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

More than 500,000 people in UK ‘will be diagnosed with cancer each year by 2040’

More than 500,000 people in the UK will be diagnosed with cancer every year by 2040, according to analysis by Cancer Research UK.
In a new report, researchers project that if current trends continue, cancer cases will rise by one-third from 384,000 a year diagnosed now to 506,000 in 2040, taking the number of new cases every year to more than half a million for the first time.
While mortality rates are projected to fall for many cancer types, the absolute numbers of deaths are predicted to increase by almost a quarter to 208,000. In total, it estimates that between 2023 and 2040, there could be 8.4m new cases and 3.5 million people could have died from cancer.
Cancer Research UK’s chief clinician, Charles Swanton, said: “By the end of the next decade, if left unaided, the NHS risks being overwhelmed by the sheer volume of new cancer diagnoses. It takes 15 years to train an oncologist, pathologist, radiologist or surgeon. The government must start planning now to give patients the support they will so desperately need.”
Read full story
Source: The Guardian, 3 February 2023
Patient Safety Learning

New strategy to boost NHS access to innovative medical technology

Patients across the UK are set to benefit from access to safe, effective and innovative equipment and medical devices as part of the first ever medical technology (medtech) strategy published today.
The blueprint for boosting NHS medtech will focus on accelerating access to innovative technologies, such as the latest generation of home dialysis machines that enable patients to manage their own health at home and in their day to day lives.
It also sets out steps which need to be taken to ensure patients can access safe, effective and innovative technology through the NHS, which can help diagnose, treat and deliver care more quickly, freeing up clinician time. The NHS spends £10 billion a year on medtech including syringes, wheelchairs,
Minister of State for Health Will Quince said:
"The UK’s innovative spirit delivered revolutionary technology during the pandemic - from COVID tests and ventilators - and we want to harness this in promoting cutting-edge medical advancements to improve patient care.
The NHS spends around £10 billion a year on medical technology and I’m looking forward to working with industry to use this as we focus on reducing hospital stays, enhancing diagnosis, preventing illness and freeing up staff time.
This new medtech strategy will help build a sustainable NHS with patients at the centre so people can continue to access the right care at the right time."
The key aims of the strategy are to:
boost the supply of the best equipment to deliver greater resilience to health care challenges, such as pandemics, and enhance NHS performance through modernised technology which will enable faster diagnosis, treatment and ultimately discharge to free up hospital beds. encourage ambitious, innovative research to secure the UK’s position as a global science superpower and attract vital investment for the UK economy and create jobs across the country. In 2021, there were already around 60 different research programmes supporting innovative technologies, representing over £1 billion of funding. increase understanding and awareness of medtech by clinicians which will lead to more informed purchasing on new products and deliver better value for taxpayer money and better services for patients. build on the Life Sciences Vision to improve collaboration between the NHS, the National Institute for Health and Care Excellence (NICE) and the Medicines and Healthcare products Regulatory Agency (MHRA) as an innovation partner to ensure patients can access the right products safely. Read full story
Source: DHSC, 3 February 2023
Patient Safety Learning

Mesh campaigners claim Scotland's Health Secretary, Humza Yousaf has 'refused' requests to meet group

Mesh campaigners claim Scotland's Health Secretary Humza Yousaf refused to meet them to hear their concerns. Patients blame surgical mesh products for leaving them disabled and in chronic pain and want the Scottish Government to hold an independent review into the use of the products.
However, followihttps://www.dailyrecord.co.uk/news/mesh-campaigners-claim-humza-yousaf-29075491ng a debate in the Scottish Parliament earlier this month, the Health Secretary denied their request.
Campaigner Roseanna Clarkin, of the Scottish Global Mesh Alliance, said Yousaf has refused several requests for meetings with campaigners spanning nearly two years.
Roseanna, who has been left with crippling pain after mesh was used on her umbilical hernia in 2015, has blasted him for “ignoring” those affected by mesh procedures.
From the late 90s until 2018, women in Scotland were treated with polypropylene mesh implants for stress urinary incontinence and pelvic organ prolapse. In some, it caused severe pain and life-changing side effects.
While the Independent Medicines and Medical Devices Safety Review called for a pause in use of vaginal mesh, the products are not banned for all procedures.
The Scottish Global Mesh Alliance were behind the petition calling for an independent review which was debated at Holyrood. They want to suspend the use of all surgical mesh and fixation devices while a review is carried out.
Roseanna said: “Why do they assume mesh in another part of the body would respond differently and not cause extreme pain and serious infections?”
Read full story
Source: Daily Record, 29 January 2023
Patient Safety Learning

Scientists identify a molecular culprit behind medical implant rejections

Every year, millions of people live fuller lives because of a medical device implanted somewhere in their body - from hip joints, to teeth, to heart valves.

