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

'My NHS hell waiting for surgery and information'

Former BBC Technology correspondent Rory Cellan-Jones, now a writer and podcaster, has Parkinson's disease. Two weeks ago, after fracturing his elbow in a nasty fall, he found out just how difficult it can be to get answers from the NHS.
"Getting information about one's treatment seems like an obstacle race where the system is always one step ahead. But communication between medical staff within and between hospitals also appears hopelessly inadequate, with the gulf between doctors and nurses particularly acute.
"I also sense that, in some cases, new computer systems are slowing not speeding information through the system. On Saturday morning, as we waited in the surgical assessment unit, four nurses gathered around a computer screen while a fifth explained to them all the steps needed to check-in a patient and get them into a bed. It took about 20 minutes and appeared to be akin to mastering some complex video game beset with bear traps."
Rory's latest experience as a customer of the health service has left him convinced that more money and more staff won't solve its problems without some fundamental changes in the way it communicates.
Read full story
Source: BBC News, 29 October 2023
Sam

The app that promised an NHS ‘revolution’ then went down in flames

Babylon Healthcare won NHS contracts after being championed by Matt Hancock but the company’s AI tech was oversold and it has now collapsed.
The NHS spent millions of pounds on a flawed AI chatbot whose creator used aggressive sales techniques and overpromised what it could do, former staff have claimed.
Babylon Health, a tech start-up championed by Matt Hancock and advised by Dominic Cummings, promised that its AI chatbot could keep patients who didn’t need to be seen by a health professional out of the overstretched NHS.
But the technology was not as sophisticated as the company claimed, with former staff now claiming that what began as a crude tool based on “decision trees written by doctors, put into an Excel spreadsheet” never realised its promised potential. Concerns — including the fact the app missed clear signs of a heart attack or dangerous blood clots — were raised.
Read full story (paywalled)
Source: The Times, 28 October 2023
Patient_Safety_Learning

Whistleblowing ‘cost Hampshire doctor dearly’ after he loses tribunal

Dr Martyn Pitman claimed retaliatory victimisation after raising morale concerns but tribunal says it was his manner that cost him his job.
A doctor has said raising whistleblowing concerns about maternity care at his hospital “cost me very dearly” after he lost his employment tribunal.
Consultant obstetrician and gynaecologist Dr Martyn Pitman was dismissed earlier this year from his job at the Royal Hampshire county hospital (RHCH) in Winchester, where he had worked for 20 years.
He told the Southampton tribunal, which concluded earlier this month, that he had been “subjected to brutal retaliatory victimisation” after exercising his rights under the Public Interest Disclosure Act.
A tribunal judgment released on Friday said there had been “unanimous” agreement that the arguments behind the whistleblowing claim “fail and are dismissed”.
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Source: Guardian, 29 October 2023
Patient_Safety_Learning

Soaring private healthcare use piling pressure on NHS GPs, survey finds

Soaring use of private healthcare for tests and treatments is piling pressure on overstretched GP surgeries, with family doctors warning that standard NHS care is being squeezed as a result.
Record numbers of people are paying for private healthcare, with some having procedures such as cataract surgery and hip replacements, amid mounting frustration at NHS hospital waiting lists. Others are opting for private health checks, genetic testing or cosmetic surgery such as liposuction.
But the surge in private healthcare use is increasing the workload of GPs, many of whom say they are increasingly having to interpret questionable health checks done privately, organise blood tests or scans and manage additional administration related to private care. Some say more of their hours are being taking up providing follow-up appointments after patients paid for treatment or surgery abroad.
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Source: Guardian, 29 October 2023
Patient_Safety_Learning

‘Misleading’ A&E figures in England hiding poor performance

NHS bosses are using misleading figures to hide dangerously poor performance by A&E units in England against the four-hour treatment target, emergency department doctors claim.
Some A&Es treat and admit, transfer or discharge as few as one in three patients within four hours, although the NHS constitution says they should deal with 95% of arrivals within that timeframe.
How well or poorly A&Es are doing in meeting the 95% target is not in the public domain because the data that NHS England publishes is for NHS trusts overall, not individual hospitals.
That means official figures are an aggregate of performance at sometimes two A&Es run by the same trust or include data for any walk-in centres, minor injuries units or urgent treatment centres that a trust also operates. Forty-eight trusts have two A&Es and many also run at least one of the latter.
The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, wants that system scrapped. It is urging NHS England to start publishing data that shows the true performance of every individual emergency department against the 95% standard.
“The current data is misleading,” Dr Adrian Boyle, the college’s president, told the Guardian. “It’s a good example of a lack of transparency and also of performance incentives. Being open about the long delays in some A&Es would shine a light in some dark places.”
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Source: The Guardian. 28 October 2023
Sam

