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

Covid: Time running out to protect vulnerable, campaigners warn

Time is running out for hundreds of thousands of vulnerable people who are facing another winter shielding from Covid, campaigners have said.
They are calling on the government to buy a drug called Evusheld to provide some protection against the virus.
The government says it is not clear how long that protection will last when up against the Omicron variant. But patients, charities and health experts argue the protection offered is better than nothing.
There are around 500,000 people in the UK with suppressed immune systems. That means their bodies struggle to produce antibodies, so the existing vaccines offer them little or no protection, leaving them very vulnerable to Covid.
Blanche Hampton has lupus, a condition where her immune system has turned against her.
The drugs she takes to control the lupus also suppress her immune system, meaning her body has no defences against Covid.
Blanche has been shielding for two and a half years, but she believes Evusheld offers a chance for at least some kind of existence outside of her small flat in Inverkip, west of Glasgow.
"Evusheld would give me a layer of protection, that is better than nothing. Because that's what I have currently - nothing."
And Blanche, like many people who find themselves in the same situation, says she feels abandoned.
Read full story
Source: BBC News, 17 October 2022
Patient Safety Learning

Hunt: Tax will need to rise to fund health and care

Jeremy Hunt believes spending on the NHS will have to rise and that the increase should be funded through higher taxation.
Mr Hunt was speaking at an event less than 48 hours before the prime minister asked him to replace Kwasi Kwarteng as chancellor.
In a discussion last Wednesday evening with HSJ editor Alastair McLellan and the audience at an event held as part of the Shoreham Literary Festival event, Mr Hunt also rejected the introduction of a social insurance model to fund the NHS and re-iterated the pressing need for the NHS to have a long-term workforce plan.
Asked by HSJ if the voices in the Conservative Party calling for a change from the NHS to a social insurance model had gained ascendancy, Mr Hunt said: “The game is not up for the NHS – absolutely not.
“We are all going to spend more on our health and care – if you’re in America you’re going to spend more through your insurance premiums – which are going to go up. If you’re in Holland and Germany you’re going to spend more through social insurance premiums. If you’re in Britain, Ireland or New Zealand you’re going to spend more through your taxes.”
Read full story (paywalled)
Source: HSJ, 17 October 2022
Patient Safety Learning

Paramedics in ‘Mexican standoff’ with A&E staff after ‘unprecedented’ rule change

Angry exchanges between paramedics and A&E staff in Liverpool have broken out after new measures were deployed to hold and treat patients in the back of ambulances.
Sources said there have been “Mexican standoff” situations at Aintree Hospital in recent days, after hospital staff insisted patients who had been brought inside should be returned to ambulance vehicles.
Staff at North West Ambulance Service told HSJ they were informed of a new protocol last week, which said patients should be kept in the back of ambulances if the corridor of the emergency department is full with patients.
There have been repeated orders from NHS England and the Care Quality Commission over the past year for hospitals to ensure patients can be offloaded by ambulance crews, even if they fear they do not have adequate staffing or beds to accept them.
One senior source at NWAS said: “To see a new protocol like this is absolutely unprecedented. I very much doubt the execs had approved it.
“We’ve had Mexican standoff situations over the weekend with crews who have brought patients into ED being told to take them back out to their vehicles, but they’ve refused to do this as it means they cannot cohort.
“We completely accept that taking extra patients means the ED and hospital staff have to deal with additional and unacceptable risk, but holding ambulances is not the solution because the risks to patients out in the community are even greater. Despite repeated instructions from NHS England and the CQC this still doesn’t seem to be understood.”
Read full story (paywalled)
Source: HSJ, 17 October 2022
Patient Safety Learning

