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

Nearly one in five of world’s newborns with sepsis die, study finds

A study in 11 countries over four continents has shown the “catastrophic impact” of antibiotic resistance on babies with sepsis, with nearly one in five dying.
The two year observational study enrolled 3204 babies with clinical sepsis in 19 hospitals in Africa, Asia, Europe, and Latin America. It found that 17.7% were blood culture pathogen positive, and mortality rates among infants up to 60 days old with culture positive sepsis was 17.7%.
The research, published in PlOS Medicine, also highlighted wide variation in treatment and frequent switching of antibiotics because of resistance, with 206 antibiotic combinations used by the hospitals studied in Bangladesh, Brazil, China, Greece, India, Italy, Kenya, South Africa, Thailand, Vietnam, and Uganda.
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Source: BMJ, 9 June 2023
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Fewer NHS staff feel able to raise clinical safety concerns, data show

The number of NHS staff who feel able to raise concerns about clinical safety has fallen for the second year in a row, an analysis of NHS staff survey data has shown.
A report by the NHS’s National Guardian’s Office, which represents local “freedom to speak up guardians” who help NHS workers to raise concerns, said that staff were increasingly disillusioned and that they believed that speaking up was “futile,” which had “worrying implications for patient safety.”
Dr Jayne Chidgey-Clark, National Guardian for the NHS said: “It is not acceptable that two in five workers responding to the NHS staff survey do not feel able to speak up about anything which gets in the way of them doing their job.
“These survey responses show us that there is a growing feeling that speaking up in the NHS is futile – that nothing changes as a result. When workers speak up about concerns, including the impact of under staffing and a crumbling infrastructure, their leaders themselves may struggle to be heard when trying to address these concerns.
“I would add my voice to that of others that this urgently needs to be addressed".
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Source: BMJ. 9 June 2023
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Puberty blockers to be given only in clinical research

Puberty blockers will only be prescribed to children attending gender identity services as part of clinical research, NHS England has announced.
The move comes after an interim report into children's gender services said there were "gaps in evidence" around the drugs.
Blockers are used to "pause puberty" and work by supressing hormone release.
Dr Hilary Cass's report called for a transformation in the model of care for children with gender-related distress.
Currently, if a child seeks medical help, the drugs are one of the options a doctor could offer to help delay the onset of physical changes that do not match a child's gender identity.
This change will come into effect when new clinics replacing the Gender Identity and Development Service (Gids) begin to open later this year. No patients being treated by the current Gids service will be affected.
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Source: BBC News, 10 June 2023
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Inquests to be held for patients of jailed breast surgeon Ian Paterson

Inquests will be held into the deaths of at least 36 patients – and potentially dozens more – treated by the jailed former breast surgeon Ian Paterson.
As the fallout of one of the most horrific medical scandals in the history of the NHS continues, a pre-inquest review hearing at Birmingham and Solihull coroner’s court on Friday heard that 417 of Paterson’s cases where breast cancer was listed as the immediate cause of death had been examined.
Paterson, who attended the hearing remotely from prison, was sentenced to 15 years in jail in 2017, later increased to 20 years, for carrying out needless surgery on patients who were left traumatised and scarred.
Inquests have been confirmed in 36 cases, with a further 21 cases deemed likely to need an inquest after “preliminary” investigations. Another 36 cases are still to be reviewed.
The judge Richard Foster said a further 130 cases had been reported to the coroner where breast cancer was listed as contributing to death. A review of a selection of those cases was being carried out and a decision on whether they should all be reviewed would be made on its completion, he said.
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Source: The Guardian, 9 June 3023
 
Sam

Police investigate dozens of deaths at hospital in Brighton following concerns from whistleblowers

Police are investigating about 40 hospital deaths over allegations of medical negligence made by two consultant surgeons who lost their jobs after blowing the whistle about patient safety.
The allegedly botched operations took place at Royal Sussex County hospital (RSCH) in Brighton, part of University hospital Sussex NHS trust, when it was run by a management team hailed by Jeremy Hunt as the best in the NHS.
Last week, detectives from Sussex police wrote to the trust’s chief executive, George Findlay, confirming they had launched a formal investigation into “a number of deaths” at the RSCH. They were investigating allegations of “criminal culpability through medical negligence” made by “two separate clinical consultants” at the trust, the letter said.
It is understood about 40 deaths occurred between 2015 and 2020 after alleged errors in general surgery and neurosurgery departments. Both whistleblowers alleged the trust failed to properly investigate the deaths and learn from the mistakes made.
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Source: The Guardian, 9 June 2023
Sam

