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

USA: Lack of information, not mistrust, the biggest barrier to Black women’s participation in clinical trials

A new report by US healthcare communications agency GCI Health found that Black women aren't avoiding clinical trials due to mistrust. The reasons for their underrepresentation are “more layered and nuanced.”
The report is based on a recent summer survey with 500 responses from Black women across the USA. It reveals that, while the majority (80%) are "open" to participating in a clinical trial, 73% have never been asked to do so.
While it's commonly believed that Black women are unwilling to participate in trials due to mistrust of the healthcare and biopharma systems, GCI's survey responses unveiled a more complex perspective.
The data suggest “that access to information is the largest barrier to participation, rather than mistrust in the medical establishment, as commonly believed,” GCI Health’s report found.
“We often hear that Black women are missing from clinical research because they are ‘hard-to-reach’ or reluctant to participate due to mistrust of the medical establishment,” said Kianta Key, group senior vice president and head of identity experience at GCI Health, in a press release. “In talking with women, we heard something more layered and nuanced that deserved exploration.”
“Our industry has a responsibility to reverse years of underrepresentation in clinical trials and do more to support better healthcare outcomes for Black women,” said Kristin Cahill, global CEO of GCI Group, in the release.
“Equity is critical to ensure new treatments and health interventions work for everyone. This research helps get us closer to understanding what needs to be done to make positive changes that will save lives and create healthier communities.”
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Source: Fierce Pharma, 14 November 2023
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Three patients died after ambulance transfer delays from private hospital

Three patients died after delayed transfers from a private hospital within a nine-month period, coroner’s findings reveal.
Three prevention of future deaths reports reviewed by HSJ raised concerns about the deaths of patients whose transfer from Spire’s Norwich facility to the NHS hospital in the same city was delayed.
The sites, which are one mile apart, are run by £1bn-turnover private company Spire Healthcare and Norfolk and Norwich University Hospitals Foundation Trust respectively.
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Source: HSJ, 15 November 2023
Prevention of Future Deaths reports:
Geoffrey Hoad (13 September 2023) Prevention of Future Deaths report: Christina Ruse (3 October 2022) Prevention of Future Deaths report: Barbara Hollis (3 October 2022)
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Give toddlers chickenpox jab, advisers tell NHS

All children in the UK should be given a chickenpox vaccine at 12 and 18 months of age, combined with the MMR jab as one shot, the NHS is advised.
It will now be up to the government to decide whether to add it to the routine immunisations children are offered.
The Joint Committee on Vaccination and Immunisation has also recommended a temporary catch-up programme for slightly older children who've missed out on this initial rollout.
Chickenpox cases dipped during the Covid pandemic due to restrictions on socialising, meaning there is currently a larger pool of children than usual who are unprotected against the highly contagious virus.
Chickenpox can be more severe if you catch it for the first time as a teen or an adult rather than as a young child.
Dr Gayatri Amirthalingam from the UK Health Security Agency said: "Introducing a vaccine against chickenpox would prevent most children getting what can be quite a nasty illness - and for those who would experience more severe symptoms, it could be a life saver.
"The JCVI's recommendations will help make chickenpox a problem of the past and bring the UK into line with a number of other countries that have well-established programmes."
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Source: BBC News, 14 November 2023
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Ward staff ‘must accept extra workload to help A&E’

Hospitals are being prevented from adopting models which spread risk away from emergency departments because other teams refuse to take on the extra work, according to a top accident and emergency doctor.
In a recent interview with HSJ, North Bristol Trust chief executive officer Maria Kane praised her trust’s risk-sharing approach to emergency care, which involves moving patients each hour from accident and emergency to the most appropriate ward for their needs and where a discharge is expected, even if it is full.
Commenting on the article, Royal College of Emergency Medicine president Adrian Boyle said: “The NBT trust leadership deserve significant credit for maintaining this. All too often there is an acceptance of unacceptable delays (and risk) in ambulance handovers and long ED stays.
“Where this fails, it is usually because inpatient teams (both nursing and medical) have objected to the extra workload, without appreciating the real harm elsewhere. The more interesting question is why isn’t this being done more widely?”
Read full story (paywalled)
Source: HSJ, 15 November 2023
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Charge trusts with criminal offence for demonising whistleblowers, says HCSA

