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

NHS app paves the way for 'immunity passports'

Facial recognition has been added as a way of logging in to an NHS app that lets people order prescriptions, book appointments and find healthcare data.
Initially, it will allow faster access to the services on the app, which is separate from the contact-tracing one, but its developers say it could also be used for COVID-19 "immunity passports".
The NHS facial-recognition system, built by iProov and available for both Android devices and iOS, requires users to submit a photo of themselves from an official document such as their passport or driving license. They then scan their face using their phone and, following a short sequence of flashing colours, their identification will be verified and they will have access to all the services on the NHS app.
Immunity passports need to link a person's identity to their coronavirus test results, so would require a robust way of allowing people to verify themselves. Those deemed clear of the virus could then prove their status via a code generated by an app.
However, the idea is controversial, not least because there is no hard scientific evidence that having had the coronavirus provides people with long-lasting immunity.
The World Health Organization has warned countries against implementing such passports, saying: "There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection."
 Dr Tom Fisher, a senior researcher at Privacy International, said the implementation of such measures needed to be "necessary, proportionate and based on the epidemiological evidence".
"For the moment, immunity passports do not meet this test," he said. "We must be concerned about the broad societal impact of such immunity passports. They are essentially about limiting the rights of those who are not deemed to be immune. This is a route to exclusion and discrimination."
Read full story
Source: BBC News, 27 May 2020
Patient Safety Learning

Coronavirus: NHS to offer drug that can shorten recovery time by four days

Selected NHS coronavirus patients will soon be able to access an experimental treatment to speed up their recovery, with the health secretary Matt Hancock suggesting it is probably “the biggest step forward’’ in medication since the beginning of the COVID-19 crisis.
The anti-viral drug remdesivir will be made available to patients meeting certain clinical criteria to support their recovery in hospital.
The drug is currently undergoing clinical trials around the world, including in the UK, and peer-reviewed data showed it can shorten the time to recovery by about four days.
Treatment will initially be prioritised for patients who have the greatest likelihood of deriving the most benefit, according to the Department of Health and Social Care (DHSC).
Satisfied the drug can help boost recovery, the government’s Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of remdesivir through its early access to medicines scheme.
The experimental anti-viral drug was granted emergency authorisation to treat Covid-19 in the US by the Food and Drug Administration earlier this month.
Read full story
Source: The Independent, 26 May 2020
Patient Safety Learning

How specialist A&E for over-80s is transforming care

An emergency unit at a Norwich hospital has reduced ward admissions and is helping shield urgent non-COVID-19 patients.
The older people’s emergency department (Oped) – a special unit at the Norfolk and Norwich university hospital – is providing emergency care for patients over 80.
Launched in 2017, the unit, just down the corridor from A&E, has six beds, two in side rooms and no waiting room. Normally, it admits patients identified as frail and usually with multiple conditions that need a lot of care (such as cognitive impairment, incontinence or reduced mobility). They are brought straight in by ambulance or trolley from other parts of the hospital and seen by a consultant geriatrician within two hours.
A team of nurses with experience in both emergency care and care of the elderly, pharmacists and physiotherapists are on hand to support patients much more quickly than A&E to get patients out of hospital and back home within the same day wherever possible. For patients who need to stay longer after treatment there is an adjacent ambulatory ward.
This unique model is showing results. The proportion of the specialist department’s patients admitted to the hospital is 50% compared with 68% for the same age group of emergency patients coming to the hospital five years ago, when they were treated at the normal A&E. When Oped patients are admitted, their average length of stay is 1.2 days less.
“It’s just what we want for old people,” says Dr Sarah Bailey, the department’s lead consultant geriatrician. “We get the experts in straight away because we recognised that’s the best thing for [them]”.
During the pandemic, the unit is helping to keep those who do not have coronavirus symptoms, such as those with injuries from falls and some stroke patients, away from the main A&E ward, providing a degree of shielding not normally possible.
But for most NHS trusts, providing a separate unit like Oped is not feasible. “Hospitals are working to separate emergency patients with respiratory problems from those with other conditions,” says Dr Jay Banerjee, who leads the Royal College of Emergency Medicine’s work on emergency care for the elderly. “But most just do not have the capacity to also try to separate elderly patients with other conditions from younger patients.”
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Source: The Guardian, 27 May 2020
Patient Safety Learning

Italy's medical workers: 'We became heroes but they've already forgotten us'

"I'm not sure I want to be a nurse anymore," she tells me. "I've seen more people die in the past two months than in the whole six years."
Some 70% of health workers dealing with COVID-19 in Italy's hardest-hit areas are suffering from burnout, a recent study shows. "This is actually the hardest moment for doctors and nurses," says Serena Barello, the author of the study.
Read story
Source: BBC News, 26 May 2020
Clive Flashman

