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

Police investigate 105 cases of alleged negligence in Brighton hospital

Police are investigating 105 cases of alleged medical negligence at the Royal Sussex County Hospital in Brighton amid claims of a cover-up.
Specialist officers from the National Crime Agency and Sussex police are looking into cases of harm, which include at least 40 deaths, in the general surgery and neurosurgery departments between 2015 and 2021.
An email from Sussex police, released to The Times after a court application, revealed the huge investigation is looking into 84 cases connected to neurology and 21 related to gastroenterology. Most of the families are yet to be told that their case is among them.
Officers were called in by the senior coroner after she heard of allegations made by two consultant surgeons at University Hospitals Sussex NHS Foundation Trust, one of the largest NHS organisations with 20,000 staff.
The trust has been accused of bullying the whistleblowers and attempting to cover up the circumstances of the deaths. Mansoor Foroughi, a consultant neurosurgeon, was sacked for “acting in bad faith” in December 2021 after raising concerns about 19 deaths and 23 cases of serious patient harm.
Another whistleblower, Krishna Singh, a consultant general surgeon, claimed that he lost his post as clinical director because he said the trust promoted insufficiently competent surgeons, introduced an unsafe rota and had cut costs too quickly.
Read full story (paywalled)
Source: The Times, 27 November 2023
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Police to investigate former neurologist Michael Watt

The police have begun an investigation into the clinical practices of former consultant neurologist Michael Watt.
He was at the centre of Northern Ireland's largest patient recall in 2018.
Over 5,000 patients were recalled amid concerns over his clinical practice.
In a highly significant move, an email was sent to patients and families of deceased patients and explained that the investigation is called Operation Begrain.
It will be conducted by a major investigation team led by Det Ch Insp Neil McGuinness and Det Insp Gina Quinn.
Danielle O'Neill, a former patient of Dr Watt, said she and others are in "complete shock and hope that at last justice will be done".
"It's been a long and difficult five years and it is not over yet," she added.
Earlier this month a medical tribunal found that the former doctor's fitness to practice was "currently impaired" and that his professional performance was "unacceptable".
An appeal will be made to former patients who have concerns regarding their medical treatment by Michael Watt, to come forward to the police.
A short questionnaire will also be shared in order to "capture patients' concerns", that information will go straight to the investigation team and will be the first step in the police investigative process.
Read full story
Source: BBC News, 28 November 2023
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At least 20,000 annual UK cancer deaths avoidable, says charity

At least 20,000 cancer deaths a year could be avoided in the UK with a national commitment to invest in research and innovation, and fix the NHS, says Cancer Research UK.
Progress is being made in finding new treatments for the condition that affects 50% of people at some point. But the charity says the UK lags behind comparable countries for survival.
It has launched a manifesto of priorities for this government and the next, ahead of a general election.
The document sets out what the charity says needs to change - and fast.
Whoever is running the country must commit to developing a 10-year cancer plan, spearheaded by a National Cancer Council accountable to the prime minister to bring government, charities, industry and scientific experts together, it says.
Key areas to focus on include:
More investment in research to close an estimated £1bn funding gap. Greater disease prevention - banishing smoking to the history books, for example. Earlier diagnosis, through screening. Better tests and treatments, as well as cutting NHS waiting lists and investing in more staff. Read full story
Source: BBC News, 28 November 2023
Patient Safety Learning

‘They thought I had cancer’: painkiller banned in UK linked to Britons’ deaths in Spain

A patients group representing several British victims has launched legal action against the Spanish government over claims it failed to safeguard people against the potentially fatal side effects of one of the country’s most popular painkillers, involved in a series of serious illnesses and deaths.
The drug metamizole, commonly sold in Spain under the brand name Nolotil, is banned in several countries, including Britain, the US, India and Australia. It can cause a condition known as agranulocytosis, which reduces white blood cells, increasing the risk of potentially fatal infection.
The Association of Drug Affected Patients (ADAF) says adverse reactions to the drugs have led to sepsis, organ failure and amputations. It has identified about 350 suspected cases of agranulocytosis between 1996 and 2023, including those of 170 Britons who live in Spain or were on holiday there.
The ADAF is examining more than 40 fatalities in which it considers the drug may have led, or contributed, to death. The patients group says that case reports, including a 2009 study, suggest the British population may be more susceptible to the drug’s side effects, but this has not been confirmed by independent scientific study.
The group is demanding an investigation into the drug and new controls. It filed its action on 14 November in the national court in Madrid. Cristina García del Campo, founder of the organisation, said: “This drug has destroyed people’s lives and it should now be withdrawn. One lady took three tablets and she had part of her feet amputated and several fingers. Even if it doesn’t kill you, once you’ve had sepsis your body is never the same.”
Read full story
Source: The Guardian, 26 November 2023
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NHS in crisis as almost half of maternity wards are offering substandard care

