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

Welsh Government announce £12.5m to reduce NHS pressures

A further £12.5 million has been made available to help the NHS recovery, alleviate waiting times and reduce “extremely challenging” winter pressures, the Welsh Government has said.
Health minister Eluned Morgan said the extra money will be spent on supporting people out of hospitals and into independent living, and pharmacies so they can help more people stay well without needing to see a GP.
Around £10 million of the pot will be distributed across the country’s 22 local authorities to buy equipment such as flow mattresses, patient turning systems, stair lifts, hoists and telecare equipment for people’s homes – allowing individuals to be discharged more quickly and freeing up hospital beds, it was revealed.
Pharmacies will get £2.5 million to improve access to treatment and advice for a range of common ailments, reducing pressures on GPs and other NHS services.
Baroness Morgan said: “The pressures on the health and social care system remains extremely challenging. We all need to work together to support our health and social care services and help us to help you this winter.
“Simple things like visiting local pharmacies or minor injuries units for advice on minor health concerns, checking symptoms online using the NHS 111 Wales website or getting a Covid vaccine can make a high difference to our NHS and help people look after their health this winter."
Read full story
Source: The National, 11 January 2022
Patient Safety Learning

Treatment disrupted as trust suffers major data loss

A major IT incident at an acute trust is disrupting treatment for eye patients after a significant data loss, it has emerged.
Sandwell and West Birmingham Hospitals Trust chief executive Richard Beeken revealed to his trust’s board that a data loss incident in December had “impacted on staff and patient care” after disrupting 20 systems across the organisation.
Recovery of the full data set for patients receiving treatment at the Birmingham and Midland Eye Centre is still under way, and some have had operations postponed.
Despite the incident, ophthalmologists are continuing to see the majority of patients, Mr Beeken said, telling HSJ: “[Numbers affected] are being kept to a minimum through the extraordinary efforts of the clinical team who are putting in extra hours to reassess each patient’s needs.”
Scanning continues in the majority of cases and the trust is pressing on with recovery work for all historic images and patient contact details, though leaders believe the chances of 100% data recovery are “still slim”.
No patient data was extracted during the incident and the information commissioner was made aware.
Read full story (paywalled)
Source: HSJ, 10 January 2022
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South East hospitals told to discharge well patients

Hospitals across Kent, Sussex and Surrey are being asked to discharge hundreds of patients who are well enough to leave by Friday.
The head of NHS South East, Anne Eden, said the beds are needed to deal with an expected surge in admissions of people ill with the Omicron variant.
The NHS nationally has agreed to a reduction of 30% of such patients based on the baseline figure of 13 December.
South East hospitals are being asked to make a 50% reduction by 31 January.
In a letter seen by the BBC, Ms Eden said: "This is in order to create the headroom to manage any further Covid pressures, with current modelling indicating a peak in Covid activity in mid-January."
She wrote: "It is now critical that we redouble our efforts to discharge those patients who no longer require bedded care, to create capacity, improve flow and reduce the pressure on staff."
Ms Eden said staff absences and the need to maintain delivery of critical care for patients mean the NHS "must continue to focus on creating the necessary capacity to meet demand".
"Failure to do this will significantly increase the risk of a further rise in patient harm," she said.
She said hospitals must work with partners, including social care providers, to achieve the reduction in the number of patients in hospital who were well enough to be discharged.
Read full story
Source: BBC News, 10 January 2022
Sam

