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

'Bolder government action' needed to address inequalities in dementia risk

"Bolder government action" is needed to address inequalities in dementia risk, the charity Alzheimer's Research UK has warned this week. The comments come in response to findings from four new studies presented at the Alzheimer's Association International Conference (AAIC) which link socio-economic deprivation with increased risk of dementia and cognitive decline.
Dr Susan Mitchell, head of policy at Alzheimer’s Research UK, said: "These findings are a stark reminder of the health gap between the most and least deprived in society, with the most deprived at a higher risk of developing dementia.
"Ultimately, these inequalities are profoundly unfair, but they are also avoidable. The Government has a key role in addressing inequalities through a range of measures to improve poverty, employment, housing and education."
She added: "We urge Government to make dementia prevention a key priority in its aim to level up healthcare across the country, and hope the forthcoming health disparities white paper lays the foundation for a fairer, healthier nation."
Read full story
Source: Medscape, 5 August 2022
Patient Safety Learning

Private provider says its ‘robust nursing pipeline’ can benefit NHS

A large private provider says it is finding it harder than ever to fill its staffing vacancies, but is optimistic that its investment in nursing apprenticeships and overseas recruitment can help expand NHS-commissioned capacity.
In an interview with HSJ, Shelley Thomas, group HR director for Spire Healthcare, said the company is facing the same staffing difficulties as NHS providers.
She said: “We’re all feeling the same things at the moment… high sickness absence, high holidays, teams that are worn out. We’re all… experiencing the same from a workforce perspective.”
However, she said Spire is “working harder than ever” to fill vacancies, and now has a “really robust pipeline” of apprentices and oversees recruits.
Despite the waiting list backlogs which have ballooned since the pandemic began, and a £10bn framework in place for the NHS to utilise private sector capacity, analysis suggests NHS activity undertaken by private hospitals has been below pre-covid levels in almost all specialities.
Ms Thomas suggested the staffing difficulties had been a factor in that, but acknowledged there were more conversations to be had locally about how the private sector could undertake more activity.
She said the pandemic was a “huge catalyst for stronger working partnerships” between the NHS and the private sector and that relationships are “stronger than they’ve ever been”.
Read full story (paywalled)
Source: HSJ, 4 August 2022
Patient Safety Learning

Economically inactive Britons with Long Covid have ‘doubled’ in a year

One in twenty people in the UK who are neither employed nor seeking paid work are suffering from Long Covid, with the figure more than doubling in the past year, official data has revealed.
The proportion is far higher than for the 1 in 29 people who are unemployed but seeking work who have long Covid symptoms, or the one in 30 employed people who are sufferers, data released by the Office for National Statistics (ONS) shows.
Individuals who are not employed and are not looking for paid work are classified as being economically inactive.
The data suggests the long-term impacts of the virus could be driving people into this category, or into retirement.
Read full story
Source: The Guardian, 4 August 2022
Patient Safety Learning

‘We should be offered compensation’ - Mesh campaigner's plea to Steve Barclay

Pelvic mesh campaigner Kath Sansom has met with the health secretary Steve Barclay to discuss financial redress for those suffering complications from the procedure.
The UK government decided last year not to provide compensation to women whose lives had been affected by vaginal mesh implants.
But Kath Sansom, a Cambridgeshire mum and former journalist for this news outlet, has continued campaigning and says she will put pressure on the health secretary to revisit the issue.
It also comes as the government revealed victims of the 1970s and 1980s blood scandal will receive compensation for the impact it has had on their lives.
Ahead of her meeting with the Secretary of State for Health, she said: “We [mesh injured] deserve to be compensated based on the fact we are suffering lifelong damage from a health treatment that caused avoidable harm.
“It is not our fault this happened to us and the State should take responsibility.”
Former Health Secretary Matt Hancock issued a public apology when a public inquiry in 2020 revealed a shocking extent of patient failings and lack of regulation for mesh victims.
“The State has apologised for the suffering of the mesh community, which is an acknowledgement of responsibility,” Kath added.
Read full story
Source: Cambs Times, 5 August 2022
Patient Safety Learning

