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

NHSX to fund and support innovations for 500k people at home

NHSX have revealed that they will fund and support 14 new projects across the country to help half a million people receive care at home using digital technology. This will include remote cardiac rehabilitation services and digital self-management systems, as well as parental support services for families of children with eating disorders.
Tara Donnelly, Chief Digital Officer at NHSX, said: “Through our Digital Health Partnership Award, these organisations will have access to the expertise and support they need to adopt or expand their digital capabilities safely and effectively, allowing many more patients with long term conditions to receive their care from the comfort of their homes rather than always having to attend primary and acute settings.”
In addition to innovation in digital technology, a number of the projects build on existing services to ensure more patients can benefit from remote services.
One of the projects also includes the expansion of secure video services at Great Ormond Street Hospital for Children, which will make it possible for patients and carers, as well as their doctors, to share seizure videos across their neurology service. Cambridgeshire Community Services are also expanding their remote health monitoring service.
Read the full article here
Source: National Health Executive
Clive Flashman

Pent up demand for care risks further inflating NHS backlog

New analysis published by the Health Foundation shows that while the waiting list for hospital care continues to grow, so too does the number of ‘missing' patients who have not yet been added to the list. There were 7.5 million fewer people referred for routine hospital care between January 2020 and July 2021 than would have been expected based on numbers prior to the pandemic. These ‘missing patients’ are in addition to the record 5.6 million people already on the waiting list.  
This lower than expected number of people referred for hospital care, including for routine procedures such as hip or knee surgery, is likely to be due to a number of reasons. Some people may not have sought treatment for health concerns during the pandemic, while others may have seen their GP but not yet been referred due to the pressure on hospital services during the pandemic. In some instances, care may no longer be needed. 
The analysis comes alongside a BBC Panorama documentary (Monday 27 September) revealing the scale of the elective care backlog and the impact delays are having on people’s lives. The Health Foundation analysis, shared with Panorama, also shows that the pandemic had a much worse effect on the hospital care provided in some areas of England than it did in others. The analysis of 42 local integrated care systems (ICSs) shows that the pandemic significantly reduced the level of routine hospital care performed across the country – in the worst affected area routine hospital care dropped by 37% while in the least affected area there was a 13% reduction.  
Read the full article here
Source: The Health Foundation
Clive Flashman

Mental health patients leaving hospital in first lockdown felt lonely and isolated

Mental health patients who were discharged from or admitted to acute mental health services during the first Covid-19 lockdown experienced loneliness and social isolation, according to a new study. Published in the British Journal of Psychiatry Open the 34 patients, carers and clinical staff were interviewed by a team of researchers from The University of Manchester. 
Mental health service users also reported ‘working harder’ to avoid admission due to fears around environmental safety as a result of COVID-19.  “Even before the pandemic, there are lots of safety concerns associated with recent discharge from inpatient mental health services, for example suicide and self-harm,“ said lead author Dr Natasha Tyler, researcher at the GM PSTRC and The University of Manchester. Dr Tyler added: ‘Our patients and carers felt that because of the national need to free-up hospital beds, the quality of discharge and admission planning was compromised at times. “That meant discharging patients from hospitals who were not ready to cope in the community or not admitting patients who needed in-patient care. “The closure of most community support services meant patients had minimal opportunities for accessing care via alternative routes.  This worsened  their feelings of helplessness and loneliness.” 
Full article here
Source: Greater Manchester Patient Safety Translational Research Centre
Clive Flashman

