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

Trust’s A&E ‘effectively running primary care service’, says chair

An acute trust chair has said its emergency department is effectively operating as a primary care service. 
Hattie Llewelyn-Davies, who has chaired The Princess Alexandra Hospital Trust since late 2021, told HSJ: “We’ve done an awful lot of changes in the way we run out A&E and same day emergency care service to try and get the flow through working better…
“We have particular problems with the Princess Alexandra because we are right in the middle of Harlow. And we have a GP service and primary care service which is under massive pressure. We have very high levels of deprivation in Harlow.
“When somebody is sick in Harlow and can’t get a doctor’s appointment on the spot, they walk into us. We have a very high level of people coming in, so a very high level of footfall but a very low level of admissions.
“We are therefore running effectively a primary care service through our A&E.”
Read full story (paywalled)
Source: HSJ, 15 May 2023
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Hepatitis C home test kits available to most-at-risk in England

Home test kits for a virus which attacks the liver are now available to order online in England, as the NHS tries to reach those needing treatment.
Hepatitis C tends to affect current or past drug users and people who have had contact with infected blood through a tattoo or medical procedure abroad.
It can lead to liver disease and cancer, but symptoms often go unnoticed for many years.
The NHS website says it can usually be cured by taking a course of tablets.
More than 70,000 people are thought to be living with the virus in England. Some may not know they have it, so would be unlikely to go to their GP for a test.
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Source: BBC News, 13 May 2023
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Nurses ‘fear being taken to court’ over degrading treatment of patients in corridors

Nurses fear they could be taken to court or struck off over the level of care they are able to give to patients, a union has warned, as the NHS stands on the brink of six more months of strikes.
The Royal College of Nursing, one of the two unions to turn down the recent government pay offer to NHS staff, revealed that over nine in 10 A&E nurses had raised concerns that patients may be receiving unsafe care and that patient dignity, privacy and confidentiality is compromised.
Six in 10 fear they will be struck off the nursing register or have a court case brought against them as a result of patient harm due to their working conditions, the RCN said.
Ms Cullen insisted that patient safety is “at the centre of everything that we do” but warned that it “cannot be guaranteed on any day of the week”, given it is missing 47,000 nurses “every single day and night”.
Speaking before its annual congress in Brighton, which begins on Monday, some nurses described themselves as “broken” and feeling “suicidal”, with corridor treatment being deemed “degrading for patients” and as “destroying staff morale”.
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Source: The Independent, 15 May 2023
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Quarter of people with dementia symptoms delay seeing doctor

Almost a quarter of people with dementia symptoms waited more than six months before seeing a doctor, new research shows.
A new survey for the Alzheimer’s Society to mark Dementia Action Week also found one in three people who notice they or a loved one has symptoms keep their fears to themselves or dismiss them as old age.
Just 15% of the 1,137 people surveyed raised the issue straight away and 11% said they hadn’t raised concerns after first spotting symptoms.
Kate Lee, chief executive of the Alzheimer’s Society, said: “We can’t continue to avoid the ‘d’ word – we need to face dementia head-on.
“As soon as you realise something is not right, come to Alzheimer’s Society – you can use our symptoms checklist to help have that all-important first chat with your GP.”
An early diagnosis is crucial to help manage symptoms, according to the charity, which has launched a new campaign called – It’s not called getting old, it’s called getting ill – to encourage people to seek support in getting a diagnosis.
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Source: The Independent, 15 May 2023
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Baby heart death parents left waiting 14 months for answers