Full extent of NHS dentistry shortage revealed

Nine in 10 NHS dental practices across the UK are not accepting new adult patients for treatment under the health service, a BBC investigation has found.
BBC's research shows no dentists taking on adult NHS patients could be found in a third of the UK's top-tier councils. And eight in 10 NHS practices are not taking on children.
The Department of Health said it had made an extra £50m available "to help bust the Covid backlogs" and that improving NHS access was a priority.
BBC News contacted nearly 7,000 NHS practices - believed to be almost all those offering general treatment to the public.
The British Dental Association (BDA) called it "the most comprehensive and granular assessment of patient access in the history of the service".
While NHS dental treatment is not free for most adults, it is subsidised.
The BBC heard from people across the UK who could not afford private fees and said the subsidised rates were crucial to getting care.
The lack of NHS appointments has led people to drive hundreds of miles in search of treatment, pull out their own teeth without anaesthesia, resort to making their own improvised dentures and restrict their long-term diets to little more than soup.
Read full story
Source: BBC News, 8 August 2022
Patient Safety Learning

‘A historic wrong’: Government set to announce compensation for victims of contaminated blood scandal

A scheme handing payments to those affected by the contaminated blood scandal will be announced this week, as ministers scramble to help those harmed by the “historic wrong”.
Whitehall sources confirmed that a programme handing interim payments will be confirmed in the coming days, once officials have ironed out issues to ensure that victims are not taxed on the payments or have their benefits affected by them. It is thought that ministers accept recent recommendations that infected people and bereaved partners should get “payments of no less than £100,000”.
More than 4,000 people are in line for the payment. Kit Malthouse, the cabinet office minister, has been prioritising the scheme in the last week to ensure payments are made as soon as possible.
“The infected blood scandal was a tragedy for everyone involved, and the prime minister strongly believes that all those who suffered so terribly as a result of this injustice should receive compensation as quickly as possible,” said a No 10 source. “He has tasked ministers with resolving this issue so that interim payments can be made to all those infected as soon as possible, and we will set out the full details later this week.”
Read full story
Source: The Guardian, 6 August 2022
Patient Safety Learning

‘Difficult discussions’ as NHS faces shortage of childbirth pain relief

The NHS has been hit by a shortage of epidural kits to give mothers-to-be, a key form of pain relief during childbirth, as well as the drug that women are offered as an alternative.
Supplies of epidural kits and the painkiller Remifentanil are now under such pressure that some hospitals cannot offer pregnant women their usual right to choose which one they want to reduce labour pains.
Anaesthetists have told the Guardian that the simultaneous shortage of both forms of pain management has led to “difficult discussions” with women who had been told during their antenatal care that they would have that choice but were upset to learn that it was not available.
The disruption to supplies of epidural kits is so acute that NHS Supply Chain (NHSSC), the health service body that ensures hospitals in England and Wales receive regular supplies of drugs and equipment, to ration deliveries to just one week’s worth of stock.
Childbirth organisations voiced their concern and warned that the disruption to supplies meant some women in labour were already facing long delays before they received pain relief.
“Offering a choice of options during birth is an integral element of good maternity care, and this includes pain relief. It is concerning that the shortage of epidural kits and Remifentanil could be denying many that right”, said Jo Corfield, the NCT’s head of communications and campaigns.
“We don’t yet fully understand the impact this shortage is having but we have heard of long waiting times to receive pain relief and epidurals.”
Read full story
Source: The Guardian, 7 August 2022
Patient Safety Learning

Cyber attack triggers 111 ‘total system outage’

