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

School uses charity to tackle pupils' toothache

A school has brought in a dental charity to treat pupils with such bad toothache they have missed lessons.
Staff at Trinity Academy Grammar in West Yorkshire have had to take pupils to hospital as they were in agony but unable to access an NHS dentist.
The Department for Health said an extra £50m funding had been given to NHS dental services for more appointments.
Charlie Johnson, headteacher of the school in Sowerby Bridge, near Halifax, said as well as being forced to take days off, some students had been left in tears during lessons due to toothache.
After becoming concerned, Mr Johnson said he had contacted public health officials who said there was a shortage of local NHS dentists taking on patients.
The school was put in touch with Dentaid, a UK charity which normally provided dental treatment to people in developing countries who cannot access it, or to vulnerable people such as the homeless.
As a result, a mobile clinic was brought to the school and volunteer dentists found around one in 10 of its 900 pupils needed treatment for conditions such as decay, cracked teeth and abscesses.
The school said it was "frustrating" it had been forced to step in to provide dental treatment, but added that parents often found it "impossible" to access help.
The British Dental Association said the fact that Trinity Academy had been forced to call on a charity for help illustrated that NHS dentistry was on its "last legs".
Chairman Eddie Crouch said: "We salute these volunteers, but this isn't the Victorian era.
"A wealthy 21st Century nation shouldn't be relying on charities to provide basic healthcare to our children."
Read full story
Source: BBC News, 28 April 2022
Patient Safety Learning

'The thought of running out of HRT is terrifying'

A shortage of specific types of hormone-replacement therapy (HRT) has left women struggling with untreated symptoms of the menopause. Demand for prescriptions has more than doubled since 2017 - partly because of work by campaigners to extend access - but supply of some products has not kept up.
Yasmin Darling's experience of the menopause was sudden and profound. Two years ago, she had two operations to reduce her risk of inherited cancer which plunged her into an early menopause.
"It's really hard to navigate medical menopause 10 years early," the 45-year-old says.
"When you don't have the product you need, it makes it much more difficult to navigate."
Because of Covid, Yasmin has never been seen by a specialist at a menopause clinic, so she is managing as best she can on her own. 
Claire Lopez, 59, spent three weeks trying to obtain her usual HRT patches from different local chemists but they were out of stock. Without them, her body becomes "very stiff", leading to slipped discs and severe back pain.
"I have severe anxiety if I do not have these patches, so the total lack of coordination between GPs and pharmacists was extremely frustrating," Claire says.
In the end, she had to arrange a private prescription through a local clinic, in the Midlands, costing £50.
The government has said it is determined to ensure supplies of HRT can meet high demand.
Minister for Women's Health Maria Caulfield said: "There are over 70 HRT products available in the UK, most of which remain in good supply.
"However, we are aware of some issues with women being unable to access certain products.
"We will be appointing a new HRT-supply chairperson and convening an urgent meeting of suppliers to look at ways we can work together to improve supply."
Read full story
Source: BBC News, 27 April 2022
Patient Safety Learning

Experts who warned over Covid risk to care homes were told they were ‘too risk averse’

Ministers and public health officials were warned that stricter proposals were needed to protect care home patients from Covid-19, Wednesday’s high court ruling revealed.
Draft versions of guidance for hospitals and care homes during the first pandemic wave included measures that were challenged by NHS officials.
The government and Public Health England (PHE) were found to have acted unlawfully over a policy that allowed patients to be discharged from hospitals into care homes during the onset of the pandemic.
In their ruling on Wednesday, Lord Justice Bean and Mr Justice Garnham concluded that policies in March and early April 2020 failed to take into account the risk to elderly and vulnerable residents from non-symptomatic transmission of the virus.
It came after two women took Public Health England, the then health secretary Matt Hancock and NHS England to court over the deaths of their fathers in care homes during the first wave of the pandemic. During the last two years more than 20,000 care home residents have died from Covid-19.
However, court documents show early draft PHE guidance advised against transferring asymptomatic patients into care homes with outbreaks and against admitting Covid positive patients who had not completed their isolation period to care homes. Senior NHS leaders challenged the draft guidance, saying it would make care homes “too risk averse”.
According to documents revealed in the judgment, the then minister for social care Helen Whately raised several concerns about the discharge of Covid-positive patients into care homes.
Read full story
Source: The Independent, 28 April 2022
Patient Safety Learning

