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

Long delays for surgery ‘will trigger public health crisis’

Surgery waiting lists will triple by 2030, triggering a “population health crisis”, unless there is a huge increase in NHS capacity, according to new research.
Experts from Birmingham University have said efforts to reduce hospital backlogs are not enough and that it is “impossible” for the existing frontline workers to tackle increasing waiting lists.
The most in-depth analysis of the challenge facing hospital waiting lists in England has revealed 4.3 million people need invasive surgery or procedures such as endoscopy, the largest number since 2007.
Of these, an estimated 3.3 million are on a “hidden waiting list”, likely to need treatment but yet to be identified by the NHS due to the impact of the pandemic.
More than 2.3 million people, 53% of the waiting list, are of working age, meaning their delayed diagnoses and treatments could have an impact on the economy.
Without a substantial increase in NHS capacity, the team behind the work say the total figure for those waiting for surgery in England could rise to 14.6 million by 2030.
Read full story (paywalled)
Source: The Times, 26 June 2022
Patient Safety Learning

UK to strengthen regulation of medical devices to protect patients

New plans to strengthen the regulation of medical devices to improve patient safety and encourage innovation have been published.
Following the UK’s exit from the European Union (EU), the Medicines and Healthcare products Regulatory Agency (MHRA) has a unique opportunity to improve how medical devices and in vitro diagnostic medical devices (IVDs) are regulated in the UK.
The package of reforms will apply to medical devices such as hearing aids, x-ray machines and insulin pumps; new technologies such as smartphone apps and Artificial Intelligence (AI); as well as certain cosmetic products like dermal fillers.
The new measures include:
Strengthening the MHRA’s powers to act to keep patients safe. Giving the public and patients greater assurance on both the performance and safety of the highest-risk medical devices, such as those which need to be implanted. Increasing the scope and extent of regulation to respond to public need. Enhancing systems that are already in place to better protect users of medical devices and certain cosmetic products, and providing greater assurance of their performance and safety. Addressing health disparities and mitigating identified inequities throughout medical devices development and use. Mitigating against inequities in medical devices, ensuring they function as intended for diverse populations. The government has launched a review into the potential equity issues in the design and use of medical devices to tackle health inequalities and will update in due course. Making the UK a focus for innovation, and the best place to develop and introduce innovative medical devices. Ensuring the new regulatory framework encourages responsible innovation so that patients in the UK are better able to access the most advanced medical devices to meet their needs. Setting world-leading standards and building the new UKCA mark. Transforming a new stamp of certification, replacing the CE mark, into a trusted brand that signifies global safety, health and environment protection standards have been met for medical device products. This will in turn boost the MHRA’s global reputation and growing partnerships with other regulators. Health and Social Care Secretary Sajid Javid said: "Now we have left the EU, these new changes will allow innovation to thrive and ensure UK patients are among the first to benefit from technological breakthroughs."
"We are now able to introduce some of the most robust safety measures in the world for medical devices to ensure patients are protected."
Read press release
Source: Gov.UK, 26 June 2022
 
Patient Safety Learning

NHS patients to be offered chance to travel for surgery

NHS patients in England who have been waiting more than two years for surgery are being offered hospital treatment in alternative parts of the country.
More than 6,000 long-term waiting-list patients are being offered travel and accommodation costs where appropriate to help the NHS through the backlog.
Health officials want to ensure nobody is waiting more than two years by the end of July.
Three patients waiting for surgery in Derby have already received treatment in the Northumbria health region, with another two patients booked in, NHS England said.
And in south-west London, 17 orthopaedic patients from the South West of England are being treated, with another 11 patients set to follow in the coming weeks.
Health and Social Care Secretary Sajid Javid said the number of two-year waits had already reduced by two-thirds since January.
"Innovations like this are helping to tackle waiting lists and speed up access to treatment, backed by record investment," he said.
But British Medical Association leader Dr Chaand Nagpaul is warning that attempts to address what he called a "once in a generation backlog of unimaginable proportions" would be undermined by a lack of staff and beds.
Read full story
Source: BBC News, 27 June 2022
Patient Safety Learning