Known as Foreign Body Response (FBR), inflammation and scarring around an implant is natural, but in some cases, it can severely damage healthy tissue and can even lead to death if the implant is not removed. FBR-related implant failure rates range widely among different medical devices, but reducing those rates has been difficult because scientists still don’t understand the underlying biology that causes FBR.

Now, researchers from the University of Maryland have discovered the molecular basis for FBR, identifying a key biological pathway that future drug therapies could target to reduce the risk of implant rejection.

Shaik O. Rahaman, an associate professor in the Department of Nutrition and Food Science in the College of Agriculture and Natural Resources at UMD, and his colleagues identified a specific cellular signaling system that kicks in when the body recognises the inherent difference in stiffness between an implant and the surrounding tissue. This system detects the mismatch and triggers inflammation and scarring, which is part of the body’s normal defense system. But in FBR, the signaling system can set up a cycle of chronic inflammation and continual scar-tissue build-up that leads to implant rejection.  

“This is a huge leap forward in this field,” Rahaman said. “So far, the medical industry has been making biomedical implants randomly, out of materials they think might work without knowing the molecular basis of the foreign body response that leads to rejection. We don’t know why it happens, and until we do, we can’t effectively develop strategies to prevent it.”
Read full story
Source: College of Agriculture and Nature Resources, 19 January 2023
Patient Safety Learning

'Potential harm' review ordered into county's cancer patients

Commissioners have begun a ‘serious incident review’ across their integrated care system after early indications showed patients may have suffered harm due to long waits for cancer treatment.
The review has been launched by Somerset Integrated Care Board into dermatology services after an initial review found five of 50 patients had seen their skin lesions increase in size since being referred to hospital by their GPs.
ICB board papers stated “potential patient harm has been identified” for those patients, who were on the two-week wait pathway to be seen by a specialist following a referral by their GP.
Read full story (paywalled)
Source: HSJ, 3 February 2023
Patient Safety Learning

Covid-19: US will end public health emergency on 11 May, says Biden

President Joe Biden has announced to the US Congress that he will end the country’s Covid-19 public health emergency on 11 May, although about 500 Americans are currently dying every day from Covid-19. He also plans to end the related national Covid-19 emergency.
In contrast, the World Health Organization said on 27 January that the Covid-19 pandemic was still a public health emergency.
The US administration’s statement said that extending the emergencies until May would provide time for an orderly transition. Ending the emergencies will mean that many Americans will lose the health insurance provided through the Medicaid programme, which helps people on low incomes and was extended during the pandemic. Many others will find that they no longer get free tests, treatments, or vaccines.
Read full story
Source: BMJ, 1 February 2023
Patient Safety Learning

Jamaica’s women let down by failure of cervical cancer vaccine drive

Plans to prevent one of the deadliest cancers for women in Jamaica have been significantly set back by the Covid pandemic, new figures reveal.
The scheme to vaccinate schoolgirls against cervical cancer in Jamaica – which is the cancer with the second highest death rate in the Americas – began in 2018, but the Pan American Health Organization says inoculation rates fell to just 2.71% in 2021. This represents a drastic drop from the 2019 rate of 32%, and far from the WHO target of 90% by 2030.
The cancer, which is curable if caught early, kills 22 in every 100,000 women in Jamaica. By comparison, in the UK the rate is 2.4 in every 100,000, and in Canada it is 2.
Prevention of cervical cancer in Jamaica is also hindered by low rates of cervical screenings. 
“Women are afraid of the screening process and potential pain, but there is also a fear of a cancer diagnosis itself,” said Nicola Skyers of Jamaica’s Ministry of Health. “Some people just prefer not to know. But I also think that healthcare providers don’t offer screenings often enough. If a healthcare provider is really ‘selling’ the pap smear, more often than not the woman will choose to have it.”
Health workers are forced to focus on cures rather than preventions amid staffing shortages and an overburdened healthcare system, said Skyers. “As a doctor, you won’t be encouraging every women you see to do a pap smear if you have 40 patients waiting outside.”
Read full story
Source: The Guardian, 2 February 2023
Patient Safety Learning

