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

Hip breaks more deadly than some cancers in elderly, study finds

A recent analysis found poor survival rates after bone fractures in older adults, with fewer than a third of men and half of women surviving five years after a fracture.
Published in JBMR Plus, the study looked at a cohort of 98,474 Ontario residents age 66 and older who suffered fractures to parts of the body associated with osteoporosis between January 2011 and March 2015. The patients were grouped into sets based on the fracture site and matched to patients with a similar demographic profile but no bone breaks during the study period.
The fracture cohort was mostly female (73 percent), and the median age at fracture was 80. In the year before the fracture, up to 45 percent of the women and 14 percent of the men had been treated for osteoporosis.
The analysis revealed that those within a year of a hip, vertebral or proximal non-hip, non-vertebral fracture were at the highest risk of death. The survival probability was lower for the oldest patients.
“Survival most dramatically declined within one month after most types of fracture, with a five-year survival being similar to or worse than some common cancers,” the paper’s lead author, Laval University department of medicine professor Jacques Brown, said
Read full story (paywalled)
Source: Washington Post, 12 May 2024
Patient-Safety-Learning

More NHS hospitals leaving patients in corridors to free up ambulances

More and more UK hospitals are leaving patients in corridors due to a lack of bed space. NHS bosses say so-called corridor care is freeing up ambulances and saving lives, but BBC Newsnight has spoken to patients who say the growing practice is humiliating and degrading.
Gregory Knowles counted 13 other patients alongside him on a corridor at the Norfolk and Norwich University Hospital (NNUH) in March. Complications after an operation put him back in hospital and on to a ward but at 04:00 one morning he was moved.
The 68-year-old was wheeled in his bed to reception. "I was waking up with people around me. It was horrendous," he told the BBC. "I had no screens and no facilities for water or for really getting changed. My possessions were on the bottom of the bed. My daughter and partner were as horrified as I was," he said.
His partner Alicia Goulty described how staff had been too rushed to attend to him. "One day when we got there his catheter had leaked in the bed when he was on the corridor. He was wet with no covers or any screens and I had to take him to the bathroom to get him cleaned". Ms Goulty said her partner's medication had been missed. "We had to ask for water for him. We had to ask sometimes for his meals because he got forgotten."
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Source: BBC News, 15 May 2024
You can read a nurse's first-hand account of a corridor care shift in this blog on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
Patient-Safety-Learning

Nurse wins staff shortages whistleblowing case

An NHS trust has lost an employment tribunal case against a nurse who had his shifts cancelled after whistleblowing when a patient was put in seclusion because of staff shortages.
A judgment published last week found that Mark Temperton, a mental health nurse, was “subjected to detriment” after having made a “protected disclosure” during his agency shift at Greater Manchester Mental Health Foundation Trust’s (GMMH) Atherleigh Park Hospital.
Mr Temperton, who is also employed by the Priory Group as a regulatory inspector as well as doing ad-hoc work for the Care Quality Commission, worked as an agency mental health nurse for Blackstone Recruitment and was booked to work a night shift in a psychiatric intensive care unit (Priestners Unit) at Atherleigh Park on 14 October 2022.
He raised concerns after a patient, brought in by the police, was put “immediately” into seclusion because of staff shortages. Mr Temperton subsequently raised it with the nurse in charge and with a locum consultant psychiatrist but the patient was kept in seclusion.
According to the Mental Health Act’s Code of Practice, seclusion “should not be used as a punishment or a threat, or because of a shortage of staff”. Serious concerns were also raised about the trust’s Edenfield Centre in September 2022 by BBC Panorama, one of them being use of inappropriate seclusion.
Paul Lewis-Grundy, associate director of corporate governance at GMMH, said: “It is absolutely vital that staff feel confident and safe to speak up, with no detrimental impact to themselves or their career and prospects. Over the past two years, we have invested significantly, and taken a number of steps, to support this across GMMH.”
Read full story (paywalled)
Source: HSJ, 15 May 2024
Patient-Safety-Learning

Weight loss drug could reduce heart attack risk by 20%, study finds

A weight loss injection could reduce the risk of heart attacks and benefit the cardiovascular health of millions of adults across the UK, in what could be the largest medical breakthrough since statins, according to a study.
It found that participants taking the medication semaglutide, the active ingredient in brands including Wegovy and Ozempic, had a 20% lower risk of heart attack, stroke, or death due to cardiovascular disease.
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Source: Guardian, 14 May 2024
Patient_Safety_Learning

Health spending £5bn less than government planned

The government is spending £5.5bn less on health in England than it suggested it would be at this stage, the Institute for Fiscal Studies says.
Plans set out in the 2019 election campaign indicated the budget would increase by 3.3% a year above inflation during this Parliament, the IFS said.
But despite extra being put in to cover the high inflation seen, spending had risen by only 2.7% a year on average.
Read full story
Source. BBC News, 14 May 2024
Patient_Safety_Learning

