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

Watchdog investigates possible failures at mental health hospital after 24 alleged rapes

The care watchdog is investigating possible safeguarding failures at an NHS trust after a documentary uncovered figures showing there were 24 alleged rapes and 18 alleged sexual offences in just three years at one of its mental health hospitals.
The Care Quality Commission (CQC) told Disability News Service (DNS) that it had suspended the trust’s ratings for wards for people with learning difficulties and autistic people while it carried out checks.
The figures were secured by the team behind Locked Away: Our Autism Scandal, a film for Channel 4’s Dispatches, which revealed the poor and inappropriate treatment and abuse experienced by autistic people in mental health units.
None of the alleged rapes at Littlebrook Hospital in Dartford, Kent, led to a prosecution, with allegations of 12 rapes and 15 further sexual offences dropped because of “evidential difficulties” and investigations into 12 other alleged rapes and two sexual offences failing to identify a suspect.
A CQC spokesperson said: “Sexual offences are a matter for the police in the first instance.
“However, we take reports of sexual offences seriously and review them all, and raise these issues directly with the trust.
“We do this alongside involvement from police and local authority safeguarding teams’ own investigations and monitor any actions and outcomes taken by the trust to ensure people are kept safe."
Read full story
Source: 30 March 2023
Patient Safety Learning

Covid testing scaled back further in England

Covid testing is being scaled back even further in England from April.
It is part of the "living with Covid" approach that relies on vaccines to keep people safe.
Most staff and patients in hospitals and care homes will no longer be given swab tests, even if they have symptoms.
Some will though, such as staff working with severely immunocompromised patients or if there is an outbreak on a ward or in a hospice or prison, for example.
The long-running Office for National Statistics Covid infection survey that estimated how many people in the community had the virus each week - based on nose and throat swabs from volunteers - has already come to an end.
The final one suggested 1.7 million people - about one out of every 35 (2.7%) - had Covid in the week ending 13 March, a14% rise on the previous week.
But the UK Health Security Agency says thanks to the continuing success of the vaccination programme, testing in England can now become more like the approach used for other common respiratory infections such as flu.
Read full story
Source: BBC News, 30 March 2023
Patient Safety Learning

Cancer drug leaflets for patients in Europe omit important facts

Cancer drug information leaflets for patients in Europe frequently omit important facts, while some are “potentially misleading” when it comes to treatment benefits and related uncertainties, researchers have found.
Cancer is the biggest killer in Europe after heart conditions, with more than 3.7m new cases and 1.9m deaths every year, according to the World Health Organization.
Medicines are a vital weapon against the disease. But critical facts about them are often missing from official sources of information provided to patients, clinicians and the public, according to a study led by researchers from King’s College London, Harvard Medical School and the University of Sydney, among others.
“Regulated information sources for anticancer drugs in Europe fail to address the information needs of patients,” the study’s authors wrote in The BMJ journal. “If patients lack access to such information, clinical decisions may not align with their preferences and needs.”
Read full story
Source: The Guardian, 29 March 2023
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Bupa to cut 85 dental practices in staff shortage

Bupa is set to cut 85 dental practices amid a national shortage of dentists, in a move that will affect 1,200 staff across the UK.
The group said patients at some practices were unable to access the NHS dental service they need.
Bupa, which provides NHS and private care, said the 85 practices would be closed, sold or merged later this year.
The healthcare group's boss said the industry faced "systematic challenges" and the decision was a "last resort".
In August the BBC revealed 9 in 10 NHS dental practices across the UK were not accepting new adult patients for treatment under the health service.
Bupa has not been able to recruit enough dentists to deliver NHS care in many practices for months and in some cases years, it said.
Read full story
Source: BBC News, 30 March 2023
Patient Safety Learning

Major law firm faces court over withheld contracts in landmark NHS whistleblowing case

A law firm that routinely advises health service bosses faces claims it withheld evidence in a landmark NHS whistleblowing case.

