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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    A spike in Covid absences and the extended heatwave have left NHS hospitals and ambulance services struggling to cope. The hot weather is also driving more patients to A&E departments, and callers are being urged not to use 999 except in serious emergencies. All 10 ambulance trusts in England are on black alert, the highest level, while health leaders warn that “ill-equipped” hospital buildings are struggling to store medicines correctly amid the abnormally high temperatures. Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said: “The NHS ambulance sector is under intense pressure, with all ambulance services operating at the highest level of four within their local resource escalation action plans, normally only ever reserved for major incidents or short-term periods of unusual demand. “Severe delays in ambulance crews being able to hand over their patients at many hospital emergency departments are having a very significant impact on the ambulance sector’s ability to respond to patients as quickly as we would like to, because our crews and vehicles are stuck outside those hospitals.” Read full story Source: The Independent, 12 July 2022
  2. News Article
    Paul Pettinger’s trip to Cyprus came because he felt the NHS had no treatments to offer him. Paul got Covid in the first wave in 2020. After the initial illness, he was left with extreme tiredness and 10% of the energy he once had. “I have a very small amount of energy and when I use up my energy, I end up with headaches, brain fog and with cognitive issues. It's very hard to think. And also I can't walk very far,” he says. His life then fell apart and he lost his job. “I have been almost housebound for over two years.” he says adding: “I’ve become a burden on family and friends.” A joint investigation between ITV News and the BMJ has found that Paul is 1 of around 120 people with Long Covid symptoms who have travelled to Cyprus for treatment. But thousands more have had the treatment in countries spending life changing sums of money. The Long Covid Center is one of several private clinics offering this treatment - others are in Germany and Switzerland. This is Paul’s seventh session. And, he says, he notices a difference and has confidence in the process. “After each treatment, I experienced a small improvement,” he says. “It is the only treatment out there at the time being and so far it's working.” However, experts have raised concerns over whether such invasive and expensive therapies should be offered without sufficient evidence. “I am worried these patients have been offered therapies which have not been assessed by modern scientific methods – well-designed clinical trials,” said Beverley Hunt, medical director of the charity Thrombosis UK. “In this situation, the treatment may or may not benefit them but, worryingly, also has the risk of harm.” Read full story Source: ITV News, 12 July 2022
  3. News Article
    Hundreds of children suffering from mental health issues are attending A&E each day, with some waiting up to five days in emergency departments, The Independent can reveal. Internal NHS data leaked to The Independent, shows the number of young patients waiting more than 12 hours from arrival has also more than doubled in the last year. A national survey of senior A&E doctors by the Royal College of Emergency Medicine (RCEM) found in some areas children’s mental health services have worsened in the last three years, while the majority of respondents warned there were no children’s crisis services open after 5pm. One NHS trust chief executive has warned his hospital’s A&Es have seen a “real surge” in both attendances of people with severe mental health issues and a sharp increase in long waits in recent months. One parent, Lee Pickwell, told The Independent his daughter was admitted to paediatric wards several times and stayed days in an emergency “section 136” unit while she waited more than two months for a mental health bed. Dr Mark Buchanan, RCEM’s lead for children’s mental health, told The Independent that despite improvements, children’s mental health services still fall short of what is needed. Dr Buchanan said: “I’ve seen children who have been not seen by Child and Adolescent Mental Health Services (CAMHS), who been refused the referrals, despite the fact that the mum and dad were taking it in turns to sleep outside their bedroom door because they were scared that they’d run away and do some harm.” Read full story Source: The Independent, 13 July 2022
  4. News Article
    More than one fifth of complaints about Irish hospitals were deemed ‘high severity' including one from a person who claimed their mother should not have died and another who alleged a patient was turned away from an A&E even though she was at risk of self-harming. An analysis of 641 complaints about HSE hospitals between October and December 2019 by NUI Galway and the HSE separated them into high severity (22%), medium severity (56%) and low severity (also 22%). Among those complaints highlighted as potentially linked to ‘catastrophic harm’ was this: “My mother would still be alive if this had not happened." However the largest number were about hospital systems at 392 — including complaints about waiting lists. “I was left on a waiting list for surgery for years,” at least one person wrote. The analysis also found 322 complaints centred around patients’ arrival into hospitals including emergency departments (ED). “She was turned away instead of admitted even though she was at risk of self-harming,” one person wrote. Some 92 complaints related to staff not listening to patients, including new parents who said: "While our newborn son was on the ward they took too long to notice his difficulty breathing and transfer him to the NICU (neonatal intensive care unit)." Read full story Source: Irish Examiner, 11 July 2022
  5. Content Article
    Hear from Amanda Hutchinson, Head of Policy for Regulatory Change and Lisa Annaly, Head of Analytic Content here at CQC, as they take you through the Care Quality Commission's (CQC) new regulatory approach. This video covers: CQC's assessment framework. CQC's assessment approach. What a 'year in the life' of a provider will look like under our new regulatory approach. Feedback from a recent engagement session CQC held with over 100 health and social care providers and professionals. Ways you can stay up to date with the changes CQC is making.
