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

Adam Price: Wales needs procurement tsar to tackle testing and PPE problems

Plaid Cymru Leader Adam Price has argued that the Welsh Government should appoint a procurement tsar to get to grips with Wales's serious shortage of COVID-19 testing kits, personal protective equipment (PPE) for frontline health and care staff and medical devices for patients.
Wales is currently only testing 1,100 people a day when it was planning to test 6,000. This follows the collapse of an alleged deal between the Welsh Government and private company Roche which would have provided for 5,000 of those tests.
Adam Price made the case for the appointment of a tsar whose "sole responsibility" would be the procurement and supply of COVID-19 tests, PPE, and oxygen and medical devices for Wales.
He cited cases of care homes with just one or two boxes of surgical masks - each enough to last just two days for one patient, as well as hospital staff being forced to wear paper underwear over their hair due to the lack of any other protection.
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Source: Plaid Cymru Party of Wales, 6 April 2020
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Government seeks refund for millions of coronavirus antibody tests

The Government will look for a refund for millions of coronavirus tests ordered from China after scientists found they were too unreliable to be used by the public.
Ministers will attempt to recoup taxpayers' money spent on the fingerprick tests after an Oxford University trial found they returned inaccurate results.
The failure is a significant setback because it had been hoped the antibody tests would show who had already built up immunity, therefore offering a swifter route out of lockdown.
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Source: The Telegraph, 6 April 2020
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Coronavirus: Ambulance staff 'feeling unprotected'

Ambulance staff are being put at risk by a lack of protective equipment to guard them against coronavirus, according to a trade union.
GMB says its members are "scared" about their own safety and their families. The union claims one in five ambulance staff in London are off sick with coronavirus-related sickness.
The government says hundreds of millions of protective items have been delivered to NHS staff around the country.
According to the GMB Union, 679 frontline ambulance crew in the London Ambulance Service are off sick due to Covid-19-related sickness.
Among those at work, some say they feel unprotected either because of a lack of or inadequate personal protective equipment (PPE).
Read full story
Source: BBC News, 8 April 2020
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Mental health hotline for NHS staff

The NHS is launching a hotline to support and advise healthcare staff during the coronavirus pandemic.
Volunteers from charities including Hospice UK, the Samaritans and Shout, will listen to concerns and offer psychological support.
The phone line will be open between 07:00 and 23:00 every day, while the text service will be available around the clock.
The phone number is 0300 131 7000 or staff can text FRONTLINE to 85258.
It comes as staff face increasing pressure to care for rising numbers of patients who are seriously ill with the virus.
Read full story
Source: BBC News, 8 April 2020
Patient Safety Learning

ORCHA launches COVID-19 Health App Formulary

Health apps have grown enormously in popularity, even more so during the COVID-19 Pandemic. Since early March, more than 500 health apps contain coronavirus-related keywords in their description.
People are taking advice from these apps, often using them to share sensitive information. Yet, in a time of fake reviews, scams and personal data breaches, not all health apps can be trusted. 
The Organisation for the Review of Care and Health Apps (ORCHA) has launched a health app formulary to help healthcare professionals and consumers know which health apps they can trust. 
As a free to use resource, the site includes reviews of health apps across a range of health conditions relevant to the COVID-19 pandemic, including reviews of COVID-19 apps launched to date.
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Source: ORCHA, 6 April 2020
Patient Safety Learning

Coronavirus concerns delay treatment for cancer patient

Nick has terminal bowel cancer. He’s been told he won't receive chemotherapy for three months because it would put him more at risk of the coronavirus.
He fears having the treatment taken away would shorten his life.
Current NHS guidelines say cancer specialists should discuss with their patients whether it is riskier for them to undergo or to delay treatment at this time.
Read full story
Source: BBC News, 6 April 2020
Patient Safety Learning

Hospitalising coronavirus patients can cause more deaths, data from Italy suggests

