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

NHS waiting list hits record 6.4 million

A new high of 6.4 million people in England were waiting for routine NHS treatment in March 2022, as 12 hours waits in A&E hit an all time high last month and ambulance services continued to struggle.
This is up from 6.2 million in February and is the highest number since records began in August 2007.
A new record of 24,138 people had to wait more than 12 hours in A&E after a decision to admit them had been made in April.
The figure is up from 22,506 in March, and is the highest for any calendar month in records going back to August 2010.
However the number of patients being seen within four hours in April improved compared to March, with 72.3% of patients seen in this time compared to 71.6%.
Professor Stephen Powis, national medical director for NHS England, said: “Today’s figures show our hardworking teams across the NHS are making good progress in tackling the backlogs that have built up with record numbers of diagnostic tests and cancer checks taking place in March, as part of the most ambitious catch up plan in NHS history.
“We always knew the waiting list would initially continue to grow as more people come forward for care who may have held off during the pandemic, but today’s data show the number of people waiting more than two years has fallen for the second month in a row, and the number waiting more than 18 months has gone down for the first time."
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Source: The Independent, 12 May 2022
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Senegal midwives convicted over mother's death

Three Senegalese midwives involved in the death of a woman in labour have been found guilty of not assisting someone in danger.
They received six-month suspended sentences, after Astou Sokhna died while reportedly begging for a Caesarean. Her unborn child also died.
Three other midwives who were also on trial were not found guilty
The case caused a national outcry with President Macky Sall ordering an investigation.
Mrs Sokhna was in her 30s when she passed away at a hospital in the northern town of Louga. During her reported 20-hour labour ordeal, her pleas to doctors to carry out a Caesarean were ignored because it had not been planned in advance, local media reported.
The hospital even threatened to send her away if she kept insisting on the procedure, according to the press reports.
Her husband, Modou Mboup, who was in court, told the AFP news agency that bringing the case to light was necessary.
"We highlighted something that all Senegalese deplore about their hospitals," 
"If we stand idly by, there could be other Astou Sokhnas. We have to stand up so that something like this doesn't happen again."
Read full story
Source: BBC News, 11 May 2022
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Lack of drugs for use in pregnancy ‘resulting in needless deaths’ in UK

Women and babies in the UK are “dying needlessly” because of a lack of suitable medicines to use in pregnancy, according to a report that calls for a radical overhaul of maternal health.
A “profound” shortage of research and the widespread exclusion of pregnant and breastfeeding women from clinical trials means hardly any new drugs are approved for common medical problems in pregnancy or soon after childbirth, the report finds.
Meanwhile, scarce or contradictory information about the safety of existing medicines women may be taking for continuing conditions can make it impossible to reach a confident decision on whether or not to continue them in pregnancy, the experts add.
“While pregnancy in the UK is generally considered safe, women and babies are still dying needlessly as a direct result of preventable pregnancy complications,” the authors say. Each year, 5,000 babies in the UK are either stillborn or die shortly after birth, while about 70 women die of complications in pregnancy.
The Healthy Mum, Healthy Baby, Healthy Future report draws on evidence from patient groups, clinicians, researchers, lawyers, insurance specialists and the pharmaceutical industry, it proposes “urgent” changes to transform women’s access to modern medicine.
The report highlights the “profound lack of research activity” and up-to-date information that leaves pregnant women and their physicians in the dark about whether to continue with certain medicines in pregnancy. Some epilepsy drugs, for example, can increase the risk of birth defects, but coming off them can put the woman at risk of severe seizures, which can also harm the baby.
Lady Manningham-Buller said the situation “urgently needs to change”, with the report setting out eight recommendations to prevent needless deaths.
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Source: The Guardian, 12 May 2022
 
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Hundreds of organisations breached patient data rules, reveals BMJ

Hundreds of organisations, including drug companies, private healthcare providers and universities, have breached patient data sharing agreements but not had their access to patient data withdrawn, a report reveals.
“High risk” breaches were revealed to have occurred at healthcare groups, pharmaceutical giants and educational institutions including Virgin Care, GlaxoSmithKline (GSK) and Imperial College London, during audits by NHS Digital, according to an investigation by the BMJ.
This means these organisations were handling information outside the remit agreed in data contracts and may be failing to protect confidentiality, the journal said.
In one instance, local NHS commissioners allowed sensitive, identifiable patient data to be released to Virgin Care without permission from NHS Digital. When auditors tried to get access to Virgin Care to check their compliance, they were denied access for several weeks and the company refused to delete the patient data, the BMJ reported.
Records about mental health, including children and young people, those with learning disabilities, diagnostic imaging and other confidential patient data was being processed outside the scope of objectives agreed with NHS Digital, at an address that had not been agreed, and without a data sharing contract.
A spokesperson for Virgin Care said it had “robust data protection in place”.
“It is outrageous that private companies and university research teams are failing to comply,” said Kingsley Manning, the former chair of NHS Digital. “How is it that these organisations can be so lax with data?”
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Source: The Guardian, 11 May 2022
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Government watchdog: 1 in 4 older Americans on Medicare harmed during hospital stays

