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

Hospital waiting list deaths double in five years

More than 120,000 died waiting for NHS treatment, as backlog hits all-time high. 
The number of NHS patients dying while waiting for treatment has doubled in five years, new figures suggest.
More than 120,000 people died while on waiting lists last year, according to an analysis of health service data. The total is even higher than it was in lockdown, with health leaders saying the pandemic and NHS strikes have made clearing backlogs more difficult.
Matthew Taylor, the chief executive of the NHS Confederation, said: “These figures are a stark reminder about the potential repercussions of long waits for care. They are heartbreaking for the families who will have lost loved ones and deeply dismaying for NHS leaders, who continue to do all they can in extremely difficult circumstances."
“Covid will have had an impact on these figures – but we can’t get away from the fact that a decade of under-investment in the NHS has left it with not enough staff, beds and vital equipment, as well as a crumbling estate in urgent need of repair and investment.”
Read full story (paywalled)
Source: The Telegraph, 31 August 2023
Sam

NHS failed to act on brain surgeon who harmed patients

NHS Tayside has been criticised over its handling of disgraced brain surgeon Sam Eljamel in a new report.
The internal due diligence review criticised health board management for putting the doctor under indirect supervision in June 2013 rather than suspending him.
The surgeon harmed dozens of patients but was allowed to continue operating until he was suspended in late 2013.
Some of his patients were left with life-changing injuries.
He was employed as a surgeon by NHS Tayside for 18 years and later became the head of the neurosurgery department in Ninewells Hospital in Dundee.
NHS Tayside has apologised to former patients of Prof Eljamel and committed to assisting in the Scottish government's independent commission for patient concerns.
The health board claimed it became aware of concerns around the surgeon in June 2013, but an NHS whistleblower told the BBC the health board knew as early as 2009 that there were serious concerns.
He is now working as a surgeon in Libya.
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Source: BBC News, 1 September 2023
Patient Safety Learning

Whistleblowers sacked by NHS fear no change after Lucy Letby case

NHS clinicians who were sacked after blowing the whistle about avoidable patient deaths say they fear lessons from the Lucy Letby murder trial have not been learned and the case will make no difference to their own claims for unfair dismissal.
They say hospital bosses are still more concerned about reputation than patient safety, despite what emerged in the Letby case about the tragic consequences of ignoring consultants who first raised suspicions about her killing babies.
Mansoor Foroughi is appealing against his dismissal by University Hospital Sussex NHS trust in December 2021 after raising concerns about patient deaths. 
Mansoor Foroughi, a consultant neurosurgeon, was sacked by University Hospital Sussex NHS trust (UHST) in December 2021 for allegedly acting in bad faith when he raised the alarm about 19 deaths and 23 cases of serious patient harm that he said had been covered up in the previous six years. Those deaths and at least 20 others are now being investigated by Sussex police after allegations of medical negligence.
Foroughi, whose appeal against his dismissal is due to be held in the coming months, told the Guardian: “I don’t think mine or anyone’s chances of success has increased [after Letby], and only a change in the law will do that.”
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Source: The Guardian, 1 September 2023
Patient Safety Learning

Brain fog after Covid linked to blood clots - study

Blood clots in the brain or the lungs might explain some common symptoms of "Long Covid", including brain fog and fatigue, a UK study suggests.
In the study, of 1,837 people admitted to hospital because of Covid, researchers say two blood proteins point to clots being one cause.
It is thought 16% of such patients have trouble thinking, concentrating or remembering for at least six months.
But the research team, from the universities of Oxford and Leicester, stress:
Their findings are relevant only to patients admitted to hospital. They are "the first piece of the jigsaw" but further research is needed before they can propose or test any potential treatments. They tracked cognitive problems at six and 12 months only and through tests and questionnaires, which may "lack sensitivity". Identifying predictors and possible mechanisms was "a key step" in understanding post-Covid brain fog, study author Prof Paul Harrison, from the University of Oxford, said.
Leicester's professor of respiratory medicine, Chris Brightling, said: "It's a combination of someone's health before, the acute event itself and what happens afterwards that lead on to physical and mental health consequences."
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Source: BBC News, 31 August 2023
Patient Safety Learning

