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

Patients ‘unaware of strike’ as some hospitals report ‘busiest day’

Acute trusts are reporting high demand at emergency departments (EDs) despite junior doctor strikes, which in some cases threaten to lead to overflowing wards and long ambulance handover delays.
Chief executives and directors from trusts around England told HSJ their EDs had been as busy or busier than usual.
Many had hoped prominent media coverage and NHS announcements about the strikes would lead to reduced demand, helping them cope with fewer doctors on duty. Several claimed it showed national communications about the strikes were lacking.
NHS England has said some hospitals saw their busiest Monday of the year so far yesterday, which it said “presents a major challenge as our staff continue to do all they can to mitigate the impact of the industrial action for patients.”
Read full story (paywalled)
Source: HSJ, 14 March 2023
Patient Safety Learning

Cough medicines containing pholcodine withdrawn over safety fears

Certain cough medicines sold behind the counter at pharmacies are being withdrawn over safety concerns.
Health experts say there is a very rare chance that some people could experience an allergic reaction linked to an ingredient called pholcodine.
People should check the packaging of any cough tablets or syrups they have at home to see if pholcodine is listed among the ingredients. If it is, talk to your pharmacist about taking a different medicine.
Products containing pholcodine do not need a prescription, but cannot be bought without consultation with the pharmacist as they are kept behind the counter.
The Medicines and Healthcare Products Regulatory Agency (MHRA) described removing the products from sale as a precautionary measure.
Read full story
Source: BBC News. 15 March 2023
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Scandal-hit children’s hospital sanctioned by watchdog after ‘systemic abuse’ revealed

A scandal-hit hospital group has been sanctioned by inspectors after The Independent revealed “systemic abuse” at a string of children’s mental health units.
England’s safety watchdog issued an official warning to Ivetsey Bank Hospital in Staffordshire, run by The Huntercombe Group, after an extensive investigation by this newspaper found the private hospital had put the safety of young mental health patients at risk.
The Care Quality Commission also downgraded the hospital’s rating to “inadequate”. If improvements are not made in line with the warning notice, the hospital could be forced to close.
An inspection was carried out two weeks after The Independent revealed widespread allegations of abuse and excessive restraint across The Huntercombe Group’s hospitals.
The investigation revealed the provider, which also runs Taplow Manor children’s hospital in Maidenhead, was facing allegations from more than 50 former patients as well as claims of poor care from staff whistleblowers and dozens of negligence claims.
Read full
Source:  The Independent, 15 March 2023
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Trust CEO apologises to staff subjected to racist behaviour

A chief executive has apologised after a survey of his trust’s staff from minority ethnic backgrounds found many had been subjected to racist behaviour by colleagues.
The staff at East of England Ambulance Service Trust said peers had made monkey noises and referred to banana boats in front of them, excluded them from social events, and assumed they could speak Middle Eastern and Asian languages just because of their skin colour, they told researchers.
The trust has had substantial cultural problems for several years, and commissioned the survey to “better understand the experience, perceptions and realities of the trust BME staff”, a board paper said.
The report on its findings, published this week in trust board papers, warns: “There are risks that a minority of EEAST employees are demonstrating behaviours or using language which could be perceived as racist. Reports of subsequent inaction by managers further risk this behaviour being normalised.”
Read full story (paywalled)
Source: HSJ, 15 March 2023
Patient Safety Learning

Doctors' strike fallout could take weeks to resolve, NHS bosses say

The disruption caused by the junior doctors' strike in England could take weeks to resolve, health bosses say.
Tens of thousands of appointments and treatments, including cancer care, had to be cancelled during the three-day walkout.
Patients with appointments coming up may see them cancelled to make room for high-priority cases hit by the strike.
Hospitals are also reporting problems discharging patients from wards, as consultants were sent to cover A&E.
Saffron Cordery, of NHS Providers, which represents NHS trusts, said the scale and length of the walkout, coupled with the fact it started on a Monday - traditionally the busiest day of the week - had made it more difficult than previous strikes by nurses and ambulance staff.
"It will take weeks to recover - just rebooking patients who have treatments and appointments cancelled is a big job," she said.
"Patients have to be individually prioritised - it may mean some patients with bookings in the coming weeks being pushed further back."
Read full story
Source: BBC News, 16 March 2023
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Steve Barclay accused of breaking pledge over NHS staff abuse data

NHS staff have accused Steve Barclay of breaking a pledge to publish details of how many of them are abused and assaulted in the course of their work.
In 2018, when Barclay was a junior minister in the Department of Health and Social Care (DHSC), he promised he would resume publication of those statistics in the following year.
However, five years later, Barclay has not fulfilled his pledge, despite being in his second stint as health secretary.
Health unions and NHS leaders have warned that frontline staff have been on the receiving end of increased abuse, threats, aggression and assaults since the first outbreak of Covid. Long waiting times for care appear to be a particular source of frustration for some patients or their relatives.
Growing numbers of ambulance crew personnel have begun using body-worn cameras in recent years to deter assaults and record any that do occur. In 2022, the London ambulance service recorded 877 reports of verbal abuse or threats of violence, 516 physical assaults – including kicking, punching, head-butting and use of a weapon – and 49 sexual assaults on staff.   Read full story   Source: The Guardian, 16 March 2023  
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UK life expectancy growing at slower rate than rest of G7, research shows

Life expectancy in the UK has grown at a slower rate than comparable countries over the past seven decades, according to researchers, who say this is the result of widening inequality.
The UK lags behind all other countries in the group of G7 advanced economies except the US, according to a new analysis of global life expectancy rankings published in the Journal of the Royal Society of Medicine.
While life expectancy has increased in absolute terms, similar countries have experienced larger increases, they wrote. In the 1950s, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Denmark, Norway and Sweden, but in 2021 the UK was ranked 29th.

