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

Paramedics set up units inside A&E to ease long queues

Paramedics have begun looking after patients inside an A&E unit, in an initiative by the health service to stop ambulances queueing outside hospitals and ease the strain on overstretched casualty staff.
The scheme has led to patients being handed over much more quickly at a hospital that was one of the worst in England for sick people being stuck, sometimes for many hours, in the back of an ambulance.
Queen’s hospital in Romford, in east London, has set up an ambulance receiving centre (ARC) near its main casualty unit in which two London Ambulance Service paramedics are on duty round the clock to help look after patients who would otherwise be trapped outside or in a corridor, waiting to be seen.
Patients who end up in the new six-cubicle unit behind the A&E nurses’ station have a better experience while they wait and are more comfortable – and safer – because they can have their relatives with them, eat and drink and use the toilet more easily.
Almost 2,000 patients have passed through the ARC since it opened last November, saving nearly 13,000 hours of ambulance crews’ time and enabling them to respond to emergency calls more quickly.
However, some A&E doctors regard the scheme as merely “a sticking plaster”, given that queues of ambulances have become common outside many hospitals and that casualty units are treating the lowest percentage of patients within four hours on record.
Read full story
Source: The Guardian, 3 July 2022
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Thalidomide survivors in Scotland to get lifelong support

Thalidomide survivors living in Scotland will receive lifelong financial support, the Scottish government has announced.
Health Secretary Humza Yousaf said he hoped the commitment to provide grants would reassure those affected.
There are 50 known survivors of the banned pregnancy drug living in Scotland, most now in their 60s. They are among thousands born with limb deformities after their mothers took thalidomide while pregnant.
The drug was commonly used to treat morning sickness from 1958 to 1961.
In 2013 the Scottish government committed £14.2m to help survivors over a 10-year period, with the money going on health and living costs.
Ministers have now extended that agreement, with grants to be allocated to survivors on a needs basis, as assessed by the Thalidomide Trust.
Mr Yousaf said: "This funding is used to give thalidomide survivors as much assistance as they need to maintain their independence. It has been a vital support in helping people adapt their homes and manage their pain.
"I hope this lifelong commitment to continue this support will reassure recipients and help them deal with any challenges they face."
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Source: BBC News, 4 July 2022
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Doctor admits killing patient in botched routine procedure

A mother was killed at her hospital appointment by a doctor who botched a routine procedure, a court has heard.
Dr Isyaka Mamman, 85, was responsible for a series of critical incidents before the fatal appointment, Manchester Crown Court heard.
Mamman, who admitted gross negligence manslaughter, had already been sacked by medical watchdogs for lying about his age but was re-employed by the Royal Oldham Hospital.
He is due to be sentenced on Tuesday.
Mother-of-three Shahida Parveen, 48, had gone to hospital with her husband for investigations into possible myeloproliferative disorder on 3 September 2018 and a bone marrow biopsy had been advised, Andrew Thomas QC, prosecuting, told the hearing.
Normally, bone marrow samples are taken from the hip bone but Mamman, of Cumberland Drive, Royton, Oldham, failed to obtain a sample at the first attempt, he said.
Instead, he attempted a rare and "highly dangerous" procedure of getting a sample from Ms Parveen's sternum - despite objections from the patient and her husband, the court heard.
Mamman, using the wrong biopsy needle, missed the bone and pierced her pericardium, the sac containing the heart, causing massive internal bleeding.
Ms Parveen lost consciousness as soon as the needle was inserted. She died later that day.
Read full story
Source: BBC News, 4 July 2022
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High covid rates spark blood supply ‘crisis’

NHS Blood and Transplant (NHSBT) which supplies blood to hospitals is reporting severe supply shortages for the first time since 2018, HSJ has learned.
Well-placed senior sources said it is close to issuing a formal “amber alert”, which would mean it could not guarantee blood supplies to hospitals, they said. NHSBT acknowledged to HSJ that it was “expecting a difficult few months”.
NHS trusts would have to start cancelling elective operations if they cannot ensure that necessary bloods are available. NHSBT has already written to trusts asking them not to over-order supplies, and to ensure management plans are in place should the situation escalate.
Supplies of the common O blood types are thought to be down to less than three days’ worth. If they were to drop to two days, this would trigger an amber alert.
Read full story (paywalled)
Source: HSJ, 5 July 2022
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Three-month ‘urgent’ cancer waits top 10,000 for the first time

