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

Barnsley care agency 'recruitment procedures unsafe'

A care agency which left people "at risk of avoidable harm" by not ensuring staff had been properly trained has been put into special measures.
Stars Social Support, which provides personal care to people living in their own home, was inspected by the Care Quality Commission earlier this year.
Inspectors found safe recruitment procedures were not in place to make sure suitable staff were employed.
A report following the inspection states that "safe recruitment procedures were not in place to ensure only staff suitable to work in the caring profession were employed."
It said people's references had not been followed up after they had been requested, according to the Local Democracy Reporting Service. The report added: "When the disclosure and barring service (DBS) identified concerns, a risk assessment had not been completed to assess staff suitability."
Inspectors also found not all staff who provided care had received appropriate training or training updates to ensure they were competent.
Read full story
Source: BBC News, 21 November 2020
Patient Safety Learning

COVID-19: Oxford University vaccine is highly effective

The coronavirus vaccine developed by the University of Oxford is highly effective at stopping people developing COVID-19 symptoms, a large trial shows.
Interim data suggests 70% protection, but the researchers say the figure may be as high as 90% by tweaking the dose.
The results will be seen as a triumph, but come after Pfizer and Moderna vaccines showed 95% protection.
However, the Oxford jab is far cheaper, and is easier to store and get to every corner of the world than the other two.
So the vaccine will play a significant role in tackling the pandemic, if it is approved for use by regulators.
"The announcement today takes us another step closer to the time when we can use vaccines to bring an end to the devastation caused by [the virus]," said the vaccine's architect, Prof Sarah Gilbert.
Read full story
Source: BBC News, 23 November 2020
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NHS ‘workforce disaster’ threatens a million operations and could cost lives, royal college warns

More than a million patient operations could be delayed because of widespread shortages of anaesthetists in the NHS – with 9 out of every 10 hospitals reporting at least one vacancy.
As coronavirus paralysed the NHS earlier this year, more than 140,000 NHS patients have already waited over a year for treatment. 
The Health Foundation has warned that 4.7 million fewer patients have been referred for treatment because of the impact of coronavirus on NHS services.
The Royal College of Anaesthetists (RCOA) told The Independent the scale of the vacancies was getting worse and labelled it a “workforce disaster” that could cost patients’ lives and have a widespread impact on hospital services.
Read full story
Source: The Independent, 22 November 2020
Patient Safety Learning

Covid antibodies 'last at least six months'

Coronavirus antibodies last at least six months and offer protection against a second infection, a study of healthcare workers suggests.
Staff at Oxford University Hospitals were regularly tested both for COVID-19 infections and for antibodies revealing a past infection.
The more antibodies people had, the lower their chances of re-infection.
A separate study found pre-existing immunity from other coronaviruses also protected against Covid.
Infection consultant Dr Katie Jeffery described the Oxford findings as "encouraging news" ahead of forthcoming Covid vaccines.
They indicated that having the virus once "provides at least short-term protection" from getting it again, she said.
Read full story
Source: BBC News, 21 November 2020
Patient Safety Learning

NHS planning to start covid vaccination of under 50s by end of January

The NHS’ current plan for the covid vaccine rollout — dependent on the arrival of supplies — would see the whole adult population able to begin receiving it before the end of January, according to leaked documents seen by HSJ.
Under the plan, everyone who wants to would have been vaccinated by early April.
NHS England’s draft COVID-19 vaccine deployment programme, seen by HSJ,  reveals when each cohort is likely to begin receiving it, based on its plans to create huge capacity across GP-run facilities, “large scale mass vaccination sites”, NHS trusts, and “roving models” for those who cannot travel.
It relies on a range of assumptions including that there will be 75% takeup, outside of residential settings like care homes and prisons, where 100% is expected.
The plan also relies on supplies, including more than 7 million doses being available in December. It is not clear what impact a delay to this would have on the rollout. With most doses due to be administered between early January and  mid March — at a rate of 4-5 million every week — a small delay may not make a huge impact to the overall schedule.
The document is dated 13 November and was shared among some senior NHS regional leaders yesterday.
Read full story (paywalled)
Source: HSJ, 23 November 2020
Patient Safety Learning