Coronavirus: Five things a COVID-19 symptom-tracking app tells us

The UK's scientists have been trying to trace COVID-19's path through the population ever since the coronavirus arrived on British shores.
In what is thought to be the largest study of its kind in the world, an app developed by King's College London (KCL) and technology company Zoe, which tracks symptoms of the disease, has been downloaded more than three million times in the UK.
Not to be confused with the government's contact-tracing app, the COVID-19 Symptom Study app allows users to report daily whether they feel healthy, and record any symptoms. The scientists have been using the data to estimate how the virus may have travelled through the population.
Read full story
Source: BBC News, 23 May 2020
Clive Flashman

Test and trace system kicks off in England and Scotland

A team of 25,000 contact tracers are making their first phone calls to track down people who will be told to self-isolate under a new scheme in England.
Tracers will text, email or call people who test positive with coronavirus and ask who they have had contact with. Any of those contacts deemed at risk of infection will be told to isolate for 14 days, even if they are not sick.
A test and trace system is also launching in Scotland, where an easing of the lockdown is expected later.
The aim of England's NHS Test and Trace system is to lift national lockdown restrictions and move towards more localised, targeted measures.
The team will start by contacting the 2,013 people who tested positive for the virus on Wednesday.
Read full story
Source: BBC News, 28 May 2020
Patient Safety Learning

BAME nursing staff experiencing greater PPE shortages despite COVID-19 risk warnings

Amid warnings that BAME nursing staff may be disproportionately affected by the COVID-19 pandemic, a Royal College of Nursing (RCN) survey reveals that they are more likely to struggle to secure adequate personal protective equipment (PPE) while at work.
The latest RCN member-wide survey shows that for nursing staff working in high-risk environments (including intensive and critical care units), only 43% of respondents from a BAME background said they had enough eye and face protection equipment. This is in stark contrast to 66% of white British nursing staff.
There were also disparities in access to fluid-repellent gowns and in cases of nursing staff being asked to re-use single-use PPE items.
The survey found similar gaps for those working in non-high-risk environments. Meanwhile, staff reported differences in PPE training, with 40% of BAME respondents saying they had not had training compared with just 31% of white British respondents.
Nearly a quarter of BAME nursing staff said they had no confidence that their employer is doing enough to protect them from COVID-19, compared with only 11% of white British respondents.
Dame Donna Kinnair, RCN Chief Executive & General Secretary, said: “It is simply unacceptable that we are in a situation where BAME nursing staff are less protected than other nursing staff.
Read full story
Source: Royal College of Nursing, 27 May 2020
Patient Safety Learning

CQC: Fears covid restrictions caused opiate addiction deaths

Problems with dispensing drugs during the COVID-19 crisis may be contributing to an “apparent increase” in deaths of patients receiving treatment for opiate addiction, the Care Quality Commission (CQC) has said. 
The regulator has said the increase in deaths “may be a result of some services stopping all daily dispensing of opiates” and has taken enforcement action against a “large national provider of substance misuse services” which ”stopped all daily dispensing”.
The provider has not been named by the CQC as it is “entitled to an appeal period,” but the regulator told HSJ the provider had not recorded their risk assessments for their clients in relation to changes in drug dispensing. The CQC said the provider had now “assured us” individualised risk assessments were in place.
The CQC is now reviewing all deaths of people which have been reported by substance misuse services since 1 March due to concerns about the apparent increase and “that some of these deaths may be related to changes in prescribing practices in response to COVID-19”.
Read full story
Source: HSJ, 27 May 2020
Patient Safety Learning

Covid-19: “Huge rise” in deaths at home is not fully explained by virus, say experts

Deaths resulting from COVID-19 infection account for only half of the number of excess deaths taking place in private homes, expert analysis of latest data suggests.
Figures from the Office for National Statistics from the seven weeks to 15 May show that more than 40 000 COVID-19 deaths have now taken place in hospitals, care homes, and private homes in England and Wales. The figures also show 14 418 excess non-covid deaths.
Although COVID-19 was mentioned on death certificates 13 500 times in care homes and private homes over the past seven weeks, some 23 500 more non-covid deaths have taken place in the community than would be expected.
Discussing the data, David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, said that “as soon as the pandemic started we saw a huge immediate spike in non-covid deaths in [private] homes that occurred close to the time hospitals were minimising the service they were providing."
“Over the seven weeks up to 15 May, as the NHS focused on covid, around 8800 fewer non-covid deaths than normal occurred in hospitals.”
He added that these had not been “exported” to care homes, since fairly few care home residents normally died in hospitals. Instead, he said, it seemed that these deaths had contributed to the huge rise in extra deaths in private homes during this period.
Read full story
Source: BMJ, 27 May 2020
Patient Safety Learning