A&Es not being overwhelmed by ‘low acuity’ patients, NHSE review finds

An NHS England review has found the proportion of ‘low acuity’ patients attending emergency departments is far smaller than expected.
During a trial of new acuity measures at 17 accident and emergency sites, NHSE found the proportion of patients with low acuity was just 4 per cent, when it had expected the figure to be between 20 and 40 per cent.
Low acuity cases are those which could often be seen by less specialist services, such as urgent treatment centres.
Read full story (paywalled)
Source: HSJ, 13 May 2024
Patient_Safety_Learning

‘Patients are choosing palliative care over cancer treatment’ due to lack of local services, CEO warns

Patients in part of the East of England are choosing to begin palliative care over cancer treatment because of prohibitive travel times and costs to get to the nearest specialist centre, a local system leader has warned.
The Bedfordshire, Luton and Milton Keynes Integrated Care Board CEO said delays to a proposed £400m project, which includes creating “satellite” treatment centres on its patch, was therefore putting lives at risk and widening inequalities.
Read full story (paywalled)
Source: HSJ, 13 May 2024
Patient_Safety_Learning

A mystery illness stole their kids’ personalities. These moms fought for answers

Before Sara Smythe began to disappear, she was thriving.
The youngest of four sisters, Sara was born with Down syndrome and lived the life of an active teen. At 13, the Toledo student was heading to middle school and loved soccer and swim practice, took dance and karate classes, and was a Girl Scout.
But in 2011, everything changed in a matter of weeks. Sara morphed from a sociable teen to a person who stopped talking and engaging with other people, and, at her worst, had full-blown catatonia.
Sara’s doctors were at a loss, but her mother, Eileen Quinn, wasn’t giving up. She embarked on what would become a 13-year quest, harnessing the power of a mother’s love to push the scientific community to pay attention to the mysterious regressions that some young people with Down syndrome were experiencing.
Read full story (paywalled)
Source: Washington Post, 12 May 2024
Patient_Safety_Learning

Birth trauma report finds care is postcode lottery

An inquiry into traumatic childbirths has called for an overhaul of the UK's maternity and postnatal care after hearing "harrowing" stories from parents.
The Birth Trauma Inquiry heard evidence from more than 1,300 women - some said they were left in blood-soaked sheets while others said their children had suffered life-changing injuries due to medical negligence.
A new maternity commissioner who would report directly to the prime minister is a key recommendation in the group's report, along with ensuring safe levels of staffing.
Read full story
Source: BBC News, 13 May 2024
Patient_Safety_Learning

Cost of dementia to UK could almost double to £91bn by 2040, study finds

Dementia could cost the UK almost £91bn a year by 2040, as the number of people affected rises inexorably, a study has found.
The “colossal” costs of the disease are likely to more than double from an already “staggering” £42.5bn today to £90.6bn, according to research undertaken for the Alzheimer’s Society.
That projected rise will happen in line with an expected increase in the number of diagnosed cases from 981,575 to 1,402,010, related to an ageing and growing population.
Read full story
Source: Guardian, 13 May 2024
Patient_Safety_Learning

NHSE should intervene in trust safety investigation, says inquiry chair

The chair of the major inquiry into rogue surgeon Ian Paterson has raised concerns over a separate patient recall process conducted by Salford Royal Hospital, and suggested NHS England should intervene.
Leaders in Salford have been resisting pressure to expand a review of patients treated by the former head of its spinal division, John Williamson, over his 23-year career at the hospital.
A review of his last five years established clear problems with his surgical techniques and found multiple cases of avoidable harm.
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Source: HSJ, 7 May 2024
Patient_Safety_Learning

New vaccine could protect against coronaviruses which have yet to emerge

A new vaccine could be effective against coronaviruses which have yet to emerge, with hopes it could be used to battle future pandemics, research suggests.
Scientists at the University of Cambridge, the University of Oxford, and Caltech in the US are developing a novel approach called “proactive vaccinology”, which aims to train the body’s immune system to recognise several different coronaviruses.
The vaccine used antigens – a substance that triggers an immune response in the body – found in eight different coronaviruses, including those circulating in bats. This trains the immune system to go after the parts of the antigens that are shared across the viruses and other similar ones, including those not included in the vaccine.
“Our focus is to create a vaccine that will protect us against the next coronavirus pandemic, and have it ready before the pandemic has even started,” said Rory Hills, a graduate researcher in the University of Cambridge’s Department of Pharmacology and first author of the report.
He added: “We’ve created a vaccine that provides protection against a broad range of different coronaviruses – including ones we don’t even know about yet.”
Read full story
Source: Independent, 7 May 2024
Patient-Safety-Learning