Rise in non-Covid virus that can leave children struggling to breathe

Parents are being warned to look out for signs of a non-Covid virus that is “rife” in the UK amid a surge in reports of children struggling to breathe.
The British Lung Foundation (BLF) said Respiratory Syncytial Virus (RSV) is staging a comeback this winter after lockdown last year meant there were fewer infections than would normally occur.
It is concerned that this year children will have “much lower immunity” at a time when the NHS is already under extreme pressure.
“In the last few weeks, we have noticed a surge in calls from parents who are worried about their child’s breathing,” said Caroline Fredericks, a respiratory nurse who supports the BLF’s helpline. “Most of these parents have never heard of RSV which is worrying.”
RSV is common in babies and children. Almost all will have had it by the time they are two. It may cause a cough or cold but for some it can lead to bronchiolitis, an inflammatory infection of the lower airways which can make it hard to breathe.
The early symptoms of bronchiolitis are similar to those of a common cold but can develop over a few days into a high temperature, a dry and persistent cough, difficulty feeding, and wheezing. While many cases clear up in two to three weeks, some children will end up being hospitalised.
“There are steps parents can take to make their child more comfortable at home if their RSV develops into bronchiolitis, such as keeping their fluid intake up, helping them to breathe more easily by holding them upright when feeding and giving them paracetamol or ibuprofen suitable for infants,” said Fredericks.
Read full story
Source: The Guardian, 12 January 2022
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‘Low priority’ community cases to be deferred as staff redeployed

NHS England has told local systems to defer ‘low priority’ cases across 11 community services, because of the pressures created by the omicron wave. 
NHSE has issued guidance for the prioritisation of the community health workforce “given the increasing pressures on the health system due to the omicron wave of COVID-19 this winter and the need to provide booster jabs as quickly as possible”.
It is hoped the guidance will encourage the redeployment of community staff to help reduce the strain on acute services.
Staff working in musculoskeletal services are being asked to deprioritise some low priority rehabilitation work, with patients enabled to self-manage at home.
It adds: “Where possible, provide capacity to support other community resources focused on rehabilitation and recovery for those discharged from acute care and those whose functioning is deteriorating at home, and/or the administration of vaccines.”
A host of other services have been advised to continue, but with “prioritised” waiting lists and a deferral of provision considered for “low priority cases” to “free up workforce capacity”, including children’s therapy interventions, children’s community paediatric services and audiology services for older adults.
Read full story (paywalled)
Source: HSJ, 11 January 2022
 
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Stepping Hill Hospital praised for A&E improvements

A hospital rated inadequate by inspectors two years ago has been praised for making improvements.
The Care Quality Commission (CQC) has welcomed changes in urgent and emergency care at Stepping Hill Hospital in Stockport, Greater Manchester.
The trust said the report was a "testament" to its staff's hard work.
The CQC's unannounced inspection in November was carried out to check improvements had been made since a previous visit in August 2020.
Among the concerns highlighted previously were patients left at high risk of harm during periods of heavy demand, staff shortages and staff who were "not competent for their roles".
The new report said inspectors found urgent and emergency care had improved from inadequate to good overall and for being safe and well-led.
"It has gone from requires improvement to good for being effective and caring. Responsive has gone from inadequate to requires improvement," the report said.
Karen Knapton, CQC's head of hospital inspections, said: "We acknowledge the efforts of the emergency care team at Stepping Hill Hospital. We found staff provided good care and treated people with compassion and kindness."
"They gave patients, their families and carers help, emotional support and advice when they needed it. Also, the service has been tailored to meet individual needs, including those living with dementia or a learning disability. "
Read full story
Source: BBC News, 12 January 2022
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Liver-branding transplant surgeon struck off medical register

A surgeon who burned his initials on to the livers of two patients during transplant surgery has been struck off the medical register.
Simon Bramhall, 57, admitted using an argon beam – used to stop livers bleeding during operations and to highlight an area to be worked on – to sign “SB” into his patients’ organs in 2013 while working at Birmingham’s Queen Elizabeth hospital.
On Tuesday, a review by the Medical Practitioners Tribunal Service (MPTS) concluded Bramhall’s actions were “borne out of a degree of professional arrogance” and that they “undermined” public trust in the medical profession.
Bramhall, of Tarrington, Herefordshire, was first suspended from his post as a consultant surgeon in 2013 after another surgeon spotted the initials during follow-up surgery on one of his patients. A photograph of the 4cm-high branding was taken on a mobile phone.
During his sentencing hearing in 2018, Bramhall was told one of the victims suffered serious psychological harm as a result of the branding. The surgeon later told police he branded the organs to relieve operating theatre tensions following difficult and long transplant operations.
Read full story
Source: The Guardian, 11 January 2022
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Nurse who saw woman, 22, self-harm and told colleague, 'leave her, she'll faint before she dies'