Many NHS 111 services are without a crucial IT system for several days, after a cyber attack on a software supplier.
Providers had to move to pen-and-paper yesterday, and have been unable to access patient records.
Adastra – which is used by 85% of NHS 111 providers  – went offline at 7am on Thursday. It was still affected as of Sunday, and staff were told it may not be online for several days.
Advanced, which supplies Adastra, confirmed on Friday evening the incident was caused by a cyberattck, but says it managed to limit the damage to a small number of its servers. It was reported on Saturday that the attack is thought to have been by a criminal group trying to extort money — so-called ransomware — rather than an attack by a group linked to a state/government.
As well as NHS 111, the system is used by some GP out-of-hours services and has also been marketed to urgent care providers. 
NHS 111 services have had to use lists of protocols when answering calls and write details down, rather than the software automatically implementing the protocols.
One briefing note from commissioners in London, seen by HSJ, described the issue as a “total system outage” for NHS 111, and said “likely delays for patients… will continue throughout the weekend and potentially over next week”.
Read full story (paywalled)
Source: HSJ, 8 August 2022
Patient Safety Learning

Number unable to get a hospital appointment after GP referral up 50% in two years

The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show.
NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020.
Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. 
The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital.
Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments.
Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.”
She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.”
Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.”
Read full story (paywalled)
Source: The Telegraph, 7 August 2022
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Patient Safety Learning

Multiple reporting systems undermine patient safety, says watchdog

A single system to report patient safety concerns would “keep people safer”, a newly appointed NHS watchdog has told HSJ.
Henrietta Hughes – who will take up the post of patient safety commissioner in September – said both clinicians and patients faced a bewildering choice when looking to raise a safety concern, and that there was a need for a “report once” system.
She said that when ”exhausted” clinicians “come to the end of a 12-hour shift, they don’t want to have to do a Datix report and a yellow card report, and if they’ve got a safeguarding concern or a concern about an individual condition, [to have to] send that somewhere else”.
Dr Hughes added: ”Wouldn’t it be better if we had one report that you do, and all the information that comes from that report just gets sent to the appropriate authority? That’s the type of change that I think we’d like to see. I know, as a GP myself, that’s what I would rather do as a professional. But also, I think, for all the organisations, we could get so much more richness of information, we would get more reporting, and we’d keep people safer as a result of it.”
She added that if a patient “wanted to report an individual clinician” they often ended getting bounced around the system, like a pinball. They get sent from pillar to post.”
Read full story (paywalled)
Source: HSJ, 8 August 2022
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Armed police sent to heart attack patients as crisis-hit NHS buckles under surging demand

Armed police are being sent to save the lives of people in cardiac arrest because ambulances “can’t cope” with demand, The Independent has revealed.
Officers are spending up to a third of their time on non-policing matters, a watchdog has warned, including responding to mental health crises and transporting patients to A&E as ambulance services face a “chronic crisis situation”.
Andy Cooke, HM chief inspector of constabulary, said that firearms officers have been responding to pleas from struggling NHS colleagues to respond to cardiac arrests.
He told The Independent that police are becoming the “first, last and only resort” as NHS services buckle under strain, taking them away from tackling crime at a time when recorded offences are at a record high in England and Wales.
Mr Cooke, the former chief constable of Merseyside Police, added: “Recently, officers in armed response vehicles (ARVs) were being sent to reports of people who were having cardiac arrests because the ambulance service couldn’t cope with the demand, because they’re trained in first aid and to use defibrillators."
“The ambulance service contacted the police to say ‘we’ve got this heart patient and we haven’t got anyone to send’."
“Being first, last and only resort, the police will go. It’s right that they did go but that hides the problems we’ve got in the rest of the system.”
Read full story
Source: The Independent, 8 August 2022
Patient Safety Learning

New IT system harms trust’s cancer performance for six months

A trust which is struggling with a new electronic patient record (EPR) is likely to see cancer performance affected for at least the rest of this year, it has said.
Ashford and St Peter’s Hospitals Foundation Trust has set up eight workstreams to ensure its EPR – supplied by Oracle Cerner – is “functioning safely, efficiently and as effectively as possible” after a host of problems since it went live in May. Cancer areas affected include breast, breast symptomatic two week waits, and dermatology.
“It is expected that the impact of the introduction of SSC [Surrey Safe Care, the name of the project] will be felt in aspects of our cancer performance until at least December 2022,” July’s board meeting was told.
The performance report warned the risk of delays causing harm to cancer patients – currently rated at 12 on the risk register – was being reviewed as a result of the introduction of SSC and was expected to rise. 
Read full story (paywalled)
Source: HSJ, 8 August 2022
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Ysbyty Glan Clwyd: Stroke patients would rather go to England

