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

Mental health charity slams Government's ‘irresponsible’ coronavirus bill

A mental health charity has branded as “irresponsible” the Government’s coronavirus bill which would grant single doctors the power to detain the mentally ill.
The Government wants to relax legal safeguards in the Mental Health Act in order to free up medical staff to deal with the COVID-19 pandemic. If passed, the bill would reduce the number of doctors needed to approve detaining individuals from the current minimum of two, to just one.
In addition, it would temporarily allow time limits in the Mental Health Act to be extended or removed altogether. This would mean patients currently detained in mental health facilities could be released into the community early, or be detained for longer.
Akiko Hart, Chief of National Survivor User Network (NSUN), a UK mental health charity, said: “Whilst we understand that these are unprecedented times, any legislative change must be proportionate and thought through, and should protect all of us. Minimising some of the safeguards in the Mental Health Act and extending its powers, is a step in the wrong direction.”
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Source: The London Economic, 19 March 2020
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WHO Health Alert brings COVID-19 facts to billions via WhatsApp

WHO has launched a messaging service with partners WhatsApp and Facebook to keep people safe from coronavirus.
This easy-to-use messaging service has the potential to reach 2 billion people and enables WHO to get information directly into the hands of the people that need it.
From government leaders to health workers and family and friends, this messaging service will provide the latest news and information on coronavirus including details on symptoms and how people can protect themselves and others. It also provides the latest situation reports and numbers in real time to help government decision-makers protect the health of their populations.
The service can be accessed through a link that opens a conversation on WhatsApp. Users can simply type “hi” to activate the conversation, prompting a menu of options that can help answer their questions about COVID-19.
The WHO Health Alert was developed in collaboration with Praekelt.Org, using Turn machine learning technology.
Read full story
Source: World Health Organization, 20 March 2020
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FDA approves first bedside COVID-19 test by Danaher’s Cepheid

A Covid-19 test can deliver results in less than an hour has been approved under an FDA emergency authorization, marking the first test that clinicians can use at the bedside.
Cepheid, a Silicon Valley molecular diagnostics company that’s a unit of Danaher Corp., announced Saturday it received an emergency authorisation from the U.S. Food and Drug Administration to use the test, making it the 13th Covid-19 test the agency has allowed on the market as long as the public health emergency exists.
But it’s the first one that can be used at the point of care, meaning providers don’t have to send patient samples to a separate lab to be processed and then come back to the hospital or provider’s office. Cepheid said it expects to start shipping tests next week.
“An accurate test delivered close to the patient can be transformative — and help alleviate the pressure that the emergence of the 2019-nCoV outbreak has put on healthcare facilities that need to properly allocate their respiratory isolation resources,” said David Persing, Cepheid Chief Medical and Technology Officer.
Read full story
Source: Bloomberg, 21 March 2020
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Protect NHS workers from coronavirus urgently, says Hunt

The NHS must ensure that doctors have proper protective equipment, Jeremy Hunt, the former health secretary, has urged.
NHS chiefs say that there are no problems with national stock levels of items including masks, gowns and gloves and that local supply issues should have been resolved over the weekend.
However, hospital staff say that they are still experiencing shortages, with nurses going to DIY shops to stock up or even refusing to work without the right equipment. One London doctor said: “Every time the government is asked they say the equipment is there, and it is just not true.”
Read full story (paywalled)
Source: The Times, 23 March 2020
Sam

Coronavirus: The new inventions inspired by a pandemic

A new ventilator, a virus-killing snood and a hands-free door pull are just some of the innovations coming out of Wales to tackle coronavirus.
Since the outbreak, doctors, scientists and designers have been working on ideas to stop the virus spreading.
The ventilator has already successfully treated a Covid-19 patient and has been backed by the Welsh Government.
Mass production of the snood-type mask is under way while a 3D design of the handle has been widely circulated.
Plaid Cymru leader Adam Price, who was part of the impetus to get the ventilator into mass production, said the innovations put Wales "on the front foot" in the battle against the pandemic.
"It shows that Wales, as a small nation, can get things done quickly as we face the biggest challenge of our generation," he said.
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Source: BBC News, 24 March 2020
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Cancer treatment delayed as patient priority lists drawn up

