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

Up to one in 20 new diabetes cases could be linked to Covid, study suggests

Up to one in 20 new diabetes cases could be related to Covid infection, data suggests.
The research adds to mounting evidence the pandemic may be contributing to a rapidly escalating diabetes crisis, with individuals who have experienced more severe Covid at greatest risk.
However, lifestyle factors such as being overweight or obese continue to be the main driver for the increase, with 4.3 million officially diagnosed cases in the UK alone.
Although previous research has hinted that Sars-CoV-2 infection may increase the risk of developing diabetes – possibly by damaging insulin-producing cells in the pancreas – these studies were either relatively small or limited to specific groups of individuals, such as US military veterans, who may not represent the general population.
To delve deeper, Prof Naveed Janjua at the University of British Columbia in Vancouver, Canada, and his colleagues turned to the British Columbia Covid-19 Cohort, a surveillance platform that links data on Covid infections and vaccinations with sociodemographic and administrative health data.
They examined records from 629,935 people who took a PCR test for Covid and found those who tested positive were significantly more likely to experience a new diagnosis of type 1 or type 2 diabetes in the following weeks and months – with 3-5% of new diabetes cases attributable to Covid overall.
Read full story
Source: The Guardian, 18 April 2023
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Hundreds of British people are needlessly going blind. Why?

The backlog for ophthalmology appointments in England is the second-largest in the NHS, with UK eye doctors concerned about the number of patients losing sight unnecessarily. Their shock is palpable.
How this could be happening in a rich country such as Britain? There are treatments for common blindness-causing conditions such as macular degeneration, but to get them patients must be able to access the service. And right now the NHS doesn’t have the capacity to deliver them in a timely way.
As junior doctors’ unions – and possibly those of consultants and nurses – proceed with strike action, it’s easy to attack medical professionals with the question: “How many people are dying because of your actions?” The truth is that the entire system has been struggling, and people have been dying anyway because of system failures. Now add to this people living with disabilities that were preventable, such as going blind.
When Labour was in power, it made a real effort, including with financial allocation, to reduce waiting-list times for non-emergency care. But since the Tories were elected in 2010, years of austerity and public-sector neglect – and the shifting of resources and wealthy patients into a lucrative and growing private sector – has meant that the NHS has been transformed from a robust, preventive healthcare service into an acute one. Its basic offering is now: “If you’re dying, we will save you.”
Read full story
Source: The Guardian, 19 April 2023
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Australia: Ambulance ramping is a signal the health system is floundering. Solutions need to extend beyond EDs

Healthcare systems across Australia are buckling in the wake of COVID waves and the flu season. Pictures of ambulances piling up outside hospitals have become commonplace in the media. Known as “ramping”, it’s the canary in the coalmine of a health system.
As a major symptom of a health system under stress, state governments across Australia are investing unprecedented amounts into ambulance services, emergency departments (EDs) and hospitals. South Australia has committed to an increased recruitment of 350 new paramedics. Likewise, New South Wales has committed to 1,850 extra paramedics.
Victoria, meanwhile, has committed an additional A$162 million for system-wide solutions to counter paramedic wait times, on top of the A$12 billion already committed to the wider health system. This could begin to alleviate the system pressures that lead to ambulance ramping.
But what happens when the paramedics return yet again to ED with another patient? Will they simply end up ramped again?
We also need to consider better care in the community – and paramedics could play a role in this too.
Read full story
Source: The Conversation, 21 July 2022
Patient Safety Learning

‘They didn’t believe I was in labour’ says Black mother ‘ignored’ by midwives

The Women and Equalities Committee in a recent report has challenged the government over failures to address inequalities in maternity care which have led to Black women dying at four times the rate of white women.
Tinuke Awe, 31, was left ‘traumatised’ and forced to go without pain relief after midwives didn’t believe she was in labour.
Ms Awe, was induced after experiencing late pre-eclampsia while pregnant with her first child in 2017. She said:  “Pre-eclampsia can be life-threatening for mum and baby, and it could’ve been fatal if I wasn’t treated. I was told I couldn’t leave the hospital and had to be induced".
“They said the hormones could take 24 hours to work, but my labour happened really quickly and when I told the midwife she didn’t even believe I was in labour.”
“I felt so overlooked and it was horrible how nobody listened to me,” she added. “I ended up having to have an assisted delivery which isn’t what I wanted, but it could’ve been avoided if someone had acknowledged I was in labour rather than ignore me. I just felt so unimportant.”
Ms Aew alongside Clotilde Abe set up the charity Five X More. The organisation helps give advice and empower Black women to make informed choices during pregnancy and after childbirth.
Five X More hope that the testimonials of the women they support can be used to show that better outcomes are possible with their ‘five steps for self-advocacy‘ being used to encourage women to ask for things like a second opinion.
Read full story
Source: The Independent, 18 April 2023
Read our interview with Tinuke Awe on the hub: Five X More campaign: Improving maternal mortality rates and health outcomes for black women
Patient Safety Learning

