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

Northern Ireland medical negligence costs double in a year

The amount of government money spent on medical negligence cases and legal fees in Northern Ireland doubled within a year.
Just over £20m was paid out during 2020-21 but that increased to more than £40m in the 2021-22 financial year.
Last year, £30.7m was paid out in damages, while £5.9m went on plaintiff costs and £3.7m in defence costs.
The increase in cost is being attributed to the coronavirus pandemic.
Last year, 3,987 clinical negligence cases were open. Almost half (1,813) of all cases open in 2021-22 related to four specialties:
Obstetrics - 564 Accident and emergency - 456 Neurology - 407 General surgery - 386 There has been a stark increase in the number of cases relating to neurology in the past five years from 23 in 2017-18 to 407 in 2021-22.
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Source: BBC News, 24 April 2023
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Sciensus: Chronically ill patients go without vital drugs amid delays by NHS-contracted firm

Chronically ill patients across the UK allege they've had to go without vital medication amid delays by a private company contracted by the NHS to deliver drugs.
In the last year alone, Sciensus was awarded NHS contracts worth more than £5 million, despite being placed into special measures by health regulators in 2021 following widespread delivery failings.
ITV News has revealed that the CQC is currently reviewing whether to take further regulatory action against Sciensus, having been made aware of concerns about the company’s performance.
The company, which is based in Burton-on-Trent and says it "works with every NHS Trust in the country", should provide a lifeline for those who rely on specialised medications.
These include those with long-term conditions - like cancer, HIV, and haemophilia - which often require drugs that can't be collected from high street or hospital pharmacies.
One new mother with rheumatoid arthritis said she was taken to A&E after Sciensus left her without medication for three weeks.
The 37-year-old, who wishes to remain anonymous, told ITV News: "I was unable walk with a small baby... it was such a chronic flare that I couldn't walk, which I've never, ever had before in my life."
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Source: ITV News, 21 April 2023
Sam

NHS plans new elective target after April deadline missed

System leaders are discussing pushing back the NHS’s target to virtually eliminate 78-week breaches from the waiting list by this month to ‘June or July’, HSJ understands.
The discussions come after the service missed its original targeted trajectory of clearing the backlog by this month, as first proposed in NHS England’s elective recovery plan last February, despite a steep reduction over the past 18 months.
Internal NHS forecasts suggest there will be around just over 10,000 long waiters still on the waiting list by the end of April, as HSJ first revealed last month. Senior sources said this week that this figure remained a likely position for the end of the month.
HSJ understands there has not been any official communication to trusts about pushing back the 78-week target, and it was not yet clear when the centre’s expectations would be finalised.
Read full story (paywalled)
Source: HSJ, 21 April 2023
Patient Safety Learning

USA: Rising focus on patient safety and regulatory compliance driving growth in medical device complaint management market

The medical device complaint management market is experiencing significant growth due to the increasing focus on patient safety and regulatory compliance. As medical devices become more complex and the regulations governing them become more stringent, it has become essential for manufacturers to have effective complaint management systems in place to ensure the safety and satisfaction of their customers.
The global medical device complaint management market is expected to grow at a CAGR of 6.3% from 2021 to 2026. 
One of the key factors driving the growth of the medical device complaint management market is the increasing emphasis on patient safety. In recent years, there has been a growing awareness of the potential risks associated with medical devices, and patients are increasingly demanding higher levels of safety and quality. This has led to a greater focus on complaint management among medical device manufacturers, who are now investing in advanced complaint handling systems to ensure that they are able to identify and address issues before they become major problems.
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Source: Digital Journal, 20 April 2023
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‘National improvement board’ to be set up by NHS England

NHS England has launched a new framework for quality improvement and delivery, including a national board that will pick a “small number of shared national priorities”.
The new document says NHSE will “establish a national improvement board, to agree the small number of shared national priorities on which NHS England, with providers and systems, will focus our improvement-led delivery work”.
The review says NHSE will, among other actions: 
Create a “national improvement board” to “agree a small number of shared national priorities and oversee the development and quality assure the impact of the NHS improvement approach”. Set an expectation that all NHS providers, working in partnership with integrated care boards, will embed a quality improvement method aligned with the NHS improvement approach”. Incentivise a universal focus on embedding and sustaining improvement practice”, including with “regulatory incentives alongside clearer and more timely offers of support. Work with the [Care Quality Commission] to align the revised CQC well-led [inspection method] with the improvement approach. Read full story (paywalled)
Source: HSJ, 21 April 2023
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Herpes deaths: NHS trust lied about virus links, inquest hears