'We will be in uncharted territory:' 4 leaders on the potential implications of Roe vs Wade reversal

The effects of the Supreme Court's proposed overrule of Roe vs Wade will touch health systems nationwide — leading some clinicians to urge industry leaders to start preparing for potential fallout prior to the decision. 
"Health systems that view abortion exclusively as a political or partisan issue, perhaps one they'd like to avoid, will soon bear witness to the reality that abortion care, or lack thereof, is a healthcare and health equity issue," Lisa Harris, MD, PhD, wrote in a 11 May for The New England Journal of Medicine. "Avoiding the issue will not be possible, short of abandoning care and equity missions altogether. Thoughtful preparation is needed now."
Four leaders at three systems share there insights.
Read full story
Source: Becker's Hospital Review, 23 June 2022
Patient Safety Learning

Possible link between blood clots and Covid symptoms investigated

A possible link between blood clots and ongoing symptoms of Covid is under scrutiny by researchers in the UK.
While Covid can cause a period of acute illness, it can also lead to longer-term problems. Research has suggested fewer than a third of patients who have ongoing Covid symptoms after being hospitalised with the disease feel fully recovered a year later.
Now researchers are due to begin a number of trials to explore whether blood thinners may help those who have had the disease.
Prof Ami Banerjee, of University College London, who is leading a study called Stimulate-ICP, said it was known that a Covid infection increases the risk of blood clots, and that people who have had the disease have a greater risk of related conditions including stroke, heart attacks and deep vein thrombosis.
In addition, Banerjee said research from scientists in South Africa had suggested that people with long Covid have microclots in their blood, while studies in the UK suggested almost a third of long Covid patients have clotting abnormalities.
But he said it was not clear if the findings were generalisable, and while there had been calls on social media for anticoagulants to be made available on the basis of such findings, further research was needed, not least as blood thinners can lead to an increased risk of bleeds.
Read full story
Source: The Guardian, 27 June 2022
Patient Safety Learning

Former prime minister calls contaminated blood scandal 'incredibly bad luck'

Former prime minister Sir John Major has described the contaminated blood scandal as "incredibly bad luck", drawing gasps from families watching him give evidence under oath to the public inquiry into the disaster.
Up to 30,000 people contracted HIV and hepatitis C in the 1970s and 80s after being given blood treatments or transfusions on the NHS. Thousands have since died.
Sir John later apologised for his choice of language.
He said: "I obviously caused offence inadvertently this morning when I referred to the fact that it was awful that people had been fed infected blood and I referred to it as sheer bad luck.
"I can only say to people it wasn't intended to be offensive. I was seeking to express the fact that I was concerned about what happened.
"It was intended simply to say that it was a random matter and I perhaps expressed it injudiciously."
The UK-wide inquiry was launched after years of campaigning by victims, who claim the risks were never explained and that the scandal was covered up.
Campaigners say those infected decades ago are now dying at the rate of one every four days as a result.
Read full story
Source: BBC News, 27 June 2022
Patient Safety Learning

UK doctors demand pay rise of up to 30% over five years

Doctors have thrown down the gauntlet to the government by calling for a pay rise of up to 30% over the next five years, in a move that increases the chances of strike action.
Delegates at the British Medical Association’s (BMA) annual conference voted to press ministers to agree to the increase to make up for real-terms cuts to their salaries over the last 14 years.
Frontline doctors said years of pay freezes and annual salary uplifts of 1% had caused the real value of their take-home pay to fall by almost a third since 2008. They now want “full pay restoration” to return the value of their pay to 2008 levels, and have instructed the BMA to pursue that goal with a government that has made clear it will not hand public sector workers sizeable salary increases in case it fuels already rampant inflation.
The motion noted “with horror that all doctors’ pay has fallen against RPI [the retail prices index] since 2008 to the tune of up to 30%”. It said the BMA’s leadership should “achieve pay restoration to 2008 for its members within the next five years” and report back annually on progress.
Proposing the motion, Dr Emma Runswick, a member of the BMA’s ruling council, said: “We should not wait for things to get worse. All of us deserve comfort and pleasure in our lives. Pay restoration is the right, just and moral thing to do. But it is a significant demand and it won’t be easy to win. Every part of the BMA needs to plan for how to achieve this.”
Read full story
Source: The Guardian, 27 June 2022
Patient Safety Learning

