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

FDA to okay second omicron-targeting booster for some, officials say

Federal regulators have decided to authorise a second omicron-specific coronavirus vaccine booster shot for people who are at least 65 or have weak immune systems in an effort to provide additional protection to high-risk individuals, according to several officials familiar with the plan. 
The Food and Drug Administration is expected to announce the step in the next few weeks, and the Centers for Disease Control and Prevention is expected to move quickly to endorse it, said the officials, who spoke on the condition of anonymity because they were not authorised to publicly discuss internal discussions. Eligible individuals will be able to receive the dose as long as it has been at least four months since their first shot of what’s known as the bivalent booster, which targets omicron subvariants BA.4 and BA.5 as well as the original novel coronavirus. The expectation is that consumers will consult with their health-care providers about whether to get the extra booster, the officials said.
John P. Moore, a professor of microbiology and immunology at Weill Cornell Medicine in New York, said an extra booster could benefit people who are in poor health or have an impaired immune system. But he was skeptical everyone older than 65 needs it. Boosters lead to “a short-term boost against mild infection but protection against severe disease is still pretty robust” because of previous shots, he said.
Read full story (paywalled)
Source: Washington Post, 3 April 2023
Patient-Safety-Learning

Fury greets cuts to funding for social care’s contribution to integration

Confirmation the government has cut hundreds of millions from budgets partly designed to boost health and care integration has been met with fury, with the decision described as leaving the social care reform agenda in ‘tatters’.
It was revealed last month that the £1.7bn promised in 2021’s social care white paper to strengthen the sector, and especially its contribution to more integrated services, was set to be drastically cut by ministers.
Today’s announcement has confirmed the investment originally ear-marked for “investment in knowledge, skills, health and wellbeing, and recruitment policies [to] improve social care as a long-term career choice” has been cut from £500m to £250m, the £300m promised to “integrate housing into local health and care strategies" cut to zero. The white paper also promised “at least £150m” for investment in digital and technology, but today’s government announcement has capped this at £100m. Overall cuts to the series of reform programme are in the region of £600m. Only £520m has been allocated, and it is unclear where the rest of the original £1.7bn will be spent.
Sarah McClinton, president of the Association of Directors of Adult Social Services, said the plan “takes us backwards” and “leaves the government’s vision for reform in tatters”, adding that it “ducks the hard decisions and kicks the can down the road again until after the next election.”
Read full story (paywalled)
Source: HSJ, 4 April 2023
Patient-Safety-Learning

England's new ambulance numbers not 800 promised, figures show

The number of new ambulances in England will be far less than the hundreds promised by the government, a Freedom of Information request has revealed.
In January, 800 new ambulances were announced, with a 10% fleet increase. But vehicles being ordered by trusts are mostly replacements they were prevented from purchasing because of procurement changes and the pandemic.
In response to a written question in February, DHSC said the "over 800 new ambulances" advertised equated to about 350 extra vehicles, plus 100 mental health ambulances. However, the FOI responses from England's ambulance trusts suggest the number of extra vehicles will be far fewer.
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Source: BBC News, 4 April 2023
Patient-Safety-Learning

Britain’s care homes crisis: children sent to live hundreds of miles away

Some of Britain’s most vulnerable children are being moved to care homes more than 300 miles away from the neighbourhoods they grew up in, according to an Observer investigation revealing a “national scandal”.
The shocking figures make clear for the first time the scale of the crisis that has long worried child welfare experts. They show dozens of children from London alone are in foster or care homes more than 250 miles from the city, as councils battle a significant shortfall in provision. Children from the capital have been placed in homes near Perth, Glasgow, Knowsley, Leeds and Carlisle.
Care experts said that the pattern is being repeated across the country, removing children from critical support networks and familiar surroundings.
About 600 children from London are in foster or residential care more than 50 miles from their home neighbourhoods. Councils have warned they often have to compete for limited places, and face “rising costs and profiteering on the backs of vulnerable children”.
Some children need to be placed in certain locations for their own safety. However, there is widespread acceptance that the care system is failing to provide enough appropriate places in the right areas. Experts warn that relocating children removed them from schools, friends and extended family, as well as clubs and activities that were often key to their wellbeing. They warned it also put some at greater risk of exploitation.
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Source: The Guardian, 3 April 2023
Sam

NHS England should scrap many of its national targets, review says

The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary.
The study by Patricia Hewitt, commissioned by the government said that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective.
It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times.
The review sets out new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff.
It  adds that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”.
Read full story
Source: The Guardian, 3 April 2023
Patient Safety Learning

Ambulance delays a ‘factor’ in 104 deaths in one region during final quarter of 2022