Government welcomes MHRA review into vaccine candidates

News that the Medicines and Healthcare products Regulatory Agency (MHRA) will review the data from trials of one of the most promising COVID-19 vaccine candidates, to see whether it meets the agency’s robust standards of quality, safety and effectiveness, has been welcomed by the UK Government.
Initial data had shown the Pfizer/BioNTech vaccine is 94% effective in protecting people over 65 years of age from coronavirus, with no serious safety concerns having been raised during the clinical trials.
Already the UK Government has pre-ordered 40 million vaccine doses – enough to provide vaccinations for up to a third of the population – and is expected to receive the total amount by the end of 2021.
The majority of doses are anticipated to be received in the first half of next year. As well as successfully protecting those over the age of 65, trial data also showed that the vaccine candidate also performed equally well in people of all ages, races and ethnicities.
Approval from the MHRA, as the UK’s independent regulator, is required for the COVID-19 vaccine to be authorised for consistent manufacture and supply. To achieve this approval, it must demonstrate that it meets strict quality, safety and effectiveness standards set by the MHRA.
Business Secretary Alok Sharma added: “Today, we have renewed hope that we are on the brink of one of the most significant scientific discoveries of our time, as we reach the crucial last stage to finding a COVID-19 vaccine.
“While this news is a cause for celebration, we must make sure that this vaccine, like all new medicines, meets standards of quality, safety, and effectiveness."
Read full story
Source: National Health Executive, 24 November 2020
Sam

‘Long-COVID’ in our community – new call for research proposals

Up to £20 million is available for new research projects which aim to understand and address the longer-term physical and mental health effects of COVID-19 in non-hospitalised individuals. 
Increasing medical evidence and patient testimony has shown that some people who contract and survive COVID-19 may develop longer-lasting symptoms.
Symptoms can range from breathlessness, chronic fatigue, ‘brain fog’, anxiety and stress and can last for months after initially falling ill. 
These ongoing problems, commonly termed ‘Long-COVID’, may be experienced by patients regardless of how severe their COVID-19 infection was and irrespective of whether they were hospitalised.
UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) are launching a call to fund two or three ambitious and comprehensive proposals and a small number of study extensions that will address ‘Long-COVID’ in the community. 
This work will complement other major studies already funded by UKRI and NIHR which focus on long covid in hospitalised patients. Projects are expected to start early in the new year and may be funded for up to three years in the first instance.
The call will open on 12 November and close on 9 December 2020.
Further information
Sam

Staff at specialist care unit 'failed to give CPR'

Staff at a specialist care unit did not attempt to resuscitate a woman with epilepsy, learning difficulties and sleep apnoea when she was found unconscious, an inquest heard.
Joanna Bailey, 36, died at Cawston Park in Norfolk on 28 April 2018. Jurors heard she was found by a worker whose CPR training had expired, and the private hospital near Aylsham - which care for adults with complex needs - had been short-staffed that night.
Support worker Dan Turco told the coroner's court he went to check on Ms Bailey just after 03:00 BST and found she was not breathing and had blood around her mouth.
The inquest heard he went to get help from colleagues, including the nurse in charge, but no-one administered CPR until paramedics arrived. 
It was heard Mr Turco's CPR training had lapsed in the weeks before Ms Bailey died, unbeknown to him.
Mr Turco said he had since received training and has had his first aid qualifications updated.
Cawston Park, run by the Jeesal Group, a provider of complex care services within the UK, is currently rated as "requires improvement" by the Care Quality Commission.
Read full story
Source: BBC News, 23 November 2020
Sam

