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

NHS only gains one ‘full-time’ GP for every two trainees, report finds

The NHS has to train two GPs to produce one full-time family doctor because so many have started to work part-time, new research reveals.
The finding helps explain why GP surgeries are still struggling to give patients appointments as quickly as they would like, despite growing numbers of doctors training to become a GP.
The disclosure is contained in a report by the Nuffield Trust health thinktank that lays bare the large number of nurses, midwives and doctors who quit during their training or early in their careers.
“These high dropout rates are in nobody’s interest,” said Dr Billy Palmer, a senior fellow at the thinktank and co-author of the report. “They’re wasteful for the taxpayer, often distressing for the students and staff who leave, stressful for the staff left behind, and ultimately erode the NHS’s ability to deliver safe and high-quality care.”
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Source: The Guardian, 28 September 2023
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Parents in England urged to ensure children get MMR jab amid uptake drop

Parents are being urged to get their children vaccinated against measles, mumps and rubella (MMR) after a “worrying” drop in uptake of key vaccines.
Figures from NHS England and the UK Health Security Agency (UKHSA) show 92.5% of children had had the first dose of the MMR jab at five years old by 2022-23, the lowest since 2010-11.
The proportion of five-year-olds who had had the second jab by 2022-23 was 84.5%, also the lowest level since 2010-11.
Vaccination programmes across England failed to meet the uptake recommended by the World Health Organization (WHO) for the year 2022-23. WHO recommends that, nationally, at least 95% of children should be inoculated for diseases that can be stopped by vaccines, in order to prevent outbreaks.
NHS data showed no routine vaccine programme met the threshold during the 12-month period. Dr Gayatri Amirthalingam, a consultant medical epidemiologist at UKHSA, said the downward trend was a “serious concern”.
“The diseases that these vaccines protect against, such as measles, polio and meningitis, can be life-changing and even deadly,” she said. “No parent wants this for their child especially when these diseases are easily preventable. Please don’t put this off, check now that your children are fully up to date with all their vaccines due. Check your child’s red book and get in touch with your GP surgery if you are not sure.”
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Source: The Guardian, 29 September 2023
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Births being delayed by strikes, says CEO

Women have faced delays in giving birth due to the ongoing strikes, a major trust’s chief executive has said.
Matthew Hopkins, who joined Mid and South Essex Foundation Trust last month, told a board meeting on Thursday that industrial action was having a “significant and growing” impact on patients.
He added that this extended beyond delays to outpatient appointments and elective operations, saying: “It is also delaying mums giving birth, because we are seeing delays now in being able to conduct our elective Caesarian sections.”
Mr Hopkins said the impact was also “really significant” on staff, with those covering for colleagues “very, very tired”.
“It is important we give a very clear message to the two sides of the argument – government and the [British Medical Association] – that we need a light at the end of the tunnel, and staff need a light at the end of the tunnel.
“Going into winter, with this continuing disruption for our patients and our staff, is in my view unacceptable.”
Read full story (paywalled)
Source: HSJ, 28 September 2023
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Safer brain surgery using AI possible within two years

Brain surgery using artificial intelligence could be possible within two years, making it safer and more effective, a leading neurosurgeon says.
Trainee surgeons are working with the new AI technology, to learn more precise keyhole brain surgery.
Developed at University College London, it highlights small tumours and critical structures such as blood vessels at the centre of the brain.
The government says it could be "a real game-changer" for healthcare in the UK.
Brain surgery is precise and painstaking - straying a millimetre the wrong way could kill a patient instantly.
Avoiding damaging the pituitary gland, the size of a grape, at the centre of the brain, is critical. It controls all the body's hormones - and any problems with it can cause blindness.
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Source: BBC News, 28 September 2023
Sam