NHS boss feared waiting for ambulance after stroke

An NHS boss who had a stroke was taken to A&E by her husband rather than calling for an ambulance because of concerns over long waits.
In a series of tweets, Gloucestershire Hospitals NHS Trust chief executive Deborah Lee praised his swift actions.
She said he had "bundled her into his car", last week, after she had showed the signs of a stroke because he had heard her "lamenting ambulance delays".
She is recovering but says it may have been different if they had called 999.
Waits for an ambulance in England are the longest since new targets were introduced, in 2017.
And Ms Lee's regional service - the South West - has the longest waits in the country, with category-two calls, which include strokes, taking nearly two hours, on average, to reach patients in March.
The target is 18 minutes.
In the tweets, Ms Lee said: "Naturally, I am eternally grateful to my husband for his swift actions… but I can't get one thing out of my head.
"What if my husband hadn't been there and my daughter had called for an ambulance and I'd been put in the cat[egory]-two stack?"
She went on to say it was not the fault of the ambulance service and the whole system was "working unrelentingly to this but to no great avail".
Ms Lee said hospitals were struggling to discharge patients, because of a lack of social care, and so delays were building up in the rest of the system.
Read full story
Source: BBC News, 28 April 2022
Sam

People with arthritis told to exercise more and use painkillers less

People with arthritis are being urged to lose weight and exercise more rather than rely on painkillers as the main therapies for their condition.
NHS guidance from the National Institute for Health and Care Excellence (NICE) says people who are overweight should be told their pain can be reduced if they shed the pounds.
Aerobic exercise such as walking, as well as strength training, can ease symptoms and improve quality of life. Exercise programmes may initially make the pain worse, but this should settle down, the guidance suggests.
The guidelines also give recommendations on the use of medicines, such as offering non-steroidal anti-inflammatory drugs (NSAIDs) but not offering paracetamol, glucosamine or strong opioids.
NICE said there was a risk of addiction with strong opioids, while evidence suggests little or no benefit for some medicines when it comes to quality of life and pain levels.
The draft guidelines say people can be offered tailored exercise programmes, with the explanation “doing regular and consistent exercise, even though this may initially cause discomfort, will be beneficial for their joints”.
Tracey Loftis, head of policy and public affairs at the charity Versus Arthritis, said: “We’ve seen first-hand the benefits that people with osteoarthritis can get in being able to access appropriate physical activity, especially when in a group setting. Something like exercise can improve a person’s mobility, help manage their pain and reduce feelings of isolation.
“But our own research into the support given to people with osteoarthritis showed that far too many do not have their conditions regularly reviewed by healthcare professionals, and even fewer had the opportunity to access physical activity support.
“The lack of alternatives means that, in many cases, many people are stuck on painkillers that are not helping them to live a life free from pain.
“While we welcome the draft Nice guidelines, healthcare professionals need further resources and support to better understand their role in promoting treatment like physical activity for people with osteoarthritis.
“There is clearly a need for people with arthritis to be given a bigger voice so that their health needs are not ignored.”
Read full story
Source: The Guardian, 29 April 2022
Patient Safety Learning

Maternity scandal families slam NHS over no confidence vote ‘silence’

