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

"Get doctors in the room for clinical negligence mediation," lawyers told

Mediators want more clinicians to come forward – and lawyers to enable them – to speak directly to patients bringing medical negligence claims against the NHS.
Alan Jacobs, mediator at the Centre for Effective Dispute Resolution, told a conference of lawyers that they should do more to encourage discussions between injured people and those allegedly responsible. His call came as figures show record numbers of clinical claims against the NHS went to mediation in 2018/19 – with the majority of mediations resulting in damages being agreed on the day.
Jacobs, speaking at the Claims Media conference in Manchester, said the challenge now is to ensure medical professionals volunteer to take part in the process.
"It allows an apology to be given face to face and allows explanations to be given," he said. "It is also an opportunity for the clinician to have a discussion, sit down with the claimant and answer questions and concerns. It can be tremendously important for a claimant to vent and express their frustrations and for the trust to hear that."
Both claimant and defendant lawyers agreed on the merits of bringing doctors in to the room, but stressed this was not always a realistic aim.
Barrister Daniel Frieze, head of the personal injury team at St Johns Buildings, said: "Often it is too late and there is too much water under the bridge. Claimants are very stressed and it may be counter-productive for them to face the other side. I know the idea is of being collaborative but I’m not sure that’s necessarily always true."
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Source: 21 February 2020, The Law Society Gazette
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New European study overhauling hospitals for nurse wellbeing

Hospitals in the UK will be among 60 across Europe that will be supported to redesign their systems and ways of working to tackle nurse burnout and stress, under a ground-breaking four-year study.
The first-of-its-kind project will see chosen hospitals implement the principles of the Magnet Recognition Programme, an international accreditation scheme that recognises nursing excellence in healthcare organisations.
Run by the accreditation wing of the American Nurses Association, the scheme is based on research showing that creating positive work environments for nurses leads to happier and healthier staff and the delivery of safer patient care, in turn improving recruitment and retention.
Among the key pillars of Magnet are transformational leadership, shared governance and staff empowerment, exemplary professional practice within nursing, strong interdisciplinary relationships and a focus on innovation.
The new study – called Magnet4Europe – is being directed by world-renowned nursing professor Linda Aiken, from the University of Pennsylvania in the US, and Walter Sermeus, professor of healthcare management at Katholieke Universiteit Leuven in Belgium.
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Source: Nursing Times, 24 February 2020
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Stop moaning and get a grip, doctors told by their leader

Doctors need to stop moaning and take responsibility for improving the NHS, the leader of Britain’s medics has said.
Ministers have given the NHS a “substantial sum” of money and doctors must now stop blaming the government for all its problems, Carrie MacEwen, Chairwoman of the Academy of Medical Royal Colleges, told The Times.
Britain’s 220,000 doctors have a professional duty to make the health service’s ten-year plan work and can no longer “sit on their hands”, Professor MacEwen said.
After years in which the loudest medical voices have tended to complain about government funding and staffing levels, she said that doctors should take advantage of a “golden opportunity”.
Read full story (paywalled)
Source: The Times, 25 February 2020
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BMA must continue to oppose assisted suicide

The British Medical Association (BMA) should not allow itself to become a campaign tool for vested interest groups seeking a dangerous change in the law, writes Dr Matthew Davis in the Guardian.
"Doctors have a responsibility to first do no harm... Even when it may feel uncomfortable, doctors must continue to exercise their Hippocratic duty", says Dr Davies.
"The BMA must remain opposed to assisted suicide if the medical profession it claims to represent is to have any credibility in safe, caring and trustworthy expertise. It must not allow itself to become a campaign tool for vested interest groups seeking an extreme and dangerous change in the law that has, even very recently, been rejected by parliament."
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Source: The Guardian, 25 February 2020
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'Corridor nursing' becoming norm in packed A&Es, warn medics

A&E units are so overcrowded that growing numbers of patients have to be looked after in hospital corridors, warn nurses and doctors.
There are rising concerns that the “shameful” trend means people stuck in corridors are not getting the care they need, or they may be even coming to harm. A&E health professionals say “corridor nursing” is becoming increasingly widespread as emergency departments become too full to look after the sheer number of people seeking treatment.
In a survey of 1,174 A&E nurses in the Royal College of Nursing’s (RCN) Emergency Care Association, 73% of those polled said they looked after patients in a “non-designated area” such as corridors every day and another 16% said they did so at least once a week, while 90% said they feared patient safety was being put at risk by those needing care having to spend time in areas of hospitals which did not have medical equipment or call bells.
Staff have had difficulty administering urgent doses of intravenous antibiotics to such patients, some of whom have been denied privacy and found it harder to use a toilet or been left in distress, nurses said.
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Source: The Guardian, 26 February 2020
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Coronavirus: UK patients face 'random' tests to check spread