£500m cut to local integration funds revealed

Integrated care boards and local authorities are cutting their voluntary contributions to the better care fund by more than £500m compared to a high point in 2021-22.
It appears to be caused by the funding squeeze in both the NHS and local government; extra pressure on ICBs to focus on hospital admissions and discharge; a shift away from pooled budgets as a method of integration; and restructure, with ICBs taking over from clinical commissioning groups in 2022.
Local BCF pooled budgets are made up of mandatory “minimum” funds from ICBs and local government – the largest share, which the government has generally ordered to grow steadily each year – and from the “additional” voluntary contributions.
In the past government has said it wants the sum pooled across the NHS and councils to grow and to ultimately account for most NHS and adult social care spending, to help join up services and decision making.
But figures published on Tuesday by NHS England show the voluntary income going backwards. At its high point in 2021-22, ICBs and councils planned a discretionary ”additional” contribution of £3bn, and the actual spend turned out to be £3.2bn – £2bn from the NHS and £1.2bn from councils.
The newly published figures show the total was planned to fall to £2.8bn in 2023-24 and £2.7bn in 2024-25 – £500m less than the 2021-22 peak spend.
Read full story (paywalled)
Source: HSJ, 8 May 2024
Patient-Safety-Learning

Whooping cough: Cases up again as five infant deaths reported

Five babies have died from whooping cough as cases continue to rise in England, health officials have announced.
The UK Health Security Agency (UKHSA) reported 1,319 cases in England in March, after just over 900 in February, making the 2024 total nearly 2,800.
It fears it could be a bumper year for the bacterial infection. The last peak year, 2016, saw 5,949 cases in England.
The infection can be particularly serious for babies and infants.
Half of cases seen so far this year have been in the under-15s, with the highest rates in babies under three months of age.
The five babies who died this year were all under three months old.
Known as pertussis or "100-day cough", the infection is a cyclical disease with peaks seen every three to five years.
UKHSA has said a steady decline in uptake of the vaccine in pregnant women and children and the very low numbers seen during the pandemic, as happened with other infections because of restrictions and public behaviour, were both factors.
The agency said a peak year was therefore overdue and urged families to come forward to get vaccinated if they had not already.
Read full story
Source: BBC News, 9 May 2024
Patient-Safety-Learning

‘Strained’ estate threatens national workforce plan, NHSE leak reveals

NHS England has found that one in five GP surgeries – and more than two-fifths in some regions – were built more than 75 years ago, and is concerned a lack of space will stop it meeting targets to train more GPs, HSJ has learned. 
An internal NHSE document seen by HSJ reveals a major audit it commissioned in 2019 – but has not made public – found 20 per cent of 8,900 buildings examined were built before 1948. The figure rises to more than 40 per cent of practices in London, HSJ understands.
These practices are likely to be in converted houses, normally owned by GP partners, with very limited space and little scope for expansion.
The NHSE slides which include the figure warn the “limited [GP] estate” means there is “strain on existing capacity and meeting current training needs is challenging”.
HSJ understands officials are concerned poor estates and lack of space will restrict the big expansion of GP training planned under the NHS long-term workforce plan. Other fears relate to poor tech and the shortage of experienced staff to supervise trainees.
NHSE said in a statement: “NHS England has asked every ICS to review their infrastructure  to assess which buildings they need to expand and reconfigure to manage additional workforce over the next 10 years.”
Read full story (paywalled)
Source: HSJ, 9 May 2024
Patient-Safety-Learning

New equipment to help patients with hard-to-find veins at Ysbyty Gwynedd

A piece of equipment known as a vein finder is being used for inpatients at Ysbyty Gwynedd in order to improve the experience for patients with hard-to-find veins.
Anyone who has difficult veins will know the discomfort when there are failed attempts to locate a vein, such as when having bloods taken.
Having noticed the need to improve the experience for patients with difficult veins, Junior Doctor Lois Williams secured a £3,000 grant from Health Education and Improvement Wales and around £600 from Menter Môn to purchase the equipment through the Trainees Transforming Training initiative.
Dr Williams said: “We’ve been very lucky to obtain a grant to purchase a vein finder and we hope this will empower nurses, phlebotomists, medical students and junior doctors to take blood and cannulate from patients who are difficult to obtain access. It works by infrared, which can bounce back and show us visibility of the vein which you cannot do with the naked eye. It also helps to reduce the time we need to attempt cannulating patients and how often we might need to cannulate them because of failed attempts, which can be quite distressing for some patients. Our hope is that this will improve the quality of patient care in the future.”
Read full story
Source: NHS Wales, 30 April 2024
Patient-Safety-Learning
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