Thousands of women left waiting for induction due to staff shortages

Thousands of women are having induction of labour delayed because of a shortage of staff, raising concerns about the safety of them and their babies, HSJ has found.
The issue has been highlighted at seven hospitals in Care Quality Commission reports over the past six months, and HSJ has identified a further three trusts declaring they are concerned about it in their own board papers over the same period. 
 At University Hospitals of Leicester Trust, more than 1,300 “red flags” were raised in a five-month period due to delays in the induction of labour, linked to staffing levels, the CQC said earlier this month. Most were dealys in continuing inductions, and a smaller number were delays between admission and beginning an induction. UHL indicated it had set its own “red flag” bar locally, so all the delays did not represent a national alert. 
Carolyn Jenkinson, CQC deputy director of secondary and specialist healthcare, told HSJ: “At some maternity services we’ve found women having to wait long periods of time to be induced or for transfer to a labour ward once the induction process has started, and in some cases a lack of effective monitoring during periods of delay.
“Where we have found concerns about delayed treatment – including induction of labour – we have made clear to those trusts that effective oversight of the issue is vital and that all action possible should be taken to mitigate any risk and keep people using the service safe.”
Read full story (paywalled)
Source: HSJ, 27 September 2023
Sam

Millions wrongly labelled with penicillin allergy, pharmacists warn

Millions of people wrongly believe they are allergic to penicillin, which could mean they take longer to recover after an infection, pharmacists say.
About four million people in the UK have the drug allergy on their medical record - but when tested, 90% of them are not allergic, research suggests.
The Royal Pharmaceutical Society says many people confuse antibiotic side-effects with an allergic reaction.
Common allergic symptoms include itchy skin, a raised rash and swelling. Nausea, breathlessness, coughing, diarrhoea and a runny nose are some of the others.
But antibiotics, which treat bacterial infections, can themselves cause nausea or diarrhoea and the underlying infection can also lead to a rash.
And this means people often mistakenly believe they are allergic to penicillin, which is in many good, common antibiotics.
These are used to treat chest, skin and urinary tract infections - but if people are labelled allergic, they are given second-choice antibiotics, which can be less effective.
Read full story
Source: BBC News, 28 September 2023
Patient Safety Learning

University Hospitals Birmingham: Half of staff felt bullied

More than half of staff at a hospital trust that has been under fire for its "toxic culture" have said they felt bullied or harassed.
The findings come from an independent review commissioned by University Hospitals Birmingham (UHB) NHS Trust.
It has been at the centre of NHS scrutiny after a culture of fear was uncovered in a BBC Newsnight investigation.
UHB has apologised for "unacceptable behaviours". It added it was committed to changing the working environment.
Of 2,884 respondents to a staff survey, 53% said they had felt bullied or harassed at work, while only 16% believed their concerns would be taken up by their employer.
Many said they were fearful to complain "as they believed it could worsen the situation," the review team found.
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Source: BBC News, 27 September 2023
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US Department of Health and Human Services awards $45 million in grants to expand access to care for people with Long Covid

The U.S. Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ), announced nine grant awards of $1 million each for up to 5 years to support existing multidisciplinary Long COVID clinics across the country to expand access to comprehensive, coordinated, and person-centered care for people with Long COVID, particularly underserved, rural, vulnerable, and minority populations that are disproportionately impacted by the effects of Long COVID.
The grants are a first of their kind. They are designed to expand access and care, develop, and implement new or improved care delivery models, foster best practices for Long COVID management, and support the primary care community in Long COVID education. This initiative is part of the Biden-Harris Administration's whole-government effort to accelerate scientific progress and provide individuals with Long COVID the support and services they need.
“The Biden-Harris Administration is supporting patients, doctors and caregivers by providing science-based best practices for treating long COVID, maintaining access to insurance coverage, and protecting the rights of workers as they return to jobs while coping with the uncertainties of their illness,” said Secretary Xavier Becerra. “Treatment of Long COVID is a major focus for HHS, and AHRQ is helping lead the way through grants to investigate best practices and get useful guidance to doctors, hospitals, and patients.”
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Source: AHRQ, 20 September 2023
Sam