Northern Ireland new model of care for pregnant women launching

Anew model of care which the Public Health Agency (PHA) say will 'improve maternity services for women and babies in Northern Ireland' is being launched.
The new model, which will see women receive support from the same midwifery team during pregnancy, birth and in the early days after birth, is being rolled out across all Health and Social Care (HSC) Trusts in the coming months.
‘Continuity of Midwifery Carer’ (CoMC) is a new model of care for women throughout their childbirth journey "that will provide positive clinical outcomes and higher care satisfaction", the PHA said.
Chief Nursing Officer for Northern Ireland, Maria McIlgorm said: “This is a very positive development for maternity services in Northern Ireland. There is a clear evidence base behind the Continuity of Midwifery Carer model which shows that when a woman knows their midwife it can make a significant difference to their experience and outcome.
“This woman and family-centred model of care will mean that women across Northern Ireland using our maternity services will receive support from the same dedicated midwifery team throughout their pregnancy, birth and postnatal period.”
Read full story
Source: Belfast Live, 12 April 2023
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NHS criticised for sending patients to children’s hospital despite 1,600 ‘sexual safety incidents’

The NHS has been criticised for sending vulnerable patients to a children’s hospital despite receiving reports of more than 1,600 “sexual safety incidents” at the 59-bed unit.
A series of investigations by The Independent have exposed allegations of systemic abuse across a group of children’s hospitals run by the former Huntercombe Group. The latest revealed that a total of 1,643 “sexual safety incidents” had been reported in four years at its hospital in Maidenhead – accounting for more than half of all sex-related investigations reported in the 209 children’s mental health units across the country since 2019.
Despite the majority of these reports being made prior to 2022-23, the NHS did not take any action and only stopped using the hospital, also known as Taplow Manor, this year.
Gemma Byrne, head of health policy and campaigns at Mind, said in response to The Independent report on sexual incidents: “These horrific reports reveal the systemic scale of abuse and neglect in inpatient mental health settings. Even when patients bravely came forward to share their stories, some of which took place more than 10 years ago, young people continued to be sent to a unit which was known to have catastrophic failings in physical and sexual safety.”
Read full story
Source: The Independent, 18 April 2023
Patient Safety Learning

Cancer survivors may be at heightened risk of cardiovascular disease

People who survive cancer may be at heightened risk of cardiovascular disease in subsequent years, data suggests.
However, heart scans may identify early heart damage, potentially opening the door to more tailored follow-up care for cancer survivors.
Although previous studies have suggested that people who have been treated for cancer may be at greater risk of future cardiovascular problems such as stroke or heart failure, these have mainly focused on the first year after a cancer diagnosis. Few have looked at longer term risks or included cardiovascular imaging to pinpoint damage that has not yet resulted in symptoms.
To plug these gaps, Dr Zahra Raisi-Estabragh at Queen Mary University of London and her colleagues assessed the cardiovascular health of 18,714 UK Biobank participants with a previous diagnosis of lung, breast, prostate, blood, womb or bowel cancer, and compared them with an equal number of participants with no cancer history, tracking their cardiovascular health for nearly 12 years.
Almost a third of cancer survivors developed a cardiovascular problem during the study period, compared with a quarter of people in the control group.
“This study adds to existing knowledge about the impact of some cancer treatments on cardiovascular disease in cancer survivors,” said Martin Ledwick, the head information nurse at Cancer Research UK.
“It may help to inform strategies for how some cancer survivors need to be monitored long-term, especially in situations where they have been discharged from cancer follow-up to the care of their GPs.”
Read full story
Source: The Guardian, 18 April 2023
Patient Safety Learning

