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Patient Safety Learning

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  1. Patient Safety Learning
    When Sarah found herself suffering sudden bouts of breathlessness in May, she took herself to hospital. But after her COVID-19 swab test came back negative, doctors said she was probably anxious, and sent her home.
    Despite this, Sarah’s symptoms continued to worsen. A week later, she was rushed to hospital in an ambulance. Paramedics told her that based on her clinic observations, she should be in a coma.
    Then came more surprising news: She had tested positive for coronavirus
    Sarah’s story – given to a patient safety charity under a pseudonym – is one that resonates with Dr Claudia Paoloni, president of the Hospital Consultants and Specialists Association. She detailed another case in which a patient tested negative twice: once when she was first admitted to hospital and once later in her hospital stay. She finally tested positive on her third test – by which time she was on a ventilator in intensive care.
    Paolini believes COVID-19 swab tests produce a troublingly high rate of false negative results, and the problem lies in the reliance on a single test.
    “To use as a one-off test in any capacity to exclude someone from having COVID-19 is a folly.” 
    If you want to exclude someone from having the virus, Paoloni said, you must do multiple tests and collect multiple negative results. “If the test and tracing system is not working, which is the case here, transmission will continue unabated in the community.”
    The most recent data published by the Office for National Statistics says the test’s sensitivity - which it says can tell us how likely it is to return a false-negative result, may be somewhere between 85% and 98%. 
    Dr Deenan Pillay, Professor of Virology at University College London and member of Independent Sage, a group of scientists providing transparent advice during the crisis, said a significant number of self-administered tests could be coming back negative for people who do in fact have the virus.
    “The single biggest reason why a swab from someone who has COVID-19 comes up as negative is the quality of the swab that is taken,” Dr Pillay said. “Swabbing your nose and throat in a way that will pick up the virus means really scraping down the side of the wall of the nose or back of the throat to get cells from the lining of the throat. That’s not a pleasant thing to do.”
    This is of course true for at-home testing, which relies on the patient or a family member to collect the swab. But it could be true at testing centres, too.
    Tom, a 29-year-old from London whose name has been changed for this story, said there were no medical staff on site when he visited a Covid testing centre in London. The only people he interacted with were staff from a third-party contractor paid to carry out testing.
    “The man simply handed me a test, read out the instructions to self-administer the test, and asked me to do it myself,” he said.
    Pillay agrees that testing methods are likely to have an impact on false negative results. “I have seen the documentation given out at testing centres and it is very confusing,” he said. “Centres often expect you to administer the test yourself or get someone else in your car to administer it for you, all of which creates difficulties.” 
    Pillay believes the solution lies in having medically trained staff at testing centres. “The way the system is developed at the moment, outsourced to private companies like Deloitte and Lighthouse Labs, is just woeful,” he said.
    “The whole system is failing at the moment. And it’s happening just as the numbers of infections are starting to rise,” Dr Pillay said.
    Read full story
    Source: Huffpost, 27 September 2020
  2. Patient Safety Learning
    Lying on a trolley in a hospital corridor in pain from a broken hip, Anne Whitfield-Ray could not believe she was in the care of the NHS.
    "It was absolute chaos - like something out of a third world country," said the 77-year-old from Worcestershire.
    "The staff were rushed off their feet, paint was peeling off the walls and patients were being squeezed in everywhere they could - in makeshift bays, in corridors and side rooms. It was horrific."
    Anne spent 15 hours in that position until a bed could be found for her.
    Such delays used to be the exception, something that happened on the odd occasion in the depths of winter.
    Now they are commonplace. Latest figures show nearly 40% of A&E patients who need admitting face what is called a trolley wait - a delay of four hours or more waiting for a bed to be found.
    These are the sickest and frailest patients - the ones who cannot be sent home immediately after treatment. Research has linked delays like this with longer hospital stays and even a higher risk of death.
    By the time patients get to this point, they may have already faced hours of waiting in A&E or, increasingly, stuck outside A&E in the back of an ambulance, as was the case for Anne.
    She is now back home recovering after surgery, a few days after her fall in October.