Sending coronavirus patients to hospital can dramatically increase death rates, the experience of two hard-hit Italian regions suggests.
Veneto and Lombardy are neighbouring regions but have seen sharply differing fatality rates since the contagion broke out in northern Italy in late February. Despite having equally well-equipped hospitals and similar levels of wealth, Lombardy’s death rate is around 17% while that of Veneto is around 5%.
One reason for the disparity is that Veneto has tested many more people – the more tests that are carried out, the more positive cases are found, and that brings down the overall death rate among those infected.
But another key factor, experts believe, is that Lombardy admitted more patients to hospital, whereas Veneto urged them to stay at home or treated them in local health clinics.
Read full story (paywalled)
Source: The Telegraph, 6 April 2020
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Report finds 'recurrent safety risks' in East Kent NHS maternity care

“Recurrent safety risks” around clinical care at an embattled NHS trust’s maternity service have been identified in a report published on Tuesday.
The Healthcare Safety Investigation Branch (HSIB) has been investigating East Kent hospitals university NHS foundation trust since July 2018 after a series of baby deaths.
Among those treated at the trust was Harry Richford, whose death was “wholly avoidable”, seven days after his emergency delivery in November 2017, an inquest found.
Speaking on Tuesday, Harry’s grandfather Derek Richford said it is clear that sufficient lessons were not learned from his death.
The independent report, published on Tuesday by the Department of Health and Social Care, discusses 24 maternity investigations undertaken since July 2018, including the deaths of three babies and two mothers.
It said: “These investigations have enabled HSIB to identify recurrent safety risks around several key themes of clinical care in the trust’s maternity services.”
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Source: The Guardian, 8 April 2020
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Design of new breathing aid developed by Mercedes to be made freely available

The designs of a new breathing aid developed by engineers at the Mercedes F1 team, University College London (UCL), and clinicians at UCL Hospital have been made freely available to support the global response to COVID-19. It's the latest development in Formula 1’s Project Pitlane effort to help fight coronavirus.
The Continuous Positive Airway Pressure (CPAP) devices, which help coronavirus patients with lung infections to breathe more easily, were developed by engineers at the Mercedes team and University College London (UCL), and clinicians at UCL Hospital after a round-the-clock effort to reverse engineer a device that could be manufactured rapidly by the thousands.
After patient evaluations at UCLH and across sister hospitals in the London area, the device received regulatory approval last week. An order for up to 10,000 has now been placed by the British National Health Service, and the Mercedes AMG High Performance Powertrains technology centre in Brixworth – the facility where the F1 team’s highly successful power units are developed and built – is now building 1,000 devices per day.
Read full story
Source: F1, 7 April 2020
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Coronavirus: NHS staff with Covid-19 given wrong test results

Some Welsh NHS staff with Covid-19 have been given wrong test results and were told they did not have coronavirus, BBC Wales has learned.
They are among a group of ten who have been given incorrect results - including eight from Aneurin Bevan Health Board and two from elsewhere.
It is not clear how many of the ten had Covid-19 and were told they did not, or vice versa.
The Gwent-based heath board said the staff were contacted "immediately".
It happened when a small number of test samples from a batch of 96 were attributed to the wrong patients.
Read full story
Source: BBC Wales, 7 April 2020
Patient Safety Learning

Could this be the start of wholesale change in how the NHS and social care operate?

The health service has been promised “whatever it needs” to deal with the coronavirus pandemic, but government spending choices reveal possible long-term changes to funding and policy. 
Having initially promised the health service “whatever it needs, whatever it costs” on 11th March, the government made this official when Matt Hancock issued a ministerial direction allowing the Department of Health to “spend in excess of formal Departmental Expenditure Limits”—effectively providing a blank cheque.
But while the government’s actions are designed for the immediate crisis, they may be difficult to reverse once the peak of coronavirus has passed. Indeed, they could yet change how the health service operates on a permanent basis.
Read full story
Source: Prospect, 7 April 2020
 
Sam

Coronavirus pressures 'put organ transplants at risk'

