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

Asthma attacks in more than 1m people linked to UK cost of living rationing

More than a million people in the UK have experienced life-threatening asthma attacks after cutting back on medicine, heating or food amid the soaring cost of living crisis, a survey suggests.
One in five (20%) people living with asthma in the UK – of which there are 5.4 million – have had an attack as a result of changes they have been forced to make due to rising energy, food and household bills, according to the research by Asthma + Lung UK. Fuel poverty campaigners described the figures as “distressing”.
Almost half of the 3,600 people with lung conditions such as asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis surveyed by the charity said their health had worsened since the crisis began.
Asthma + Lung UK warned there could be a “tidal wave” of hospital admissions in the next few months as cold weather, an abundance of viruses and people cutting back on medicines, heating, food and electricity put them at increased risk.
Sarah Woolnough, the charity’s chief executive, said: “Untenable cost of living hikes are forcing people with lung conditions to make impossible choices about their health.
“Warm homes, regular medicine and a healthy diet are all important pillars to good lung condition management – but they all come at a cost. We are hearing from people already reporting a sharp decline in their lung health, including many having life-threatening asthma attacks.
Read full story
Source: The Guardian, 28 September 2022
Patient Safety Learning

“Hyperbole” in government media releases on new drugs can undermine confidence in NHS, says editor

Phrases such as “cutting edge,” “game changing,” and “ground breaking” have no place in the description of new drugs by the government and NHS agencies, a therapeutics specialist and GP has warned.
James Cave, editor in chief of the Drug and Therapeutics Bulletin (DTB), said in an editorial1 that the degree of hyperbole and omission of important information in government press releases and media statements “leaves patients and healthcare professionals with a limited and unbalanced view of a medicine.”
In a letter to the heads of NHS England, the National Institute for Health and Care Excellence (NICE), and the Medicines and Healthcare Products Regulatory Agency (MHRA) he referred to a loss of objectivity in statements about new drugs over the past few years. Rather, some statements contained “a degree of hyperbole that might be more associated with an advertising agency.”
Read full story (paywalled)
Source: BMJ, 28 September 2022
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‘Twindemic’ warning as health chiefs launch Covid and flu vaccination drive

Health chiefs have warned of a Covid and flu “twindemic” this winter as they launched a renewed vaccination drive.
Around 33 million people in England will be eligible for a free flu vaccination this year, while 26 million are also eligible for an autumn Covid-19 booster.
Officials at the UK Health Security Agency (UKHSA) warned there will be lower levels of natural immunity to flu this year after the past few winters saw the public socialising less during restrictions.
The UKHSA warned of a possible "difficult winter" ahead as respiratory viruses, including flu and Covid, circulate widely as the public return to pre-pandemic levels of mixing.
One expert said they were more worried about flu than they had been for several years because of the reduction in population immunity.
There are also concerns patients may have vaccine fatigue and may choose to have one vaccine but not the other.
Read full story (paywalled)
Source: The Telegraph, 28 September 2022
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Dangerous NHS England hospital roofs ‘will not be fixed until 2035’

Dangerous roofs that could collapse at any time at hospitals across England will not be fixed until 2035, NHS bosses have admitted.
The disclosure came in NHS England’s response to a freedom of information request from the Liberal Democrats about hospitals that have roofs at risk of falling down on to staff, patients and equipment.
One of the hospitals used by Liz Truss’s constituents, the Queen Elizabeth in King’s Lynn, Norfolk, is at joint highest risk, with four dangerous roofs.
The roofs are built with reinforced autoclaved aerated concrete (RAAC), a lightweight, cheaper form of material that one hospital boss has called “a ticking timebomb”.
Some hospital managers are so worried that their RAAC roofs could crash down without warning that they have had to install hundreds of steel props to hold them up.
Matthew Taylor, the chief executive of the NHS Confederation, a hospitals group, said: “The prime minister acknowledged during the leadership contest that her own local hospital is falling apart and is being held up by stilts. Yet her government has not yet signalled any intention to give the NHS the urgent capital investment it needs to update its buildings and estates.
The Department of Health and Social Care said it was “committed to urgently addressing any risks to patient and staff safety”.
Read full story
Source: The Guardian, 28 September 2022
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Hospital seclusion: ‘I’ve been treated like an animal’