    She said that despite her experience she cannot fault the staff: "They are doing the best they can. But this is not what should be happening in the NHS".
    Read full story
    Source: BBC News, 8 December 2022
  3. Patient Safety Learning
    One in five deaths around the world is caused by sepsis, also known as blood poisoning, shows the most comprehensive analysis of the condition.
    The report estimates 11 million people a year are dying from sepsis - more than are killed by cancer. The researchers at the University of Washington said the "alarming" figures were double previous estimates. Most cases were in poor and middle income countries, but even wealthier nations are dealing with sepsis.
    There has been a big push within the health service to identify the signs of sepsis more quickly and to begin treatment. The challenge is to get better at identifying patients with sepsis in order to treat them before it is too late. Early treatment with antibiotics or anti-virals to clear an infection can make a massive difference.
    Prof Mohsen Naghavi said: "We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable. We need renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition."
    Read full story
    Source: BBC News, 17 January 2020
  4. Patient Safety Learning
    “Stop killing us,” protesters across Poland chanted this evening, demanding the legalisation of abortion, after reports reached the media of a pregnant woman’s death in a hospital in May.
    On Monday, Poland’s patients’ rights ombudsman, Bartłomiej Chmielowiec, said that the John Paul II hospital should have told 33-year-old Dorota Lalik that her life could be saved through an abortion. The hospital violated her rights by withholding the information, the ombudsman ruled.
    The woman died in the hospital in Nowy Targ, in the south of the country, on 24 May, three days after her admission.
    “No one told us that we had practically no chance for a healthy baby … The entire time they were giving us false hope that everything will be OK … that [in the worst case] the child will be premature,” Lalik’s husband told Polish media. “No one gave us the choice or the chance to save Dorota, because no one told us her life was at risk.”
    Read full story
    Source: The Guardian, 14 June 2023
  5. Patient Safety Learning
    The mother of a man who died after suffering neglect said she felt "extreme distress and anger" at a critical new report into his care home.
    James Delaney, 37, died while he was a resident at Sapphire House in Bradwell, Norfolk, in July 2018. After an inadequate rating by the Care Quality Commission (CQC), Mr Delaney's mother said she felt lessons had not been learned from her son's death.
    A spokeswoman for operator Crystal Care said it had "addressed all concerns".
    Mr Delaney, who died of a diabetes-related illness, was required to take insulin twice a day, but, despite staff noting he had not taken insulin for three days, they failed to take action.
    Jacqueline Lake, senior coroner for Norfolk, said at his inquest in 2019 there had been "a gross failure" by the care home to provide "basic medical attention".
    The home, which houses up to five people who have a learning disability or autistic spectrum disorder, was inspected in January and February 2021 after two whistleblowers alleged that abusive practices were taking place - a claim which is being investigated by the local safeguarding team.
    CQC inspectors found "people were not safe and were at risk of avoidable harm", and while risk assessments for diabetes, medicines and behaviour management existed, information was often "lacking or inaccurate".
    After reading the report, Mr Delaney's mother, Roberta Conway, said her reaction was one of "extreme distress and anger". She said the coroner had "pointed out what needed to be done, and it hasn't been done".
    "It cost my son his life and I don't want to see anybody else's life being wasted," she added.
    Read full story
    Source: BBC News, 21 April 2021
  6. Patient Safety Learning
    Waiting times for gynaecology services in Northern Ireland are so bad that an independent and rapid review is taking place, BBC News NI has learned.
    It is being conducted by the Getting it Right First Time (GIRFT) programme which helps improve the quality of care within the NHS.
    A GIRFT team spent a week this month visiting all five health and social care trusts.
    In October 2022, 36,900 women in NI were on a gynaecology waiting list. A report from the Royal College of Obstetricians and Gynaecologists said that figure was a 42% increase since the start of the Covid-19 pandemic and that Northern Ireland had the longest gynaecological waiting lists in the UK.
    While waiting lists show that some women are waiting about 110 weeks to see a consultant gynaecologist for the first time, consultants have told BBC News NI that the reality is women depending on their medical issue are waiting much longer.
