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

Top health chief slams ‘shameful’ level of sexual harassment in the NHS

Sexual harassment levels in the NHS are “shameful”, with incidents happening all the time, one of the country’s top health chiefs has admitted.
Dr Navina Evans, chief workforce officer at NHS England, urged leaders to act on shocking levels of sexual harassment, following exposes by The Independent.
Asked about the one in eight workers who have reported unwanted sexual behaviour, she said: “It is shameful... I could tell you stories from my own experience from when I was a trainee right up to last year.
Last year, the NHS published its “sexual safety charter” which requires organisations to commit to eliminating sexual harassment and assault among staff and patients.  However, not all 240 NHS trusts have signed up to the charter yet, according to Dr Evans. She said: “It is really important that every organisation signs up.”
The NHS staff survey this year found one in eight workers – around 58,000 – had reported experiencing unwanted sexual behaviour in the last 12 months, while one in 26 reported experiencing similar harassment from a work colleague.
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Source: Independent, 27 April 2024
Patient-Safety-Learning

Fears over patient safety as Mid and South Essex NHS Foundation Trust looks to axe 600 jobs

Fears over patient safety have been raised after it was revealed that 600 jobs will be lost at hospitals in parts of Essex to save money.
Mid and South Essex NHS Foundation Trust - which runs Southend, Basildon, Broomfield, St Peter's in Maldon and Braintree hospitals - is facing a £91m pound black hole in it's budget and said that "reducing headcount" would be necessary.
The trust is one of the largest acute trusts in the country and employs 16,000 members of staff. It has a budget of around £1bn each year. Bosses said in a letter to staff that "all posts" must be reviewed, "including clinical roles". All current vacancies are being reviewed and no vacancies will be approved until that process is complete, they add.
The news has been criticised by campaign groups and union bosses, who say that patients could be put at risk. UNISON Eastern regional organiser Sam Older said: "This vacancy freeze will ring alarm bells for already overworked staff. These 600 posts weren't created for the hell of it - they are there to provide healthcare to 1.2 million people in Essex. The trust was already struggling with rising demand. Slashing staff numbers, cancelling bank shifts and long waits to fill vacancies is only going to make this worse. And there's a clear risk that cutbacks will pose a threat to patient safety if staffing levels fall too low."
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Source: ITV, 27 April 2024
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Inquest finds gross failings in care of woman who drank too much water

An inquest jury has found there were “gross failings in care amounting to neglect” before a woman had a heart attack at a private mental health hospital due to complications from drinking excessive amounts of water.
Lillian Lucas, 28, known as Lily to her family and friends, died in September 2022 after being found unresponsive in her room on Milton ward at the Cygnet hospital in Kewstoke, near Weston-super-Mare, where she had been an inpatient since June.
An inquest jury at Avon coroner’s court found on Wednesday that opportunities were missed by staff to render care that would have prevented Lucas’s death, including a failure to monitor her worsening condition and inadequate response to her deterioration.
On 8 September 2022 she was found unresponsive in her room after drinking excessive amounts of water and transferred to Bristol Royal Infirmary (BRI), the jury heard. She died the following day. Postmortem examinations found she died of a heart attack and the impact of psychogenic polydipsia, when due to a mental disorder a person experiences an uncontrollable urge to drink water.
The jury concluded on Wednesday that there were “gross failings in her care amounting to neglect”. In the record of the inquest, the jury said the Milton ward was “understaffed at a level deemed to be unsafe”.
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Source: Guardian, 24 April 2024
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NIHR funded study offers hope for targeted treatment of long COVID

An NIHR and UK Research and Innovation (UKRI) funded study has revealed that Long Covid leads to ongoing inflammation which can be detected in blood. 
This suggests that existing drugs which help treat conditions that affect the body’s immune system could be helpful in treating Long Covid, and should be investigated in future clinical trials. The study, which has been published in Nature Immunology, is from two collaborative UK-wide consortia, PHOSP-COVID and ISARIC-4C. These involve scientists and clinicians from universities across the UK, including Imperial College London and the Universities of Leicester, Edinburgh and Liverpool, among others.
The research compared 426 people who were experiencing symptoms consistent with Long Covid with 233 people who were also hospitalised for Covid-19 but had fully recovered. The researchers took samples of blood plasma and measured a total of 368 proteins known to be involved in inflammation and immune system modulation.
They found that, relative to patients who had fully recovered, those with Long Covid showed a pattern of immune system activation indicating inflammation of myeloid cells and activation of a family of immune system proteins called the complement system.
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Source: NIHR, 11 April 2024
Patient-Safety-Learning