Evidence of abusive and inappropriate treatment of vulnerable patients at a secure mental health hospital has been uncovered by BBC Panorama. One young woman was locked in a seclusion room for 17 days, was then allowed out for a day, only to be hauled back in for another 10 days.
Harley was sitting on the floor wearing pink pyjamas, with her hair tied up in neat braids, when hospital staff piled through the door one after another.
Two male nurses grabbed her by the arms.
"You're not giving me a chance to work with you," she screamed.
"Let me get up."
But it was no use. Managers at the secure mental health hospital had decided there would be - in their words - "no negotiation".
As she struggled, other nurses and support staff joined in. With her arms, legs and head restrained, she was pinned to the floor, face down.
Secret filming by BBC Panorama captured the moment the 23-year-old was forced into a seclusion room at the Edenfield Centre in Prestwich, near Manchester. The hidden camera had already recorded staff justifying their actions and agreeing they would not try to reason with her this time.
Panorama's undercover reporter was told that Harley had previously been aggressive towards staff - but, this time they said she was being isolated for screaming and being verbally abusive.
Seclusion should only be used when it is of "immediate necessity" to contain behaviour that is likely to harm others, with patients locked away for the shortest time necessary, guidelines say.
England's independent healthcare regulator, the Care Quality Commission, says it should only be used in extreme cases - while the government has said the use of restrictive methods in hospitals should be reduced. But research by BBC News has found the numbers are steadily increasing.
Read full story
Source: BBC News, 28 September 2022
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CQC triggers two reviews into whistleblowing concerns

The Care Quality Commission (CQC) has commissioned an independent review into handling of a high-profile whistleblower case, and a wider internal review of how it responds when it is given “information of concern”. 
The independent review will be led by Zoë Leventhal KC of Matrix Chambers and will consider how the regulator handled “protected disclosures” from University Hospitals of Morecambe Bay Foundation Trust surgeon Shyam Kumar, alongside “a sample of other information of concern shared with us”.
Mr Kumar won a tribunal against the CQC earlier this month, which found he was unfairly dismissed as a special advisor on hospital inspections after raising serious patient safety concerns.
Between 2015 and his dismissal in 2019 Mr Kumar wrote to senior colleagues at the CQC with a number of concerns within his trust around bullying, patient harm and the quality of CQC hospital inspections. The tribunal drew particular attention to the two whistleblowing disclosures made by Mr Kumar about the CQC itself, which it found “clearly had a material influence on the decision to dismiss”.
The CQC said in an announcement today that the independent review would aim to determine whether it took “appropriate action” in response to the information disclosed in Mr Kumar’s case and others. It will include consideration of whether the ethnicity of the people raising concerns impacted on decision making or outcome and is expected to conclude by the end of the year.
Read full story (paywalled)
Source: HSJ, 28 September 2022
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Dying patient should have been seen in person

NHS officials ruled a man who died after his ear infection was not picked up in GP telephone consultations should have been seen face to face, a BBC Newsnight investigation has found.
David Nash, 26, had four remote consultations over three weeks during Covid restrictions but was never offered an in-person appointment. His infection led to a fatal abscess on his brainstem.
David first spoke to the practice on 14 October 2020, after finding lumps on his neck. He sent a photograph but was never examined.
With David worried the lumps might be cancerous, the GP asked a series of questions about his health and reassured him that while she could not rule it out completely, she was not worried about cancer.
She suggested he booked a blood test for two to three weeks' time.
In those three weeks, David would go on to speak to another GP and two advanced nurse practitioners but never face to face or via video call.
He was actually due to be seen in person at the GP surgery that day, for the blood tests booked some 19 days earlier, when he had presented with neck lumps. But - fearing he could have coronavirus, despite a negative PCR test - the nurse cancelled the bloods and asked David to retest for Covid.
In its investigation, NHS England found "the overarching benefit [of this decision] was less than the risk with going ahead with blood tests".
After five calls to NHS 111, David was taken to hospital in an ambulance that day but died two days later.
NHS England, in a finding seen by Newsnight, said: "A face-to-face assessment should have been offered or organised to confirm the diagnosis and initiate definitive management."
Read full story
Source: BBC News, 29 September 2022
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NI Health: Cancer treatment waits show 'system is failing'

