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

NHS calls for ban on toy neodymium magnets amid child safety fears

An online trend that involves using tiny magnets as fake tongue piercings has led the NHS to call for them to be banned amid people swallowing them.
Ingesting more than one of them can be life-threatening and cause significant damage within hours.
In England, 65 children have required urgent surgery after swallowing magnets in the last three years.
The NHS issued a patient safety alert earlier this month and is now calling for the small metal balls to be banned.
It said the "neodymium or 'super strong' rare-earth magnets are sold as toys, decorative items and fake piercings, and are becoming increasingly popular". It added that unlike traditional ones, "these 'super strong' magnets are small in volume but powerful in magnetism and easily swallowed".
The online trend sees people placing two such magnets on either side of their tongue to create the illusion that the supposed piercing is real.
But when accidentally swallowed, the small magnetic ball bearings are forced together in the intestines or bowels, squeezing the tissue so that the blood supply is cut off.
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Source: BBC News, 30 May 2021
Sam

Patients were sent back to care homes without Covid test despite bosses’ plea

Thousands of hospital patients were allowed to return to their care homes without a Covid test despite a direct plea to the government from major care providers not to allow the practice, the Observer has been told.
As the crisis began to unfold in early March 2020, providers held an emergency meeting with department of health officials in which they urged the government not to force them to accept untested residents. However, weeks later, official advice remained that tests were not mandatory and thousands of residents are thought to have returned to their homes without a negative Covid result.
The revelation will heap further pressure on the health secretary, Matt Hancock, who has admitted some care residents returned from hospital without a test. It comes after Dominic Cummings, the prime minister’s former senior adviser, last week accused Hancock of misleading the prime minister over the policy, during his unprecedented evidence in parliament.
Some 25,000 people were discharged to care homes between 17 March and 15 April, and there is widespread belief among social care workers and leaders that this allowed the virus to get into the homes.
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Source: The Guardian, 29 May 2021
Sam

NHS Scotland Assure: New service for healthcare facilities

A new national service has been established to improve the quality and management of healthcare construction and refurbishment projects across NHS Scotland.
NHS Scotland Assure brings together experts to improve quality and support the design, construction and maintenance of major healthcare developments. This world first interdisciplinary team will include microbiologists, infection prevention and control nurses, architects, planners, and engineers.
Commissioned by the Scottish Government and established by NHS National Services Scotland, the service will work with Health Boards to ensure healthcare buildings are designed with infection prevention and control practice in mind, protecting patients and improving safety.
Cabinet Secretary for Health and Social Care Humza Yousaf said:
“NHS Scotland Assure will support a culture of collaboration and transparency to provide the reassurance patients and their families deserve to feel safe in our hospitals. This service is unique to Scotland and is leading the way in risk and quality management across healthcare facilities.
“With services designed with patients in mind, we can make a real, positive difference to people’s lives.”
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Source: Scottish Government, 1 June 2021
Sam

Injured patient left in urine-soaked bed sheets and labelled ‘lazy’ by nurses after botched surgery

A second “mutilated” patient left with life-changing injuries after botched hospital surgery has described how she was left in urine-soaked bed sheets for days by nurses who called her lazy when she was unable to get out of bed.
Lucy Wilson told The Independent she believes she would have been better looked after at a veterinary practice compared to the level of care she received from nurses at Norfolk and Norwich Hospital Trust in January last year.
She was one of three patients harmed by surgeon Camilo Valero in the same week and almost died after Dr Valero and other staff failed to recognise her life-threatening injuries following the operation to remove her gall bladder.
Dr Valero is under investigation by the General Medical Council but is still practising under supervision at the trust, which has refused to say whether the third patient survived their ordeal.
After requests by The Independent, bosses at the NHS trust have now committed to publishing details of a secret review carried out by the Royal College of Surgeons into Dr Valero’s work and the wider surgical services at the trust.
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Source: The Independent, 31 May 2021
Sam

Major trust faces bullying concerns from hundreds of senior doctors

Concerns over bullying and discrimination have been raised in a survey of hundreds of doctors at a major hospital trust, HSJ  can reveal.
University Hospitals of North Midlands Trust’s medical staff committee carried out a survey of its doctors earlier this year, after bullying concerns were raised by members of the British Association of Physicians of Indian Origin at the trust.
A summary of the survey findings, published in a newsletter sent to all doctors at the trust last week and seen by HSJ, showed more than two-thirds of the 348 respondents claimed to have experienced bullying, harassment or victimisation at work. Nearly 80% said they had witnessed bullying or harassment, while 50 per cent of respondents said the bullying and harassment was due to race or ethnicity.
Fifty-five per cent of those answering the survey also said they had not reported concerns as they had “no confidence in the investigative process within the organisation”.
Read full story (paywalled)
Source: HSJ, 2 June 2021
Patient Safety Learning