    Read full story
    Source: 31 May 2023
  7. Patient Safety Learning
    A new report by Research Australia details more than 200 ongoing COVID-19 studies that extend far beyond the search for a vaccine.
    Almost every COVID-19 research project being led by Australians has been in the new report, including studies of breastfeeding guidelines for parents with COVID-19, filter systems to remove the virus via air-conditioning systems, monitoring of sewage to detect the prevalence of COVID-19, and repurposing technology normally used to identify explosives to see if it can detect the presence of COVID-19.
    The report was compiled by Research Australia, the national peak body for health and medical research.
    It’s chief executive, Nadia Levin, said the report was not a complete catalogue of COVID-19 related research in Australia, but provided a useful insight into the scale of the response from the health and innovation sectors.
    “All of this Australian research kept popping up and we were blown away by the scale and scope of it, so we asked all of our members to share what they are working on,” Levin told the Guardian Australia.
    Read full story
    Source: The Guardian, 27 June 2020
  8. Patient Safety Learning
    "Bolder government action" is needed to address inequalities in dementia risk, the charity Alzheimer's Research UK has warned this week. The comments come in response to findings from four new studies presented at the Alzheimer's Association International Conference (AAIC) which link socio-economic deprivation with increased risk of dementia and cognitive decline.
    Dr Susan Mitchell, head of policy at Alzheimer’s Research UK, said: "These findings are a stark reminder of the health gap between the most and least deprived in society, with the most deprived at a higher risk of developing dementia.
    "Ultimately, these inequalities are profoundly unfair, but they are also avoidable. The Government has a key role in addressing inequalities through a range of measures to improve poverty, employment, housing and education."
    She added: "We urge Government to make dementia prevention a key priority in its aim to level up healthcare across the country, and hope the forthcoming health disparities white paper lays the foundation for a fairer, healthier nation."
    Read full story
    Source: Medscape, 5 August 2022
  9. Patient Safety Learning
    Critically ill children are being rushed from one part of England to another because NHS hospitals are running short of intensive care beds in which to treat them, the Guardian has revealed.
    An increase in severe breathing problems in children driven by winter viruses and infections, including flu, means some are having to be transferred sometimes many miles from their home area because there are not enough paediatric intensive care (PICU) beds locally.
    Specialist doctors who staff the units say the situation is “dangerous and rotten for the families” involved and that staff are firefighting to handle the number of children needing sometimes life-saving care, many of whom are on a ventilator to help them breathe.
    In the past few weeks, young patients have been sent from the Midlands to Sheffield, from London to Cambridge, and from one side of the Pennines to the other in order to get them a place in a PICU.
    One doctor at a PICU in the Midlands said: “PICU beds are always in high demand. But since winter hit this year, around six weeks ago, the situation feels like we are simply firefighting. Many days I come on shift to find there are no beds in [our] region and the patients referred to us end up in Southampton, Sheffield, Oxford and other centres far away."
    “The PICU network is overstretched. There aren’t enough beds, nurses or skilled doctors.”
    Read full story
    Source: The Guardian, 29 December 2019
  10. Patient Safety Learning
    A former consultant gynaecologist has told how he raised concerns over bullying, unsafe practices and a "dysfunctional culture" ahead of a report into a maternity scandal.
    Bernie Bentick, who worked at Shrewsbury and Telford Hospitals Trust (Sath) for almost 30 years, has spoken publicly about maternity care at the trust for the first time.
    Sath is at the centre of the largest inquiry in the history of the NHS into maternity care, which is expected to report next month. An official investigation is examining the care that 1,862 families received.
    Mr Bentick says he told senior management several times about a deteriorating culture at Sath.
    “I was increasingly concerned about the level of bullying, of dysfunctional culture, of the imposition of changes in clinical practice that many clinicians felt was unsafe," Mr Bentick told BBC's Panorama.
    "If the resources had been made available to employ adequate numbers, to provide safe levels of care in accordance with national guidelines, then the situation may have been profoundly different.”
    Mr Bentick went on to say that though some “cursory” investigations were launched into his complaints, he believed the trust responded in a way that tried to “preserve the reputation of the organisation.”
