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

NHS spends £14.7bn a year treating patients in England hurt by care mistakes, says report

The NHS is forced to spend a “staggering” £14.7bn a year treating people who have been harmed by mistakes made during their care, a report reveals.
And a stark north/south divide on patient safety has opened up across England, with double the amount of death and disability caused by medical negligence in the north-east than in London.
The report, by experts at Imperial College London, found that the safety of the care patients receive had declined over the past two years.
The authors include Prof Lord Ara Darzi, the surgeon and former health minister who produced a major NHS report for the Labour government, which highlighted avoidable patient deaths.
Darzi said there had been “alarming declines” in 12 key metrics of patient safety in England since 2022. They include maternity care, in which there are growing rates of stillbirth, babies dying during or soon after they are born and also women dying while giving birth.
“Our analysis highlights a troubling increase in neonatal and maternal deaths, with Black women disproportionately affected,” said Darzi, the co-director of Imperial’s Institute of Global Health Innovation, which drew up the report.
He urged ministers and NHS bosses to take “immediate action” to improve maternity care. The Royal College of Midwives said staff shortages, including of specialist midwives, were a key reason for the recent deterioration in women’s experiences during pregnancy, labour and afterwards – a decline which reviews by other organisations have also identified.
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Source: The Guardian, 12 December 2024
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Malaria cases rise for fifth year as disasters and resistance hamper control efforts

Malaria killed almost 600,000 people in 2023, as cases rose for the fifth consecutive year, according to a new report from the World Health Organization (WHO).
Biological threats such as rising resistance to drugs and insecticides, and climate and humanitarian disasters continue to hamper control efforts, world health leaders warned.
Globally, there were 263m cases last year, 11m more than the previous year; the vast majority (94%) occurred in Africa.
Officials said a $4.3bn (£3.4bn) annual funding shortfall was among further challenges, which also include the spread of a new insecticide-resistant species of mosquito, genetic mutations in the malaria parasite that stop tests working, and the emergence of a new type of malaria parasite in south-east Asia.
Dr Tedros Adhanom Ghebreyesus, WHO director general, said: “No one should die of malaria; yet the disease continues to disproportionately harm people living in the African region, especially young children and pregnant women.”
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Source: The Guardian, 11 December 2024
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Mothers came to harm at maternity unit says report

Mothers and newborn babies came to harm because of staffing shortages and a "toxic" culture at Edinburgh's maternity unit, according to a whistleblowing investigation seen by BBC News.
NHS Lothian commissioned a report into the obstetrics triage and assessment unit at Edinburgh Royal Infirmary after a member of staff raised concerns in February this year.
The investigation upheld or partially upheld 17 concerns about safety.
NHS Lothian said an "improvement plan" designed to enhance patient safety and improve the working environment for staff was already under way as a result of the report.
The health board said a detailed review was taking place into the death in a bid to give the family much-needed answers.
But staff say they fear the risks to patients remain.
"We are afraid we can't provide safe patient care and that women and babies are being harmed," one staff member said, speaking to the BBC anonymously.
"The situation has been getting worse over the past five years and it is at its worst now."
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Source: BBC News, 10 December 2024
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Cost and safety concerns hamper crisis care

Most integrated care boards report a lack of funding is hampering the NHS’s efforts to respond better to mental health crisis incidents, rather than requiring a police response.
The Department of Health and Social Care has published an evaluation of the Right Care, Right Person model, which was introduced nationally last year in response to the police arguing they were spending huge resources on these cases, and would stop answering them.
The NHS said it would move to RCRP, based on a pilot in Humberside in which the health service had dealt with more crises without police input. 
However, mental health service leaders have consistently raised concerns about funding, and the speed of rollout.
The concerns have now been confirmed in the DHSC evaluation, which includes a survey of integrated care boards and councils.
Of the 34 ICBs asked between autumn 2023 and spring 2024, 62% said they had experienced “barriers”. The majority of these ICBs said “cost/funding pressure” was the biggest barrier (86%), followed by “lack of clarity regarding responsibilities of agencies when responding to incidents” (71%), then “lack of workforce to cope with demands” (67%).
Sixty per cent of ICBs reported their “health-based place of safety” — where patients are meant to be taken after being detained under section 136 of the Mental Health Act — did not ”meet demand”. This was mostly because of a lack of adult inpatient beds, followed by a rising number of detentions, ICBs said. 
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Source: HSJ, 11 December 2024
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‘Medical misogyny’ condemns women to years of gynaecological pain, MPs told