Almost half of all English maternity units are offering substandard care, making it one of the worst performing acute medical services in the NHS, Byline Times analysis has found.
The analysis, based on inspections of English hospitals by the Care Quality Commission (CQC), found that 85 of 172 inspected maternity services in England received ratings of ‘inadequate’ (18) or ‘requires improvement (67) at their latest inspection.
Some 65% of maternity wards were given subpar ratings for patient ‘safety’ one of several metrics looked at by the CQC.
The findings come after the health regulator began a focused inspection programme of maternity wards last year after the a government review into the Shropshire maternity scandal, which saw 300 babies left dead or brain damaged by shoddy care.
In one unit at Gloucestershire Royal Hospital, there was a shortage of midwives, not all medicines practices were safe which “potentially placed women at risk of harm” and serious incidents were not being investigated. The report found a backlog of 215 patient safety incidents that had not yet been looked into, as of March this year.
Maria Caulfield, Minister for Women’s Health Strategy, told Byline Times that “maternity care is of the utmost importance to this Government” and stressed they have “invested £165 million a year since 2021 to grow the maternity workforce and improve neonatal services”.
“Every parent must be able to have confidence in the care they receive when giving birth, and we are working incredibly hard to improve maternity services, focusing on recruitment, training, and the retention of midwives,” she added.
Read full story
Source: Byline Time, 28 November 2023
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Coeliac UK calls for change following death of coeliac patient in hospital

A North Wales coroner has concluded there was a ‘gross failure’ in the case of a coeliac patient, who tragically died in Wrexham Maelor hospital.
Mrs Hazel Pearson, 79, had coeliac disease and a number of other medical conditions and died from aspiration pneumonia four days after being given Weetabix for breakfast while at the hospital.
Whilst her coeliac disease was noted on her admission records, there was no sign above her bed and staff were unaware of her dietary needs and as a result Mrs Pearson had been fed gluten containing food on multiple occasions.  
Tristan Humphreys, Head of Advocacy for Coeliac UK said: 
“We are deeply saddened and concerned by this verdict and our thoughts go out to Mrs Pearson’s loved ones at this very difficult time. Her death reflects a clear failure of care and it is patently unacceptable that this was allowed to happen. Coeliac disease is a serious autoimmune condition for which the only treatment is a medically prescribed gluten free diet. It is critical that people with coeliac disease can access the gluten free food they need to be healthy. This is all the more important when someone is unwell and, as in Mrs Pearson’s tragic case, unable to advocate for themselves. Wales has mandatory food standards which make very clear the level of care that should be provided yet these have not been met. As a charity, we are empowering patients, family members, carers and working with hospital caterers by providing advice and guidance to support safe provision of gluten free food. However, it’s high time the health service consistently delivered the care people with coeliac disease deserve.” 
Read full story
Source: Coeliac UK, 24 November 2023
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NHS care delays in England harmed 8,000 people and caused 112 deaths last year

Almost 8,000 people were harmed and 112 died last year as a direct result of enduring long waits for an ambulance or surgery, prompting warnings that NHS care delays are “a disaster”.
The fatalities included a man who died of a cardiac arrest after waiting 18 minutes for his 999 call to be answered by the ambulance service and was dead by the time the crew arrived.
The figures are the first time NHS England has disclosed how often doctors and nurses file a patient safety report after someone suffers harm while waiting for help.
They show that patient deaths arising directly from care delays have risen more than fivefold over the last three years, from 21 in 2019 to 112 last year, as the NHS has come under huge strain. The number of people who came to “severe harm” has also jumped from 96 to 152 during that period.
“These data are alarming and show quite clearly the human impact the crisis in the NHS is having on individual patients,” said Rachel Power, the chief executive of the Patients Association. “We have been watching a disaster unfolding across the NHS and have repeatedly warned about the threat to patient safety because of it.”
Read full story
Source: The Guardian, 27 November 2023
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Scandal of healthy mental health patients trapped in hospitals for years