NHS patients will spend last years in pain, warns top doctor

Suffering is “the new norm” in the NHS and people can expect to spend their last few years in pain, the outgoing chairman of the British Medical Association said.
Chaand Nagpaul, who steps down this week, said the NHS was in a “perilous state”. He also wants people to have sympathy for the “plight” of junior doctors, who have said they will prepare for a ballot on strikes over pay.
There are 6.5 million people on NHS waiting lists, many of whom have been waiting a year or more. Nagpaul, who has been a GP for 33 years, said: “I have not come across this scale of suffering, of unmet need. And what we’re going to be seeing is people spending the last years of their lives, literally in pain, unable . . . to have a hip operation. That will be the final years of their lives.”
He said there was a “whole, larger population of patients just literally not featuring in the statistics” waiting for outpatient treatment, mental health care and diabetes checks.
Read full story (paywalled)
Source: The Times, 27 June 2022
Patient Safety Learning

USA: OBGYNs reacting to Roe Vs Wade fear for patient safety and health

Reproductive health doctors are reacting to the Supreme Court's decision to overturn Roe vs Wade, the 1973 case that allowed people to seek abortions with limited government intervention.
On Friday, Justice Samuel Alito delivered his opinion on the case Dobbs vs Jackson Women's Health, saying he favoured the state of Mississippi in the case. Now, Roe vs Wade, which allowed abortion until about 24 weeks of pregnancy, is overruled, and individual states have the power to decide their residents' abortion rights.
OBGYNs who provide abortion care and family-planning services told Insider they worry for their patients' health and safety, and the future of all reproductive healthcare including miscarriages, fertility treatments, and birth control.
"This decision made by the SCOTUS is one that completely obliterates freedom from reproductive justice and women's health directly," Dr. Jessica Shepherd, a Texas-based gynecologist and Chief Medical Officer at Verywell Health, told Insider.
Dr. Stephanie Ros, a Florida-based OBGYN, says she fears most for working-class abortion seekers.
"I'm not worried about my wealthy patients – they will have the means to go 'visit an aunt' in Europe or elsewhere, and access abortion care if they so desire. I'm terrified for my middle class and poor patients, who don't have the means to pick up and travel on a moment's notice, and who often don't have access to medical care to even discover they're pregnant until later than their wealthy counterparts." 
Read full story
Source: Insider, 24 June 2022
Patient Safety Learning

UK medics call US abortion ban 'catastrophic blow'

The UK response to the removal of the constitutional right to abortion in the US has been one of anger, sadness, and disbelief.
The US Supreme Court has voted to overturn the 1973 case of Roe vs Wade, so in effect revoking the constitutional right to abortion that American women have had since the landmark decision. It means the 50 individual US states will be able to set their own abortion laws. Half are expected to ban abortions, some already have, and already clinics across the US have been closing down.
The ruling has been widely condemned by the UK’s healthcare organisations, including the British Medical Association and the Royal College of Obstetricians and Gynaecologists.
The BMA called it "deeply worrying for the future of women’s reproductive health". Dr Zoe Greaves, chair of the BMA’s medical ethics committee said: "Banning or severely restricting abortion prevents only the safe termination of pregnancy, it doesn’t prevent abortions. If women are denied necessary and appropriate care, they will be forced to travel out of their home state to access services, something which is also being suggested will be made illegal. It could also drive abortion services underground and lead to an increase in self-administered abortions, placing the most vulnerable of women at greatest risk of harm. Restricting abortion will harm ‘rural, minority and poor patients’ the most, according to leading health organisations in the US."
Dr Helen Munro, vice-chair of the Faculty of Sexual and Reproductive Healthcare (FSRH) said: "Criminalising abortion and hampering access to care only serves to increase the number of unsafe abortions, putting women’s lives at risk.
"All women should be able to receive prompt access to abortion services, which should include good pregnancy decision-making support and access to post-abortion contraception by trained healthcare professionals if they choose."
Read full story
Source: Medscape, 27 June 2022
Patient Safety Learning

