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

Test and trace chief warned lack of transparency on performance could ‘destroy confidence’

The head of NHS test and trace has refused to give MPs any data on the first six days of the new service, leading health committee chair Jeremy Hunt to warn that a lack of transparency could “destroy confidence” in its work.
Baroness Dido Harding, who is leading the new effort, said she was working to validate performance data, which relies on people with COVID-19 symptoms isolating and being called by a team of tracers to identify others they have been in contact with.
MPs had wanted to know how many patients had been contacted within 24 hours as well as how many were willing to share their contacts, and the compliance with self-isolation advice.
But Baroness Harding said she would not share the information until the UK Statistics Authority was happy with the data and could ensure it can be trusted. The UKSA criticised the government earlier this week over its public use of test results data.
Chair of the committee and former health secretary Jeremy Hunt said he was “disappointed” with her refusal and said it was hard for the committee to scrutinise services if it did not have the data, which she had been pre-warned it would ask for.
Leaked information on Tuesday suggested only two-fifths of coronavirus patients and one-third of their contacts were identified and contacted by the tracing service.
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Source: The Independent, 3 June 2020
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Johnson and Johnson pays hundreds of women in Scotland harmed by mesh implants

The pharmaceutical giant Johnson and Johnson has agreed to pay an undisclosed sum to settle a legal action by hundreds of Scottish women who claimed they suffered serious injuries from the company’s pelvic mesh implants.
The settlement came as four lead cases brought by women who suffered pain and other serious side effects from the implants, made by Johnson and Johnson subsidiary Ethicon, were about to reach court in Edinburgh.
Read full story (paywalled)
Source: BMJ, 2 June 2020
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New rapid coronavirus test dramatically reduces hospital stay time

A new rapid coronavirus testing device has been shown to reduce the average stay for patients on a COVID-19 holding ward at a UK hospital by almost half.
The Samba II portable machines can diagnose the virus in less than 90 minutes and have been trialled at Addenbrooke’s Hospital in Cambridge.
The average length of stay for patients on a coronavirus holding ward, before they were either discharged or could progress with treatment, fell from 58.5 hours to 30 hours, according to the Cambridge University study.
Researchers said the devices “could make all the difference” in freeing up hospital capacity as the NHS faces a mounting backlog of operations due to the pandemic.
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Source: The Independent, 3 June 2020
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NASA and other innovators work to redesign ventilators for COVID-19 patients

NASA scientists as well as other innovators are busy developing alternatives to the traditional ventilator being used worldwide to treat severe cases of COVID-19.  The movement is in response to growing evidence that in some cases ventilators can cause more harm than good in some patients with low oxygen levels. Statistics tell the story: 80% of patients with the coronavirus die on such machines.
Its VITAL machine is tailored for COVID-19 patients and is focused on providing air delicately to stiff lungs — a hallmark symptom of the virus.
Eight U.S. manufacturers have been selected to make the ventilator that was made in 37 days by engineers at NASA’s Jet Propulsion Laboratory.
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Source: CNBC, 30 May 2020
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'Tens of thousands' of heart procedures delayed by pandemic

The postponement of tens of thousands of hospital procedures is putting the lives of people with long-term heart conditions at risk, according to the British Heart Foundation.
The coronavirus pandemic has created a backlog which would only get larger as patients waited for care, it said.
People with heart disease are at increased risk of serious illness with COVID-19, and some are shielding.
The BHF estimates that 28,000 procedures have been delayed in England since the outbreak of coronavirus in the UK. These are planned hospital procedures, including the implanting of pacemakers or stents, widening blocked arteries to the heart, and tests to diagnose heart problems.
People now waiting for new appointments would already have been waiting for treatment when the lockdown started, the charity said, as it urged the NHS to support people with heart conditions "in a safe way".
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Source: 5 June 2020
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Patient restraint spikes as covid measures spark ‘frustration’