Royal Pharmaceutical Society launches updated patient safety professional standards

The Royal Pharmaceutical Society (RPS) has published updated professional standards to support pharmacists, pharmacy technicians and pharmacy teams in responding to patient safety incidents.
Created in collaboration with the Association of Pharmacy Technicians UK (APTUK) and the Pharmacy Forum Northern Ireland (PFNI), the Patient safety professional standards: responding to patient safety incidents are designed to support pharmacy professionals to meet regulatory standards.
The standards, published on 24 April 2024, reflect new legislation and updated guidance from the General Pharmaceutical Council and NHS England, replacing the previous standards published in 2016.
They also provide a framework for reflecting, reporting and recording incidents, and sharing learning, taking action and reviewing and evaluating incidents as part of a patient safety culture.
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Source: The Pharmaceutical Journal, 24 April 2024
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Antipsychotics associated with much wider harms in dementia patients than thought

Use of antipsychotic medications in patients with dementia is linked with a much wider range of serious harms than previously thought, say UK researchers.
Although there have been safety warnings on use of the antipsychotics from regulators about increased risk of stroke and death, a large study has now found increased risks for pneumonia, venous thromboembolism, heart attack, heart failure, fracture, and acute kidney injury.
Reporting the findings in the BMJ, researchers from the University of Manchester said it underscores the need for increased caution when prescribing. The analysis showed that antipsychotic use was associated with increased risks for all outcomes looked at with the exception of ventricular arrhythmia. Over the first six months of treatment, it was estimated that antipsychotic use was linked with one additional case of pneumonia for every nine patients treated, and one additional heart attack for every 167 patients treated.
Professor Charles Marshall, professor of clinical neurology at Queen Mary University of London, said the study findings should prompt renewed efforts to reduce the prescribing of antipsychotics to people living with dementia. "There are rare circumstances where antipsychotics are genuinely required, and the benefits outweigh these risks, but for the majority of patients with behavioural symptoms that might lead to them being prescribed anti-psychotics, we should be focussing on much safer behavioural management approaches."
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Source: Pulse, 24 April 2024
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Biden administration imposes first-ever staff minimum for nursing homes

The Biden administration set a first-ever minimum staffing rule for nursing homes Monday, making good on the president’s promise more than two years ago to seek improvements in care for the nation’s 1.2 million nursing home residents. 
The final rule, proposed in September, requires a registered nurse to be on-site in every skilled nursing facility for 24 hours a day, seven days a week. It mandates enough staff to provide every resident with at least 3.48 hours of care each day. And it beefs up rules for assessing the care needs of every resident, which will boost staff numbers above the minimum to care for sicker residents.
For a facility with 100 residents, it translates to a minimum of two or three registered nurses and at least 10 or 11 nurse aides per shift, as well as two additional staffers who could be nurses or aides per shift, according to the administration’s interpretation of its new formula. Set to phase in over the next few years, the mandate will replace the current vague standard that gives operators wide latitude on how to staff their facilities.
While the administration has said the rule will improve care, industry lobbyists have said it’s unworkable, with staffing goals that will be impossible to achieve because of a shortage of workers.
The administration received 47,000 public comments on the rule since it was proposed last September. They included observations of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, Secretary of Health and Human Services Xavier Becerra said in an interview Monday.
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Source: Washington Post, 22 April 2024
Patient-Safety-Learning

Deprivation linked to higher second cancer risk among England breast cancer survivors

Female survivors of breast cancer living in the most deprived areas have a 35% higher risk of developing second, unrelated cancers, compared with those from the most affluent areas, research shows.
Breast cancer is the most commonly diagnosed cancer in the UK, with about 56,000 people being told they have it each year. Improved diagnosis and treatments mean that five-year survival rates are now 86% in England. People who survive breast cancer have a greater likelihood of second primary (unrelated) cancer, but until now the exact risk has not been clear.
A team of researchers led by the University of Cambridge analysed NHS data from almost 600,000 patients in England and found, compared with the general female population, women who had survived breast cancer had an increased risk of developing 12 other primary cancers. Compared with the most affluent, the least well-off female survivors of breast cancer had a 166% greater chance of developing lung cancer, a 78% higher risk of stomach cancer, more than 50% increased risk of bladder and oesophagus cancers, 48% higher risk of head and neck cancer and 43% increased risk of kidney cancer.
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Source: Guardian, 24 April 2024
Patient-Safety-Learning

