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

Local control of NHS screening could jeopardise patient safety

Patients could be put at risk by plans to allow local NHS bodies to oversee the quality of health screening programmes for diseases such as breast and bowel cancer, experts have suggested.
At the moment, NHS England runs the Screening Quality Assurance Service (SQAS) to make sure local organisations comply with national standards, are safe and can be subject to inspections. There are 11 national screening programmes in England, including those for breast, cervical and bowel cancer, plus antenatal and newborn screening, abdominal aortic aneurysm and diabetic eye screening. At the moment, screening programmes must report all safety incidents to the SQAS and the SQAS inspectors visit local sites to pick up urgent issues and make recommendations.
Now, a report in the British Medical Journal questions plans by NHS England to allow local bodies to have more control.
Sue Cohen, former national lead of screening quality assurance at Public Health England, told the BMJ that devolving responsibility for SQAS to local organisations would be a “retrograde” step. She pointed to previous issues, such as in Kent where a lack of oversight of a cervical screening programme led to women with cancer not being picked up.
She said: “If you don’t have a quality assurance service that is properly resourced and has that ability to keep a national view, you will simply not have the oversight of the system and there is a bigger risk of incidents going undetected.”
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Source: Medscape News, 22 May 2024
Patient-Safety-Learning

Mentally unwell children put through ‘torture’ on wrong NHS wards, watchdog warns

Children with mental health illnesses are forced to stay in wards not fit to care for them with patients warning these hospital stays are like a “form of torture”, an NHS safety watchdog has found.
Children with mental health conditions were admitted to general hospital wards, not intended for mental health care, nearly 44,000 times in 2021 and 2022, the Health Services Safety Investigation Body has warned.
These wards which are “noisy, busy and brightly lit” are not often appropriate for these children who require mental healthcare and are unable to keep them safe, HSSIB said in a report on Thursday.
The watchdog is calling for new guidance for hospitals on how to adapt their general paediatric wards for children who have mental health support needs.
In a new investigation, the watchdog said it found in some hospitals patients were placed in rooms with “little or no consideration of therapeutic elements” which are “stripped of everything” including window blinds and shower curtains. In one hospital, staff said even the mattresses are removed.
Between 2021 and 2022 11.7 per cent, or 39,926 admissions to paediatric wards, for physical health, were for children who had a mental health condition.
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Read HSSIB investigation report – Keeping children and young people with mental health needs safe: the design of the paediatric ward (23 May 2024)
Source: The Independent, 23 May 2024
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New dentists could be forced to work in NHS to tackle England’s ‘dental deserts’

Dental graduates in England could be forced to work in the NHS to help tackle the crisis in access that has left millions struggling to get their teeth repaired.
Under the government’s plan they would have to undertake NHS work for “several years” after leaving university or face paying back some of the £200,000 cost of training them.
A fall in the number of dentists doing NHS work has helped create “dental deserts”, where patients cannot get treatment, and prompt some people to turn to “DIY dentistry”, including pulling their own teeth out.
However, the British Dental Association (BDA), which represents dentists, claimed ministers were seeking to “shackle graduates to a service facing collapse” and said the plan would do little to improve access to NHS care.
Victoria Atkins, the health secretary, said: “Taxpayers make a significant investment in training dentists, so it is only right to expect dental graduates to work in the NHS once they’ve completed their training.”
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Source: The Guardian, 23 May 2024
Patient-Safety-Learning

Patient safety commissioner warns calls for changes are 'falling on deaf ears'

England's patient safety commissioner says her calls for changes following failings highlighted in three health scandals are "falling on deaf ears".
Dr Henrietta Hughes made the comments at a meeting in Westminster on Tuesday of MPs and campaigners of medical scandals.
It comes after Sir Brian Langstaff's highlighted a decades-long "subtle, pervasive, chilling" cover-up by successive governments and the NHS in the conclusion of his report on the infected blood scandal.
Like the victims of that scandal, those affected by epilepsy drug Valproate, as well as vaginal mesh implants, and the hormone pregnancy test Primodos, are also waiting on the government to implement a redress scheme. The three campaign groups have already had a combined review. In July 2020, the Cumberlege review found similar failings to the blood scandal: damaging products, poor regulatory decisions, and one government after another refusing to accept wrong had been done.
In February this year, the patient safety commissioner set out her "blueprint" of a redress scheme for victims.
However, Ms Hughes, who attended the First Do No Harm All Parliamentary group meeting, said on Tuesday: "I'm itching to get the changes that are needed, but I feel my words are falling on deaf ears."
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Source: Sky News, 21 May 2024
Patient-Safety-Learning

