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

Older women ‘less likely’ to be offered ovarian cancer treatment

Older women could be less likely to receive ovarian cancer treatment.
A new report analysed data from more than 17,000 cases of ovarian cancer diagnosed across England between 2016 and 2018. Three in five (60%) of women with ovarian cancer over the age of 79 did not receive either chemotherapy or surgery, while 37% of women over the age of 70 did not receive any treatment.
The nature of ovarian cancer means surgery is essential in the large majority of cases to remove the tumour.
The researchers cautioned that with an ageing population it is vital that women of all ages have access to the best possible treatments.
Researchers also examined the various rates of treatments for ovarian cancer among women in different parts of England.
They found the probability of receiving any treatment fell below the average in the East Midlands, the East of England, Greater Manchester and Kent and Medway.
The report was jointly funded by The British Gynaecological Cancer Society, Ovarian Cancer Action, Target Ovarian Cancer and delivered by analysts at the National Cancer Registration and Analysis Service.
Commenting on the report, Cary Wakefield, chief executive of Ovarian Cancer Action, said: "Neither your age nor location should decide your chance of survival if you are diagnosed with ovarian cancer."
"Our audit is the first step in addressing the health inequalities women across England face, so we can begin to dismantle them."
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Source: The Independent, 11 November 2020
Patient Safety Learning

Coronavirus: Seven in 10 hospital patients suffer from long COVID for weeks after discharge

Study finds 54 days after discharge, 69% of patients still had fatigue, and 53% were suffering from persistent breathlessness.
Almost seven out of 10 patients hospitalised due to coronavirus still suffer from debilitating symptoms more than seven weeks after being discharged, according to a new study.
Researchers from the University College London (UCL) division of medicine, in collaboration with with clinicians at the Royal Free London (RFL) and UCL, followed 384 patients who had tested positive and had been treated at Barnet Hospital, the Royal Free Hospital or UCLH. Collectively the average length of stay in hospital was 6.5 days.
The team found that 54 days after discharge, 69% of patients were still experiencing fatigue, and 53% were suffering from persistent breathlessness. They also found that 34% still had a cough and 15% reported depression. In addition 38% of chest radiographs (X-rays) remained abnormal and 9% were getting worse.
Dr Swapna Mandal, an honorary clinical associate professor at UCL division of medicine, said the data shows so-called long COVID is a real phenomenon and that further research is needed to understand how the symptoms of COVID-19 can be treated over an extended period. She said: "Patients whose COVID-19 illness is serious enough for them to require hospital care often continue to suffer significant symptoms for many weeks after their discharge."
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Source: Sky News, 11 November 2020
Clive Flashman

Eating disorders to be tackled with early intervention treatment amid pandemic rise

A new NHS treatment programme targeting young people with eating disorders has been launched amid a rise in numbers needing treatment during the coronavirus pandemic.
Recent NHS data showed record numbers of children and young people are currently being treated across England for eating disorders while waiting times in some places are dangerously long.
On Monday, children’s charity NSPCC warned that counselling sessions for eating and body image disorders rose by 32% after lockdown was introduced in March. The new scaling up of intervention services for those with eating disorders such as anorexia and bulimia will mean young people can gain access to rapid specialist NHS treatment across England.
The service will be rolled out to 18 sites, building on a successful trial model at King's College London, where one patient described the treatment as the “gold standard” of care.
Nadine Dorries, Minister for Health, said: “Eating disorders can have a devastating impact on individuals and their families – and can very sadly be fatal. I am committed to ensuring young people have access to the services and treatment they need which can ultimately save lives."
Read full story
Source: The Independent, 10 November 2020
Patient Safety Learning

Fatigue syndrome exercise therapy loses NICE recommendation

A controversial exercise technique used to manage chronic fatigue syndrome is no longer being recommended by National Institute for Health and Care Excellence (Nice).
The decision to stop recommending graded exercise therapy (GET) – which involves incremental increases in physical activity to gradually build up tolerance – represents a crucial win for patient advocates who have long said the practice causes more harm than good.
Patient groups have argued that the use of exercise therapy suggests that those with chronic fatigue syndrome (also known as ME) have no underlying physical problem but are suffering symptoms due to inactivity.
“We have been so widely dismissed and had our suffering at the hands of this condition constantly diminished by the inappropriate and damaging guidance/notion that we can simply exercise or think our way out of a physical illness none of us asked for nor deserve,” said ME patient Glen Buchanan.
Chronic fatigue syndrome is thought to affect about 250,000 people in the UK and has been estimated to cost the economy billions of pounds annually. One in four are so severely affected they are unable to leave the house and, frequently, even their bed.
Read full story
Source: The Guardian, 10 November 2020
Patient Safety Learning