A judge has called for full evidence disclosure to assess claims that healthcare specialist firm Hill Dickinson acted fraudulently in a dispute over a lack of legal protection for NHS doctors in whistleblowing claims.
The firm will now have to account for its actions in litigation that saw more than 50,000 doctors below consultant level in England deprived of legal whistleblowing protections, according to the junior medic at the centre of it, Chris Day. The case also had implications for 865,000 agency workers across other sectors – including construction.
Read full story
Source: ByLine Times, 9 February 2023
Patient Safety Learning

NHS Highland reprimand for HIV patient email data breach

NHS Highland has been reprimanded for a data breach which revealed the personal email addresses of people invited to use HIV services.
The health board used CC (carbon copy) instead of BCC (blind carbon copy) to send an email to 37 people.
The Information Commissioner's Office (ICO) said the error amounted to a "serious breach of trust". It called for improvements to be made to data protection safeguards for HIV service providers.
The mistake meant all recipients of the email could see the personal addresses of the others receiving it.
One person said they recognised four other individuals, one of whom was a previous sexual partner.
Read full story
Source: BBC News, 30 March 2023
 
Patient Safety Learning

Children must wait for ‘crisis’ before autism diagnosis, say overwhelmed systems

New restrictions are being introduced for autism assessments, with some areas now only accepting referrals for patients in crisis, HSJ has learned.
Commissioners in North Yorkshire and York have become the latest to introduce new criteria for autism and attention deficit hyperactivity disorder referrals.
Getting a diagnosis is key to unlocking care packages such as speech and language therapy, counselling, or special educational needs.
They said the changes are due to “unprecedented demand that has exceeded supply, resulting in unacceptable wait times and the need to prioritise resources towards children and most at-risk adults”.
Read full story (paywalled)
Source: HSJ, 30 March 2023
Patient Safety Learning

Government reviews whistleblowing laws

A review of the whistleblowing framework – the laws that support workers who blow the whistle on wrongdoing in the workplace – has been launched by the Government.
The review will seek views and evidence from whistleblowers, key charities, employers and regulators.
Whistleblowing refers to when a worker makes a disclosure of information which they reasonably believe shows wrongdoing or someone covering up wrongdoing.  Workers who blow the whistle are entitled to protections, which were introduced through the Public Interest Disclosure Act 1998 (PIDA). Successive governments have taken steps to strengthen whistleblowing policy and practice.
It provides a route for employees to report unsafe working conditions and wrongdoing across all sectors.
This was keenly felt during the height of the Covid-19 Pandemic, when the Care Quality Commission and Health and Safety Executive recorded sharp increases in the number of whistleblowing disclosures they received.
The review will gather evidence on the effectiveness of the current regime in enabling workers to speak up about wrongdoing and protect those who do so. The evidence gathering stage of the review will conclude in Autumn 2023.
Read full press release
Source: Gov.UK, 27 March 2023
Patient Safety Learning

Slimming jabs could see rise in unsafe treatment for excess skin, surgeons warn

A rise in the use of slimming jabs could lead to an increase in unsafe treatment for tummy tucks and surgery to remove excess skin, UK surgeons have warned.
Drugs such as semaglutide and liraglutide are approved for use on the NHS for certain groups of people with obesity, and could help people reduce their weight by more than 10%.
Surgeons have warned that people using the jabs may not realise they could be left with excess skin.
“Whilst the newly introduced weight-loss drugs are not likely to produce comparable weight loss to bariatric surgery there is always the possibility that accompanying weight loss, a patient might be left with a degree of deflation and redundant skin,” said Marc Pacifico, the president of the British Association of Aesthetic Plastic Surgeons.
However, access to surgery on the NHS to remove excess skin is limited because the NHS do not fund post-weight loss plastic surgery any more, so it has to be undertaken in the private sector. That costs about £4,500 to £6,000 in the UK, so Mr Pacifico warned patients might seek cheaper procedures abroad..
“I would strongly warn against this as there might not be the safeguards and assurances that the drugs being used are of the same quality and provenance as those being prescribed in the UK,” he said.
He also warned that there are risks associated with having weight-loss plastic surgery abroad, such as the inability to undertake proper research on a surgeon, as well as the risks associated with flying straight after significant surgery – such as blood clots, as well as a lack of accessible follow-up with the surgeon and clinic to treat post-operative wound infections.
Read full story
Source: The Independent, 29 March 2023
Patient Safety Learning