More than 10,000 people are waiting three months or longer following an urgent referral for suspected cancer, internal NHS data seen by HSJ reveals.
Patients with suspected cancer are not supposed to wait more than two months from a referral. However, information shared with HSJ shows that of the 313,000 people on the national cancer waiting list, just over 10,000 had waited 104 days or more.
Information about three-month cancer waits is not made public on a regular basis. NHS England publishes data for the total backlog of patients waiting over 62 days, but does not make public the regional or trust-level results, or reveal how many patients are waiting three months or more.
One senior figure in cancer policy told HSJ the backlog position was “awful” and “a reflection of a worsening trajectory overwhelming diagnostic capacity in particular”. Breast, skin and lower gastro-intestinal cancers saw the biggest increases in long waiters.
Read full story (paywalled)
Source: HSJ, 5 July 2022
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JCVI chief calls for mandatory masks in hospitals amid Covid surge

It would be “sensible” for hospitals to reintroduce mandatory mask-wearing, the chair of the Joint Committee on Vaccination and Immunisation has said, as several trusts in England and Wales announced the move.
When NHS rules on wearing masks in England were dropped on 10 June, local health bodies were given the power to draft their own policies. Their guidance, however, is no longer legally enforceable.
Figures from NHS England show there were about 10,658 patients hospitalised with coronavirus on Monday. Infections have doubled in a fortnight across England – with about 1,000 patients being admitted with the virus each day.
Prof Andrew Pollard, who is also the director of the Oxford Vaccine Group, which developed the AstraZeneca jab, said there were an “extraordinary” number of cases at the moment. “I certainly know more people now who have had Covid than at any time in the past,” he told the BBC Radio 4’s Today programme.
“Because there’s so much in the community, anything we can do in our hospitals to reduce the potential outbreaks make sense and so the mandatory mask wearing in hospitals is very sensible policy,” he added.
Read full story
Source: The Guardian, 5 July 2022
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NHS to test using drones to fly chemotherapy drugs to Isle of Wight

The NHS plans to use drones to fly chemotherapy drugs to cancer patients in England to avoid the need for long journeys to collect them.
The devices will transport doses from Portsmouth to the Isle of Wight in a trial that, if successful, will lead to drones being used for similar drops elsewhere.
They will take 30 minutes to travel acrss the Solent, which will save patients on the island a three to four-hour round trip by ferry or hovercraft.
On Tuesday, Amanda Pritchard, NHS England’s chief executive, unveiled the move to help mark the 74th anniversary of the health service’s creation by the postwar Labour government.
“Delivering chemo by drone is another extraordinary development for cancer patients and shows how the NHS will stop at nothing to ensure people get the treatment they need as promptly as possible, while also cutting costs and carbon emissions,” she said.
Read full story
Source: The Guardian, 5 July 2022
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Woman kept in police cell for 36 hours after stillbirth due to suspicions she had ‘illegal abortion’

A woman was kept in police custody for 36 hours after having a stillbirth because of suspicions she had an abortion after the legal cut-off point, it has been claimed.
UK abortion providers, who supported the woman, denied she had flouted the legal deadline and warned the treatment she endured “should be unthinkable in a civilised society”, with “no conceivable” public interest in holding her.
They added that the woman has been under investigation for a year and a half, but still not charged with any crime.
Jonathan Lord, medical director of MSI Reproductive Choices, one of the UK’s leading abortion providers, told The Independent the woman unexpectedly delivered a stillborn foetus at home that was about 24 weeks old.
Dr Lord, the co-chair of the British Society of Abortion Care Providers, who shared the woman’s story with The Independent, said: “She was shocked to give birth due to not knowing how far along pregnant she was. She was admitted to hospital.
“Because healthcare colleagues were suspicious, and knew she had been in touch with us, an abortion provider, as she told them, they suspected her of having an illegal abortion and called the police. But she wasn’t over the limit for a legal abortion.
Dr Lord said the experience of having an “extraordinarily unexpected” stillbirth before being taken into police custody during lockdown was “traumatic” and “distressing” for the woman.
Read full story
Source: The Independent, 5 July 2022
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Doctors to overhaul car wreck rescue techniques amid new evidence