Eating disorders: Toolkit to help schools cope developed

Mental health professionals have unveiled a "toolkit" to help school nurses support pupils with eating disorders.
Bath-based campaigner Hope Virgo developed the strategy with the School and Public Health Nurses Association (Saphna) after a rise in cases.
The toolkit aims to equip school nurses with techniques to discuss eating disorders, and also "what not to say".
Ms Virgo has called on the government to deal with the backlog those waiting for treatment, which totalled 1,946 at the beginning of March, data from eating disorder charity Beat shows.
Sharon White, Saphna's chair, said the organisation had been promoting the toolkit among its members.
"We can't solve the huge waiting lists and reduced services, but what we can do is inform ourselves better," she said.
The toolkit provides "the hints, the tips, the language, the stock phrases, and importantly, what not to say", Ms White added.
The Department of Health and Social Care has been supportive of the scheme, Ms White said, adding it may adopt it as part of its own guidance in future.
Read full story
Source: BBC News, 17 October 2022
Read a recent blog Hope Virgo wrote for the hub: People with eating disorders should not face stigma in the health system and barriers to accessing support in 2022
Patient Safety Learning

Family hit a 'brick wall' seeking justice for baby

The grandfather of a baby who died at a hospital that was fined over failings in the delivery has spoken of his five-year fight for justice.
Derek Richford was speaking as an independent report into baby deaths at the East Kent Hospitals Trust will be released this week.
He said he "came up against a brick wall" while searching for answers over the death of grandson Harry Richford.
An inquest into Harry's death at Margate's Queen Elizabeth the Queen Mother Hospital in 2017 found it was wholly avoidable and contributed to by neglect.
Coroner Christopher Sutton-Mattocks said the inquest, which was finally held in 2020, was only ordered due to the family's persistence.
The following year the trust was fined £733,000 after admitting failing to provide safe care and treatment for mother Sarah Richford and her son following a prosecution by the Care Quality Commission (CQC).
Mr Richford said: "To start with we felt fairly alone and we felt like we were coming up against a brick wall.
"The trust were refusing at that time to call the coroner. They were reporting Harry's death as 'expected'.
"We didn't contact anyone other than the CQC just to say 'look there's been a problem here'."
He said at a meeting with the trust, more than five months later, "we suddenly realised that there were a huge [number] of errors".
Mr Richford told the BBC: "It took me about a year to come up with all the detail I needed and to speak to all the right people."
He said the family then spoke to the Health Safety Investigation Branch who found there were issues.
Mr Richford also tracked down a "damming" report by the Royal College of Obstetricians and Gynaecologists (RCOG).
"In the end it was like peeling back the layers of an onion, and the more you took off, the more you found," he said.
Read full story
Source: BBC News, 18 October 2022
Patient Safety Learning

Slow cancer diagnosis twice as likely for ethnic minority patients, survey shows

New patient data shows significant regional differences in the effectiveness of primary care in getting cancer sufferers diagnosed – with an even more alarming picture when the data is broken down by ethnicity.
A survey of cancer patients asked how many times they had “spoken to a healthcare professional at [their] GP practice about health problems caused by cancer” before they were diagnosed, with a range between one and more than five times.
The overall figure for five times or more in England was 7% – but all four cancer alliances in London scored significantly above this.
Cancer Research UK said this could reflect the greater concentration of ethnic minority patients in the capital, and the data bore this out.
Nationally, 6.6% of white cancer patients had seen five or more primary care staff before getting a diagnosis. This compared to 11.7% for Asian cancer patients and 12.9% for Black cancer patients.
Read full story (paywalled)
Source: HSJ, 18 October 2022
Patient Safety Learning

'Speaking about the 22 babies I lost is seen as taboo'