Several mental health trusts have reported spikes in incidents of physical restraint or seclusion on patients, driven by COVID-19 restrictions, HSJ has learned.
Concerns have been raised nationally about the potential for incidents to increase during the pandemic, due to temporary measures which have had to be introduced such as visiting restrictions and communication difficulties due to personal protective equipment.
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Source: HSJ, 5 June 2020
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Extra 10,000 dementia deaths in England and Wales in April

There were almost 10,000 unexplained extra deaths among people with dementia in England and Wales in April, according to official figures that have prompted alarm about the severe impact of social isolation on people with the condition.
The data, from the Office for National Statistics, reveals that, beyond deaths directly linked to COVID-19, there were 83% more deaths from dementia than usual in April, with charities warning that a reduction in essential medical care and family visits were taking a devastating toll.
“It’s horrendous that people with dementia have been dying in their thousands,” said Kate Lee, chief executive officer at Alzheimer’s Society. “We’ve already seen the devastating effect of coronavirus on people with dementia who catch it, but our [research] reveals that the threat of the virus extends far beyond that.”
The charity thinks the increased numbers of deaths from dementia are resulting partly from increased cognitive impairment caused by isolation, the reduction in essential care as family carers cannot visit, and the onset of depression as people with dementia do not understand why loved ones are no longer visiting, causing them to lose skills and independence, such as the ability to speak or even stopping eating and drinking.
Another factor may be interruptions to usual health services, with more than three-quarters of care homes reporting that GPs have been reluctant to visit residents.
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Source: The Guardian, 5 June 2020
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BMA urges plan to tackle backlog of patients awaiting non-covid treatment

The government urgently needs to set out a plan to reduce the huge backlog of patients waiting for NHS treatments unrelated to COVID-19 in the wake of the pandemic, the BMA has said.
The call came as the BMA released the results of its latest survey of over 8000 doctors. It found that more than half (3754 of 7238) were either not very confident or not confident at all that their department would be able to manage patient demand as NHS services resumed.
“The government must be honest with the public about the surge to come and start meaningful conversations with frontline clinicians about how we can, together, begin to tackle the backlog,” said the BMA’s chair of council, Chaand Nagpaul. “Covid-19 has brought with it the worst health crisis in a century. The NHS must not return to its previous perilous state.”
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Source: BMJ, 4 June 2020
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Michael Seres, an influential patient who hacked together a ‘smart’ ostomy bag, dies at 51

Michael Seres, an entrepreneur, patient advocate, husband and father of three, died on Saturday in Orange County, California, of a sepsis infection. He was 51. 
Seres was widely considered to be one of the first and most prominent “e-patients,” a term which has become popular to denote patients who are informed and engaged in their health, often sharing their experiences online. He is also one of a small number of patient inventors who helped design and build a medical device – a digitally enhanced ostomy bag – that got FDA clearance in 2014. His invention eased the suffering of millions of people with bowel injuries, chronic gut illnesses and cancer.
Source: CNBC, 2 June 2020
Read more about Michael and his innovative patient work in our hub blog
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Respiratory patients still avoiding A&E

Emergency attendances for several conditions are still well below their normal levels, despite a steady increase in overall activity since the peak of the coronavirus outbreak.
Weekly data from Public Health England suggests overall A&E attendances increased to around 105,000 in the last week of May, which was an increase from 98,813 over the previous seven days.
Data from the 77 A&E departments included in the research suggests that overall attendances are up to an average of 15,000 day, compared to around 10,000 at the peak of the pandemic and the long-term trend of just under 20,000. However, attendances for bronchitis, acute respiratory infections, respiratory, pneumonia, asthma, gastroenteritis are still far below their normal levels.
It did not offer an explanation for why attendances for these conditions have remained low, while those for cardiac, influenza, myocardial Ischaemia, and gastrointestinal problems have returned to normal levels or above.
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Source: HSJ, 5 June 2020
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Contact tracing system rolled-out across Wales