I was brainwashed by the NCT — and nearly died

Exhausted after three sleepless days in labour, Jane O’Hara, then 34, screamed and burst into tears when the midwives and doctors at Harrogate District Hospital told her the natural birth she wanted was not going to happen.
She ended up needing life-saving surgery and 11 pints of blood after a severe haemorrhage. Mercifully, Ivy was fine and is now a healthy 12-year-old. 
In recent weeks, the NHS has been rocked by the conclusions of an inquiry into the worst maternity disaster in its history: 201 babies and nine mothers died and another 94 babies suffered brain damage as a result of avoidable poor care at Shrewsbury and Telford Hospital NHS Trust. This has been linked to a culture of promoting natural — that is, vaginal — birth and avoiding caesarean sections. 
Blame thus far has been aimed largely at the NHS — but parents have started speaking out online about what they believe has been the role of the National Childbirth Trust (NCT), a leading provider of antenatal classes in Britain, in promoting vaginal births.
“I can absolutely point to key decisions that I made that were influenced by the NCT’s mantra. I was led into a position where I believed I had more control over my birth than I actually did,” says O’Hara, who is now a professor of healthcare quality and safety at the University of Leeds. She believes she was a victim of a “normal birth” ideology that was heavily promoted at the NCT classes she attended.
Read full story (paywalled)
Source: The Times, 10 April 2022
Sam

Whistleblowers ‘frustrated and disappointed’ by CQC, review finds

The Care Quality Commission’s follow-up of whistleblowing concerns from health and care staff has been poor and inconsistent, and there is a “widespread lack of competence and confidence” on dealing with race and racism at the organisation, two reviews have found.
A “Listening, learning, responding to concerns” review was published by the Care Quality Commission, alongside a linked independent review into how the regulator failed Shyam Kumar, a consultant orthopaedic surgeon in the North West, who was also a CQC specialist professional adviser.
The wider review looked at a range of issues including how the CQC deals with racism; how well it listens to whistleblowers in providers; and how it deals with its own staff, including as part of a recent restructure, and its internal “Freedom to Speak Up” process. It followed concerns bring raised, in addition to Mr Kumar’s case, about these issues.
Scott Durairaj, a CQC director who joined it last year and led the review work along with a panel of advisers, reported there was “clear evidence, during the scoping, design phase and throughout the review, of a widespread lack of competence and confidence within CQC in understanding, identifying and writing about race and racism”.
Read full story (paywalled)
Source: HSJ, 29 March 2023
Patient Safety Learning

Trust leaders must admit ‘entrenched’ bullying culture or leave, says review author

The leaders of University Hospitals Birmingham (UHB) must acknowledge and seek to tackle the organisation’s pervasive bullying culture, and those who cannot may need to leave, the lead author of its patient safety review has warned.
In an interview with HSJ, Mike Bewick said humility is required to address major cultural issues identified through conversations he had with senior medics and former employees.
Professor Bewick’s overall view was that UHB was a “safe” place to receive care, but his team had been “disturbed” by consistent reporting of a bullying culture. Professor Bewick wrote in his report that even during his six-week review, initial goodwill from the trust had “dissipated”, adding his team has seen an organisation that is “culturally very reluctant to accept criticism”.
Speaking to HSJ, he acknowledged there were people within UHB who do not accept cultural problems, adding: “I would hope they see the right thing to do is to accept [they] didn’t get everything right, to do a bit of mea culpa, have some humility, and move on. Because I don’t think there’s necessarily a place for people who can’t move on.”
Read full story (paywalled)
Source: HSJ, 28 March 2023
Patient Safety Learning