A nurse who was struck off for refusing to admit a woman to a mental health unit before she killed herself said 'leave her, she will faint before she dies' before he kicked her out of the facility.
Paddy McKee allegedly made the comment as Sally Mays, 22 - who had mental health issues - tried to strangle herself when she was refused admission.
Ms Mays killed herself at home in Hull in July 2014 after being refused a place at Miranda House in Hull by McKee and another nurse.
Despite her being a suicide risk, they would not give her a place at the hospital after a 14-minute assessment.
Her parents Angela and Andy have fought for several years for improvements to be made and lessons to be learnt from her death.
McKee was this month struck off following a Fitness to Practice hearing conducted by the Nursing and Midwifery Council. The report by the NMC was this week published and condemned McKee, saying 'he treated her in a way that lacked basic kindness and compassion'.
The NMC found his actions to refuse Ms Mays' admission had contributed to her death.
Read full story
Source: Mail Online, 12 January 2022
Sam

Ill health in ‘left behind’ areas costs England £30bn a year, says report

Endemic ill-health in England’s “left behind” neighbourhoods costs the country almost £30bn a year because people are often too ill to work and die earlier, a report claims.
The cost of lost productivity results directly from those very deprived areas having much worse health than the rest of the country, according to parliamentarians and academics.
Experts from the Northern Health Science Alliance (NHSA) have calculated that the economy would grow by that amount if health in those areas was improved to such an extent that local people began to enjoy the same health as those in better-off places.
The report, by the NHSA and all-party parliamentary group for left behind neighbourhoods (LBNs), highlights the scale of the challenge Boris Johnson faces in meeting his pledge to level up England’s poorest and richest areas.
“The health of people living in left behind neighbourhoods is considerably worse than the health of people living in the rest of the country,” said Dr Luke Munford, the report’s lead author and a lecturer in health economics at the University of Manchester. “This is true across all measures of health.”
The report shows rates of obesity, lung conditions, high blood pressure, mental health problems and other diseases are much higher than the national average in the 225 LBNs. This means people there have less “healthy life expectancy” and also shorter lives and thus are less productive over their lifespan than those elsewhere.
Read full story
Source: The Guardian, 13 January 2022
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Staffing at UK care homes 30% less than needed, survey finds

Care homes are missing a third of the staff they need and more than one in four have closed their doors to new admissions in a deepening labour crisis that is “putting safety and dignity at risk”.
With thousands of care workers off sick with Covid on top of a rising number of vacancies, the situation in social care has become “grim, difficult and relentless”, according to the National Care Forum (NCF), which ran a survey of its not-for-profit care-home members.
Omicron absences are running at 14% on top of an 18% vacancy rate – a sharp increase on estimates before the pandemic – as beleaguered care workers quit jobs, often for better paying roles in retail or warehouses. The picture is even worse for domiciliary care, with two-thirds of providers forced to decline families’ new requests for help because they are short of carers.
The executive director of the NCF, Vic Rayner, said the worsening situation showed the government’s approach to tackling the problem of staff shortages by giving social care “crumbs from the table” was negligent.
We “have been highlighting the growing shortages in the workforce and the knock-on impact on those who remain working in the sector and those who use care and support services for many months”, she said. “How many times does this message need to be repeated for it to be heard?”
Read full story
Source: The Guardian, 13 January 2022
Patient Safety Learning