Grieving parents have been left waiting more than 14 months for answers about why their 12-day-old son died.
Elijah was born at Merthyr Tydfil's Prince Charles Hospital on 25 February 2022 and died after being diagnosed with enterovirus and myocarditis.
Joann and Christian Edwards said they were told they would have a report by the end of 2022, but are still waiting.
Joann and Christian, from Mountain Ash, Rhondda Cynon Taf, said they were told Elijah's myocarditis was a "one off" but subsequently read about 10 babies, including one who died, getting severe enterovirus with myocarditis across south Wales.
Public Health Wales (PHW) said Elijah's death was not being looked into as part of an investigation into this cluster of cases, as the dates were set at June 2022 to April 2023 to coincide with the enterovirus season.
But it said it would look to include Elijah's death as part of a "wider clinical investigation" of the cases.
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Source: BBC News, 15 May 2023
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Warnings over NHS data privacy after ‘stalker’ doctor shares woman’s records

The confidentiality of NHS medical records has been thrown into doubt after a “stalker” hospital doctor accessed and shared highly sensitive information about a woman who had started dating her ex-boyfriend, despite not being involved in her care.
The victim was left in “fear, shock and horror” when she learned that the doctor had used her hospital’s medical records system to look at the woman’s GP records and read – and share – intimate details, known only to a few people, about her and her children.
“I felt violated when I learned that this woman, who I didn’t know, had managed to access on a number of occasions details of my life that I had shared with my GP and only my family and very closest friends. It was about something sensitive involving myself and my children, about a family tragedy,” the woman said.
The case has prompted warnings that any doctor in England could abuse their privileged access to private medical records for personal rather than clinical reasons.
Sam Smith, of the health data privacy group MedConfidential, said: “This is an utterly appalling case. It’s an individual problem that the doctor did this. But it’s a systemic problem that they could do it, and that flaws in the way the NHS’s data management systems work meant that any doctor can do something like this to any patient.
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Source: The Guardian, 14 May 2023
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Patient safety at risk in crumbling hospital Boris Johnson promised to replace

Patients, doctors and nurses are enduring constant ward closures and flooding in “dilapidated and unpleasant” buildings because a new hospital promised by the government has still not been delivered, one of its most senior medics has warned.
Patient safety could soon be at risk unless the replacement for St Helier Hospital, in south London, is finally confirmed by ministers, according to the outgoing chief medical officer of its NHS trust. Some of the buildings pre-date the NHS, while wards have been shut due to sinking foundations.
Writing in the Observer, Dr Ruth Charlton, the chief medical officer of Epsom and St Helier University Hospitals NHS Trust, warns:
“Right now, we are delivering safe care – but it’s not easy in such a dilapidated and unpleasant environment, and I fear we won’t be able to provide the level of care we’d like to – or should be – for much longer,” she writes. “Our patients and our staff deserve so much better than this current state – where wards are being shut down because the foundations are sinking, and floods and leaks are a certainty every winter.
“Every day we wait costs money, and each year we have to spend more and more on updating our old, rundown buildings – diverting scarce resources from the front line … there’s no other option. We must progress our plans to build our new hospital and make improvements to our existing sites.”
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Source: The Guardian, 13 May 2023
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ADHD: Private clinics exposed by BBC undercover investigation

Patients are being offered powerful drugs and told they have attention deficit hyperactivity disorder (ADHD) after unreliable online assessments, a BBC investigation has discovered.
Three private clinics diagnosed an undercover reporter via video calls. But a more detailed, in-person NHS assessment showed he didn't have the condition.
Panorama spoke to dozens of patients and whistleblowers after receiving tip-offs about rushed and poor-quality assessments at some private clinics, including Harley Psychiatrists, ADHD Direct and ADHD 360.
The investigation found that:
Clinics carried out only limited mental health assessments of patients. Powerful drugs were prescribed for long-term use, without advice on possible serious side effects or proper consideration of patients' medical history. Patients posting negative reviews were threatened with legal action. The NHS is paying for thousands of patients to go to private clinics for assessments. Commenting on Panorama's findings, Dr Mike Smith - an NHS consultant psychiatrist - said he was seriously concerned about the number of people who might "potentially have received an incorrect diagnosis and been started on medications inappropriately".
"The scale is massive."
Read full story
Source: BBC News, 
Patient Safety Learning

