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

Fifty senior doctors ask CEO for protection against bullying

Fifty senior consultants from a minority ethnic background at University Hospitals North Midlands have written to Tracy Bullock and trust chair David Wakefield asking for action to ‘protect’ staff from bullying behaviours following an internal survey in which 348 medics claimed to have experienced bullying and harassment.
In a subsequent letter on 5 August, seen by HSJ, 50 doctors have now said: “We are forced to express our concerns over the prevailing poor culture within our organisation with most senior medical staff presently reporting they have suffered or witnessed first-hand discrimination, bullying, harassment, or victimisation. We… ask for urgent action by the executive and non-executive boards to immediately implement measures to protect senior medical staff from unacceptable ill-treatment.”
A separate external review is now understood to have been commissioned amid concerns over bullying within ophthalmology services. 
Read full story (paywalled).
Source: HSJ, 19 August 2021
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Trust reviewing harm to 175 patients after referrals breakdown

Ashford and St Peter’s Hospitals Foundation Trust, has apologised after nearly 1,000 patients faced delays due to a breakdown of referral systems. It was found 175 of these patients were considered urgent cases by their GPs and are now being reviewed for clinical harm. 
When the error was discovered, the patients were added to the referral tacker by 9 July, however until that point, they had not been on any patient waiting list, nor were they visible to either operational management or clinical teams.
Trust chief executive Suzanne Rankin said in a statement: “We are very sorry for any inconvenience these delays may have caused patients and we contacted all concerned and issued appointments where necessary.”
Read full story (paywalled).
Source: HSJ, 19 August 2021
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Trust served with CQC warning notice over ‘culture’ and governance concerns

Nottingham University Hospitals Trust has been served with a section 29a warning notice by the Care Quality Commission requiring it to ensure a ‘more positive culture’.
A CQC spokeswoman confirmed: “The trust was issued with a warning notice requiring it to take action to improve corporate and clinical governance and oversight of risk, and to ensure a more positive, open and supportive culture across the organisation. We will report on the full findings from the inspection as soon as we are able to.”
Although it is still not clear why the warning was issued, the trust is currently engaged in concerns over their accident and emergency department and maternity services. 
“We accept the CQC’s comments and work is already underway to learn from the findings and make improvements so that the organisation is led as effectively as possible and we continue to provide world class care for our patients.” Nottingham University Hospitals Trust acting chief executive and chief finance officer Rupert Egginton has said. 
Read full story (paywalled).
Source: HSJ, 18 August 2021
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Army supporting ambulance services in England

Almost 100 members of the army have been brought in to help four ambulance trusts amid staff shortages in the South Central, South West, North East and East areas of England, with Unison saying it was a sign "things were not right".
Vicky Court, assistant chief operating officer at North East Ambulance Services has said "It will ensure everyone continues to get the care they need by freeing up paramedics to be more available to attend potentially life-threatening incidents."
Read full story.
Source: BBC News, 21 August 2021
Patient-Safety-Learning

Covid: ‘Harrowing’ rise in child deaths since coronavirus lockdowns

There has been a "harrowing" rise in child deaths and serious cases of harm linked to to abuse or neglect of children since the first Covid lockdown, according to reports from the Local Government Association (LGA).
Data has revealed there were 536 serious incident notifications in England between April 2020 and March 2021, with LGA saying it was a "huge cause for concern" and it is extremely concerned about children’s safety.
Councillor Anntoinette Bramble, chair of the LGA’s children and young people board, has said, "The pandemic has put extra pressure on families, particularly those living in difficult circumstances, which can fuel harmful acts of abuse or neglect on children. Councils have been working hard with their partners to identify this and provide the help children need, but it is vital that children’s social care services are funded to meet this need.”
Read full story.
Source: The Independent, 21 August 2021
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COVID-19: Antibody testing programme to be rolled out across the UK for COVID positive people

A new antibody testing programme has been launched where participants will be sent two finger-prick tests to complete at home and then inform the UK Health Security Agency of the antibody response to different coronavirus variants.
The new programme was created in order to generate new data on antibody protections for people following infection by different coronavirus variants, and from Tuesday, anyone over the age of 18 in England, Wales, Northern Ireland and Scotland, will be able to opt into the programme.
Health Secretary Sajid Javid has said "Our new national antibody testing will be quick and easy to take part in [and by] doing so you'll be helping strengthen our understanding of COVID-19 as we cautiously return to a more normal life. I'm proud to see all parts of the UK uniting around this new initiative and working together to arm ourselves with even more valuable insights into how COVID-19 vaccines are protecting people up and down the UK."
Read full story.
Source: Sky News, 22 August 2021
Patient-Safety-Learning