ECG-based AI could reduce hospital mortality

An artificial intelligence (AI) system that sends text messages to alert hospital physicians about the high risk for mortality in their patients reduces the number of deaths, according to a study published in Nature Medicine.
Chin-Sheng Lin, PhD, associate professor of cardiology at the Tri-Service General Hospital of the National Defense Medical Center in Taipei, Taiwan, and his colleagues have developed an AI system that identifies patients with a high risk for mortality on the basis of a 12-lead ECG. The system is intended to identify patients who would benefit from intensified care.
"It is widely acknowledged that providing intensive care to critically ill patients reduces mortality. Delays in providing intensive care for critically ill patients result in catastrophic outcomes. Most in-hospital cardiac arrests are potentially preventable; however, the early signs of deterioration might be difficult to identify," wrote the researchers.
The authors emphasized that exactly how the AI warning messages lead to a decrease in overall mortality must still be clarified. But the results suggest that they help in detecting high-risk patients, triggering timely clinical care, and reducing mortality, they wrote.
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Source: Medscape, 21 May 2024
Patient-Safety-Learning

Attacks on health workers in conflict zones at highest level ever – report

Attacks on health workers, hospitals and clinics in conflict zones jumped 25% last year to their highest level on record, a new report has found.
While the increase was largely driven by new wars in Gaza and Sudan, continuing conflicts such as Ukraine and Myanmar also saw such attacks continue “at a relentless pace,” the Safeguarding Health in Conflict coalition said.
Researchers recorded more than 2,500 incidents of “violence against or obstruction of healthcare” in 2023, including the killing or kidnapping of health workers and the bombing, looting and occupation of hospitals.
The coalition called for national and international prosecutions of “war crimes and crimes against humanity involving attacks on the wounded and sick, health facilities and health workers.”
Its report highlighted cases of attacks on children’s hospitals and sites running immunisation campaigns, leaving people vulnerable to infectious diseases. It also warned of a new trend in which drones armed with explosive weapons are used to target health facilities.
Leonard Rubenstein, of the Johns Hopkins school of public health, who chairs the coalition, said violence inflicted on healthcare workers and facilities had “reached appalling levels”. The report included examples where workers had been deliberately targeted, and others where combatants were reckless or indifferent to the harm caused, he said. “The lack of restraint we are seeing, from the beginning of conflicts, suggests to me that the law on protecting healthcare has had no meaning to combatants.”
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Source: The Guardian, 22 May 2024
Patient-Safety-Learning

Long Covid course is ‘exploiting people’, says ex-GB rower

A former Team GB rower claims a treatment she underwent for long Covid leaves participants feeling "blamed" for being ill.
Oonagh Cousins was offered a free place on a course run by the Lightning Process, which teaches people they can rewire their brains to stop or improve long Covid symptoms quickly.
Ms Cousins, who contracted Covid in March 2020, said it "exploits" people.
However, the programme's founder denied it blames patients for their illness, saying that was completely at odds with the concepts of the programme
Ms Cousins had reached a career goal many athletes can only dream of - being selected for the Olympics - when she developed long Covid. By the time the cancelled 2020 Olympic Games in Tokyo were rescheduled for 2021, Ms Cousins was too ill to take part.
When she went public with her struggles, she was approached by the Lightning Process. It offered her a free place on a three-day course, which usually costs around £1,000.
"They were trying to suggest that I could think my way out of the symptoms, basically. And I disputed that entirely," the former rower said. "I had a very clearly physical illness. And I felt that they were blaming my negative thought processes for why I was ill." She added: "They tried to point out that I had depression or anxiety. And I said 'I'm not, I'm just very sick'."
Prof Danny Altmann, a leading long Covid researcher, says such behavioural approaches disregard the "mass" of underlying damage in patients that can be measured in tests.
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Source: BBC News, 21 May 2024
Patient-Safety-Learning