The UK's organ transplant network could be forced to shut down as a result of the coronavirus outbreak, the body that runs the scheme is warning.
One factor is the pressure on intensive care beds, according to NHS Blood and Transplant (NHSBT). But there is also the risk to transplant patients, who have their immune systems suppressed so their bodies don't reject new organs.
This is a dilemma for those like Ana-Rose Thorpe, from Manchester, who is waiting for a liver transplant.
Now aged 29, Ana-Rose has lived with hepatitis almost her entire life after contracting it as a baby. The disease has taken its toll and now her liver is failing and she is in desperate need of a transplant.
"Having to go into hospital while there are coronavirus patients there is very worrying," she says.
"Whilst my body could withstand the transplant, the longer I'm not being monitored, not being seen as often as I was, the longer I leave it, I could just get sicker and sicker.
"I feel like it's patients that are already on the transplant list, patients waiting for other operations, we have just been swept aside."
"It's my life - it is a matter of life and death," Ana-Rose says.
Read full story
Source: BBC News, 9 April 2020
Patient Safety Learning

We need a Nightingale model for rehab after COVID-19

A major new model of post-acute care is needed for the discharge and rehabilitation of patients following COVID-19 infection, say Alice Murray, Clare Gerada, and Jackie Morris.
A comprehensive plan must be made for the 50% of COVID-19 patients who will require some form of ongoing care following admission to intensive care, with the goal of improving their long-term outcomes and freeing-up much-needed acute hospital capacity.
While the current focus is quite rightly on emergent cases, planning should be set in place to create post-acute care resources and facilities for the surge in numbers of people with the physical, psychological and functional consequences of prolonged ITU stays and or hospital admission following COVID-19 infection.
One potential solution is to provide mass facilities, on a scale to match the Nightingale Hospitals in so-called “Centres of Excellence”, requisitioned for those who survive but need care and cannot return to their own homes, with both residential and day care units available.
Read full story
Source: HSJ, 9 April 2020
Patient Safety Learning

Hospitals recruit vets to staff COVID-19 wards

Hospitals are turning to the veterinary workforce to fill staffing gaps on intensive care wards ahead of an expected peak of COVID-19 patients, HSJ can reveal.
Torbay and South Devon Foundation Trust has recruited 150 vets to enrol as “respiratory assistants”, amid preparations for a 10-fold increase of intensive care patients.
Another trust, Hampshire Hospitals FT, has asked vets and dentists to become “bedside support workers” as part of its response to COVID-19 pressures.
Read full story
Source: HSJ, 9 March 2020
Patient Safety Learning

Record fall in A&E attendances sparks fear sick people could be avoiding hospitals

Medical leaders have warned sick patients not to avoid getting help from the NHS after a huge drop in the numbers of people attending A&E departments sparked fears some could die without care.
In March, the number of people going to their local emergency department fell by 600,000, or 29 per cent, compared to same month last year, the lowest number of attendances since 2010.
While the NHS has battled for years to reduce the number of people going to A&E for unnecessary reasons, the sudden fall during the coronavirus epidemic has worried officials that the pandemic could be deterring people who have genuine need and who could become sicker or even die as a result of staying away.
Read full story
Source: HSJ, 9 April 2020
Patient Safety Learning

Trusts to ‘run out of gowns this weekend’

London trusts have been warned not to expect deliveries of gowns from the national supply chain for at least the next few days, HSJ understands.
Without central deliveries, providers risk running out of gowns ahead of the Easter weekend. Trusts will have to rely on existing supplies and any new stock they procure independently. 
Staff performing or assisting aerosol-generating procedures on confirmed or suspected covid-19 patients should wear gowns, according to the latest guidance from Public Health England.
But supplies have been an issue for weeks, with trust procurement leads raising concerns about dwindling gown stocks last month. It recently emerged that gowns were not included in national pandemic stockpiles, unlike other forms of personal protective equipment like masks and gloves.
Read full story
Source: HSJ, 9 April 2020
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