Chair who was ‘not always honest’ in old job gets NHSE’s ‘full support’

An integrated care board chair is keeping her job despite complaints being upheld against her in a previous role, it has emerged.
Danielle Oum left her position as Birmingham and Solihull Mental Health Foundation Trust chair last October.
It later emerged that an independent investigation carried out the month before her departure, the results of which were leaked to HSJ, had upheld several complaints against her and found she did not always act with “honesty, truthfulness and clarity”.
She was appointed to the ICB position in October 2021, four months before the complaints were made against her by an individual at the trust.
But NHS England now says it has reviewed the matter and concluded that it “continue[s] to offer Danielle our full support in her role as chair of Coventry and Warwickshire ICB”.
Following the independent investigation, which upheld 16 complaints against Ms Oum in total, NHSE carried out its own review of the issues.
NHSE said its review involved a “rigorous fact-finding process” and it was grateful to those who raised “freedom to speak up” concerns.
It said in a statement: “A thorough review has taken place at regional and national level, and the committee responsible for adjudicating these issues has delivered what we believe is a fair decision."
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Source: HSJ, 31 August 2023
Patient Safety Learning

Junior doctors and consultants to strike together

Junior doctors and consultants in England are to coincide strikes during the autumn in an escalation of the pay dispute with the government.
It will be the first time in this dispute they have walked together and comes after junior doctors voted in favour of continuing with strikes.
In the British Medical Association ballot 98% voted in favour, giving the union a fresh six-month mandate.
Junior doctors have already staged five walkouts this year.
They will strike on 20 to 22 September - the first day of which coincides with a walkout by consultants.
They will then walkout on 2 to 4 October, which is when consultants will also be striking.
When the two groups strike together cover will be provided to staff emergency services as well as a small amount of cover on the wards.
Read full story
Source: BBC News, 31 August 2023
Patient Safety Learning

‘National tragedy’: figures show large rise in people dying while on NHS waiting list

More than 120,000 people in England died last year while on the NHS waiting list for hospital treatment, figures obtained by Labour appear to show.
That would be a record high number of such deaths, and is double the 60,000 patients who died in 2017/18.
For example, the Royal Free hospital in London said it had had 3,615 such deaths, while there were 2,888 at the Morecambe Bay trust in Cumbria and 2,039 at Leeds teaching hospitals trust.
Hospital bosses said the deaths highlighted the dangers of patients having to endure long waits for care and reflected a “decade of underinvestment” that had left the NHS with too few staff and beds.
Healthwatch England, a patient advocacy group that scrutinises NHS performance, said the number of people dying while waiting for care was “a national tragedy”.
Louise Ansari, the chief executive, said: “We know that delays to care have significant impacts on people’s lives, putting many in danger.”
Read full story
Source: The Guardian, 31 August 2023
Patient Safety Learning

NHS urges breast cancer patients from minority backgrounds to participate in trials

An NHS body is encouraging women with breast cancer from minority backgrounds to take part in more clinical trials, after research found they are under-represented in studies that can offer life-saving treatment.
The pilot project, supported by the NHS Race and Health Observatory, is intended to improve representation in breast cancer clinical trials partly through culturally sensitive communications to people from racially diverse backgrounds.
Research from the UK Health Security Agency suggests young black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research.
Their lack of inclusion in trials could be partly down to distrust of the research process and a lack of knowledge, according to research by the UK’s National Institute for Health Research.
The project, which works in conjunction with Macmillan Cancer Support and the pharmaceutical company Roche, will run for a year and look at developing new ways for people with breast cancer to access clinical trials. It will develop action plans to improve representation and provide enhanced support for patients.
Read full story
Source: The Guardian, 31 August 2023
Patient Safety Learning