Delays have begun to cancer treatments, as patients are reprioritised ahead of capacity becoming overwhelmed by the coronavirus crisis.
In three separate developments:
A London trust announced it was cancelling chemotherapy and routine cancer operations for a fortnight due to coronavirus pressure; An NHS England covid-19 guidance document indicated palliative care cancer patients will be less likely to receive appropriate treatment; and Cancer waiting times guidance has been changed to provide for some urgent referrals for suspected cancer to be sent back to GPs without diagnosis. Read full story (paywalled)
Source: HSJ, 23 March 2020
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Intensive care staffing ratios dramatically diluted

The staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients, HSJ has learned.
Acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants. 
Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”.
Nicki Credland, chair of the British Association of Critical Care Nurses, confirmed the plans had been agreed today nationally.
She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available. We simply don’t have the capacity to increase our staffing levels quickly enough."
“It will dilute the standard of care but that’s absolutely better than not having enough critical care staff. There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.”
Read full story (paywalled)
Source: HSJ, 24 March 2020
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Top NHS doctor warns frontline staff battling coronavirus are "lambs to the slaughter"

A leading NHS doctor has warned frontline medical staff dealing with Britain’s coronavirus outbreak feel like “cannon fodder” and "lambs to the slaughter".
Dr Rinesh Parmar, chairman of the Doctor's Association UK, is battling the disease on an intensive care ward at a city hospital in Birmingham.
The Anaesthetic Registrar begged Boris Johnson to provide better Personal Protective Equipment (PPE), describing the current crisis the "calm before the storm"
Doctors and nurses fear a lack of masks, gloves, aprons and protective suits is putting them at risk as they care for patients diagnosed with Covid-19.
Speaking after a night shift on the ward, Dr Parmar told The BBC's Andrew Marr Show: "We have had doctors tell us they feel like lambs to the slaughter, that they feel like cannon fodder. GPs tell us that they feel absolutely abandoned."
Read full story
Source: The Sun, 23 March 2020
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UH partners with Masimo to pilot remote patient monitoring tool to aid COVID-19 response efforts

University Hospitals has partnered with medical technology company Masimo to pilot a telehealth solution, Masimo SafetyNet, that is designed to help clinicians care for patients remotely with a finger sensor and phone app.
The demand for remote monitoring and patient engagement in different settings has "significantly increased" during the COVID-19 pandemic. To help prepare for a surge in COVID-19 patients and protect other patients and providers, the tool allows University Hospitals and other hospitals to expand patient monitoring to the home or other locations (for instance, a skilled nursing facility or an under-utilised med-surg floor) that are temporarily set up to address increased demand.
Guidelines from the World Health Organization suggest monitoring the oxygen saturation, respiration rate and temperature of suspected or confirmed COVID-19 patients. Adapting this existing technology aims to offer a secure remote solution.
Read full story
Source: Crain's Cleveland Business, 23 March 2020
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"There have been stories of doctors having to go to Screwfix to find themselves masks"

UK doctors fighting coronavirus still say they don't have personal protective equipment (PPE). 
Jon Snow spoke to Dr Jenny Vaughan, a leading member of the Doctors’ Association  who have written to the government to demand better personal protective equipment for medical staff.
He asked her whether the PPE equipment promised by the government was starting to reach the medical staff on the frontline, and what kinds of problems medical personnel had been encountering.
Watch news story
Source: Channel 4 News, 23 March 2020
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Staff in ‘near revolt’ over protective gear crisis