The number of people in Northern Ireland waiting more than a month to start cancer treatment is five times higher than a decade ago.
Macmillan Cancer research collated between April 2011 and March 2012 said on average 18 people each month waited more than a month for treatment.
By March 2022 that monthly figure had increased to 92 people - or by more than 400%.
Macmillan Cancer said the jump revealed a system that was "failing" patients.
Sarah Christie, Macmillan policy and public affairs manager, told BBC News NI that the figures revealed a "dark insight into a healthcare system that is failing time and again to meet the needs of people living with cancer".
Ms Christie said: "People have a right to be frustrated. They deserve access to care at the right time.
"We need a government in place so that change can happen and, crucially, that the three-year budget that had been planned before the executive collapsed can be signed off.
"It is impossible to deliver transformation on short-term budget."
Read full story
Source: BBC News, 29 September 2022
Patient Safety Learning

Mental health hospital under investigation for abuse says it's taking 'urgent action'

Greater Manchester Mental Health NHS Foundation Trust said a number of staff at its Edenfield Centre had been suspended after an undercover investigation found what was described as a "toxic culture" of humiliation, verbal abuse, and bullying of patients.
BBC Panorama reporter, Alan Haslam, spent 3 months as a support worker at the Centre in Prestwich. Wearing a hidden camera, he said he observed staff swearing at patients, mocking them, and falsifying observation records.
A consultant psychiatrist, Dr Cleo Van Velsen, who was asked by the BBC to review its footage, said it showed a "toxic culture" among staff at the Centre with "corruption, perversion, aggression, hostility, [and a] lack of boundaries".
Dr Van Velsen told the BBC that staff members at the Edenfield Centre acted "like a gang, not a group of healthcare professionals".
Patients at the Centre told the undercover reporter that they felt "bullied and dehumanised".
Greater Manchester Police said it was working with the Crown Prosecution Service with a view to prosecuting anyone who had committed a crime. 
In a statement, Greater Manchester Mental Health NHS Foundation Trust said: "We are taking the allegations raised by Panorama very seriously since the BBC sent them to us earlier this month. We have put in place immediate actions to protect patient safety, which is our utmost priority.
"Since then, senior doctors at the Trust have undertaken clinical reviews of the patients affected, we have suspended a number of staff pending further investigations, and we have also commissioned an independent clinical review of the services provided at the Edenfield Centre. "
Read full story
Source: Medscape. 29 September 2022
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Coroner criticises NHS trust’s treatment of family of woman who killed herself

An NHS trust has “not covered itself in glory” in its dealings with the family of a vulnerable young woman who killed herself after being refused admission to hospital, a coroner has found.
The three-day hearing looked at evidence withheld from the original inquest into the death of Sally Mays, who killed herself in 2014 after being turned away from a mental health unit.
Mays was failed by staff “neglect” at Miranda House in Hull, a 2015 inquest ruled, after a 14-minute assessment led to her being refused a place, despite being a suicide risk.
Her parents, Angela and Andy Mays, won a high court battle in December to hear details of an informal chat outside the building between Laura Elliot, a community mental health nurse who was supporting Mays, and the consultant psychiatrist Dr Kwame Fofie, which only later came to light.
This was ruled to be “neither a clinical conversation nor an attempt to escalate her care” by senior coroner Prof Paul Marks on Wednesday.
He said: “It was a conversation between colleagues in which the frustrations of the working day were vented.”
But, he said: “The trust has not covered itself in glory with regard to its dealings with the family and the disclosing of documents.”
The Mays have spent the last seven years fighting to hear details of the car park conversation, which could have changed their understanding of what happened before their daughter died.
Angela Mays added: “I never considered myself to be a campaigner. I have only considered myself to be a mother who actually wants the truth about the facts relating to her daughter’s death.”
Read full story
Source: The Guardian, 28 September 2022
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‘Terrorist activity’ concerns trump patient confidentiality, NHS staff told

Health professionals should not let fears about sharing personal data “stand in the way” of reporting patients at risk of ”being groomed into terrorist activity”, new government guidance has stressed.
New guidance has been developed in response to concerns raised by clinicians about information sharing without consent for the purposes of the anti-terror Prevent and Channel programmes.
It stresses that “fears about sharing personal data should not be allowed to stand in the way of the need to safeguard and promote the welfare of children and adults at risk of abuse or exploitation”.
However, despite the need for clarity it describes how the decision for making a referral without someone’s informed consent should be subject to a “case-by-case” basis assessment, which considers whether the informed consent of the individual can be obtained, and if the proposed data sharing is legitimate, necessary, proportionate and lawful.
It said: “This assessment should be based on your professional opinion that there is tangible public interest or best interest considerations involved.”
Read full story (paywalled)
Source: HSJ, 29 September 2022
Sam

Mental health policies for drug users not being followed in Scotland, say experts

