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

Poorer mothers three times ‘more likely to have stillborn children’

Poorer mothers are three times more likely to have stillborn children than those from more affluent backgrounds, according to a new study.
The wide-ranging research, conducted by pregnancy charity Tommy’s, also found that high levels of stress doubled the likelihood of stillbirth, irrespective of other social factors and pregnancy complications. Unemployed mothers were almost three times more at risk.
The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity.
Researchers said getting more antenatal care can stop women from having a stillbirth — with mothers who went to more appointments than national rules stipulate having a 72% lower risk.
Ros Bragg, director of Maternity Action said, “If the government is serious about combatting stillbirths, it must address the social determinants of health as well as clinical care. Women need safe, secure employment during their pregnancy and the certainty of a decent income if they find themselves out of work. It is not right that increasing numbers of pregnant women are dealing with the stress of financial insecurity, putting them at increased risk of serious health problems, including stillbirth.”
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Source: The Independent, 29 October 2020
Sam

Hundreds of GPs a month seek mental health support as COVID-19 pressure bites

More than 200 GPs a month are seeking mental health support as COVID-19 drives up pressure on the NHS - and demand for help is rising fastest among doctors in primary care, figures from a confidential support service suggest.
NHS Practitioner Health medical director and former RCGP chair Professor Dame Clare Gerada warns that the pandemic 'must surely be contributing to the increase in numbers of doctors presenting for help compared to pre-pandemic levels'.
Before the pandemic, around 60 doctors per week were coming forward for support from NHS Practitioner Health, a free, confidential NHS service for doctors and dentists in England with mental illness and addiction problems.
After an initial dip during the first wave of the pandemic, numbers of doctors coming forward each week spiked to 90 per week by June and now 'regularly over 100' per week, Professor Gerada said.
Junior doctors and international medical graduates now make up 25% of referrals to the service, and younger women have been particularly affected.
Data from NHS Practitioner Health show that up to 69% of all referrals to the service are for women, and nearly a third of all referrals it receives are for female doctors aged 30-39 - for issues 'ranging from anxiety, depression, burnout, PTSD and suicidal thoughts'.
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Source: GP Online, 28 October 2020
Sam

Doctors accuse trust of caving to political pressure to reopen ‘unsafe’ A&E

Senior clinicians say their trust board has caved into political pressure by making an ‘unsafe’ decision to re-open a small emergency department — having previously suggested this would not happen if there was a second wave of coronavirus.
In a letter to management at Lancashire Teaching Hospitals Foundation Trust, seen by HSJ, a group of 17 emergency medicine consultants have raised serious concerns over the planned re-opening of the accident and emergency department at Chorley and South Ribble Hospital next week.
The unit, which has long suffered from staffing shortages and temporary closures, was again closed on a temporary basis at the start of the coronavirus pandemic. When covid subsided in the summer, plans were put forward to reopen it in the autumn.
However, when announcing this, chief executive Karen Partington said: “It is really important that everybody recognises that if covid-19 cases begin to rise significantly, or other safety concerns are identified, we will need to revisit the situation.”
The letter from the clinicians, addressed to trust clinical director Graham Ellis, said: “We consider that the trust has been subjected to an undercurrent of external pressure which has resulted in an unsafe decision being taken to re-open the ED prematurely…"
Read full story (paywalled)
Source: HSJ, 30 October 2020
Sam

Delays in discharging patients adds pressure on hospitals amid coronavirus second wave

Delays in discharging patients from hospitals is making pressure on the NHS from the second wave of coronavirus worse, hospital chiefs have warned.
Some hospitals are already reporting almost all of their beds are full with patients as the number of coronavirus cases continues to surge with more patients needing hospital care every day.
Doctors have told The Independent the lack of discharges means fewer beds are free and some hospitals are seeing long waits in A&E for beds to become available.
NHS Providers chief executive Chris Hopson said: “Some of our chief executives are saying they are seeing bed occupancy levels of 92, 93, 94 per cent at the end of October when they would normally expect these to be 86, 87, 88 per cent. “Given where we are in terms of the winter cycle, and the fact we are not really at the beginning of winter yet, that is a worry."
“There are much higher bed occupancy levels now than you would normally expect to see at this time of the year.”
Without enough spare beds, hospitals will not be able to go ahead with planned surgeries and will have to make patients wait longer for a bed in accident and emergency departments.
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Source: The Independent, 30 October 2020
Sam

NHS staff and families accounted for one in six Covid hospital cases, study reveals

NHS staff and their families accounted for one in six patients in hospital with Covid, due in part to inadequate personal protective equipment (PPE), new research suggests.
A study of hospitals from March to June revealed that healthcare workers in patient-facing roles were around three times more likely to be hospitalised with the virus than the general population.
Writing in the BMJ, the study's authors called for an urgent focus on how COVID-19 spreads around hospitals to prevent a similar toll in future waves of the pandemic.
They also call for hospitals to consider re-deploying staff with vulnerable family members away from high-risk zones.
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Source: The Telegraph, 29 October 2020
Sam