People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said.
Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire.
North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen.
The report said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand". Many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers.
However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients, including:
Doctors were left to "come across" high-risk patients instead of being alerted to them. Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk. Children were at serious risk of harm as the public could enter the paediatric area unchallenged. Inspectors found evidence of children leaving unseen or being discharged against medical advice. Betsi Cadwaladr health board said it was committed to improvements.
Read full story
Source: BBC News, 8 August 2022
 
Patient Safety Learning

Man with diabetes died after GPs ‘failed to spot deteriorating health’

A 27-year-old man died from complications linked to diabetes after GPs failed to properly investigate his rapidly deteriorating health.
Lugano Mwakosya died on 3 October 2020 from diabetic ketoacidosis, a build-up of toxic acids in the blood arising from low insulin levels, two days before he could see a GP in person.
His mother, Petronella Mwasandube, believes his death could have been avoided if doctors at Strensham Road Surgery, in Birmingham, had given “adequate consideration” to Lugano’s diabetic history and offered face-to-face appointments following phone consultations on 31 July and 16 and 30 September.
An independent review commissioned by NHS England found two doctors who spoke to Lugano did not take into account his diabetes or “enquire in detail and substantiate the actual cause of the patient’s symptoms”.
The review raised concern over the “quality and brevity” of the phone assessments and said the surgery should have offered Lugano an in-person appointment sooner.
Read full story
Source: The Independent, 7 August 2022
 
Patient Safety Learning

Britain really isn’t working – and the collapsing NHS is to blame

After lockdown raided the savings of hairdresser and gym instructor Lucie Wilby, a lengthy wait for a hip replacement dealt another blow to her family’s finances.
“We’re in a lot of debt because of it and that’s a combination of Covid and obviously surgery [and] waiting times,” the 53-year-old mother from Cornwall says. 
“If I hadn’t had to wait six months, we’d be nowhere near this issue.”
Like many of the 6.6 million people on an NHS waiting list, work had become painful and eventually impossible for Wilby as the backlog in treatment forces people to cut their hours or stop employment altogether. 
“By the time of the operation, I was barely walking and I’m self employed,” she says. 
“It took about three years to get diagnosed. That’s one of the major problems – it’s not just the waiting time for the operation once you’re on the list, it’s the waiting time for diagnosis.”
While tax cuts and even trans issues may have stolen the limelight in the Tory leadership race, the struggle to get a grip of record NHS backlogs post-Covid is having a huge economic, as well as human, cost.
Read full story (paywalled)
Source: The Times, 7 August 2022
Patient Safety Learning

NHS backlog of two-year waits for routine surgery in England shrinks to below 200

The backlog of people waiting more than two years for a routine operation in England has shrunk from 22,500 at the start of the year to fewer than 200.
NHS England figures show the number of patients waiting that length of time has fallen to just 168, excluding more complex cases.
Staff have been praised for carrying out the NHS elective recovery plan, published this year to tackle backlogs built up during the coronavirus pandemic.
At the start of the year, more than 22,500 people had been waiting two years or longer for scans, checks and surgery. A further 51,000 who would have passed the two-year mark by the end of July have also been treated, figures show.
The NHS England chief executive, Amanda Pritchard, said: “It has only been possible because the NHS has continued to reform the way we deliver care, using innovative techniques and adopting pioneering technology like robot surgery, and through building new relationships and mutual aid arrangements across systems to offer patients the opportunity to be transferred elsewhere and get the care they need as quickly as possible.
“The next phase will focus on patients waiting longer than 18 months, building on the fantastic work already done, and, while it is a significant challenge, our remarkable staff have shown that, when we are given the tools and resources we need, the NHS delivers for our patients.”
Read full story
Source: The Guardian, 9 August 2022
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