Police launch investigation into ‘abuse’ at NHS unit

A police investigation is under way into allegations of abuse at an NHS-run home for men with severe learning disabilities and autism, it has emerged.
Several staff from the home have already been “removed” from the site by Surrey and Borders Partnership Foundation Trust, although the trust would not comment on whether any disciplinary action has been taken against them.
The home – Oakwood, in Caterham, Surrey – will close at the end of the summer in response to the failings, the trust said. No one has been charged in relation to the allegations, which HSJ understands focus on coercive behaviour and unnecessary deprivation of liberty, with no allegations of violent or sexual behaviour.
Read full story (paywalled)
Source: HSJ, 9 June 2023
Sam

All NHS board members to get equality objectives

Trusts and systems must draw up plans to improve the diversity of their executive and senior leadership teams over the next 12 months, and evidence progress against them by summer 2025, NHS England has announced.
A new equality, diversity and inclusion (EDI) improvement plan also says every board and executive team member will have EDI objectives they will be assessed against during annual appraisals by spring 2024.
The targets form part of six “high impact actions,” each with set targets that aim to address the “widely known intersectional impacts of discrimination and bias” within the NHS.
Read full story (paywalled)
Source: HSJ, 8 June 2023
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Covid inquiry: Families unhappy with Welsh government

Bereaved families of coronavirus victims feel the Welsh government has not adequately taken part in the Covid public inquiry, their solicitor says.
Craig Court, who represents bereaved families, said the Welsh government had not participated "as well as they should have".
He claimed the Welsh government failed to deliver crucial paperwork with just days to go before Tuesday's inquiry. The UK-wide inquiry could go on as long as three years, and will predominantly look at the UK government's approach to the pandemic.
A Wales-specific inquiry was blocked by Labour members of the Senedd, with First Minster Mark Drakeford saying it should wait until after the UK-wide investigation had been completed.
Mr Court told BBC Wales "there is a great concern over the duty of candour" displayed by the Welsh government.
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Source: BBC News, 9 June 2023
Patient Safety Learning

Ministers accused of neglecting ‘tidal wave’ of child mental ill health in England

Ministers have been accused of failing to grasp the “tidal wave” of mental ill health blighting children’s lives, after research found that only a quarter of English primaries will be able to offer vital school-based support by the end of next year.
With almost one in five pupils aged 7 to 16 now thought to have a mental health disorder, specialist support teams were set up to work with children in schools, addressing early symptoms and reducing pressure on overstretched NHS services.
According to new figures shared exclusively with the Guardian, however, pupils in almost three-quarters (73.4%) of primary schools in England will have had no access to the new mental health support teams (MHSTs) by the end of 2024.
The research follows reports that a quarter of a million children in the UK with mental health problems have been denied help by the NHS, with some trusts failing to offer treatment to 60% of those referred by GPs.
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Source: The Guardian, 9 June 2023
Patient Safety Learning

WHO treaty on future pandemics is being watered down, warn health leaders

The World Health Organization’s new pandemic preparedness treaty is being watered down and stripped of the key stipulations needed to prevent another global health disaster, say leading international health experts and civil society groups.
WHO’s 194 member states agreed in December 2021 to draw up a new convention to ensure that the world would be prepared for future global health threats and to prevent the “catastrophic failure” seen during the covid pandemic.
The “zero draft” of the accord, published in February, had excited observers because its scope went beyond the closest existing legally binding framework, the International Health Regulations. That draft stipulated strong obligations for information sharing and the importance of having a strong health workforce and universal healthcare, among other requirements.
The latest 42 page document, leaked during the World Health Assembly, has revealed that many passages that experts regard as key to improving global health have been weakened or made optional, meaning that they could be removed in the final draft.
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Source: BMJ, 31 May 2023
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Met intervention ‘will not serve London well’, says ‘very disappointed’ NHSE