  6. Event
    The World Patients Alliance (WPA) is the largest international patient’s organization that is working across all disease areas and in all regions of the world. Join WPA’s 1st World Patients Conference. The two-day conference’s theme is New Normal, New Challenges for Patients, which will bring together global leaders of non-profit organizations, medical experts and leaders in the field of patient advocacy to network, exchange information, share experiences, learn from each other, raise your voice, and advocate for patients’ cause internationally. Hybrid meeting: The 1st World Patients Conference will be a hybrid event, so you can participate in the conference both in person and virtually. Register
  7. News Article
    The Food and Drug Administration will consider an application for the first birth control pill to be sold without a prescription. The application from HRA Pharma would seek to make Opill – an every day, prescription-only hormonal contraception first approved in 1973 – available over-the-counter. Such an approval from the FDA would allow people to purchase “the pill” without a prescription for the first time since oral contraceptives became widely available in the 1960s. The application will also cast oral contraceptives into a fraught political moment in the US. The US supreme court ended federal protection for abortion rights late last month, throwing into question the future of birth control. “This historic application marks a groundbreaking moment in contraceptive access and reproductive equity in the US,” said HRA Pharma’s chief strategic operations and innovation officer, Frédérique Welgryn. “More than 60 years ago, prescription birth control pills in the US empowered women to plan if and when they want to get pregnant.” Making birth control available without a prescription will “help even more women and people access contraception without facing unnecessary barriers”, said Welgryn, whose company has already submitted the application. Read full story Source: The Guardian, 11 July 2022
  8. News Article
    The Scottish government has signed a contract to allow NHS patients to visit a US expert for mesh removal surgery. Patients can book appointments with Dr Dionysios Veronikis in Missouri with their travel and accommodation costs paid for by the NHS. The cost of each procedure is estimated to be £16,000 to £23,000. Transvaginal implant use was stopped in Scotland after hundreds of women were left with painful, life-changing side effects. NHS National Services Scotland said it would work with NHS Greater Glasgow and Clyde and local health boards to take forward arrangements for those who wish to travel to the US for the procedure. Health Secretary Humza Yousaf said: "I fully understand that women want mesh removal surgery undertaken by surgeons who enjoy their full confidence and a range of measures are now in place to ensure this happens. "I am determined to ensure that those with mesh complications get the treatment they want and need." Read full story Source: BBC News, 12 July 2022
  9. News Article
    The Health and Social Care Secretary Steve Barclay has today appointed Dr Henrietta Hughes OBE as the first ever Patient Safety Commissioner for England. Adding to and enhancing existing work to improve the safety of medicines and medical devices, the appointment of a Commissioner is in response to the recommendations from Baroness Cumberlege’s review into patient safety, published in 2020. Dr Hughes will be an independent point of contact for patients, giving a voice to their concerns to make sure they are heard. She will help the NHS and government better understand what they can do to put patients first, promote the safety of patients, and the importance of the views of patients and other members of the public. Health and Social Care Secretary Steve Barclay said: "It is essential that we put patient safety first and continue to listen to and champion patients’ voices. Dr Henrietta Hughes brings a wealth of experience with her as the first ever Patient Safety Commissioner to improve the safety of medicines and medical devices and her work will help support NHS staff as we work hard to beat the Covid backlogs." Patient Safety Commissioner Henrietta Hughes said: "I am humbled and honoured to be appointed as the first Patient Safety Commissioner. This vital role, recommended in First Do No Harm, will make a difference to the safety of patients in relation to medicines and medical devices. Patients’ voices need to be at the heart of the design and delivery of healthcare. I would like to pay tribute to the incredible courage, persistence and compassion of all those who gave evidence to the report, their families and everyone who continues to campaign tirelessly for safer treatments. I will work collaboratively with patients, the healthcare system and others so that all patients receive the information they need, all patients’ voices are heard and the system responds quickly to keep people safe." Read full story Source: Gov.UK, 12 July 2022
  10. Gallery Image
    Glyco ampoules.jpg
    Can you read this glyco ampoule? Very small writing on the label - difficult to read, especially when in a hurry.
