of the Cygnet-run sites, the Acer Hospital in Chesterfield. It was given an “inadequate” rating, an unusual outcome for a focused inspection, and put into special measures over risks to patients and poor staffing.
The inspector at the centre of the case – who cannot be named because of reporting restrictions – had previously been detained in two hospitals run by Cygnet in 2012-13 – and had complained about his care and treatment.
The former mental health nurse went on to become a CQC inspector and started to inspect facilities run by Cygnet in 2019.
At a court hearing, Cygnet argued seven inspection reports on five of its sites, and enforcement action taken against one of them, were affected by the inspector’s apparent bias. The CQC had previously refused to review these reports and enforcement action, the provider said.
Read full story (paywalled)
Source: HSJ, 24 February 2025
Sam

USA: HHS issues guidance recognising only 2 sexes in one of Kennedy's first moves at health agency

The Department of Health and Human Services (HHS), under the leadership of Robert F. Kennedy Jr., will define sex as an "immutable biological classification" and only recognise two sexes, male and female, according to guidance issued this week.
The guidance builds on President Donald Trump's executive order that instructed the federal government to officially recognize only a person's sex at birth and to stop recognizing the concept of gender identity. The HHS released the guidance to the U.S. government, external partners and the public.
"The guidance recognizes there are only two sexes: male and female. HHS will use these definitions and promote policies acknowledging that women are biologically female and men are biologically male," officials said Wednesday in a press release issued by HHS.
RFK Jr. assumed his role as HHS secretary last week, and the guidance marks one of his first policy moves.
“This administration is bringing back common sense and restoring biological truth to the federal government,” RFK Jr. said in a statement. "The prior administration’s policy of trying to engineer gender ideology into every aspect of public life is over.”
The American Academy of Pediatrics is one medical organization that recognizes not everyone fits into the narrow definitions of male or female.
In a fact sheet released this month, the American Society for Reproductive Medicine wrote that legislation and proposals "to define sex into two easily determined categories are unsupported by science and oversimplify the intricate nature of human biology."
"It is crucial to understand that biological sex is determined by biology, not politics," ASRM wrote.
Major medical groups also support gender-affirming care for transgender individuals, which is comprised of a range of social, behavioral and medical interventions, the latter of which include puberty-blocking medications, hormone treatments and, in rarer cases, surgical procedures.
Read full story
Source: Fierce Healthcare, 19 February 2025
Patient Safety Learning

Healthcare execs confront safety as a purpose

Surveying the US healthcare landscape, some leaders are wondering, what if safety was valued as a purpose, rather than a priority? 
Patricia Gaffigan, senior advisor on patient and workforce safety for the Institute for Healthcare Improvement (IHI), voiced this question at an IHI conference in December. She said priorities are at risk of being reduced to a set of improvement projects — like fleeting goals, or something beholden to a start and end date. 
When asked to describe the difference between safety as a priority and safety as a purpose, leaders from UCSF Health, M Health Fairview, Inova Health System and Jefferson Health told Becker's that while priorities are important, they can deprioritise other plans, or even be deprioritised themselves. 
"We, like all health systems, have a mission," said Chapy Venkatesan, chief quality and safety officer of Fairfax, Va.-based Inova. "The center component of our mission is world-class healthcare. So that is really our purpose. Safety is part of that purpose."
Read full story
Source: Becker's Clinical Leadership, 18 February 2025
Patient Safety Learning

USA: Sepsis soared 50% after Texas banned abortions

After Texas banned abortion in 2021, sepsis rates increased more than 50% for women hospitalized after losing their pregnancies in the second trimester, according to a ProPublica analysis. 
The outlet previously reported on the deaths of three pregnant women who were denied timely care due to the state's restrictive abortion laws. In September, the Texas Maternal Mortality and Morbidity Review Committee, which examines all pregnancy-related deaths, decided to not examine cases from 2022 to 2023 and instead review more recent deaths. 
In a first-of-its-kind data analysis, ProPublica found that, compared to prepandemic years, dozens more pregnant and postpartum women died in Texas hospitals. 
When abortion was legal in the state, the sepsis rate hovered at about 2.9%. After abortion was banned, the rate of sepsis increased to 4.9%. 
Texas outlaws abortion with the exception of medical emergency cases, but healthcare providers in the state have expressed confusion and hesitance about the exception's parameters. Some physicians have said their hospitals do not allow them to empty the uterus — the standard of care for patients miscarrying in the second trimester — until they can diagnose a life-threatening complication or the fetal heartbeat stops. 
This sepsis risk increase was most striking for patients whose fetus may have had a heartbeat when they entered the hospital, ProPublica reported.
Read full story
Source: Becker's Hospital Review, 20 February 2025
Patient Safety Learning

