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

Thousands of children unsure of gender identity ‘let down by NHS’, report finds

Thousands of vulnerable children questioning their gender identity have been let down by the NHS providing unproven treatments and by the “toxicity” of the trans debate, a landmark report has found.
The UK’s only NHS gender identity development service used puberty blockers and cross-sex hormones, which masculinise or feminise people’s appearances, despite “remarkably weak evidence” that they improve the wellbeing of young people and concern they may harm health, Dr Hilary Cass said.
Cass, a leading consultant paediatrician, stressed that her findings were not intended to undermine the validity of trans identities or challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress.
But she said this care was made even more difficult to provide by the polarised public debate, and the way in which opposing sides had “pointed to research to justify a position, regardless of the quality of the studies”.
“There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.”
Read full story
Source: The Guardian, 10 April 2024
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England falls short on early cancer diagnosis goals

The ambition to diagnose cancer in its earliest stages in England is “seriously off target”, according to a new report by QualityWatch, a research programme by the Nuffield Trust and The Health Foundation
A rise in urgent referrals in recent years has contributed to delays, along with patients finding it difficult to raise concerns about cancer with GPs. Inequalities in diagnosis, particularly among young people, those in deprived areas, and patients from ethnic minorities, was also highlighted by researchers.
Experts said that while family doctors are “highly trained” to identify cancers, the issue remains a challenge in primary care because some symptoms can be vague.
The NHS Long Term Plan said the health service is aiming to diagnose 75% of cancer patients when the disease is in its early stages by 2028.
However, analysis of NHS data by QualityWatch said “our current course shows we are seriously off target”.
More than 320,000 people in England were diagnosed with cancer in 2021 – the equivalent of some 900 a day – the report said, with the number of urgent cancer referrals rising since 2009 to more than two million in 2020/21.
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Source: Medscape, 24 April 2024
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Urology inquiry: Waiting lists greatest source of harm

A former consultant at the Southern Health Trust has told an inquiry into urology services that waiting lists are the "greatest source of patient harm".
The inquiry was established in 2021 and is examining the trust's handling of urology services prior to May 2020.
Aidan O'Brien became a consultant urologist in Craigavon Area Hospital in July 1992.
His work is at the centre of the inquiry.
Giving evidence on Monday, he said waiting list figures highlighted what "myself and my colleagues [have said] for decades" and described it as a "grossly inadequate service".
"If you look at four-and-a-half years for urgent surgery, it is appalling," he told the inquiry.
"I don't have a magic solution to the current situation, which is dire."
Read full story
Source: BBC News, 8 April 2024
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One in three health workers suffering ‘burnout’ amid NHS staffing crisis

Almost one in three NHS employees have had to take time off work suffering poor mental health in the past year, new research suggests.
The Unison union said its survey of 12,000 health workers shows the impact of a staffing crisis, with many suffering “burnout”.
Panic attacks, high blood pressure, chest pains and headaches are among the physical signs of stress reported by nurses, porters, 999 call handlers and other NHS staff who completed the survey.
The news comes as more than half of the mental health hubs launched for NHS workers after the pandemic have closed since last year, according to the British Psychological Society.
Unison said workforce pressures are taking a huge toll as staff tackle a waiting list backlog, with many struggling to look after their wellbeing.
Of those who were off with mental health problems, one in five said they did not tell their employer the real cause of their absence, mainly because they did not feel their manager or employer would be supportive.
The union said staff feel undervalued and frustrated, with many quitting for less stressful jobs that pay more.
Read full story
Source: The Independent, 8 April 2024
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Rats and cockroaches among thousands of pests found at English hospitals

Thousands of pests including rats, cockroaches and bedbugs have been found at NHS hospitals in England as the health service buckles under a record high repair bill.
Hospital bosses are having to spend millions of pounds on pest control after discovering lice, flies and rodents in children’s wards, breast clinics, maternity units, A&E departments and kitchens, in the most graphic illustration yet of the dismal and dangerous state of the NHS estate.
NHS bosses have repeatedly warned ministers of the urgent need to plough cash into fixing rundown buildings in order to protect the safety and dignity of patients and staff. The maintenance backlog now stands at £11.6bn in England.
Figures obtained under freedom of information laws and reviewed by the Guardian suggest the NHS is struggling to cope with an army of pests plaguing decrepit hospitals.
There were more than 18,000 pest incidents in the last three years, the NHS data reveals. There were 6,666 last year, equivalent to 18 a day. The figures also show NHS bosses are having to spend millions of pounds calling out pest control and dealing with infestations, with £3.7m spent in the last three years.
Read full story
Source: The Guardian, 9 April 2024
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Black people who spot cancer symptoms are taking twice as long to be diagnosed