The Hospital Consultants and Specialists Association (HCSA), a hospital doctors union, has called for an independent body to register and monitor cases where doctors raise safety concerns and for criminal charges to be brought against trusts when whistleblowers suffer harm.
Naru Narayanan, president of HCSA, called for the changes after a survey found that doctors worry that speaking up about patient safety will put their careers at risk and that the creation of freedom to speak up guardians in 2016 has not increased their confidence.
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Source: BMJ, 13 November 2023
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Overseas doctors will remain 'crucial' despite recruitment drive

Attracting skilled overseas-trained doctors to the UK will remain "crucial", despite plans to train more healthcare staff here, the doctors' regulator has said.
The General Medical Council (GMC) found that nearly two-thirds (63%) of new doctors in 2022 qualified abroad.
The government launched a major plan in June to train and recruit more healthcare workers in England. But it will take many years for this to take effect, the GMC says.
NHS England says it currently has 10,855 full-time doctor vacancies - a rate of 7.2%.
Under NHS England's Long Term Workforce Plan, it hopes to recruit and retain "hundreds of thousands" more healthcare staff over the next 15 years. The plan includes spending £2.4bn on additional training places for healthcare workers, with the number of medical school places for student doctors set to double to 15,000 a year.
Charlie Massey, the GMC's chief executive, said the drive to boost the workforce was "brilliant", but said "it takes a long time to make a doctor".
"We're not going to see the impact of that coming on stream for probably the best part of a decade. And that means we're going to need to rely on doctors who have trained overseas coming to the UK in much greater numbers than in recent years to maintain the workforce that we need to meet the needs of the population."
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Source: BBC News, 13 November 2023
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NHS struggling to open extra winter beds and fill staffing gaps

Hospital bosses in England are warning a lack of funds means they are having to scale back on plans to open extra beds to cope with winter.
The warning, from NHS Providers, which represents managers, came after the Treasury rejected pleas for an extra £1bn to cover the cost of strikes.
Recruitment to plug gaps in the workforce was also having to be put on hold, NHS Providers said.
But the government said winter planning was on track.
It pointed out the goal to open 10,000 "virtual" hospitals beds had been met. This is where doctors remotely monitor patients with conditions such as respiratory and heart problems who would otherwise have to be in hospital.
Progress was also being made on opening 5,000 new permanent hospital beds - a 5% increase in numbers, the government said.
"We recognise the challenges the NHS faces over the coming months, which is why we started preparing for winter earlier than ever," a Department of Health and Social Care spokesman added.
But NHS Providers said the steps being taken may be insufficient.
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Source: BBC News, 14 November 2023
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AI could predict heart attack risk up to 10 years in the future, finds Oxford study

Artificial intelligence could be used to predict if a person is at risk of having a heart attack up to 10 years in the future, a study has found.
The technology could save thousands of lives while improving treatment for almost half of patients, researchers at the University of Oxford said.
The study, funded by the British Heart Foundation (BHF), looked at how AI might improve the accuracy of cardiac CT scans, which are used to detect blockages or narrowing in the arteries.
Prof Charalambos Antoniades, chair of cardiovascular medicine at the BHF and director of the acute multidisciplinary imaging and interventional centre at Oxford, said: “Our study found that some patients presenting in hospital with chest pain – who are often reassured and sent back home – are at high risk of having a heart attack in the next decade, even in the absence of any sign of disease in their heart arteries.
“Here we demonstrated that providing an accurate picture of risk to clinicians can alter, and potentially improve, the course of treatment for many heart patients.”
Read full story
Source: The Guardian, 13 November 2023
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NHS board named in Glasgow hospital corporate homicide probe