Young people warn of long Covid in NHS vaccination drive

Young people experiencing long Covid have urged people to get their vaccine in a new NHS video, featuring three previously healthy people in their early 20s and 30s.
Quincy Dwamena, a 31 year-old a support worker, described himself in the video as a “healthy young guy”, warned “I ended up being hospitalised and thought I was going to die. My advice is to get the vaccine: don’t put yourself and others at risk, I wish I’d got mine as soon as it was offered.”
Data from Public Health England has shown young people aged 16 to 29 at more likely to develop long Covid, however, vaccine uptake among this age group is lower than average, particularly within the London area. 
Speaking in the NHS video, Dr Emeka Okorocha, an emergency medicine physician said, “As an A&E doctor, I’ve seen a lot during the pandemic. But nothing has shaken me like the sight of young, otherwise healthy adults being rushed into our hospitals with Covid-19. As well as their age, many of them have one other thing in common: they are unvaccinated.”
Read full story.
Source: The Guardian, 23 August 2021
Patient-Safety-Learning

'Exhausted and broken' midwives at West Suffolk Hospital in Bury St Edmunds speak out about 'substandard care' in whistleblowing letter

Midwives at Suffolk Hospital have spoken out in a whistleblowing letter describing problems in their department as ‘demoralising and heartbreaking’.
In the letter, written by midwives who declined to give their names "for fear of retribution", describe constant staff shortages, a culture of blame and fear, a high pressure environment and substandard care, saying " We entered midwifery to be able to give women centred, holistic care. Instead it feels like we are being overwhelmed by the unmanageable and relentless workload, and as a result are giving substandard care which is demoralising and heartbreaking. We are all feeling like we are now desperate for change. This change is beyond what we can achieve ourselves so we urge you to please help us to generate it. It should not be accepted or tolerated for us to be forced into giving unsafe care entirely due to unsafe staffing". 
In response, Karen Newbury, head of midwifery at the trust, said: “We are working exceptionally hard to recruit additional midwives and we are very grateful for the flexibility and dedication of our staff in ensuring that we provide a safe and caring service – this was recognised by our Care Quality Commission inspection in April which found we managed safety well. We have recently completed recruitment so there will be at least two senior midwives on every shift to provide flexible and experienced support to our maternity teams, and we are working with colleagues regionally to recruit staff both locally and internationally as well as running a full student training programme.”
Read full story.
Source: Suffolk News, 20 August 2021
Patient-Safety-Learning

Social care charges: Disabled and vulnerable adults hit by steep rises

BBC News Research has revealed disabled and vulnerable adults in England will face a steep rise in the amount they have to pay towards their care, with Directors of council services blaming years of government funding cuts.
One woman, Saskia Granville earlier this year was shocked when she found her care charges had increased from £92 to £515 per month. A sum of almost £1,500 was also taken out of Saskia's bank account as a backdated payment, in March, leaving her in debt.
Her mother, Bobbie, says: "Without my intervention, she wouldn't have had any food that week. She wouldn't have been able to pay her gas, electricity or water bills."
Read full story.
Source: BBC News, 24 August 2021
Patient-Safety-Learning

Covid returns to top 10 causes of death

According to reports, Covid-19 was the 9th biggest cause of death in England in July, and the 26th most common in June, with data showing it was the 22nd leading cause of death in Wales.
Figures from the Office for National Statistics show the number of deaths was 7.6% higher than average in England and 10.4% higher in Wales.
However, when there isn't a pandemic, the top causes of death are usually heart disease and dementia, but in the months when Covid-19 has been dominant, it has been the leading cause by a long way. 
Read full story.
Source: BBC News, 23 August 2021
Patient-Safety-Learning

Mothers at risk of premature birth could be identified as soon as 10 weeks into pregnancy, study finds