Ambulance crews in England to get body cameras after 30% rise in assaults

Thousands of ambulance crews in England will be given body cameras after a sharp rise in attacks on NHS staff treating patients, the government has announced. Data shows that 3,569 ambulance staff were physically assaulted by members of the public last year – 30% more than in 2016-17.
The plans come after successful trials in London and the north-east. The cameras will be given to crews in 10 ambulance trusts across the country. Medics will wear the cameras and be able to press a button to start recording if patients or the public become aggressive or abusive, and the film will be given to the police where needed.
Prerana Issar, the chief people officer for the NHS, said: “Every member of our dedicated and hardworking NHS staff has the fundamental right to be safe at work and it is our priority to eliminate violence and abuse, which we will not tolerate. As well as reducing the number of incidents towards our staff, these cameras are a vital step towards ensuring our people feel safe too.”
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Source: The Guardian, 2 June 2021
Patient Safety Learning

UK rights watchdog endorses compulsory Covid jabs for care home staff

The prospect of care home workers being required to get vaccinated against COVID-19 has moved a step closer, with a crucial endorsement from the UK’s human rights watchdog.
Ministers are considering changing the law to make vaccination a condition of deployment for people in some professions that come into regular close contact with elderly and vulnerable people at high risk from the coronavirus.
In a report to the government seen by the Guardian, the Equality and Human Rights Commission (EHRC) admitted that making vaccines compulsory for care home staff would be a “significant departure from current public health policy”.
But they judged that ministers were “right to prioritise protection of the right to life for residents and staff” and said it would be reasonable for care home workers to need a jab “in order to work directly with older and disabled people, subject to some important safeguards”.
The EHRC is also likely to make a similar recommendation about healthcare workers, after the vaccines minister, Nadhim Zahawi, suggested over the weekend that NHS staff could face mandatory jabs, too, as some patients were “being infected in hospital”.
Zahawi said no decisions had been made yet, and stressed there was a precedent: surgeons were required to be vaccinated against hepatitis B. He added: “It would be incumbent on any responsible government to have the debate, to do the thinking about how we go about protecting the most vulnerable by making sure that those who look after them are vaccinated.”
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Source: The Guardian, 2 June 2021
Patient Safety Learning

Annual checks can lengthen life

A group set-up following the Winterbourne View scandal is urging more people with learning disabilities to attend their annual health check-up.
Healthwatch South Gloucestershire said regular health checks could prevent people from dying unnecessarily.
It formed after BBC Panorama exposed abuse of patients at Winterbourne View hospital 10 years ago. Only about 36% of people with learning difficulties are believed to have an annual GP health check-up.
The Local Democracy Reporting Service (LDRS). said the lack of regular, medical observations contributed to them having a life expectancy of 20 years lower than in the wider population.
Healthwatch South Gloucestershire, a regional, independent health and social care champion, has created a checklist to encourage more people to attend appointments to help them improve their life expectancy.
Vicky Marriott from the group said: "It is our unrelenting mission to listen and share people's lived experience so that the information informs how health and social care services improve.
"We recently listened to people with learning disabilities and their families and developed with them an accessible info-sheet packed full of easy-to-read explanations about the lifesaving benefits of annual health checks."
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Source: BBC News, 1 June 2021
Patient Safety Learning

NHS mix-up led to female patient having unnecessary cervical examination

A woman was subjected to an unnecessary invasive procedure in an NHS outpatient clinic after she was confused for another patient, a safety watchdog has found.
The Healthcare Safety Investigation Branch has called for a review of how the NHS can avoid the mishap happening again after investigating the case of a 39-year-old woman who was subjected to an unnecessary cervical examination.
HSIB said a better system was needed as the number of outpatient appointments has increased from 54 million to 94 million during the last 10 years with many clinics carrying out more invasive procedures.
According to its latest investigation, the female patient was attending a gynaecological outpatient clinic for a fertility treatment assessment.
The error happened when she was called through from the waiting room as another patient had a similar sounding name.
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Source: The Independent, 2 June 2021
Sam

‘Secretive’ safety findings set to be revealed direct to CQC

The Care Quality Commission may in future be notified when ‘secretive’ external reviews have looked at patient safety issues within trusts.
Last summer, HSJ revealed guidance for trusts to publish summaries of royal colleges’ reviews was being widely ignored, with some even failing to inform the CQC.
A recent BBC Panorama programme has again raised the issue, with Academy of Medical Royal Colleges chair Helen Stokes-Lampard saying she was “dismayed” the body’s guidance was not being followed.
But she has now told HSJ of “advanced discussions” with the CQC about changes which would see the royal colleges routinely inform the regulator when reviews raise patient safety issues.
Read full story (paywalled)
Source: HSJ, 3 June 2021
Sam

COVID-19: Health staff in plea for better protection

More than 20 healthcare organisations, including those representing nurses, doctors, surgeons and therapists, are calling for stricter UK guidelines to be introduced on face masks and other personal protective equipment (PPE).
In a virtual meeting with officials, they will say existing rules leave them vulnerable to infection through the air, especially by new Covid variants.
The unprecedented appeal will see them argue that other countries, such as the United States, protect their health workers with higher-grade equipment.
It is thought to be the first time health and care organisations have united on a single issue in this way - a sign of the desperation many feel about the need for staff to be kept safe.
The delegation will include representatives of the British Medical Association, the Royal College of Nursing and many other professional organisations and unions.
On the government side will be about 20 of the most senior officials from all four UK nations, many involved in setting the guidelines on personal protective equipment (PPE).
Read full story
Source: BBC News, 3 June 2021
Sam