Women and girls are enduring years of pain because their reproductive conditions are being dismissed due to “medical misogyny”, according to a damning parliamentary report.
The report, by the Women and Equalities committee, found that gynaecological conditions such as endometriosis and adenomyosis are treated with inadequate care due to a “pervasive stigma”, a lack of education by healthcare professionals and “medical misogyny”.
The Commons select committee, which set out to examine the experiences of care women with reproductive conditions get in England, found that symptoms are often “normalised” and it can take years for women to get a diagnosis and treatment.
The substandard gynaecological care cited by the report also includes routine IUD contraceptive fittings, cervical screenings, and hysteroscopies.
The report said women were being left in pain and discomfort that “interferes with every aspect of their daily lives”, including their education, careers, relationships and fertility, while their conditions worsen.
It also found there to be a “clear lack of awareness and understanding of women’s reproductive health conditions among primary healthcare practitioners” and concluded that gynaecological care is not being treated as a priority.
Pervasive stigma associated with gynaecological and urogynaecological health, a lack of education and “medical misogyny” has contributed to poor awareness of these conditions.
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Source: The Guardian, 11 December 2024
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New leaders bring ‘energy, focus and grit’ to troubled trusts, says NHSE

Changing chairs, CEOs and finance chiefs has helped turn around several poorly performing trusts and systems, NHS England has said, but it plans to do more to “strengthen” leadership at troubled organisations.
Dame Emily Lawson made the comments in an update to NHSE’s board on its “recovery support programme”, which is the current name of its intervention regime for the most poorly performing trusts and systems.
The NHSE chief operating officer said: “We know we have got more to do… to strengthen leaders at the most challenged places. We are developing a more systematic way of identifying and developing talented leaders and matching them to roles where they can make the biggest impact when in post.
“That means we need to give leaders the right flexibilities, incentives and support to turn things around.”
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Source: HSJ, 6 December 2024
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USA: Price stops 1 in 6 adults with asthma from taking their life-saving medications as prescribed

The cost of medication to treat asthma, the chronic lung disease, is stopping one in six US adults from taking their medication as it has been prescribed, researchers have warned.
Furthermore, failure to stick to drug treatment was associated with nearly doubling the risk of an asthma attack and a more than 60 percent heightened risk of visiting an emergency department, they said.
“Adults with asthma who reported experiencing cost-related medication non-adherence had a higher likelihood of experiencing asthma exacerbations,” Emily Graul and Dr. Christer Janson — of the Emory University School of Medicine and Sweden’s Uppsala University, respectively — explained in an editorial article linked to the research.
Asthma can be treated using medications, lifestyle treatments, and inhalers. Inhalers are handheld devices that get medicine directly into peoples’ lungs. While Americans with asthma are more likely to have health insurance, the agency says most adults aged 18 to 64 report cost barriers.
The prices of inhaled medicines have increased by an average of 50 percent since 2009, according to the Asthma and Allergy Foundation of America. The cost of inhalers ranges between tens and hundreds of dollars, with some companies agreeing to a $35 cap earlier this year.
On average, 10 people in the US die from asthma each day and more than 3,200 people died in 2022, the foundation said. An estimated 22 million American adults had asthma in the US that year, according to the Centers for Disease Control and Prevention.
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Source: The Independent, 10 December 2024
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Hospitals running with 20% fewer children’s doctors than they need, new figures reveal

Hospitals across the UK are running with 20% fewer children’s doctors than they need on daily shifts, new research shows.
NHS staff are facing “unacceptable” pressures as paediatric units report a shortfall of 20 per cent in doctors and trainees on shift, the Royal College of Paediatrics and Child Health (RCPCH) has warned.
Top doctors have said the government’s plans to bring down waiting lists would be “doomed to fail” if the workforce gaps for children’s services were not filled.
Professor Steve Turner, president of the RCPCH, said the gaps were having a detrimental impact on the wellbeing, morale and training of doctors and ultimately impacted patient care.
He said: “This report highlights how paediatricians are being stretched far too thin every day.  It is completely unacceptable that our current paediatric services are only operating at 80 per cent capacity when the level of demand on these services is now higher than ever…We cannot allow 80 per cent to become the new normal.
“Our children and the clinicians who serve them deserve more. Investing in and reforming paediatric services is not only valuable but is fundamental to the future health and economic wellbeing of our country.”
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Source: The Independent, 10 December 2024
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'My autistic son had no safety net when in crisis'