  11. News Article
    An ambulance trust lost 1,700 hours of working time in one week in April due to vehicles waiting outside a hospital. The BBC has discovered that the figure was reached twice during April as ambulance crews waited outside Gloucestershire Royal Hospital in Gloucester to handover patients. That equates to about 70 days worth of waiting time each week. The trust that runs the hospital said it was facing "significant challenges" as it dealt with "unrelenting demand". Figures show that since the end of January, South Western Ambulance Service NHS Foundation Trust (SWASFT) has lost a minimum of 800 hours of working time each week due to ambulances having to wait outside Gloucestershire Royal Hospital, unable to get patients into A&E. The national target for transferring patients from ambulances in to A&E is 15 minutes, but in some cases people had to wait up to 10 hours in ambulance queues in Gloucester. Read full story Source: BBC News, 12 July 2022
  12. Content Article
    Rates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
  13. News Article
    Patients are being put at risk because GPs wrongly assume they will actively seek their test results, a study says. Researchers from the University of Bristol said the mismatched expectations could harm patients, with delayed diagnosis a likely result. The study found: “Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety.” Dr Jessica Watson, a GP and doctoral research fellow at the Centre for Academic Primary Care at the university, who led the study, said: “GPs have a medico-legal and ethical responsibility to ensure they have clear, robust systems for communicating test results.” Watson added: “Relying on patients to get in contact and making assumptions about their knowledge of how to do so were particular risks highlighted.” Read full story (paywalled) Source: The Times, 12 July 2022
  14. News Article
    Monkeypox is continuing to spread in the UK, with current efforts insufficient to curb the outbreak, experts have warned as a whistleblower claimed there were serious flaws in the support given to those who think they have been exposed. According to the UK Health Security Agency (UKHSA), there have been 1,552 confirmed cases of monkeypox in the UK related to the outbreak as of 7 July. “[There is] no evidence that current strategies are likely to bring this to an end anytime soon,” said Paul Hunter, a professor in medicine at the University of East Anglia, although he noted that while total case numbers were continuing to rise, the rate of new infections may have plateaued. The concerns came as a whistleblower working on a UKHSA monkeypox inquiries line said it had numerous issues, including offering little support for people who are not confirmed contacts of cases – i.e. somebody whose name has been provided to contact tracers by a person with monkeypox. The Guardian has seen scripts that show even if someone calls because they are worried they may have had a contact with a confirmed case, they are told their risk is very low if they have not been formally identified as a contact. The whistleblower said that made little sense when a caller has said a sexual partner has monkeypox symptoms. In addition, the whistleblower said call handlers were not allowed to suggest callers contact a sexual health clinic unless sexual health was brought up by the caller, They added that some clinics had turned off their phone lines. The UKHSA has rejected the claims, saying the phone line is an additional service to provide non-clinical advice to members of the public. Read full story Source: The Guardian, 11 July 2022
  15. News Article
    Patients may be turned away at A&E in Portsmouth as the UK’s heatwave drives extreme hospital pressures. Staffing pressures coupled with additional strain from the current heatwave have forced Portsmouth Hospitals University Foundation Trust to declare a critical incident. The trust said it only had space in its emergency department for patients with life-threatening illnesses and critical conditions and so would be forced to redirect other patients elsewhere. In a statement, Portsmouth Hospitals University FT said: “Our emergency department remains full with patients and we have very limited space to treat emergency patients. We are only able to treat patients with life-threatening conditions and injuries, so anyone patients who arrive at ED without a life-threatening condition or injury, will be redirected to alternative services that can help... “Our immediate priority is to ensure there are beds available to admit our most seriously ill patients into and we are focusing on safely discharging as many patients as possible. We ask that families and loved ones support us with this and collect patients as soon as they are ready to be discharged.” Read full story Source: The Independent, 11 July 2022
  16. News Article
    The NHS's approach to tackling children’s mental health is “threatening to overwhelm the social care system”, the president of the Association of Directors of Children’s Services has warned. Steve Crocker believes the NHS is “not doing a very good job” for children, describing how children are typically now waiting four months for a mental health assessment and over a year for treatment as being “simply not good enough”. He admitted he was being “deliberately provocative” around children’s mental health at the opening of the ADCS conference yesterday, as he wants to see “more collaboration” from the new Integrated Care Systems (ICSs), which were put on a statutory footing this month. Mr Crocker warned delegates that under the ICS reforms, there is an “ongoing risk that the needs of children are sidelined by the ongoing pressure in acute adult services”. “The House of Lords amendment ensuring each ICS has a children’s strategic lead was a welcome development, but does it go far enough?” he asked. Mr Crocker told LGC: “Children's mental health should be a priority for every ICS in the country. I can't imagine any reason why any ICS would not do that." Read full story Source: Local Government Chronicle, 8 July 2022
