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

Maternity units must only remove gas and air as a ‘last resort’

Hospital trusts must only remove gas and air on maternity wards as a “last resort”, NHS England has said.
Several hospitals temporarily suspended the use of gas and air following concerns that midwives and staff are being exposed to too-high levels of gas over prolonged periods of time.
Some pregnant women have posted on social media, saying the decisions have left them feeling anxious and worried about their pain relief options.
Some NHS trusts have also come under fire for the way they communicated the message that gas and air would be suspended.
In new guidance to trusts, NHS England said it had looked at the health impacts for staff of levels of nitrous oxide exceeding prescribed levels, “drawing upon relevant legislation and existing guidance on the safe management of gas and air in healthcare settings”.
It said trusts must ensure they are compliant with legislation and national guidance on the use of gas, but must only remove it for women as a last resort and must tell them about other pain relief.
“Where, following the meeting of the (medical gas) committee, there is concern that the trust is not compliant, then this should be formally reported by the trust to the NHS England regional operations centre for the attention of the regional chief midwife,” the guidance said.
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Source: The Independent, 3 March 2023
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Elon Musk's bid to implant microchips in human brains rejected over safety concerns

Elon Musk's attempt to implant microchips into human brains has been rejected by US medical regulators over concerns about the safety of the technology.
Mr Musk's Neuralink business, which is hoping to insert tiny chips into people's skulls to treat conditions such as paralysis and blindness, was denied initial permission for clinical trials last year.
US medical regulators were said to have "dozens" of concerns over the risks posed by the device, Reuters reported. Concerns include fears that tiny electrodes could get lodged in other parts of the brain, which could impair cognitive function or rupture blood vessels.
Neuralink's chips are designed to be threaded into the brain using tiny filaments and harness artificial intelligence technology to pick up brain activity using a so-called "brain computer interface".
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Source: The Times, 3 March 2023
Sam

Surge in patients paying for GP appointments as pressure on NHS grows

Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice.
Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021.
The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022.
It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”.
On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.”
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Source: The Independent, 4 March 2023
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Nursing shortages are delaying spinal operations

Nursing shortages are contributing to children waiting up to three times longer for spinal surgery than pre-pandemic, a top surgeon has claimed.
Chris Adams says up to one in four operations are cancelled at NHS Lothian, with staffing the main reason.
Mr Adams also claims that some children are not being put on waiting lists as early as they should be.
NHS Lothian disputes some of Mr Adams' statements but says "significant pressures" are affecting waiting times.
The senior clinician, one of Scotland's three paediatric spinal surgeons, said he was speaking out of behalf of spinal patients and their families
The surgeon's claims appear in a new BBC Disclosure investigation into Scotland's NHS, which reveals that some children are waiting up to three times longer than pre-pandemic for spinal surgery, with some waiting more than a year. At least 51 out of a possible 190 planned spinal surgeries at RHCYP were cancelled at short notice in 2022, with nursing shortages understood to be the main cause
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Source: BBC News, 7 March 2023
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Rheumatic patients 'left behind' after lockdown

Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research.
The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them.
Researchers interviewed 15 rheumatology patients from the Bristol area. Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives.
"I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards.
"How do I get food? I cannot leave the house. How can I see friends? I was not allowed to."
Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield.
"It is a new normal, which is about being on high alert and managing risk every day," she said.
Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment".
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Source: BBC News, 6 March 2023
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Ministers blasted by scandal inquiry chair

The government’s response to the East Kent maternity scandal inquiry has been condemned as ‘very disappointing’ by its chair. 
More than four months on from the inquiry report, ministers this morning issued what they called an “initial response” to it, as a brief written statement to Parliament. It contained few specific proposals, instead saying government was kicking off a series of other reviews, and “working” with various other agencies.
Inquiry chair Bill Kirkup, the well-regarded former medic and expert in care failures, told HSJ the response was poor and should have been “wider and deeper”.
Dr Kirkup said the response showed government had “not grasped how fundamental” some of the issues outlined in his report were, and “what sort of initiative” was needed to address them.
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Source: HSJ, 7 March 2023
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Number of patients hurt by rogue surgeon unknown

