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

Fifth of health and care workers to leave sector due to work pressures and cost of living crisis

A study of over 1,000 health and social care workers, conducted by Florence, the tech platform providing health & social care workers access to available shifts, found that almost a third of healthcare workers admit to feeling overwhelmed at least once a week, with 17% feeling burnt-out every day. A staggering 97% believe the cost-of-living crisis has caused further stress or burnout among healthcare professionals. 
It comes after more than half of healthcare workers (56%) admit to working more than 2-3 times a week over their contracted hours, with 7% working overtime every day. Not having enough staff is causing the most pressure in their role (50%), followed by low pay (39%) and high workload (35%).   
The study revealed nine in ten NHS and social care workers state chronic staff shortages are affecting the quality of care. Analysing this deeper, three quarters of respondents stated that the quality of care is already being ‘severely’ impacted as high vacancy rates sweep across the industry.  
Dr Charles Armitage, Former NHS doctor and CEO and Founder of Florence, observed: “If you’ve got fewer people there on-shift to look after people, the quality of care decreases because the people that are there are overstretched, they’re trying to do too many things and are suffering from severe burnout. As a result, mistakes are made as they’re not able to just spend as much time with people and provide that really important patient-centred care.” 
Read full story
Source: Hospital Times, 17 August 2022
Patient Safety Learning

Staffing crisis leaves many English care home residents’ basic needs unmet

Thousands of vulnerable people are suffering inadequate care as severe staffing shortages in previously good care homes push operators to break rules and put residents at risk.
A wave of inspections has revealed the human impact of a worsening nationwide staffing crisis, with people being left in their rooms 24 hours a day, denied showers for over a week, enduring assaults from fellow residents, and left soaking in their own urine.
Stretched staff have described scrambling to help residents with buzzers going off and fear the squeeze on their time is dangerous.
Analysis by the Guardian revealed that staff shortages were identified as a key problem in three-quarters of all the care homes in England where the Care Quality Commission regulator had cut their rating from “good” before Covid-19 to “inadequate” this summer.
A further 10% of homes whose rankings slumped had enough staff, but failed to recruit safely, either not taking references properly, carrying out criminal records checks, or training staff adequately.
Families said the staffing shortages had reached “crisis point”.
“Older people are paying a heavy price for these failings, as poor care robs them of their dignity, breaks their will and makes them feel unsafe in their own home,” said Helen Wildbore, director of the Relatives and Residents Association. “Older people need much more than empty slogans from the next prime minister about ‘fixing social care’.”
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Source: The Guardian, 21 August 2022
Patient Safety Learning

NHS whistleblower recorded her bosses’ ‘racist’ chat

A black NHS worker has launched legal action against the health service’s blood and transplant authority after witnessing years of alleged racism within the service.
Melissa Thermidor, 40, from Bushey, Hertfordshire, has lodged an employment tribunal claim against NHS Blood and Transplant (NHSBT) and two executives who have since left the authority. Betsy Bassis and Millie Banerjee, who were the chief executive and chairwoman, have denied the allegations and intend to fight the tribunal claims.
One colleague allegedly said: “White donors are more likely to shop at Waitrose and black donors at Tesco.” At subsequent meetings, the phrase “Tesco donors” was used. Staff also allegedly referred to “you people” when speaking to black members of the team.
Thermidor claims she was constructively dismissed after whistleblowing about racism within NHSBT. The health authority, which supported 3,386 organ donations in the year to March last year as well as collecting blood from 761,000 donors, has been embroiled in allegations of bullying, racism and poor culture under Bassis and Banerjee’s leadership.
Read full story (paywalled)
Source: The Times, 21 August 2022
Read NHS Blood and Transplant's response to the article.
Patient Safety Learning