USA: COVID-hospitalisation numbers are as bad as they look

Many supposedly “incidental” infections aren’t really incidental, and cannot be dismissed, writes Ed Yong.
More Americans are now hospitalised with COVID-19 than at any previous point in the pandemic. The current count—147,062—has doubled since Christmas, and is set to rise even more steeply, all while Omicron takes record numbers of healthcare workers off the front lines with breakthrough infections. For hospitals, the math of this surge is simple: Fewer staff and more patients mean worse care. Around the United States, people with all kinds of medical emergencies are now waiting hours, if not days, for help.
Some reporters and pundits have claimed that this picture is overly pessimistic because the hospitalisation numbers include people who are simply hospitalised with COVID, rather than for COVID—“incidental” patients who just happen to test positive while being treated for something else. In some places, the proportion of such cases seems high. UC San Francisco recently said a third of its COVID patients “are admitted for other reasons,” while the Jackson Health System in Florida put that proportion at half. In New York State, COVID “was not included as one of the reasons for admission” for 43% of the hospitalised people who have tested positive.
But the “with COVID” hospitalisation numbers are more complicated than they first seem. Many people on that side of the ledger are still in the hospital because of the coronavirus, which has both caused and exacerbated chronic conditions. And more important, these nuances don’t alter the real, urgent, and enormous crisis unfolding in American hospitals. Whether patients are admitted with or for COVID, they’re still being admitted in record volumes that hospitals are struggling to care for. “The truth is, we’re still in the emergency phase of the pandemic, and everyone who is downplaying that should probably take a tour of a hospital before they do,” says Jeremy Faust, an emergency physician at Brigham and Women’s Hospital, in Massachusetts.
Read full story
Source: The Atlantic, 12 January 2022
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Paramedics jailed for stealing medication from dying patients

Two paramedics have been sentenced to five years in prison for stealing medication from terminally ill patients.
Ruth Lambert, 33, and Jessica Silvester, 29, of the South East Coast Ambulance Service (Secamb), preyed specifically on people receiving end-of-life care packages, Kent Police said in a statement.
The pair, who live together at Gap Road in Margate, accessed addresses of patients in the east Kent area through their work and posed as nurses to gain access to patients’ homes to steal morphine and other painkillers.
They worked in tandem, one researching the addresses and sending details to the other who would visit and steal the medication, police said, with victims being targeted in Thanet, Canterbury, Whitstable, Faversham and Herne Bay.
Evidence gathered from the pair’s mobile phones showed they had also conspired to steal from Secamb by taking medication from ambulances when on duty.
Detective sergeant Jay Robinson, from Kent Police, described the offences as “an astonishing abuse of position”.
“Many of their victims have since passed away and will never know that justice has been done,” he said. “Our investigation was carried out, knowing we had to represent those victims and do the very best for them.”
Dr Fionna Moore, medical director for Secamb, added that Lambert and Silvester’s behaviour was a “clear and targeted abuse of their position and does not reflect the commitment and integrity of our staff”.
Read full story
Source: The Independent, 12 January 2022
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Trust launches investigation after staff member’s death

East of England Ambulance Service Trust has launched an ‘independent investigation into the circumstances’ surrounding the death of a staff member, its chief executive told a board meeting today.
Nick Lee, 46, from Ovington in west Norfolk, died on 3 December. The cause of death is yet to be officially established. He was a leading operations manager for west Norfolk, and hospital ambulance liaison officer at Queen Elizabeth Hospital King’s Lynn Foundation Trust and had worked for the ambulance trust for nearly 20 years.
This is not the first time the trust, which has faced significant cultural problems in recent years, has been required to investigate the circumstances surrounding the deaths of members of their workforce.
The trust launched an investigation into the “underlying factors associated with” the sudden deaths of three of its employees in November 2019, HSJ exclusively revealed in January 2020.
A whistleblower alleged in 2019 that staff at the ambulance provider were at risk of suicide because of its “completely toxic culture”. A month after the allegations were reported in October, three young staff members died suddenly in 11 days.
The deaths happened while the trust was transitioning to a new staff welfare provider. The staff who died were ambulance dispatcher Luke Wright, aged 24, and paramedics Christopher Gill, from Welwyn Garden City, and Richard Grimes, from Luton.
Read full story (paywalled)
Source: HSJ, 13 January 2022
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Maternity service safety threatened by staff vacancies and mandatory vaccination, warns trust