Families impacted by the Nottingham maternity scandal say they have been left in “limbo” following silence from NHS England in response to their concerns over a major review, as 50 more come forward.
The review into failures in maternity services at Nottingham University Hospitals Foundation Trust has now had 512 families come forward with concerns, up from 460 last month, and has spoken to 71 members of staff.
The update comes as families told The Independent they were yet to receive a direct acknowledgement or response to their warning on Monday that they had no confidence in newly appointed review chairwoman Julie Dent.
In response to a letter outlining her appointment, the families asked for Ms Dent to decline the offer and instead pushed for NHS England to ask Donna Ockenden, who is chairing a similar inquiry into Shrewsbury maternity care.
Former health secretary and health committee chairman, Jeremy Hunt, has now also challenged the NHS on Ms Dent’s appointment, and echoed the families’ call to ask Ms Ockenden.
Read full story
Source: The Independent, 29 April 2022
Patient Safety Learning

Patients died after catalogue of errors by Priory mental health chain

NHS bosses have attacked the country’s leading private mental healthcare chain for failing to keep patients safe, The Times has learnt, as an investigation reveals the Priory Group has been criticised for failings in the care of 30 patients who have died.
An investigation by this newspaper reveals that the company, which earns at least £400 million a year from public sector contracts for looking after mentally ill patients, has been repeatedly criticised for the same failures of care over the past decade.
This week the Priory was criticised in the inquest of Eliana Hanton, 20, who died after hanging herself using a ligature point that had been highlighted as a risk in an internal audit four months earlier.
An inquest in Birmingham last week concluded that neglect by the Woodbourne Priory Hospital contributed to the death of Matthew Caseby, 23.
The company has repeatedly been criticised for the same failings in relation to patient deaths, leading to questions about whether it is learning from its mistakes, including inadequate or inaccurate risk assessments, staff's lack of training or expertise, a failure to address known ligature points or escape routes and materials which could be used to self-harm, and poor record keeping.
Read full story (paywalled)
Source: The Times, 29 April 2022
Patient Safety Learning

Government to review the future of CQC and NHS England

NHS England, the Care Quality Commission and other arm’s length bodies will be subject to an efficiency and performance review led by the Cabinet Office.
The terms of a review into all government arm’s length bodies were set out this week, with minister Jacob Rees-Mogg insisting there is an “urgent need for public service reform”.
The ‘public bodies review’ programme will consider whether ALBs “should be abolished or retained”, should continue to deliver all their functions, and whether they have an “effective relationship” with their relevant departments.
Other ALBs include the National Institute for Health and Care Excellence, Health Education England, and the UK Health Security Agency.
A guidance document says: “The outcome of this work should see powers returned to accountable ministers, greater efficiency and where appropriate, the state stepping back both financially and from people’s lives…
Read full story (paywalled)
Source: HSJ, 29 April 2022
Patient Safety Learning

Lack of Covid testing leaves researchers blind to evolution patterns, WHO warns

A dramatic drop in testing for Covid-19 has left the world blind to the virus’s continuing rampage and its potentially dangerous mutations, the head of the World Health Organization has warned.
The UN health agency said that reported Covid cases and deaths had been dropping dramatically. “Last week, just over 15,000 deaths were reported to WHO – the lowest weekly total since March 2020,” WHO chief Tedros Adhanom Ghebreyesus told reporters.
While saying this was “a very welcome trend”, he warned that the declining numbers could also be a result of significant cuts in testing for the virus.
“As many countries reduce testing, WHO is receiving less and less information about transmission and sequencing,” he said. “This makes us increasingly blind to patterns of transmission and evolution."
“When it comes to a deadly virus, ignorance is not bliss.”
William Rodriguez, who heads the global diagnostics alliance FIND, also decried that many governments in recent months simply stopped looking for Covid cases.
Speaking at the press conference hosted by WHO, he pointed out that in the past four months, amid surging Covid cases from the Omicron variant, “testing rates have plummeted by 70% to 90% worldwide”.
The plunging testing rates came despite the fact that there is now more access to accurate testing than ever before.
“We have an unprecedented ability to know what is happening,” Rodriguez said. “And yet today, because testing has been the first casualty of a global decision to let down our guard, we’re becoming blind to what is happening with this virus.”
Read full story
Source: The Guardian, 26 April 2022
Patient Safety Learning