Patients left waiting on trolleys for four days due to ‘unsafe’ staffing levels, report finds

Patients were left on trolleys for up to four days at a major NHS hospital where whistleblowers raised concerns over “unsafe” staffing levels, it has emerged.
In a scathing report, the NHS safety watchdog said it found patients waiting on trolleys, in corridors and outside nursing bays at Good Hope and Heartlands hospital, run by the scandal-hit University Hospitals Birmingham NHS Foundation Trust.
In one incident flagged by the Care Quality Commission (CQC), a patient’s skin ulcers had grown significantly worse while they waited for four days on a trolley without an appropriate mattress. At the time of the inspection, most patients had been waiting for more than two days on trolleys, according to the CQC.
The inspection took place in December, after concerns were raised by patients and families over care. The CQC said staff told inspectors they’d been left in “unsafe situations” due to poor staffing.
Read full story
Source: The Independent, 19 April 2023
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Coroner calls for allergies tsar after 17-year-old dies from anaesthetic reaction

A senior coroner has warned that more allergy sufferers will die due to a “lack of national leadership” following the death of a 17-year-old aspiring doctor.
Heidi Connor said the “tragic” case of Alexandra Briess was “not new territory”, citing three recent cases where people had died from anaphylaxis.
She has now written to the Government saying lives are at risk without better funding and research into the condition and calling for the appointment of an allergies tsar.
The Berkshire coroner’s warning comes after an inquest into the death of “bright and well loved” Alexandra, who died from a reaction to a common anaesthetic.
Read full story (paywalled)
Source: The Times, 18 April 2023
Patient Safety Learning

USA: A silent crisis in men’s health gets worse

A silent crisis in men’s health is shortening the life spans of fathers, husbands, brothers and sons.
For years, the conventional wisdom has been that a lack of sex-specific health research mainly hurts women and gender minorities. While those concerns are real, a closer look at longevity data tells a more complicated story.
Across the life span — from infancy to the teen years, midlife and old age — the risk of death at every age is higher for boys and men than for girls and women:
Men are at a greater risk of dying from covid-19 than women, a gap that cannot be explained by rates of infection or preexisting conditions.  More men die of diabetes than women.  The cancer mortality rate is higher among men — 189.5 per 100,000 — compared with 135.7 per 100,000 for women.  Men die by suicide nearly four times more often than women, based on 2020 data from the Centers for Disease Control and Prevention.  “Some people think health care is a zero sum gain and one dollar to men’s health is taking something away from women,” said Ronald Henry, president and co-founder of the Men’s Health Network, an advocacy group. “That’s wrong. We are fully supportive of women’s health efforts and improving quality of life for women.”
"But by viewing men as the privileged default, health experts are ignoring important sex differences that could illuminate health issues across gender and minority groups."
Read full story (paywalled)
Source: The Washington Post, 17 April 2023
Patient Safety Learning

Dr Michael Watt tribunal was 'unlawful corner-cutting exercise'

A tribunal which allowed a doctor's voluntary removal from the medical register was an "unlawful corner-cutting exercise", a judge has said.
Neurologist Michael Watt was at the centre of Northern Ireland's biggest recall of patients.
The Medical Practitioners Tribunal Service (MPTS) allowed him to voluntarily remove himself in 2021. It meant he would not face a public hearing about any fitness to practice issues.
More 2,500 patients who were in his care had their cases reviewed - with around one in five having their diagnosis changed.
Having already quashed the decision to grant removal, Mr Justice McAlinden delivered a scathing assessment of how the application was handled on Monday.
In Belfast's High Court, he described the process where Dr Watt's request was heard without the necessary jurisdiction as a "fiasco".
The court also heard how Dr Watt appeared to have a "get out of jail free card" where patients were denied public scrutiny of their medical care.
Read full story
Source: BBC News, 17 April 2023
Patient Safety Learning

NHS Scotland calls 13,000 women for smear tests after error

Thousands of women are to be called for smear tests after errors in Scotland's cervical screening programme.
In June 2021 it was discovered that several women had died from cervical cancer after being wrongly excluded from NHS Scotland's screening list.
Now a further review expects to find 13,000 patients who have had a hysterectomy will need further tests.
MSPs were told two years ago that a small number had died from cervical cancer after wrongful exclusion from the programme, and that further incorrect exclusions were possible.
The most common reason for exclusion was after a total hysterectomy, where the entire cervix has been removed, meaning there was no need for cervical screening. But some were recorded as having had this procedure where there was only a sub-total or partial hysterectomy, meaning cervical screening was still needed.
An urgent audit followed and all affected women were invited for follow-up examination. Now, a wider audit of 150,000 women who have had subtotal hysterectomies has been launched.
Read full story
Source: BBC News, 17 April 2023
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Junior doctors’ April strike led to 195,000 NHS hospital cancellations