Tests for coronavirus are being increased to include people displaying flu-like symptoms at 11 hospitals and 100 GP surgeries across the UK.
The tests will provide an "early warning" if the virus is spreading, Public Health England Medical Director Prof Paul Cosford said.
Up to now, people were tested only if they displayed symptoms having recently returned from one of the countries where there has been an outbreak, including China, South Korea and northern Italy. However, Prof Cosford said Public Health England was now working with hospitals and GP surgeries to conduct "random" tests.
These will target some patients with coughs, fevers or shortness of breath, regardless of whether they have travelled to a place where the virus is spreading.
"If we do get to the position of a more widespread infection across the country, then it will give us early warning that's happening," said Prof Cosford.
Read full story
Source: BBC News, 26 February 2020
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Prisoners suffer cancelled appointments and poorer healthcare

Prisoners in Britain frequently have hospital appointments cancelled and receive less healthcare than the general public, a new study has found.
As many as 4 in 10 hospital appointments made for a prisoner were cancelled or missed in 2017–18, with missed appointments costing the NHS £2 million.
The in-depth analysis of prison healthcare by the Nuffield Trust think tank examined 110,000 hospital records from 112 prisons in England. It revealed 56 prisoners gave birth during their prison stay, with six prisoners giving birth either in prison or on their way to hospital.
The Nuffield Trust said its findings raised concerns about how prisoners are able to access hospital care after a cut in the number of frontline prison staff and a rising prison population.
Lead author Dr Miranda Davies, a senior fellow at the Nuffield Trust, said: “The punishment of being in prison should not extend to curbing people’s rights to healthcare. Yet our analysis suggests that prisoners are missing out on potentially vital treatment and are experiencing many more cancelled appointments than non-prisoners.”
Read full story
Source: The Independent, 26 February 2020
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Young people put at risk by delays for treatment

More than 70 children and young people have been put at risk by long delays in treatment by mental health services in Kent and Medway, HSJ has learned.
According to a response to a Freedom of Information request submitted by HSJ, 205 harm reviews have been carried out for patients waiting for treatment following a referral to the North East London Foundation Trust, which runs the child and adolescent mental health services in Kent and Medway.
Of those, 76 patients, who had all waited longer than the 18 week target time for treatment, were found to be at risk of harm. One patient had to be seen immediately as they were judged to be at “severe” risk. Seven were found to be at “moderate” risk and 68 at “low” risk. 
The trust said “risk” meant a risk of harm to themselves or others. But it said none of the 76 patients had come to actual harm. 
Read full story (paywalled)
Source: HSJ, 25 February 2020
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Hundreds of social care residents allegedly sexually assaulted, watchdog reveals

Hundreds of elderly and vulnerable social care residents have allegedly been sexually assaulted in just three months, a shock new report from the care regulator has revealed.
According to the Care Quality Commission there were 899 sexual incidents reported by social care homes between March and May 2018. Almost half were categorised as sexual assault. In 16% of the cases members of staff or visiting workers were accused of carrying out the abuse.
The watchdog said it was notified of 47 cases of rape and told The Independent local authorities were informed and 37 cases were referred to police for investigation.
Kate Terroni, Chief Inspector of adult social care at the regulator, said: “Supporting people as individuals means considering all aspects of a person’s needs, including sexuality and relationships. However, our report also shows all too starkly the other side of this – the times when people are harmed in the very place they should be kept safe. This is utterly devastating, both for the people directly affected and their loved ones."
“It is not good enough to put this issue in a ‘too difficult to discuss’ box. It is particularly because these topics are sensitive and complex that they should not be ignored.”
Read full story
Source: The Independent, 27 February 2020
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Only six of 200 NHS private units signed up to complaints watchdog

Just six of the English NHS’s more than 200 private patient units (PPUs) are signed up to the independent complaints adjudicator, HSJ has learned.
The figures follow the publication of the Paterson Inquiry earlier this month. The inquiry’s report warned patients treated in private units, including PPUs, which are not regulated by the Independent Sector Complaints Adjudication Service (ISCAS) “will not have access to independent investigation or adjudication of their complaint”.
ISCAS is the main independent adjudicator for the private healthcare sector and takes on approximately 125 adjudications each year on unresolved patient complaints. Most standalone independent providers have signed up to the watchdog. However, ISCAS membership is not mandatory and it is concerned patients wishing to complain about care at PPUs will have little choice but to pursue costly legal action. 
The government is now considering the inquiry’s recommendation that all private patients are given the right to a mandatory independent resolution of their complaint.
Read full story
Source: HSJ, 26 February 2020 
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Babylon Health lashes out at doctor who raised AI chatbot safety concerns

