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

Guernsey endoscopy waiting list patients 'at risk'

Some patients waiting for an endoscopy in Guernsey may be "at risk" because of a large backlog in procedures, the States medical director has warned.
The government has announced a tender process to bring in clinicians to help clear the list, which is three times longer than before the Covid pandemic.
More than 430 people were on the gastroenterology waiting list as of Tuesday, Dr Peter Rabey said.
"We're worried that there is risk to patients in waiting too long," he said.
"Although a lot of patients who get an endoscopy have completely normal results, and some have benign disease which can be treated with tablets and things, there will be some patients who might have cancer and we need to find out as best as possible".
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Source: BBC News, 20 December 2022
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Sick child’s mother rebukes Steve Barclay over NHS staff being ‘worked to the bone’

The mother of a sick girl has confronted the health secretary during a hospital visit in London, telling him that NHS staff are “worked to the bone” and the government is doing “terrible damage” to families on waiting lists.
Sarah Pinnington-Auld, whose three-year-old daughter, Lucy, has cystic fibrosis, rebuked Steve Barclay over NHS staff working conditions and long waits for treatment as he visited King’s College hospital.
She told the Conservative cabinet minister how her daughter was pushed off an “absolutely horrific” waiting list because of “the obscene number of people who came through and the lack of resources”.
“The damage that you’re doing to families like myself is terrible, because it was agony for us as a family waiting for that call,” she said. “Preparing our children, for their sister and her hospital visit, for then it to be cancelled. And I know you look and we’re all numbers, but actually they’re people waiting for care.”
“The doctors, the nurses, everyone on the ward is just brilliant, considering what they’re under, considering the shortage of staff, considering the lack of resources,” she said.
“That’s what’s really upsetting, actually, because we have a daughter with a life-limiting, life-shortening condition and we have some brilliant experts and they’re being worked to the bone, and actually the level of care they provide is amazing, but they are not being able to provide it in the way they want to provide it because the resourcing is not there.”
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Source: The Guardian, 19 December 2022
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Avoid any ‘risky activities’ on ambulance strike day, says health minister

Health minister Will Quince has warned the public to avoid any “risky activities” on Wednesday as ambulance drivers stage strike action.
The NHS is set to be hit by major disruption as ambulance workers including paramedics, control room workers and technicians walk out in England and Wales.
During the strike, the military will not drive ambulances on blue lights for the most serious calls but are expected to provide support on other calls.
Mr Quince urged the public to avoid anything risky on Wednesday, telling BBC Breakfast: “Where people are planning any risky activity, I would strongly encourage them not to do so because there will be disruption on the day.”
The health minister did not offer examples of what might be defined as risky behaviour but told the public that in any emergency calling 999 should still be the first option.
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Source: The Independent, 20 December 2022
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Preet Gill calls for public inquiry into patient safety at University Hospitals Birmingham

The Birmingham MP Preet Gill has called on the UK health secretary to launch a major public inquiry into allegations that a bullying and a toxic culture is risking patient safety at University Hospitals Birmingham (UHB).
The MP for Edgbaston, where UHB is based, said she had received complaints from staff alleging elderly patients had been left on beds in corridors outside wards due to mismanagement, and medics were discouraged from speaking out about problems.
In a letter to Steve Barclay, seen by the Guardian, Gill said: “I have been inundated by messages from UHB staff, past and present, who have contacted me to share their experience of what has been repeatedly described as a toxic culture that has had an alarming impact on staff and patient care.”
After an investigation by BBC Newsnight earlier this month, which found that doctors at the trust were “punished” for raising safety concerns, the Birmingham and Solihull Integrated Care Board (ICB) announced a three-part review into the culture at UHB. The first report is expected at the end of January.
But Gill criticised the plans, saying she did not think it would “be sufficient to adequately investigate this scandal”, and instead called for a major independent public inquiry, similar to the 2013 Francis inquiry into the Stafford hospital scandal.
“We cannot rely on an ICB investigation to solve this issue. Many of those on the ICB are former members of the senior leadership team from UHB and would not offer the independence required to recommend the changes that are so needed or give confidence to whistleblowers,” she said.
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Source: The Guardian, 19 December 2022
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93-year-old left ‘screaming in pain’ on floor during 25-hour ambulance wait