‘Devastating, tragic, and deadly’: VA leaders in Arkansas allowed impaired pathologist to harm hundreds of veterans, watchdog finds

Oversight failures, a fearful workplace culture and lax quality standards for years at a Veterans Affairs hospital in Arkansas, USA, allowed a pathologist who was routinely drunk on the job to misdiagnose thousands of veterans — sometimes with dire or deadly consequences, a new investigation has found.
Hospital leaders “failed to promote a culture of accountability” that would have led more of the doctor’s colleagues to come forward with accounts that his behavior was putting patients at risk, according to the report released Wednesday by VA’s Office of Inspector General. But the staff members at the Veterans Health Care System of the Ozarks in Fayetteville feared that reporting their concerns would lead to retaliation from their bosses.
“Any one of these breakdowns could cause harmful results,” Inspector General Michael Missal’s staff wrote in an 86-page report about the failures to stop the pathologist, Robert Morris Levy. “Together and over an extended period of time, the consequences were devastating, tragic, and deadly.”
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Source: The Washington Post, 2 June 2021
Sam

Self-harm in over-65s ‘needs post-pandemic focus’

Self-harm among the over-65s must receive greater focus because of the increased risks associated with the pandemic, a leading expert has said.
Loneliness, bereavement and reluctance to access GPs can all be causes in older adults, said Prof Nav Kapur, who has produced guidelines on the subject.
He warned that in over-65s, without the right help, self-harm can also be a predictor of later suicide attempts.
The NHS's mental health director said it had expanded its community support.
Claire Murdoch added that its services, including face-to-face appointments, had "continued for all who needed them", and 24/7 crisis lines had been established.
Over-65s are hospitalised more than 5,000 times a year in England because of self-harm and self-poisoning, figures obtained from NHS Digital show.
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Source: BBC News, 3 June 2021
Sam

Longer GP consultations could help prevent cases where patient deterioration is missed, study finds

Patients who had longer consultations with their GP were less likely to subsequently self-refer themselves to hospital due to a worsening of their condition, a study has found.
The study, which looked at factors associated with potentially missed acute deterioration, said this might be because GPs with more time to assess patients ‘are more likely to recognise deterioration and refer the patient for secondary care’.
A longer consultation might also allow GPs more time to provide advice, such as telling the patient to contact the practice again if their condition worsens, the British Journal of General Practice study found.
The researchers defined a potentially missed acute deterioration as a patient having a self-referred admission to hospital after being seen by a GP in the three days beforehand.
They found that 116,097 patients had contacted a GP three days before an emergency admission, with patients with sepsis or urinary tract infections more likely to self-refer.
GP appointment duration was associated with self-referral, with a five-minute increase in appointment time resulting in a 10% decrease on average in the odds of self-referred admissions.
Patients having a telephone consultation compared with face-to-face, previous health service use, and the presence of comorbidities were all also associated with self-referred admission, according to the research.
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Source: Management in Practice, 2 June 2021
Patient Safety Learning

Nearly 400,000 people still have long Covid a year after initial infection, new stats show

The number of people suffering from symptoms of long covid more than a year after their initial Coronavirus infection has jumped to almost 400,000.
New data from the Office for National Statistics based on a survey of patients found the numbers of patients with persistent symptoms after 12 months jumped from 70,000 in March to 376,000 in May.
Overall, the ONS said an estimated one million people had self-reported signs of long Covid which last for more than four weeks.
The effects of long Covid were reported to be affected the day-to-day activities of 650,000 people, with 192,000 of those saying their ability to undertake day-to-day activities had been limited a lot.
Fatigue was the most common symptom reported, with 547,000 people affected. A total of 405,000 people reported a shortness of breath, while 313,000 had muscle aches. More than a quarter of a million patients, 285,000 people, said they had difficulty concentrating.
According to the ONS the prevalence of long Covid was higher among those aged between 35 and 69-year-old and women were more likely to be affected than men along with those living in the most deprived areas as well as staff working in health and social care.
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Source: The Independent, 3 June 2021
Patient Safety Learning

Trust to move people with learning disabilities up waiting lists

A hospital trust has decided to prioritise people with learning disabilities for elective treatment, after analysis showed they were disproportionately affected by lengthy waits for care, along with some people who have a minority ethnic background.
The decision forms part of wider analysis at Calderdale and Huddersfield Foundation Trust of how the impact of covid, and work to recover from it, can exacerbate health inequalities and how this can be addressed.
The FT said in a board paper it would “initially prioritise [people with a learning disability] for treatment after cancer and urgent patients”.
Papers said it wanted to prioritise patients “around health inequalities and need based” rather than chronologically, as part of its covid elective recovery work.
It made the decision about people with a learning disability as they have a shorter average life expectancy “and therefore the impact of waiting for treatment can both further reduce this as well as disproportionately impact on their quality of life whilst waiting,” according to trust board papers.
Read full story (paywalled)
Source: HSJ, 4 June 2021
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