Patient Safety Learning

Doctors at Department of Veterans Affairs (VA) hospitals nationwide could refuse to treat unmarried veterans and Democrats under new hospital guidelines imposed following an executive order by Donald Trump. The new rules, obtained by the Guardian, also apply to psychologists, dentists and a host of other occupations. They have already gone into effect in at least some VA medical centers. Medical staff are still required to treat veterans regardless of race, color, religion and sex, and all veterans remain entitled to treatment. But individual workers are now free to decline to care for patients based on personal characteristics not explicitly prohibited by federal law. Language requiring healthcare professionals to care for veterans regardless of their politics and marital status has been explicitly eliminated. Doctors and other medical staff can also be barred from working at VA hospitals based on their marital status, political party affiliation or union activity, documents reviewed by the Guardian show. The changes also affect chiropractors, certified nurse practitioners, optometrists, podiatrists, licensed clinical social workers and speech therapists. In making the changes, VA officials cite the president’s 30 January executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. The primary purpose of the executive order was to strip most government protections from transgender people. The VA has since ceased providing most gender-affirming care and forbidden a long list of words, including “gender affirming” and “transgender”, from clinical settings. Medical experts said the implications of rule changes uncovered by the Guardian could be far-reaching. They “seem to open the door to discrimination on the basis of anything that is not legally protected”, said Dr Kenneth Kizer, the VA’s top healthcare official during the Clinton administration. He said the changes open up the possibility that doctors could refuse to treat veterans based on their “reason for seeking care – including allegations of rape and sexual assault – current or past political party affiliation or political activity, and personal behavior such as alcohol or marijuana use”. Read full story Source: The Guardian, 16 June 2025

NHS call handlers are quitting amid burnout at dealing with 999 calls about suicides, stabbings and shootings and the long delays before ambulances reach patients. The pressure is so intense that 27% of control room staff in ambulance services across Britain have left their jobs over the last three years, NHS figures show. Many feel overwhelmed by the demands of their roles, unsupported by their employers and powerless to help patients who are facing life-or-death emergencies, according to a report by Unison, with some resigning within a year of starting the role. Call handlers get so stressed that they took an average of 33 sick days a year each between 2021/22 and 2024/25, data obtained by the union also showed. That is far higher than the average four days taken off sick by workers in the UK overall. A report by Unison found that call handlers’ jobs have become increasingly challenging in recent years as the demand for care, which rose during Covid, has remained consistently high since, while ambulance handover delays outside hospitals have worsened. “These findings paint a bleak picture of the conditions faced by 999 control room staff. TV programmes about ambulance services don’t show things as they really are,” said Christina McAnea, the Unison general secretary. Unison’s report said: “Relentless exposure to traumatic and increasingly complex incidents, verbal abuse, long shifts and low pay are contributing to stress, burnout and fatigue. One call handler told Unison: “Some shifts are overwhelmingly traumatic, with 90% of the calls of a distressing nature. One shift, I handled three road traffic accidents and two cardiac arrests.” “There’s a persistent pressure to remain on the phone, no matter how emotionally drained we are.” Read full story Source: The Guardian, 17 June 2025

When Tassie Weaver went into labour at full term, she thought she was hours away from holding her first child. But by the time she was giving birth, she knew her son had died. Doctors had previously told Tassie to call her local maternity unit immediately, she says, as she was considered high risk and needed monitoring, due to high blood pressure and concerns about the baby's growth. But a midwife told her to stay at home. Three hours later she called again, worried because now she couldn't feel her baby moving. Again, she was told to stay at home, the same midwife saying that this was normal because women can be too distracted by their contractions to feel anything else. "I was treated as just a kind of hysterical woman in pain who doesn't know what's going on because it's their first pregnancy," the 39-year-old tells us. When she called a third time, a different midwife told her to come to hospital, but when she arrived it was too late. His heart had stopped beating. Tassie and her husband John believe Baxter's stillbirth at the Leeds General Infirmary (LGI), four years ago, could have been prevented - and a review by the trust identified care issues "likely to have made a difference to the outcome". The couple are among 47 new families who have contacted the BBC with concerns about inadequate maternity care at Leeds Teaching Hospitals (LTH) NHS Trust between 2017 and 2024. As well as the new families, three new whistleblowers - two who still work for the trust - have shared concerns about the standard of care at its two maternity units - at the LGI and St James' University Hospital. This is in addition to the two we spoke to in the initial BBC investigation. Read full story Source: BBC News, 17 June 2025