  17. News Article
    Implementation of Boris Johnson’s flagship pledge to build 40 new hospitals is “moving at a glacial pace” and is hamstrung by delays and a lack of funding, NHS bosses have warned. Some of the construction schemes have already fallen as much as four years behind schedule, while others have been hit by massive cost increases because of difficulties in obtaining sign-off on certain points. The new hospitals programme in England is progressing so slowly that bosses of half of the hospitals earmarked to benefit doubt whether they will ever get the money to deliver the promised rebuild, according to a report and survey of health service trust chiefs by NHS Providers. One hospital in a rural area had to send seriously ill patients to other hospitals as much as 50 miles away and cancel cancer surgery when an inspection found that the ceiling of its intensive care unit was in danger of collapsing. Another hospital has had to close an entire ward for the same reason, while another is plagued with sewage regularly leaking into clinical areas because of the age of the facility. One trust chief executive said: “The whole fabric of the building is shot and we need to rebuild. The build was supposed to be completed in 2024 but [we are] now looking at 2027.” Another boss said: “We operate 21st-century healthcare from 19th-century buildings – increasingly unsustainable.” Read full story Source: The Guardian, 8 July 2022
  18. News Article
    Artificial intelligence (AI) could lead to UK health services that disadvantage women and ethnic minorities, scientists are warning. They are calling for biases in the systems to be rooted out before their use becomes commonplace in the NHS. They fear that without that preparation AI could dramatically deepen existing health inequalities in our society. A new study has found that AI models built to identify people at high risk of liver disease from blood tests are twice as likely to miss disease in women as in men. The researchers examined the state of the art approach to AI used by hospitals worldwide and found it had a 70% success rate in predicting liver disease from blood tests. But they uncovered a wide gender gap underneath – with 44% of cases in women missed, compared with 23% of cases among men. “AI algorithms are increasingly used in hospitals to assist doctors diagnosing patients. Our study shows that, unless they are investigated for bias, they may only help a subset of patients, leaving other groups with worse care,” said Isabel Straw, of University College London, who led the study. “We need to be really careful that medical AI doesn’t worsen existing inequalities.” Read full story Source: iNews, 9 July 2022
  19. News Article
    Female doctors have launched an online campaign that they say exposes shocking gender-based discrimination, harassment and sexual assault in healthcare. Surviving in Scrubs is an issue for all healthcare workers, say the campaign’s founders, Becky Cox and Chelcie Jewitt, who are encouraging women to share stories of harassment and abuse to “push for change and to reach the people in power”. The campaign has called for the General Medical Council (GMC), which regulates doctors, to explicitly denounce sexist and misogynistic behaviour towards female colleagues and “treat them with respect”. More than 40 stories have been shared on the campaign’s website, ranging from sexual harassment by patients to inappropriate remarks and sexual advances from supervisors. The campaign is bolstered by evidence that shows 91% of female respondents had experienced sexism at work within the past two years. The findings are a result of nearly 2,500 surveyed doctors working in the NHS – the majority of whom were women – published in a 2021 report by the British Medical Association (BMA). Read full story Source: The Guardian, 11 July 2022
  20. Content Article
    Sexism, sexual harassment, and sexual assault are commonplace in the healthcare workforce. Too many healthcare staff have witnessed or been subject to it… the female med student asked to stay late lone working with a senior male doctor, being looked over for opportunities at work, unwelcome touching at conferences, comments on your looks… the list goes on. A 2021 survey from the BMA reported 91% of women doctors had experienced sexism in the last 2 years and 47% felt they had been treated less favourably due to their gender. Over half of the women (56%) said that they had received unwanted verbal comments relating to their gender and 31% said that they had experienced unwanted physical conduct. Despite these statistics these issues remain endemic in healthcare. The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, aims to tackle this problem, giving a voice to women and non-binary survivors in healthcare to raise awareness and end sexism, sexual harassment, and sexual assault in healthcare. You can share your story through the Submit Your Story page anonymously and the story will be published on the Your Stories page. This will create a narrative of shared experiences that cannot be ignored.