Report into Covid-related whistleblowing calls to the Protect advice Line

What does whistleblowing in a pandemic look like? Do employers take concerns more seriously – as we would all hope? Does the victimisation of whistleblowers still happen? Does a pandemic compel more people to speak up? We wanted to know, so Protect analysed the data from all the Covid-19 related calls to theirr Advice Line. They found:
* 41% of whistleblowers had Covid-19 concerns ignored by employers
* 20% of whistleblowers were dismissed
* Managers more likely to be dismissed (32% ) than non-managers (21%)
 
They found that too many whistleblowers feel ignored and isolated once they raise their concerns and that these failing are a systematic problem.
Protect, which runs an Advice Line for whistleblowers, and supports more than 3,000 whistleblowers each year, has been inundated with Covid-19 whistleblowing concerns, many of an extremely serious nature. Its report, The Best Warning System: Whistleblowing During Covid-19 examines over 600 Covid-19 calls to its Advice Line between March and September. The majority of cases were over furlough fraud and risk to public safety, such as a lack of social distancing and PPE in the workplace.
 
Clive Flashman

COVID-19: 338 patients with the virus were discharged from Scottish hospitals to care homes

A total of 338 patients with a diagnosis of COVID-19 were discharged from Scottish hospitals into care homes in the three months from March this year, says a report from Public Health Scotland.
The discharges were necessary to free up space in hospitals for COVID-19 patients but some care home owners have claimed that it introduced the virus into their premises, causing almost 2000 deaths across Scotland.2
Public Health Scotland says that most of the 3599 discharges that took place in the busiest month of March were among people who had never been tested. Of the 650 who were tested, 78 were positive, but the discharges still went ahead.
Scotland has been found to have the highest rate of COVID-19 related deaths in care homes of any part of the UK.
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Source: BMJ, 29 October 2020
Sam

Using Twitter to assess patient takes on patient experience

A qualitative study of Twitter hashtags revealed power hierarchies can damage the patient experience and clinician relationship.
In an analysis of a popular Twitter hashtag, researchers found that patients largely take umbrage when they feel their doctor does not believe their ailment or knowledge about their healthcare, and when they perceive a power hierarchy between themselves and their clinician.
Although not as many patients are using Twitter to get peer feedback on certain providers (the Binary Fountain poll showed only 21% of patients do this), the social media website still holds a lot of power, researchers from the University of California system explained. Twitter is a large platform that hosts social discourse. Healthcare professionals use Twitter to disseminate public health and patient education messages and to network, while 61% of patients use Twitter to learn more about their health, as well.
Read full article
Source: Patient Engagement HIT, 29 October 2020
Clive Flashman

Tens of thousands of NHS staff off sick because of COVID-19, data reveals

Almost half of all staff absence linked to coronavirus in parts of northern England
Tens of thousands of NHS staff are off sick or self-isolating because of coronavirus, according to data shared with The Independent as the second wave grows.
In some parts of northern England, more than 40% – in some cases almost 50% – of all staff absences are linked to COVID-19, heaping pressure on already stretched hospitals trying to cope with a surge in virus patients. The problem has sparked more calls for wider testing of NHS staff from hospital leaders and nursing unions who warned safety was being put at risk because of short staffing on wards.
Across England, more than 76,200 NHS staff were absent from work on Friday – equivalent to more than 6% of the total workforce. This included 25,293 nursing staff and 3,575 doctors.
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Source: The Independent, 1 November 2020
Clive Flashman

UCL researchers publish ‘Find, Test, Track, Isolate and Support’ Covid dashboard

Researchers at UCL-led collaboration i-sense, have published a dashboard to collate data on five stages, Find, Test, Track, Isolate and Support, with an aim to provide a complete picture of the pandemic.
The i-sense COVID Response Evaluation Dashboard (COVID RED) collates and presents data from the Office of National Statistics, Public Health England, and the NHS under five categories; Find, Test, Track, Isolate and Support for those asked to Isolate (FTTIS). It presents indicators of performance under each of these headings, and identifies areas where more data is needed.
Co-developer Professor Christina Pagel, UCL Mathematics & Physical Sciences, said: “Increasing volumes of data are being shown in the media and in government press conferences as a basis for local tightening of restrictions.”
“However, these data are often from disparate sources, and are not linked together to give a more complete picture of how we are doing. This was the motivation behind our dashboard development. We wish to contribute to the public understanding of COVID-19’s spread, and support policymakers in identifying current areas of the Find, Test, Trace, Isolate and Support structure requiring strengthening.”
Read full article
Source: Health Tech Newspaper, 30 October 2020
To access the dashboard, click here
Clive Flashman