NHS staff have voiced concern about the growing numbers of patients who are filming themselves undergoing medical treatment and uploading it to TikTok and Instagram. Radiographers, who take X-rays and scans, fear the trend could compromise the privacy of other patients being treated nearby and lead to staff having their work discussed online. The Society of Radiographers (SoR) has gone public with its unease after a spate of incidents in which patients, or someone with them in the hospital, began filming their care. On one occasion a radiology department assistant from the south coast was inserting a cannula into a patient who had cancer when their 19-year-old daughter began filming. “She wanted to record the cannulation because she thought it would be entertaining on social media. But she didn’t ask permission,” the staff member said. “I spent the weekend afterwards worrying: did I do my job properly? I know I did, but no one’s perfect all the time and this was recorded. I don’t think I slept for the whole weekend.” They were also concerned that a patient in the next bay was giving consent for a colonoscopy – an invasive diagnostic test – at the same time as the daughter was filming her mother close by. “That could all have been recorded on the film, including names and dates of birth,” they said. Ashley d’Aquino, a therapeutic radiographer in London, said a colleague had agreed to take photographs for a patient, “but when the patient handed over her phone the member of staff saw that the patient had also been covertly recording her, to publish on her cancer blog. “As NHS staff we wear name badges, so our names will be visible in any video. It makes people feel very uncomfortable and anxious.” Read full story Source: The Guardian, 17 June 2025

Dozens of trusts have been hit with financial penalties after regulators questioned their claims to be compliant with maternity safety standards. The maternity incentive scheme, run by NHS Resolution, gives trusts “refunds” on their payments to its clinical negligence scheme if they meet 10 safety-related criteria, which trust boards must declare against each year. The 10 requirements include appropriate staffing, reviewing deaths using a national tool, and board oversight of maternity services. However, NHS Resolution can investigate if concerns are raised — for example in a Care Quality Commission inspection — and these conflict with the trust’s submission. The payments to trusts can then be withdrawn, or withheld if they have not already been paid. HSJ analysis of data shared by NHS Resolution found 24 trusts had to make one or more repayments in the first four years of the scheme, which started in 2018 and was relaunched after the pandemic. Read full story (paywalled) Source: HSJ, 17 June 2025

On 9 June 2025, federal employees at the National Institutes of Health (NIH) stood up for the health and safety of the American people and faithful stewardship of public resources by authoring and signing the Bethesda Declaration. Read the open letter in support of the Bethesda Declaration.

Health Secretary Robert F. Kennedy Jr. has unveiled eight people he has chosen to serve on the Centers for Disease Control and Prevention's vaccine advisory panel – just two days after taking the unprecedented step of removing all 17 sitting members. On Wednesday, Kennedy listed the names and short bios of the new advisers who will join the Advisory Committee on Immunization Practices, or ACIP, at its upcoming meeting in late June. "All of these individuals are committed to evidence-based medicine, gold-standard science, and common sense," Kennedy said in a post on X, "They have each committed to demanding definitive safety and efficacy data before making any new vaccine recommendations." The new members are Dr. Joseph R. Hibbeln, Martin Kulldorff, Retsef Levi, Dr. Robert Malone, Dr. Cody Meissner, Dr. Michael A. Ross, Dr. James Pagano and Vicky Pebsworth. "This is a huge win for the medical freedom [m]ovement," David Mansdoerfer, former deputy assistant secretary for the Department of Health and Human Services in the first Trump administration, wrote in a post on X, "they did everything by the book to put together this excellent slate of appointees." Public health advocates are wary. "Kennedy did not pick people with strong, current expertise in vaccines," says Dorit Reiss, a professor at UC Law, San Francisco, who studies vaccine policy. "It tells me that Kennedy is setting up a committee that would be skeptical of vaccines, and possibly willing to implement an anti-vaccine agenda." Read full story Source: NPR, 11 June 2025

The backlog in routine hospital treatments in England has reached its lowest level for two years. Data for the end of April showed the waiting list dropped to 7.39 million, down from 7.42 million in March. But it is nine years since the NHS has met its target of 92% of patients being seen in 18 weeks – currently it is just below 60%. The government has made meeting the target one of its key missions for this parliament – and on Wednesday announced above-inflation rises for the NHS in the coming years to help achieve it. Responding to the latest figures, Health and Social Care Secretary Wes Streeting, said: "We are putting the NHS on the road to recovery." And he added this was "just the start" as the extra investment announced in the spending review, which will see the NHS budget rise by 3% a year in the next three years, combined with reforms that will be announced in the 10-year plan due next month, would help build on what has been achieved. The drop in the numbers on the waiting list, which covers people waiting for routine treatments like hip and knee operations, came after March saw a rise in numbers – the first time in six months the waiting list had gone up. Although a little bit of fluctuation from month to month is normally seen, the government said it was clear the numbers waiting were on a downward trend. Read full story Source: BBC News, 12 June 2025