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

Thousands of patients recalled over eye damage concerns

Thousands of patients are being recalled for urgent eye checks after regulators raised safety concerns related to a product used in cataract surgery.
It is thought around 20 trusts have suspended use of the EyeCee One lenses, after the Medicines and Healthcare Products Regulatory Agency warned of links to higher pressure in the eye, which can cause lost vision.
The MHRA has issued an alert ordering trusts to recall patients who have had surgery since October, and estimates between 2 and 4 per cent of patients could have complications. The watchdog stressed reduced vision would only occur if patients were not treated.
It is thought the complications could be down to the way the implant was being used in surgery, rather than the product itself.
Read full story (paywalled)
Source: HSJ, 7 February 2023
Patient Safety Learning

NHS waiting lists in England unlikely to fall in 2023, research suggests

NHS waiting lists are unlikely to fall in 2023, and the backlog is unlikely to be significantly tackled until mid-2024 despite being one of Rishi Sunak’s priorities for this year, research suggests.
The NHS has struggled to increase the number of people it is treating from its waiting lists each month due to ongoing pressures from Covid-19, although there have been signs of improvement in the past month, analysis from the Institute for Fiscal Studies (IFS) has found.
Max Warner, an IFS economist and one of the report’s authors, said that although the NHS had made “real progress” to reduce the number of patients waiting a very long time for care, efforts to increase overall treatment volumes had “so far been considerably less successful”.
The NHS Providers’ chief executive, Julian Hartley, urged the government to introduce a fully funded workforce plan and to talk to unions about pay for this financial year as strikes were causing huge disruption to services, and risked undoing hard-won progress made on care backlogs.
“Mounting pressures on acute, ambulance, mental health and community services, such as chronic workforce shortages, could hamper efforts to cut the backlog further if left unchecked,” he said.
Read full story
Source: The Guardian, 8 February 2023
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Mother of suicidal girl held in locked hospital room ‘frightened’ for child’s life

A mother who has seen her suicidal 12-year-old daughter shuttled between placements and then held in a locked and windowless hospital room says she is frightened for her child’s life.
Since going into care in Staffordshire nine months ago, Becky (not her real name) has attempted to take her own life on several occasions. Her case throws fresh light on the chronic nationwide shortage of secure accommodation for vulnerable children.
“I am constantly told there is nowhere for her,” said her mother, who cannot be identified for legal reasons. “I fear I’ll soon be arranging her funeral due to the systemic failings in health and social care.”
Becky has been alone in a locked hospital room since 27 January. The room has no window or access to the outdoors, no furniture except for a bed, and she is permitted no belongings. All human contact is conducted through a hatch.
The child’s court-appointed guardian told the high court at a hearing to discuss Becky’s case that she considered “the risk to Becky’s life to be catastrophic”.
Read full story
Source: The Guardian, 7 February 2023
Patient Safety Learning

Surgeon given warning over life-changing injuries

A Norfolk surgeon who left two patients with life-changing injuries has received a formal warning by a disciplinary panel.
Camilo Valero Valdivieso was found guilty of "serious misconduct" by an independent medical panel after two operations went wrong in six days.
One of his patients, Paul Tooth, 65, said his life was "a constant struggle" since his operation in January 2020.
However, the panel found the surgeon had "learned from these events".
The findings from the Medical Practitioners Service (MPTS) panel said that his actions had "risked damaging public confidence in the profession".
It heard that he twice "misinterpreted the anatomy" - on one occasion severing a patient's gallbladder.
The panel also concluded Mr Valero's fitness to practise was not currently impaired, allowing him to continue working.
Read full story
Source: BBC News, 7 February 2023
Patient Safety Learning

NHSE must ‘demonstrate it is trustworthy’ on data, says watchdog

The independent data watchdog has called for greater clarity from NHS England on how it will ensure there are “as strong… if not stronger” safeguards on health and care data following its takeover of NHS Digital.
NHS Digital – whose role included controlling access to large amounts of NHS data – became part of NHS England on 1 February, and its teams and functions are due to merge in coming months.
In an interview with HSJ, national data guardian Nicola Byrne said the merger creates “an inherent tension in having one organisation be both data custodian and the organisation seeking to access the data”, although it “makes sense in terms of streamlining and efficiencies”.
Concerns have been raised about the merger’s information governance implications by campaign group medConfidential, the British Medical Association and politicians. These include that there would be less transparency over the handling of data, and that NHSE would be “marking its own homework” as both controller of, and a major user of, data.
Read full story (paywalled)
Source: HSJ, 8 February 2023
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Mental health patients at risk of sexual assault on mixed sex wards, watchdog warns

Vulnerable female patients have been sexually “exposed” on a mixed gender ward deemed not “fit for purpose”, the NHS watchdog has warned.
The Care Quality Commission found that sexual incidents had occured at Hill Crest, a 25-bed mixed gender mental health unit in Redditch, as male and female were being put at risk.
It found male patients are able to walk into female bathrooms and bedrooms, leading to risks of sexual assault and relationships. It found that sexual incidents had taken on the unit because of the risks.
The rate of assaults on mixed sex wards is significantly higher than on single-sex wards, data has shown.
According to the CQC, the trust graded sexual incidents between patients as “low harm” but did not fully consider them or follow up actions to keep patients safe.
Read full story
Source: The Independent, 8 February 2023
Sam