Trusts may no longer be fined for missing quality standards

Trusts may be spared financial penalties if they fail to meet care quality standards under new proposals from NHS England. 
NHSE is looking at “pausing” the financial element of the Commissioning for Quality and Innovation scheme from next year according to information seen by HSJ. This states “a wider review of incentives for quality” is also under way.
Read full story (paywalled)
Source: HSJ, 30 October 2023
Patient_Safety_Learning

Death of baby after UK hospital missed vitamin jab ‘beyond cruel’, parents say

The parents of a baby boy who died at seven weeks old after a hospital did not give him a routine injection have described the failure as “beyond cruel”.
William Moris-Patto was born in July 2020 at Addenbrooke’s hospital in Cambridge, where it was recorded in error that he had received a vitamin K injection – which is needed for blood clotting. The shot is routinely given to newborns to prevent a deficiency that can lead to bleeding.
His parents, Naomi and Alexander Moris-Patto, 33-year-old scientists from Chatteris, Cambridgeshire, want to raise awareness about the importance of the vitamin after a coroner concluded William would not have died had the hospital administered the injection. On Friday, the coroner Lorna Skinner KC described the omission as “a gross failure in medical care amounting to neglect”.
Alexander Moris-Patto, a researcher at the University of Cambridge who recently co-founded William Oak Diagnostics to test for deficiencies in babies, said: “What’s come out of the inquest for me is that the systems they [the trust] put in place to try to prevent this happening again are not satisfactory.”
He stressed the importance of the vitamin K injection, adding that about 1% of the UK population opt out of it. “We want people to know more about it, to understand how critical it can be, and for hospitals to take seriously the responsibility they have in those first precious hours of a baby’s life,” he said.
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Source: The Guardian, 29 October 2023
Sam

Complaints about poor NHS dental services rise 66% in five years

Record numbers of patients are complaining to the NHS Ombudsman about poor care, exorbitant fees and difficulty getting treatment from NHS dental services in England.
Mistakes by dentists mean some patients are being left in agony – in some cases unable to eat – while others are being landed with huge bills for work on their teeth.
“Poor dental care leaves patients frustrated, in pain and out of pocket,” said Rob Behrens, the parliamentary and health service ombudsman.
The number of complaints he receives every year about NHS dental services has jumped from 1,193 in 2017-18 to 1,982 in 2022-23 – a rise of 66%.
Behrens also disclosed that the proportion of complaints he upholds about NHS dentistry after an investigation has increased from 42% to 78% over the same period. That 78% figure for upheld complaints about dental services is “significantly more” than for any other area of NHS care, such as GP, hospital or mental health care, where the overall average is 60%, he said.
Dentistry has become one of the public’s main concerns about the NHS, especially the obstacles many people face when trying to access NHS care. A BBC survey last year found that 90% of surgeries across the UK were not accepting new adult patients and 80% were not taking on children as new patients.
Read full story
Source: The Guardian, 30 October 2023
Related reading on the hub:
“I’ve been mocked, scolded and gaslighted”: a harmed patient’s experience of orthodontic treatment
A patient harmed by orthodontic treatment shares their story
We want to hear from patients with experience of NHS and/or private orthodontists and dentists in any healthcare setting, including community practices and hospitals.
Did the orthodontist/dentist give you the treatment and support you needed? If you had ongoing problems, how did the orthodontist/dentist and other healthcare professionals respond? Have you tried to make a complaint? Share your experience of orthodontist and dentistry services
 
Sam

Michael Watt hearing: Lawyers withdraw over mental health concerns

Lawyers for a doctor at the centre of Northern Ireland's biggest patient recall have withdrawn from his new fitness to practise hearing.
Legal representatives for Michael Watt said they are "concerned about his serious mental health condition".
They told the Medical Practice Tribunal Service that the continuation of the hearing in public "presents a real risk to his mental health".
A new fitness to practise hearing began in September.
The legal team has also formally withdrawn an application to the tribunal for Michael Watt to remove himself from the medical register.
It followed a ruling by the High Court earlier this year to quash a decision where he previously was voluntary erased from the medical register.
 
