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

Revolutionary gene-editing therapy for sickle cell ‘offers hope of a cure’ for NHS patients

NHS patients with sickle cell disease will be able to benefit from a groundbreaking gene-editing treatment that offers the prospect of a cure for the condition.
The one-off gene therapy, known as exagamglogene autotemcel (or ‘exa-cel’), has been approved for use on the NHS in England by the National Institute for Health and Care Excellence (NICE) for older children and adults with a severe form of sickle cell disease.
Clinical trials suggest exa-cel can stop painful and unpredictable sickle cell crises – the most common symptom of sickle cell disease – where blood vessels become blocked causing severe pain, with experts saying the therapy offers patients a chance of disease-free life.
Researchers concluded there was a ‘functional cure’ in 96.6% of exa-cel trial participants that received it.
NHS chief executive, Amanda Pritchard, said: “More than a step, this is a leap in the right direction for people with sickle cell disease – which can be an extremely debilitating and painful condition.
“This innovative, gene-editing therapy offers hope of a cure for people facing a severe form of the disease and could be absolutely transformative – it could enable patients to live free from the fear of sickle cell crises hanging over them.
“It is just the latest in a series of revolutionary gene therapies NHS England has secured for patients, and we are funding this new treatment option straight away so patients can benefit from the enhanced quality of life it offers.”
Read full story
Source: NHS England, 31 January 2025
Patient Safety Learning

Care home safety ratings can’t be trusted, says watchdog boss

The public can no longer trust safety ratings when choosing a care home for elderly parents, the new head of England’s care watchdog has admitted.
Sir Julian Hartley, the chief executive of the Care Quality Commission (CQC), said the problems applied across NHS hospitals, care homes and other health and social care facilities. The regulator has “lost its way” with many of its reports now years out of date, he said.
A new IT system brought in to streamline the inspection process didn’t work, meaning that reports were lost and information could not be recorded. In some cases the system failed to note actions in responses to safety concerns raised with the CQC so staff are having to go back over a backlog of 5,000 alerts.
Hartley said the system had been “a complete failure in terms of what it set out to achieve”. A review has been launched and he promised it would be made public.
He aid the issue was a matter of public confidence. “If you’re thinking about where to put your mum in a care home you want to have reliable information that’s up to date. Effectively the CQC is not delivering on its operational performance. It’s not delivering for people that use services and patients.”
Read full story (paywalled)
Source: The Times, 1 February 2025
Patient Safety Learning

USA Medicare Advantage prior authorisation rates keep climbing

The number of prior authorisation determinations issued by Medicare Advantage insurers continued to grow in 2023, according to a new report from KFF. 
The report examines data from 2023, the latest year available. That year, Medicare Advantage insurers made 49.8 million prior authorisation determinations, or 1.8 per Medicare Advantage enrolee. 
Virtually all enrolees in Medicare Advantage (99%) are required to obtain prior authorisation for some services – most commonly, higher cost services, such as inpatient hospital stays, skilled nursing facility stays, and chemotherapy. This contrasts with traditional Medicare, where only a limited set of services, including certain outpatient hospital services, non-emergency ambulance transport, and durable medical equipment, require prior authorisation.
Prior authorisation requirements are intended to ensure that healthcare services are medically necessary by requiring approval before a service or other benefit will be covered. Medicare Advantage insurers typically use prior authorization, along with other tools, such as provider networks, to manage utilisation and lower costs. 
Medicare Advantage insurers denied 3.2 million, or 6.4%, of prior authorisation requests in 2023.  The percentage of denied prior authorisation requests declined from 2022, when Medicare Advantage insurers denied 7.4% of requests that year. 
Read full story
Source: Becker's, 29 January 2025
Patient Safety Learning

Government abandons commitment to hit cancer, mental health and A&E targets

The government cannot commit to meeting national cancer, A&E, diagnostic, mental health and ambulance waiting time targets by the end of this Parliament, Wes Streeting has told HSJ.
The health and social care secretary made the admission in an interview in which he also questioned the wisdom of creating NHS England and pledged to support controversial service cuts.
Prime minister Keir Starmer has confirmed his intention to hit the 18 week elective waiting time target by 2029, but government has given mixed messages on whether it would do the same for the other constitutional standards — which have largely gone unmet for about a decade.
He said: “I can’t say hand on heart I will definitely deliver those targets over the course of the Parliament. Or that it would be fair to set that expectation on NHS leaders.”
However, Mr Streeting added: “The constitutional standards matter. They are there for a reason and I know the frustration the public feel about the NHS not being there for them when they need it is also felt acutely by staff, who are confronted with the grim reality of what that means for patients.”
NHS England and the Department of Health and Social Care yesterday revealed they would shrink their organisations, and consider more joint working. 
He said although he would not legally scrap NHSE, there would be more change to “eliminate waste and duplication” across the two and on “clarifying roles and responsibilities in the coming months”.
“As far as I’m concerned, the [department] is responsible for policy and strategy… and we drive improvement through the delivery organisation which is NHS England.”
Read full story (paywalled)
Source: HSJ, 31 January 2025
Sam

