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

Fears of side-effects fuel reluctance to get Covid jabs, survey finds

Most people who are reluctant to be vaccinated against Covid are worried about side-effects and whether the vaccines have been adequately tested, a survey in 15 countries has shown.
Other reasons cited in the survey of 68,000 people, led by Imperial College London’s Institute of Global Health Innovation in collaboration with YouGov, were the uncertainty that people would not get the vaccine they preferred and worries about efficacy.
The survey was carried out in Australia, Canada, Denmark, France, Germany, Israel, Italy, Japan, Norway, Singapore, South Korea, Spain, Sweden, the United Kingdom and the United States.
Excluding eligibility, the top reasons for not having the vaccine across all 15 countries surveyed were “concerns about side effects” and/or “concerns that there has not been enough testing of vaccines”.
Trust in vaccines was highest in the UK, at 87%, and lowest in Japan, at 47%. The UK respondents also had the highest level of confidence in their health authorities (70%), while South Korea had the lowest (42%).
Among those who had not yet been vaccinated, confidence was highest in the Pfizer/BioNTech vaccine in nine out of the 15 countries, and in three others – Canada, Singapore and Sweden – among those under 65.
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Source: The Guardian, 4 June 2021
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Labour asks NHS andMatt Hancock to pause plans for sharing patient data

Labour has urged the NHS and Matt Hancock to pause their plan to share medical records from GPs to allow time for greater consultation on how the idea would work, saying that maintaining patients’ trust must be paramount.
In a letter to the head of NHS Digital and the health secretary, the shadow public health minister, Alex Norris, said Labour backed the principle of improved data collaboration but shared the concerns of some doctors’ groups.
The Royal College of General Practitioners warned NHS Digital a week ago that plans to pool medical pseudonymised records on to a database and share them with academic and commercial third parties risked affecting the doctor-patient relationship.
NHS Digital needed to explain the plans better to the public, the group said, as well as outlining how people could opt out.
The British Medical Association (BMA) has also called for a pause to the General Practice Data for Planning and Research scheme. Another group, the Doctors’ Association, said it was worried it would “erode the doctor/patient relationship, leaving patients reluctant to share their problems due to fears of where their data will be shared”.
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Source: The Guardian, 6 June 2021
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NHS trust contacts hundreds of families in effort at honesty over Covid hospital infections

An NHS trust has become the first in the country to individually contact every family of patients who caught coronavirus while they were in hospital in a large-scale bid to be transparent over the scale of infections.
Bosses at the Queen Elizabeth Hospital Kings Lynn NHS Trust have set up a team to work through hundreds of cases where patients caught coronavirus in hospital.
At least 99 patients are known to have died after becoming infected with more cases still to review.
In a unique approach to transparency the trust is sending a letter by recorded delivery to every affected patient or family where it is thought the patient picked up the virus within the hospital.
The letter offers an apology for what happened and is followed by a phone call with a nurse and a meeting with officials if families have more concerns. Some families have asked to meet the nurses who cared for their loved ones.
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Source: The Independent, 6 June 2021
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‘Young people need help’: parents call for change in eating disorder care

It is more than eight years since Averil Hart died after being found passed out in her university room, but the words left in her diary are etched in her father’s mind. “She said: ‘dear God please help me’ and that was four or five days before she collapsed,” says Nic Hart. “It sums up what many young people desperately need. They need help. Here we are eight-and-a-half years on and what has changed?”
Averil, who was diagnosed with anorexia aged 15, was taken to Norfolk and Norwich University hospital at 19 in a “severely malnourished” state but received no nutritional or psychiatric support during her four-day admission, according to an inquest into her death. She was then urgently transferred to Addenbrooke’s hospital in Cambridge.
The coroner found a litany of failings. She was treated by doctors who knew “practically nothing” about anorexia. There had been no follow-up from the local eating disorder team and a failure to provide life-saving treatment. The inquest was the last in a series of coroners’ examinations of five women who died from eating disorders while in the care of the NHS in the east of England.
“I suppose listening to the NHS arguments on delivery … they would say it is an organisation of a million people and these things [real changes] take time,” her father says. “But you wonder what it takes to turn all these well-meaning policies that seem to come up from time to time into action.”
Hart says we need to learn from how the UK has tackled potentially life-threatening conditions such as sepsis and think about how we can “train clinicians to turn this around quickly”.
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Source: The Guardian, 6 June 2021
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‘Significant risks to patient safety and trust’s reputation’ uncovered by external review