NHS England has described the Metropolitan Police commissioner’s warning that his force will stop responding to emergency mental health calls as ‘very disappointing’, HSJ has learned.
Last month, Sir Mark Rowley told NHS and social care chiefs he had instructed his force to withdraw from health-related calls in the capital no later than 31 August – a warning which attracted high-profile media coverage.
Sir Mark stressed the “urgency” of needing to implement a model that originated in Humberside called “right care right person”, where after a year of tense negotiations, police and health services reached an agreement under which many mental health calls are dealt with by health professionals rather than officers.
NHSE’s letter says it agrees with the issues Sir Mark raises, adding it is inappropriate for police to spend significant amounts of time on mental health callouts.
But it adds that the NHS was “very disappointed” to receive the commissioner’s letter, stressing that the problem is better solved in partnership than unilaterally declaring the force will not respond to calls.
Read full story (paywalled)
Source: HSJ, 8 June 2023
Patient Safety Learning

Kettering General Hospital chief apologises over children's care

A chief executive whose hospital has been accused of failing children has admitted it has not always "got it right" and apologised at a meeting.
The care regulator has warned Kettering General Hospital (KGH) over its children's and young people's services and rated them inadequate.
Dozens of parents with children who died or became seriously ill have contacted the BBC with concerns.
Deborah Needham told a board meeting she was "here to listen" to worries.
In April it was revealed inspectors from the Care Quality Commission (CQC) raised concerns over sepsis treatment, staff numbers, dirt levels and not having an "open culture" where concerns could be raised without fear, following an inspection in December.
The CQC had inspected the Northamptonshire hospital's paediatric assessment unit, Skylark ward, and the neonatal unit after hearing concerns of safety.
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Source: BBC News, 9 June 2023
Patient Safety Learning

NHS chiefs blame staff shortages for record 7.4m people on waiting lists in England

Health leaders have blamed staff shortages for waiting lists reaching another record high, with 7.4 million people in England waiting to start treatment as of the end of April.
One NHS leader said the figures showed that unsustainable “pressure continues to pile on an overstretched NHS”, and urged the government to speed up publication of its long-awaited workforce plan, which has been repeatedly postponed.
Waiting list figures in England have crept up again after showing signs of improvement in recent months, despite Rishi Sunak citing bringing numbers down as one of the government’s top five priorities for 2023.
Downing Street on Thursday insisted the NHS was “continuing to make progress to ensure patients are seen more quickly”, pointing to record numbers of doctors and nurses in the NHS.
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Source: The Guardian, 8 June 2023
Patient Safety Learning

Patients may be guilty of discrimination if they refuse care of transgender medic, NHS bosses told

Patients may be found guilty of discrimination if they refuse the care of a transgender medic, according to new NHS guidance.
Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth.
However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says.
The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff member in limited circumstances, such as if they are having an intimate examination.
It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”.
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Source: Telegraph, 9 June 2023
Patient Safety Learning

Covid-19: Metformin reduces the risk of developing long term symptoms by 40%, study finds

Metformin—a cheap, safe, and widely available diabetes drug—could reduce the incidence of long covid if given during the acute phase of Covid-19, a new study indicates.
A two week course of metformin given within three days of testing positive for SARS-CoV-2 led to 40% fewer Long Covid diagnoses over the following 10 months compared with people who had taken placebo, according to a randomised controlled trial.
The authors of the study, published in Lancet Infectious Diseases, caution that the trial did not look at whether metformin would be effective as a treatment for those who already have Long Covid.
Jeremy Faust from Harvard Medical School, who was not involved in the research, said the findings, if confirmed, are “profound and potentially landmark.” Writing in a linked comment, he said, “This is the first high quality evidence from a randomised controlled trial to show that the incidence of long covid can be reduced by a medical intervention, metformin—an inexpensive treatment with which clinicians have ample experience".
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Source: BMJ, 8 June 2023
Patient Safety Learning

6,500 staff gap in government cancer plan revealed

Community diagnostic centres (CDCs) — the government’s flagship policy for recovering cancer testing after Covid — will have up to 6,500 fewer staff than they need by 2025, according to NHS England projections seen by HSJ. 
The workforce “gap analysis” modelling highlights large and sustained staffing shortfalls across most professional groups required to run the CDCs until at least 2025. It was released after a Freedom of Information Act request to the Department of Health and Social Care, which said it was given the analysis by NHSE. 
The total gap between demand and supply for the programme by 2025 is estimated at 6,663, out of a total demand of 61,152 (about 1 in 10 staff).
Read full story (paywalled)
Source: HSJ, 8 June 2023
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