The tribunal is inquiring into the allegation that, between 7 and 22 of October 2018, Michael Watt underwent a General Medical Council assessment of the standard of his professional performance.
It is alleged that that performance was unacceptable in the areas of maintaining professional performance, assessment, clinical management, record keeping and relationship with patients.
Read full story
 
Source: BBC News, 27 October 2023
Patient Safety Learning

Performance of vital demand management service collapses

The performance of one of the NHS’s flagship strategies to reduce demand on over-stretched hospitals has collapsed, HSJ  can reveal.
Internal NHS figures show the number of processed advice and guidance requests (A&G) from GPs to hospital consultants fell by 28% between June and August, alongside a 32% fall in the number of processed cases where patients were diverted away from secondary care. This comes despite the overall number of A&G requests from GPs only falling by 5% in the same period.
A&G services allow GPs to contact hospital consultants before making a referral in order to ensure only clinically appropriate patients are referred to secondary care.
The model is described by NHS England as a ”a key part of the National Elective Care Recovery and Transformation Programme’s work.”
The data showing the fall in processed requests and diversions from secondary care came from NHSE’s specialist advice activity dashboard, which HSJ has seen.
Read full story (paywalled)
Source: HSJ, 26 October 2023
Patient Safety Learning

Women 'angry and frustrated' over smear test review

Women affected by a review of cervical smears in the Southern Health Trust have said they are "angry, frustrated and scared" for their future.
About 17,500 patients in the trust are to have their previous smears re-checked as part of a major review of cervical screening dating back to 2008.
Some of these women will be recalled to have new smear tests carried out. But the process has not started yet and will take at least six months to complete.
Letters were sent out by the trust earlier this month to those affected.
The Southern Trust says it expects to recall around 4,000 women for a new smear test after it reviews 17,368 historic slides.
The Trust's medical director, Dr Steve Austin, told its board meeting that the review of slides was expected to start next week.
It also emerged that the number of calls from concerned women has increased with many asking for more "specialist" answers.
Read full story
Source: BBC News, 27 October 2023
Patient Safety Learning

Sunak ‘highly unlikely’ to meet promise to cut NHS waiting lists, warn health leaders

Rishi Sunak is “highly unlikely” to meet his promise to cut NHS waiting lists, health leaders have warned, as a “sobering” analysis suggests the backlog will rise to 8 million and won’t begin to fall until next summer.
The prime minister vowed in January that “NHS waiting lists will fall” as he outlined five pledges upon which he staked his premiership. The backlog was 7.2 million at the time. It is now 7.75 million, the highest since records began in 2007.
But a grim report published today by the Health Foundation, an independent thinktank, will pile further pressure on Sunak over the NHS. The 15-page analysis predicts that the waiting list for hospital treatment in England will continue to rise for at least 10 months and ultimately top 8 million, regardless of whether or not strikes continue.
The thinktank modelled four different scenarios and concluded that, based on current trends, NHS waiting list figures could peak by August 2024 if there was no more strike action by healthcare workers, before starting to come down. If strikes were to continue, the list could increase a further 180,000, it said.
Matthew Taylor, the chief executive of the NHS Confederation, said: “This analysis all but confirms that the prime minister’s pledge to reduce the size of the waiting list is increasingly unlikely to be met.”
He added: “As the Health Foundation report rightly says, the root cause of the delays to treatment that patients are now experiencing is a decade of underinvestment in the NHS.”
Read full story
Source: The Guardian, 27 October 2023
Patient Safety Learning

A home help for eight days after giving birth? Why Dutch maternity care is the envy of the world