Former patients of a surgeon who has been struck off say their lives have been ruined by his misconduct.
The number of people harmed by Jeremy Parker is unknown but at least 123 are taking legal action.
Their lawyer said the scale of harm caused by his malpractice "could be huge".
A total of 53 allegations against him were found "proved" including dishonestly adding to the case notes of 14 patients, botching operations, not diagnosing infections, failing to consult colleagues and not obtaining patient consent.
The General Medical Council also confirmed a patient had a leg amputated below the right knee after a procedure carried out by Mr Parker went awry.
Christian Beadell from Fletchers Solicitors, which is representing former patients in a class action, said East Suffolk and North Essex NHS Trust (ESNEFT) had not answered questions over whether it had initiated a recall process to determine the number patients harmed.
"It's difficult to say how many patients have been injured by him," Mr Beadell said.
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Source: BBC News, 8 March 2023
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Baby died after deadly bowel condition was mistaken for cow’s milk allergy

A two-month-old baby died after doctors mistook symptoms of a suspected perforated bowel for a cow’s milk intolerance.
Nailah Ally was diagnosed with a hole in the heart before she was born and necrotising enterocolitis (NEC) shortly after her birth in October 2019.
Nailah died from multiple organ failure after she was sent home from hospital and went into septic shock
A consultant believed Nailah might have an intolerance to cow’s milk and changed the formula she was being fed.
A spokesman for the family said: “Nailah’s case not only vividly highlights the dangers of sepsis, but the potential consequences of poor communication between doctors as well as between doctors and families.”
Read full story (paywalled)
Source: The Telegraph, 7 March 2023
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Three-quarters of children detained under mental health act are girls, new report warns

Nearly three-quarters of children detained under the mental health act are girls, a new report has found, amid warnings youngsters face a “postcode lottery” in their wait for treatment.
Average waiting times between children being referred to mental health services and starting treatment have increased for the first time since 2017 with the children’s commissioner describing support across the country as “patchy”.
In the annual report on children’s mental health services, the watchdog warned that, although the average wait is 40 days, some children are waiting as long as 80 days for treatment after being referred in 2021-22.
The analysis, published on International Women’s day, also says young girls represented the highest proportion of children detained under the mental health act last year, highlighting “stark and worrying” gender inequalities.
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Source: The Independent, 7 March 2023
Further reading on the hub:
Top picks: Women's health inequity  
Patient Safety Learning

‘We wouldn’t have sent Dad there’: CQC accused of failing to keep care homes safe

England’s care regulator has been accused of failing to keep private nursing home residents safe after a family alleged a delay in exposing serious risks led to a loved one’s painful premature death.
Relatives of Bernard Chatting, 89, said they relied on a “good” rating from the Care Quality Commission when they moved him into a £1,200-a-week home in Dorset. But after he experienced care so unsafe he ended up in hospital and died a few weeks later, it emerged the CQC already knew the home was failing badly.
The case comes as CQC’s traffic light ratings become increasingly important for people looking to place relatives in England’s 17,000 care homes amid a staffing and funding crisis which experts fear could increase the risk of maltreatment of the most vulnerable citizens. The ratings from inadequate to outstanding are one of the few ways that families can check care standards.
“We wouldn’t have sent Dad there if we knew,” said Chatting’s son-in-law, Phil Davenport. “It is beyond my understanding how the CQC inspect, have serious concerns, and yet not advise the public more quickly.
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Source: The Guardian, 8 March 2023
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Covid’s effect on mental health not as great as first thought, study suggests