‘A bit of a nightmare’: fuel shortages starting to affect vulnerable patients

Patients are starting to suffer because health and care workers are unable to purchase fuel.
The fuel crisis is starting to have an effect on the care of vulnerable patients, community and mental health service providers have warned. Many petrol stations are running short of fuel as a result of panic buying, after the oil firm BP warned that it would have to close some of its petrol stations because of the lack of lorry drivers. Currently there is a shortage of about 100,000 HGV drivers.
Crystal Oldman, chief executive for the Queen’s Nursing Institute, which represents community nurses, told the journal HSJ that the fuel shortage was already affecting them: “This potentially means nurses cannot get to the patients they need to if they are unable to access fuel. At the very least, it will mean more time searching for petrol stations that have a supply, taking valuable time from their working day and more unpaid overtime will be undertaken as nurses will always prioritise their patient care.”
Patient transport has also been affected. A source at a patient transport provider in the West Midlands told HSJ that it had been “a bit of a nightmare”. The provider had had to turn down a request for a patient going to London because of the fuel shortage and because of climate protesters disrupting motorway transport: “Ultimately those patients are either at home and distressed carrying a big risk in the community or [accident and emergency] departments which [are not] the right settings.”
Read the full article here
Source: Future Care Capital
Clive Flashman

£7.5m Covid-19 vaccine study for pregnant women launches in Manchester

The country’s largest clinical study is being launched in Greater Manchester to investigate the best gap between first and second Covid-19 vaccine doses for pregnant women.
Led by St George’s, University of London, the Preg-CoV study will provide vital clinical trial data on the immune response to vaccination at different dose intervals – either four to six weeks or eight to 12 weeks. This data will help determine the best dosage interval and reveal more about how the vaccine works to protect pregnant mothers and their babies against Covid-19.
Pregnant women are more likely to develop severe Covid-19 or die from the disease but are excluded from clinical trials with new vaccines. This means there are currently very limited clinical trial data on the immune response and side effects caused by the vaccines for these women.
Read the full story here
Source: National Health Executive
Clive Flashman

Government launches landmark review of health and social care leadership

The government has launched a review of leadership in health and social care. The review will be led by former Vice Chief of the Defence Staff General Sir Gordon Messenger, and will report back to Secretary of State for Health and Social Care Sajid Javid, in early 2022.
The Health and Social Care Leadership Review will look to improve processes and strengthen the leadership of health and social care in England. Working with the health and care systems, retired General Sir Gordon Messenger will have a team from DHSC and the NHS to support him led by Dame Linda Pollard, chair of Leeds Teaching Hospital.
The review comes as the government invests a record £36 billion to put health and social care on a sustainable financial footing and deliver the biggest catch-up programme in NHS history. Any recommendations made as the review progresses will be considered carefully and could be rapidly implemented to make every penny of taxpayer’s money count.
Secretary of State for Health and Social Care, Sajid Javid, said:
"I am determined to make sure the NHS and social care delivers for the people of this country for years to come and leadership is so important to that mission.
We are committed to providing the resources health and social care needs but that must come with change for the better.
This review will shine a light on the outstanding leaders in health and social care to drive efficiency and innovation. It will help make sure individuals and families get the care and treatment they need, wherever they are in the country, as we build back better."
Read full story
Source: Department of Health and Social Care, 2 October 2021
Patient Safety Learning

NHS trust apologises to families of patients who died after catching Covid at hospital

Queen Elizabeth Hospital Kings Lynn carried out a transparent review of 389 Covid infections
An NHS trust has apologised to hundreds of families whose relatives caught Covid-19 in hospital and died, after a review found a lack of private rooms contributed to the spread of the virus.
The Queen Elizabeth Hospital (QEH) in Kings Lynn, Norfolk, has carried out a review of all 389 cases of patients who either definitely or probably contracted Covid while in the hospital between March 2020 and February this year. Of those, 151 patients died. 
The trust is the only NHS trust to have carried out a full and transparent review of hospital acquired infections of Covid-19 with staff speaking with each family to understand their concerns and views.
Read full article here
Source: Independent
Clive Flashman