Mental health patients have been left languishing in hospitals for years due to a chronic shortage in community care, as the number of people trapped on wards hits a record high, The Independent can reveal.
Analysis shows 3,213 patients were stuck on units for more than three months last year, including 325 children kept in adult units. Of those a “deeply concerning” number have been deemed well enough to leave but have nowhere to go.
One of these cases was Ben Craig, 31, who says he was left “scarred” after being stranded on a ward for two years – despite being fit enough to leave – because two councils fought over who should pay for his supported housing.
He missed his daughter's birth and didn’t meet her until she was 18 months old while waiting to be discharged, which only exacerbated his depression.
He told The Independent: “I was promised I was going to be moving on, but it just seemed like it went on forever.”
Saffron Cordery, deputy chief executive for NHS Providers, which represents hospitals, told The Independent mental health patients stuck in hospitals were experiencing “personal distress” and getting ill again while they wait.
She called on the government to put mental health on an “equal foot” to physical care and said not doing so suggested the government was content not to treat all patients equally.
Read full story
Source: The Independent, 27 November 2023
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Chaotic communication by NHS in England ‘causing treatment delays’

Chaotic communication by the NHS in England is causing harmful delays to treatment and endangering patient health, according to research.
Widespread communication problems that leave patients and staff scrambling to find their referrals, missing appointments, or receiving late diagnoses have been uncovered in a study by the Demos thinktank, the Patients Association, and the PMA, a professional membership body for healthcare workers.
In a poll of 2,000 members of the public and NHS staff across England in October, more than half said they had experienced poor communication from the health service in the past five years, with one in 10 saying their care had been affected as a result.
The research also found that over the last year, 18% had their care, or the care of an immediate family member, delayed or affected because they were referred to the wrong service, while 26% said they or a close family member had been inconvenienced because they were given the date and time of an appointment without enough notice.
Miriam Levin, the director of participatory programmes at Demos, said that despite the great esteem and pride in the NHS, patients found navigating the system frustrating and stressful. “We heard countless stories of critical appointments missed, diagnoses not shared or shared too late, and referrals for treatment that went missing. This leads to real harm,” she said.
Read full story
Source: The Guardian, 27 November 2023
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Hysteroscopy without anaesthetic like being flayed alive

Undergoing a medical procedure without an anaesthetic felt like being "flayed alive", according to Dee Dickens.
The 53-year-old is one of many in the UK who have reported having a hysteroscopy, which is used to examine the uterus, without enough pain relief.
Clinical guidelines say patients must be given anaesthetic options before the gynaecological exam.
Cwm Taf Morgannwg health board said it was concerned by the experiences of Ms Dickens and urged her to get in touch.
Ms Dickens, from Pontypridd, Rhondda Cynon Taf, had a hysteroscopy as an outpatient at the Royal Glamorgan Hospital in Llantrisant after experiencing bleeding despite being menopausal.
Ms Dickens said her medical notes and past childhood sexual abuse were not considered and she was not offered a local anaesthetic prior to the procedure in October 2022.
Due to underlying health conditions, including fibromyalgia and Ehlers-Danlos Syndromes (EDS), she was reluctant to have a general anaesthetic as it would have left her "poorly for weeks" so she had the hysteroscopy on painkillers only.
"Everybody's bustling, so it's really difficult to advocate for yourself," said Ms Dickens.
When the procedure began, she said she felt extreme pain, adding: "I was very aware that I was a black woman who felt like she was being experimented on with no anaesthetic.
"They took out my coil and then they started on the biopsies and good God, that felt like being flayed alive. It was awful.
"It was like having my insides scraped out and blown up all at the same time."
Read full story
Source: BBC News, 27 November 2023
What is your experience of having a hysteroscopy? Add your story to our painful hysteroscopy hub community thread.
 
Patient Safety Learning

‘A fake Ozempic jab nearly killed me – it’s time for the Government to step in’

A 45-year-old mother who almost died after injecting herself with a life-threatening amount of insulin she thought was Ozempic is calling on the Government and social media companies to crack down on the online counterfeit weight-loss jab trade.
Michelle Sword, a receptionist from Carterton, Oxfordshire, first took Ozempic without any issues after she was prescribed it by a legitimate online pharmacy in early 2021. Ms Sword said she completed an online questionnaire and gave a false BMI that she knew would qualify her the drug. “I just told them what they wanted to hear,” she said.
Ms Sword said she takes responsibility for her actions, but criticised rogue sellers for taking advantage of people with insecurities and selling a product that “can kill you”.
She also wants the Government and social media companies to step in to tackle the trend. “I think the drug was in such infancy in what we knew about it that they weren’t able to “police” who got it, who took it, who sourced it. I think they [the Government] need to look at that.”
Read full story (paywalled)
Source: inews, 26 November 2023
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Bristol surgeon Tony Dixon defends not waking patient for consent