Staff seen dragging children in hospital

Staff in a children's hospital were caught on CCTV footage abusing patients by dragging them, according to a health watchdog's report.
Care Quality Commission (CQC) inspectors found three cases where children were physically abused by staff at Cygnet Joyce Parker Hospital in Coventry.
The report said children told inspectors staff "sometimes bent their wrist" or hurt them by "twisting their knee".
The hospital said it continued to "strongly refute" any allegations of abuse and police had ended an investigation into safeguarding cases. 
The hospital, run by Cygnet Health Care Limited, has changed its use since the inspection and now only provides services to adult male patients.
The report, after a CQC visit to the 43-bed mental health unit in July, said inspectors reviewed CCTV footage for three cases of restraint where children were physically abused by staff.
"Staff were observed dragging children and young people during these incidents," they said.
"For all three incidents reviewed, there was no apparent risk requiring restraint presented by the young person."
They added there was no evidence of staff trying to de-escalate the situation before restraining the children.The report said footage identified 12 members of staff as "passive bystanders" who did not raise concerns.Read full story
Source: BBC News, 30 January 2025
Sam

World-first warning system launched in UK in bid to stop future pandemics

A world-first genetic warning system to stop future pandemics has been launched in the UK.
The surveillance programme, run by the UK Health Security Agency (UKHSA), will see experts rapidly checking NHS samples for pathogens that could lead to serious outbreaks.
It is thought it could also stop emerging diseases.
Experts believe if such a system had been around pre-Covid-19, the virus would have been spotted much more quickly and there would have been early signs it was taking root in the UK.
Traditionally, genomic methods rely on scientists or medics knowing what virus or bacteria they are looking for when they test a swab sample.
But a more detailed method – known as metagenomics – means they do not need to know what the pathogen is, and they can test samples to find new ones.
All this information is also now being fed to the UKHSA at a national level, bringing together samples from NHS hospitals across England to spot trends and emerging clusters of disease.
Read full story
Source: The Independent, 30 January 2025
Sam

Children in UK suffering ‘irreversible harm’ due to physiotherapy delays

Children in the UK are suffering “irreversible harm” and lifelong consequences as a result of “unacceptable” delays in accessing physiotherapy, experts have warned.
Teenagers face lifelong trauma from untreated chronic pain while children as young as four are waiting 18 months for critical treatment, according to a survey of paediatric physiotherapists.
Lengthy delays to treatment while children’s bodies are still growing can have seriously harmful repercussions for their health that can last decades.
Some families are being forced to travel more than 200 miles for NHS physiotherapy services because of delays or a lack of access where they live. Others are having to go private to ensure their children get the urgent care that they need.
The Association of Paediatric Chartered Physiotherapists (APCP), a professional network of members of the Chartered Society of Physiotherapy, surveyed 155 staff across the UK who specialise in treating babies, children and teenagers.
Sara Hazzard, assistant director at the Chartered Society of Physiotherapy, said children waiting for rehabilitation for illnesses and injury were experiencing harm and distress that could last a lifetime.
“The fact that this is happening up and down the UK is not just unacceptable, it is failing a generation.”
Staff shortages and cuts to services were causing the delays, while at the same time the NHS was failing to create enough new posts to meet the “overwhelming” demand for care, Hazzard said.
“Families should not fear for their child’s health and future because they can only get help and rehabilitation if they can afford to pay. Urgent action is needed.”
Read more
Source: The Guardian, 31 January 2025
Sam

Returning to ‘good’ regulation and looking ahead

Care Quality Commission (CQC) Chief Executive, Julian Hartley, has been reflecting on his first 6 weeks in the role and looking ahead to the focus for the coming months. 
In a recent blog, Julian said that the CQC are taking some immediate actions to make sure they can publish reports, carry out more assessments, clear their registration backlog, and ensure they've acted promptly on information of concern and notifications.
At the same time as delivering these immediate actions, the CQC will also deliver a foundational piece of work to re-focus on their purpose and ensure that they have the right values that guide their work. This will involve developing a set of behavioural expectations for how CQC will work together with providers, the public and stakeholders. 
Alongside all of this, CQC are currently in the process of recruiting four permanent chief inspectors.
The changes they're making are focused on enabling CQC to complete more and better-quality assessments at a faster pace. This will provide a more up-to-date view of quality across health and social care.
Read full story
Source: Medium, 27 January 2025
Patient Safety Learning