New edition of The Journal of Patient Safety issued

The latest edition of the Wolters Kluwer Journal of Patient Safety has just been published.
Original studies include:
Is There a Mismatch Between the Perspectives of Patients and Regulators on Healthcare Quality? A Survey Study The Ideal Hospital Discharge Summary: A Survey of U.S. Physicians Impact of an Original Methodological Tool on the Identification of Corrective and Preventive Actions After Root Cause Analysis of Adverse Events in Health Care Facilities: Results of a Randomized Controlled Trial Detach Yourself: The Positive Effect of Psychological Detachment on Patient Safety in Long-Term Care Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles Prescribing Errors With Low-Molecular-Weight Heparins Development and Psychometric Evaluation of the Speaking Up About Patient Safety Questionnaire Descriptive Analysis of Patient Misidentification From Incident Report System Data in a Large Academic Hospital Federation Medication Errors at Hospital Admission and Discharge: Risk Factors and Impact of Medication Reconciliation Process to Improve Healthcare Reducing and Sustaining Duplicate Medical Record Creation by Usability Testing and System Redesign Full articles are payalled but the abstracts may be viewed free of charge.
Access the Journal here
Clive Flashman

Enhancing patient safety and outcomes in high-risk surgery

A team of world-leading medical experts have collaborated to improve patient safety and outcomes following high-risk surgery.
The endeavour, which includes industry specialists such as anaesthetists, surgeons, and patient representatives, is called the Improving Patient Outcomes (ImPrOve) Think Tank. The ImPrOve team has recently published its European report that highlights and looks to address a severe patient safety and health issue in which death and serious complication rates in the 30-days following high-risk surgery are alarmingly high.
The insightful report outlines an array of practices and innovations in the health sector that can improve patient safety and outcomes. These include calling for better physician training on the latest guidelines, funding for modern digital monitoring, utilisation of data from current technologies in health policies, and the right for patients to be involved in the discussion of the management of their procedure.
Perils of high-risk surgery
Around 2.4 million patients undergo high-risk surgery annually in Europe alone, with UK evidence indicating that 80% of postoperative deaths occur in a 10% sub-population of high-risk patients. If this startling trend continues throughout Europe, it is estimated that a staggering 192,000 people will die within the 30-day period following their surgery, demonstrating the immense dangers posed to patient safety and outcomes. There is an array of challenges during high-risk surgery; however, the ImPrOve Think Tank believes that potentially the most alarming complication is haemodynamic instability, which manifests as drops in blood pressure (known as IOH).
Mitigating risks and increasing patient safety
Professor Olivier Huet, the ImPrOve Chair and Professor of Anaesthesia and Intensive Care Medicine, said: “Our mission is to work collaboratively with patient representatives, clinicians and policymakers to improve perioperative patient safety and experience with the help of advanced haemodynamic monitoring technologies.
Full article here
Source: Health Europa
Clive Flashman

Mental health services in the England are being ‘Uberised’ – and that’s bad for patients and therapists

There is a mental health crisis in England, with rates of depression doubling since the COVID pandemic began. Strategies of “speaking up”, mindfulness sessions at work, and national “happiness” campaigns have been touted as an effective approach to tackling mental health at work, but therapists are unconvinced.
But what of mental health services offered by the state? This has been equally unconvincing. Over the past decade or so, mental health services in England have been undergoing a process of “Uberisation”. This refers to how services are effectively treated as commodities marketed through online platforms, changing the way they are delivered as well as making the jobs of the people delivering them more precarious – similar to the effect of ride-hailing apps on taxi drivers.
Specifically, this has happened through the introduction of a standardised and digitalised model of therapy called Increased Access to Psychological Therapies (IAPT). This Uberisation appears to be contributing to a mental health crisis within the therapy profession itself.
IAPT, which was introduced in 2008, provides psychotherapy for depression and anxiety to over a million people each year – the largest NHS programme in England. It uses a model of cognitive behavioural therapy – made up of short-term interventions of four to 12 sessions – that use techniques, such as relaxation exercises, to encourage positive mood and behaviour.
With extremely high levels of depression and anxiety among therapists, there is a genuine question about patient safety that is being overlooked. If the mental health model itself is broken, are services deepening the mental health crisis, rather than solving it?
Read the full article here
Source: The Conversation
Clive Flashman