    Read full story
    Source: Shropshire Star, 23 February 2022
  11. Patient Safety Learning
    A care home manager said it had become an "impossibility" to get NHS dentists to visit her elderly residents when they needed treatment.
    Liz Wynn, of Southminster Residential Home, near Maldon in Essex, said she had battled for years for site visits.
    It comes as a health watchdog revealed that 25% of care home providers said their patients were denied dental care.
    NHS Mid and South Essex said it was considering a number of approaches to improve access for housebound patients.
    Ms Wynn said the shortage of NHS community dentists available to come into the home to carry out check-ups and treatment had been an "on-going concern" for almost 10 years.
    Ms Wynn said the home relied on its oral care home procedures - such as checking residents' mouths daily - to prevent problems from escalating. However, she said while its residents were "our family", conditions such as dementia made it difficult to spot when patients were in pain.
    She also said poor dental hygiene in the elderly could result in a number of potentially life-threatening infections.
    Read full story
    Source: BBC News, 24 April 2023
  12. Patient Safety Learning
    A patient in north Wales suffered "catastrophic" consequences when staff didn't connect their oxygen supply correctly.
    The Betsi Cadwaladr health board, which was caring for the patient at the time, is investigating and says it was one of a small number of recent similar incidents.
    But it refused to say whether the patient died, or to explain what the “catastrophic” consequences were.
    It says it is working to improve staff training to avoid similar incidents happening again.
    On Tuesday, Wales' health minister Eluned Morgan said the health board still had "a lot to do," before it could be taken out of special measures.
    A report to the committee said: “Further patient safety incidents have occurred in the health board related to the preparation and administration of oxygen using portable cylinders.
    “On review, the cylinder had not been prepared correctly, resulting in no flow of oxygen to the patient.
    “One incident had a catastrophic outcome and is under investigation.”
    Read full story
    Source: BBC News, 20 February 2024
  13. Patient Safety Learning
    A&E units are so overcrowded that growing numbers of patients have to be looked after in hospital corridors, warn nurses and doctors.
    There are rising concerns that the “shameful” trend means people stuck in corridors are not getting the care they need, or they may be even coming to harm. A&E health professionals say “corridor nursing” is becoming increasingly widespread as emergency departments become too full to look after the sheer number of people seeking treatment.
    In a survey of 1,174 A&E nurses in the Royal College of Nursing’s (RCN) Emergency Care Association, 73% of those polled said they looked after patients in a “non-designated area” such as corridors every day and another 16% said they did so at least once a week, while 90% said they feared patient safety was being put at risk by those needing care having to spend time in areas of hospitals which did not have medical equipment or call bells.
    Staff have had difficulty administering urgent doses of intravenous antibiotics to such patients, some of whom have been denied privacy and found it harder to use a toilet or been left in distress, nurses said.
    Read full story
    Source: The Guardian, 26 February 2020
  14. Patient Safety Learning
    Becoming a father can be the happiest time in a man's life, but for some it can bring unexpected feelings of anxiety, stress and guilt. Until recently, mental health concerns for new dads were little understood and, often, went unaired. But some men who have experienced postnatal depression hope telling their stories will encourage others to open up.
    When Stephen's daughter was born five years ago he knew he was meant to feel happy but instead began to think his wife and newborn child might be better off without him.
    "You don't get a chance to sit back, take it in, relax and enjoy it," he said. "I'd come home on a weekend after a long week, tired out, and my wife was back at work, working weekends."
    "It just affects you, you don't see each other, you don't have the chance to enjoy it, and all the stress and anxiety builds up. I got to such a low point I considered my family were better off without me."
    An international study in 2010 suggested that as many as one in 10 men struggle with postnatal depression (PND). More recently, in 2015, a survey by the National Childbirth Trust (NCT) found one in three new fathers had concerns about their mental health.
    The NCT has called for more recognition around mental health issues affecting new dads. It has set up Parents in Mind: Partners Project, which offers support to everyone who has an active role raising a child under two.
    "Becoming a parent is an emotional rollercoaster," said Catherine Briars, who runs the project in St Helens.