One in four older Americans covered by Medicare had some type of temporary or lasting harm during hospital stays before the COVID-19 pandemic, government investigators said in an oversight report published Thursday. 
The report from the U.S. Department of Health and Human Services Office of Inspector General said 12% of patients had “adverse events” that mainly led to longer hospital stays but also permanent harm, death or required life-saving intervention. Another 13% had temporary issues that could have caused further complications had hospital staff not acted.
Investigators reviewed the medical records of 770 Medicare patients discharged from 629 hospitals in 2018 to formulate a national rate on how often patients were harmed, whether preventable or not. An earlier Inspector General review found 27% of patients experienced some type of harm – an investigation that led to new patient safety efforts and incentives. 
The incremental improvement follows intense focus on patient safety since at least 1999 when the then-Institute of Medicine published To Err is Human, a landmark report that estimated up to 98,000 deaths per year could be due to medical errors. Initiatives have since sought to improve patient safety by limiting medical errors, reducing medication mix-ups and holding hospitals with a poor record of patient safety accountable through Medicare's program to dock the pay of the worst performers on a list of safety measures. 
While Inspector General investigators noted improvements in certain safety measures, officials said the 25% harm rate is concerning and deserves renewed attention from hospitals and two federal agencies that oversee patient safety: the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality.
"We still have a significant way to go in terms of improving patient safety," said Amy Ashcraft, a deputy regional inspector general. 
Read full story
Source: USA Today News, 12 May 2022
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New report demonstrates the importance of working with patients to reduce digital health inequalities

A recent report based on research and case studies of good practice in combatting digital health inequalities demonstrates the importance in working with patients who are digitally excluded.
The report, Putting patients first: championing good practice in combatting digital health inequalities, is the second report by the Patient Coalition for AI, Data and Digital Tech in Health. 
This report focuses on digital health inequalities and the impact that digital exclusion is having on health in the UK. It highlights different reasons for disparities in a person’s ability to access and use digital health technology and provides insights into the severity of the UK’s digital inequalities.
The Coalition report concludes recommending that the Government and NHS should:
Engage with those digitally excluded Ensure patients have a choice Ensure the language is appropriate for all audiences Learn from good practice. Read full story
Source: The Patients Association, 9 May 2022
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Children’s lives ‘put at risk’ as eating disorder waits reach record high

Children’s lives are being put at risk, charities warn, as waiting times for eating disorder services soar to record highs.
The number of children waiting more than four months following an urgent referral for an eating disorder was more than seven times higher at the end of 2021-22 compared to the same period in the previous year.
Data showed that at the end of quarter four of 2021-22, 94 children were waiting more than 12 weeks following an urgent referral, the highest on record, compared to just 13 at the end of 2020-21.
The latest NHS data on waiting times for community eating disorder services for children also showed more than 1,900 children were waiting for treatment at the end of March. Of these, 24 were waiting to start urgent treatment - up from 130 last year.
Sophie Corlett, director of external affairs at Mind, said: “Our government is shamefully failing children and young people with eating disorders at the time when they need help most. Eating disorders have one of the highest mortality rates of any mental health problem. Children in need of urgent NHS treatment for eating disorders should always be seen within one week yet some children are still waiting for treatment after twelve weeks. This is irresponsible and disgraceful.”
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Source: The Independent, 12 May 2022
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Dangerous staffing levels in Borders hospitals, says union

A trade union has written to every politician representing the Scottish Borders to highlight "dangerous staffing levels" in local hospitals.
Unison claims serious breaches of safety guidelines are occurring daily due to a lack of nurses, auxiliaries and porters. The letter says staff are unable to take proper rest breaks or log serious incidents in the reporting system.
NHS Borders said patient and staff safety was its number one priority.
Unison said working conditions in the area were regularly in breach of regulations.
Greig Kelbie, the union's regional officer in the Borders, said: "We are getting regular messages from our members to tell us about the pressure they are under - and that they can't cope.
"The care system was under pressure before Covid, but the pandemic has exasperated the situation, particularly at NHS Borders.
"The NHS has been stretched to its limits and it is now at the stage where it is dangerous for patients and staff - we're often told about serious breaches of health and safety, particularly at Borders General Hospital where there are issues with flooring and staff falling.
"We work collaboratively with NHS Borders to do what we can, but we also wanted to make politicians aware of how bad things have become.
"We need our politicians to step up and implement change - we want them to make sure the Health and Care Act is brought to the fore and that it protects our members."
Read full story
Source: BBC News, 13 May 2022
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Tougher cancer target considered by ministers