The family of a man who died after he repeatedly banged his head against a wall in a mental health suite said there was no "safety net" for people with their son's needs.
Declan Morrison, 26, from Cambridge, was autistic, had severe learning disabilities and attention deficit hyperactivity disorder.
In the hours before his death, he was left naked in a room with CCTV cameras, but his family said the alarm was only raised after he was found unresponsive by staff.
His parents, Graeme and Sam Morrison, are now calling for answers about what went wrong with their son's care.
Mrs Morrison said: "He was left to his own devices in a surrounding that he couldn't understand, with no stimuli, bright lights and bare walls."
In March 2022, Declan spent 10 days in the Section 136 mental health assessment suite, as there were no beds available across the UK.
But he could not cope with the austere, clinical environment which, under the Mental Health Act, should be used for a maximum of 24 hours.
The suite was described by coroner Simon Milburn as "wholly inappropriate", external for Declan's needs.
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Source: BBC News, 9 December 2024
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Fifth cyber incident in a week under investigation

Cyber security teams are investigating the fifth suspected attack on the NHS to have taken place last week.
HSJ can reveal Medway Community Health shut down some systems last week after suspicious activity.
The incident comes after declared cyber incidents at Alder Hey Children’s Foundation Trust, Royal Liverpool University Hospital and the Liverpool Heart & Chest Hospital last week.
Last week also saw the end of an incident from a fortnight ago at Wirral University Teaching Hospital FT.
The three NW trusts with an ongoing incident last week said in a statement: “Criminals gained unlawful access to data through a digital gateway service hosted by Alder Hey. This digital gateway is shared by Alder Hey and Liverpool Heart and Chest Hospital.
“This has resulted in the attacker unlawfully getting access to systems containing data from Alder Hey Children’s, Liverpool Heart and Chest Hospital, and a small amount of data from Royal Liverpool University Hospital. We have launched an investigation which is still ongoing to determine the full facts around what data has been obtained unlawfully.”
The trusts would not confirm how many patient records had been accessed online, but said “we do not believe the data published or accessed unlawfully relates to children and young people”.
Read full story (paywalled)
Source: HSJ, 9 December 2024
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Streeting ‘shocked’ by his lack of ‘oversight’ of social care

Health and social care secretary Wes Streeting has said he is “shocked” by his lack of oversight of adult social care and said he is “determined to improve this” in a call with local leaders this morning.
Addressing a webinar on winter pressures with NHS and care leaders, Mr Streeting said he was “shocked by poor levers and line of sight [from DHSC] into the social care system” compared with the NHS, and said this contrast was “day and night, and I’m determined to improve this”, according to sources present.
Mr Streeting also stressed the importance of reform and a “plan” for social care on the call, alongside NHS England chief executive Amanda Pritchard this morning.
The health secretary also told trust leaders to “prioritise patient safety” by focussing on improving emergency ambulance response times, addressing handover delays and tackling the longest waits in accident and emergency.
He said he did not want trusts to prioritise patients who can be seen and discharged more quickly — and therefore would help meet the four-hour A&E target — above those with the greatest clinical need. Trusts were pressured to do this last winter amid efforts to meet the flagship target.
In a press statement, Mr Streeting said: “We inherited a broken NHS that saw annual winter crisis as the norm. This year, we’re seeing record pressures on services as we move into December.
“This winter I want to see patient safety prioritised as we brace ourselves for the coming months. I’m asking trusts to focus on ambulance delays, handovers and the longest A&E waits.”
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Source: HSJ, 9 December 2024
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Baby's inquest finds serious hospital failures after family's £250k battle

A coroner has found neglect and failure to provide adequate medical care contributed to the preventable death of a baby.
Hayden Nguyen died aged six days at the Chelsea and Westminster Hospital in London in 2016.
The conclusion came after his parents spent seven years and £250,000 fighting for justice.
In a statement, the hospital said it was "committed to learning from any findings to improve our practices".
Senior Coroner Richard Travers said in his findings that Hayden had "obvious needs that were simply not met" by clinicians when his parents took him to the Chelsea and Westminster Hospital in west London in August 2016.
They were concerned about a fever he had but his condition quickly deteriorated. He had a cardiac arrest and died within 12 hours of arriving at the hospital. The treatment Hayden received, Mr Travers found, fell "very seriously below expected standards" and had he received appropriate and timely care, he would have survived.
An internal investigation by the hospital following Hayden's death found there had been eight errors in the care he'd received, including failures to identify signs of septic shock and to act on abnormal test results.
However, the original inquest into Hayden's death, held at Westminster Coroner's Court in 2017, concluded he had died of natural causes.
The coroner, Dr Shirley Radcliffe, had contacted the hospital to raise concerns about their investigation.
The hospital produced a second report, which halved the number of errors found and said the root cause of Hayden's death was an infection "which is known to have a high mortality".
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Source: BBC News, 6 December 2024
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Wes Streeting holds winter crisis talks with NHS bosses in England