A trust’s gastroenterology service was ‘in a very poor state with significant risks to patient safety’ and had poor teamworking which “blighted” the service, an external review found.
The problems in the service at Salisbury Foundation Trust, Wiltshire, were so severe that the Royal College of Physicians suggested it should consider transferring key services such as management of GI bleeds and the care of hepatology patients to other hospitals.
The service was struggling with poor staffing which had led to increased reliance on a partnership with University Hospital Southampton Foundation Trust, outsourcing and the daily use of locum consultants, according to the report. The trust board had identified “inability to provide a full gastroenterology service due to lack of medical staff capacity” as an extreme risk.
The report said: “This review was complex and necessary as the gastroenterology service is in a very poor state with significant risks to patient safety and the reputation of the trust. We found a wide range of problems which now need timely action to ensure patients are safe.”
Read full story (paywalled)
Source: HSJ, 7 June 2021
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New website to help patients and NHS staff to see hospital waiting times at a glance

A group of patient activists has set up a new website using official NHS data to allow patients to check the waiting times for treatments at their local hospital.
The new waiting times tool is thought to be the first automated and regularly updated website that shows hospital performance against key waiting time targets, by medical specialty such as cardiology or orthopaedics.
The service, developed by volunteers from the not-for-profit Patient Experience Library, not only shows patients how many people are waiting to be treated overall but also shows data on the median waiting time as well as how well the hospital is performing against targets over time.
Patients can also compare different hospitals and look at the performance of the NHS in England overall. Wait times for mental health services are treated separately and not included.
Miles Sibley, co-founder of the Patient Experience Library, said the website was an attempt to bring transparency to NHS England’s “impenetrable spreadsheets” which not only affected patients but also other NHS staff who told Sibley they spend hours downloading data and working out their organisations performance.
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Source: The Independent, 7 June 2021
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COVID-19 saw spike in new mothers seeking help with mental health

Mental health consultations among new mothers were 30% higher during the COVID-19 pandemic than before it, particularly during the first three months after birth, suggests Canadian research.
Study authors noted that postpartum mental illness, including postnatal depression, usually affected as many as one in five mothers and could have long-term effects on children and families if it becomes chronic.
They looked at mental health consultations by 137,609 people in Ontario during the postpartum period – from date of birth to 365 days later – from March to November 2020.
They found mental health visits to both primary care and psychiatrists were higher than before the pandemic, especially among those with anxiety, depression, and alcohol or substance use disorders.
Read full story
Source: The Nursing Times, 7 June 2021
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Dozens of hospitals hit dangerous bed occupancy levels

Dozens of acute trusts have operated at very high levels of bed occupancy in the past month, as they deal with a surge in non-covid patients with thousands fewer beds than normal.
At one point in May, 49 general acute trusts out of 145 — the most since before covid — operated at occupancy of 95 per cent or more in adult acute beds. Up to eight trusts at a time were operating at 99 or 100% occupancy during May, according to analysis of published data. 
NHS England, prior to covid, told trusts to keep occupancy below 92%, and others believe even this is dangerously high, although trusts do often exceed it during winter.
Trusts are seeing the largest numbers of non-covid emergency patients since at least winter 2019-20; and are also trying to return as many planned operations as possible.
They are doing so with thousands fewer beds than normal, due to measures to deal with ongoing covid patients without further outbreaks of the virus in hospital. 
Read full story (paywalled)
Source: HSJ, 8 June 2021
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Burnout among staff in the NHS and social care at 'emergency levels'