There are plans for a major overhaul of how people are rescued from car wrecks amid growing evidence that current methods where people wait to be cut free may be harmful.
Last year there were 127,967 casualties and 1,560 deaths in England caused by motor vehicle collisions. During the same period, more than 7,000 patients needed to helped out of the vehicle through a process known as extrication, where rescue crews use “Jaws of Life” and other tools to pry apart the wreckage, and then carefully lift people out.
“Since at least the 1980s, firefighters have been trained with movement minimisation as the absolute paradigm,” said Dr Tim Nutbeam, an NHS emergency medicine consultant, and medical lead for the Devon air ambulance. “They’ve been told that one millimetre of movement could turn someone into a wheelchair user, so will often disassemble the car around the patient, to avoid movement of the neck.”
Yet, doing so takes time – 30 minutes on average – and if that person has another serious injury, such as a head, chest, or abdominal injury, every minute counts.
Nutbeam began researching the issue and discovered that trapped patients were almost twice as likely to die as those who were rapidly freed from the wreckage. Further, that the prevalence of spinal injuries among such patients was, in fact, extremely low – just 0.7% – and in around half of these cases, they had other serious injuries needing urgent medical attention.
“Our absolute focus on movement minimisation works for maybe 0.3% of patients, but it extends the entrapment time for 99.7% of them,” Nutbeam said. “Potentially hundreds of people in this country have died as a result of extended entrapment times, and if you multiply that worldwide, it’s many, many people.”
Read full story
Source: The Guardian, 6 July 2022
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Oldham doctor jailed for killing patient in botched procedure

A doctor who killed a mother-of-three when he botched a procedure during a routine appointment has been jailed.
Dr Isyaka Mamman, now thought to be 85, admitted gross negligence manslaughter over the death of Shahida Parveen, 48, at the Royal Oldham Hospital in 2018.
He used the wrong needle and inserted it in the wrong place, piercing the sac holding Mrs Parveen's heart.
Mrs Justice Yip at Manchester Crown Court said Mrs Parveen's death was his fault and sentenced him to three years.
She also criticised the NHS trust, pointing to the fact that Mamman had both lied about his age and had been involved in two critical incidents similar to that which led to Mrs Parveen's death.
The court heard Mrs Parveen attended Royal Oldham Hospital on 3 September, 2018, to give a bone marrow sample.
This is usually taken from the hip bone but, after failing in his first attempt, Mamman tried to instead take it from her sternum.
This was a "highly dangerous" procedure, the court was told, and one which had led to another of Mamman's patients being permanently disabled three years earlier.
Read full story
Source: BBC News, 5 July 2022
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NHSE sets trusts ‘100-day challenge’ to reduce delayed discharges

NHS England has set trusts and systems a ‘100-day challenge’ to discharge more patients from hospital and free up beds before winter.
David Sloman, chief operating officer of NHSE, has asked leaders of integrated care boards, acute and community trusts in a letter sent last week to adopt 10 “best practice initiatives” which he said “can make a significant difference in facilitating discharge and improving care for patients”.
Trusts and systems have been given until 30 September to have a “full understanding” of the initiatives (listed below) and “infrastructure in place” to implement them.
The initiatives include setting expected dates of discharge for patients within 48 hours of admission, “apply seven-day working” to discharge more patients at weekends, treat delayed discharge as “a potential harm event” and to manage workforces in community and social care services “to better match predicted patterns in demand”.
Sir David has told regional and local leaders that a dedicated national NHSE team will set up “launch meetings” in each system, which will ensure there is “a focus on improving processes and performance around discharge”.
Read full story (paywalled)
Source: HSJ, 5 July 2022
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New health secretary named