Nurse gaps must be considered in NHS winter planning, warns RCN

Planning around what the NHS can deliver this winter must be based on how many nursing staff are available and the workload they can safely take on, the Royal College of Nursing (RCN) has warned.
Amid widespread nursing shortages, the union has called on the government to “be honest” about nurse vacancies and address what steps need to be taken to keep staff and patients safe.
“It is essential that learning is applied to planning for this winter, including what service can be delivered safely with the workforce available”
Last week NHS England moved to its highest level of emergency preparedness. But the RCN warned it still had grave concerns around how services would be safely staffed, claiming it was too late to find the nurses needed to meet the anticipated demands of the incoming winter.
Despite an increase in the number of nurses registered with the Nursing and Midwifery Council this year, the college said there were still around 40,000 nurse vacancies in the NHS in England alone.
These shortages, which were felt across all areas of nursing, had been exacerbated because of staff self-isolating or being off sick because of COVID-19, the RCN noted.
The impacts of workforce shortages meant there was “enormous responsibility” on the nurses working and “intolerable pressure” on senior nursing leaders, it said. Unless local staffing plans prioritised safe and high-quality care, the few nurses in post were at risk of “burn out” this winter, the college added.
Read full story (paywalled)
Source: Nursing Times, 9 November 2020
Patient Safety Learning

Author of gov review forms group to fight ‘woeful’ DHSC response

A Tory peer has attacked the Department of Health and Social Care’s ‘woeful’ response to the patient safety review she authored and has revealed she intends to create a cross-party group to force action.
Baroness Julia Cumberlege - who led the “First Do No Harm” report on device and medicine safety– has said she has “not had a whisper” from the department over the report’s key recommendations since it was published in July.
She told HSJ’s Patient Safety Congress she is setting up a cross-party parliamentary group to “pressure” the department to adopt the report’s recommendations.
The report arose from The Independent Medicines and Medical Devices Safety Review, which spoke to more than 700 people, mostly women, who suffered avoidable harm from surgical mesh implants, pregnancy tests and the anti-epileptic drug sodium valproate.
The report discovered “a culture of dismissive and arrogant attitudes” including the unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. It concluded that the NHS has “either lost sight of the interests of all those it was set up to serve or does not know how best to do this.”
Health and social care secretary Matt Hancock and minister Nadine Dorries have apologised to the women who were harmed but the department has so far not responded to the report’s other eight recommendations in detail.
Baroness Cumberlege said the cross party group would “[try] to open up a firmly shut departmental door. A department that doesn’t seem to get it.” She said: “We have been disappointed [in the department’s response] because we hoped by now we would have some sort of inclination about what’s going on."
“The response from the department on the other key recommendations has been woeful. The reason they give is ‘there is a terrible amount of work to do’”.
Read full story (paywalled)
Source: HSJ, 11 November 2020
Patient Safety Learning

Russian Covid vaccine shows encouraging results

Early results from trials of a Covid vaccine developed in Russia suggest it could be 92% effective.
The data is based on 20 cases of COVID-19 from 16,000 volunteers given the Sputnik V vaccine or a dummy injection.
While some scientists welcomed the news, others said the data had been rushed out too early. It comes after Pfizer and BioNTech said their vaccine could prevent 90% of people getting Covid-19, based on a study of 43,500 people.
Although the Sputnik data is based on fewer people being vaccinated and fewer cases of Covid developing during the trial, it does confirm promising results from earlier research.
The Sputnik V vaccine, developed at the National Research Centre for Epidemiology and Microbiology in Moscow, is currently going through phase III clinical trials in Belarus, UAE, Venezuela and India.
So far there are no safety issues, with Russian researchers saying there were "no unexpected adverse events" 21 days after volunteers received their first of two injections.
Read full story
Source: BBC News, 11 November 2020
Patient Safety Learning