Invest in health workforce or risk collapse, WHO warns governments

Last year the World Health Organization (WHO) released a report warning of a “ticking time bomb” threatening health systems in Europe and Central Asia: a growing shortage of health workers.
With quickly ageing populations and an ageing health workforce—40% of doctors in Europe are close to retirement in a third of countries—along with a surge in chronic illnesses and the ongoing effects of the covid pandemic, WHO warned that many countries could soon see their healthcare systems collapse unless they take urgent action.
Six months on, the situation has worsened, as healthcare workers throughout Europe increasingly resort to industrial action over pay and conditions.
Hans Kluge, WHO regional director for Europe, said, “The health workforce crisis in Europe is no longer a looming threat—it is here and now. Health providers and workers across our region are clamouring for help and support...
“We cannot wait any longer to address the pressing challenges facing our health workforce. The health and wellbeing of our societies are at stake—there is simply no time to lose.”
Read full story (paywalled)
Source: BMJ, 24 March 2023
Patient Safety Learning

Inside one hospice as struggling sector faces turning the dying away

Hospices will be forced to turn dying patients away because they are struggling with steeply rising costs at a time when the NHS is not increasing funding.
Hospices look after 300,000 patients and families every year across the UK. It costs about £1.5 billion a year for them to provide this care, with only a third of that coming from the NHS. The rest relies on charitable donations and fundraising in local communities as well as sales in charity shops.
As hospices battle to keep going, the Treasury has rejected pleas for a £30 million rescue package this year.
The money, those in the sector say, would prevent some from having to close inpatient units and beds or reduce their hospice-at-home teams, which care for patients in the community. Some are already making staff redundant and getting rid of beds.
Toby Porter, chief executive of Hospice UK, said the government was making “a huge avoidable mistake”, adding: “People will have a lesser experience at an incredibly important moment and it will lead to system pressures affecting the whole health system.”
Read full story (paywalled)
Source: The Times, 26 March 2023
Patient Safety Learning

Will Jeremy Hunt foot the bill for NHS staffing? The signs aren’t promising

“There’s a gap today that no locum filled, so I am carrying both bleeps and doing the work of two people.” That recent tweet, by a children’s doctor, is one of many examples posted on social media by medics illustrating how NHS staff shortages affect them, patients, the smooth running of important services – and, sometimes, the safety of those who are receiving care.
It is a concern shared by every organisation that represents frontline staff, by regulators such as the Care Quality Commission (CQC), and by NHS England, the body that oversees the service. 
In January the CQC reported that an inspection it had undertaken of Colchester hospital in Essex found patients were missing out on meals because there were too few staff on duty to feed them. Some patients were wearing dirty dressings, and others did not have their call bells answered promptly, for the same reason.
In a letter to the trust that runs the hospital, it said: “All wards’ actual staffing levels and skill mix meant staff were often overstretched. All staff we spoke with expressed concern about the impact on patient care and personal wellbeing.
“Some staff we spoke to were tearful, reported feeling exhausted and concerned that they were unable to care for patients well enough to keep them safe.”
Read full story
Source: The Guardian, 26 March 2023
Patient Safety Learning

Ringfence 10% of UK health spending for preventive measures, report urges

Governments should set aside 10% of health spending for preventive and public measures such as cycle lanes and anti-obesity strategies, a thinktank has said, warning that “political short-termism” over health is making the UK increasingly ill and unequal.
The report by the Tony Blair Institute argues that a centralised NHS model “almost entirely focused on treating sickness” rather than on wider objectives is not only harming people’s health but hampering the economy, with more than 2.5 million people out of the labour market because of long-term ailments.
The report emphasises the human cost as well, noting that the effect of diseases caused or exacerbated by lifestyle means UK life expectancy is stagnating, while men living in the London borough of Kensington and Chelsea can now expect to live 27 years longer than their peers in Blackpool, Lancashire.
Along with a coherent central plan, the authors stressed the need for effective localism, with accountable regional bodies working to improve public health, rather than “the existing top-down and reactive approach of the NHS”.
Read full story
Source: The Guardian, 24 March 2023
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