Lucy Letby: Inquiry given powers to compel witnesses to give evidence

The inquiry into how nurse Lucy Letby was able to murder seven babies will now have greater powers to compel witnesses to give evidence.
In a significant move, ministers upgraded the independent inquiry after criticism from families of the victims that it did not go far enough.
The inquiry, ordered after Letby was found guilty this month, was not initially given full statutory powers.
Health Secretary Steve Barclay said he had listened to the families.
He said he had decided a statutory inquiry led by a judge was the best way forward and "respects the wishes" of the families.
Mr Barclay said the key advantage was the power of compulsion.
"My priority is to ensure the families get the answers they deserve and people are held to account where they need to be," he added.
He said an announcement about who would chair the inquiry would be made in the coming days - ministers have already said it will be a judge.
Richard Scorer, a lawyer who is representing two of the families, welcomed the government's announcement.
"It is essential that the chair has the powers to compel witnesses to give evidence under oath, and to force disclosure of documents. Without these powers, the inquiry would have been ineffectual and our clients would have been deprived of the answers they need and deserve," he said.
Read full story
Source: BBC News, 30 August 2023
Sam

CEO to take joint leadership of neighbouring trust

The leadership of a specialist trust in Liverpool is set to be taken over by the chief executive of the city’s main acute provider.
A message to staff seen by HSJ said James Sumner, who leads Liverpool University Hospitals Foundation Trust, will also become interim CEO of Liverpool Women’s FT at the end of the year when Kathryn Thomson steps down.  Ms Thomson announced her retirement in May.
There have been long-standing ambitions to move Liverpool Women’s standalone hospital to the new Royal Liverpool Hospital site in the city centre, run by LUHFT, with a possible merger of the organisations.
The relocation remains the ambition, although the trusts are focusing on service integration in the short term.
The message to staff, sent this afternoon by chair Robert Clarke, said: “We have been clear for some time about our preferred future direction of travel for the trust, namely a closer collaboration with the large acute provider of services in the city as we believe this will support the long term clinical and financial sustainability of services for the benefit of women, babies and others who access our services.
“Liverpool Women’s has secured agreement with NHS Cheshire & Merseyside on our ambition to move to a shared CEO model…This is a positive step in providing ongoing stability for Liverpool Women’s.”
Read full story (paywalled)
Source: HSJ, 30 August 2023
Patient-Safety-Learning

A public defibrillator may be a mile away in deprived areas

In the most deprived areas of England and Scotland, the nearest 24/7 accessible defibrillator is on average a round trip of 1.8 km away—over a mile—according to a pioneering study supported by the British Heart Foundation (BHF).
The researchers, led by Dr Chris Wilkinson, senior lecturer in cardiology at Hull York Medical School, used data from national defibrillator network The Circuit to calculate the median road distance to a defibrillator with unrestricted public access across Great Britain's 1.7 million postcodes.
Among the 78,425 defibrillator locations included, the median distance from the centre of a postcode to a 24/7 public access defibrillator was 726.1 metres – 0.45 miles. In England and Scotland, the more deprived an area was, the farther its average distance from a 24/7-accessible defibrillator – on average 99 metres more in England, and 317 metres farther in Scotland for people living in the most compared with the least deprived areas. There was no link between defibrillator location and deprivation in Wales.
The researchers said they hoped the findings, presented at the European Society of Cardiology (ESC) Congress in Amsterdam and published in the journal Heart, would lead to more equal access to defibrillators. They noted that there were over 30,000 out-of-hospital cardiac arrests (OHCA) annually in the UK; in England nearly 30% happened at weekends, and 40% between 6pm and 6am. 
Read full story
Read research study: Automated external defibrillator location and socioeconomic deprivation in Great Britain (28 August 2023)
Source: Medscape, 29 August 2023
Patient-Safety-Learning

NHS 'to employ half of public sector by 2026'

The NHS workforce plan will cost £50 billion and result in the health service employing half the public sector by the 2030s, analysis concludes today.
Jeremy Hunt, the chancellor, has in effect “stolen more than a decade’s worth of budgets” from his successors by setting out plans to hire almost a million extra NHS staff without a clear way to pay for them, the Institute for Fiscal Studies (IFS) says.
Hunt has been urged to use his autumn statement to start setting out whether tax rises, borrowing or cuts elsewhere will be used to fund the “massive spending commitment”.
Read full story (paywalled)
Source: The Times, 30 August 2023
Patient-Safety-Learning

Targeted screening of diabetic patients ‘could double heart condition diagnoses’