Nurse Lucy Letby charged with murder after Chester hospital baby deaths

A nurse is due in court charged with eight counts of murder following an investigation into baby deaths at the Countess of Chester hospital neonatal unit in Cheshire.
Lucy Letby, 30, is due to appear at Warrington magistrates court on Thursday. She was arrested for a third time on Tuesday as part of the investigation into the hospital, which began in 2017.
A force spokesman said: “The Crown Prosecution Service has authorised Cheshire police to charge a healthcare professional with murder in connection with an ongoing investigation into a number of baby deaths at the Countess of Chester hospital.”
He said Letby was facing eight charges of murder and 10 charges of attempted murder relating to the period from June 2015 to June 2016.
On Tuesday, police said parents of all the babies involved were being kept fully updated on developments and were being supported by officers.
Read full story
Source: The Guardian, 11 November 2020
Patient Safety Learning

Cluster of never events has sparked ‘great deal of soul searching’ says trust CEO

An acute trust’s record of eight never events in the last six months has raised concerns that quality standards have slipped since it was taken out of special measures.
The never events occurred at Royal Cornwall Hospitals Trust. They included three wrong site surgeries within the same speciality and an extremely rare incident in which a 30cm (15 inch) wire was left in a cardiology patient.
Kate Shields, chief executive of the trust, said the incidents have led to a “great deal of soul searching”.
Prior to the incidents the trust had gone 13 months without recording a never event, and Ms Shield acknowledged that pressure created by the pandemic was likely to have been a contributing factor behind the cluster of never events.
She stressed that none of the patients affected had suffered physical harm.
Read full story (paywalled)
Source: HSJ, 12 November 2020
Patient Safety Learning

Covid patients ‘head to toe’ on trolleys in A&E spark warnings over ‘lethal’ situation

Patients, including those with the coronavirus, are being kept “head to toe” on trolleys in accident and emergency departments in Manchester, with some forced to wait up to 40 hours for a bed.
The “dangerous” situation has sparked warnings from the president of the Royal College of Emergency Medicine over the “potentially lethal” crowding of patients in A&Es across the country this winter. 
Katherine Henderson said she was “absolutely terrified” by what was happening in some departments. She said she had warned NHS England about the dangers of crowding patients in A&E but that not enough action had been taken.
She told The Independent: “Crowding in A&E is unsafe, but with coronavirus it is potentially lethal. We have said this endlessly to NHS England."
“Everyone agrees crowding is bad, but what they’re not doing is translating that into action.”
After hearing of the situation in Manchester, she added: “Exactly what we said should not happen is happening. I am absolutely terrified by this. What more can I do? I have highlighted this risk everywhere I can over the past few months.”
Read full story
Source: The Independent, 11 November 2020
Patient Safety Learning

Royal College review warned trust of ‘very significant risk for patient care’

A community trust was told to urgently review prescribing of stimulant medications for children after concern that some were posted to families but never arrived.
Bridgewater Community Healthcare Foundation Trust was told that sending prescriptions through the post may be a potentially unsafe practice by the Royal College of Paediatrics and Child Health. The warning came in a report from the college after it was invited by the trust to review its community paediatrics service
The trust was urged to work with primary care and clinical commissioning groups to establish shared care for children who needed these medications. Stimulant medicines are often used for children with attention deficit hyperactivity disorder.
The review also found there was a “a very significant risk for patient care” with letters, reports and prescriptions being delayed or going missing due to “recurrent issues” with the post in the building used by the team covering St Helen’s.
It highlighted issues with the safeguarding procedures at the trust, with each locality team having its own processes and handling a small number of cases, and called for urgent work to streamline services.
Read full story (paywalled)
Source: HSJ, 11 November 2020
Patient Safety Learning

Ambulances waiting up to five hours as SE trust feels covid pressure

A trust in the south east is coming under increasing pressure from a growing number of covid patients, leading to long delays in ambulance handovers.
HSJ has been told that ambulances have been waiting up to five hours to hand over patients at Medway Foundation Trust, which has around 90 covid patients. 
The trust is currently continuing with elective work but covid patients are taking up close to 20% of its beds. Sources have told HSJ that bed occupancy at the trust is already very high – with a high proportion of acutely ill patients - and there are issues with discharging patients into nursing homes which is affecting the ability to admit patients swiftly through A&E.
Read full story (paywalled)
Source: HSJ, 11 November 2020
Patient Safety Learning