Trust’s pension fix refusal risks wave of doctor resignations

A ‘significant flurry’ of senior doctors will look to retire after a trust rejected a scheme designed to avoid higher taxes on their pensions, according to internal emails.
Emails from senior doctors suggest Liverpool University Hospitals Foundation Trust has rejected proposals to introduce “pension recycling”, a scheme endorsed nationally to avoid the tax rules.
Government policy changes in 2016 reduced tax relief on higher earners’ pension contributions. This has discouraged clinical consultants from taking on extra shifts, and in some cases, prompted people to retire earlier than planned.
Last month, NHS England’s chief executive Amanda Pritchard suggested this was a continuing problem for hospitals as they seek to increase elective activity.
Read full story (paywalled)
Source: HSJ, 29 April 2022
Patient Safety Learning

Whistleblowing Bill launched in Parliament to widespread support

The Doctors’ Association UK (DAUK) has expressed its support for the Whistleblowing Bill launched in Parliament last week, with its first reading in the House of Commons by Mary Robinson MP, Chair of the All Party Parliamentary Group for Whistleblowing.
DAUK urged people to tweet their MP to show their support for the Bill.
DAUK Chair Dr Jenny Vaughan said: "Healthcare staff need to be able raise patient safety issues all of the time. We’re trained to do that, expect it, point this out as best we can. But sometimes poor safety arises because of the way we are told to work. Then, it can be just as hard for staff to speak up as it is for anyone else, because we can also be threatened, sanctioned, isolated, ignored and bullied.
"Blowing the whistle for us means saving lives, in the end. But we stand to lose as much as anyone. DAUK has supported many doctors who have been made to suffer because they spoke out, and there are many more who feel they should but are afraid to.  That is why this Bill is so important. For all staff within healthcare. And most of all, for patients  - the public. Stopping the greater harm for the greater good.”
The most important changes in the private members bill, led by Baroness Kramer would:
Require disclosures to be acted upon and whistleblowers protected. Provide criminal and civil penalties for organisations and individuals failing to do so. Establish a fully independent parliamentary body on whistleblowing, and provide easy access to redress. Read full story
Source: Medscape UK, 26 April 2022
Patient Safety Learning

Republic of Ireland: Significant rise in ‘extreme’ incidents involving harm to patients

The number of notified “extreme” and “major” incidents involving serious harm to patients and others in hospital has risen significantly in the Republic of Ireland in recent years, new figures reveal.
Reported “extreme” incidents, which can involve death or permanent incapacity, rose from 373 in 2017 to 579 last year.
The number of cases classified as “major”, where there is long-term disability or incapacity, climbed from 46 to 82 in the same period.
“Moderate” incidents, when there is a patient injury involving medical treatment, also increased from 9,219 in 2017 to 13,563 last year.
Minor incidents, involving injury or illness needing first aid, also increased over the same time from 9,210 to 15,483.
The figures, involving patients, staff, visitors, contractors and the public, were released by the HSE in response to a parliamentary question from Aontú leader Peadar Tóibín.
A spokewoman for the HSE said: “It is HSE policy that all incidents are identified, reported and reviewed so that learning from events can be shared to improve the quality and safety of services.” 
“The number of reported incidents has increased year on year since 2004 with a significant increase noted since 2015, with the introduction of the National Incident Management System.”
Read full story
Source: Independent.ie, 3 May 2022
Patient Safety Learning

‘Lives at risk’ in Britain’s crumbling hospitals

Patients’ lives are at risk because NHS hospitals have been allowed to crumble into disrepair, with ceilings collapsing and power cuts disrupting surgery.
The number of clinical incidents linked to the failure to repair old buildings and faulty equipment has tripled in the past five years, an investigation by The Times found.
Hundreds of vital NHS operations and appointments are being cancelled as a result of outdated infrastructure, undermining attempts by doctors to tackle record waiting lists.
Recent incidents include an unconscious patient on a ventilator being trapped in a broken lift for 35 minutes and power running out as a patient lay in an operating theatre.
On Saturday, April 23, a five-hour power cut at the Royal London Hospital in east London led to the cancellation of operations including two lifesaving kidney transplants, and meant women giving birth had to be transferred to different maternity units in the backs of taxis.
Hospitals have also recorded hundreds of rat and pest infestations, and some rooms containing patients have been left “overflowing with raw sewage”.
Read full story (paywalled)
Source: The Times, 2 May 2022
Patient Safety Learning