Controversial healthcare app maker Babylon Health has criticised the doctor who first raised concerns about the safety of their AI chatbot.
Babylon Health’s chatbot is available in the company’s GP at Hand app, a digital healthcare solution championed by health secretary Matt Hancock. The chatbot aims to reduce the burden on GPs and A&E departments by automating the triage process to determine whether someone can treat themselves at home, should book an online or in-person GP appointment, or go straight to a hospital.
A Twitter user under the pseudonym of Dr Murphy first reached out to us back in 2018 alleging that Babylon Health’s chatbot was giving unsafe advice. Dr Murphy recently unveiled himself as Dr David Watkins and went public with his findings at The Royal Society of Medicine’s “Recent developments in AI and digital health 2020“ event.

Over the past couple of years, Dr Watkins has provided countless examples of the chatbot giving dangerous advice.
In a press release (PDF) on Monday, Babylon Health calls Dr Watkins a “troll” who has “targeted members of our staff, partners, clients, regulators and journalists and tweeted defamatory content about us”.
Read full story
Source: AI News, 26 February 2020
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New pharmacy referral service to help patients avoid hospital readmission

From July, hospitals will be able to refer patients who would benefit from extra guidance around new prescribed medicines to their community pharmacy. Patients will be digitally referred to their pharmacy after discharge from hospital.
The NHS Discharge Medicines Service will help patients get the maximum benefits from new medicines they’ve been prescribed by giving them the opportunity to ask questions to pharmacists and ensuring any concerns are identified as early as possible.
This is part of the Health Secretary’s ‘Pharmacy First’ approach to ease wider pressures on A&Es and general practice.
Read full story
Source: Department of Health and Social Care, 23 February 2020
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Coronavirus: Weakest patients could be denied lifesaving care due to lack of funding for NHS, doctors admit

NHS patients could be denied lifesaving care during a severe coronavirus outbreak in Britain if intensive care units are struggling to cope, senior doctors have warned.
Under a so-called “three wise men” protocol, three senior consultants in each hospital would be forced to make decisions on rationing care such as ventilators and beds, in the event hospitals were overwhelmed with patients.
The medics spoke out amid frustration over what one said was the government’s “dishonest spin” that the health service was well prepared for a major pandemic outbreak.
The doctors, from hospitals across England, said the health service’s existing critical care capacity was already overstretched and “would crumble” under the demands of a pandemic surge in patients who may all need ventilation to help them breathe.
Those denied intensive care beds could be those suffering with coronavirus or other seriously ill patients, with priority given to those most likely to survive and recover.
Doctors said this would lead to “tough decisions” needing to be made about the wholesale cancellation of operations to free-up beds.
Read full story
Source: Independent, 28 February 2020
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Approachable managers linked to better error reporting, analysis finds

There is a “strong association” between staff experience of senior management and whether an organisation acts on error reporting, exclusive analysis for HSJ of the staff survey data suggests.
Analysis by health and social care charity Picker Institute examined statistical relationships between responses to staff survey questions regarding staff communication with managers and those relating to error reporting.
The analysis, which included all trust types, looked at the relationships between statements such as “communication between senior managers and staff is effective” and “I know who the senior managers are here” to “When errors, near misses or incidents are reported, my organisation takes action to ensure they do not happen again” and other similar indicators.
A high correlation to the questions does not categorically prove a direct causal relationship but the data suggested “strong associations”, Picker Institute chief statistician Steve Sizmur told HSJ.
He said: “There are a number of strong associations in the latest staff survey data, to the extent that there is likely to be a link between staff experiences of senior management and their views about error reporting and whether the organisation addresses their concerns.”
Read full story (paywalled)
Source: HSJ, 27 February 2020
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Woman died after being given the wrong medication

An 87-year-old woman died after her carers gave her the wrong medication, a coroner was told.
Heather Planner, from Butler's Cross in Buckinghamshire, died at Wycombe Hospital on 1 April from a stroke. Senior coroner Crispin Butler heard three staff from Carewatch Mid Bucks had failed to spot tablets handed over by the pharmacy were for a male patient.
Mr Butler said action should be taken to prevent similar deaths.
A hearing in Beaconsfield on Thursday, where he issued a Prevention of Future Deaths report, followed an inquest in November. In the report he said he was told at the inquest that the carers from Carewatch Mid Bucks gave widow Mrs Planner the wrong medication four times a day for two and a half days. She suffered a fatal stroke because she did not receive her proper apixaban anticoagulation medication.
Mr Butler said he would send his concerns to the chief coroner and the Care Quality Commission. He said there was no procedure in place to ensure individual carers read and specifically acknowledged any medication changes.
Read full story
Source: BBC News, 27 February 2020
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