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

Global COVID-19 data gap grows as countries stop reporting to WHO

Fewer than 20 countries worldwide still report COVID-19 hospitalisation and ICU data to the World Health Organization (WHO), leaving the UN health body blind to the impact and evolution of the virus in most of the world, agency leaders have said.
The decline in data reporting is a major setback for the WHO’s efforts to track the pandemic. Without reliable data, the WHO cannot accurately assess the burden of disease, identify new variants, or target its resources where they are most needed.
“We don’t have good visibility of the impact of COVID-19 around the world,” said Dr. Maria Van Kerkhove, who leads the WHO’s COVID-19 task force. “It is really important that surveillance continues, and this is on the shoulders of governments right now.”
“While we are certainly not in the same situation that we were in a year ago or two years ago, SARS-Cov-2 circulates in all countries right now,” said Van Kerkhove. “It is still causing a large number of infections, hospitalisations, admissions to the ICU and deaths.”
The current set of dominant COVID-19 variants can still cause the “full spectrum” of disease, from asymptomatic infections to severe disease and death, Kerkhove said.
Read full story
Source: Health Policy Watch, 25 August 2023
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‘Cost of living crisis’ contributing to stillbirths, research finds

The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas.
The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. 
The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend.
The research findings include:
‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments; “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”; Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.” Read full story (paywalled)
Source: HSJ, 25 August 2023
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USA: Why are so many kids losing Medicaid coverage?

At the end of the COVID pandemic, more than half (54%) of US children were covered by Medicaid or CHIP; the vast majority by Medicaid. So, the lifting of the pandemic-related Medicaid continuous enrolment protection this spring is a really big deal, putting low-income children at risk of losing access to health care and/or exposing their families to medical debt.
In fact, researchers at federal Office of the Assistant Secretary for Planning and Evaluation (ASPE) projected that just shy of three-quarters of children losing Medicaid would be disenrolled despite remaining eligible. Children are most at risk of losing coverage during the unwinding despite being eligible and the likelihood that the child uninsured rate will go up if states do not take care in the process.
Over half a million children have lost Medicaid already in 21 states where there is data. And that large number doesn’t include Texas, a state that disenrolled more than 500,000 people on June 1st, and where state agency employees recently blew the whistle on systems errors that caused inappropriate terminations.
The Biden Administration must take swift and definitive action to pause all terminations in states with systemic problems. Governors who see large numbers of children losing coverage must pause the process. Coverage must be reinstated for those who lose coverage inappropriately. The time for action to protect children is now.
Read full story
Source: McCourt School of Public Policy at Georgetown University, 23 August 2023
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University Hospitals Birmingham: Whistleblowers fear no change at 'toxic' NHS trust

Whistleblowers who first revealed a toxic environment at one of England's largest NHS trusts say they do not believe crucial changes will be made.
In a letter, they said families who suffered due to management failings at University Hospitals Birmingham (UHB) "have every reason to feel let down".
Investigations have been examining UHB after staff told the BBC a climate of fear put patients at risk.
The letter was written by three doctors to the Labour MP For Birmingham Edgbaston, Preet Gill, who is heading a cross-party reference group on the trust.
In their letter, the consultants raise concerns about the appointment from within the trust of new chief executive Jonathan Brotherton and feel the management team remains largely unchanged.
"More than six months have elapsed since we spoke to you of the need to repay the debt owed to those UHB staff, patients and their families who have suffered as a result of the board's serious failings," they wrote.
"They now have every reason to feel let down."
Read full story
Source: BBC News, 29 August 2023
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Norfolk and Suffolk NHS trust deaths report 'watered down to spare bosses'

A critical report into how a mental health trust mismanaged its mortality figures was edited to remove criticism of its leadership, the BBC has found.
In June, auditors Grant Thornton revealed how the Norfolk and Suffolk NHS Foundation Trust (NSFT) had lost track of patient deaths.
But earlier drafts included language around governance failures that were missing in the final version.
NSFT and Grant Thornton said the changes were due to fact-checking.
A number of drafts of the report were produced, with the first dated 23 February this year.
The first version described "poor governance" in the way deaths data was managed, with governance also being called "weak" and "inadequate".
But many of these critical words were missing from the report released to the public, with "governance" also being replaced with "controls", according to leaked documents.
After losing her son Tim in 2014, Caroline Aldridge has been highlighting what she and others claimed had been the trust's undercounting of deaths.
"I think people need to know what was removed and what was changed, because I suspect that the first report is a lot nearer to the truth," she said.
Ms Aldridge added: "It takes all responsibility from governance, removing the words 'inadequate', 'poor', 'weak' governance, removing significant pieces of information that's not factual accuracy.
"We cannot have people watering it [the report] down when it's about deaths."
Read full story
Source: BBC News, 29 August 2023
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NHSE calls urgent meeting over powers to strike off managers