Millions with mental health needs not seeking NHS help, watchdog says

Millions of people in England with mental ill-health are not seeking NHS help, and many who get it face long delays and a “poor experience”, a report says.
Long waits for care will persist for years because soaring demand, exacerbated by Covid, will continue to outstrip the ability of severely understaffed mental health services to provide speedy treatment, the National Audit Office (NAO) found.
The report found that “NHS mental health services are under continued and increasing pressure and many people using services are reporting poor experiences”. Under-18s, the LGBT+ community, minority ethnic groups and people with more complex needs are most likely to find the system inadequate.
“While funding and the workforce for mental health services have increased and more people have been treated, many people still cannot access services or have lengthy waits for treatment,” the NAO said.
It found:
An estimated 8 million people with mental health needs are not in contact with NHS services. There are 1.2 million people waiting for help from community-based mental health services. While the mental health workforce grew by 22% between 2016-17 and 2021-22, the NHS recorded a 44% increase in referrals over the same period. In 2021-22, 13% of mental health staff quit. Read full story
Source: The Guardian, 9 February 2023
Patient Safety Learning

Covid: Scientists reveal ‘perfect’ room layout to prevent spread of virus

The ‘optimal layout’ for an isolation room to contain the spread of Covid has been created following tests at a London hospital.
The room was designed by researchers at Imperial College London to reduce the risk of infection for health care staff as far as possible.
Researchers used a state-of-the-art fluid model to simulate the transmission of the virus within an isolation room at the Royal Brompton Hospital in Chelsea, west London.
They found that the area of highest risk of infection is above a patient’s bed at a height of 0.7 to two metres, where the highest concentration of Covid is found.
After the virus is expelled from a patient’s mouth, the research team explained that it gets driven vertically by wind forces within the room.
The research, published in the journal Physics of Fluids, is based on data collected from the room during a Covid patient’s stay.
The work centred on the location of the room’s air extractor and filtration rates, the location of the bed, and the health and safety of the hospital staff working within the area.
Read full story
Source: The Independent, 8 February 2023
Sam

Mental health sick days for NHS staff surge – and cost more than £460m in a year

Mental health sick days cost the NHS almost half a million pounds as staff anxiety and stress levels haved skyrocketed.
Costs have almost doubled compared to before the pandemic from £279 million to £468 million.
The sickness data shared with The Independent by GoodShape, an employee well-being and performance analysis company, shows the number of staff sick days increased in 2022 to 12 million from 7.21 million in 2019. That is despite the overall number of people working in the NHS increasing from 1.2 to 1.3 million.
The overall cost to the NHS of absences for the five most common reasons – which includes mental health – increased to a “staggering” £1.85 billion from £1.01 billion between 2019 to 2022, according to figures from GoodShape.
Covid was still the most common reason for staff sickness last year, according to the analysis, accounting for 4.4 million lost days, while mental health was a close second driving 3 million days off due to illness.
Pat Cullen, chief executive and general secretary for the Royal College of Nursing said in response: “These figures are shocking but not surprising. With 47,000 vacant nurse posts in England alone, the pressures on staff are unrelenting.
Read full story
Source: The Independent, 8 February 2023
Sam

NHS to use test that prevents babies going deaf

A rapid test that can help preserve the hearing of newborn babies is set to be used by NHS hospitals.
For some babies, commonly used antibiotics can become toxic. The drugs damage sensory cells inside the ear leading to permanent hearing loss.
The test - which analyses babies' DNA - can quickly spot those who are vulnerable. It means they can be given a different type of antibiotic and avoid having a lifetime of damaged hearing.
Gentamicin is the first-choice antibiotic if a newborn develops a serious bacterial infection. It is life-saving and safe for the majority of people.
However, it has a rare side effect. About 1,250 babies in England and Wales are born with a subtle change in their genetic code that allows the antibiotic to bind more strongly to the hair cells in their ears, where it becomes toxic.
These tiny hairs help convert sounds into the electrical signals that are understood by the brain. If they are damaged, it results in hearing loss.
The side effect is well known, but until now there was no test that could get the results fast enough. It would be dangerous to delay treatment, and alternative antibiotics are not used as they have their own side effects and because of concerns about antibiotic resistance.
The new genedrive kit analyses a sample taken from inside the baby's cheek. Tests at two neonatal intensive care units in Manchester and Liverpool showed it could spot who was susceptible to hearing loss in 26 minutes, and using it did not delay treatment.
Read full story
Source: BBC News, 9 February 2023
Sam