Lack of staff testing, workforce shortages and running out of personal protective equipment (PPE)are the three biggest concerns for trusts fighting the coronavirus outbreak, according to an HSJ chief executive survey conducted over the last 36 hours.
Thirteen of the 34 trust chief executives who responded to the snap survey, who were from trusts across England, also warned they would run out of intensive care capacity by next week as the number of coronavirus cases continue to rise.
The survey also revealed some trusts were already being forced to dilute safe staffing ratios and ration facilities. One chief warned: “We are preserving ventilation capacity by ensuring that only those who may survive are considered.”
However, the majority of respondents were supportive of system leaders’ guidance so far. Several respondents praised the “impressive pace and detail of the advice."
The three biggest areas of concern raised by the chiefs surveyed were:
Lack of staff testing, raised by 26 of the 34 respondents (77%); Staff shortages, raised by 26 of the 34 respondents (77%); and PPE shortages, raised by 23 of the 34 respondents (68%. Read full story
Source: HSJ, 24 March 2020
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GP given masks with expiry dates that have passed

A GP has criticised the practice of giving doctors surgical masks with expiry dates that have passed.
Dr Kate Jack said doctors felt "like cannon fodder" after discovering the paper masks had expired in 2016. A box delivered to her Nottingham surgery had a 2021 label placed over the original date of 2016.
The Department of Health and Social Care (DHSC) said equipment underwent "stringent tests" and was given a "new shelf-life" where appropriate.
"I don't feel protected at the moment," said Dr Jack, a GP of 22 years. "They are really not designed for prevention of infection and are practically useless."
Read full story
Source: BBC News, 25 March 2020
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Government buys 3.5m tests and promises staff checks ‘online soon’

The government has bought 3.5 million coronavirus antibody tests — with more widespread testing of NHS workers coming “online soon”, the health secretary has said.
Matt Hancock also told a press conference this evening that a new testing facility had been opened in Milton Keynes as the government aims to “ramp up” the number of antibody tests — which will determine whether people have had the virus and can therefore return to work.
Mr Hancock also said the government had shipped 7.5 million pieces of personal protective equipment over the last 24 hours, following major shortages, and confirmed the conversion of east London’s Excel centre into a huge temporary hospital facility, with between 500 to 4,000 beds.
Read full story
Source: HSJ, 24 March 2020
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Covid-19: medical students should not work outside their competency, says BMA

Medical students who are employed in the NHS as part of efforts to swell staff numbers to tackle covid-19 should not be expected to “step up” and act outside of their competency, says the BMA in new guidance.
This is the first set of guidance released by the BMA specifically for medical students, who have had placements and exams cancelled and are uncertain about how they might be employed in the NHS in the current crisis. It says that any employment should be voluntary and within the competency of the student, who should have adequate access to personal protective equipment.
The BMA refers to General Medical Council guidance that states that plans are not currently in place to move provisional registration forward from the normal August date. It warns that there are concerns around the boundaries of practice and the level of supervision that students who take on roles in the NHS would have, which could lead to unsafe working practices. The BMA is in talks to negotiate a safe national contract for such roles.
Read full story
Source: BMJ, 24 March 2020
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Frantic action to stop London ‘running out of beds in four days’

Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity.
In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak.
According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said.
The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. 
Read full story
Source: HSJ, 24 March 2020
Patient Safety Learning

We face a pandemic of mental health

Currently we have a frightening, deadly viral pandemic, but there will another plague, one we are not hearing nearly enough about from our leaders, which will arrive in a wave just behind it, reports Paul Daley in the Guardian. 
There will be a pandemic of severe depression and anxiety that will sweep over the world as the unemployment rate pushes into previously unseen digits, families who’d prefer to be socially distant are thrust together and young people are denied the certainty and structure of school.
We will need to support – medically, financially, emotionally and psychiatrically – those who are going to do it hardest. Psychiatric support services will need to be dramatically bolstered to fight this mental health pandemic
Read full story
Source: The Guardian, 24 March 2020
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