Targeted screening of patients with type 2 diabetes could more than double new diagnoses of heart conditions, a study suggests.
When applied at a larger scale, such an approach could translate into tens of thousands of new diagnoses, researchers believe.
Conditions such as coronary artery disease, atrial fibrillation and heart failure affect millions of people worldwide, causing a large number of deaths and increasing healthcare costs.
Treatments are available that can prevent stroke or acute heart failure, but systematic screening is not currently common practice.
Those living with conditions such as type 2 diabetes or chronic obstructive pulmonary disease (COPD) – a group of lung conditions that cause breathing difficulties – are at high risk of such conditions.
A team of researchers led by Dr Amy Groenewegen, from the University Medical Centre Utrecht in the Netherlands, has developed a three-step screening process to detect conditions in high-risk people at an early stage.
Study author Dr Groenewegen said: “An easy-to-implement strategy more than doubled the number of new diagnoses of heart failure, atrial fibrillation and coronary artery disease in high-risk patients.”
Read full story
Source: Independent, 29 August 2023
Patient-Safety-Learning

Flu jab IT system to be ‘switched off’ weeks before vaccine programme starts

All tech support for flu and covid vaccinations will be switched off on Thursday after NHS England decided against extending its contract with its supplier in favour of developing an in-house system, according to HSJ.
NHSE last week told suppliers System C and Graphnet it would not extend the contract for the National Immunisation Management Service – just one week before the contract ends.
NIMS, provided by the two British firms in partnership with NHS South Central and West Commissioning Support Unit, has been used for the last three years to manage the vaccination programme.
Its functionalities include a single data store holding vaccination records for more than 60 million people, a call and recall service that can identify and contact groups of eligible individuals according to age and clinical priority, and reporting and analysing of vaccination activity in “near real time”.
NHSE informed System C it would not extend the contract last Thursday – five working days before it was due to expire, according to a message from System C to customers, seen by HSJ.
In its message, System C said: “This means that all functionality, including the NIMS application programming interface links to third party booking systems, all outgoing feeds and extracts, NIMS dashboards and the point of vaccination data capture application will stop working after 31 August.”
There is currently “significant usage” of the system by GPs and trusts, which means NIMS users “may need to take action to deal with the retirement of the system” – the message stated.
Read full story (paywalled)
Source: HSJ, 30 August 2023
Patient-Safety-Learning

Close to 1m NHS appointments lost to strikes

The number of appointments and treatments postponed by strike action in the NHS in England is nearing one million.
The 48-hour walkout by consultants in England last week saw more than 45,000 appointments being cancelled.
It brings the total number of postponed hospital appointments since industrial action began in the NHS in December to 885,000.
Once mental health and community bookings are included, it tops 944,000.
The true total is likely to be even higher, as services have stopped scheduling appointments on strike days and these will not be included in the figures released by NHS England.
Alongside consultants, junior doctors, nurses, physios, ambulance workers and radiographers have also walked out at various stages.
NHS national medical director Professor Sir Stephen Powis said: "Industrial action continues to have a huge impact on the NHS, and on the lives of patients and their families. This strike took place into a bank holiday weekend, when NHS activity is generally lighter, but many services have for some time avoided scheduling any planned appointments for strike days in order to prioritise emergencies. This means the true impact of this action will be even higher, and as we move into September, the extraordinary cumulative effect of more than nine months of disruption poses a huge challenge for the health service, as staff work tirelessly to tackle the backlog."
Read full story
Source: BBC News, 29 August 2023
Patient-Safety-Learning

Nurses caring ‘for too many patients’ as vacancy rates rise again

Around one in ten NHS nursing jobs remain unfilled leaving already stretched service struggling to cope.
The number of unfilled NHS nursing jobs in England has risen again after falling slightly earlier this year.
Between March and June of this year, the number of vacant nursing positions across the NHS in England increased by 3,243 taking the total to a staggering 43,339.
With the number of applications to study nursing also falling by a massive 13,380 in just two years, experts admit they are concerned about how the NHS is going to cope.
In real terms, the figures mean around one in ten NHS nursing jobs remain unfilled.
The Royal College of Nursing (RCN) has warned the high vacancy rate will leave the health service “underprepared” for winter.
Read full story
Source: Nursing Notes, 25 August 2023
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