The researchers said this was partly due to income inequality, which rose considerably in the UK during and after the 1980s.
Prof Martin McKee, of the London School of Hygiene & Tropical Medicine, said: “That rise also saw an increase in the variation in life expectancy between different social groups. One reason why the overall increase in life expectancy has been so sluggish in the UK is that in recent years it has fallen for poorer groups".
Read full story
Source: The Guardian, 16 March 2023
Patient Safety Learning

Gonorrhoea cases rising quickly in England

Gonorrhoea cases in England have resurged since the easing of Covid restrictions, health officials are warning people who are sexually active.
The disease is caused by the bacterium Neisseria gonorrhoeae. The infection is spread by unprotected vaginal, oral and anal sex.
Symptoms can include a thick green or yellow discharge from sexual organs, pain when urinating and bleeding between periods, but some people will have no symptoms.
Condoms can stop the spread of this and other sexually transmitted infections. 
Experts say people should practise safe sex and get tested regularly if they are having sex with new or casual partners. Testing is simple, free and discreet, they advise.
Provisional data shows diagnoses in the first half of 2022 hit 56,327 - 21% higher than for the same period in 2019.
An untreated infection can lead to infertility, pelvic inflammatory disease and can be passed on to a child during pregnancy.
Read full story
Source: BBC News, 16 March 2023
Patient Safety Learning

‘I kept begging for pain relief’: the women forced to give birth without gas and air

Some hospitals are suspending supplies of gas and air, after it was found to pose health risks to midwives. What can be done to ensure pregnant women still get the help they need?
When Leigh Milner was expecting her first baby, she knew exactly how she wanted her labour to go. Her birth plan included an epidural for the pain and she was hoping, she says ruefully, for “all the drugs”. But that is not how things worked out. Milner, 33, a BBC presenter, ended up giving birth to Theo at Princess Alexandra hospital in Harlow last month with nothing but paracetamol for pain relief, in what she calls a positively “Victorian” experience.
“I kept begging over and over again – ‘I need something for pain relief’ – and the only thing they could give me was paracetamol because they didn’t have gas and air. I was quite frightened, I didn’t know what else to do,” says Milner.
"Birth is painful, but it shouldn’t be traumatic.”
Read full story
Source: The Guardian, 16 March 2023
Patient Safety Learning

USA: 83 best hospitals for patient experience, safety

Healthgrades recognised 864 US hospitals with its 2023 Patient Safety Excellence Awards and Outstanding Patient Experience Award. Only 83 of those hospitals received both awards. 
The dual recipients spanned 28 states. Texas had the most dual recipients with 12 honorees — including three Baylor Scott and White Health hospitals. 
Read full story
Source; Becker's Hospital Review, 14 March 2023
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‘Covert filming could get you prosecuted’, trust warns staff after undercover exposé

An ambulance trust that was the subject of a documentary involving covert filming by an employee has warned staff they could be subject to ‘disciplinary action and even prosecution’ if they take this type of action.
East of England Ambulance Service Trust sent an all staff email yesterday outlining the potential consequences of filming covertly and reminding staff they must adhere to the trust’s social media and digital guidelines.
The email, seen by HSJ, followed Channel 4 broadcasting a documentary called Undercover ambulance: NHS Chaos – Dispatches which featured footage filmed covertly by one of the trust’s apprentice emergency technicians, and laid bare the extreme pressures on hospital and ambulance staff.
The message sent on Thursday by the trust’s interim officer Melissa Dowdeswell, said the apprentice who carried out the filming had since resigned and then set out what support staff could access from the trust if they had been affected by “an incredibly difficult couple of weeks”.
Read full story (paywalled)
Source: HSJ, 17 March 2023
Patient Safety Learning

Missed contraceptive coil left woman unable to have children

A woman was denied the chance to have children with her husband after a contraceptive coil was accidentally left in place for 29 years.
Jayne Huddleston, from Crewe, had eight rounds of fertility treatment she did not need because the correct checks were not carried out by her doctor.
She said the mistake happened in 1990.
"The GP said it couldn't be seen, so I was sent for a scan and the scan didn't pick anything up, the GP recommended another coil was fitted," she told the BBC.
She was told the coil she had fitted around a year earlier had probably fallen out.
When she and her husband, David, then decided they wanted to have a child, the second coil was removed, but the first coil, which had gone undetected, remained inside her.
They tried for years to have a baby, with no success, including IVF treatment which cost them thousands of pounds.
The mistake was only discovered when she went for an X-ray in 2019 after complaining of back pain and the original coil was revealed.
Mr and Mrs Huddleston were awarded a six-figure out of court settlement after taking their case to Irwin Mitchell solicitors.
Read full story
Source: BBC News, 16 March 2023
Patient Safety Learning