‘Feminist approach’ to cancer could save lives of 800,000 women a year

Health experts are calling for a “feminist approach” to cancer to eliminate inequalities, as research reveals 800,000 women worldwide are dying needlessly every year because they are denied optimal care.
Cancer is one of the biggest killers of women and ranks in their top three causes of premature deaths in almost every country on every continent.
But gender inequality and discrimination are reducing women’s opportunities to avoid cancer risks and impeding their ability to get a timely diagnosis and quality care, according to a new Lancet Commission on women, power and cancer.
The largest report of its kind, which studied women and cancer in 185 countries, found unequal power dynamics across society globally were having “resounding negative impacts” on how women experience cancer prevention and treatment.
Gender inequalities are also hindering women’s professional advancement as leaders in cancer research, practice and policymaking, which in turn perpetuates the lack of women-centred cancer prevention and care, the report adds.
It is calling for a new feminist agenda for cancer care to eliminate gender inequality.
Read full story
Source: The Guardian, 26 September 2023
 
Patient Safety Learning

Scotland: MSPs to vote on patient safety commissioner plan

MSPs are set to vote on a new law to establish a patient safety commissioner.
The bill to create an "independent public advocate" for patients will go through its final stage on Wednesday.
Public Health Minister Jenny Minto has said the commissioner would be able to challenge the healthcare system and ensure patient voices were heard.
The Scottish government has been told the new watchdog must have the power to prevent future scandals.
In 2020, former UK Health Minister Baroness Julia Cumberlege published a review into the safety of medicines and medical devices like Primodos, transvaginal mesh and the epilepsy drug sodium valproate.
She told the House of Lords: "Warnings ignored. Patients' concerns ignored. A system that seemed unwilling or unable to listen let alone respond, unwilling or unable to stop the harm."
Her findings led to the recommendation for a patient safety commissioner.
Speaking ahead of the vote on the Patient Safety Commissioner for Scotland Bill, Ms Minto said the watchdog would listen to patients' views.
"I think it's a really important role for us to have in Scotland," she said.
"There's been a number of inquiries or situations where the patient's voice really needs to be listened to and that's what a patient safety commissioner will do."
Read full story
Source: BBC News, 27 September 2023
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NHS whistleblower tells tribunal he faced ‘brutal retaliatory victimisation’

A consultant obstetrician has claimed he was sacked from his hospital for raising whistleblowing concerns about patient safety over fears they would cause “reputational damage”.
Martyn Pitman told an employment tribunal in Southampton that managers dismissed his concerns and he was “subjected to brutal retaliatory victimisation” after he criticised senior midwife colleagues.
He said: “On a daily basis there was evidence of deteriorating standards of care. We were certain that the situation posed a direct threat to both patients’ safety and staff wellbeing. Concern was expressed that there was a genuine risk that we could start to see avoidable patient disasters.”
Rather than addressing these, Pitman said the trust had considered it “the path of least resistance to take out [the] whistleblower”.
Pitman was dismissed this year from his job at the Royal Hampshire County hospital (RHCH) in Winchester, where he had worked as a consultant for 20 years. He is claiming he suffered a detriment due to exercising rights under the Public Interest Disclosure Act.
He said he “fought against [an] absolute barrage of completely unprofessional assaults on me” after he raised concerns about foetal monitoring problems that resulted in the death of a baby and the delivery of another with severe cerebral palsy.
Read full story
Source: The Guardian, 26 September 2023
Patient Safety Learning

Vapes '95% safer' than cigarettes messaging backfired

The message that vaping is 95% safer than smoking has backfired, encouraging some children to vape, says a top health expert.
Dr Mike McKean treats children with lung conditions and is vice-president for policy at the Royal College of Paediatrics and Child Health. He says the 2015 public messaging should have been clearer - vapes are only for adults addicted to cigarettes.
Evidence on the possible health risks of vaping is still being gathered.
In an exclusive interview with the BBC, Dr McKean said: "Vaping is not for children and young people. In fact it could be very bad for you," although he stresses that it is not making lots of children very sick, and serious complications are rare.
"Vaping is only a tool for adults who are addicted to cigarettes."
He says the 95% safe messaging was "a very unwise thing to have done and it's opened the door to significant chaos".
"There are many children, young people who have taken up vaping who never intended to smoke and are now likely addicted to vaping. And I think it's absolutely shocking that we've allowed that to happen."
Read full story
Source: BBC News, 26 September 2023
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Some police have stopped answering mental health calls, with no alternative support in place, experts warn