A trust has warned it could be forced to restrict maternity services due to a high midwife vacancy rate, and large numbers unvaccinated among the current staff.
The government has mandated that all patient-facing NHS staff must have had two covid vaccination doses from 1 April — meaning they will need to have received their first dose by 3 February. If not, they can be redeployed to non patient-facing roles, or face dismissal.
Barking, Havering and Redbridge University Hospitals Trust’s board heard on Tuesday that the current numbers pose a “significant operational problem” amid efforts to encourage more staff to get both covid jabs before the government’s deadline.
The board meeting was told that, of the trust’s 7,550 staff, approximately 1,300 workers – or 17.4% – do not have a vaccination recorded against them, with the areas of greatest concern being women’s and children’s health, geriatric services, the emergency departments and some clinical support services.
At the board meeting, BHRUHT chief executive Matthew Trainer said: “The vacancy rate, plus the unvaccinated rate, would put us in quite a serious position.
“At the minute, for example, the Queen’s Birth Centre [at Queen’s Hospital in Romford, east London], I don’t think, has been open since I got here. I couldn’t see any circumstances in which it would reopen if we lost another chunk of midwives, for the foreseeable future certainly, in terms of vaccination.
“I think it would leave us in a position where we’d have to look at constraining services and focusing in on core [services], establishment being focused on the labour ward, looking at complex births and making sure we’re doing everything we possibly can to manage it as safely as possible.”
Read full story (paywalled)
Source: HSJ, 12 January 2022
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Covid in pregnancy linked to birth-related complications

A new study has linked COVID-19 to complications during pregnancy.
Scottish researchers found that women who catch the virus near the end of pregnancy were more vulnerable to birth-related complications. They are more likely to suffer them than women who catch Covid in early pregnancy or not at all.
The researchers say getting vaccinated is crucial to protect pregnant women and their babies from life-threatening complications.
The latest findings come from the Covid in Pregnancy Study (Cops), which carried out research across Scotland to learn about the incidence and outcomes of Covid-19 infection and vaccination in pregnancy. It is one of the first national studies of pregnancy and Covid.
They found that preterm births, stillbirths and newborn deaths were more common among women who had the virus 28 days, or less, before their delivery date. The majority of complications occurred in unvaccinated women.
The results, which have been published in Nature Medicine, come after recent data showed 98% of pregnant women admitted to UK intensive care units with coronavirus symptoms were unvaccinated.
Researchers are now calling for measures to increase vaccine uptake in pregnant women.
Read full story
Source: BBC News, 13 January 2022
Patient Safety Learning

Record 6m people waiting for routine hospital treatment in England

Just under 6 million people in England are now waiting for hospital treatment – a record high – as latest performance figures show how the NHS was struggling even before the Omicron Covid variant emerged.
A total of 5,995,156 patients were on the waiting list for an operation in November, of whom more than 2 million had already waited longer than the maximum standard of 18 weeks for routine treatment.
Figures published by the NHS underlined its growing inability to provide timely care. They also showed that more than 300,000 people have been waiting more than a year for surgery and that performance against the crucial four-hour A&E target is the worst ever.
The figures led to warnings from the Health Foundation thinktank that the NHS was “being stretched to its limits” and from the Liberal Democrat health spokesperson Daisy Cooper that “patients are being catastrophically let down by this government’s woeful neglect of the NHS”.
“With the NHS now in the thick of one of the most uniquely challenging periods in its history, unacceptably long waits for hospital care are becoming increasingly commonplace,” said Siva Anandaciva, the chief analyst at the King’s Fund.
Read full story
Source: The Guardian, 13 January 2022
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