Deadlock over NHS pay putting patients in danger, chief nurses warn

Deadlock over NHS pay is putting patients in danger and risks hardening the position of unions, 10 chief nurses have warned.
Unions have warned that the government is making no moves towards resolving the strikes, with one general secretary accusing the government of lying about the state of negotiations.
In a joint statement shared with the Guardian, chief nurses from 10 leading hospitals known as the Shelford group highlighted their concern that patients’ health could suffer as a direct result of the increasing disruption the stoppages are causing.
Tens of thousands of nurses and ambulance workers in England will stage what will be the biggest strike in the NHS’s 75-year history on Monday.
In a plea to the government and health unions, but especially ministers, the 10 Shelford group chief nurses stress that they want both sides to end their standoff as a matter of urgency “because of the impact on the patients and communities we serve.
“Industrial action means appointments cancelled, diagnostics delayed [and] operations postponed. The longer industrial action lasts, the greater the potential for positions to harden, waits for patients to grow, and risks of harm to accumulate.”
This week will see just one day – Wednesday – when there are no NHS strikes. Nurses will strike again on Tuesday, physiotherapists will stage their second walkout on Thursday and ambulance personnel will stage a further stoppage on Friday.
Read full story
Source: The Guardian, 5 February 2023
Patient Safety Learning

‘It’s soul destroying’: why so many NHS staff are off sick with burnout

“Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.”
While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite.
The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.”
Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether.
Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken.
“The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK.
Read full story
Source: The Guardian, 5 February 2023
Sam

HIV testing: Free DIY home kit offered in England

Free HIV tests that can be done at home are being offered this week to people in England.
It is part of a government drive to improve diagnosis, which dropped off during the Covid pandemic.
The kit is small enough to fit through the letterbox and arrives in plain packaging through the post.
It gives a result within 15 minutes by testing a drop of blood from a finger prick. A "reactive" result means HIV is possible and a clinic check is needed. Support and help is available to arrange this.
About 4,400 people in England are living with undiagnosed HIV, which comes with serious health risks.
HIV medication can keep the virus at undetectable levels, meaning you cannot pass HIV on and your health is protected.
Most people get the virus from someone who is unaware they have it, according to the Terrence Higgins Trust (THT) charity which campaigns about and provides services relating to HIV and sexual health.
HIV testing rates remain a fifth lower than before the Covid-19 pandemic - with heterosexual men in particular now testing far less than in 2019.
Read full story
Source: BBC News, 5 February 2023
Sam

Patient safety fears could stop nurses joining further coordinated walkouts

Nurses could refuse to carry out any further strikes alongside other health workers because of fears over patient safety, The Independent has learnt.
A mass walkout billed as the largest strike in NHS history is due to take place on Monday as tens of thousands of nurses, paramedics and 999 call handlers walk out in a bid to force ministers to the negotiating table.
But the coordinated strikes could be a one-off if nurses feel that the decision to take part in direct action compromises patient safety, The Independent has been told.
One union source said walkouts are not carried out on a “come what may” basis, and that the unions would have to assess whether striking together was “helpful” or not.
Unions have been escalating their industrial action in recent weeks in an attempt to secure higher pay rises. Any de-escalation in tactics will be seen as a blow to their campaign and a boost to Rishi Sunak’s hopes of riding out the wave of protests.
With patient safety the priority, sources insisted there are strong local controls that will pull nurses from picket lines if they think there is an issue.
Read full story
Source: The Independent, 5 February 2023
Sam

Delay and confusion led to woman's death in labour

Rana Abdelkarim died at Gloucestershire Royal Hospital in March 2021 after suffering a bleed post-birth.
The Healthcare Safety Investigation Branch (HSIB) found there were delays in calling for specialist help.
Her husband, Modar Mohammednour, said that in March 2021 his wife attended the maternity unit at 39 weeks into her pregnancy for what she thought was a routine check-up.
Mr Mohammednour said due to language barriers his wife thought she was going "for a scan and to check on her health" and then "come back home", but in fact she was being sent to be induced.
"Immediately" after the labour, Ms Abdelkarim suffered heavy bleeding and her condition deteriorated - something Mr Mohammednour said he was "unaware of", until he was eventually called into the hospital to speak to a doctor.
According to the investigation by the HSIB, the obstetric team of senior doctors were not told about the drastic change in her condition for almost 30 minutes.
An investigation into her death by the HSIB found that once Ms Abdelkarim had been given a drip to speed up labour, regular support from midwives and assessments could not be given to her because the maternity ward was so busy.
It also found there was a 53-minute delay from the point of bleeding to administering the first blood transfusion.
HSIB also found Ms Abdelkarim was "uninformed" about the reason for her admission, "consent to induce labour was not given" and because she was thin and small, staff underestimated how much relative blood volume she was losing.
Read full story
Source: BBC News, 7 February 2023
 