Medicines courier Sciensus was warned it was failing patients three years ago

The boss of a private healthcare company exposed by the Guardian for putting seriously ill children and adults at risk was warned it was failing patients three years ago.
Darryn Gibson, the chief executive of Sciensus, Britain’s biggest medicines courier, was told in November 2020 that patients with bleeding disorders were being left dangerously exposed to internal bleeding with little or no treatment at home as a result of botched, delayed or missed deliveries.
Gibson received the written warning from Kate Burt, the chief executive of the Haemophilia Society, a leading health charity, after she had become outraged at how vulnerable patients were being let down.
Sciensus blamed IT issues and promised action. However, three years later, patients remain at “very serious” risk of harm because of “recurring” problems with the company, Burt said.
“We continue to receive complaints about missing, incomplete or inaccurate deliveries and are very concerned to see the same issues recurring, indicating that far more needs to be done to improve Sciensus’s ordering and delivery systems,” she said.
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Source: The Guardian, 12 May 2023
 
Sam

Children’s surgery waiting lists hits record high as NHS fails to tackle spiralling backlog

Hospitals are failing to tackle spiralling children's surgery waiting lists as the backlog hits more than 400,000 for the first time.
Leaked documents show children’s waiting lists for both inpatient and outpatient care are “increasing at double the rate of adults” and, despite efforts, services have failed to catch up after they were paused during the pandemic.
NHS leaders have repeatedly raised concerns about the backlog amid warnings that services for young people have been “deprioritised” to cut adult lists.
One NHS leader warned that the long waits would be likely to affect some children’s “ability to lead full and active lives” and worsen existing inequalities between adult and children’s care.
Read full story
Source: The Independent, 11 May 2023
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Artificial intelligence could ‘transform’ heart attack diagnosis, scientists say

Artificial intelligence (AI) could be “transformational” in improving heart attack diagnosis to reduce pressure on emergency departments, a new study suggests.
Doctors could soon use an algorithm developed using AI to diagnose heart attacks with better speed and accuracy than ever before, the research from the University of Edinburgh indicates.
It could also help tackle dangerous inequalities in diagnosing the condition, scientists suggest.
Researchers found that, compared to current testing methods, the algorithm called CoDE-ACS was able to rule out a heart attack in more than double the number of patients, with an accuracy of 99.6%.
Nicholas Mills, British Heart Foundation (BHF) professor of cardiology at the Centre for Cardiovascular Science, University of Edinburgh, who led the research, said: “For patients with acute chest pain due to a heart attack, early diagnosis and treatment saves lives.
“Unfortunately, many conditions cause these common symptoms, and the diagnosis is not always straight forward.
“Harnessing data and artificial intelligence to support clinical decisions has enormous potential to improve care for patients and efficiency in our busy emergency departments.”
Read full story
Source: The Independent, 11 May 2023
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World-renowned NHS centre downgraded by watchdog

A world-renowned cancer centre hit by whistleblowing concerns over alleged bullying has been downgraded by the health watchdog.
The Care Quality Commission (CQC) told The Christie NHS Foundation Trust in Manchester it "requires improvement" in safety and leadership.
A former trust nurse told the BBC leaders had intimidated staff to stop them voicing concerns to inspectors.
Rebecca Wight worked at The Christie - Europe's largest cancer centre - from 2014 but quit her role as an advanced nurse practitioner in December, claiming her whistleblowing attempts had been ignored.
She told BBC Newsnight the trust had attempted to manipulate the inspection by intimidating those who wished to paint an honest picture.
Roger Kline, an NHS workforce and culture expert from Middlesex University Business School, told BBC Newsnight there was a culture at The Christie which was "unwelcoming of people raising concerns".
He said: "The trust response is more likely... to see the person raising the concerns as the problem rather than the issues they have raised," adding this was "not good for patient care".
Read full story
Source: BBC News, 12 May 2023
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Monkeypox: WHO declares global emergency over