Systemic issues identified within mental health services

A new report from the Health Services Safety Investigations Body (HSSIB) has shed light on significant systemic issues within mental health services, highlighting a persistent culture of fear and blame, and a lack of patient and family involvement, which obstruct effective learning from inpatient deaths.
The HSSIB report scrutinises how mental health providers learn from deaths occurring in inpatient units and within 30 days post-discharge. The investigation reveals multiple processes involved in learning from deaths, including the Learning from Deaths Framework, coroner's inquests, and investigations following patient safety events.
The report indicates that there are substantial challenges in maintaining safety, conducting effective investigations, and ensuring system-wide learning. It identifies that investigations and patient safety event analyses, although intended to promote transparency and learning, often suffer from variable quality. Local investigations frequently lack comprehensive information and fail to observe clinical work practices in real-time, hindering a complete understanding of care delivery.
A critical revelation of the investigation is the prevalent culture of blame within mental health services. Patients, families, and organisations often fear safety investigation processes, which are perceived as punitive rather than educational. The report underscores that patient safety investigations rarely account for the emotional distress experienced by those involved, leading to compounded harm.
Read full story
Source: National Health Executive, 30 January 2025
Patient Safety Learning

Staff wellbeing, community care and mental health targets axed from 2025-26 NHSE guidance

More than a dozen national priorities have been dropped from the national planning guidance, but several new targets for 2025-26 have been revealed.
The government and NHS England said the 2025-26 planning guidance features fewer priorities than last year’s edition so that local leaders can have greater freedom in how they balance their budgets, and meet the core priorities of improving elective, emergency and primary care performance in the context of a very tight financial settlement.
The most significant targets dropped from the 2025-26 list of objectives include:
All the workforce objectives included in the 2024-25 planning guidance have been removed. They were to improve “the working lives of all staff and [increase] staff retention and attendance”, especially those of “doctors in training”, and to “provide sufficient clinical placements and apprenticeship pathways”. The 2025-26 guidance, however, does ask the service to continue a focus on retention. “Improve community service waiting times, with a focus on reducing long waits.” The removal of the target comes amid a sharp rise in children waiting more than a year, and two years, for help from community services. Increase the percentage of cancers diagnosed at stages 1 and 2 in line with the 75% early diagnosis ambition by 2028. Several mental health priorities have been cut from the guidance. They include increasing access to adult community mental health and perinatal mental health, and ensuring that people with severe mental illness or a learning disability receive a physical health check. A target to increase dementia diagnosis has also been dropped. Implementing the “patient safety incident response framework”. This is thought to have been widely implemented already Read full story (paywalled)
Source: HSJ, 30 January 2025
Patient Safety Learning

Bowel cancer prediction test for IBD patients 90% accurate

A new method for detecting bowel cancer is more than 90% accurate at predicting which higher-risk people will develop the disease, according to research.
About 500,000 people in the UK live with inflammatory bowel disease (IBD), including Crohn's and ulcerative colitis.
Currently, they are offered regular checks for pre-cancerous growths in their gut, which, if detected, indicate about a 30% chance of bowel cancer developing over 10 years.
But the UK research found DNA changes in those pre-cancerous cells, when analysed by an algorithm, were more than 90% accurate in predicting who would develop bowel cancer over the next five years.
Prof Trevor Graham, from the Institute of Cancer Research in London, said: "Most people with ulcerative colitis or Crohn's disease won't develop bowel cancer.
"But for those that have these conditions and are showing signs of pre-cancer in their colon, there are some tough decisions to make.
"Either they have it monitored regularly, in the hope that it doesn't become cancer, or they have their bowel removed to guarantee they don't get cancer in the future.
"Neither of these options are particularly pleasant.
"Our test and algorithm give people with IBD, and the doctors who care for them, the best possible information so that they can make the right decision about how to manage their cancer risk."
Read full story
Source: BBC News, 30 January 2025
Sam

'Not at heart of NHS': Fears women's health hubs could be reduced in new targets

The NHS “doesn’t always have the needs of women at its heart”, the head of the service has admitted to MPs.
Amanda Pritchard, chief executive of NHS England, insisted that women’s health is a “priority” following criticism over plans to scrap a number of targets – including a pledge over women’s health.
Reports suggest that one current NHS pledge, for a women’s health hub to be established in each region, will not be renewed in the 2025-26 guidance, due to be published on Thursday.
The hubs are intended to provide a wide range of services under one roof, including pelvic health physiotherapy, mammograms, cervical smears, contraception, menopause support, and diagnosis and treatment for common gynaecological issues.
But The i Paper revealed last month that despite the promise to have at least one hub in every region by the end of 2024 – just 11 out of 42 NHS integrated care boards (ICBs) had set up dedicated women’s health hubs.
The remaining ones either relied on existing primary and secondary networks for women, or had a “one-stop shop” providing other services outside of just women’s health. Some areas had no women’s health hub at all.
The Royal College of Obstetricians and Gynaecologists (RCOG) has implored health leaders to reconsider the decision to ditch the pledge, saying that the hubs have had a “transformational impact” and scaling them back could lead to delays in essential services.
Read full story
Source: iNews, 29 January 2025
Patient Safety Learning