According to the South West Ambulance Service Foundation Trust, 104 patient deaths reviewed under National Quality Board guidelines in quarter three of 2022-23 related to delays “which are thought to be a result of pressures within the wider health system”.
The trust has stressed the deaths were not necessarily directly caused by delays, but that delays were a “common factor” in the 104 cases.
Since July 2019, all ambulance trusts have been required to implement Learning from Deaths reviews following a report by the Care Quality Commission three years earlier, which found that opportunities were being missed to learn from patient deaths.
A total of 876 incidents were identified as being within the scope of a review at the end of last year by SWASFT, of which 210 were reviewed.
Deaths included in the review occurred while the patient is under the care of the ambulance service, from the initial 999 call being made to their care being transferred to another part of the system or to the point where a decision is made not to convey them to hospital.
Read full story (paywalled)
Source: HSJ, 4 April 2023
Patient Safety Learning

NHS Trust deaths probe could get full legal powers

The government is actively considering whether to give full legal powers to an independent inquiry investigating the deaths of mental health patients.
Roughly 2,000 deaths at the Essex Partnership University NHS Foundation Trust (EPUT) are being examined.
The BBC understands Conservative Health Secretary Stephen Barclay is minded to make the inquiry statutory, which would compel witnesses to come forward.
Only 11 current and former trust staff have agreed to give live evidence.
Melanie Leahy, whose son Matthew died aged 20 while an inpatient at the Linden Centre in Chelmsford, said families were "definitely" a step closer to what they had campaigned for.
"We just need it converted [to a statutory inquiry] - it's just delay after delay after delay and we need those powers," she told BBC Essex.
Read full story
Source: BBC News, 3 April 2023
Patient Safety Learning

Social care workforce funding halved for England, government confirms

Funding promised to develop the social care workforce in England has been halved, the government has confirmed.
In 2021 the government pledged "at least" £500 million for reforms, to be spent on training places and technology over three years.
But that figure is now £250 million, according to the Department of Health.
A coalition of charities said this cut is "just the latest in a long series of disappointments" over social care.
The government said its reforms would give care "the status it deserves" but some organisations in the sector say they fall short of what is needed.
Caroline Abrahams, co-chair of the Care and Support Alliance - which represents more than 70 charities - and charity director of Age UK, said the measures "aren't remotely enough to transform social care".
Millions of older and disabled people and their carers "needed something far bigger, bolder and more genuinely strategic to give them hope for the future", she said.
Read full story
Source: BBC News, 4 April 2023
Patient Safety Learning

Use of private providers damaging NHS eye care, survey reveals

The independent sector should be commissioned to provide more NHS outpatient appointments, rather than just be focused on cutting cataract waiting lists, the president of the Royal College of Ophthalmologists has said.
A “workforce census” survey carried out by the college and shared with HSJ found almost 60% of respondents believed independent providers were having a “negative impact” on care and ophthalmology services in their area.
Speaking about its findings to HSJ, RCOphth president Bernie Chang said Covid had exacerbated problems caused by use of independent sector providers. These problems included cases being passed back to the NHS when IS care failed, and the NHS being left with a greater concentration of more serious, and costly, cases as the IS focussed on routine cataract operations.
Read full story (paywalled)
Source: HSJ, 3 April 2023
 
Patient Safety Learning

‘Aggressive’ NHSE campaign insists trusts enable digital communications with patients

NHS England has launched a “very aggressive campaign” to ensure all acute trusts give patients the ability to make appointments and receive messages online. 
Details of the new “national requirement” which must be met by the end of 2023-24 were sent by NHS England to acute trust chief information officers on Friday.
NHSE wants all trust portals to integrate with the NHS App to enable patients to manage outpatient appointments and respond to messages through a single channel. 
Under NHSE’s requirements, the portals must:
Enable patients to view their outpatient appointments; Enable the trust to send a waiting list validation questionnaire to patients; Provide patients with a single point of access to contact the provider, for example to cancel appointments; and Enable patients to access their correspondence from the trust. Read full story (paywalled)
Source: HSJ, 31 March 2023
Patient Safety Learning

NHS England warns against block cancellations during ‘unprecedented’ strikes

NHS England has told trust, system and regional leaders to avoid “block rescheduling” of elective cases during the four-day junior doctors’ strike next month.
In a letter sent by national medical director Sir Steve Powis and NHSE’s chief operating officer Sir David Sloman, NHS leaders are asked instead to use “rolling day-to-day cancellations” and reschedule cases “based on clinical risk”.
The letter also urges leaders to maintain “as much day case and outpatient capacity as possible” and to use digital or virtual consultations to support outpatient delivery. However, it acknowledges that because of the “unprecedented scale and timing of these strikes we accept that rescheduling activity is going to be essential to minimise risks to patients”.
Read full story (paywalled)
Source: HSJ, 31 March 2023
Patient Safety Learning