The Welsh ambulance service has apologised after a 93-year-old woman was left “screaming in pain” while lying on the floor with a broken hip during a 25-hour ambulance wait.
Elizabeth Davies fell at her care home on Saturday and was finally picked up at 1.15pm on Sunday and admitted to Ysbyty Gwynedd hospital in Bangor on Monday, where she endured another 12-hour wait before being admitted to a ward. A hip fracture was later confirmed in surgery.
Her family have said the incident, which occurred before a 24-hour strike on Wednesday by ambulance workers, was “unacceptable”. Her son, Ian Davies, from Pwllheli, said: “It was very upsetting to have to see her lying on the floor screaming in pain for over 24 hours.”
After her injury, staff at the care home, where Davies has lived for 17 years, are understood to have propped a pillow under her head and tried to make her comfortable on the wooden floor, using a small heater to keep her warm in case she went into shock, as well as providing an absorbent pad so she could urinate.
Her son, a community care worker, said: “They called for an ambulance but were advised an ambulance wouldn’t be available for six to eight hours as they were so busy.
“They said my mother would be a priority because of her age. The care home then called us and we came immediately.
“I don’t blame the ambulance staff because they are told what jobs to do and my mother wasn’t on the list.”
It is understood the care home made nine calls, with a 10th made by Ian Davies.
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Source: The Guardian, 20 December 2022
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Risk to patients getting worse, NHS leaders warn

The risk to patients will only get worse unless the government reaches an agreement to prevent further strikes, NHS leaders have warned.
In a letter to the prime minister and health secretary, they said there was "deep worry" about today's strike.
People are being asked to only call 999 in a life-threatening emergency, but NHS England says emergency care will continue to be provided.
Ambulance response times are already twice as long as two years ago.
The letter, signed by the leaders of NHS Confederation and NHS Providers, says the action being taken by ambulance workers "isn't just about pay but working conditions: many have said they are doing this because they no longer feel able to provide the level of care that their patients need and deserve."
They urged ministers to "do all you can to bring about an agreed solution".
Health Secretary Steve Barclay said the pay deal on offer to both ambulance staff and nurses had been agreed by an independent pay review body.
In England, eight out of the 10 major ambulance services have declared critical incidents - a sign of the intense pressure they are already under.
Ministers have urged the public to take extra care and suggested they avoid contact sports and unnecessary car journeys.
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Source: The Guardian, 21 December 2022
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‘Significant rise’ in suspected UK scarlet fever cases brings total to nearly 30,000

The number of suspected scarlet fever cases since September has risen to nearly 30,000 after the UK Health Security Agency added almost 10,000 potential new infections in the last week.
More than 27,000 people could have had infections since 12 September, according to the UKHSA, who revealed on Tuesday that there were more cases than first thought because of the “significant rise” in infections.
The figures come from medical practitioners referring suspected cases to the local authority or health protection team.
A total of 16 children aged under 18 have died from invasive group A streptococcus (iGAS), otherwise known as strep A.
Parents are advised to contact 111 or a GP surgery if a child has symptoms. They can also include nausea and vomiting.
New serious shortage protocols were issued to pharmacists last week in an attempt to help those experiencing supply issues with penicillin.
Chemists had widely reported problems getting hold of liquid penicillin and amoxycillin due to the increase in demand. The antibiotics are often prescribed for children who have scarlet fever or strep A. People in the industry have also reported rising prices.
Pharmacists are now able to prescribe an alternative antibiotic or formulation of penicillin, such as tablets.
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Source: The Guardian, 20 December 2022
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Fury as minister says strikers choosing to harm

Ambulance unions have reacted with anger after the health secretary said they had "taken a conscious choice to inflict harm on patients".
Steve Barclay said unions had refused to work with the government at a national level on how they would cover emergency calls during strike action.
Unison said it was "utterly shocked" by the comments, while the GMB union said they were "insulting".
Paramedics are among those striking in England and Wales on Wednesday.
Control room staff and support workers who are members of the Unison, GMB and Unite unions are also involved.
NHS bosses are warning patient safety cannot be guaranteed during the action, although unions say life-threatening callouts will still be responded to by an ambulance.
They also argue patients are already being put at risk due to waiting times and the pressure on the health service, made worse by staff shortages.
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Source: BBC News, 21 December 2022
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How Covid has dealt the NHS a lasting blow