New elective contract ‘unworkable’, say providers

New national payment rules for private providers of elective care are “unworkable” and will undermine patient choice, the sector is warning.
Independent sector sources say NHS England’s proposed 2025-26 contract, which will cap the amount commissioners will pay for elective activity, will effectively force private hospitals to treat some NHS patients for free.
The proposed 2025-26 payment scheme says integrated care boards will set a “payment limit” for elective services, “above which [value] the commissioner is not required to make further payments” to providers.
However, it also says the limits do “not cut across patient choice rules, as providers would continue to be obliged to accept referrals and to offer patients choice on where they get their treatment”.
Private sector leaders told HSJ it effectively meant they could have to treat patients who choose them for free if their cap is reached. Sector sources said it was financially unviable for providers, and one branded the proposals “unworkable”.
Read full story (paywalled)
Source: HSJ, 21 February 2025
Patient Safety Learning

App spots patients at risk and moves them up the NHS waiting list

Software developed in Cambridge is helping nine hospitals to prioritise care, saving lives and freeing beds sooner
Hospitals are using artificial intelligence to select high-risk patients to go to the front of the 7.5 million-long NHS waiting list. Software trained on more than 200 million records in 46 countries considers blood pressure, age, respiratory rate and where a patient lives to give them a risk score. Its introduction is part of increasingly urgent efforts by the health service to manage record numbers of patients stuck on waiting lists for routine treatment. Many will be deteriorating while they wait.
 This month The Sunday Times revealed that thousands have died, gone blind or suffered serious injuries, including having limbs amputated, because of delays and failures in their care. The problem is costing almost £900 million a year in negligence payouts. 
 The NHS last hit its target to treat most patients within 18 weeks of being referred from their GP in February 2016. Now trusts are experimenting with new ways to balance the risks of such large waiting lists after the pandemic.
 AI software developed by the Cambridge-based company C2-Ai is being used in nine hospitals in Cheshire and Merseyside; similar tools are being piloted elsewhere.
 The technology helps identify patients who have a high risk of deteriorating while they wait, or who might struggle to recover after major surgery. These people are given help to improve their health while waiting and can be prioritised for surgery sooner.
 Almost 1,000 patients have benefited from interventions such as health coaching before and after surgery. The approach has almost eradicated post-op chest infections and halved the rate of other complications. It has also reduced the amount of time patients are staying in hospital by more than four days — meaning beds are free for those waiting in A&E or others needing routine surgery.
 One of those who is benefiting is Tim Ashcroft, a 74-year-old businessman who was diagnosed with oesophageal cancer in 2023. After six weeks of chemotherapy, Ashcroft, from Winsford, Cheshire, had surgery to remove his oesophagus and possible cancer of the colon. After the surgery he had a stoma — an opening in the abdomen — which led to a double hernia; he was put on a waiting list to have the procedure reversed.
 Ashcroft had lost five stone since the initial surgery. In October, the C2-Ai technology flagged him as a potential risk and he was given a referral to use a phone app, Surgery Hero, which provides tools for exercise, tracking food intake and mental health support. The app linked Ashcroft with a dietitian who helped manage his nutrition and maintain his weight. They also spoke to consultants to bring forward his surgery, which he is hoping to have in the coming weeks.
 “It gave me a sense that I can look after my health while I wait, and that’s important especially as waits are so long at the moment,” Ashcroft said. “If this is a process which can generally save time and save lives … I don’t think anyone would object to that.”
 Rowan Pritchard Jones, medical director of the Cheshire and Merseyside NHS region, said it was right for the NHS to prioritise higher-risk patients. “We really need to think more smartly about the risk that is sitting on our waiting lists,” he said. “Nobody gets better while waiting but there are certain groups of patients who disproportionately deteriorate while they wait — patients whose [mortality risk] might move from 15 per cent to 45 per cent.”
 According to Cheshire and Merseyside, 40 per cent of its highest risk patients — those living with a number of conditions or diseases at the same time — come from the 20 per cent most deprived members of the population. Pritchard Jones said: “We have patients to worry about here, patients who will do badly. Let’s think about stratifying patients by risk.”
 C2-Ai’s technology is not the only innovation being tried to spot patients at higher risk from waiting times.
 In Coventry, the cardiologist Kiran Patel developed an algorithm to identify patients who had higher clinical risks and underlying social and demographic factors that meant they should be prioritised for treatment. It took into account whether a person had made repeat visits to A&E and whether they lived in a deprived area or had other health conditions. Patel, now chief medical officer at University Hospitals Birmingham, believes similar approaches could be considered there. “We know from the evidence that people are dying more from non-pandemic related issues and deprivation of care,” he said. “So that evidence is out there, and the fact that we have long waiting lists, and the fact that there are millions of people on there, would suggest that it’s inevitable some may be dying.”
 The approach is likely to prove controversial, particularly if it is used to prioritise patients according to factors such as getting them back to work.
 Jo Andrews, a consultant anaesthetist and chief medical officer at the consultancy Carnall Farrar, said: “If we look at the national challenge around people who are off work sick, we need to go after the things where it’s going to make the greatest difference. “That requires a difficult conversation with people, because you would be saying to the 75-year-old waiting for their hip replacement who can’t play golf, ‘Sorry, you’re going to have to wait a bit longer’, because the 65-year-old who can’t work and is the sole breadwinner for their family needs to take priority.”
From The Sunday Times
Clive Flashman