Trans boy takes NHS to court over delays to gender identity treatment

A transgender boy is taking NHS England to court over delays in accessing gender identity treatment.
The 14-year-old, who was referred to the UK’s only youth gender identity clinic in October 2019, has been told he may have to wait at least another year to be seen.
He said he was experiencing “fear and terror” while he waits for treatment.
Young people are currently facing “extensive waits” to see a therapist, with the average delay being 18 months or more, according to the Good Law Project, which is representing the boy.
The not-for-profit organisation said the health service was legally required to ensure patients referred to gender identity development services (GIDS) are seen within 18 weeks.
Gender clinics for adults across the country have reported similar delays, with the Devon Partnership NHS Trust reporting “lengthy waiting times” while the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust said patients were facing delays “in excess of 32 months” for an initial appointment and 62 months from referral to treatment.
Trusts have blamed a surge in demand as well as reduced capacity, including staffing problems.
The teenager involved in the case said in a statement: “The length of the NHS waiting list means the treatments which are essential for my well being are not available to me."
“By the time I get to the top of the list it will be too late, and in the meantime I suffer the fear and terror that gender dysphoria causes, every day.”
Read full story
Source: The Independent, 23 November 2020
Sam

Hancock calls for routine flu testing as part of major diagnostics expansion

Matt Hancock has called for British people to routinely get tested for the flu, saying covid diagnostic capacity should be kept and used for “everything” once the pandemic dies down.
Speaking at the Commons health and social care committee this morning, the health and social care secretary said the nation “must hold on to” the mass diagnostic capacity it has created for coronavirus.
Going further, he called for a change in culture to one of “if in doubt, you get a test”, and for a long-term expansion of diagnostics.
Mr Hancock said: “Why in Britain do we think it’s acceptable to solider on when you have flu symptoms or a runny nose, and go in [to work] and make everyone ill?
“If you have flu-like symptoms you should have a test for it and find out what is wrong with you and stay at home. We are peculiar outliers in soldiering on and going to work and that… culture, that should change.”
Read full story (paywalled)
Source: HSJ, 24 November 2020
Patient Safety Learning

Jeremy Hunt criticises children’s hospital over ‘cover up’ case

Former health secretary and chair of the Commons health committee Jeremy Hunt has criticised Great Ormond Street Hospital after it was accused of covering up errors that may have led to the death of a toddler.
Writing for The Independent, Mr Hunt, who has set up a patient safety charity since leaving government, said it was “depressing” to see how the hospital had responded to the case of Jasmine Hughes, which has now been taken to the Parliamentary Health Service Ombudsman for a new investigation.
Mr Hunt said the hospital had chosen to issue a “classic non-apology apology of which any politician would be proud” and added he was left angry over the hospital’s “ridiculous decision” to stop talking to Jasmine’s family and the refusal to apologise for what went wrong.
The MP for South West Surrey said the case was symbolic of a wider problem in the health service of a blame culture that prevents openness and transparency around mistakes.
Read full story
Source: The Independent, 24 November 2020
Patient Safety Learning

Hospital staff likely to get covid vaccine first

Hospital trusts have been put on notice that the challenging storage requirements of the first covid vaccines are likely to mean the vaccination of their staff will have to form the vanguard of the planned roll-out next month due.
HSJ reported last week that healthcare staff would share priority with “care home residents and staff” in the vaccine roll-out. 
However, a letter sent to trust chief executives by NHS England seeks to clarify the situation by stressing that “different vaccines are likely to be better suited to different settings because the vaccines are likely to have different storage, reconstitution and administration requirements”. 
“Given what we currently know about the first expected vaccine, the imperative is that NHS trusts are ready to start vaccinating from the beginning of December.” 
Trusts are one of several components of the vaccination programme that includes primary care-run sites, mass vaccination centres, and “roving” visits to those who need them. Local systems and regional teams will decide “the most appropriate combination of models required to deliver the vaccine to their local populations based on local needs” the letter says. However, during the early stages of the roll-out this is likely to be dictated by the vaccine types that become available.
Read full story (paywalled)
Source: HSJ, 25 November 2020
Patient Safety Learning