    "Fathers sometimes feel uncomfortable opening up about their feelings but we encourage them to do so if they're struggling. It's often the first step to recovering and regaining good mental health."
    She said they encourage men to talk to someone they trust or their GP.
    Read full story
    Source: BBC News, 19 November 2021
  15. Patient Safety Learning
    "Taking medication meant my brain was quiet for the first time; it was amazing, I cried because I was so happy," Jass Thethi, whose life was transformed after an ADHD diagnosis just over a year ago, told a BBC North West investigation.
    But the 34-year-old's joy was short-lived because, like more than 150,000 others who live with the condition and are reliant on medication, Jass has been affected by a UK-wide medicine shortage that started in September.
    Jass, who lives in Levenshulme, Greater Manchester, said: "When the medication shortage started I had to go back to white knuckling everyday life… I had to take the decision to change things and I had to quit the job I was doing."
    The charity ADHD UK said it had recorded a "significant decline" in the availability of medicines, with only 11% having their normal prescription in January, a drop from 52% in September.
    The Department of Health and Social Care (DHSC) said increased global demand and manufacturing issues were behind the shortages.
    Dr Morgan Toerien, associate specialist in mental health at Beyond Clinics in Warrington, said Jass's experience was not unique and many patients' lives had been "completely destabilised".
    Read full story
    Source: BBC News, 27 February 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? 
    To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our Community post.
    We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. 
  16. Patient Safety Learning
    "It's a full-time job that you can't quit. It's a massive burden that you didn't ask for, didn't expect."
    Diagnosed with type 1 diabetes at the age of 19, Naomi, now 33, says she reached a point where she simply could not handle "the physical or mental challenges of diabetes any more", a condition known as "diabetes burnout".
    About 250,000 people in England have type 1 diabetes, which means the body cannot produce insulin, the hormone that controls blood sugar levels. It can lead to organ damage, eyesight problems and - in extreme cases - limb amputation. But for many there is also a significant psychological impact of learning to manage the condition.
    Naomi felt she could no longer bear testing her blood sugar levels many times each day to calculate how much insulin she needed to inject, even though she knew she was risking her long-term health and putting herself in extreme danger, at risk of developing diabetic ketoacidosis (DKA), which can lead to a coma. She became so ill she was admitted to an eating disorder unit even though she was not struggling to eat.
    The head of the unit, Dr Carla Figueirdo, says of her diabetes patients: "These people are seriously unwell, seriously unwell. They are putting themselves at harm every day of their lives if they don't take their insulin."
    Naomi's consultant at the Royal Bournemouth Hospital, Dr Helen Partridge, says the psychological impact of a diabetes diagnosis should not be underestimated. 
    The hospital is hosting one of two NHS England pilot projects looking at how to treat type 1 diabetes patients whose chronic illness affects their mental health.
    NHS England diabetes lead Prof Partha Kar says: "The NHS long-term plan commits strongly on getting mental and physical health together. If we do tackle these two together, it will help improve outcomes."
    Read full story
    Source: BBC News, 16 November 2020
     
  17. Patient Safety Learning
    People who may be having a stroke should still call 999 for emergency medical care, even during the coronavirus pandemic, say UK experts.
    They are concerned that many are not seeking urgent help when they most need it, possibly due to fear of the virus or not wanting to burden the NHS.
    Any delay in seeking help can lead to disability or even death, warns the Stroke Association. Prompt assessment and treatment saves lives, it says.
    Data suggest people are currently staying away from hospitals, which is fine unless you really need care.
    Latest figures for England and Scotland suggest attendance to Emergency Departments has dropped by over a third on the same week last year. Those who need urgent medical help should still attend, say experts.
    Read full story
    Source: BBC News, 6 April 2020
  18. Patient Safety Learning
    A "dire" lack of dentists has led to people "self-medicating every night", an MP has said.
    Barrow and Furness MP Simon Fell said his constituents included seven-year-olds who had never seen a dentist and pregnant women who could not get an appointment.
    “That simply is not good enough," he said.
    "I now have constituents who have not seen a dentist in years," he said.