Wes Streeting has held urgent talks with NHS leaders in England about how the service will cope with an impending winter crisis, amid signs that it is already under intense pressure.
At the meeting today, the health secretary told the chief executive of NHS England, Amanda Pritchard, and the bosses of large hospital trusts to prioritise patient safety over trying to meet waiting time targets.
He convened the meeting days after NHS England said hospitals faced being overwhelmed by a potential “quad-demic” of flu, Covid, respiratory syncytial virus (RSV) and the diarrhoea and vomiting bug (norovirus).
There is mounting alarm that more than 2,000 of the service’s 100,000 beds are already filled with people with Covid (1,390) or norovirus (756), another 142 occupied by children with RSV and that ambulance services are struggling to cope with the number of 999 calls they are receiving.
Streeting said: “We inherited a broken NHS that saw annual winter crisis as the norm. This year, we’re seeing record pressures on services as we move into winter. This winter I want to see patient safety prioritised as we brace ourselves for the coming months.”
He has asked local NHS leaders to make it a priority to get patients out of ambulances and into their hospitals as soon as possible, so crews can get back on the road to attend other incidents, and also to ensure that patients do not wait too long for care in A&E units.
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Source: The Guardian, 9 December 2024
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National probe into deaths of NHS heart patients as scale of cardiology crisis revealed

A national probe has been launched into the deaths and harm of thousands of NHS patients waiting for cardiac surgery, as doctors and experts warn of a “crisis in heart care”, an investigation by The Independent has revealed.
The audit was ordered by NHS England after concerns were raised about the impact on patients left waiting too long for specialist surgery, according to a leaked memo. Waiting times for all types of cardiac surgery are also under review.
Senior doctors have described how the NHS is struggling to provide life-saving care to those suffering heart attacks and strokes, with worsening ambulance delays meaning patients are being deprioritised.
The latest figures show waiting lists for cardiology services have doubled since the onset of the pandemic in March 2020 with 412,164 patients waiting for routine care in October 2024 – up from 397,956 the year before.
The Independent can also reveal:
Ambulances are transferring just 31% of patients between hospitals for life-saving heart attack surgery in the target time. Nearly 1,000 patients in London face a 10- to 12-week wait for heart surgery who should have had it within four weeks. Multiple coroners have issued warnings in the last year after patients died waiting for routine and emergency cardiology surgery. British Heart Foundation figures suggest 39,000 people died prematurely from cardiovascular disease in 2022. Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation (BHF), and consultant cardiologist, said: “Unacceptably long waits for time-critical heart care puts people at significant risk of life-long heart failure or even premature death."
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Source: The Independent, 9 December 2024
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Scans reviewed amid concerns about radiologist

More than 1,000 CT scans carried out in Scotland have been reviewed after concerns were raised about the work of one consultant radiologist, BBC Scotland News has learned.
The medic was responsible for interpreting the detailed images of internal body parts and identifying health issues like cancer.
The scans were carried out at hospitals around the country and assessed by one of a central pool of experts working for the Scottish National Radiology Reporting Service (SNRRS) between April 2022 and July 2024.
It is understood that the review found that about 10 patients had potentially been affected.
The SNRRS said the patients would be contacted by their local NHS board to discuss further action.
They added that the consultant radiologist at the centre of review no longer works for the SNRRS.
It is understood that information about the review has been provided to the health board where the radiologist normally works.
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Source: BBC News, 9 December 2024
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More than 100 alerts over deaths linked to antidepressants taken by Thomas Kingston

More than 100 alerts were made in a decade to the UK’s medicines regulator over deaths linked to the antidepressants which Thomas Kingston was taking before he killed himself.
A coroner ruled that Mr Kingston, the husband of Prince and Princess Michael of Kent’s daughter Lady Gabriella Kingston, fatally shot himself after an adverse effect to the medications he had been prescribed, which included the common antidepressant citalopram.
The UK’s medicines regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA) said it is undertaking a review of safety warnings for 30 antidepressants including citalopram and prozac.
Data analysis by The Independent has now found the MHRA has received more than 71 alerts over fatalities linked to the antidepressant citalopram since 2014.
The data, called yellow card alerts, also shows 114 alerts over fatal adverse reactions linked to sertraline, another antidepressant taken by Mr Kingston, over the same period.
However, the data does not determine whether the drug was the direct cause of death.
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Source: The Independent, 8 December 2024
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