Police forces in parts of the UK have stopped answering urgent calls related to mental health even before alternative support is available to people, under a policy designed to free up officers’ time, MPs were told last week.
The move means many vulnerable people are being left without help in areas where the necessary services and arrangements with other agencies are not yet in place, warned Sarah Hughes, chief executive of the mental health charity Mind.
Giving evidence to the House of Commons health select committee on Tuesday 19 September, Hughes said, “We know of local Mind and local trust partners who are already experiencing people having no response because the police are saying they no longer respond to mental health calls.”
The policy, Right Care, Right Person, which was developed by Humberside Police over nearly three years, is being rolled out in England and Wales from the end of October at varying speeds. Backed by the government and police representative bodies, it aims to ensure that patients in a mental health crisis are treated by the most appropriate agency, rather than have police act as default responder, when they may not be best suited to help.
But the Royal College of Psychiatrists is among the organisations to have raised concerns over the levels of preparation and resourcing for the policy and the absence of evaluation of clinical outcomes or benefits and harms to the population.
Read full story (paywalled)
Source: BMJ, 25 September 2023
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Thousands with breathing problems undiagnosed due to lack of tests in England

Thousands of people with asthma and other lung problems are going undiagnosed because most GPs in England do not offer tests for them, according to a new report.
The failure to diagnose and start treating people with breathing problems threatens to create “a deluge of hospital admissions this winter” when the NHS is under intense pressure.
Sarah Woolnough, the chief executive of charity Asthma and Lung UK, said: “The abysmal lack of testing and patchy basic care is causing avoidable harm to people with lung conditions and the NHS.”
The report, which the Charity Commissioned from consultants PricewaterhouseCoopers, found that most GP surgeries in England do not provide basic lung function tests.
Patients’ inability to access a test to check if they have asthma or chronic obstructive pulmonary disease (COPD) represents a “crisis in care” that could lead to many being hospitalised this winter “as respiratory viruses take hold and people struggle to heat their homes”, Asthma and Lung UK added.
Read full story
Source: The Guardian, 26 September 2023
Patient Safety Learning

As a physio, Bev was sure she had a DVT - but it was only diagnosed after she nearly died

One of the most serious complications of a DVT is when a part of the clot breaks off and travels through the bloodstream to the lungs, leading to a blockage called a pulmonary embolism — this can cause chest pain, breathing difficulties, a faster heartbeat, coughing up blood, and can be life-threatening if not treated quickly.
Worryingly, research suggests 40 per cent of patients who die from a pulmonary embolism complained of nagging symptoms for weeks before their death.
For every pulmonary embolism diagnosed in time, there are at least another two where the diagnosis was missed and resulted in sudden death, according to the charity Thrombosis UK.
Read full story
Source: Daily Mail, 25 September 2023
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24,000 hospital letters lost in computer error

A hospital trust failed to send out 24,000 letters from senior doctors to patients and their GPs after they became lost in a new computer system, the BBC has learned.
Newcastle Hospitals warned the problem, dating back to 2018, is significant.
The BBC has been told the problems occurred when letters requiring sign-off from a senior doctor were placed into a folder few staff knew existed.
The healthcare regulator has sought urgent assurances over patient safety.
Most of the letters explain what should happen when patients are discharged from hospital. But a significant number of the unsent letters are written by specialist clinics spelling out care that is needed for patients. It means that some crucial tests and results may have been missed by patients.
Staff have been told to record any resulting incidents of patient harm and ensure these are addressed.
Following a routine inspection by the regulator - the Care Quality Commission (CQC) - in the summer, staff at the trust raised concerns about delays in sending out correspondence.
A subsequent review of the trust's consultants revealed that most had unsent letters in their electronic records.
Read full story
Source: BBC News, 26 September 2023
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