    “There are pregnant mothers who are unable to make their appointments, constituents who are self-medicating every night because they cannot find care, seven-year-olds who have never seen a dentist and constituents performing their own dental care with packs they buy from Boots the Chemist."
    Mr Fell told Parliament dental practices had told him they were unable to recruit enough dentists, especially in "rural, isolated areas such as mine".
    He had been told the process for bringing in dentists from overseas "does not meet demand" and the administration for recording patient care, and the resulting payment to dentists, was "long-winded and overly complex", he said.
     
    Read full story
    Source: BBC News, 3 May 2023
     
  19. Patient Safety Learning
    Adults in Northern Ireland seeking assessment for attention deficit hyperactivity disorder (ADHD) are being forced to go private because of a dire lack of referral services in some areas, a charity has said.
    Some health trusts have not been able to accept new referrals for adult assessment and diagnosis.
    ADHD charities said a lack of services or even waiting lists has forced many people to pay for a private diagnosis.
    The charity's chief executive Sarah Salters added that some people who do get a private diagnosis cannot then get medication from their GP through the NHS.
    The Department of Health said officials "are considering longer-term arrangements" for ADHD services, with future decisions "likely to be subject to ministerial approval and availability of funding".
    Read full story
    Source: BBC News, 2 April 2023
  20. Patient Safety Learning
    South West Ambulance has the longest waits in the country for people to get through to the operator. It takes almost a minute on average for ambulance control to answer 999 calls compared with just five seconds for the West Midlands service.
    Jean and Claire Iles called 999 six times to request an ambulance for Steven Iles' internal bleeding and two of their calls were unanswered for 10 minutes
    "He just looked at me and he just passed away before they could even get to him," 41-year-old Claire Iles said.
    "I rang about 4pm and said he has gone grey, and I said if you don't come now he is going to die, and it was still 20 minutes before the ambulance turned up."
    She was at home with her parents in Yate, near Bristol, when her father, Steve, 63, fell ill.
    It took 11 hours for a South West Ambulance crew to arrive, but Jean said by that time it was too late.
    Mr Iles died at 17:10 GMT on 19 March from a strangulated hernia that cut off the blood supply to his heart.
    The trust has apologised for the distress and anxiety caused but said it remained under "enormous pressure".
    Read full story
    Source: 4 November 2022
  21. Patient Safety Learning
    "Cultural and ethnic bias" delayed diagnosing and treating a pregnant black woman before her death in hospital, an investigation found.
    The probe was launched when the 31-year-old Liverpool Women's Hospital patient died on 16 March, 2023.
    Investigators from the national body the Maternity and Newborn Safety Investigations (MSNI) were called in after the woman died.
    A report prepared for the hospital's board said that the MSNI had concluded that "ethnicity and health inequalities impacted on the care provided to the patient, suggesting that an unconscious cultural bias delayed the timing of diagnosis and response to her clinical deterioration".
    "This was evident in discussions with staff involved in the direct care of the patient".
    The hospital's response to the report also said: "The approach presented by some staff, and information gathered from staff interviews, gives the impression that cultural bias and stereotyping may sometimes go unchallenged and be perceived as culturally acceptable within the Trust."
    Liverpool Riverside Labour MP Kim Johnson said it was "deeply troubling" that "the colour of a mother's skin still has a significant impact on her own and her baby's health outcomes".
    Read full story
    Source: BBC News, 16 February 2024
  22. Patient Safety Learning
    A frailty index is rationing treatment for older and disabled people who catch coronavirus, says Patience Owen. Patience has has a debilitating connective tissue disorder and, like thousands of others with rare conditions, is already in a minority within a minority, marginalised by our NHS, battling increasing disability day by day.
    Back in March, without consultation and days before the first lockdown, the Clinical Frailty Scale (CFS), a worldwide tool used to swiftly identify frailty in older patients to improve acute care, was adapted by the National Institute for Health and Care Excellence (NICE). It asked NHS staff in England to score the frailty of Covid patients. Rather than aiming to improve care, it seems the CFS – a fitness-to-frailty sheet using scores from one to nine – was used to work out which patients should be denied acute care. Nice’s new guidelines advised NHS trusts to “sensitively discuss a possible ‘do not attempt cardiopulmonary resuscitation’ decision with all adults with capacity and an assessment suggestive of increased frailty”.