Almost 38,000 mental health appointments miss vital 72-hour window

Nearly 38,000 vital follow-up appointments with mental health patients were missed at the time when they were most at risk of suicide, the Royal College of Psychiatrists has said.
The medical body has called for “urgent action” to ensure more people are seen for follow-ups within 72 hours of their discharge from inpatient care, to prevent them from falling “through the cracks when they are so vulnerable”.
The risk of suicide is highest on the second and third days after leaving a mental health ward, but 37,999 follow-up appointments with patients were not made within this timeframe in England between April 2020 and May 2022.
According to NHS data, of the 160,430 instances when patients were eligible for follow-up care within 72 hours after discharge from acute adult mental health care, only three-quarters (76%) took place within that period.
The Royal College of Psychiatrists is calling for more trained specialists to check on those perceived to be at risk, which they say requires more staffing and funding.
The president of the Royal College of Psychiatrists, Dr Adrian James, said: “We simply can’t afford to let people fall through the cracks at a time when they are so vulnerable. It’s vital that our mental health services are properly staffed and funded to offer proper follow-up care and help prevent suicides.
“Staff are working as hard as they can to provide high-quality care, but it’s clear that current resources are not enough to meet these targets. We need urgent action to tackle the workforce crisis and achieve the suicide prevention goals set out in the NHS long-term plan.”
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Source: The Guardian, 22 August 2022
Patient Safety Learning

NHS trialling 'smart goggles' so nurses can see more patients

NHS nurses will wear “smart goggles" as part of efforts to see more patients under a £400,000 pilot scheme.
Health chiefs said the virtual reality headsets would mean details of a consultation could be directly transcribed, reducing the amount of time spent filling in patients’ notes.
The technology will also allow live footage to be streamed to hospital specialists for second opinions, so patients do not have to have extra appointments in hospitals.
The intention is to give nurses more time for clinical duties such as checking blood pressure, dressing wounds and assessing a patient’s health needs.
Dr Tim Ferris, NHS director for transformation, said: “These new smart glasses are the latest pioneering tech and really show us what the future of the NHS could look like.
“They are a win-win for staff and patients alike, freeing up time-consuming admin for nurses, meaning more time for patient care.”
Read full story (paywalled)
Source: The Telegraph, 20 August 2022
Patient Safety Learning

Large hospital trusts still missing key crisis support in A&E

Some of the country’s leading acute hospitals are not meeting a key NHS standard for mental health support in emergency departments, HSJ research suggests, with some regions faring better than others.
Latest official estimates indicate that more than a third of EDs (36 per cent) are not yet meeting ‘core 24’ standards for psychiatric liaison – which requires a minimum of 1.5 full-time equivalent consultants and 11 mental health practitioners.
The long-term plan target is for 70 per cent of acute trust emergency departments to have the optimum ‘core 24’ standard service by 2023-24. The NHS appears to be on track to hit this, with significant progress made, despite the pandemic.
Annabel Price, chair of the Royal College of Psychiatrists’ liaison faculty, said tackling the workforce crisis with a fully funded plan would “prove instrumental in boosting recruitment across all acute trusts”.
Read full story (paywalled)
Source: HSJ, 23 August 2022
Patient-Safety-Learning

25 million children missed out on lifesaving vaccines in 2021, WHO and UNICEF data shows

Vaccine coverage continued to decline worldwide in 2021, with 25 million children missing out on lifesaving vaccines, according to data published by the World Health Organization and UNICEF.
"The largest sustained decline in childhood vaccinations in approximately 30 years has been recorded," the organisations have said.
Between 2019 and 2021, there was a 5-point drop in the percentage of children who got three doses of DTP3, the vaccine against diphtheria, tetanus and pertussis. This took the coverage down to 81%.
DTP3 coverage is used as a marker for broader immunization coverage, WHO and UNICEF said.
"As a result, 25 million children missed out on one or more doses of DTP through routine immunization services in 2021 alone. This is 2 million more than those who missed out in 2020 and 6 million more than in 2019, highlighting the growing number of children at risk from devastating but preventable diseases," they said. Eighteen million of these children didn't get a single dose of the vaccine, the majority of whom lived in low- and middle-income countries.
Other decreases were seen in HPV, with which over a quarter of the coverage achieved in 2019 was lost, and measles, with which first-dose coverage dropped to 81% in 2021. WHO notes that this is the lowest level since 2008 and means 24.7 million children missed their first dose in 2021.
Read full story
Source: CNN, 14 July 2022