Top trusts failed mortuary security checks

Some of England’s most prestigious trusts have been caught with inadequate security for their mortuaries — despite recent high-profile breaches, HSJ can reveal.
In a national exercise last August and September, the Human Tissue Authority (HTA) found 37 out of 128 mortuaries checked were non-compliant with its licensing standards, while a further 64 had to be issued with advice in order to meet them. Only 27 were declared compliant.
Mortuary security shot up the agenda when maintenance supervisor David Fuller was jailed for violating the bodies of more than 100 women and girls in hospital mortuaries for more than a decade.
An inquiry set up to look into how he was able to carry out the assaults was highly critical of access controls at Maidstone and Tunbridge Wells Trust, where he worked, and is due to report later this year on the security of mortuaries and funeral directors nationally.
Meanwhile, the HTA, which licenses premises for post-mortems and similar uses, stepped up its focus on mortuary standards last year with a series of unannounced inspections, due to the severity of shortfalls it was finding.
Read full story (paywalled)
Source: HSJ, 20 February 2025
Patient Safety Learning

Norovirus hospital cases reach highest level ever

There are a record number of patients in hospital with Norovirus in England.
Data from NHS England showed 1,160 patients a day on average were in hospital with the vomiting bug last week – double the level at the same period last year.
It comes after a 22% rise on the week before, pushing it to the highest level since records began in 2012. It means more than 1% of beds are occupied by patients ill with the bug.
But Norovirus puts added pressure on hospitals because of the need to isolate and clean infected wards – nearly 300 empty beds a day were taken out of action because of this.
NHS England medical director Prof Sir Stephen Powis said: "It is concerning to see the number of patients with Norovirus hit an all-time high and there is no let up for hospital staff who are working tirelessly to treat more than a thousand patients each day with the horrible bug, on top of other winter viruses.
"To help stop the spread of Norovirus, it is important to remember to wash your hands frequently with soap and water and avoid mixing with other people until you have not had symptoms for two days."
Read full story
Source: BBC News, 20 February 2025
Patient Safety Learning

Poorest more likely to get cancer – and to die from it

Cancer death rates are 60% higher in the UK’s most deprived areas, new research shows, with the poorest more than 50% more likely to be diagnosed after a trip to A&E than their wealthiest counterparts.
A new report from Cancer Research UK has found that there are more than 28,000 extra cancer deaths a year linked to deprivation, and that people living in the poorest areas are up to a third more likely to wait more than 104 days to begin treatment despite an urgent referral.
Those in the most deprived group are also less likely to take part in national screening programmes, and half as likely to receive cutting-edge treatment than people in the least deprived group.
While cancer care for many has broadly improved over recent decades – last year more cancers were caught at earlier, more treatable stages than ever before – there are huge disparities in care, as the new research shows.
Dr Ian Walker, executive director of policy and information at Cancer Research UK, said cancer treatment and outcomes should be the same for everybody, regardless of their postcode or their income.
“No one should be at a greater risk of dying from this devastating disease simply because of where they live. These figures are shocking and unacceptable – but crucially, they’re avoidable,” he said.
Read full story
Source: The Independent, 21 February 2025
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