Black and Asian people who spot cancer symptoms are taking twice as long to be diagnosed as white people, a shocking new study shows.
Research by Bristol Myers Squibb (BMS) and Shine Cancer Support shows that people from minority ethnic backgrounds face an average of a year’s delay between first noticing symptoms and receiving a diagnosis of cancer.
These groups report more negative experiences of cancer care than white people, limited knowledge about the diseases and lack of awareness of support services, which all contribute to later diagnostic rates.
“In a year that’s revealed that the UK’s cancer survival lags behind comparable countries, I am saddened but unsurprised that people from minority ethnic groups face additional hurdles that delay their diagnosis.” said Ceinwen Giles, co-ceo of Shine Cancer Support.
“We know that catching cancer earlier saves lives, yet with year long waits for some people, collaborative efforts between health leadership, advocacy groups and the pharmaceutical industry are required.”
Read full story
Source: The Independent, 9 April 2024
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Sexual harassment of NHS staff widespread

NHS staff including ambulance workers, porters, nurses and cleaners have been shown pornographic images, offered money for sex, and assaulted at work, according to new research.
The widespread incidents of sexual harassment are revealed in a wide-ranging survey published by the Unison union on the first day of its annual health conference in Brighton.
In the study of more than 12,200 health workers, one in 10 reported unwanted incidents including being touched or kissed, demands for sex in return for favours, and derogatory comments.
Royal College of Nursing chief nurse Professor Nicola Ranger said: “These figures paint an incredibly disturbing picture."
In the survey, sexual assault was reported by 29% of respondents who had experienced harassment, while half said they have been leered at or been the target of suggestive gestures.
One in four who had been harassed said they have suffered unwelcome sexual advances, propositions or demands for sexual favours.
Half the staff had not reported sexual harassment to their employer, amid concerns of being considered “over-sensitive” or feeling complaints would not be acted on.
Read full story
Source: BBC News, 8 April 2024
Patient Safety Learning

Plans for Royal Mail delivery cuts could risk patient safety, NHS leaders warn

NHS leaders have warned that Royal Mail’s plans to cut second-class deliveries to two days a week could risk patient safety.
The changes are part of wider measures announced by Royal Mail’s parent company, International Distributions Services (IDS), including cuts of up to 9,000 routes, which could take more than two years to implement, saving £300m a year. IDS has assured the Royal Mail workforce that there will be no compulsory redundancies and they will request only 100 voluntary redundancies.
In a letter sent to the Telegraph, executives from the NHS, Healthwatch England, the Patients Association and National Voices said the Royal Mail proposals would increase the cost of missed appointments, which already exceeds £1bn.
The letter said: “Provisional Healthwatch data suggest that more than 2 million people may have missed medical appointments in 2022-23 due to late delivery of letters, and this will only deteriorate under the proposed new plans.”
Sir Julian Hartley, the chief executive of NHS Providers, said the proposed delays were “extremely unhelpful”.
“It’s really important that patients be updated at the earliest opportunity on developments in their care and treatment,” he said.
“An efficient, punctual postal service remains a key part of that process. At a time when far too many patients already face long delays – the last thing any trust leader wants – anything that adds to that uncertainty, and possibly the worsening of conditions, would be extremely unhelpful.”
Jacob Lant, the chief executive of health charity National Voices, said: “The proposals being consulted on risk further delaying vital communications and worsening digital exclusion, therefore unfairly widening health inequalities. NHS mail must remain a priority service.”
Read full story
Source: The Guardian, 6 April 2024
Patient Safety Learning

Long Covid blood clues could prompt future trials

People with long Covid have evidence of continuing inflammation in their blood, which could help understanding of the condition and how it may be treated, a UK study suggests.
It found the presence of certain proteins increased the risk of specific symptoms, such as fatigue, in people sick enough to need hospital treatment.
It is unclear whether milder cases of Covid have the same effect on the body.
A test remains a long way off - but the findings may prompt future trials.
Read full story
Source: BBC News, 8 April 2024
Related reading on the hub:
Top picks: 12 research papers on Long Covid
Patient Safety Learning