UK launches new office to tackle health inequalities

The Office for Health Improvement and Disparities (OHID) has been officially launched by the UK Government, aimed at preventing health disparities across the country and supporting people to live longer, healthier, and happier lives.
OHID will focus on stopping debilitating health conditions before they develop and represents a distinct step-change in focus from the Government towards a more preventative, rather than reactionary, approach to health.
One of the key intentions of this is to reduce the backlog and also put social care on a long-term sustainable footing, tackling health issues much earlier in their presentation, tackling the underlying causes of many of these, or preventing them altogether.
The new government office will see Professor Chris Whitty, Chief Medical Officer, provide professional leadership to the organisation.
Announcing the official launch of OHID, the Government pointed to some of the clear trends shown in recent figures, which highlight how geographical location can play a significant role in a person’s life expectancy and the years that they can expect to live a healthy life. For example:
men in the most deprived areas in England are expected to live nearly 10 years fewer than those in the least deprived. Women in the same areas can expect to live 7 years fewer smoking is more prevalent in more deprived areas and one of the leading causes of inequalities in life expectancy; an international study found it accounts for half the difference in mortality between the least and most deprived men aged 35 to 69 obesity is widespread but more prevalent among the most deprived areas; prevalence is almost 8% higher among those living in the most deprived decile of local authorities (66.6%) compared to those in the least deprived areas (58.8%) Under its new remit, OHID will work to coordinate across local and central government, the NHS and wider society – utilising expert advice, analysis, and evidence – to drive improvements in the public’s health which may be able to have preventative roles and level up health across the UK.
Preventative approaches to health can, it is intended, reduce the pressure on existing healthcare services, saving significant resource and money, and ensure that record investments into health and social care services can go further.
Source: National Health Executive
Health and Social Care Secretary, Sajid Javid said: “The pandemic has laid bare the health disparities we face not only as a country, but as communities and individuals.
“This must change, and this body marks a new era of preventative healthcare to help people live healthier, happier and longer lives.
“The Office for Health Improvement and Disparities will be the driving force across government, supported by communities, academics, industry and employers, to level up the health of our nation, which will reduce the pressure on our NHS and care services.”
Clive Flashman

Stanford Center for Digital Health newsletter - Digital Health Equity

Where Healthcare Is Improving and Where It Needs More Work
While the public discourse on health equity has increased in recent years, there are still many problems in health disparities research and in care delivery. Health systems are struggling to tackle health equity issues as highlighted by a recent study that evaluated online consumer reviews of hospitals and experiences of racism. 

However, organizations are making a positive impact toward health equity in a variety of areas. Walmart is partnering with virtual care company Grand Rounds Health and Doctor On Demand on a digital health program aimed at tackling health disparities among African American workers. Women's health company Tia is looking to welcome female-identifying patients in an effort to improve inclusivity in health tech. For more content on companies that are addressing health equity gaps, including specialized care for women and individuals with female biologies, check out the recent blog post where we collaborated with Rock Health: Building comprehensive women+ digital health: Eight sectors serving women+ needs. 
Clive Flashman

Baby died after hospital’s ‘catalogue of failings’, NHS inquiry finds

Bristol Children’s hospital tried to ‘deceive’ Ben Condon’s parents about his death, NHS ombudsman says
An eight-week-old baby died after “a catalogue of failings” in his treatment at a children’s hospital, which then tried to “deceive” his parents about his death, an official inquiry has found.
Doctors failed to spot that Ben Condon was suffering from a deadly bacterial infection and did not give him antibiotics until an hour before he died, the NHS ombudsman said.
“We found that Ben and his family suffered serious injustice in consequence of the failings we found in his care and treatment,” the parliamentary and health service ombudsman said in a report that contained damning criticisms of Bristol Children’s hospital. The errors were all “lost opportunities” to help Ben recover from his illness and so increased the risk of him dying.
Read the full article here
Source: The Guardian
Also covered in the Independent
Clive Flashman

50% rise in number of women in UK who have not had vital breast screening since services restarted