Imtiaz Fazil has been pregnant 24 times, but she only has two living children.
She first fell pregnant in 1999 and, over the subsequent 23 years, has had 17 miscarriages and five babies die before their first birthdays due to a rare genetic condition.
The 49-year-old, from Levenshulme in Manchester, told BBC North West Tonight her losses were not easy to talk about, but she was determined to do so, in part because such things remained a taboo subject among South Asian groups.
She said she wanted to change that and break down the stigma surrounding baby loss.
She said her own family "don't talk to me very much about the things" as they think "I might get hurt [by] bringing up memories".
"It's too much sadness; that's why nobody approaches these sort of things," she said.
Sarina Kaur Dosanjh and her husband Vik also have the hope of breaking the silence surrounding baby loss.
The 29-year-olds, from Walsall in the West Midlands, have set up the Himmat Collective, a charity which offers a virtual space for South Asian women and men to share their experiences.
The couple, who have had two miscarriages in the past two years, said the heartache was still not something that people easily speak about.
"I think it's hidden," Sarina said.
"It's really brushed under the carpet."
Read full story
Source: BBC News, 13 October 2022
Patient Safety Learning

‘Irresponsible’: Alarm over Coffey’s ‘plans to let patients get antibiotics without seeing GP’

Doctors have criticised new health secretary Therese Coffey over reports that pharmacists will be allowed to prescribe antibiotics without the approval of a doctor.
According to The Times, Ms Coffey’s “Plan for Patients” will give pharmacists the power to prescribe certain drugs, such as contraception, without a prescription in an effort to reduce the need for GP appointments and tackle waiting lists.
Responding to reports of the plans, Rachel Clarke, an NHS palliative care doctor and writer, wrote on Twitter: “This is staggeringly irresponsible of Therese Coffey and will cause so much more harm than good.
“Doctors do not – unlike Coffey – dish out spare antibiotics to our family and friends because we’re painfully aware of the harms of antibiotic resistance. Utter recklessness.”
Stephen Baker, a professor at Cambridge University and an expert in molecular microbiology and antimicrobial resistance, branded the health secretary’s plans “moronic”.
He told the newspaper that the more antibiotics were used “the more likely we are to get drug-resistant organisms”.
He added that it was “nuts” to consider widening access to drugs, adding that resistance against antibiotics is “clearly one of the biggest problems humanity is facing in respect of infectious disease at the moment”.
Read full story
Source: The Independent, 17 October 2022
Patient Safety Learning

End rules stopping thousands of doctors working in GP surgeries, says GMC chief

Thousands of doctors are being prevented from working in overstretched GP surgeries across the UK because of unnecessary “red tape”, leaving NHS patients experiencing “unprecedented” waits for care, the head of the doctors’ regulator in the UK has said.
Charlie Massey, the chief executive of the General Medical Council, said barriers that stopped medics from being deployed to meet areas of high demand, such as in primary care, must be removed urgently if the NHS workforce crisis was to be resolved and access to care improved.
“Red tape is stopping the UK from making the most of many of its skilled and experienced doctors,” he said. “Without action, patients will suffer.”
The regulator will on Tuesday call for a relaxation of rules so the fastest-growing part of the medical workforce – skilled doctors in non-training roles – can undertake a wider range of work beyond hospitals, such as in GP surgeries.
“There are no easy answers to the challenges facing the NHS. There is no army of new doctors coming over the horizon, so part of the solution must be to make sure that we have more doctors in the places that patients need them,” Massey said.
“The government should make a start immediately by changing the performers list criteria so more doctors are allowed to work alongside GPs. That needs to be done urgently.
“But beyond technical changes there is also a need for fresh thinking in the way our health services are structured and in how teams of health professionals work together. We can’t keep doing things the same way they have always been done, or nothing will change."
Read full story
Source: BBC News, 18 October 2022
Patient Safety Learning

Woman with endometriosis forced to pay £25,000 for private care after condition ‘missed’ for 8 years