Women's health: Body part names taboo a risk to health

Doctors are warning that embarrassment about naming parts of the female anatomy is putting women's health in jeopardy.
Dr Aziza Sesay said the hyper-sexualisation of women's bodies and anatomy "perpetuates the taboo, stigma and embarrassment".
She said it could lead to women not getting the medical help they need.
She said a lot of women's health conditions are often considered benign - meaning they're not life-threatening - but that she disliked the term as it minimised "how much it will affect someone's life".
Dr Sesay is one of a number of women's health specialists who are due to appear at Cardiff's Everywoman Festival on 24 June, where topics will range from periods to menopause.
The festival is the brainchild of colorectal surgeon, Julie Cornish, who works for Cardiff and Vale health board.
She said "embarrassing" symptoms are all too often never discussed.
"It's not uncommon to see patients who waited 10, 15 years with symptoms," she said. "It's got to the point where they've had to stop working, or their relationship has broken down.
"People retire early, they stop working or stop socialising. And that delay often means it's more severe. They might need surgery rather than simple physiotherapy, dietary tricks or modifications that could've worked so easily early on."
Read full story
Source: BBC News, 3 April 2023
Patient Safety Learning

‘Free’ NHS makes people ‘lazy’ says pharmacy chief

The director of a leading pharmacy chain invited to advise the prime minister on healthcare reform has claimed the NHS makes people too “lazy” to take responsibility for their health.
Day Lewis director Sam Patel also said the fact the NHS was “free” meant there was little “jeopardy” discouraging people from becoming ill, and encouraged people to accept a lower level of care.
Mr Patel’s fellow Day Lewis director Jay Patel was one of the private healthcare leaders invited to Rishi Sunak’s Downing Street health summit this January. The company has more than 250 branches concentrated in London and the south of England.
Speaking at an event organised by strategy advisory firm Global Counsel last week, Mr Patel said: “Having an NHS fundamentally makes too many people lazy about taking care of their own health.
“Anything that’s free we just accept a lower level of care…. [We should be] making sure we’re taking good care of ourselves with vitamins, minerals, supplements, staying fit."
”... the jeopardy of feeling ill is not that bad because you get taken care of. In other countries, even in emerging markets like India where my parents originally come from, people spend vast amounts to make sure they don’t get ill because there is jeopardy in doing so. We need to change the population’s mindset to take care of themselves.”
Read full story (paywalled)
Source: HSJ, 3 April 2023
Patient Safety Learning

'Dire' situation for adults waiting for ADHD diagnosis in NI

Adults in Northern Ireland seeking assessment for attention deficit hyperactivity disorder (ADHD) are being forced to go private because of a dire lack of referral services in some areas, a charity has said.
Some health trusts have not been able to accept new referrals for adult assessment and diagnosis.
ADHD charities said a lack of services or even waiting lists has forced many people to pay for a private diagnosis.
The charity's chief executive Sarah Salters added that some people who do get a private diagnosis cannot then get medication from their GP through the NHS.
The Department of Health said officials "are considering longer-term arrangements" for ADHD services, with future decisions "likely to be subject to ministerial approval and availability of funding".
Read full story
Source: BBC News, 2 April 2023
Patient Safety Learning

Thousands of children in England facing ‘unacceptable’ NHS delays

Thousands of children experiencing “unacceptable” long waits for NHS treatment face a “lifelong” impact on their health, a senior doctor has warned, as shocking figures reveal that nearly 15,000 paediatric operations were cancelled over the last year.
Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said the mounting treatment backlog in England risked “serious” and “devastating” physical and mental consequences for children and their families.
She sounded the alarm as data obtained under freedom of information laws by the Liberal Democrats showed that a record high 14,628 children’s operations were postponed in 2022, up from 11,870 the year before and the highest in five years of data examined. Some children have now waited several years for surgery, according to the data.
Delaying a child’s operation risks having a “lifelong impact” on their development, Kingdon said, and also “seriously impact” their mental health, with knock-on effects on their ability to socialise, go to school and reach their full potential.
Read full story
Source: The Guardian, 3 April 2023
Patient Safety Learning

Trusts given five years to achieve safe midwife staffing

NHS trusts have been given until 2027-28 to employ enough midwives to meet safe staffing requirements, NHS England’s new maternity delivery plan has said.
The three-year delivery plan for maternity and neonatal services sets out to “make maternity and neonatal care safer, more personalised and more equitable for women, babies and families”.
It says: “Trusts will meet establishment [requirements] set by midwifery staffing tools and achieve fill rates by 2027-28, with new tools to guide safe staffing for other professions from 2023-24.”
The plan follows a series of high-profile maternity scandals in the NHS at Shrewsbury and Telford, East Kent, Morecambe Bay and an ongoing independent review by Donna Ockenden into Nottingham University Hospitals Trust. The Care Quality Commission has highlighted a string of other concerns across the NHS.
Read full story
Source: HSJ, 31 March 2023
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