The mother of a young woman who died with herpes said she was "disgusted" with an NHS trust which "lied" about the potential cause of the virus.
Kim Sampson and Samantha Mulcahy died with herpes after the same obstetrician at the East Kent Hospitals University NHS Trust carried out their caesareans.
Yvette Sampson's daughter had been "fit and healthy" until she gave birth on 3 May 2018, an inquest has heard.
She said the trust had lied about links between the two mothers' deaths.
They were treated by the same surgeon and midwife six weeks apart, neither of whom were tested for herpes, the inquest in Maidstone was told.
Ms Sampson said her daughter had been "in agony" from 3 May when she gave birth to her second child, until she died on 22 May.
She told the inquest she had received "poor treatment" by midwives at the Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate, which she felt also "contributed" to her daughter's death.
Ms Sampson was initially denied a Caesarean and instead told to push for almost three hours, despite repeatedly telling midwives that "something wasn't right" and "clinging to the bed in agony", her mother said.
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Source: BBC News, 20 April 2023
Patient Safety Learning

NHS threatens legal action to block second day of nurses’ strike

The NHS has launched a legal challenge that could end in the high court to block the second day of an upcoming strike by tens of thousands of nurses.
Officials at NHS Employers wrote to the Royal College of Nursing (RCN) on Wednesday saying the union’s plans for a two-day strike were unlawful.
In response, it is understood the RCN has said it will “forcibly resist” employers’ attempts to seek a high court injunction designed to block the strike, which they insist is lawful.
The threat raises the possibility of a high court clash between NHS lawyers backed by the government and those of the nursing union. It also highlights the increasingly bitter relationship between the government and those representing workers on the frontline of the health service.
Read full story
Source: The Guardian, 20 April 2023
Patient Safety Learning

Millions wait more than a fortnight to see a GP in England

Nearly five million patients each month in England wait more than a fortnight for a GP appointment, NHS figures show, which Labour is calling "unacceptable".
The government says it expects all patients needing a GP appointment to be seen within two weeks.
The Royal College of GPs says 85% of appointments happen within two weeks and nearly half on the same day.
Those taking longer than two weeks may be routine ones for which the wait is therefore appropriate, it says.
Prof Kamila Hawthorne, who chairs the Royal College of GPs, said: "GPs and our teams are working tirelessly to deliver safe, timely and appropriate care and to give patients the choice of appointment they want.
"We share our patients' frustration when they struggle to access our care. However, this is not down to GPs and their hard-working teams, but due to decades of underfunding and poor resource planning."
Read full story
Source: BBC News, 21 April 2023
Patient Safety Learning

Child health checks failed to recover after covid, figures show

Inadequate health visiting provision has led to gaps in care for children and heaped pressure on acute services, senior clinicians have told HSJ. 
Government data suggests that a fifth of infants are not receiving one or more of their five mandatory health visiting reviews across the first two years of life, with rates still substantially below pre-covid levels.
Meanwhile, nationally about 1 in 10 children are still being seen virtually, contrary to the government’s delivery model and despite clinicians saying in-person contact is vital to spotting problems. Senior figures in children’s services told HSJ that in some areas a much higher rate was still being carried out with no in-person contact.
Clinicians said the reasons were ongoing funding and staffing constraints, and that the problems were leading to parents turning to emergency departments and GPs instead.
Read full story (paywalled)
Source: HSJ, 20 April 2023
Patient Safety Learning

Mifepristone: US Supreme Court delays abortion pill access decision

The US Supreme Court has extended until Friday a temporary block on limits to access of a popular abortion pill.
A Texas judge suspended approval of abortion drug mifepristone on 7 April, questioning its safety.
Parts of that decision were upheld on appeal, prompting the Biden administration to make an emergency request to the Supreme Court.
It's the most significant such case since the Supreme Court last year ended the nationwide right to abortion.
The pill - used in more than half of abortions in the US - was first approved by the Food and Drug Administration (FDA) more than two decades ago. 
Critics say that by overriding the FDA's approval, the court in Texas has usurped the federal health agency's remit to regulate food, medicine, and medical devices. Legal experts warn the ruling opens the door for challenges to other approved medicines in the US and could also stifle development of future drugs.
Read full story
Source: BBC News, 20 April 2023
Patient Safety Learning

Top scientists warn ‘the next pandemic is coming and we’re not ready’

The UK is not ready for the next global pandemic because public services are being dismantled and key research is being defunded, experts have claimed.
More than three years after the global outbreak of coronavirus, top scientists have warned that the UK is no better prepared for a pandemic than it was in 2020.
They say another epidemic on the scale of Covid-19 is inevitable, but that disinvestment in infection-monitoring services, dismantling of key infrastructure, and the state of the NHS mean the country is “losing ground”.
Sir John Bell, a leading immunologist and a member of the UK’s Covid vaccine taskforce during the pandemic, said it was too easy to dismiss Covid-19 as a “once in a generation crisis”.
Writing in The Independent, he warned that it is “a question of when, not if, another pandemic strikes”, adding that the nation needs to adopt an “always on” approach that includes building a more resilient healthcare system, carrying out better surveillance, and identifying future threats.
Read full story
Source: The Independent, 18 April 2023
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Medical leaders call for arbitration to resolve junior doctors’ dispute