The number of women in the UK who have not had vital NHS breast screening, which can stop people dying from breast cancer, has risen by an estimated 50% - to nearly 1.5 million women - since services resumed, the leading UK breast cancer charity warns during Breast Cancer Awareness Month.  
Breast Cancer Now reveals an alarming increase of around half a million women who haven’t been screened since services restarted in summer 2020, estimating that around 1,480,000 fewer women in the UK had breast screening between March 2020 and May 2021, compared to pre-pandemic levels. This comes a year after the charity reported that almost one million women had missed breast screening due to COVID-19 seeing services paused.
According to the charity, nearly 12,000 people in the UK could have been living with undiagnosed breast cancer at the end of May 2021, due to the impact of the pandemic on breast screening services and fewer women being referred to specialists with possible symptoms of the disease since March 2020 – a frightening prospect when early detection can stop people dying from the disease.
Full article here
Source: Breast Cancer Now
Also covered in the Independent
Clive Flashman

Government launches new mental wellbeing campaign for general public

As part of the UK Government’s efforts to tackle health problems, including mental health, earlier in the cycle, the newly-created Office for Health Improvement and Disparities (OHID) has launched the latest Better Health – Every Mind Matters campaign to improve the general public’s mental wellbeing.
The new campaign aims to empower members of the general public to look after their mental health through tips and practical advice, helping to find what works for them in reducing stress and anxiety, boosting their mood, sleeping better, and feeling in greater control of their lives.
New research commissioned by OHID revealed nearly half of adults (49%) in England said the Covid-19 pandemic had a negative impact on their mental wellbeing. In the same research, more than a third of all adults in England (34%) said they did not know what to do to improve their mental wellbeing. That equated to 15.1 million people. Younger adults were the most significantly affected group with their mental health, with 57% of 18-34 year olds suggesting the pandemic had negatively impacted their mental health. Just under half (44%) reported not knowing what to do to help improve it.
This is the first campaign delivered by OHID since being officially launched on October 1, 2021. They have been set up with the aim of tackling health inequalities across the country.
Minister for Care and Mental Health, Gillian Keegan, said: “The public showed great resilience throughout the pandemic, but it has served as a stark reminder that we all need to look after ourselves not only physically, but mentally. “There are simple steps we can all be taking to improve our mental wellbeing and reduce feelings of stress and anxiety. For anyone who is unsure what they can do, I urge you to visit Every Mind Matters and take advantage of the expert advice and practical tips available to you.”
Claire Murdoch, NHS National Director for Mental Health, added: “The last year has taken its toll on people’s mental health but NHS staff have responded rapidly to treat more people with mental health issues than ever before – rolling out 24/7 crisis lines across the country and mental health support teams in schools during the pandemic. “The NHS is here for you, so if you’re struggling with anxiety and depression our rapidly expanding talking therapy services are available, while anyone who needs urgent help can access our 24/7 NHS crisis lines – available to people of all ages. “I would encourage everyone to look after their mental health, and by answering 5 simple questions, get a tailored ‘mind plan’ which will give you tips to help boost your mood, sleep better and deal with stress and anxiety.”
Over 3.4 million individual Mind Plans have already been created since the campaign was first launched in October 2019.
Original source: National Health Executive
Clive Flashman

GPs in England failing to urgently refer patients with ‘red flag’ signs of cancer

GPs are failing to urgently refer patients with “red flag” signs of suspected cancer to a specialist, research suggests.
Six out of 10 patients in England with key symptoms indicating possible cancer did not receive an urgent referral for specialist assessment within two weeks, as recommended in clinical guidelines, according to a new study.
Nearly 4% of these patients were subsequently diagnosed with cancer within the next 12 months. The findings were published in the journal BMJ Quality & Safety.
In the study, researchers analysed records from almost 49,000 patients who consulted their GP with one of the warning signs for cancer that should warrant referral under clinical guidelines. Of the 29,045 patients not referred, 1,047 developed cancer within a year (3.6%).
Early diagnosis and prompt treatment is crucial to survival chances. Every four-week delay in cancer treatment increases the risk of death by 10%.
Read full story
Source: The Guardian, 5 October 2021
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