A woman says she was forced to pay around £25,000 for private healthcare to treat endometriosis after her symptoms were “overlooked” for eight years.
Aneka Hindocha, 34, started voicing her concerns about painful periods when she was aged 25 but says she was initially told by doctors this was normal.
Ms Hindocha, who described the pain of endometriosis as “someone ripping your insides out”, says the condition should have been diagnosed sooner but argued women’s pain often gets overlooked and ignored.
Endometriosis is a very common chronic inflammatory condition, impacting an estimated 1.5 million women in the UK. An inquiry by the All-Party Political Group found that like Ms Hindocha, it takes an average of eight years to get a diagnosis.
The condition sees tissue comparable to womb-lining grow in other places in the body - with symptoms often debilitating and spanning from infertility to painful periods, tiredness, pain while having sex, as well as depression and anxiety.
“I was told painful periods were normal, which they are not, but I believed that at the time,” Ms Hindocha told The Independent. “I thought the issue was me. I thought I was being a hypochondriac.”
Her health massively deteriorated in the summer of 2020 and she became bedbound for three days.
“I needed someone to find out what was wrong with me,“ Ms Hindocha added. “I was crying I was in so much pain.”
She says that two years later she still had not received her laparoscopy despite the fact her pain was getting more severe and so she ended up paying for a private scan. She finally got diagnosed with stage 4 endometriosis a week later.
“By the time of having my surgery at the end of February 2022, it had been nearly two years on the NHS waiting list and I was still being told to wait.”
Read full story
Source: The Independent, 18 October 2022
Patient Safety Learning

Trusts need hundreds of millions to stop hospitals’ roofs collapsing

Trusts need hundreds of millions of pounds to remediate dangerous roofs.
A series of freedom of information requests submitted by New Civil Engineer has revealed five of the worst affected trusts have applied for £331.9m of additional funding to be spent on fixing reinforced autoclaved aerated concrete planks during the next three years.
In response to NCE’s freedom of information investigation, Liberal Democrat deputy leader and health spokesperson Daisy Cooper said “patients are paying the price for years of neglect” by successive governments.
“It is truly shocking that patients are being treated in crumbling buildings that could be at risk of collapse. The NHS is crying out for the funds to fix creaking roofs so that patients can be treated safely. The public needs to know that the funds to fix this are on the way as soon as possible.”
Read full story
Source: HSJ, 17 October 2022
Patient Safety Learning

Ovarian cancer: 1 in 4 patients ‘see GP three times before referral for tests’

More than a quarter of women with ovarian cancer saw their GP three or more times before getting a referral for tests, according to a new study.
Researchers also found that almost a third had waited for longer than three months after first going to see their GP before being given the right diagnosis.
If doctors are able to diagnose ovarian cancer at the earliest stage, nine out of 10 women will go on to live for five years or longer, but only around one in 10 survive if it is not caught until it has progressed to stage 4, the most advanced stage.
The report, by Target Ovarian Cancer, also revealed that 14 per cent of women polled said they were not given their diagnosis in private, meaning others could listen in on the exchange.
“I was told of my stage 4 diagnosis behind the curtain on a busy respiratory ward. The rest of the ward heard the conversation,” one woman said.
Meanwhile, GPs and ovarian cancer patients told researchers that the support available for the disease is insufficient – with almost half of the women polled not having been asked by a doctor, nurse or other individual providing treatment about how the cancer diagnosis was affecting their mental health.
This is despite the fact that 60% of the women diagnosed with ovarian cancer said their mental health had been harmed by the disease.
Read full story
Source: The Independent. 18 October 2022
Patient Safety Learning