Patient Safety Learning

Cost of living: 700 doctors could leave Welsh NHS over pay - union

Nearly 700 doctors are likely to leave the Welsh NHS as a result of a recent 4.5% pay rise, the British Medical Association has warned.
The warning follows a survey by BMA Cymru, in which more than half of the 1,397 respondents said they could leave and most felt morale had dropped.
The below-inflation pay rise will apply to consultants, junior doctors and GPs. The Welsh government said it accepted the NHS pay review body's advice and was limited on how far it could go.
Dr Iona Collins, chairwoman of the BMA's Welsh Council, said the findings resonated with what she was hearing from colleagues across Wales. "Doctors' take-home pay has reduced over several years, making the NHS an increasingly unattractive employer," said Dr Collins.
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Source: BBC News (23 August 2022)
Patient-Safety-Learning

New Covid warning over symptom that affects sleep

An immunologist has warned the new strain of Covid-19 could be causing different symptoms – including one that emerges during the night.
Omicron BA.5 is a highly-contagious subvariant prompting concern as it contributes to a fresh wave of infections across the globe, including the UK. Scientists have been finding differences with previous strains, including the ability to reinfect people within weeks of having Covid.
“One extra symptom from BA.5 I saw this morning is night sweats,” Professor Luke O’Neill from Trinity College Dublin told an Irish radio station in mid-July.
Read full story
Source: The Independent (24 August 2022)
Patient-Safety-Learning

LMC creates letter for GPs to reject hospital workload dumping ‘tsunami’

An LMC has created template letters to help practices reject secondary care workload dumping, including rejected referrals and requests to complete work on behalf of hospital trusts.
Cambridge LMC said it developed the tools amid a growing ‘tsunami’ of secondary care workload transfer into general practices.
One template letter tackles the rejection of a referral ‘on the basis that a proforma was not enclosed or completed in full’. It points out that the GMC requires GPs to refer when they ‘believe it is necessary to do so’ and that their ‘contractual obligations make no mention of a requirement to complete a proforma’.
Cambridgeshire LMC chief executive Dr Katie Bramall-Stainer told Pulse that ‘we need the temperature to rise on the understanding around pressures across general practice’.
Read full story
For more information on the issues raised, read a blog by Patient Safety Learning about the patient safety risks of rejected outpatient referrals.
Source: Pulse (19 August 2022)
Patient-Safety-Learning

Liz Truss: I’ll halt NHS doctor exodus

Liz Truss has pledged to halt the exodus of doctors from the NHS to tackle the Covid backlog and surging waiting lists.
The frontrunner in the Conservative leadership race is planning to unveil a series of radical reforms that will stop doctors from retiring early and entice retirees to return.
One in 10 consultants and GPs is expected to retire in the next 18 months because of pension rules that mean they are "paying to work". A source close to her said she would deal with it by “cutting red tape and dealing with issues in the pension and tax system that currently act as barriers for people wanting to return”.
It comes amid concerns that the NHS backlog after lockdown is causing more than 1,000 excess deaths per week - more than the figure now killed each week by coronavirus.
A source close to Liz Truss also said: “The Covid pandemic put unprecedented strain on our NHS, and the resulting backlog is seeing people struggling to get appointments and treatments. We must act to tackle it, and we will. We will make it easier for doctors and nurses who have recently left or are planning to leave the NHS but want to return or stay to do so.” 
Read full story (paywalled)
Source: The Telegraph (20 August 2022)
Patient-Safety-Learning

NHS 111 chaos may harm patients, experts claim

Patients may come to harm as a result of NHS 111 chaos, experts claimed on Tuesday as patients were advised to avoid the service this weekend. The helpline for urgent medical advice was targeted by cyberhackers earlier this month, leaving staff working on pen and paper.
The Adastra computer software, used by 85 per cent of 111 services, was taken offline after the attack leaving call handlers unable to book out-of-hours urgent appointments and fulfil emergency prescriptions. But almost three weeks on, most staff are still operating without the system, leaving GPs unable to see patients’ medical records during urgent consultations or automatically forward prescriptions to pharmacies.
The NHS has told hospitals to prepare public awareness campaigns to “minimise” pressures on urgent and emergency care services this winter. Some hospitals have already issued messaging urging patients not to turn up at accident and emergency (A&E), unless they are facing a “serious emergency.”
Helen Hughes, chief executive of the charity Patient Safety Learning, said the continuing chaos raises “serious patient safety concerns” and will “inevitably result in avoidable harm”. 
Telling patients not to go to A&E “unless it is absolutely necessary” is only possible if GPs and NHS 111 “have the capacity and the resources to meet the demands that this places on them”, Ms Hughes said.
“Significant delays in receiving a response are potentially missed opportunities for patients to receive timely medical advice and treatment that may prevent future harm,” she added. “Delays in receiving timely care and treatment will inevitably result in avoidable harm to patients.”
Read full story (paywalled)
Source: The Telegraph (23 August 2022)
Patient-Safety-Learning