Scotland's largest health board has been named as a suspect in a corporate homicide investigation following the deaths of four patients at a Glasgow hospital campus.
NHS Greater Glasgow and Clyde (NHSGGC) informed families of the development via a closed Facebook group set up during a water contamination crisis.
The board confirmed it had received an update from the Crown Office. But it added there was no indication prosecutors had "formed a final view".
Police Scotland launched a criminal investigation in 2021 into a number of deaths at the Queen Elizabeth University Hospital (QEUH) campus, including that of 10-year-old Milly Main.
The Crown Office and Procurator Fiscal Service (COPFS) instructed officers to investigate the deaths of Milly, two other children and 73-year-old Gail Armstrong.
Milly's mother previously told a separate public inquiry into the building of several Scottish hospitals that her child's death was "murder".
A review earlier found an infection which contributed to Milly's death was probably caused by the QEUH environment.
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Source: BBC News, 13 November 2023
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Record number of child deaths last year with hundreds more dying since pandemic

The number of child deaths has hit record levels, with hundreds more children dying since the pandemic, shocking new figures show.
More than 3,700 children died in England between April 2022 and March 2023, including those who died as a result of abuse and neglect, suicide, perinatal and neonatal events and surgery, new data from the National Child Mortality Database has revealed – with more than a third of the deaths considered avoidable.
Children in poorer areas were twice as likely to die as those in the richest, while 15 per cent of those who died were known to social services.
The UK’s top children’s doctor, Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, hit out at the government for failing to act to tackle child poverty, which she said was driving the “unforgivable” and “avoidable” deaths.
The report said: “Whilst the death rate in the least deprived neighbourhoods decreased slightly from the previous year, the death rate for the most deprived areas continued to rise, demonstrating widening inequalities.”
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Source: The Independent, 11 November 2023
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Widespread ‘toxic culture’ is forcing us out, say staff

Large numbers of midwives report being left feeling undervalued and afraid to speak up due to bullying and widespread staffing shortages, which some say is putting mothers’ and babies’ lives at risk, according to a new publication shared with HSJ.
The Say No to Bullying in Midwifery report comprises hundreds of accounts, ranging from students, newly qualified and senior midwives, heads of midwifery, maternity support workers and more. It aims to publicise and share concerns they have raised online.
The report said: “Midwives have described their experiences of toxic cultures within their workplaces, with cliques, preferential treatment, unfounded allegations and poor working conditions leading to a negative impact on their health and wellbeing, including suicide attempts and midwives leaving their job or profession.
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Source: HSJ, 13 November 2023
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Collective intelligence can help reduce medical misdiagnoses

An estimated 250,000 people die from preventable medical errors in the U.S. each year. Many of these errors originate during the diagnostic process. A powerful way to increase diagnostic accuracy is to combine the diagnoses of multiple diagnosticians into a collective solution. However, there has been a dearth of methods for aggregating independent diagnoses in general medical diagnostics.
Researchers from the Max Planck Institute for Human Development, the Institute for Cognitive Sciences and Technologies (ISTC), and the Norwegian University of Science and Technology have therefore introduced a fully automated solution using knowledge engineering methods.
The researchers tested their solution on 1,333 medical cases provided by The Human Diagnosis Project (Human Dx), each of which was independently diagnosed by 10 diagnosticians. The collective solution substantially increased diagnostic accuracy: Single diagnosticians achieved 46% accuracy, whereas pooling the decisions of 10 diagnosticians increased accuracy to 76%. Improvements occurred across medical specialties, chief complaints, and diagnosticians’ tenure levels.
"Our results show the life-saving potential of tapping into the collective intelligence," says first author Ralf Kurvers. He is a senior research scientist at the Center for Adaptive Rationality of the Max Planck Institute for Human Development and his research focuses on social and collective decision making in humans and animals.
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Source: Digital Health News, 2 November 2023
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Two-thirds of homecare patient safety incidents linked to major provider