Patient safety is not a ‘priority’ for NHSE claims watchdog chief

The outgoing chief investigator of the national safety watchdog has described his frustration with the organisation’s ‘ambivalent’ relationship with NHS England.
Keith Conradi, who is due to retire from the Health Safety Investigation Branch in July, said he did not think he had “ever really spoken to any of the hierarchy in NHS England”. He added “their priorities are elsewhere”.
In an interview with health commentator Roy Lilley for the Institute for Health and Social Care Management, Mr Conradi also described HSIB’s relationship with NHSE as “ambivalent”.
“It wobbled along that sort of line and got worse as time has gone on,” he said. “At the very start I had a chat with the permanent secretary of the Department of Health and said we would be better off in the department than NHS England. He disagreed and felt that we’d be too close to [then health secretary] Jeremy Hunt, and particularly at that time that would have a negative effect.”
Mr Conradi was also critical of the decision to ask HSIB to take on investigations into maternity care early in its life. He said he was “shocked” that it happened so quickly “when we hadn’t really got going”.
He continued: “We hadn’t developed a method of doing normal national investigations and suddenly we were being asked to do maternity ones. There was a huge amount of pressure to do this.”
Read full story (paywalled)
Source: HSJ, 28 June 2022
Patient Safety Learning

Falling NHS continuity of care poses ‘existential threat’ to patient safety

Rapidly falling continuity of care levels pose an “existential threat” to patient safety, Britain’s top family doctor will warn today as research reveals only half of Britons regularly see the same GP.
Prof Martin Marshall, chair of the Royal College of GPs (RCGP), will say trusted relationships between family doctors and patients are the most “powerful intervention” for delivering effective, high-quality care as they boost patient satisfaction and health outcomes, and reduce use of hospital services.
But in a keynote speech to the college’s annual conference, Marshall will warn that continuity of care is becoming almost impossible to deliver on the NHS amid soaring demand and shrinking numbers of GPs, in what he will describe as the “most worrying crisis in decades”.
There are mounting concerns over the ability of the NHS to tackle record waiting lists, with 6.5m patients awaiting care in England alone. Earlier this month Sajid Javid, the health secretary, admitted the current model of GP care “is not working” but insisted there would be no more money for the health service.
At the RCGP conference in London, Marshall will tell delegates that because of rising workloads and fewer staff, GPs no longer have the time to properly assess patients, with 65% warning safety is being compromised due to appointments being too short, according to a recent survey commissioned by the college.
Only 39% of respondents said they were able to deliver the continuity of care their patients need – down from 60% two years ago.
Read full story
Source: The Guardian, 29 June 2022
Patient Safety Learning

Hospitals bring back masks on wards just weeks after rules relaxed

Hospitals are bringing back requirements for masks on wards just weeks after rules were relaxed as Covid rates spike, The Independent can reveal.
Experts have warned of a surge in cases, believed to be the fifth wave, with one in 40 people in the UK testing positive for the virus.
Meanwhile, latest NHS data shows more than 8,000 Covid-positive patients on wards following a warning of a “deleterious” impact on hospital waiting times.
In response, three major hospital trusts have told staff they must wear masks, with warnings more must follow if the NHS is to handle another wave of Covid.
Dr Tim Cooksley, president of the Society for Acute Medicine told The Independent: “Over the past 2 years Covid has highlighted and exacerbated what was an already growing crisis.
“High staff absence levels, burn-out and low morale have dominated staff landscapes during this time and continue to do so. Future waves and potentially large numbers of upcoming flu cases will only serve to deepen these problems making the hopes of patients, clinicians and politicians alike of elective recovery seem somewhat fanciful."
Read full story
Source: The Independent, 29 June 2022
Patient Safety Learning

Are we failing young people with cancer?