DHSC review ‘compounded mother’s suffering’, concludes watchdog

The Department of Health and Social Care (DHSC) has been criticised by the national health ombudsman for the ‘maladministration’ of a 2018 review into the death of a teenage girl under the care of one of England’s top specialist hospitals, HSJ can reveal.
The Parliamentary and Health Service Ombudsman (PHSO) came to the conclusion after investigating a DHSC review into the 1996 death of 17-year-old Krista Ocloo which had been requested by her mother.
Krista died at home of acute heart failure in December 1996. She had been admitted to the Royal Brompton Hospital with chest pains in January of that year. The PHSO report states her mother was told “there was no cause for concern” and that another appointment would be scheduled in six months. This follow-up appointment did not happen.
The young woman’s death was considered by the hospital’s complaints process, an independent panel review and an inquiry into the hospital’s paediatric cardiac services. They concluded the doctor involved was not responsible for Krista’s death – though the paediatric services inquiry criticised the hospital for poor communication. A coroner declined to open an inquest into the case.
Civil action against the hospital, brought by Ms Ocloo, found Krista’s death could not have been prevented. However, a High Court judge found that the failure to arrange appropriate follow-up by the RBH was “negligent”.
A spokeswoman for PHSO said: “Our investigation found maladministration by the Department for Health and Social Care, which should have been more transparent in its communication. The department’s failure to be open and clear compounded the suffering of a parent who was already grieving the loss of her child.”
A DHSC spokeswoman said: “We profoundly regret any distress caused to Ms Ocloo.
“[The PHSO] report found that in communicating with Ms Ocloo the department’s actions were – in places – not consistent with relevant guidance. The department has writen to Ms Ocloo to apologise for this and provide further information about the review.”
Read full story (paywalled)
Source: HSJ, 12 November 2020
Sam

Coronavirus: Year-long waits for hospital care in England worst since 2008

The number of people waiting over a year for hospital treatment in England has hit its highest levels since 2008.
Patients are meant to be seen within 18 weeks - but nearly 140,000 of the 4.35 million on the waiting list at the end of September had waited over a year.
Surgeons said it was "tragic" patients were being left in pain while they waited for treatment, including knee and hip operations.
And others warned the situation could become even worse during winter.
In recent weeks, major hospitals in Bradford, Leeds, Nottingham, Birmingham and Liverpool, which have seen high rates of infection, have announced the mass cancellation of non-urgent work.
Read full story
Source: BBC News, 12 November 2020
Sam

Covid deaths for people with learning disability in England six times average

People with learning disabilities are dying of coronavirus at more than six times the rate of the general population, according to “deeply troubling” figures that have prompted a government review.
A report from Public Health England (PHE) found that 451 in every 100,000 people registered as having learning disabilities died after contracting Covid-19 in the first wave of the pandemic, when the figures were adjusted for age and sex.
Because not all Covid deaths among people with learning disabilities are registered as such, the true figure is likely to be 692 in every 100,000, or 6.3 times the UK average, the report estimated.
Campaigners said the figures showed the government had failed to protect the most vulnerable.
The report found that Covid deaths among those with learning disabilities were also more widely spread across age groups, with far greater mortality rates among younger adults. Those aged 18-34 were 30 times more likely to die with the virus than their counterparts in the general population.
The higher death rate is likely to reflect the greater prevalence of health problems such as diabetes and obesity among those with learning disabilities, the report said. It also noted that some learning disabilities, such as Down’s syndrome, can make people more vulnerable to respiratory infections.
People with learning disabilities are also likely to have difficulty recognising symptoms and following advice on testing, social distancing and infection prevention, the report said. It may also be harder for those caring for them to recognise symptoms if these cannot be communicated, it added.
Read full story
Source: The Guardian, 12 November 2020
Patient Safety Learning

Black and Asian people ‘up to twice as likely to be infected with Covid’

Black and Asian people are up to twice as likely to be infected with COVID-19 compared to those of white ethnicities, according to a major new report.
The risk of ending up in intensive care with coronavirus may be twice as high for people with an Asian background compared to white people, data gathered from more than 18 million individuals in 50 studies across the UK and US also suggests.
The report, published in the EClinicalMedicine by The Lancet, is the first-ever meta-analysis of the effect of ethnicity on patients with COVID-19.
The scientists behind it said their findings should be of "importance to policymakers" ahead of the possible roll out of a vaccine.
Read full story
Source: The Independent, 12 November 2020
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