GP training to be overhauled to meet ‘ever-shifting’ needs of patients

Health Education England (HEE) has outlined a new vision for general practice training which it says will better prepare GPs for future models of care.
The programme will have greater focus on areas such as addressing health inequalities and managing the growing proportion of patients with mental health care needs seen in general practice, HEE said.
Innovative placements, perhaps with charities, third sector organisations and services such as CAHMS will be explored, the Training the Future GP report said.
And it should include educational opportunities around improving cancer detection and referral, the report said, as well as training in the harms of overdiagnosis.
Overall the goal is to move to a flexible model of training that meets the needs, skills and experiences of the trainee as well as the area they are working in.
HEE said it would also continue to work to address issues of discrimination, prejudice, bias and specifically racism at individual, institutional and systemic levels, and to reduce differential attainment.
It will include plans to ensure patients in deprived areas are able to access care, with the development of specific training offers on these issues and prioritising expansion of training capacity to areas in need.
Read full story
Source: Pulse, 17 March 2023
Patient Safety Learning

NHS warned ‘cramming’ A&Es with medics is not working

The NHS’s efforts to prop up emergency departments with thousands of additional medical staff has been the wrong approach to solving the crisis in these services, experts have argued.
Analysis of NHS staffing data by HSJ shows the emergency care medical workforce has grown by almost two-thirds since 2016, far outstripping the growth in other specialties. Despite this, waiting times in accident and emergency have deteriorated significantly over the same period.
John Appleby, chief economist at the Nuffield Trust think tank, said: “Cramming the A&E department with more doctors doesn’t look like it’s having the intended effect over the last four to five years. Waiting times have got worse and we have more staff.
“Increasing staffing has helped with waiting times in the past, but maybe we have reached a point where it’s not staffing in A&E which is the issue. The issue is the front door and the backdoor of the A&E.”
Read full story (paywalled)
Source: HSJ, 17 March 2023
Patient Safety Learning

Four in 10 NHS hospitals in England found to use outdated equipment

Four in 10 NHS hospitals in England are using outdated medical equipment including 37-year-old X-ray machines, according to research from the Lib Dems, who are calling for extra funding to replace outdated devices.
NHS hospitals are using hundreds of old X-ray machines, CT scanners and radiotherapy machines, with some dating back to the 1980s, according to research based on freedom of information requests to 69 hospital trusts. Of these, 41 said they had at least one X-ray machine that was more than 20 years old.
The Liberal Democrat leader, Ed Davey, said he would call for urgent government investment in medical equipment at the party’s spring conference.
“It beggars belief that NHS staff are having to rely on results from decades-old hospital scanners, machinery that may have been built before they were even born. Understaffed and exhausted NHS staff are being pushed to breaking point, while patients are treated in crumbling hospitals with outdated equipment,” he said.
“The potential for error from poor-quality machines doesn’t bear thinking about. People up and down the country will be worried about whether they will get an accurate reading from these decades-old machines.”
Read full story
Source: The Guardian, 20 March 2023
Patient Safety Learning

Women left in extreme pain from invasive hysteroscopy procedures hit out

Women have been left in extreme pain from an invasive procedure that’s been described as the “next big medical scandal”.
The Campaign Against Painful Hysteroscopy (CAPH) has collated more than 3000 accounts of “pain, fainting and trauma during outpatient hysteroscopy” throughout the UK – including more than 40 so far from Scotland.
CAPH said female patients are being subjected to barbaric levels of pain and claim hospitals prioritise efficiency and cost-cutting over their needs and welfare.
The group believes the issue could become as bad as the vaginal mesh scandal, which saw women left in severe pain and with life-changing side effects after being treated with polypropylene mesh implants for stress urinary incontinence and pelvic organ prolapse.
Katharine Tylko, of CAPH, said: “Severely painful outpatient hysteroscopy is the next medical scandal after vaginal mesh. Cheap, quick and easy-ish NHS outpatient hysteroscopy without anaesthesia/sedation causes severe pain/distress/trauma to approximately 25 per cent of patients.”
Margaret Cannon, from Rutherglen in Lanarkshire, told how she had an “excruciatingly painful” hysteroscopy at Stobhill Hospital in April 2020 without anaesthetic or analgesia.
She said: “I am a qualified nurse and midwife, so have good insight into how all the medical and nursing professionals failed me. I had been told to expect mild cramp and I kept thinking, ‘What’s wrong with me that I can’t tolerate the pain?’ I felt violated and assaulted.”
She felt so strongly about her experience that she complained. When she finally received a response, she said it “was dismissive and none of my points were addressed”.
Read full story
Source: Daily Record, 19 March 2023
See also our 'Painful hysteroscopy' thread in the hub Community.
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