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

I worry we're killing people - ambulance dispatcher

Ambulance staff will take part in their second day of strike action this winter on Wednesday 11 January. Alongside paramedics, call-centre staff will walk out across England and Wales in the dispute over pay. These workers play a vital role, taking calls from the public and assigning ambulance crews.
An ambulance dispatcher at the North West Ambulance Service, who wishes to stay anonymous, has described working amid the extreme pressures of this winter. They said, "The thought of going in and having to manage those calls just fills me with absolute dread. I have seen people leave the ambulance service - they have had enough. We are physically and mentally exhausted."
Most frustrating, the dispatcher says, is the number of crews stuck outside hospital waiting to hand patients over to accident-and-emergency staff. In the last week of 2022, more than 40% of crews in England had waits of more than 30 minutes - it should take 15.
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Source: BBC News, 10 January 2023
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7,000 ‘exhausted and burnt out’ NYC nurses walk out

More than 7,000 nurses at two major New York City hospitals walked off the job Monday, arguing immense staffing shortages are causing widespread burnout and hindering their ability to properly care for their patients.
The nurses say they are working long hours in unsafe conditions without enough pay – a refrain echoed by several other nurses strikes across the country over the past year. The union representing the nurses said an offer of 19% pay hikes isn’t enough to solve staffing shortages.
This is the latest in a series of strikes in the health care industry in recent years. Those union members who were on the front lines during the three-year battle with the Covid pandemic say the system is no longer able to function with the widespread shortages that arose during those years.
“We’ve been fighting for working under safer conditions,” Warren Urquhart, a transplant nurse at Mount Sinai, told CNN Monday while on the picket line. “We do the best we can every day. There’s something wrong inside the hospital. That’s why we’re outside the hospital.”
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Source: CNN, 9 January 2023
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Excess deaths in 2022 among worst in 50 years

More than 650,000 deaths were registered in the UK in 2022 - 9% more than 2019. This represents one of the largest excess death levels outside the pandemic in 50 years.
Though far below peak pandemic levels, it has prompted questions about why more people are still dying than normal. Data indicates pandemic effects on health and NHS pressures are among the leading explanations.
Although the ongoing impact of the pandemic is a contributing factor, a number of doctors are blaming the wider crisis in the NHS. On 1 January 2023, the president of the Royal College of Emergency Medicine suggested the crisis in urgent care could be causing "300-500 deaths a week".
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Source: BBC News, 10 January 2023
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Errors in overflowing EDs causing heart attacks, NHS England warns

Patients have suffered cardiac and respiratory arrests because of errors using oxygen cylinders, NHS England has warned, citing more people being cared for in “areas without access to medical gas pipeline systems” such as corridors and ambulances queuing outside A&E.
A patient safety alert issued by NHS England today identifies 120 incidents in the past year related to oxygen cylinder use, including cylinders either being empty at point of use, not switched on, inappropriately transported, or inappropriately secured. 
Some of the incidents involved “compromised oxygen delivery to the patient, leading to serious deterioration and cardiac or respiratory arrest” the alert said, and at least 43 caused harm.
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Source: HSJ, 10 January 2023
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Fraudster posed as doctor in UK for 19 years, court hears

A “most accomplished fraudster” was paid between £1m and £1.3m by the NHS during the nearly two decades she posed as a qualified doctor after forging a degree certificate, a court has heard.
Zholia Alemi, believed to be 60 years old, worked as a psychiatrist in the UK for 19 years after claiming to have qualified at the University of Auckland in New Zealand, a trial at Manchester crown court heard. The defendant is accused of 20 offences, including forgery and fraud, which she denies.
The jury heard Alemi’s case was that she was appropriately qualified and documents demonstrating her qualifications were genuine.
She denies 13 counts of fraud, three counts of obtaining a pecuniary advantage by deception, two counts of forgery and two counts of using a false instrument.
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Source: The Guardian (paywalled)
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Record number of cancer patients in England waiting over three months for treatment

A record number of people in England are waiting longer than ever for cancer treatment, as the total waiting more than three months surpassed 12,000 for the first time.
More than 4% of the 287,000 people on cancer waiting lists had waited more than 104 days to receive treatment after diagnosis, despite 2,000 of those being considered urgent patients, according to NHS England figures for the week ending on 1 January, seen by Health Service Journal.
Michelle Mitchell, Cancer Research UK’s chief executive, said that missing waiting time targets–which have not been fully met since December 2015–was “unacceptable when a matter of weeks can be enough for some cancers to progress”. She called on the government to publish an “ambitious and fully funded” 10-year cancer plan. “Only then will we see significant improvements in early diagnosis and survival,” she said.
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Source: The Guardian
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What is Kraken? All we know about renamed Covid variant XBB 1.5