The NHS in England has more funding and staff than before the pandemic - but in many types of care, it is treating fewer patients. Why?
The Institute for Fiscal Studies (IFS) says this is a puzzle with no simple explanation - but the pandemic has dealt a lasting blow to the NHS and it could be costing more to treat patients, on average, than before.
Despite higher staff sickness rates, compared with pre-pandemic levels, the NHS has available to work:
8% more nurses 9% more consultants 15% more junior doctors. But - not counting those filled by patients who have tested positive for Covid, even though they may be there mainly for something else - there were 5% fewer beds available in the third quarter of this year than in 2019, the IFS says.
IFS research economist Max Warner says: "The NHS is showing clear signs of strain heading into the winter and is treating fewer patients than it was pre-pandemic, across many types of care.
"The real risk, almost three years on from the start of the pandemic, is that the Covid hit to NHS performance is not time-limited.
"Going forward, we need to grapple with the possibility that the health service is just able to treat fewer patients with the same level of resources."
A Department of Health spokesperson said: "As the IFS report acknowledges, Covid had a significant impact on the NHS, and we are focused on delivering the biggest catch-up programme in health history".
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Source: BBC News, 14 December 2022
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The real test is yet to come as ambulance strike causes little disruption

The NHS entered the last six hours of the ambulance strike with a sense that the real test will be seen in the coming days.
Call volumes were down and many A&Es quieter than in previous days. NHS111 was very busy.
Despite the fears expressed by leaders ahead of the strike not yet coming to fruition, the day ended with eight integrated care systems declaring critical incidents, along with all striking ambulance trusts and a number of hospital trusts.
Leaders across the country told HSJ they feared that those who stayed away today in response to pleas for “common sense” amid industrial action may come back tomorrow, seeing demand return strongly.
A senior London source said: “The ambulances will have stacked some calls and we may have a flood of movement tomorrow.”
Read full story (paywalled)
Source: HSJ, 21 December 2022
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UK hospices warn of bed closures and staff cuts as energy bills soar

Hospice charities providing end-of-life services in partnership with the NHS have warned they will have to shut beds and sack staff because of the catastrophic impact of rising energy bills on their day-to-day running costs.
The UK’s network of independent, mainly voluntary-run palliative care providers said hospices were experiencing a perfect storm of soaring costs and rising demand just as revenues from traditional public fundraising methods are collapsing.
They have also warned that many patients who receive palliative care at home are struggling to maintain optimal care standards because they can’t afford to run central heating and the electrical medical equipment used in their everyday clinical care.
Hospices, which typically rely on charitable donations for 70%-80% of their running costs, and which are intensive users of gas and electricity, have reported facing energy bill rises of up to 350%.
Rachel McMillan, the chief executive of one of the UK’s biggest hospices, St Ann’s, in Greater Manchester, said: “We are at the point where we will have to take some very difficult decisions in terms of our business model and our service provision. Closing beds would be a last resort, but we are seriously going to have to think about this.
“The government needs to sit up and listen to hospices; we are an essential part of the care delivery system. We are not a luxury.”
Read full story
Source: 22 December 2022
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Trust drops from ‘outstanding’ to ‘requires improvement’

A teaching hospital that was lauded for its culture and championed by ministers has been downgraded from ‘outstanding’ to ‘requires improvement’ by the Care Quality Commission.
CQC inspectors found multiple issues at Salford Royal Hospital during an inspection in August and September. These included nurse staffing, governance, and some cultural concerns. The trust’s urgent and emergency services were rated “inadequate” for safety.
The hospital in Greater Manchester had been rated “outstanding” since 2015, and was frequently hailed as a leader on the patient safety agenda, particularly by former health secretary Jeremy Hunt.
Read full story (paywalled)
Source: HSJ, 22 December 2022
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Major German research funder launches audit of clinical trial portfolio