‘NHS factors’ lead to more than a third of delayed discharges

More than a third of delayed discharges for long-stay patients are being caused by factors generally associated with the NHS, according to new data obtained by HSJ.
Delayed discharges from hospital are often blamed on issues around social care, but figures for the nine months to January, for patients who have been in hospital for at least 21 days, suggest a significant proportion are due to NHS-related delays.
The most common reason is waiting for rehabilitation beds in a community hospital or similar facility, which accounts for 23% of total delayed discharges, based on daily averages.
Other reasons generally associated with NHS-related issues included delays around medical decisions (4%), therapist decisions (4 per cent), transfers to another acute site (2%), and diagnostic tests (1%).
On top of this, a further 12% of the causes were at least partly associated with the NHS, such as delays relating to transfer of care hubs, which are generally jointly run with councils.
Read full story (paywalled)
Source: HSJ, 9 February 2023
Patient Safety Learning

Ambulance waits down by nearly an hour in a month

Ambulance crews reached emergencies such as heart attacks and strokes one hour quicker in January than December in England, figures show.
They took 32 minutes on average, compared with more than 90 the month before.
The target is 18 minutes but January's average was the quickest for 19 months.
A&E waiting times also improved, with just over a quarter of patients waiting longer than four hours - down from more than a third in December.
But Society for Acute Medicine president Dr Tim Cooksley said wait times remained "intolerable".
And he highlighted the waits the sickest and most frail were facing for a bed on a ward.
Nearly four out of every 10 patients waited over four hours on trolleys and in corridors.
"The fundamental problem remains a significant shortage of workforce, leading to woefully inadequate inpatient bed and social-care capacity," Dr Cooksley added.
Read full story
Source: BBC News, 9 February 2023
Patient Safety Learning

Hip surgery could halve waiting times

Changes to hip and knee surgery could halve waiting lists at one hospital within a year, say doctors.
Tweaks to surgeries at the Princess of Wales hospital in Bridgend have allowed more patients to be sent home on the same day. Therefore, a shortage of hospital beds is not a barrier for them.
It comes as over 37,000 orthopaedic patients are waiting over one year for surgery in Wales.
Consultant orthopaedic surgeon Keshav Singhal said a number of "minor tweaks" were made to the procedure "but all of them add up to a huge effect".
He said the anaesthetic and pain medication given to patients is "fine-tuned" to reduce pain and nausea after the operation and extra time is spent pinpointing any potential area of bleeding and cauterising it to "prevent wound leakage".
"In day surgery we are not constrained by beds - there are no beds here," said Mr Singhal.
"Patients can come in, be very well cared for in a state of the art day-surgery unit, and go home in the evening, and that totally cuts down on the inpatient beds."
Read full story
Source: BBC News, 10 February 2023
Patient Safety Learning

Ian Paterson victim calls for patient safety to be prioritised

A woman who underwent needless surgery at the hands of convicted surgeon Ian Paterson said patient safety was still not being prioritised.
Paterson was convicted of 17 counts of wounding with intent in 2017 and was jailed for 20 years.
Debbie Douglas, who now campaigns for his victims, said more still needed to be done following a damning report.
In December, the Department for Health said it was making "good progress" on changes.
The inquiry, published in 2020, made 15 recommendations and Ms Douglas called on health chiefs to "get on" with the improvements.
"It's three years and technically none of the recommendations are closed," she said.
"It's all around patient safety and it's not being given the priority it deserves."
Read full story
Source: BBC News, 9 February 2023
Patient Safety Learning

Children in mental health crisis spent more than 900,000 hours in A&E in England

Children suffering mental health crises spent more than 900,000 hours in A&E in England last year seeking urgent and potentially life-saving help, NHS figures reveal.
Experts said the huge amount of time under-18s with mental health issues were spending in A&E was “simply astounding” and showed that NHS services for that vulnerable age group were inadequate.
Children as young as three and four years old are among those ending up in emergency departments because of mental health problems, according to data obtained by Labour.
Dr Rosena Allin-Khan, the shadow mental health minister, who is also an A&E doctor, said: “With nowhere to turn, children with a mental illness are left to deteriorate and reach crisis point – at which time A&E is the only place left for them to go. Emergency departments are incredibly unsuitable settings for children in crisis, yet we’re witnessing increasingly younger children having to present to A&E in desperation.”
Young people who endured long A&E waits included those with depression, psychosis and eating disorders as well as some who had self-harmed or tried to kill themselves, doctors said.
Read full story
Source: The Guardian, 9 February 2023
Patient Safety Learning

Health ombudsman issues unprecedented warning over safety and culture

A health watchdog has issued an unprecedented warning over patient safety, culture and leadership at a scandal-hit NHS trust,The Independent has learned.
The Parliamentary Health Service Ombudsman, the government body that investigates patients’ complaints, has used powers for the very first time to raise “serious concerns” about University Hospitals Birmingham Foundation Trust.
The body does not have its own powers to intervene but the warning has triggered an investigation by NHS England.
Ombudsman Rob Behrens said there needed to be “significant improvements” in culture and leadership at the trust. He also raised concerns that the trust had failed to “fully accept or acknowledge” the impact of findings from investigations on patient safety.
The decision to trigger the alert, known as the emerging concerns protocol, was “not taken lightly”, Mr Behrens said.
Read full story
Source: The Independent, 12 February 2023
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