Amanda Pritchard has said it is time to ‘look again’ at whether NHS England should be given formal powers to disbar managers for ‘serious misconduct’.
In an email to regional leaders and some national bodies yesterday, seen by HSJ, the chief executive officer of NHS England said the murder trial of neonatal nurse Lucy Letby has brought the issue of professional regulation for managers back into focus. She has planned an urgent meeting next week to discuss the options.
Ms Pritchard said she wanted the meeting to explore; the feasibility of NHSE being given the powers and resources to act as a regulator; who this could apply to and how it could operate; and how a dedicated regulatory body for NHS leaders might fulfil the role.
She stressed any new powers would need to be determined by the government, but said the NHS “should contribute proactively and fully, and with an open mind, to this decision-making process”.
Read full story (paywalled)
Source: HSJ, 25 August 2023
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Chilling warning that scandals across NHS will be covered up as staff say whistleblowers are ignored

More than half of NHS staff believe bosses would ignore whistleblowers amid fresh concerns hospitals could be covering up potential scandals following the Lucy Letby case.
New national figures seen by the The Independent reveal that in the majority of hospitals, most doctors and nurses do not believe their concerns would be acted upon if they were raised with senior managers.
It comes after The Independent revealed that NHS bosses accused of ignoring complaints about Letby were the very same people later appointed to act on whistleblower concerns at the hospital where she murdered seven babies and tried to kill six more.
Several doctors who worked alongside her during the killing spree say they attempted to raise the alarm with hospital managers – only to have their pleas ignored. They believe the lack of action by bosses resulted in more babies being killed, stating managers who failed to act were “grossly negligent” and “facilitated a mass murderer”.
In nearly three-quarters of general hospitals – such as the Countess of Chester where Letby worked – fewer than half of staff believed their trust would act on a concern, according to results from the latest NHS staff survey.
Read full story
Source: The Independent, 27 August 2023
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‘Insecure’ junior medics ‘crying every day’ in ‘chaotic’ department

Delays in patient care and a lack of consultant support have left junior medics fearing for their mental health, an NHS England investigation has discovered.
Junior doctors described haematology services delivered from University Hospitals Birmingham’s Heartlands Hospital as “chaotic”.
Their concerns are raised in a report by NHS England Workforce, Training and Education (formerly Health Education England). UHB’s haematology service has been under scrutiny since 2021, when HSJ revealed whistleblower concerns over patient safety, including a series of blood transfusion’ never’ events.
The WTE team visited UHB in April. As a result, the haematology service is now subject to the General Medical Council’s enhanced monitoring regime. This means intensive support is given to trainees and the trust to improve medical training. UHB’s obstetrics and gynaecology department is also under enhanced monitoring.
The WTE report warns that consultants working across multiple sites left trainee medics at Heartlands without sufficient support and supervision. Most conversations with consultants were via telephone, leaving juniors feeling “unsupported and insecure”. 
The report stated: “Trainees described the workload … as chaotic and some reported the stress … was affecting their mental health… Some reported they do not feel valued, and the panel heard examples of people crying every day. Most described their roles as 100 per cent service provision… [they] reported very limited learning opportunities overall.”
Read full story (paywalled)
Source: HSJ, 24 August 2023
Patient-Safety-Learning

Early death risk grows with just three ‘slightly unhealthy mid-life traits’