According to a new study, mothers at risk of premature birth could be identified as soon as 10 weeks into their pregnancy.
The study, conducted by King's College London and published in the Journal of Clinical Investigation, found that by looking for specific bacteria in the in a pregnant woman’s cervicovaginal fluid, it could reveal warning signs for premature birth, meaning inflammation can be found and treated early to protect mothers and babies.
Study author Andrew Shennan OBE, who is Professor of obstetrics at King’s College London, explained: “Premature birth is very hard to predict, so doctors have to err on the side of caution and mothers deemed to be at risk often don’t actually have their babies early, putting undue strain on everyone involved. My team has developed preterm birth prediction tools that are very accurate later in pregnancy, like fetal fibronectin tests – but at that stage, you can only manage the risks, not stop it from happening. The sooner we can find out who’s at risk, the more we can do to keep mothers and babies safe.”
Read full story.
Source: The Independent, 23 August 2021
Patient-Safety-Learning

Moving A&E patients to other departments has ‘high mishap rate’

The authors of a new study in Australia, published in the Emergency Medicine Journal, have said moving emergency care patients to other hospital departments by wheelchair or trolley is prone to a high rate of mishaps, with nearly 40% leading to incidents.
The study, which took place at Austin Hospital, a teaching hospital in the Melbourne suburb of Heidelberg, also found endotracheal tubes, ventilator hoses, and arterial lines were also associated with high mishap rates. 
“Risk events are common and some result in harm. Risk factors include a high equipment number, transport to a ward and some abnormal vital signs. As many risk events are likely preventable, our identified predisposing factors may inform preventative strategies that may benefit other emergency departments.” The authors have said. 
Read full story.
Source: Nursing Times, 24 August 2021
Patient-Safety-Learning

Unvaccinated NHS staff will be barred from entering care homes

New rules for care home staff are set to come into force on November 11, 2021, requiring all staff to be vaccinated against Covid-19, unless they are exempt.
Care homes will also be able to refuse entry to anyone who is unable to prove they have been fully vaccinated, with the Care Quality Commission warning that care homes will be monitored around their implementation of the new rules.
In a letter to members of the House of Lords it warned: “The sector faces 112,000 vacancies currently, if the 5 per cent, who may eventually choose not to have the vaccine, leave the sector and are added to the current vacancies it will completely destabilise an already fragile sector.”
Read full story.
Source: The Independent, 23 August 2021
Patient-Safety-Learning

‘Unrelenting’ pressure forces hospital to turn away non-emergency patients from A&E

According to reports, a hospital in the northeast of England is having to turn away non-emergency patients from A&E due to "unrelenting" pressures on the service. This new policy was announced on Tuesday by Hull Teaching Hospitals Trust, warning patients they may need to travel up to 30 miles in order to receive care. 
Dr Makani Purva, chief medical officer said in a statement on the trust website on Tuesday: “Staff are working incredibly hard to provide care for patients in challenging circumstances but we need people to use the full range of services available. One in four patients who attend A&E in Hull could have been treated more appropriately elsewhere, that’s around 100 patients every day. So from today, after an initial screening process, those arriving at A&E who could safely be cared for elsewhere will be referred on to one of several alternative care centres and providers. Doing so will help us to reduce waiting times for more seriously ill patients and ensure they receive the priority care they need in hospital, while enabling those patients with non-urgent needs to receive care more quickly from a suitably skilled health professional elsewhere.”
Read full story.
Source: The Independent, 24 August 2021
Patient-Safety-Learning

NHS pharmacies to offer blood pressure checks to tackle heart problems

In an effort to tackle heart problems, a new NHS scheme will be rolled out in pharmacies where patients over 40 will be able to have their blood pressure checked. 
The scheme, set to begin checks from October in some 11,300 pharmacies across England, will also give patients clinical and lifestyle advice or referred to treatment where necessary when getting their blood pressure checked. 
Helen Williams, national speciality adviser for Cardiovascular Disease Prevention at NHS England and NHS Improvement, said: “As a pharmacist, I am delighted that this service is being rolled out across England. Community pharmacies are ideally placed to deliver blood pressure checks, being accessible within local communities and regularly used by most adults. This service will enable people with high blood pressure to be identified and treated early and will encourage conversations about lifestyle change to help people live healthy lives for longer.”
Read full story.
Source: The Independent, 24 August 2021
Patient-Safety-Learning

Blood tube shortage: Healthcare staff should not be asked to delay tests, says BMA

On 10 August NHS England issued guidance for healthcare workers, including medical directors and GPs, in the light of global shortages of blood tube products, now, doctors have raised concerns about the effects that a shortage of blood tubes in England will have on patient care and the NHS, which already faces backlogs.
Read full story (paywalled).
Source: BMJ, 24 August 2021
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