'Utterly inhumane' hospitals still ban bedside visitors as Covid cases plunge

Hospitals are still banning patients from having bedside visitors in ‘immoral’ Covid restrictions. 
Last night, MPs, patient groups and campaigners criticised the postcode lottery that means some frail patients are still denied the support of loved ones. 
Nine trusts continue to impose total bans on any visitors for some patients, The Mail on Sunday has found. 
Almost half of trusts maintain policies so strict that they flaunt NHS England’s guidance that patients should be allowed at least two visitors a day. 
Shrewsbury and Telford Hospital NHS Trust, Sandwell and West Birmingham Hospitals NHS Trust and Royal Papworth Hospital NHS Foundation Trust are among those continuing total bans on visiting for some of their patients. 
University College London Hospitals NHS Foundation Trust (UCLH) has even been imposing its draconian restrictions on disabled patients who need special help for their care – only allowing visits on three days a week for a maximum of an hour each time. 
Tory MP Alicia Kearns said: ‘It is utterly unforgivable and immoral. There is no scientific evidence for any remaining inhumane restrictions on visiting. Trusts are breaching the rights of families. 
'Visitors save lives, they advocate and calm their loved ones. When will this madness end?’ 
Read full story
Source: MailOnline, 1 May 2022
You may also be interested in:
Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative  
Patient Safety Learning

Cancer checks: Record number of patients referred in England

A record 2.7 million people were referred for cancer checks in the last year, NHS England has said.
It comes after figures suggested the Covid pandemic saw numbers dramatically decline in 2020. But at least 30,000 people are still waiting to start treatment.
Charities have welcomed the increase in referrals but warned of the "devastating" impact the pandemic has had on cancer care.
Referrals for suspected cancer remain at about 16% higher than pre-pandemic levels and rose overall from 2.4 million to 2,65m in the past 12 months.
Dame Cally Palmer, national cancer director for NHS England, said there were still 30,000 people who had not started treatment due to the pandemic but that the new figures suggested some progress.
She said: "We are going further and faster than ever before in our ambitions to diagnose more cancers at an earlier stage so that we can save more lives."
It is "vital that we keep these referral rates high", she added.
Read full story
Source: BBC News, 2 May 2022
Patient Safety Learning

US Supreme Court may overturn abortion law, leak suggests

The US Supreme Court could be about to overturn the nationwide legal right to abortion, according to an unprecedented leaked draft of a court document.
In a 98-page draft opinion, Justice Samuel Alito writes that the 1973 Roe v Wade decision legalising abortion across the US is "egregiously wrong".
If the top US court strikes down the ruling, "trigger laws" could instantly make abortion illegal in 22 US states.
The justices are not expected to issue a ruling until early July.
It sparked immediate outcry from Democrats, and protests - by both pro and anti-abortion supporters - outside the Supreme Court on Monday night.
Speaker of the House of Representatives Nancy Pelosi and Senate Majority Leader Chuck Schumer - both Democrats - issued a joint statement saying that if the report was accurate, the "Supreme Court is poised to inflict the greatest restriction of rights in the past 50 years".
News outlet Politico published the leaked document in full, quoting Justice Alito as saying: "Roe was egregiously wrong from the start. Its reasoning was exceptionally weak, and the decision has had damaging consequences.
"And far from bringing about a national settlement of the abortion issue, Roe and Casey have enflamed debate and deepened division."
Read full story
Source: BBC News, 3 May 2022
 
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