East Kent NHS inquiry finds better care might have prevented 45 babies’ deaths

The deaths of at least 45 babies could have been avoided if nationally recognised standards of care had been provided at one of England’s largest NHS trusts, a damning inquiry has found.
Dr Bill Kirkup, the chair of the independent inquiry into maternity at East Kent hospitals university NHS foundation trust, said his panel had heard “harrowing” accounts from families of receiving “suboptimal” care, with mothers ignored by staff and shut out from discussions about their own care.
The inquiry’s report said: “An overriding theme, raised with us time and time again, is the failure of the trust’s staff to take notice of women when they raised concerns, when they questioned their care, and when they challenged the decisions that were made about their care.”
Of 202 cases reviewed by the experts, the outcome could have been different in 97 cases, the inquiry found. In 69 of these 97 cases, it is predicted the outcome should reasonably have been different and it could have been different in a further 28 cases.
Of the 65 babies’ deaths examined, 45 could have had a different outcome if nationally recognised standards of care had been provided.
In nearly half of all cases examined by the panel, good care could have led to a different outcome for the families.
Some of the bereaved parents accused the trust of “victim blaming” mothers for their children’s deaths.
Kelli Rudolph and Dunstan Lowe, whose daughter Celandine died at five days old, said: “Doctors sought to blame Kelli for Celandine’s death. This victim blaming was the first in a long line of interactions with those in the trust who sought to delay, deflect and deny our search for the truth about what happened to our baby.
“In isolation, these tactics traumatised us after the tragedy of our daughter’s death. But when seen in the light of 10 years of failures, they signal a concerted effort to cover up the trust’s responsibility for what happened to Celandine and the many others who lost their lives due to failures in clinical judgment.”
Read full story
Source: The Guardian. 19 October 2022
Patient Safety Learning

‘Mothballed beds’ must be brought back into service to boost elective activity says NHSE

NHS England has warned trusts that it is “essential” that elective procedures go ahead over winter, despite acknowledging hospital occupancy is running at an “all time high”.
New winter planning guidance from NHS England, published today, says electives should go ahead “unless there are clear patient safety reasons for postponing activity,” and trusts considering cancelling significant levels of elective activity should escalate to their regional directors to mobilise mutual aid where possible.
NHSE has said bed occupancy “continues to be at all-time highs” and encouraged systems to “take all opportunities” to maximise physical and virtual bed capacity, including the use of “previously mothballed beds”.
Read full story (paywalled)
Source: HSJ, 18 October 2022
Patient Safety Learning

Leadership review launched at ‘outstanding’ trust

The Care Quality Commission has launched a review of leadership at an “outstanding”-rated specialist trust, after receiving multiple concerns from whistleblowers.
The regulator is understood to have made an unannounced visit to The Christie Foundation Trust within the last week to inspect its medical services. The review will also cover the trust’s overall leadership.
HSJ understands the review is, at least, partly in response to the regulator receiving a number of concerns from whistleblowers about the trust’s leadership culture and behaviour of senior staff.
It comes after the trust came under scrutiny from NHS England last year, with independent reviews finding there had been multiple failings around the handling of a major research project.
The reviews also criticised the trust’s reaction to staff who had raised concerns, but failed to answer a key accusation that was made about the detriment suffered by whistleblowers.
Read full story (paywalled)
Source: HSJ, 19 October 2022
Patient Safety Learning

Urgent safety measure took three years to implement

A key national policy change recommended by the inquest which led to the East Kent maternity inquiry will not be implemented until next February – more than three years after it was called for by a coroner.
The recommendation – that obstetric locum doctors be required to demonstrate more experience before working – was made in a prevention of future deaths report following the inquest into the death of seven-day-old Harry Richford at East Kent Hospitals University Foundation Trust.
The remaining 18 recommendations from the PFD report were requiring specific actions by the trust, rather than national policy makers. The trust says they have been implemented. 
However, NHS England and the Royal College of Obstetricians and Gynaecologists have only in recent months produced guidance on using short-term locums in these services, and it will not come into effect until February.
When it does, it will require them to complete a certification of eligibility, demonstrating they have had recent experience in a number of clinical situations, including complex Caesarean sections. Middle-grade locums have until next February to gain the certificate.
The independent inquiry into maternity at the trust – prompted by Harry’s death – will report tomorrrow, Wednesday 19 October, and is expected to be highly critical of the trust, and of national efforts to make services safe over recent years. 
Read full story (paywalled)
Source: 18 October 2022
Sam
Registered address: Patient Safety Learning, China Works SB203, 100 Black Prince Road Vauxhall, London, SE1 7SJ

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