Patient Safety Learning launches Oscar, the friendly health chatbot

We’re living in an unprecedented time and facing new challenges. We’re asking questions we’ve never had to ask before – questions that differ according to our unique circumstances, concerns and needs.
With an increasingly complex health and social care system, Patient Safety Learning wants to continue working towards a future that is safe for both patients and staff.
It’s for this reason that we’ve launched Oscar, the friendly health chatbot. Available on the hub, Oscar answers the public’s question about their safety – or that of their family members and friends – during the coronavirus pandemic.
Oscar is not a diagnostic tool. We at Patient Safety Learning are not medical experts ourselves, but we want to connect patients to the best guidance currently in the public domain. This is what Oscar seeks to do, in pointing visitors to helpful and trustworthy answers, relevant to their specific situations.
Whether you’re a well adult seeking general information about how to stay safe from coronavirus, a concerned woman about to give birth and wanting to know your options, or a carer looking for advice, Oscar is here to help you find the answers you need. In time, as we see how the public uses Oscar – and especially as we hear your feedback – we plan to build on the range of information Oscar currently offers. 
Like everything else on the hub, Oscar is free to use.
Please do send us any feedback, including information you’d like Oscar to provide, by emailing [email protected]
Patient Safety Learning

COVID-19 rehab centre takes first patients

The first hospital dedicated to helping coronavirus patients recover from the long-term effects of the illness has received its first patients.
Surrey's NHS Seacole Centre opened this month at Headley Court, a former rehab centre for injured soldiers.
COVID-19 patients can be left with tracheostomy wounds from having a tube inserted in the windpipe or need heart, lung or muscle therapy, the NHS said.
Others who have survived the virus may need psychological or social care.
NHS chief executive Sir Simon Stevens said: "While our country is now emerging from the initial peak of coronavirus, we're now seeing a substantial new need for rehab and aftercare."
He said while patients had survived life-threatening complications, many would see a longer-lasting impact on their health.
Read full story
Source: BBC News, 29 May 2020
Patient Safety Learning

Maternity unit under investigation for baby deaths was often operating without senior doctor

A hospital trust under the spotlight over avoidable baby deaths provided inadequate antenatal care, with inexperienced junior midwives working alone and doctors not always available to assess high risk women, the Care Quality Commission (CQC) has found.
The latest CQC report on maternity services at East Kent Hospitals University Foundation Trust follows a report last month by the NHS Healthcare Services Investigation Branch on 24 maternity care investigations at the trust.
Read full story (paywalled)
Source: BMJ, 28 May 2020
Patient Safety Learning

Dental practices to reopen

Dental practices in England have been told they can reopen from Monday 8 June, if they put in place appropriate safety measures. All routine dental care in England has been suspended since 25 March.
The British Dental Association (BDA) has welcomed the announcement but says key questions remain.
Currently, any patient with an emergency dental problem is supposed to be referred to an Urgent Dental Care (UDC) hub for treatment.
In a letter to all practices, NHS England's chief dental officer, Sara Hurley, said: "Today, we are asking that all dental practices commence opening from Monday, 8 June for all face-to-face care, where practices assess that they have the necessary IPC and PPE requirements in place."
The BDA said that while dentists would be relieved by the announcement, the ability of practices to reopen would depend on the availability of personal protective equipment (PPE).
"It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as is safely possible, but we will need everyone to be patient as practices get up and running," said BDA chairman Mick Armstrong.
Read full story
Source: BBC News, 28 May 2020
Patient Safety Learning

NHS staff 'not told when colleagues test positive for COVID-19'

NHS staff at a hospital that has stopped taking new patients amid a COVID-19 spike have lodged a series of concerns, including that they are not routinely being informed of when colleagues test positive for the virus.
The concerns were laid out in a letter from union representatives to management at Weston general hospital in Somerset, which is now testing all staff while carrying out a deep clean.
Another concern raised by Unison was that priority for testing was not being given to BAME staff. 
University Hospitals Bristol and Weston NHS foundation trust said on Wednesday that as many as 40% of staff from a cohort tested after contact with infected patients were found to be positive.
The trust’s chief executive, Robert Woolley, told the BBC the figure was from a sample testing last week and authorities were now attempting to understand the scale of the infection. More than 60 patients were found to be infected last weekend.
Read full story
Source: The Guardian, 28 May 2020
Patient Safety Learning

Coronavirus: GPs not told when patients removed from 'shielding lists'

Some extremely vulnerable people have been told they have been removed from shielding lists via text message, without the knowledge of their GP.
This has caused confusion, with charities demanding clearer guidance for this group as lockdown eases. GPs say they should be notified when their patients are added or removed from the lists.
Shielding has now been extended until the end of June and is under constant review, the government says.
Around 2.2 million people in the UK are staying at home to protect themselves from the virus because they were told they were at high risk of being seriously ill with COVID-19.
But 40 healthcare charities say the lack of a clear plan for their future is causing anxiety and potentially putting their health at risk.
Read full story
Source: BBC News, 30 May 2020
Patient Safety Learning
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