The Government is considering setting a tougher cancer diagnostic target as part of its declared ‘war on cancer’, HSJ  has been told.
Sajid Javid announced a “war on cancer” and launched a call for evidence on what could be done to improve services in February.
HSJ understands one of the measures being considered is increasing the existing target for cancer diagnosis, set in the 2019 NHS long-term plan.
The current target committed the service to diagnosing 75% of cancers at stages one and two by 2028.
At present, performance is around 54% and late stage diagnosis is a key factor behind the UK’s poor performance on cancer mortality, compared with other wealthy nations.
Cancer Research UK has asked for government, as part of the latest consultation, to set a target of at most 20% diagnosed at stage three and four – effectively, 80% or more at stages one and two – by 2032.
The Royal College of Radiologists pointed out in February that there was a shortfall of nearly 2,000 consultant radiologists and 20% fewer consultant oncologists to meet the existing gaps.
Read full story (paywalled)
Source: HSJ, 13 May 2022
 
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Covid inquiry broadens scope to include children

The scope of the UK public inquiry into the handling of the Covid pandemic has widened to include a focus on children.
When the draft terms were published in March, there was criticism that they failed to even mention the impact on children and young people. But after a public consultation, the final terms have been published and now incorporate the effect on the health, wellbeing and education of children.
The final terms of reference were decided following a four-week public consultation on the draft terms.
As well as expanding the terms to include the impact on the health, wellbeing and education of children and young people, the inquiry will also look at the wider mental health impact across the population.
The focus on inequalities will also be strengthened, the inquiry said, so that the unequal impact on different sections of society will be considered at all stages.
Alongside these issues, the UK-wide inquiry will also look at the following issues which were included originally:
the UK's preparedness for the pandemic the use of lockdowns and other "non-pharmaceutical" interventions, such as social distancing and the use of face coverings the management of the pandemic in hospitals and care homes the procurement and provision of equipment like personal protective equipment and ventilators support for businesses and jobs, including the furlough scheme, as well as benefits and sick pay. Read full story
Source: BBC News, 12 May 2022
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US overdose deaths hit record 107,000 last year, CDC says

More than 107,000 Americans died of drug overdoses last year, setting another tragic record in the nation’s escalating overdose epidemic, the Centers for Disease Control and Prevention (CDC) estimated Wednesday.
The provisional 2021 total translates to roughly one U.S. overdose death every 5 minutes. It marked a 15% increase from the previous record, set the year before. The CDC reviews death certificates and then makes an estimate to account for delayed and incomplete reporting.
Dr. Nora Volkow, director of the National Institute on Drug Abuse, called the latest numbers “truly staggering.”
The White House issued a statement calling the accelerating pace of overdose deaths “unacceptable” and promoting its recently announced national drug control strategy. It calls for measures like connecting more people to treatment, disrupting drug trafficking and expanding access to the overdose-reversing medication naloxone.
Experts say the COVID-19 pandemic has exacerbated the problem as lockdowns and other restrictions isolated those with drug addictions and made treatment harder to get.
Read full story
Source: AP News, 11 May 2022
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Waiting list jumps as A&E chaos persists

The NHS has recorded its largest monthly increase in the waiting list for 10 months, as unprecedented challenges in urgent and emergency care continue to disrupt recovery.
The elective figures published today for March presented mixed results, but much of the good news – a drop in the number of two-year waiters – had already been announced by NHS England in unvalidated figures for April.
Meanwhile, the system recorded its largest monthly rise in the overall list for 10 months, with the number of patients growing by 174,847 to hit a new record 6.36 million. This is the biggest month-on-month increase since the number jumped between April and May 2021 when it rose by 181,708 to hit 5.3 million.
The overall list has risen every month since May 2021, but the rises in the last four months have all been under 80,000.
The NHS warned in February it expects the waiting list to continue rising until March 2024, with patients now seeking care after various covid lockdowns.
Meanwhile, the number of patients waiting 12 hours from a decision to admit in accident and emergency departments reached a new high in data published today, covering April. 
Ambulance response times also improved slightly last month from March’s all-time low. Average category one performance – for immediately life-threatening conditions, such as cardiac or respiratory arrest - was 9:02 minutes against a seven-minute target, but still an improvement on last month’s 9:35 minutes. 
Read full story (paywalled)
Source: HSJ, 12 May 2022
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Medical director wins 'whistle blowing' unfair dismissal case