Novel strains of the coronavirus are creating new health concerns around the world as fresh descendants of the highly-transmissible Omicron variant now make up 40 per cent of cases in the US.
The two strains, XBB and XBB.1.5 have seen a surge in cases in countries worldwide. The World Health Organisation has warned the new and “recombinant” Covid variant XBB.1.5 is the “most transmissible yet.” It has been nicknamed 'Kraken' on social media.
XBB.1.5 has now been found in 25 countries and is a mutated version of Omicron XBB, which was first found in India in August. XBB can get past the body’s immune system and XBB.1.5 is just as able at doing so. It is also better at “binding” to cells, so it can spread with much more ease. Whether or not the so-called Kraken will trigger a new Covid surge in the UK remains to be seen, but reports suggests that a rise in cases may well be seen.
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Source: Independent, 11 January 2023
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Five million children worldwide die before fifth birthday, says UN

Five million children worldwide died before their fifth birthday in 2021, with almost half (47%) dying during their first month, according to new UN figures.
Most of the deaths could have been prevented with better healthcare, say campaigners, adding that deaths among newborn babies haven’t reduced significantly since 2017.
Children born in sub-Saharan Africa are 15 times more likely to die in childhood than children in Europe and North America.
UN figures also show that 1.9 million babies were stillborn during 2021, more than three-quarters (77%) in sub-Saharan Africa and in south Asia. The risk of a woman having a stillborn baby in sub-Saharan Africa is seven times greater than for women in Europe and North America.
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Source: The Guardian, 10 January 2022
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France's health system under pressure of increasing demands

The UK's health system is buckling under the weight of staff shortages and a lack of beds. In France, meanwhile, there are more doctors and many more nurses, yet its healthcare system is still in crisis.
President Emmanuel Macron has promised to change the way its hospitals are funded, and to free doctors from time-consuming administration, in a bid to break what he called a "sense of endless crisis" in its health service.
A series of eye-catching measures over the past few years - such as signing-up bonuses of €50,000 (£44,000) for GPs in under-served areas, and ending a cap on the number of medical students in France - have failed to plug healthcare gaps. 
Some hospitals are reporting up to 90% of their staff on "sick leave protest" at the conditions. And France's second-largest health union has called an "unlimited walkout" this week, following a fortnight of strikes by French GPs.
Guillaume Garot, a Socialist MP leading a cross-party bill to tackle the problem of medical deserts, said, "Eight million French people live in a medical desert, and six million don't have an attending doctor," he says. "It takes six months, on average, to find an appointment in my department of Mayenne; in Paris it takes two hours."
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Source: BBC News, 12 January 2023
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Record 50,000 patients a week face 12-hour A&E waits

An investigation by The Independent has revealed that the number of patients waiting more than 12 hours in A&E for treatment has exceeded 50,000 a week for the first time.
Leaked NHS data shows that last month as many as one in eight patients faced a “trolley wait”—the time between attending A&E and being admitted—longer than 12 hours, as the health service comes under ever greater strain.
Sources across the country told The Independent that hospitals are having to “squeeze” patients into spaces other than normal wards or A&E, with no direct oxygen lines. Meanwhile patients wait for hours in ambulances outside emergency departments.
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Source: The Independent, 11 January 2023
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Organ transplants: Black people wait up to six months longer, NHS figures show

Black patients wait up to six months longer for an organ transplant than the general population, new NHS data shows.
The best match comes from someone of the same ethnicity - but only 2% of donors in 2021/22 were black, while black people are 4% of the population.
Black families are also less likely to agree to organ donation than white families, the figures show. The NHS says there's an "urgent need" for more people from ethnic minorities to donate.
Winnie Andango from NHS Blood and Transplant said, "Black people wait longer because there's less people coming forward to give their organs from their ethnic group. During covid, so many patients were suspended but those have been added back onto the list, and that means if we had less organs for this ethnic minority group, we have even less right now."
Health Minister Neil O'Brien said: "We need more people, especially those from black and Asian heritage, to register their organ donation decision and share it with their family so loved ones can follow their wishes."
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Source: BBC News, 12 January 2023
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Alarm raised at decline in women’s maternity experiences in England