A contact tracing system has this week been launched in Wales, initially a telephone based process, followed by an online system next week.
Anyone who has a positive coronavirus test result will be contacted by a team of contact tracers and asked for details of everyone they have had close contact with while they have had symptoms.
From Monday 8th June, a new online system will be used to support the process. People will have the option to use the system to provide details of their close contacts electronically.
The system has been trialled in four health board areas over the last two weeks and more than 600 contact tracers have so far been employed, with more to be employed.
Health Minister,  Vaughan Gething said “Today’s roll-out of the contact tracing element of our Test, Trace, Protect strategy is a significant step forward in the gradual move out of lockdown.”
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Source: HTN, 2 June 2020
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After coronavirus, we may not recognise changed NHS

In many ways it is wrong to talk about the NHS restarting non-coronavirus care. A lot of it never stopped — births, for instance, cannot be delayed because of a pandemic.
However, exactly what that care looks like is likely to be very different from what came before. There are more video and telephone consultations and staff treat patients from behind masks and visors.
That is likely to be the case for some time, experts have told The Times.
Read full story (paywalled)
Source: The Times, 6 June 2020
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More than half of England’s coronavirus-related deaths will be people from care homes

Care home residents are on course to make up more than half the deaths caused directly or indirectly by the coronavirus crisis in England, according to a new analysis.
The study warns that the death toll by the end of June from OVID-19 infections and other excess deaths is “likely to approach 59,000 across the entire English population, of which about 34,000 (57%) will have been care home residents”.
The estimate, produced by the major healthcare business consultancy LaingBuisson, includes people who list a care home as their primary residence, wherever they died – including those who died in hospital.
It is based on data from the Office for National Statistics, as well as the analyst’s own modelling of the number of care home resident deaths likely to have occurred in the absence of the pandemic.
The new study coincides with mounting concerns over the failure to protect care homes earlier in the pandemic. Senior care industry figures point to the decision to move some hospital patients back to care homes in mid-March. There have also been complaints that non-Covid-related healthcare became less accessible to homes during the height of the pandemic, leading to extra deaths.
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Source: The Guardian, 7 June 2020
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Coronavirus: NHS trust bosses not consulted over new face mask rules

NHS trusts were not consulted before the government announced changes to the use of face coverings and visitor policy in English hospitals, the chief executive of NHS Providers has said.
Chris Hopson said trust leaders felt "completely in the dark" about the "significant and complex" changes.
From 15 June, hospital visitors and outpatients must wear face coverings and staff must use surgical masks.
A spokeswoman said that, while the public were "strongly urged" to wear a face covering while inside hospitals, no-one would be denied care.
Separately, NHS England has lifted the national suspension on hospital visiting with new guidance for NHS trusts.
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Source: BBC News, 6 June 2020
 
 
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Coronavirus: Risk higher for pregnant BAME women

The high proportion of pregnant women from black and ethnic minority (BAME) groups admitted to hospital with COVID-19 "needs urgent investigation", says a study in the British Medical Journal.
Out of 427 pregnant women studied between March and April, more than half were from these backgrounds - nearly three times the expected number. Most were admitted late in pregnancy and did not become seriously ill. Although babies can be infected, the researchers said this was "uncommon".
When other factors such as obesity and age were taken into account, there was still a much higher proportion from ethnic minority groups than expected, the authors said.
But the explanation for why BAME pregnant women are disproportionately affected by coronavirus is not simple "or easily solved," says Professor Knight, lead author.
"We have to talk to women themselves, as well as health professionals, to give us more of a clue."
Gill Walton from the Royal College of Midwives says, "Even before the pandemic, women from black, Asian or ethnic minority backgrounds were more likely to die in and around their pregnancy,"
She said they were "still at unacceptable risk" and getting help and support to affected communities was crucial. 
Ms Walton added: "The system is failing them and that has got to change quickly, because they matter, their lives matter and they deserve the best and safest care."
Read full story
Source: BBC News, 8 June 2020
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