A surgeon has said it would have been "cruel and unacceptable" to have woken up a patient to get consent for a mesh operation.
Anthony Dixon is accused of failing to provide adequate clinical care to five patients at Southmead Hospital and the private Spire Hospital in Bristol.
He had pioneered the use of artificial mesh to lift prolapsed bowels.
Mr Dixon appeared at a Medical Practitioners Tribunal Service (MPTS) hearing in Manchester on Thursday.
He faces charges of performing procedures that were not "clinically indicated", failing to carry out tests and investigations and failing to obtain consent from patients.
It followed complaints many had suffered pain or trauma after having pelvic floor surgery using artificial mesh, a technique known as laparoscopic ventral mesh rectopexy (LVMR).
Giving evidence, he was asked why he did not consider waking up one female patient who underwent an LVMR, to get her consent to surgery.
Mr Dixon said it would have meant giving her more drugs for pain relief and could have "multiplied the risks" to her.
He is also accused of failing to advise patients about the risks of procedures, failing to discuss non-surgical options and dismissing patients' concerns when they experienced pain or other symptoms following surgery.
Read full story
Source: BBC News, 23 November 2023
Related reading on the hub:
Woman’s mesh consent form was changed after signing – how can patients be better protected?  
Patient Safety Learning

Official data masking long waits for the sickest patients

Several trusts are failing to admit their sickest emergency patients in a timely fashion, despite performing well in official waiting time statistics, HSJ can reveal. 
The internal NHS England data, obtained via a Freedom of Information request, reveals 12 trusts which have performed above the average against the four-hour accident and emergency target are delivering relatively poor waiting times for patients who require admission, as opposed to those who, for example, can be discharged after being seen. 
The unpublished provisional data shows an average of just 30% of admitted patients in England spend four hours or less in A&E against the 95% target.
But many trusts are falling significantly below this – including those trusts at or around NHSE’s interim target of 76% for four hours performance for all patients by March 2024.
Read full story (paywalled)
Source: HSJ, 24 November 2023
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Poor people much more likely to die from sepsis, study finds

Poor people and those with existing health problems are much more likely to die from sepsis, one of the UK’s biggest killers, a study has found.
Sepsis, or blood poisoning, is a potentially fatal condition triggered when the body reacts to an infection by attacking its own tissues and vital organs. It leads to an estimated 48,000 deaths a year in Britain.
Research from the University of Manchester has disclosed for the first time how some groups are at much higher risk of dying from the condition than the general population.
An analysis of 248,767 cases of non-Covid sepsis in England between January 2019 and June 2022 has found that the most deprived people are twice as likely to die from it within 30 days.
The findings, published in the journal eClinicalMedicine, also show that:
People with learning disabilities are almost four times more likely to get sepsis. People with liver disease have about three times greater risk. Patients with chronic kidney disease that is at stage 5 are more than six times as likely to develop it. “This study shows socioeconomic deprivation, comorbidity and learning disabilities are associated with an increased risk of developing non-Covid related sepsis and 30-day mortality in England.”
Read full story
Source: The Guardian, 23 November 2023
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Dumped in A&E and left untreated for 5 days or more: Shameful plight of some of our most vulnerable patients

Doctors have sent a stark warning over the dire state of emergency care for mental health patients after half of A&Es revealed patients were waiting more than five days in hospital before getting the treatment they need.
The “truly alarming” figures, shared exclusively with The Independent, show vulnerable patients are being let down by “unacceptable delays” to their treatment, with one campaigner warning the issue has become a national emergency.
The data, collated by the Royal College of Emergency Medicine (RCEM), prompted a bleak verdict from top doctor Dr Adrian Boyle who said the system – which sees patients being cared for by A&E staff who are not specifically trained for their needs – was failing the most “fragile” patients.
Warning that mental health patients are being hit the hardest by long waits in A&E, Dr Boyle, the RCEM president, added: “These patients need effective and efficient care, they deserve compassionate care – crucially, they deserve better.”
Read full story
Source: The Independent, 20 November 2023
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Medicine shortages show broken system, pharmacists warn

The system for sourcing medicines in England is broken and needs a fundamental overhaul to prevent shortages, senior pharmacists have told MPs.
They were giving evidence at the first session of an inquiry by the Commons Health and Social Care Committee, which is exploring issues largely affecting community, primary care, and hospital pharmacy services.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, told MPs that shortages of antibiotics, hormone replacement therapy, and medicines to treat attention deficit hyperactivity disorder over the past few years were symptomatic of "a real problem". Pharmacists constantly find that "medicines come on the market and then, all of a sudden as soon as the demand goes a little bit up, they are no longer available," she explained.
She told the inquiry: "That indicates that something in the system is not right."
Read full story
Source: Medscape, 22 November 2023
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