Watchdog investigating national rise in stillbirths

A national review has been launched by regulators because of an increased number of stillbirths during the first wave of covid, HSJ can reveal.
The Healthcare Safety Investigation Branch (HSIB) is investigating 40 intrapartum stillbirths which took place between April and June this year, when the country experienced the first wave of COVID-19. During the same three months in the previous year, 24 stillbirths were reported to HSIB.
The HSIB has told HSJ it has now launched a thematic review into the stillbirths, which will investigate stillbirths in all settings across England during that time period.
The Royal College of Obstetricians and Gynaecologists, which has also launched a national review into perinatal outcomes during the pandemic, estimates that 86 per cent of maternity units reported a reduction in emergency antenatal presentations in April, “suggesting women may have delayed seeking care”.
HSIB is aiming to complete the thematic review early next year. It said the stillbirths being investigated are not concentrated on any geographical area or trust.
Read full story (paywalled)
Source: HSJ, 2 November 2020
Sam

Second lockdown will take heavy toll on mental health, charities warn

A month-long national lockdown in winter will take a heavy toll on people's mental health, charities fear.
Paul Farmer, chief executive of mental health charity Mind, says it could be "the greatest test of our mental health this year”, not just for the public but for healthcare staff who are "working tirelessly, but may be struggling with their mental health too”.
Both Mind and Carers UK say the Government has to learn from mistakes in the first wave and make sure people can get help early on.
Mind has also urged the Government to support those who feel alone through a second lockdown in England, with Mr Farmer saying there is an “urgent need” for a winter mental health support package including in-person and online services.
Read full story
Source: The Independent, 1 November 2020
Sam

Hospitals may be forced to move Covid patients elsewhere

Several hospitals in the north of England are already at full capacity and may have to start moving patients to other regions, doctors have warned.
Consultants fear that if Covid infection rates do not begin to fall significantly the NHS will be overwhelmed in less than a month from now.
Members of the British Medical Association have reported that Intensive Care Units (ICU) in a number of regions, including Manchester, Liverpool and Hull, are close to capacity as the number of people hospitalised with COVID-19 continues to grow.
Dr Vishal Sharma, chairman of the BMA’s consultants committee, told The Telegraph: “Capacity in the north of England is at the limits and in some places above the limit. Our next concern is ICU capacity, which is always tight at this time of year, even without Covid.”
Dr Sharma said some general ward beds could be adapted to provide intensive breathing support for Covid patients, and the re-opening of Manchester’s Nightingale Hospital may also take the pressure off ICU departments.
But more radical steps may have to be taken if numbers of hospitalised patients continue to rise.
“We may have to move patients around the country to create extra capacity, but if the whole country starts to struggle things will get very difficult."
Read full story
Source: The Telegraph, 
Sam

Trust ‘could have avoided four never events’ if it had acted on alert

A trust which had four ‘never events’ where patients were connected to air rather than an oxygen supply could have avoided them if it had been more proactive when a national patient safety alert was sent out several years earlier, a report has found.
In one case, a baby being investigated for sepsis had oxygen saturation levels of just 75% before the mistake was realised. In another, a woman with COPD and pneumonia had oxygen saturation at 80% when she was connected to the air outlet.
Calderdale and Huddersfield Foundation Trust asked the Royal College of Physicians to carry out an invited review after the four never events at Calderdale Royal Hospital in 2018 and 2019. The earliest incident happened in February 2018 but was not identified until a retrospective audit nearly a year later.
The RCP’s report said that, had this been identified earlier, “steps could have been put in place to avoid such incidents from subsequently occurring”.
But it added: “All four never events could have been avoided if the trust had responded more proactively to the previous NHS Improvement patient safety alert about the dangers of erroneously connecting patients to air instead of oxygen and had subsequently restricted access to air outlets.”
Read full story (paywalled)
Source: HSJ, 2 November 2020
Sam

COVID-19: Liverpool to pilot city-wide coronavirus testing

People in Liverpool will be offered regular COVID-19 tests under the first trial of whole city testing in England.
Everyone living or working in the city will be offered tests, whether or not they have symptoms, with follow-up tests every two weeks or so. Some will get new tests giving results within an hour which, if successful, could be rolled out to "millions" by Christmas, the government says.
Liverpool has one of the highest rates of coronavirus deaths in England. The latest figures show the city recorded 1,754 cases in the week up to 30 October. The average area in England had 153.
The pilot aims to limit spread of the virus by identifying as many infected people as possible, and taking action to break chains of transmission.
It is thought around four-fifths of people who are infected with coronavirus show no symptoms.
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Source: BBC News, 3 November 2020
Patient Safety Learning

North West Ambulance Service declares 'major incident' over high level of calls

North West Ambulance Service has declared a “major incident” over a high number of calls. 
People were warned they could be asked to make their own way to hospital if their call was not life-threatening, while some patients faced delays. There were no signs the surge in demand was linked to coronavirus, a spokesperson for the service said. 
“North West Ambulance Service has declared a major incident due to the high level of activity in the North West region, in particular the Greater Manchester area,” the service said on Monday evening.
“If your call is not life-threatening, you may be asked if you can seek an alternative source of care or make your way to hospital by alternate means," the statement on Facebook said.
The Independent understands at one point hundreds of calls were live - which triggered the major incident alert.
Read full story
Source: The Independent, 3 November 2020
 
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