‘Rolls-Royce’ EPR still being driven ‘like a Ford Focus’ admits trust CEO

The chief executive of an acute trust operating in one of the country’s most troubled healthcare economies has admitted his organisation is struggling to get the most from its top of the range electronic patient record system three years after rollout. 
Royal Devon University Healthcare Foundation Trust implemented the Epic EPR in October 2020, but the system is still causing problems with reporting performance. 
In an interview with HSJ, chief executive Sam Higginson described Epic as a “Rolls-Royce of an EPR”, but he added: “For lots of different reasons we’re still driving it a little bit like it’s a Ford Focus.
He added: “We assumed by installing an EPR that basically it would have a sufficient level of functionality that we could switch off pretty much everything else. But then you find actually it doesn’t quite have the functionality you thought it did, or you don’t quite know how to use it.”
However, Mr Higginson said the trust’s use of the EPR was improving “every month”, and the trust is testing a new cancer reporting module which it hopes will resolve the reporting problems.
Read full story (paywalled)
Source: HSJ, 21 May 2024
Patient-Safety-Learning

NHS’s leading wheelchair provider told to improve as people wait up to two years

The NHS’s leading wheelchair provider has been told to urgently improve its complaints system by the health service ombudsman amid concerns disabled people are waiting up to two years for chairs.
The parliamentary and health service ombudsman (PHSO) took the unusual step of writing to AJM Healthcare after a sharp rise in complaints from wheelchair users. Most related to people not receiving new wheelchairs or the correct parts. The waits range from a month to two years, the ombudsman said.
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Source: Guardian 21 May 2024
Patient_Safety_Learning

Infected blood scandal: Sunak promises 'comprehensive' blood compensation

Rishi Sunak has promised to pay "comprehensive compensation" to people affected by the infected blood scandal.
The prime minister said the government would pay "whatever it costs" following a damning report on the scandal, external, which saw 30,000 people infected.
A public inquiry found authorities had exposed victims to unacceptable risks and covered up the NHS's biggest treatment disaster.
The government will set out compensation details on Tuesday.
Ministers have reportedly earmarked around £10bn for a compensation package.
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Source: BBC News, 21 May 2024
Patient_Safety_Learning

Rishi Sunak: 'Unequivocal apology' for victims of infected blood scandal

Prime Minister Rishi Sunak has apologised for the infection of around 30,000 people with contaminated blood products, and the failure to address the problem.
Mr Sunak accepted the findings of Sir Brian Langstaff's inquiry report: "Was there a cover-up? Let me directly quote him - there has been".
Watch the recording
Source: BBC News, 20 May 2024
Patient_Safety_Learning

UK pharmacists demand powers to change whooping cough prescriptions

Pharmacists are calling for fresh powers to provide patients with alternative prescriptions as they warned that drugs shortages are hampering their ability to tackle whooping cough.
More than 2,700 cases have been reported across England so far in 2024 – more than three times the number recorded in the whole of last year.
But some pharmacies have been forced to turn away families seeking help for their children because they have run out of clarithromycin, a key antibiotic used to treat the condition.
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Source: Guardian, 20 May 2024
Patient_Safety_Learning

I love being a pharmacist, but the UK’s drug shortage makes me want to give up – and Brexit makes it worse

For the past 16 years, I have run a small community pharmacy in rural west Dorset. My business is older than me – the little yellow-brick building I own is about to turn 235. Right now, I am really concerned about it getting through the next 12 months.
In my years as a pharmacist, I have never seen things as bad as they are at the moment. We are going through a period of rampant drug shortages in England, caused by global shortages, the NHS’s insistence on paying unsustainably low prices for medicines and Brexit, among other things, and people are on the brink. Long gone are the days when customers could place a prescription order safe in the knowledge their life-saving medication would arrive the next day.
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Source: Guardian, 17 May 2024
Patient_Safety_Learning

‘NHS bosses use dirty tricks to force out whistleblowing doctors’

Hundreds of senior doctors have been driven out of their jobs in the NHS after raising concerns about patient safety, a campaign group has claimed.
The senior consultants say managers of NHS trusts employ a playbook of “dirty tricks” to sack whistleblowers or force them to move trusts or take early retirement. Justice for Doctors (JFD), which represents 140 whistleblowing doctors, claims some have been forced to sell their homes to pay legal fees, had their careers destroyed and had been pushed to the brink of suicide.
Read full story (paywalled)
Source: The Times, 16 May 2024
Patient_Safety_Learning

NHS bosses destroy careers of whistleblowers who stand up to protect patients’ lives

NHS managers are destroying the careers of whistleblowers who raise concerns about patient safety, a group of medics warns.
More than 50 doctors and nurses have told The Telegraph they have been targeted after raising concerns about upwards of 170 patient deaths and nearly 700 cases of poor care. One consultant described it as “the biggest scandal within our country” and said the true number of avoidable deaths was “astronomical”.
Read full story (paywalled)
Source: Telegraph, 18 May
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