Surge in Americans getting sterilisations given states’ abortion laws

For nearly two years, in the wake of the Supreme Court overturning Roe v. Wade, Alexander W. Pastuszak and his wife grappled with growing anxiety about the implications of an unplanned pregnancy.
As the parents of two children, with no desire to have a third, the Utah couple worried they might not be able to get access to an abortion if the unexpected occurred.
So in May, he underwent a vasectomy. Despite their state allowing abortion up to 18 weeks of gestation or later under certain circumstances, he worried that a national ban could be implemented.
“Are we going to fly to another country to have an abortion? I mean, that just seems ridiculous and unsafe,” said Pastuszak, a urologist at the University of Utah School of Medicine.
His decision reflects a growing trend across the country, with health experts predicting that more people will choose sterilization because of fears over restricted access to reproductive health care during a second Trump administration.
Research shows a significant increase in vasectomies and tubal ligations in the months just before and after the Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization, the 2022 decision that ended a constitutional right to abortion after nearly half a century.
Read full story (paywalled)
Source: Washington Post, 27 January 2025
Patient Safety Learning

EU acts to boost cybersecurity in hospitals

The European Commission has introduced an action plan to strengthen the cybersecurity of hospitals and healthcare providers across the European Union (EU). The initiative includes creating a pan-European Cybersecurity Support Centre, managed by the European Network and Information Security Agency, to address the rising number of cyber threats targeting healthcare institutions.
In 2023 alone, 309 significant incidents were reported in healthcare, more than in any other critical sector. 
“The healthcare sector faces the highest proportion of high-impact cybersecurity incidents,” Robin van Kessel, PhD, a Hoffmann fellow in health system financing and payment models at the London School of Economics, London, United Kingdom, and the World Economic Forum, told Medscape Medical News. 
This disproportionate impact reflects the fact that healthcare organisations store a large amount of sensitive patient data, including medical histories, diagnoses, and treatment information. Cyberattacks on healthcare systems can disrupt critical medical services, thus causing potentially severe consequences for patient care and safety. 
Read full story
Source: Medscape Medical News, 27 January 2025
Patient Safety Learning

HMPV: Virus cases on the rise in UK as doctors issue ‘mask up’ warning

The rate of positive tests for a virus that swept hospitals in China is on the rise in the England, according to official figures.
Latest UK Health Security Agency data show one in 20 (5 per cent) of hospital swabs for respiratory infections in England came back positive for human metaphneumovirus (HMPV) in the week ending January 19.
It’s the highest recorded rate of the virus so far this winter season, and above the 4.18 per cent of cases recorded at the start of 2024 - but still well below the 10 per cent recorded in 2021.
UKHSA, which does not publish case numbers, said the level of HMPV in England is currently “medium” based on the almost 8,000 samples tested. Doctors have urged people with symptoms of a respiratory illness to wear a face mask when out in public.
The age group with the highest proportion of HMPV cases was those aged 80 and over, soaring to 7.3 per cent and well above pre-Christmas levels. Cases have also risen to about 7 per cent in children up to the age of five.
Read full story
Source: The Independent, 28 January 2025
Patient Safety Learning

‘Complacent’ health chiefs in England lack drive to transform NHS, say MPs

Plans to radically reform the health service are at risk because senior leaders of both NHS England and the Department of Health and Social Care (DHSC) are “complacent” and lack dynamism, MPs have said.
In a report the public accounts committee (PAC) warns that officials in England have neither the ideas nor the drive to implement the health service transformation required by Keir Starmer and Wes Streeting.
The influential cross-party Commons committee did not identify individuals by name. But it reached its conclusions after questioning in November five top-level civil servants including Amanda Pritchard, NHS England’s chief executive, and Sir Chris Wormald, the DHSC’s then permanent secretary, who has since become the new cabinet secretary.
“The scale of government’s ambitions is great but senior officials do not seem to have ideas, or the drive, to match the level of change required, despite this being precisely the moment where such thinking is vital,” the PAC said in its report on the health service’s financial sustainability.
Their lack of energy and urgency risks wasting “a golden opportunity” to modernise how the NHS works and thus improve the country’s health, the MPs said.
Read full story
Source: The Guardian, 29 January 2025
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