Almost 200,000 hospital appointments and procedures in England were cancelled during last week’s junior doctors’ strikes, it has been revealed.
There were 20,000 more appointments cancelled in the strikes that ran between 11 and 15 April than in the shorter strike in March, NHS England figures show. A total of 27,361 staff were not at work during the peak of the strikes, though the true figure could be higher as some workforce data was incomplete.
The NHS’s national medical director, Prof Sir Stephen Powis, said the figures showed the “colossal impact of industrial action on planned care in the NHS”, with nearly half a million appointments rescheduled over the last five months.
He said every postponed appointment had “an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days”.
Read full story
Source: The Guardian, 17 April 2023
Patient Safety Learning

End racial disparities in maternal deaths

An MPs' report is calling for faster progress to tackle "appalling" higher death rates for black women and those from poorer areas in childbirth.
The Women and Equalities Committee report says racism has played a key role in creating health disparities.
But the many complex causes are "still not fully understood" and more funding and maternity staff are also needed.
The NHS in England said it was committed to making maternity care safer for all women.
The government said it had invested £165m in the maternity workforce and was promoting careers in midwifery, with an extra 3,650 training places a year.
Black women are nearly four times more likely than white women to die within six weeks of giving birth, with Asian women 1.8 times more likely, according to UK figures for 2018-20.
And women from the poorest areas of the country, where a higher proportion of babies belonging to ethnic minorities are born, the report says, are two and a half times more likely to die than those from the richest.
Caroline Nokes, who chairs the committee, said births on the NHS "are among the safest in the world" but black women's raised risk was "shocking" and improvements in disparities between different groups were too slow.
"It is frankly shameful that we have known about these disparities for at least 20 years - it cannot take another 20 to resolve," she added.
Patient Safety Learning

Nine out of 10 beauty clinics breaking the law by advertising Botox

Nine in 10 beauty clinics are breaking the law by advertising Botox, new research reveals, sparking fresh concern that Britain’s booming £3.6bn cosmetic treatments industry is like the “wild west”.
Academics at University College London (UCL) found 88% clinics in London are flouting regulations intended to protect public health banning the advertising of Botox and other forms of botulinum toxin.
The disclosure prompted warnings the illegal advertisements could help persuade vulnerable people to undergo injections that could leave them feeling traumatised.
Promotion of the anti-ageing substance is illegal because it is a prescription-only medicine, which cannot be advertised under the Human Medicines Regulations 2012.
A group of beauty professionals who are seeking to rid the industry of its reputation for dubious practices said the findings showed consumers were being subjected to “a tsunami of untamed and unrestricted promotional activity that presents a threat to public protection and patient safety”.
Read full story
Source: The Guardian, 14 April 2023
Patient Safety Learning

Investigation launched into gel nail polish allergic reactions

The government is investigating reports that growing numbers of people are developing life-changing allergies to some gel nail products.
Dermatologists say they are treating people for allergic reactions to acrylic and gel nails "most weeks".
Dr Deirdre Buckley of the British Association of Dermatologists urged people to cut down on gel nail use and stick to "old-fashioned" polishes.
Some people have reported nails loosening or falling off, skin rashes or, in rarer cases, breathing difficulties, she said.
Although most gel polish manicures are safe and result in no problems, the British Association of Dermatologists is warning that the methacrylate chemicals - found in gel and acrylic nails - can cause allergic reactions in some people.
It often occurs when gels and polishes are applied at home, or by untrained technicians.
Dr Buckley said: "We're seeing it more and more because more people are buying DIY kits, developing an allergy and then going to a salon, and the allergy gets worse."
The allergies can leave sufferers unable to have medical treatments like white dental fillings, joint replacement surgery and some diabetes medications. This is because once a person is sensitised, the body will no longer tolerate anything containing acrylates.
Read full story
Source: BBC News, 15 April 2023
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