The battle for survival in Britain's intensive care units

Across Britain, intensive care nurses and doctors are being pushed to their limits as they try to save lives from coronavirus. During 12-hour shifts in sweltering conditions, they are faced with technical and emotional challenges that many have never faced as they tackle a virus that has swept across the globe in a matter of days, threatening to kill tens of thousands in the UK.
Britain has yet to even hit the peak of infections, but intensive care specialists are already asking how long they can keep working relentlessly.
“We are trained for and used to dealing with difficult and emotional scenarios, but this is like a major incident that never ends,” says critical care nurse Karin Gerber.
As an advanced nurse practitioner in critical care outreach, the 47-year-old sees patients in hospital who are getting sicker and may need to be admitted to intensive care. She says she has never seen anything “at this intensity”.
The Royal London Hospital is at the forefront of the capital’s fight against the virus and has created more than 200 extra beds at its Whitechapel site in east London. They are filled with COVID-19 patients.
Simon Richards, senior charge nurse at the Royal London’s critical care unit, tells The Independent: “In 20 years as a nurse this situation is by far the worst I have ever seen and totally unexpected, but the team spirit that people have shown has been amazing.
“It’s extremely difficult, we are working so hard. The whole team is being pushed to their limit and you do wonder how long can this be sustained for? I wish we could see light at the end of the tunnel.”
Read full story
Source: The Independent, 24 November 2020
 
Patient Safety Learning

Dido Harding to speak tomorrow (Thursday) at HSJ provider summit

NHS Test and Trace chief Baroness Dido Harding will be interviewed by HSJ editor Alastair McLellan at 9am tomorrow  as part of HSJ’s virtual provider summit.
HSJ’s subscribers working in the NHS or a non-profit organisation can register to attend the summit here.
Other speakers will include new Health Education England chief executive Navina Evans and King’s Fund chief executive Richard Murray. The subjects due to be covered include how the NHS will tackle the drive to recover routine care, the service’s workforce challenges and how forthcoming legislation may impact the governance of the service.
Full details of the programme can be seen here.
Patient Safety Learning

Long Covid: How knowledge of ME could help sufferers

While both ME and long Covid, or post-Covid syndrome, are long-term illnesses, they aren’t the same thing. But, there are ways in which our knowledge of ME has helped experts treat long Covid. It’s also helped those with the illness understand what they’re going through. Evan was diagnosed with ME in 2017, and she believes her experience can help her support those living with long Covid.
Watch video
Source: BBC News, 26 November 2020
Patient Safety Learning

111 First to go live imminently amid ‘vehement’ opposition in some EDs

Emergency care leaders are warning it will take up to six more months to determine whether pilots of a radical change to accident and emergency are working, even though it is due to go live nationally next week, HSJ  has learned.
HSJ understands the new “111 First” system — where walk-in patients not in medical emergencies call 111 to “book” urgent care — is set to “go live” across England from next week following pilots in acute trusts which have been run since the summer.
From 1 December, people will be able to call NHS 111 from anywhere in the country and have urgent care “booked” for them if needed, it is understood. NHS England has been pursuing the 111 First model to help reduce overcrowding and the risk of nosocomial infections in A&Es. The service is also intended to be able to book them into GP practice appointments.
Well-placed sources confirmed most acute trusts have now implemented some form of 111 First and the model is set to be part of their standard operations when the national system “goes live” next week. A national advertising campaign is expected to promote the approach.
But the Royal College of Emergency Care Medicine said there was a “vocal minority” of clinicians who are “vehemently against” 111 First as they believe it will increase demand in emergency departments.
Read full story (paywalled)
Source: HSJ, 25 November 2020
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