Grieving father calls for criminal inquiry into Priory following deaths of four women

A bereaved father whose vulnerable son died after managing to escape from the Priory has called for a criminal inquiry into the mental health care group after the deaths of four more patients.
Richard Caseby, who lost his son Matthew, has campaigned for three years against the privately run group after an inquest found his son’s death was contributed to by neglect. The 23-year-old was able to abscond from the hospital over a fence which had previously been identified as a risk. He was hit by a train just hours later.
Now the Priory, one of the UK’s largest mental health providers, faces new scrutiny as coroners are set to examine the death of 20-year-old Amina Ismail, who died while at the Cheadle Royal Hospital in Stockport. Ms Ismail died in September 2023, a year after three other young women died at the same unit - Beth Matthews, 26, Lauren Bridges, aged 20, and 30-year-old Deseree Fitzpatrick.
Mr Caseby, a former newspaper editor, told The Independent: “The Priory is a fundamentally dangerous company, one that persistently refuses to learn from its mistakes and neglect. The roll call of death and disgrace at its hospitals just gets longer.”
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Source: Independent, 25 April 2024
Patient-Safety-Learning

Unplanned ‘Ozempic babies’ may be harmed by weight-loss drugs

Women have been told to avoid using weight-loss drugs to help them get pregnant, as doctors report a rise in surprise “Ozempic babies”.
Some women struggling with infertility have unexpectedly become pregnant after being prescribed semaglutide, which is used to treat obesity and type 2 diabetes under the brand names Wegovy and Ozempic.
However, scientists have now issued a warning that the weight-loss injections may cause birth defects and should not be used by anyone hoping to become pregnant.
Professor Tricia Tan, from the department of metabolism, digestion and reproduction at Imperial College London, said: “Women need to know that these drugs should not be used during pregnancy. You can also see that most of the clinical trials have not included women who are intending to become pregnant. Animal studies did show that the animal babies born to animals who were given these medications had problems.”
Read full story (paywalled)
Source: The Times, 23 April 2024
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Asthma: Action needed on needless deaths, says charity

Urgent government action is needed to stop preventable asthma deaths, a leading charity has said.
More than 12,000 people in the UK have died from asthma attacks since 2014, according to Asthma and Lung UK.
It said the figures meant "shockingly little" had changed since a major report a decade ago which found two thirds of asthma deaths could have been avoided with better care.
People with asthma should get an annual condition review, a written action plan and inhaler technique checks.
But the charity said people with asthma were being "failed", with seven out of 10 not receiving basic care, partly because healthcare workers were over-stretched.
Asthma and Lung UK said 31% of asthmatics were "disengaged" with managing their condition, putting them at higher risk, according to its research.
Ministers in England and Wales said they were trying to improve services.
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Source: BBC News, 24 April 2024
Patient Safety Learning

Stroke and heart attack patients wait more than a day for ambulances, new figures reveal

Patients needing urgent treatment for life-threatening illness such as strokes or heart attacks waited more than 24 hours for an ambulance response, new figures show.
New data shows the crisis facing NHS ambulance services resulted in every region missing vital NHS targets to respond to some of the most critically unwell patients last year.
Despite improvements compared to 2022, figures obtained by the Liberal Democrat party show ambulance services continued to struggle with response times to category two patients, which may include those who have suffered a stroke or heart attack and should receive a response within 18 minutes.
In two cases patients needing this level of response, in Warrington and Staffordshire, waited more than 25 hours for an ambulance.
Sir Julian Hartley, chief executive at NHS Providers, which represents all NHS trusts, called for “urgent” investment and warned that “rising demand, limited resources and vast staff shortages are piling pressure on an already-stretched service, further driving up ambulance waiting times.”
He said NHS hospital and ambulance leaders are working to reduce delays and responses at a time “when demand has never been higher.”
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Source: The Independent, 23 April 2024
Patient Safety Learning