To new parents processing the shock of delivery and swimming in hormones, newborns can feel like a tiny, terrifying mystery; unexploded ordinance in a crib. “We were totally unprepared,” says Odilia. Neither she or her husband had ever changed a nappy and had no idea the baby needed feeding every three hours. “If you’re a new mum or dad, you have no idea,” recalls Anouk, a new mother. “I’m a doctor,” says Zarah, another new mother, incredulously. “So, you would expect that I’d know something, and I knew some things, but you really don’t have any clue.”
The difference for these new parents, compared to the rest of us, is that they gave birth in the Netherlands. That meant help was instantly at hand in the form of the kraamzorg, or maternity carer. Everyone who gives birth in the Netherlands, regardless of their circumstances, has the legal right – covered by social insurance – to support from a maternity carer for the following week.
These trained professionals come into your home daily, usually for eight days, providing advice, reassurance and practical help. It’s a different role to midwives, who continue to monitor women and babies after the birth in the Netherlands; the maternity carer updates the midwife on the mother and baby’s health and progress as well as supporting the parents as they come to terms with their new child.
A maternity carer in the Netherlands, explains Betty de Vries of Kenniscentrum Kraamzorg, the organisation that registers maternity carers, “takes care of the woman the first week, advises her on breastfeeding and bottle feeding, hygiene, gives advice … everything to do with safe motherhood and a safe baby. She is there for the whole day most of the time so she can see how they are doing.” Her colleague, director Esther van der Zwan, adds: “It’s a lot of responsibility.” To prepare, maternity carers train for three years – a combination of academic and on-the-job placements – and have regular refresher training in everything from CPR to breastfeeding support.
Sam

Scottish Covid Inquiry: Care home residents 'left to starve'

Some care home residents may have been "neglected and left to starve" during the pandemic, Scotland's Covid Inquiry is expected to hear.
Lawyers representing bereaved relatives said they also anticipate the inquiry will hear some people were forced into agreeing to "do not resuscitate" plans.
Shelagh McCall KC told the inquiry that evidence to be led would "point to a systemic failure of the model of care".
The public inquiry is investigating Scotland's response to the pandemic.
Ms McCall is representing Bereaved Relatives Group Skye, a group of bereaved relatives and care workers from Skye and five other health board areas of Scotland.
In her opening statement, she told the public inquiry that families wanted to know why Covid was allowed to enter care homes and "spread like wildfire" during the pandemic.
She added: "As well as revealing the suffering of individuals and their families, we anticipate the evidence in these hearings will point to a systemic failure of the model for the delivery of care in Scotland, for its regulation and inspection.
"We anticipate the inquiry will hear that people were pressured to agree to do not resuscitate notices, that people were not resuscitated even though no such notice was in place, that residents may have been neglected and left to starve and that families are not sure they were told the truth about their relative's death."
Read full story
Source: BBC News, 25 October 2023
Sam

Lack of ownership within NHSE for struggling service is ‘complete failure of leadership’

No senior NHS England director is prepared to take responsibility for ADHD services — which are facing waits of up to a decade and severe medication shortages — HSJ has discovered. 
Despite soaring demand for assessments and widespread drug shortages recently triggering a national patient safety alert, responsibility for attention-deficit/hyperactivity disorder services does not sit within any NHS England directorate.
HSJ understands that none of NHSE’s mental health, learning disability, or autism programmes have been given any resources for ADHD. It is also claimed that the medical and long-term conditions teams “are not very interested” in taking responsibility, and “assumed someone else was doing it”.
A senior source, very close to the issue, told HSJ that no NHS senior director had taken “ownership” of the issue, and there was a widespread misapprehension that responsibility for ADHD services was part of the autism remit given to the mental health directorate. 
“We haven’t got the attention we need around ADHD,” said the source, “we need a [dedicated] neurodiversity programme.”
Read full story (paywalled)
Source: HSJ, 26 October 2023
Sam

Several hospitalised in Austria after using suspected fake diabetes drug

Several people have been admitted to hospital in Austria after using suspected fake versions of Novo Nordisk’s diabetes drug Ozempic, the country’s health safety body has said, the first report of harm to users as a European hunt for counterfeiters widened.
The patients were reported to have suffered hypoglycaemia and seizures, serious side-effects that indicate that the product contained insulin instead of Ozempic’s active ingredient semaglutide, the health safety regulator Bundesamt für Sicherheit im Gesundheitswesen (BASG) said on Monday.
The European Medicines Agency (EMA) warned last week that pens falsely labelled as Ozempic were in circulation, and Austria’s criminal investigation service said on Monday that the fake injection pens could still be in circulation.
The Danish maker of the drug, Novo Nordisk, has warned of a rise in the online offers of counterfeit Ozempic as well as its weight-loss drug Wegovy, both based on semaglutide.
“It appears that this shortage is being exploited by criminal organisations to bring counterfeits of Ozempic to market,” said BASG.
Read full story
Source: The Guardian, 24 October 2023
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