Just three “slightly unhealthy traits” in mid-life increase the risk of early death by a third, research suggests.
The study found people carrying extra weight in their 40s and 50s who also had slightly raised blood pressure, cholesterol or blood sugar levels were also 35 per cent more likely to have a heart attack or stroke over the next three decades.
Researchers warned that middle-aged people with this “cluster of slightly unhealthy traits” – known as metabolic syndrome – typically had a heart attack or stroke two years earlier on average than healthier people the same age.
Dr Lena Lönnberg, of Västmanland County Hospital, Sweden, who was lead researcher for the study, said: “Many people in their 40s and 50s have a bit of fat around the middle and marginally elevated blood pressure, cholesterol or glucose but feel generally well, are unaware of the risks and do not seek medical advice. “In fact, most people live with slightly raised levels for many years before having symptoms that lead them to seek healthcare.”
She warned that because the individual “unhealthy traits” did not usually make people feel unwell, most people were unaware of the risks combined with excess weight.
An estimated one in four UK adults has metabolic syndrome, with rising obesity levels one of the main drivers.
On their own, diabetes, high blood pressure, and obesity can damage the blood vessels. 
But even if patients only have mild versions of each condition, experts warn having the three together can be particularly dangerous.
Read full story (paywalled)
Source: The Telegraph, 25 August 2023
Patient-Safety-Learning

Sepsis: Perforated bowel Barry mum told to drink tea

A mum suffered a perforated bowel and sepsis after being told she was anxious and should take constipation medication and drink peppermint tea.
Farrah Moseley-Brown was in "agonising pain" after having her second son, Clay, but the hospital sent her home.
Because of the delay in treating her, Ms Moseley-Brown, 28, of Barry, Vale of Glamorgan, now has a stoma.
Cardiff and Vale health board admitted failures in her care and gave its "sincere apologies".
Since the error, Ms Moseley-Brown has turned to TikTok to inform people about the dangers of sepsis and has had 15 million views one one video alone.
She was booked into University Hospital Wales, Cardiff, for a Caesarean on 7 May 2020. After Clay was born, Ms Moseley-Brown lost about two-and-a-half pints of blood and needed further surgery to stem the bleeding.
"I felt really unwell and I said this to the nurses and the staff at the hospital which they didn't listen to. They kept saying it was after-pain but it was just agonising," Ms Moseley-Brown said.
Read full story
Source: BBC News, 25 August 2023
Patient-Safety-Learning

Covid cases double in a month as scientists warn about spread of new variants

Covid cases in England have almost doubled in a month after the rise of two new variants.
According to the most recent government statistics available, 875 cases were logged in England on August 11, compared to just 449 a month earlier. Hospital admissions have also risen by a fifth in a week.
UKHSA statistics show Covid cases in England rose from a seven-day rolling average of 373 on July 8 to 879 as of August 8. Also, 589 out of 6,500 neighbourhoods in England had detected at least three Covid cases in the week to August 12.
The uptick comes after reports of a new variant called Eris which makes up one in four new cases. Also, another strain nicknamed Pirola is quickly spreading globally. 
The US is also seeing an increase in hospital admissions with coronavirus, its first significant uptick since December 2022.
The UK Health Security Agency (UKHSA) said they are unsettled by the variant and suggested the rapid spread could suggest an international transmission.
Christina Pagel, a member of the Independent Scientific Advisory Group for Emergencies that advises on the virus, said: "Without ramping up surveillance, and in the face of waning immunity, we are travelling into winter more vulnerable and with blinkers on."
Prof Pagel predicted the new wave could cause extreme pressure on the health service, with a repeat of last winter’s “unprecedented” NHS crisis of Covid, flu and respiratory virus that came all around the same time.
Read full story
Source: Independent, 24 August 2023
Patient-Safety-Learning

UK facing ‘brain drain’ of cancer researchers after failure to join EU scheme

Top young cancer researchers are leaving the UK in a “brain drain” fuelled by the continuing failure to reach an agreement over the EU’s study programme, scientists warn.
The two-and-a-half-year delay in joining the £85bn Horizon Europe scheme, the largest collaborative research programme in the world, has “damaged the UK’s reputation” and made it more difficult to attract and retain the brightest researchers into the nation’s labs.
Cancer Research UK (CRUK) surveyed 84 cancer specialists about Horizon Europe and found that three-quarters of respondents favoured association with the programme compared with only 11% who wanted the UK to go it alone with the government’s plan B, known as Pioneer.
Prof Julian Downward, head of the Oncogene Biology Lab at the Francis Crick Institute in London, said: “We need Horizon Europe very badly. The current situation is damaging UK science every day. We are losing top junior faculty regularly who decide to move to EU countries so they can take up European Research Council grants.”
Read full story
Source: Guardian, 25 August 2023
Patient-Safety-Learning