Medical leaders have called for third-party arbitration to break the impasse on a pay dispute between junior doctors and the government after hundreds of thousands of procedures and appointments were cancelled as a result of last week’s strike in England.
The “colossal impact” of the four-day stoppage compounded by a health service already stretched by the coronavirus pandemic and facing workplace shortages has led the Academy of Medical Royal Colleges (AoMRC) to intervene and urge both parties to engage with an independent organisation.
The AoMRC, the membership body for the UK and Ireland’s 24 medical royal colleges and faculties, said in a statement it was “concerned that a solution has not yet been reached and about the anticipated impact on NHS services and patients that will potentially follow any future action”.
It added: “Both parties need to rapidly engage with an independent organisation to work out how the deadlock can be broken for the sake of patients and the wider NHS.”
Read full story
Source: The Guardian, 20 April 2023
Patient Safety Learning

Forty trusts are set elective target less ambitious than last year

NHS trusts have been given targets to increase elective activity that range from 103% of pre-pandemic levels to nearly 130%, internal data seen by HSJ reveals.
The wide gap between the targets, which are based on past performance and reflect the value of activity carried out, indicate the slow pace of recovery at many trusts last year.
Forty trusts have been set the least ambitious target, to deliver 103% of pre-covid activity levels in 2023-24, including Leeds Teaching Hospitals, Barts Health, and University Hospitals Birmingham.
All providers were supposed to deliver at least 104% of pre-covid activity last year, but few managed to achieve this, with emergency pressures, the impact of covid and flu, and workforce problems hampering efforts to ramp up activity.
Amanda Pritchard has previously admitted the health service would have to “re-profile” the trajectory to achieving 130% of pre-covid activity levels by 2025.
Read full story (paywalled)
Source: HSJ, 20 April 2023
Patient Safety Learning

National ambitions for use of NHS App undermined by plateauing performance

Take-up and usage of the NHS App in England has begun to plateau, after covid drove huge growth, figures seen by HSJ suggest.
This can be seen in the percentage of GP appointments booked or cancelled using the app; the number of records viewed; and the number of times it has been downloaded.
Rapid uptake was driven during covid restrictions, when travel and other activities often required a covid vaccination pass. Government has said it wants the growth to continue.
The number of GP appointments booked or cancelled using the app fell for a third consecutive month in March to 212,954, representing a decrease of 15% since January and 28% on October 2022, when usage peaked.
The NHS app is central to government’s plan for digital health and care, published last year, billed as the “digital front door” to the NHS which would aid the recovery of services post-pandemic.
Read full story (paywalled)
Source: HSJ, 19 April 2023
Patient Safety Learning

Kettering hospital ward accused of failing children rated inadequate

The safety of a ward accused of failing children has been rated as inadequate by inspectors.
The care regulator warned Kettering General Hospital (KGH) in Northamptonshire over its children's and young people's services.
Inspectors' worries include sepsis treatment, staff numbers, dirt levels and not having an "open culture" where concerns can be raised without fear.
Since the BBC's first report in February highlighting the concerns of parents with children who died or became seriously ill at KGH, dozens more families have come forward, bringing the number to 50 to date.
Inspectors found that "staff did not always effectively identify and quickly act upon patients at risk of deterioration".
They said there were sometimes "delays in medical reviews being undertaken outside of normal working hours", highlighting one case where a seemingly deteriorating patient was not seen until three hours after being escalated to the on-call team.
Read full story
Source: BBC News, 20 April 2023
Patient Safety Learning

NHS Ayrshire & Arran team hailed for Parkinson's medication breakthrough

A team from NHS Ayrshire & Arran has successfully created a system to ensure that people with Parkinson’s get their medication on time while they are in hospital.
Parkinson’s nurse specialist Nick Bryden, who led the team, explains: “The timely administration of medication is hugely important in helping to control symptoms in people with Parkinson’s.
"Guidance states that Parkinson’s medication should be administered within 30 minutes, either side, of the prescribed time which can be challenging within a busy hospital ward environment."
Nick, who works out of Biggart Hospital in Prestwick, added: “When we initially worked with our digital pharmacist, Richard Cottrell, it was to develop a system that would alert us to when a Parkinson’s patient was admitted to hospital.
"It then became clear that we could take the system a step further and use it to monitor if people are on the right medication and whether or not it is being administered at the right time.”
The team worked to develop a further system of clear visual prompts with NHS Digital services, which appear alongside relevant patient details on wards’ electronic whiteboards.
Every patient prescribed Parkinson’s medication has a tulip symbol beside their name which changes colour and flashes when it’s close to the time to administer the medication. The system was initially piloted in a couple of wards and, due to its success, has now been rolled out to almost every ward in Ayrshire and Arran.
Read full story
Source: The Herald, 19 April 2023
Related reading on the hub:
Top picks: Seven resources about Parkinson’s Professionals with Parkinson’s tackle time critical patient safety issue: a blog by Sam Freeman Carney
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