Two-thirds of patient safety incidents recorded during hospital trusts’ monthly reporting period for homecare medicine provision were for services provided by the company Sciensus, an investigation by The Pharmaceutical Journal has revealed.
In response to a freedom of information request sent to 131 hospital trusts in England in August 2023, 32 trusts recorded 417 patient safety incidents during their most recent monthly reporting period, which ranged from May to July 2023.
Some 66% of these incidents (277) related to services delivered by homecare provider Sciensus, despite providing medicines to fewer than half (44%) of the 96,849 patients covered in the data.
The findings come after the House of Lords Public Services Committee opened an inquiry into homecare medicines services in May 2023 following press reports of complaints from patient organisations and others about the service provided. The inquiry heard evidence from patient groups, regulators, homecare companies and the government during the summer and the committee will publish its report on 16 November 2023.
Sciensus was previously known as Healthcare at Home and is one of the UK’s largest homecare companies.  
The data also uncovered that Sciensus was a poor performer on “failed” deliveries, defined as those that did not arrive on the scheduled day.
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Source: The Pharmaceutical Journal, 9 November 2023
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NHS staff are carrying out the equivalent of one 'never-event' every day, figures show

NHS staff are carrying out the equivalent of one 'never-event' every day, figures show. 
This is despite the Government ordering a crackdown on the mistakes, which cost hospitals an estimated £800million in compensation each year. 
Experts today demanded further action on 'unacceptable' levels of never-events, blaming inadequate staffing levels and a lack of investment in the NHS. 
A MailOnline audit of a decade's worth of NHS data found a colossal 4,328 never-events have occurred in England since 2013. This equates to roughly eight a week. 
Shocking incidents uncovered include women getting parts of their reproductive anatomy cut out instead of an appendix, men getting unwanted circumcisions and laser procedures to the wrong eye. 
The Royal College of Surgeons said the level of never-events was 'unacceptable' and blamed NHS staffing levels for increasing the risk to patients. 
"Surgeons will be working hard to do their best for patients, but they do so in difficult circumstances," a spokesperson said. 
"The NHS is overstretched, with staff shortages, a workforce suffering from burn-out and pressure to get record waiting times down. 
"This increases the risk of mistakes happening." 
Read full story
Source: MailOnline, 10 October 2023
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Doctors plan to leave NHS in growing numbers due to burnout, GMC warns

A growing number of doctors plan to leave the profession due to burnout and dissatisfaction, the General Medical Council has said, highlighting fears that the government’s long-term strategy for the NHS may have come too late.
The GMC’s annual report on the medical workforce said the benefits of measures announced by the government in the NHS long-term workforce plan in June, such as the ambition to create more medical school places, “will only start to be seen a decade from now”.
The report found that the number of licensed doctors increased in 2022, with 23,838 joining and 11,319 leaving. However, it said there were “still high vacancy rates and workforce pressure”, and that the rate of doctors leaving the profession was returning to pre-pandemic levels, at 4% last year.
The GMC warned there were “worrying signs” that a growing number “plan to leave the profession as a result of high levels of dissatisfaction and high risk of burnout”. It added that there may be “a limited window of opportunity to address current issues” before more medics leave.
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Source: The Guardian, 12 November 2023
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Woman who suffered complications from vaginal mesh implant awarded at least £1m

A woman who suffered traumatic complications from a vaginal mesh implant has been awarded a record settlement of at least £1m from the NHS.
Yvette Greenway-Mansfield, 59, was given a mesh implant at Coventry’s University Hospital in 2009 and went on to suffer serious complications. Her medical negligence claim against the hospital trust found that the surgery was carried out prematurely and unnecessarily and that her consent form had been doctored to include additional risks after Greenway-Mansfield had signed it.
Greenway-Mansfield said that being awarded the compensation was a “huge relief”, but added that many other women who have suffered similar damage had received little or no compensation, and criticised the government’s failure to establish a financial redress agency for victims.
“I’m not the only one. There are thousands of mes,” she said. “There should be a pot of money to provide damages for these women and a care plan in place as an automatic response to mesh-damaged people. It comes down to a perception of women and women’s health problems. We’ve all had enough of it.”
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Source: The Guardian, 13 November 2023
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