Families sue government for failing to protect care homes from Covid

Thirty families are starting legal action against the government, care homes and several hospitals in England over the deaths of their relatives in the early days of the Covid pandemic.
The families argue not enough was done to protect their loved ones from the virus.
They are claiming damages for loss of life and the distress caused.
The government says it specifically sought to safeguard care home residents using the best evidence available.
The legal claims focus on the decision in March 2020 to rapidly discharge hospital patients into care homes without testing or a requirement for them to isolate.
The cases follow a 2022 High Court judgement that ruled the policy was unlawful - as it failed to take into account the risk to elderly and vulnerable care home residents of asymptomatic transmission of the virus.
One of the cases is being brought by Liz Weager, whose 95-year-old mother Margaret tested positive for the virus in her care home in May 2020 and died later in hospital. "What was happening in the management of those care homes? What advice were they having?" Liz asks. "It goes back to the government. There was a lack of preparedness, which then translated down to the care home."
Read full story
Source: BBC News, 25 August 2023
Patient-Safety-Learning

Bristol mesh surgeon to face allegations of patient harm

Details of allegations against a surgeon who left dozens of patients in agony after undergoing mesh operations have been published.
A tribunal will look at whether Tony Dixon failed to provide adequate clinical care to six patients at Southmead Hospital and the private Spire Hospital in Bristol.
He had pioneered the use of artificial mesh to lift prolapsed bowels.
The surgeon, who was dismissed in 2019, has always maintained the operations were done in good faith, and that any surgery could have complications.
The Medical Practitioners Tribunal, which starts in Manchester on 11 September and is due to end on 23 November, will look into allegations that between 2010 and 2016 Mr Dixon failed to provide adequate clinical care in a number of areas, including:
ensuring procedures for some of the patients were clinically indicated adequately advising some of the patients regarding options for treatment obtaining informed consent before performing clinical procedures adequately performing a procedure for one patient providing adequate post-operative care for some communicating appropriately with some of the patients and their family members. Read full story
Source: BBC News, 24 August 2023
Sam

Lucy Letby: NHS could face record compensation bill of more than £60m

The NHS could face a record compensation bill of more than £60m from civil claims lodged by the families of Lucy Letby’s victims, experts have said.
Parents whose babies have disabilities caused by Letby’s attacks at the Countess of Chester hospital could each expect to receive a payout of more than £10m to fund their future care.
Compensation paid by the NHS to parents whose babies died or were left with disabilities as a result of care at Shrewsbury hospital in Britain’s largest maternity scandal reportedly amounted to almost £50m. In a separate case, the health service had to pay £37m to a boy who was left brain damaged at birth.
Stephen Jones, the head of Leigh Day’s medical negligence team in Manchester, said the trust could argue that by committing the offences, Letby breached the employer-employee relationship to an extent such that it was not responsible for her. But he added: “I think there would be outrage that the trust wouldn’t accept responsibility for babies in their care.” He said compensation could run into eight figures for a family whose baby was severely injured and had a long life expectancy.
Emma Wray, a partner in Hodge Jones & Allen’s medical negligence department, suggested the NHS could set up a scheme for victims, as it has done with other scandals, to make claiming compensation easier.
Read full story
Source: The Guardian, 23 August 2023
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NHS whistleblowers warn of 'unsafe' A&E staff shortages

A group of senior doctors has accused NHS Grampian of ignoring their safety concerns about emergency departments.
They told BBC Scotland News they were speaking out because they feel they cannot deliver a safe level of care.
The medics said staff shortages meant Grampian's two A&Es have no senior registrars on shift to make key decisions about patients for the majority of weekend night shifts.
Documents seen by the BBC News show medics have been raising concerns since 2021, both with NHS Grampian and the Scottish government, and in July this year submitted a formal whistleblowing complaint about the situation.
One doctor said: "The staff are in an impossible situation.
"We are witnessing ongoing harm with unacceptable delays to the assessment and treatment of patients.
"There have been avoidable deaths and at other times there are too long delays getting to patients who may be suffering from a serious condition like stroke or sepsis."
Read full story
Source: BBC News, 23 August 2023
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