Monkeypox is no longer a global public health emergency, the World Health Organization (WHO) has said, almost a year after the threat was raised.
The virus is still around and further waves and outbreaks could continue, but the highest level of alert is over, the WHO added.
The global health body's chief Tedros Adhanom Ghebreyesus called on countries to "remain vigilant".
More than 87,000 cases and 140 deaths have been reported from 111 countries during the global outbreak, according to a WHO count.
But almost 90% fewer cases were recorded over the last three months compared with the previous three-month period, meaning the highest level of alert is no longer required, Tedros said.
Read full story
Source: BBC News, 11 May 2023
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WHO issues warning on weight loss drug Wegovy

New weight loss drugs such as Wegovy will not be a “silver bullet” in tackling obesity, the World Health Organization (WHO) has warned.
Francesco Branca, WHO director of food and nutrition safety, said weight loss drugs must be used alongside a healthy diet and exercise.
Ms Branca’s comments come as the health body conducts its first review of obesity management guidelines in two decades.
Semaglutide, marketed as Wegovy by drugmaker Novo Nordisk, is an appetite suppressant drug that has been approved by the UK medicines regulator and described by some as a “game changer” in helping people to shed weight.
People will only be given Wegovy on prescription as part of a specialist weight management service involving input from several professionals and for a maximum of two years.
Some experts described the decision as a “pivotal moment” for the treatment of people living with obesity but others warned that the drug is not a “quick fix”.
Read full story
Source: The Independent, 12 May 2023
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Legal action may be needed to lower ‘appalling’ death rates of black women in childbirth

The death rates for black women in childbirth were revealed in a recent report from MPs and were described as “appalling”, yet action, not words, are needed for what could be considered breaches of the Human Rights Act.
Ministers are not giving priority to reducing the gap in health inequalities, write Nicola Wainwright and Suleikha Ali in a commentary to the Times. 
"If the response to the review is foot-dragging from the government and senior health service officials, then legal action may be the only way to draw focus to this issue and to try to reduce the number of ethnic minority women and babies dying unnecessarily."
The report, published by the women and equalities committee last month, highlights the “glaring and persistent” disparities faced by ethnic minority women compared to their white counterparts with regards to pregnancy and birth. However, these same disparities have been known and reported on for 20 years, while progress on improving the situation has been shockingly slow.
Read full story (paywalled)
Source: The Times, 11 May 2023
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'Hidden' rise in blood clot deaths 'breaking families' warns charity

Thrombosis UK has warned that deaths involving blood clots are higher than expected as it called for more transparency over the work hospitals are doing to reduce the risk for patients.
Before the pandemic hit, hospitals were regularly publishing data on the number of patients who had been risk assessed for blood clots. In March 2020, the NHS in England took the decision to suspend the data collection on venous thromboembolism (also known as VTE) risk assessments to “release capacity in providers and commissioners to manage the Covid-19 pandemic”.
But the data collection and publication is yet to resume. The charity said the data shows how many VTE cases are missed in hospitals.
One bereaved man described how his mother died last year after the condition was missed. Tim Edwards, 42, said healthcare workers missed signs of the condition while Jennifer Edwards, 74, was in hospital on the south coast.
Despite having many symptoms of a pulmonary embolism she was discharged home and died three days later. Mr Edwards said: ““My mother’s symptoms were missed from her admission to hospital right up to her time in the cardiology department.
“She was discharged and passed away three days after phoning the NHS with shortness of breath. She should not have died. I took it upon myself to enquire about the circumstances surrounding her death and was overwhelmed by the lack of care taken.
“Sadly, I know this is not an isolated case.”
Read full story
Source: Wales Online, 12 May 2023
Further reading on the hub:
Pulmonary embolism misdiagnosis – a systemic problem (a blog from Tim Edwards) Independent review of pulmonary embolism fatalities in England & Wales – recent trends, excess deaths, their causes and risk management concerns (Tim Edwards) Jenny, and why we must learn from her misdiagnosis of pulmonary embolism National Voices: Pulmonary embolism misdiagnosis - a blog by Helen Hughes.
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