Ethnic minorities in England ‘need more GP visits’ before cancer diagnosis

Ethnic minorities and young people require more visits than other people to the GP before being diagnosed with cancer, according to new analysis.
On average, one in five people across England require three or more GP interactions before being diagnosed with cancer. But for people from ethnic minority backgrounds, the figure rises to one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation.
For young people aged between 16 and 24, about half needed at least three GP visits before being diagnosed, with 20% needing at least five visits. Despite this, young people were still more likely to be diagnosed at an early stage in their cancer.
Prof Kamila Hawthorne, the chair of the Royal College of GPs, said that identifying cancer symptoms in young people could be challenging as the risk for the group was generally much smaller.
Hawthorne said: “Ensuring patients receive timely and appropriate referrals for suspected cancers is a priority for GPs – and to this end, they are doing a good job, making more urgent referrals and ensuring more cancers are being diagnosed at an early stage than ever.
“Whilst GPs are highly trained to identify cancers, this remains challenging in primary care, not least and particularly with some cancers, because the symptoms are often vague and typical of other, more common conditions.”
Dr Liz Fisher, senior fellow at the Nuffield Trust, said: “Delays to a cancer diagnosis pose real risks for people and an early diagnosis plays a pivotal role in determining the treatments available to people and determining outcomes.
“The NHS has set an ambitious goal to dramatically increase early detection of cancer, but performance in this area has stubbornly stalled in recent years. Everyone’s experience of cancer diagnosis is different but the risks to delays aren’t felt equally, with younger people and those from minority ethnic groups requiring more visits to health professionals to secure a diagnosis.”
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Source: The Guardian, 24 April 2024
Patient Safety Learning

Block on data sharing contributed to death

A failure to share medical information between IT systems contributed to the death of a man in prison custody, a coroner has concluded.
In a newly published report on the death of Finlay Finlayson at HMP Lewes in 2019, the coroner highlighted “information sharing” problems and “permissions issues” between the prison IT system and that of the man’s GP surgery. 
Mr Finlayson died from blood clots in his lungs, having suffered from multiple long-term health conditions including cancer during his life. At the time of his death in 2019, health services at HMP Lewes were provided by Sussex Partnership Foundation Trust, though they are now provided by the Practice Plus Group.
According to the Prevention of Future Deaths report issued last month, coroner Laura Bradford heard evidence that Mr Finlayson’s care was affected by “confusion and uncertainty about his medical conditions caused by information sharing and permissions issues with SystmOne”.
It appears the GP practice had not enabled sharing of the data, which would have been required for it to be accessed in the prison.
Read full story (paywalled)
Source: HSJ, 22 April 2024
Further reading on the hub:
NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn? The digitalising of patient records — why patients MUST be involved
Patient Safety Learning

Medical device companies pay millions to NHS while pushing products, says study

Medical device companies are paying millions of pounds to hospitals in the UK to fund staff places, as well as training and awareness campaigns, while pushing sales of their products, including implants, heart valves and diagnostic equipment, a new report reveals.
An analysis of disclosures by medical device companies found that between 2017 and 2019 they reported €425m (£367m at today’s rates) in payments to healthcare organisations in Europe, according to the study in the journal Health Policy and Technology.
The businesses reported paying more than €37m to hospitals and other healthcare bodies in the UK over the three-year period. The disclosures include payments to some of the biggest hospital trusts in England.
James Larkin, one of the authors of the study and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the filings did not include consultancy fees for medical staff and many companies did not register their payments. “This is just the tip of the iceberg,” he said. “There is a huge number of payments that are not being disclosed. The descriptions for payments which are disclosed are very vague and it is not completely clear what they are for.”
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Source: The Guardian, 20 April 2024
Patient Safety Learning

How Covid is pushing up waiting lists for cancer treatment

New figures have quantified what the pandemic has meant for cancer waiting lists—and the impact is stark. 
Official data show that 15,971 cancer patients in the UK have had to wait more than 124 days, or four months, after diagnosis for their treatment to start since 2020 as the pandemic sends waiting lists soaring. The statistics show that the number of untreated patients has more than doubled since Covid began, with one patient waiting for more than two years, according to data released following a freedom of information request from the Liberal Democrats. This is despite an NHS target for patients to receive cancer treatments within two months of an urgent referral.
Last year, 6,334 patients waited more than 124 days, compared to 2,922 in 2022, the figures show. Data was received from 69 out of 137 acute health trusts in the UK, meaning the true number of people waiting long periods for treatment is likely to be much higher. Over 1,100 cancer patients last year were left waiting more than six months to receive treatment, triple the NHS target time.
Liberal Democrat Leader, Ed Davey, said: “Every single one of these figures is a tragedy. Long delays for treatment can have a devastating impact on cancer patients and their families, and in certain cases can even cost lives."
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Source: inews, 22 April 2024
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