The Care Quality Commission (CQC) has sounded the alarm over a “concerning decline” in women’s experiences with maternity services.
Fewer women feel they always got the help they needed during labour and birth, many were disappointed at the amount of time their partners could stay with them after the delivery of their babies, and a significant number reported that they did not feel listened to when they raised concerns.
The CQC said it has noticed a “deterioration” over the last five years in the ratings women gave their care. 
It came as a major new national poll showed a “statistically significant downward trend” on most measures examined to track maternity care across the country. In particular, concerns were raised about staff availability, confidence and trust, as well as kindness and understanding of staff. Ratings also tumbled for whether women felt they had been treated with dignity and respect, the amount of information provided to mothers, and their concerns about being listened to.
Victoria Vallance, from the CQC, said: “These results show that far too many women feel their care could have been better. This reflects the increasing pressures on frontline staff as they continue in their efforts to provide high-quality maternity care with the resources available.”
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Source: The Guardian, 11 January 2023
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‘Tearful’ staff raise patient safety concerns to CQC

An inspection of a hospital has found all wards were understaffed, while ‘tearful [and] exhausted’ clinicians raised patient safety concerns to the Care Quality Commission (CQC).
The CQC’s visit to Colchester hospital, run by East Suffolk and North East Essex Foundation Trust, also found patients going unfed because of low staffing ratios and patient confidentiality concerns.
The concerns were raised in a letter sent by the CQC to the trust, which also runs Ipswich hospital, ahead of publication of an inspection report for older people’s medical services, which is due later this month.
The CQC’s letter, published in board papers for a meeting on Thursday, said: “All wards’ actual staffing levels and skill mix meant staff were often overstretched. All staff we spoke with expressed concern about the impact on patient care and personal wellbeing. Some staff we spoke with were tearful, reported feeling exhausted and concerned that they were unable to care for patients well enough to keep them safe.”
The letter also said significant positives were found. Inspectors “found staff to be welcoming, hardworking and supportive of each other… We found staff at all levels working together with the aim of putting the patients first and providing a safe and effective service”.
Read full story (paywalled)
Source: HSJ, 11 January 2023
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Uganda’s Ebola outbreak ends, leaving relief and unanswered questions

No new Ebola infections have been detected in Uganda for 42 days, and so on Wednesday, the World Health Organization and the Ugandan Ministry of Health officially declared that the country’s most recent outbreak of the deadly virus is at an end.
Since the outbreak was officially recognised on September 20, 164 people have had confirmed or probable Ebola infections; there 55 deaths confirmed by lab testing, with another 22 deaths suspected of being caused by the virus.
Those who have recovered from the virus will receive ongoing support and will be closely monitored to help scientists understand the long term impacts of the Sudan strain of the virus, for which there are currently no treatment or prevention options.
The Ugandan government has also set a goal of finally identifying the animal reservoir for Ebola.
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Source: CNN, 11 January 2023
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'My dying husband could not get an ambulance'

Ambulance bosses have apologised to the family of a man who died after he had a heart attack but no ambulance came.
Martin Clark, 68, started suffering with chest pains at his home in East Sussex on 18 November - before any strike action started in the NHS.
His family rang three times for an ambulance and after waiting 45 minutes drove him in their car to hospital. When they arrived, the father of five went into cardiac arrest and, despite receiving medical attention, died.
Dr Sonya Babu-Narayan of the British Heart Foundation (BHF), said cases such as the Clarks' were "incredibly distressing".
"The difference between life and death can be a matter of minutes when someone is having a heart attack or stroke," she said. "Extreme delays to emergency heart and stroke care cannot become a new normal. Healthcare staff are doing all they can—but there aren't enough of them and many will be working in difficult conditions without fit-for-purpose facilities."
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Source: BBC News
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Trusts given 20 days to book in all 78-week waiters

Trusts have been told today by NHS England that they must book appointments by the end of this month for all patients who have been waiting longer than 78 weeks. A letter from NHS England sent to trust leaders set out the new orders and represents system leaders’ attempt to ramp up progress on this cohort of patients, which the NHS and government elective recovery plan commits to eliminating by March.
The appointments must be issued this month, and be dated before the end of March, for these pathways, of which about 48,000 are recorded nationally. The letter also warns trusts that, while NHSE will accept some inpatient cancellations are unavoidable, cancelling outpatient appointments — even during strike action — is viewed as less acceptable.
Read full story (paywalled)
Source: HSJ, 12 January 2023
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