Patient Safety Learning

Betsi Cadwaladr did not discuss resuscitation decision with family

A health board has apologised to the family of a patient after medical staff failed to consult with them over a decision not to resuscitate her.
While the decision was clinically justified, the public services ombudsman for Wales said Betsi Cadwaladr health board did not discuss it with the patient and her family.
The ombudsman, Michelle Morris, also upheld a complaint by the patient's daughter, identified only as Miss A, that her mother's discharge from Ysbyty Gwynedd in Bangor was "inappropriate" and that insufficient steps were taken to ensure her needs could be safely met at home.
The final complaint, which was also upheld, was that medics failed to communicate with the family about the deteriorating condition of the patient, identified as Mrs B, which meant a family visit was not arranged before she died.
In her report she said the Covid pandemic had contributed to the failings, but added "this was a serious injustice to the family".
As well as apologising to the family, she asked that all medical staff at Ysbyty Gwynedd and Ysbyty Penrhos Stanley be reminded of the importance of following the proper procedure when deciding when a patient should not be resuscitated.
Read full story
Source: BBC News, 6 February 2023
Patient Safety Learning

The patients with treatable eating disorders who are dying before the NHS can help them

A record number of eating disorder patients are not getting the life-saving treatment they need due to lengthy waits, leaked NHS data shows.
More than 8,000 adults are waiting to be seen for therapy, according to internal figures from NHS England – the highest figure recorded since data collection began in 2019. In March 2021, there were around 6,000 adults waiting, while it was less than 2,000 in March 2019.
One leading doctor warned that delays were leading to avoidable deaths, while multiple coroners investigating the deaths of nine patients since 2021 have repeatedly called on the NHS and ministers to improve services to prevent more.
An investigation by The Independent can also reveal that long waits have led to a woman, 24, taking her own life while waiting two years for appropriate care, and patients being admitted to hospital because their conditions became so severe they developed life-threatening physical conditions.
Dr Agnes Ayton, the Royal College of Psychiatrists’ lead for adult eating disorders, said long waits meant patients were “dying avoidably” because under-resourced services were forced to turn them away or leave them waiting for years. Anorexia has the highest morality rate of any psychiatric disorder.
“One important thing is eating disorders are treatable, people can get better with time and treatment. We shouldn’t accept anorexia has the highest mortality rate because a lot of these deaths are avoidable and treatable. We should be aiming to provide high-quality care,” she said.
Read full story
Source: The Independent, 6 February 2023
Further reading on the hub:
People with eating disorders should not face stigma in the health system and barriers to accessing support in 2022 Eating disorders: challenges of the pandemic  
Patient Safety Learning

Draft NHSE plans seek to ‘eradicate’ police role in SIM care model

A draft NHSE statement suggests mental trusts could be asked to eradicate features of the ‘serenity integrated mentoring’ (SIM) care model from clinical practice, following a whirlwind of concerns in 2021 and an investigation by national clinical director Tim Kendall.
A core feature of SIM is to place a police officer within a healthcare team charged with supporting patients who frequently attend emergency services in crisis, and creating crisis plans.
The draft position statement produced by NHSE, which the regulator said is not its final version and is subject to changes, says SIM should not be used.
It also proposes the eradication of the following practices from any equivalent care model:
Police involvement in delivery of therapeutic interventions in planned, non-emergency, community mental healthcare; The use of coercion, sanctions (criminal or otherwise), withholding care and otherwise punitive approaches; and Discriminatory practices and attitudes towards patients who express self-harm behaviours, suicidality and/or those who are deemed “high intensity users”. The statement, which is the first indication of NHSE’s position on the SIM model but not its final stance, also suggests Professor Kendall will be seeking assurance from trust medical directors that SIM or similar models, and the above three features of concern, are no longer used. A full policy and public statement on the model is expected by the spring.
The StopSIM coalition, whose campaigning prompted the NHSE review, said: “Unless and until the full policy is freely available to service users and the public, service users are not equipped to protect themselves against the dangers of SIM and similar approaches".
Further reading on the hub:
The High Intensity Network (HIN) approach and SIM model for mental health care and 'high intensity users' – views and discussion
StopSIM: Mental health is not a crime
 
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