New CQC inspections put on hold by ministers

The Care Quality Commission’s assessments of integrated care systems (ICSs) have been put on hold at the last minute, as the government declined to sign off on the process.
They were due to begin this month, following pilots in Birmingham and Solihull and Dorset ICSs, but the Care Quality Commission (CQC) has put the brakes on assessments elsewhere until it receives government approval.
Under the legislation brought in when ICSs were set up in 2022, the CQC can review and assess systems, but ministers must approve its methodology.
Interim chief inspector of adult social care and integrated care James Bullion wrote to integrated care board chiefs this week stating that, following discussions with the Department of Health and Social Care, the CQC had agreed to a “short delay… to allow for further refinements to our approach”.
He added: “In particular we have been working with NHS England on their strengthened approach to performance evaluation and rating of the ICB elements of the ICS which we will take into account as evidence for our scoring and reporting approach.”
Read full story (paywalled)
Source: HSJ, 8 April 2024
Patient Safety Learning

Fire warnings yet to be fully dealt with at eight hospitals

Eight hospitals in England have fire safety warnings attached to them, with half in place since 2022 or earlier, HSJ can reveal.
All are enforcement notices issued by fire brigades when serious risks are not being managed. Issues raised include risk assessments, maintenance, and emergency routes.
There were more than 1,300 fires across the NHS trust estate in 2022-23, according to official estates data, which was an increase of 18% on the year before.
NHS Providers deputy chief executive Saffron Cordery said the figures highlighted the “urgent need” to address maintenance backlog – which includes fire safety – across the NHS estate. The overall backlog figure has been growing yearly and is approaching £12bn.
Ms Cordery said: “Greater capital investment is essential to enabling a safe environment for patients and staff.”
Rory Deighton from NHS Confederation said more than a decade of underinvestment was behind the “dilapidated” state of the NHS estate.
Read full story (paywalled)
Source: HSJ, 5 April 2024
Patient Safety Learning

NHS testing initiative to eliminate hepatitis C in England by 2025

Thousands of people who are unknowingly living with hepatitis C in England could be identified and treated due to an expanded NHS testing initiative.
The initiative includes new liver scanning and portable testing units to be rolled out in communities where people may be at a higher risk of contracting the infection.
Also included in the initiative are testing events happening at GP surgeries and community outreach at drug and alcohol support services.
Read full story
Source: Guardian 8 April 2024
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Tenfold rise in A&E patients waiting more than 24 hours for a bed

More than 150,000 patients had to wait a day in A&E before getting a hospital bed last year, according to new data.
Freedom of information data compiled by the Liberal Democrats from 73 hospital trusts – about half the total – found that the number of patients forced to wait more than 24 hours in A&E before a bed could be found for them has increased by tenfold since 2019. The majority of those forced to wait were elderly or frail, with two-thirds of the patients over the age of 65.
Read full story
Source: Guardian 8 April 2024
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Black women in England suffer more serious birth complications, analysis finds

Black women are up to six times more likely to experience some of the most serious birth complications during hospital delivery across England than their white counterparts, with the figures being described as “stark” and disheartening”, according to analysis.
Black women made up 26% of women who experienced the birth complication pre-eclampsia superimposed on chronic hypertension during delivery, despite making up just 5% of all deliveries across England, according to a Guardian analysis of NHS figures for 2022-23.
They were six times more likely to experience this pregnancy complication than their white counterparts, who made up 47.2% of these cases despite making up 70% of all deliveries.
Read full story
Source: Guardian, 8 April 2024
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‘I had no idea my baby was at risk’: The fight to raise awareness of pre-eclampsia

Pre-eclampsia affects between 1% and 5% of pregnant women, but more can be done to inform people about its dangers.
While pregnant with her son in 2015, Chipiliro Kalebe-Nyamongo’s pregnancy was generally smooth – until she reached about 33 weeks. She started to develop high blood pressure, and was admitted to hospital to be monitored. It was during this period that Kalebe-Nyamongo became concerned when she didn’t feel her baby’s movements as usual.
Read full story
Source: Guardian, 8 April 2024
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Spire Healthcare: Death of NHS-funded private patient raises safety concerns

A woman died when a major private healthcare provider failed to transfer her to NHS intensive care quickly enough after she became critically ill.
Sabrina Khan said Spire Healthcare staff "should have known something was wrong" with her mother, Nafisa.
The BBC also obtained testimony from doctors - contracted by the company to work up to 168 hours a week - who say long hours could put patients at risk.
Spire Healthcare has apologised for failings in Nafisa Khan's care.
The death of Mrs Khan from east London is one of several deaths following surgery at Spire Healthcare, looked at by BBC Panorama.
Read full story
Source: BBC News, 8 April 2024
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