When you think of cancer, a glamorous mum in her mid-30s is not the first image that springs to mind.
But You, Me and the Big C podcaster Dame Deborah James was just 35 when she found out she had bowel cancer. Blood and stool tests had come back normal and her GP had laughed "not once, but three times over the course of six months" at the idea she could possibly have a tumour in her bowels. The diagnosis came only when she paid to have her colon examined privately.
Her experience has raised questions about how good we are at spotting and treating cancer in the under-40s. Simply - are we failing young people with cancer?
Overall, around 4.3% of cancers diagnosed in the UK are in the under-40s, while those over 75 make up more than a third of all cancer cases, which poses a challenge for us and the doctors who treat us.
When we are young, we're less likely to attribute any ill health to cancer. Changes to our bowel movements could just be stress, blood in the toilet after we poo could be inflammatory bowel disease or haemorrhoids. Because, for most people, cancer is something that happens to our parents or grandparents.
Your doctor should be alert to major warning signs of cancer, but there is a medical saying: "When you hear hooves, think horses, not zebras". It's a call to look for the most common or likely explanation, and the younger you are, the less likely cancer is to be behind your symptoms. This helps channel the health service's limited resources to those most likely to need them.
But that means some younger people aren't being seen quickly enough, although the problem can affect older people too. Bowel Cancer UK's Never Too Young report in 2020 found that four in 10 people surveyed had to visit their GP three or more times before being referred for further tests to see if they had cancer.
"I don't think GPs are a problem," says Genevieve Edwards, chief executive of Bowel Cancer UK. "It [bowel cancer] is rare in younger people... It will usually be something else."
The question is - what if you are the zebra, that relatively rare case who does have cancer at a young age?"
Read full story
Source: BBC News, 14 May 2022
Patient Safety Learning

NHS App to get new digital features by 2023

The NHS App will soon be updated with features to help offer people in England more personalised care.
It is part of the government's plan for a digital revolution to speed up care and improve access while saving the health service time and money.
By March 2023, more users will receive messages from their GP and be able to see their medical records and manage hospital elective-care appointments.
By March 2024, the app should offer face-to-face video consultations.
The government's ambition is for at least 75% of adults to be using it by March 2024. Currently, less than half - about 28 million - have it on their phone or tablet.
The government also wants 90% of NHS trusts to have electronic patient records in place or be processing them by December 2023 and for all social-care providers to adopt a digital social-care record.
And patients across the country should be able to complete their hospital pre-assessment checks from home by September 2024.
Read full story
Source: BBC News, 29 June 2022
Patient Safety Learning