Covid-19 may not have taken as great a toll on the mental health of most people as earlier research has indicated, a new study suggests.
The pandemic resulted in “minimal” changes in mental health symptoms among the general population, according to a review of 137 studies from around the world led by researchers at McGill University in Canada, and published in the British Medical Journal.
Brett Thombs, a psychiatry professor at McGill University and senior author, said some of the public narrative around the mental health impacts of Covid-19 were based on “poor-quality studies and anecdotes”, which became “self-fulfilling prophecies”, adding that there was a need for more “rigorous science”.
However, some experts disputed this, warning such readings could obscure the impact on individual groups such as children, women and people with low incomes or pre-existing mental health problems. They also said other robust studies had reached different conclusions.
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Source: The Guardian, 8 March 2023
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Great Ormond Street Hospital unable to hire dentists for two years amid national staffing crisis

A staffing crisis in children’s dentistry has prompted the urgent removal of junior doctors from Great Ormond Street Hospital NHS Foundation Trust (GOSH.
GOSH has struggled to recruit consultants for its paediatric dentistry services for at least two years, which has led to trainee doctors going unsupervised, according to a new report by regulator Health Education England.
A report seen by The Independent said the service was running with just one part-time consultant but needed at least two.
The news comes amid a national “crisis” in dentistry, with the latest data from the government showing that half of all children’s tooth extractions in 2021-22 were due to “preventable tooth decay”.
GOSH told The Independent it was struggling with a “limited pool” of paediatric dentists and, as a result of shortages, many patients were waiting longer than the 18-week standard.
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Source: The Independent, 8 February 2023
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Nine Whorlton Hall care workers accused of verbal abuse and neglect

Nine care home workers are facing trial for neglecting, verbally abusing and deliberately antagonising extremely vulnerable patients in care described as “devoid of kindness and respect” but also criminal.
The six men and three women, aged 25-54, are being prosecuted after a reporter went undercover and filmed the behaviour for a BBC Panorama documentary.
Opening the case at Teesside crown court in Middlesbrough, the prosecuting barrister, Anne Richardson, said the patients all resided at Whorlton Hall, a 17-bed independent specialist hospital unit near Barnard Castle, County Durham, operated by Cygnet Health Care.
Richardson said caring for such residents was a “hard, demanding job, and that carers can face complex, difficult, obstreperous, and sometimes violent people who sadly do not realise what they are doing and cannot help their actions.” But they deserved to be treated with “kindness, respect and patience.”
Richardson said the jury would hear evidence of ill-treatment which was “cruel and abusive”. It was “not only devoid of the respect and kindness that those residents deserved but was also a criminal offence”.
It included care workers repeatedly saying words they knew to be triggers to patients, belittling those in their care and deliberately antagonising them.
Read full story
Source: The Independent, 8 March 2023
 
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NHS backlog progress at risk from junior doctors' strike in England

Progress being made on tackling the hospital waiting backlog will be put at risk by next week's junior doctors' strike, NHS bosses are warning.
NHS England medical director Prof Sir Stephen Powis said there had been huge achievements over the winter.
But he said it was inevitable the 72-hour walkout in England, which starts on Monday, would have an impact.
It comes as the annual NHS staff survey shows a falling number happy to recommend the care at their service.
The poll found 63% would be happy to see a friend or relative treated - down by five percentage points in the past year and 11 over two years.
Meanwhile, latest performance data shows NHS emergency services are continuing to miss their targets, although the situation is not getting worse.
Dr Tim Cooksley, president of the Society for Acute Medicine, said despite the situation not getting worse it still presented a "damning" picture, and warned it was "increasingly causing harm to patients".
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Source: BBC News, 9 March 2023
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The best and worst acute trusts to work at, according to staff

Which trusts receive the highest recommendations from staff as a place to work? HSJ has analysed the full results of today’s 2022 NHS Staff Survey for general acute and acute/community trusts.
HSJ has also analysed the results for mental health trusts and ambulance and community trusts.
More than 630,000 staff responded to the NHS staff survey between September and December 2022 – a 46% response rate, down from 48% in 2021.
Nationally, across all trust types, 57.4% said they would recommend their organisation as a place to work in 2022. That was down from 59.4% in 2021, and from 63.4% in 2019.
Read full story (paywalled)
Source: HSJ, 9 March 2023
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