UK to recruit nurses from Nepal under new government deal

Up to 100 nurses are to be recruited from Nepal to work in the NHS, despite global restrictions on employing health workers because of staff shortages in the country.
The Department of Health and Social Care (DHSC) and the Government of Nepal have signed a new government-to-government agreement regarding the recruitment of Nepali health professionals to the UK.
The move comes after the new health and social care secretary Steve Barclay announced plans to “significantly increase” overseas recruitment of health workers to help mitigate staff shortages in the UK. A 15-month pilot phase will initially see up to 100 nurses recruited from Nepal to work at Hampshire Hospitals NHS Foundation Trust.
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Source: Nursing Times (23 August 2022)
Patient-Safety-Learning

Lack of ‘psychological safety’ at trust with ‘acceptance of poor behaviours’

An acute trust has “palpable” cultural problems and staff “at all levels” have described an acceptance of “poor behaviours”, according to the Care Quality Commission.
Some staff at Gloucestershire Hospitals Foundation Trust also reported a lack of trust in their senior managers and a “fear of speaking up”.
The Care Quality Commission feedback was set out in a post-inspection letter to the trust’s acting chief executive Mark Pietroni last month following an inspection in June. The trust’s CEO Deborah Lee is currently off work as she recovers from a stroke.
According to the CQC letter, published in the trust’s board papers ahead of a full inspection report which is due in the autumn, staff “articulated [to inspectors and said they] had observed rudeness and incivility throughout the organisation”.
In a written statement, Professor Pietroni told HSJ he “fully recognised” the CQC’s feedback.
Read full story (paywalled)
Source: HSJ (24 August 2022)
Patient-Safety-Learning

Aishwarya Aswath's parents say Perth Children's Hospital staff ignored their pleas for help as daughter was dying

The mother of a seven-year-old girl who died at Perth Children's Hospital says she pleaded with staff to help her daughter but was not taken seriously.
Aishwarya Aswath died in April last year after attending the Perth Children's Hospital (PCH) with a high temperature and cold hands.
The Perth Coroner's Court on Wednesday heard a statement from Aishwarya's mother Prasitha Sasidharan, who described how she grew increasingly worried about her daughter while in the hospital waiting room. She approached staff five times while they were in the waiting room for almost two hours. "I feel like I was ignored and not taken seriously," she said. The court heard from both parents on Wednesday, the start of an eight-day inquest. After Aishwarya died her father wanted to hold her but was only allowed to do so for a brief time. In his statement, read to the court, he said there were "many missed opportunities to save her."
Former PCH chief executive Aresh Anwar said the hospital was grappling with a rise in mental health presentations and a shortage of staff when Aishwarya died.
Read full story
Source: ABC News (24 August 2022)
Patient-Safety-Learning

Former King's Lynn journalist Kath Sansom's Sling the Mesh campaign raises awareness of mesh implant surgery

Kath Sansom, a former journalist from Lynn is raising awareness about the potential risks associated with vaginal and rectal mesh surgery.
Mesh implant surgery is used to treat prolapse and incontinence in women usually following childbirth, and some men have also had the procedure. But pain and complications after the implants have left hundreds of people in the UK in pain and so a campaign in 2015 was launched which has led to the Government announcing a suspension in the use of vaginal mesh.
Kath initiated the Sling The Mesh campaign in 2015 following her own experience of mesh surgery. She said: "What is most important to women is financial redress. We are all innocent and have had our health and lives compromised. We shouldn't have to wait 40 years, as the victims of contaminated blood have. Some women are in wheelchairs and have lost pensions. I am not the woman that I was. It has taken a financial, physical and emotional toll."
Read full story
Source: Lynn News (24 August 2022)
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