German public research funder Deutsche Forschungsgemeinschaft (DFG) is conducting an audit of the clinical trials it has supported in the past. The audit was announced in response to a request from TranspariMED asking DFG for a list of all its trials completed between 2009 and 2017, to which DFG replied that it currently has no such comprehensive dataset.
DFG stated that it is "currently preparing an evaluation of its clinical trials programme. In the framework of this evaluation the data you requested will be collected and analysed, as the outcomes of trials supported by DFG is of high interest including for DFG itself."
TranspariMED, an organisation which aims to end evidence distortion in medicine, sees this development as a good opportunity for DFG to check whether and when clinical trials were registered and their results made public.
Previous research has shown that nearly a third of German academic trials never make their results public.
This not only wastes public money, but also harms patients because it leaves gaps in the evidence base on the efficacy and safety of drugs, medical devices, and non-drug treatments.
Due to gaps in German law, there is still no legal obligation to make the results of many German clinical trials public.
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Source: TranspariMed, 20 December 2022
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Antiviral does not cut Covid hospital admissions or deaths in vaccinated

The antiviral, molnupiravir, does not reduce coronavirus hospital admissions or deaths in vaccinated people at high risk, new research suggests.
But the treatment was associated with a shorter recovery time, by four days, and reduced viral load.
People who received molnupiravir reported feeling better compared to those who received usual care, the study found.
Researchers suggest that while the drug could have some benefits in terms of symptom reduction, the cost of the drug may mean it is not the best choice for the general population, given the study findings.
But it may be useful in reducing the pressure on UK health systems, they added.
Chris Butler, professor of primary care in the Nuffield Department of Primary Care Health Sciences and co-chief investigator of Panoramic, said: “Finding effective, safe and scalable early treatments for Covid-19 in the community is the next major frontier in our research response to the ongoing worldwide pandemic.
“It is in the community where treatments could have a massive reach and impact.
“But decisions about who to treat should always be based on evidence from rigorous clinical trials that involve people who would most likely be prescribed the drugs.”
Read full story
Source: The Independent, 23 December 2022
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Stay at home if you’re unwell, say experts, as flu and Covid cases rise in England

Flu and Covid are on the rise in England, with experts stressing the importance of vaccination and warning that people who feel unwell should stay at home rather than mingling with others during the festive season.
The figures come as cases of scarlet fever and strep A infections continue to rise.
The UK Health Security Agency (UKHSA) added that while invasive strep A infections remain rare there have now been a total of 94 deaths in England, including 21 children.
Dr Colin Brown, the deputy director at UKHSA, sought to reassure parents. “I understand how this large rise in scarlet fever and ‘strep throat’ may be concerning to parents, however the condition can be easily treated with antibiotics and it is very rare that a child will go on to become more seriously ill,” he said, adding that parents should visit NHS.UK, contact 111 online or their GP surgery if their child has symptoms so they can be assessed for treatment.
Dr Mary Ramsay, the director of public health programmes at UKHSA, noted a link between indoor mixing and the rise in cases and hospital admissions for flu and Covid.
“Both Covid and flu can cause severe illness or even death for those most vulnerable in our communities, and so it is also important to avoid contact with other people if you are unwell in order to help stop infections spreading over the Christmas and new year period,” she said.
Read full story
Source: The Guardian, 23 December 2022
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Ambulance workers in England to strike again in January

Ambulance staff in five areas of England are to stage two further strikes in January, union leaders say.
The industrial action on 11 and 23 January is likely to heap more pressure on emergency care, which is already under serious strain.
Health Secretary Steve Barclay said further strike action was in no one's best interest.
Unison leaders say the action is a direct result of the government's refusal to negotiate over pay.
Life-threatening calls to 999, as well as the most serious emergency calls, will still be responded to, they say.
Services in London, Yorkshire, the North West, North East and South West will take action over pay and staffing.
The January strikes will each last for 24 hours from midnight, Unison says, and will involve all ambulance employees - not just 999 response crews.
Read full story
Source: BBC News, 22 December 2022
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