A former medical director on the Isle of Man, who lost her job when she questioned decisions made on the island during the COVID-19 pandemic, has won her case for unfair dismissal at an employment tribunal.
The hearing, which began in January, heard how Dr Rosalind Ranson was victimised and dismissed from her role after making 'protected disclosures' as part of her efforts to persuade the Manx Government to deviate from Public Health England (PHE) advice in the early stages of the pandemic.
Dr Ranson, who had extensive experience as a GP and as a senior medical leader in the NHS in England, was appointed to her post as the island's most senior doctor in January 2020 with the aim of tackling what she identified as a disillusioned medical workforce, failings in management, and a bullying culture.
She was soon called on to provide expert medical advice and guidance on how the Isle of Man’s health system should respond to the spread of COVID-19. In March, Dr Ranson channelled concerns from the island's doctors that the advice from PHE was flawed, and that a more robust approach should be taken to stem the spread of SARS-CoV-2. That included closing the island’s borders – a move that was initially ignored.
Dr Ranson became concerned that her medical advice was not being heeded and that it might not be being passed on to ministers by the then Chief Executive of the Isle of Man’s Department of Health and Social Care (DHSC), Kathryn Magson, who was not medically qualified.
The tribunal heard that because Dr Ranson had "blown the whistle" when she spoke out, she was sidelined and eventually dismissed unfairly.
Read full story
Source: Medscape, 11 May 2022
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Nurses take to streets ahead of RaDonda Vaught sentencing

Nurses from across the country are heading to Washington, D.C., and Nashville, Tenn., this week to march for better working conditions and to show support for nurse RaDonda Vaught. 
Ms. Vaught, 38, was convicted of criminally negligent homicide and abuse of an impaired adult for a fatal medication error she made in December 2017 after overriding an electronic medical cabinet as a nurse at Vanderbilt University Medical Center in Nashville. Her case has spurred a national outcry from nurses who argue the ruling sets a dangerous precedent for the profession and will discourage nurses from speaking up about errors. 
Ms. Vaught's sentencing is scheduled for 13 May in Nashville, and she faces up to eight years in prison. Hundreds of nurses are planning to march in Nashville the day of the hearing to show their support for Ms. Vaught and to fight for better protection for nurses against criminal prosecution of errors. 
"We expect a large number of people to show up … just to show our strength in numbers and hope that the judge takes this into consideration and makes it slightly better by not sentencing her to any prison time," said Erica, a Las Vegas-based hospice nurse who is attending the sentencing.
Read full story
Source: Becker's Hospital Review, 13 May 2022
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US faces deficit of 450,000 nurses by 2025

The United States could see a deficit of 200,000 to 450,000 registered nurses available for direct patient care by 2025, a 10 to 20% gap that places great demand on the nurse graduate pipeline over the next three years.
The new estimates and analysis come from a McKinsey report published this week. The shortfall range of 200,000 to 450,000 holds if there are no changes in current care delivery models. The consulting firm estimates that for every 1% of nurses who leave direct patient care, the shortage worsens by about 30,000 nurses.
To make up for the 10 to 20%, the United States would need to more than double the number of new graduates entering and staying in the nursing workforce every year for the next three years straight. For this to occur, the number of nurse educators would also need to increase.
"Even if there was a huge increase in high school or college students seeking nursing careers, they would likely run into a block: There are not enough spots in nursing schools, and there are not enough educators, clinical rotation spots or mentors for the next generation of nurses," the analysis states. "Progress may depend on creating attractive situations for nurse educators, a role traditionally plagued with shortages."
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Source: Becker's Hospital Review, 12 May 2022
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Inside Britain’s flagship Covid lab that no one knows what to do with

It was hailed as a cutting-edge laboratory that would play a key role in response to Covid-19 and future epidemics, carrying out 300,000 tests a day.
Announcing the project in November 2020, then-health secretary Matt Hancock said the project “confirms the UK as a world leader in diagnostics”.
But less than 18 months later, the Rosalind Franklin Laboratory – named in honour of the renowned British scientist – has been plagued by failure while costing almost twice as much as its initial £588m budget, The Independent understands.
Instead of being at the forefront of the fight against Covid, the project opened six months late, facing a string of issues with equipment, staff and construction, with barely 20% of its touted capacity being reached.
Now, as the government winds down its “lighthouse” testing labs as part of the plan to “live with Covid”, leaving the Leamington Spa facility as the last lab standing, there are questions about the future of the site – and whether it would be able to cope with the nation’s testing needs alone if another deadly wave of Covid were to emerge.
Read full story
Source: The Independent, 28 April 2022
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