A new report commissioned by the House of Commons finds NHS staff and social care workers are suffering from burnout at 'emergency levels'. The report has said problems with burnout among the NHS and care staff already existed but was increased due to the Covid-19 pandemic. 
Staff shortages have been indicated as one of the causes of burnout as the work days became longer and the pressure on staff grew. It was also found that staff felt overwhelmed after lockdown ended as patients who had not been to see their GP during lockdown were now coming in with an array of health problems. NHS and care staff felt insufficiently equipped to deal with the incoming patients due to a lack of proper staffing support in the workforce. 
Read the full story
Read the full report here
 
Source: BBC News, 8 June 2021
Patient-Safety-Learning

New data reveals 44 per cent jump in ambulance handover times pre-pandemic

New data has found patients in ambulances experienced significant delays in hospital admissions before the pandemic began. The data revealed patients were waiting for up to an hour or more before they were given to the care of A&E staff and may have had to wait in the ambulance or A&E corridors before they could be admitted to the hospital. 
It has also been found that in the midst of the Covid-19 pandemic, patients were having to wait even longer before they could be admitted into hospital. A case report by West Midlands Ambulance Service detailed how a woman in her nineties experienced worsening health whilst waiting for treatment and died a short time later. 
Read the full story.
Source: The Independent, 08 June 2021
Patient-Safety-Learning

Maternity unit found 'inadequate' after unannounced inspection

After concerns were raised regarding safety and quality of care for women and babies at the Jessop Wing maternity unit in a Sheffield Teaching Hospital, an unannounced inspection found the unit to be 'inadequate'. 
Whilst the Care Quality Commission found the maternity service had some good areas which included staff feeling respected and supported, there were concerns raised regarding midwife shortages and whether the staff had the knowledge and experience to run the service appropriately. 
As a result of the report, several actions were taken to impose conditions on the maternity unit which included proper training of staff, improving infection control and ensuring staff were able to follow the correct safety procedures regarding urgent or serious incidents and proper storage of medicines.
Read full story (paywalled)
Source: HSJ, 9 June 2021
Patient-Safety-Learning

Patients facing regional disparities in hospital waiting times

News insights from a a review of NHS England data has found access inequalities across regions in England.
Notably, the review found Orthopaedics patients suffered worse waiting times than others with some having to wait for more than 52 weeks before they could receive their treatment.
Data analysis showed that by the end of March 2021, there were more than 400, 000 people on hospital waiting lists for more than a year. 
Read full story.
Source: BBC News, 10 June 2021
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Data reveals a possible increase in risk of treatable blood disorder from AstraZeneca Vaccine

New analysis from Scotland has found there may be a possible, though small, increased risk of developing a condition called idiopathic thrombocytopenic purpura (ITP) after administration of the Oxford/AstraZeneca Vaccine. 
Doctors assure patients that the condition is treatable and often mild and it is more often seen in those who have pre-existing health conditions such as diabetes, heart disease or kidney disease. 
The condition has also been seen in patients after taking other vaccines including the flu, MMR and hepatitis B.
Read full story.
Source: The Guardian, 9 June 2021
Patient-Safety-Learning

Children under five with respiratory symptoms should have in-person appointments with GP

It has been recommended that GPs should see all children under five who present with respiratory symptoms in-person. 
Concerns have been raised that whilst in lockdown, respiratory viruses will rise when lockdown lifts due a lack of exposure owing to current safety measures.
The new guidance was given to Primary Care staff via their latest bulletin advising that if children are showing respiratory symptoms, they should be tested for Covid-19 but that doctors should also make a clinical assessment in-person. 
Read full story.
Source: BMJ, 9 June 2021
Patient-Safety-Learning

Risk to patient safety due to rise in 'non-nurses' being recruited for registered nursing roles

The Royal College of Nursing has warned there has been a rise in unqualified people being recruited for registered nursing roles, posing a significant risk to patient care and safety. 
Owing to staff shortages, employers have opted to encourage candidates without a registered nursing qualification to apply for nurse vacancies.  
It has been found that registered nursing positions have been opened up to allied health professionals as well as a matron role being open to those without the appropriate qualifications and experience. It has been warned that this continued practice with raise the risks to patient safety and create unnecessary vacancies elsewhere. 
Read full story.
Source: Nursing Times, 9 June 2021
 
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