Scotland’s health services are failing to tackle a mental health crisis affecting thousands of people with drug or alcohol problems because the right policies are not being followed, an expert body has found.
The Mental Welfare Commission for Scotland, a statutory body founded to protect the human rights of people with mental illness, said only a minority of health professionals were using the correct strategies and plans for at-risk patients.
Dr Arun Chopra, its medical director, said there had been a “collective failure” to act: few local services were using the correct procedures despite so much evidence about the scale of Scotland’s drugs and alcohol problems.
Nearly four in five of those professionals said their patients were not given the documented care plans required by national policy. Of the 89 family doctors interviewed, 90% had experienced difficulties referring patients to mental health services or addiction services.
In some cases, mental health services then rejected patients because they were addicts, without helping them find the right support.
The commission recommended far clearer policies, protocols, auditing and monitoring by health boards and the Scottish government, with better training for professionals. Health workers needed to stop stigmatising patients and see patients as people affected by trauma.
Read full story
Source: The Guardian, 29 September 2022
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Racism against nurses: nurse speaks out following hours of abuse

A nurse has told how she almost quit her job this month after a patient shouted out racist slurs for hours on a recent night shift.
Beverly Simpson, who works as a nurse in a care home in Derry, Northern Ireland, said she was left angry and broken after a patient repeatedly used derogatory racist language and told her ‘to go back to her own country’.
Ms Simpson reported the incident on 4 September to managers, who are now investigating. In the meantime, she has called on all employers and peers to do more to protect staff from racism that she says she encounters every week.
"I have been a nurse for almost 30 years, but that night made me feel like I wanted to quit,’ she told Nursing Standard. ‘I was just worn down with it all. I’m human, I am hurt, but I still have to go back and treat this patient, be professional and hold my head up high."
"It’s all very well a black nurse standing up and saying it is wrong, but we need allies. There needs to be training and protocols on what to do in these situations. Instead, there is a blanket of silence."
Read full story
Source: Nursing Standard, 28 September 2022
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Record number of nurses quitting the NHS

Record numbers of nurses are quitting the NHS in England, figures show.
More than 40,000 have walked away from the NHS in the past year - one in nine of the workforce, an analysis by the Nuffield Trust think tank for the BBC revealed.
It said many of these were often highly skilled and knowledgeable nurses with years more of work left to give.
And the high number of leavers is nearly cancelling out the rise in new joiners that has been seen.
There were just 4,000 more joiners than leavers in the year to the end of June.
But a Department of Health and Social Care spokesman said progress was being made and the government was already halfway to meeting its target to increase the numbers of nurses working in the NHS in England during this Parliament by 50,000.
He said a workforce strategy would be published soon, setting out how the NHS will continue to recruit and retain nurses in the coming years.
Read full story
Source: BBC News, 30 September 2022
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Zambia: Avoid buying medicines in undesignated places such as buses

Copperbelt province Clinical Care Specialist Morgan Mweene has warned people against buying medicines from undesignated places such as buses or on the street as the trend is risky to their health.
And stakeholders on the Copperbelt have come together to advocate for reduced deaths or disability related cases resulting from wrong administering of medicine to patients in health facilities.
Speaking at the inaugural World Patient Safety Day, commemorated in Ndola under the theme, “Medication Safety”, Dr Mweene emphasised the need for people to avoid buying medicines from undesignated places such as buses and on the streets.
He further urged patients to take keen interest in medication given at hospitals.
“As health workers, we also need to take interest in patients. As health workers let us not tire as we the custodian of health. It is our duty that we take keen interest of whatever we administer to our patients,” he said.
Read full story
Source: Mwebantu, 30 September 2022
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New hospitals could be required to have single patient rooms only

New hospitals may be required to have single patient rooms only, HSJ has revealed
Chiefs at the New Hospitals Programme (NHP) are assessing whether to include a requirement for 100% single rooms in the new facilities, in what would be a major change for NHS hospital design.
It comes a year after NHS England medical director Stephen Powis said single patient rooms should be “the default” in hospitals as this would improve infection control and patient flow. Currently, the Department of Health and Social Care expects hospitals to consider a minimum of 50% single rooms when refurbishing or building new sites.
HSJ understands the NHP is working with the NHS’ technical standards team on how many single rooms will be required in the new hospitals the government has committed to building by 2030. The teams are considering recommending the percentage to be raised from 50% to 100%. The work is part of efforts to standardise design across the NHP projects and so therefore better control costs. 
Read full story (paywalled)
Source: HSJ, 30 September 2022
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