Sajid Javid has resigned and been replaced by Steve Barclay as health and social care secretary. 
Mr Barclay, previously chief of staff to the prime minister, was reported as having been given the role on Tuesday evening.
Mr Barclay said: “It is an honour to take up the position of Health and Social Care Secretary. Our NHS and social care staff have showed us time and again - throughout the pandemic and beyond - what it means to work with compassion and dedication to transform lives.  This government is investing more than ever before in our NHS and care services to beat the Covid backlogs, recruit 50,000 more nurses, reform social care and ensure patients across the country can access the care they need.” 
Mr Barclay’s appointment came hours after Mr Javid — health secretary since June last year — announced his resignation, saying in a letter to Boris Johnson that he “can no longer, in good conscience, continue serving in this government” and that Mr Johnson has lost his confidence.
Read full story (paywalled)
Source: HSJ, 6 July 2022
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Baby died two days after birth despite mum begging doctors to assess her

A two-day old baby died just days after his mother begged doctors to assess her ahead of a c-section despite her pregnancy being deemed high risk. Davi Heer-Do Naschimento was born via emergency caesarean section during the early hours of 29 September 2021, after doctors at Royal London Hospital failed to communicate crucial details during handover meetings.
An inquest at Poplar Coroners Court heard that his parents, Ruth Heer and Tiago Do Naschimento, had asked numerous times for assistance and were not seen by the obstetrics team the day before her planned caesarean. Tragically, after becoming "feverish" during the night, she was rushed into theatre with Devi sadly dying two days later.
Speaking on behalf of the family, Francesca Kohler said that there had been “multiple occasions” throughout the day when Ms Heer and her partner had called for assistance and had raised concerns, but were not attended. She had also not been seen by the obstetrics team and had not been spoken to about the upcoming caesarean section.
Read full story
Source: My London, 4 July 2022
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Trust stands down service which achieved ‘marked improvement’ in A&E handover delays

An acute trust has had to stand down a new service which led to a ‘marked improvement’ in ambulance handover times, due to a lack of permanent funding to support it.
In recent months, York and Scarborough Teaching Hospitals Foundation Trust has deployed additional staff to receive and care for patients arriving by ambulance, meaning ambulance crews could be released more quickly.
A report to the trust board last month said of the scheme: “Data shows a marked improvement in ambulance release times when deployed.”
However, it would cost £1m per year to fully implement the service and the report said commissioners had confirmed there is “no external funding to support this cost”.
There have been mounting concerns in recent months over the handover delays experienced by paramedics when taking patients to hospital, which have severely affected their response times for new incidents.
In a statement, the trust said it was discussing with system partners how the service, which was introduced on a “short-term basis”, could be supported in future. It was delivered by independent ambulance and healthcare provider CIPHER Medical and used at peak times such as bank holiday weekends.
Read full story (paywalled)
Source: HSJ, 6 July 2022
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Police role ‘blurred’ with healthcare staff, reviews find

The controversial ‘SIM’ mental healthcare model sometimes ‘blurred’ the role of police with healthcare staff, according to results of local reviews seen by HSJ.
Following a whirlwind of concerns last summer, national clinical director Professor Tim Kendall wrote to mental health trust medical directors urging them to review use of the controversial Serenity Integrated Mentoring (SIM) programme.
Pressure to investigate the model, which has been used by at least 22 NHS trusts in recent years, came from patient groups and clinicians alike. 
One year on and results of local reviews, obtained under the Freedom of Information Act, have revealed a varying picture of SIM’s use across English mental health trusts.
Professor Kendall’s letters, seen by HSJ, asked trusts to investigate five key areas of concern. These included: a lack of patient reported outcomes; adherence to National Institute for Health and Care Excellence guidelines on self-harm and personality disorders; the principle of police involvement in case management; the legal basis for sharing patient records; and human rights/equalities implications.
Read full story (paywalled)
Source: HSJ, 7 July 2022
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Steve Barclay: What will new health secretary tackle first?

Steve Barclay has been named as the new health secretary following the resignation of Sajid Javid, who stepped down after saying he had lost faith in Boris Johnson's leadership.
He starts as secretary of state at a time when the NHS and social care in England are under serious pressure.
Amanda Pritchard, the head of NHS England, has warned that the next two years could be even tougher for the health service than the two years since the start of the pandemic.
NHS Providers, which represents hospitals and other NHS trusts, described the problems Mr Barclay faces on his first day in the job as "big and pressing".
At the very top of that list is a record backlog for planned operations.
Read full story
Source: BBC News, 6 July 2022
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