Press release: System-wide action needed to improve safety in healthcare

Press release: 29 June 2022
Today, Dean Russell MP, a member of the Health and Social Care Select Committee, with the charity Patient Safety Learning and the Safety for All campaign, are hosting a Parliamentary reception with MPs, Peers and representatives of the wider patient safety and healthcare community.
Each year in the UK thousands of people are killed and harmed as a result of unsafe care, costing the NHS billions of pounds for additional treatment, support, and compensation costs relating to litigation by those harmed. Following the unprecedented impact that the Covid-19 pandemic has placed on health and social care, both the public and the healthcare sector believe politicians must prioritise the improvement of both patient and healthcare worker safety.
At this reception politicians and members of the wider healthcare community will discuss how we can harness the knowledge, enthusiasm and commitment of healthcare organisations, professionals and patients for system-wide change, to improve care and reduce avoidable harm to patients and healthcare workers.
This event also marks the launch by the Safety for All campaign of a new guide for Staff directly involved in a serious safety incident. This step-by-step good practice guide sets out how to ensure we support staff involved in serious safety incidents better, so that these can be more effectively investigated and result in learning and improvement. It is also an opportunity to discuss the recently published report, Mind the implementation gap: The persistence of avoidable harm in the NHS, which highlights a patient safety implementation gap in the UK that results in the continuation of avoidable harm.
Dean Russell MP said:
“I am delighted to host this event to reinvigorate parliamentary action in improving patient and healthcare worker safety. The NHS estimates that there are 11,000 avoidable deaths in the UK each year due to patient safety incidents. We must look at the issue of patient safety holistically. If we can change blame culture and allow workers to be open and learn from mistakes, then we can reduce the number of serious safety incidents. Also, if we ensure, in the transition back normality following the pandemic, that the safety of healthcare workers is a priority this will also impact positively on patient safety.”
Jonathan Hazan, Chair of Patient Safety Learning, said:
“Patient Safety Learning is working to make patient safety the core purpose of health and social care, not just one of many priorities to be traded with others. We engage with politicians, healthcare organisations, professionals and patients to campaign for system change and we work together on projects to reduce harm to patients. Dean Russell MP and his colleagues in Parliament can play a major role in improving safety and we look forward to working with them.”
Dr. Paul Grime, Chairman of Safer Healthcare Biosafety Network (SHBN), said:
“Today’s reception is a chance for the patient safety and wider healthcare community to meet and discuss how we can harness the knowledge, enthusiasm and commitment of healthcare organisations, professionals and patients for system-wide change, to improve care and reduce avoidable harm to patients and healthcare workers. The Safety for All campaign will be pressing MPs and Peers here today and those in leadership roles within the NHS and social care to address these recommendations and lend their support to the campaign and the practical actions we are taking to deliver safety for all.”
Ian Duncalf, Chair of Patient Safety Group at ABHI, said:
“The Patient Safety group at the Association of British HealthTech Industries has been supporting and helping to deliver the patient and staff safety agenda for many years. The ABHI are very pleased to be supporting the work of the Safety for All campaign, which with Patient Safety Learning, is now implementing the practical plan, activities and deliverables of the campaign over the next year and beyond. I am delighted that I am joined today by members of the Safer Healthcare and Biosafety Network and the Safety for All campaign Industry Group who are committed to delivering improved patient and staff safety outcomes.”
Notes to editors
1. Patient Safety Learning is a charity and independent voice for improving patient safety. We harness the knowledge, enthusiasm and commitment of healthcare organisations, professionals and patients for system-wide change and the reduction of harm. We support safety improvement through policy, influencing and campaigning and the development of ‘how to’ resources such as the hub, our free award-winning platform to share learning for patient safety.
2. The Safer Healthcare and Biosafety Network is an independent forum focused on improving healthcare worker and patient safety and has been in existence more than 20 years. It is made up of clinicians, professional associations, trades unions and employers, manufacturers and government agencies with the shared objective to improve occupational health and safety and patient safety in healthcare. COVID-19 pandemic has provided a stark reminder of the vital role healthcare professionals play in providing care to those in our society who need it most and this was recognized in the WHO Patient Safety Day in September 2020: only when healthcare workers are safe can patients be safe. In 2020, the Network launched a campaign called ‘Safety for All’ to improve practice in, and between, patient and healthcare worker safety to prevent safety incidents and deliver better outcomes for all.
The Safety for All white paper is calling for improvements in, and between, patient and healthcare worker safety to prevent safety incidents and deliver better outcomes for all by:
Improved understanding and advocacy of the mutual benefits to be accrued for patient safety by improving healthcare worker safety, and vice versa, and of the common risks, factors and interventions across patient and healthcare worker safety
The application of shared learning and best practice between workplace and patient safety and, where appropriate, aligned or integrated synergistic solutions in safety systems, standards, governance and preventive measures
Resources, leadership and staff committed to a stronger, reciprocal patient and workplace safety culture, with safety as a core purpose for both, underpinned by better education and training
Greater support for staff, and for them to speak up, following patient safety incidents, including a safety care pathway for both patients and staff, and to ingrain a just culture
Improved risk management and reporting of safety incidents, learning and communication across patient and healthcare worker safety
3. ABHI is the UK’s leading industry association for health technology (HealthTech). ABHI supports the HealthTech community to save and enhance lives. Members, including both multinationals and small and medium sized enterprises (SMEs), supply products from syringes and wound dressings to surgical robots and digitally enhanced technologies. We represent the industry to stakeholders, such as the government, NHS and regulators. HealthTech plays a key role in supporting delivery of healthcare and is a significant contributor to the UK’s economic growth. HealthTech is now the largest employer in the broader Life Sciences sector, employing 131,800 people in 4,060 companies, with a combined turnover of £25.6bn. The industry has enjoyed growth of around 5% in recent years. ABHI’s 320 members account for approximately 80% of the sector by value.
Patient Safety Learning
Registered address: Patient Safety Learning, China Works SB203, 100 Black Prince Road Vauxhall, London, SE1 7SJ

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