  21. News Article
    Hospital leaders say they have been pressured to deliver more ‘corridor care’ as a result of efforts to ease the ambulance handover crisis. Due to the collapse in ambulance response times over the last year, hospitals have been told to receive patients from ambulance crews more quickly, to enable those crews to respond to new incidents in the community. This can mean patients being kept on trolley beds in corridors, with a lack of appropriate staff to care for them. Tracy Bullock, chief executive of University Hospitals of North Midlands, told HSJ her trust almost eradicated “corridor care” before the pandemic. But she added: “There have been discussions about going back to corridor care, but we have resisted that, as it brought significant patient safety and staff wellbeing issues… although these never received the same airtime as ambulance waits as they are unseen and only impact on the acutes. “The terminology has now changed and instead of corridor care it’s ‘cohorting’, and the space is not necessarily a corridor but a designated space for ambulances to drop more patients off.” She said this only works with enough staff, “otherwise you end up with the same safety issues that we had delivering corridor care pre-pandemic”. Read full story (paywalled) Source: HSJ, 11 July 2022
  22. News Article
    When Susan Sullivan died from Covid-19, her parents’ world fell quiet. But as John and Ida Sullivan battled the pain of losing their eldest, they were comforted by doctors’ assurance that they had done all they could. It was not until more than a year later, when they received her medical records, that the family made a crushing discovery. These suggested that, despite Susan being in good health and responding well to initial treatments, doctors at Barnet hospital had concluded she wouldn’t pull through. When Susan was first admitted on 27 March 2020, a doctor had written in her treatment plan: “ITU (Intensive therapy unit) review if not improving”, indicating he believed she might benefit from a higher level of care. But as her oxygen levels fell and her condition deteriorated, the 56-year-old was not admitted to the intensive unit. Instead she died in her bed on the ward without access to potentially life-saving treatment others received. In the hospital records, seen by the Observer, the reason Susan was excluded is spelled out: “ITU declined in view of Down’s syndrome and cardiac comorbidities.” A treatment plan stating she was not to be resuscitated also cites her disability. For John, 79, a retired builder, that realisation was “like Susan dying all over again”. “The reality is that doctors gave her a bed to die in because she had Down’s syndrome,” he said. “To me it couldn’t be clearer: they didn’t even try.” Susan is one of thousands of disabled people in Britain killed by Covid-19. Last year, a report by the Learning Disabilities Mortality Review Programme found that almost half those who died from Covid-19 did not receive good enough treatment, including problems accessing care. Of those who died from Covid-19, 81% had a do-not-resuscitate decision, compared with 72% of those who died from other causes. Read full story Source: The Guardian, 10 July 2022
  23. News Article
    Two-thirds of defective breathing machines distributed by the health service have not been repaired or replaced in the 12 months since they were subject to a worldwide recall over safety concerns. Philips Respironics last year issued a field safety notice for a series of ventilation devices because the polyester-based foam used to dampen the noise of the machines can break down. The foam particles or potentially toxic chemicals may be inhaled or ingested by patients. Almost 8,000 of the affected machines have been contracted by the Health Safety Executive (HSE) for use in hospitals and private homes, including 6,394 continuous positive airway pressure (CPAP) devices, 1,348 bilevel positive airway pressure (BPAP) devices, and 147 mechanical ventilators. However, the HSE told The Times that only 2,723 devices had been repaired or replaced a year after the recall was announced. A spokesman did not respond when asked if the HSE was concerned about patient safety, given that more than 5,000 devices have not been attended to. Read full story (paywalled) Source: The Times, 8 July 2022
  24. Content Article
    The Professional Standards Authority (PSA) are an independent body, accountable to the UK Parliament. PSA helps to protect the public through their work with organisations that register and regulate people working in health and social care: PSA oversee 10 statutory bodies that regulate health and social care professionals in the UK. PSA accredit registers of health and care professionals held by non-statutory bodies. PSA aim to improve regulation by providing advice to UK government and others, conducting/ commissioning research and promoting the principles of right-touch regulation. Here is a snapshot of the work they have done in 2020/21.
  25. Content Article
    The Professional Standards Authority (PSA) performance reviews look at a regulators’ performance against PSA's Standards of Good Regulation, which describe the outcomes regulators are expected to achieve. They cover the key areas of the regulators’ work, together with the more general expectations about the way in which regulators are expected to act. Here is the review of the General Osteopathic Council performance review.
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