    "Checking the scale, I found I would score five, the 'mildly frail' category, and therefore should I get Covid I could be steered towards end-of-life care. Bluntly, if I catch the virus, the NHS may help me to die, not live," says Patience.
    By early April, there was a proliferation of illegal “do not resuscitate” (DNR) notices in care homes for people with learning disabilities, and for older people in care homes and in hospitals. Many acutely ill patients stayed at home with Covid symptoms in the belief that they risked being denied care in hospital. Following warnings by the healthcare regulator, the Care Quality Commission, and other medical bodies, that the blanket application of the notices must stop, and legal challenges by charities, exclusions were made to the NICE guidelines.
    These included “younger people, people with stable long-term disabilities, learning disabilities or autism”. Yet the guidelines remain in place, in spite of the fact that they appear to contravene the Human Rights Act (including the right to life, article 2, and the right to non-discrimination, article 14). 
    A spokeswoman for NICE says it is “very aware of the concerns of some patient groups about access to critical care, and we understand how difficult this feels. Our COVID-19 rapid guideline on critical care was developed to support critical care teams in their management of patients during a very difficult period of intense pressure."
    “'Difficult' is a hollow word for the feeling of being selected to die," says Patience. "It’s difficult not to conclude that those with long-term conditions and disabilities, like myself, have become viewed as a sacrificial herd."

    Read full story
    Source: The Guardian, 29 September 2020
  23. Patient Safety Learning
    An Independent Patients' Commissioner is set to be appointed to act as champion for people who have been harmed by medicines or medical devices.   
    Baroness Cumberlege, who recommended the new role in a landmark report earlier this year, announced that the government had budged on the issue after initial resistance.
    She welcomed the move saying: "Had there been a patient safety commissioner before now, much of the suffering we have witnessed could have been avoided."
    But she added "the risk still remains" and further urgent action is needed to protect patients from potentially harmful drugs."
    At an online meeting of parliamentarians, the baroness described the testimony of a victim of the medical device vaginal mesh, which has left some patients in chronic pain.
    The woman had told her review team: "This device took everything from me. My health, my life, my job, my dignity, my marriage, my freedom."
    Reflecting on this the baroness added: "The scale of suffering we witnessed means nothing short of profound change is necessary. Not necessary in a couple or three years, but necessary now."
    Read full story
    Source: Sky News, 16 December 2020
  24. Patient Safety Learning
    There was a "gross failure in basic care" which led to a baby being starved of oxygen during birth, a coroner said.
    Zak Ezra Carter died at the Royal Gwent Hospital, Newport, two days after being born in July 2018 at Ystrad Fawr Hospital in Caerphilly county.
    Gwent coroner Caroline Saunders said the monitoring of Zak and his mother Adele Thomas fell "well below the standards expected". She said she was reassured the health board had taken steps to improve care.
    Ms Thomas told the Newport hearing she felt "scared" and staff "didn't care" when she arrived to give birth on 20 July 2018. In a statement to the inquest she described being turned away from the centre after going into labour on three occasions, before being admitted on the fourth.
    Ms Thomas said she was initially offered paracetamol as pain relief at the midwife-led centre.
    She described "a lot of arguing between nurses", one of whom was "bolshie and rude and rough handled me", adding the midwives "did not appear to be in any rush". 
    When Zak was born, he was described as being "white and pale" and without a heartbeat. He did not cry and was taken away to a room for resuscitation. Zak was transferred to the Royal Gwent Hospital where he died two days later.
    During the first stage of labour, Prof Sanders said "everything was progressing at a normal healthy rate and the fetal heart rate was recorded as completely normal". But she said it was "highly unusual" for the heart rate to not be documented contemporaneously, and the midwives had not been able to explain why they had not done so.
    Recording a narrative conclusion, Ms Saunders said the monitoring of Ms Thomas and her baby had "fallen well below the standards expected", leading to a "gross failure in basic care" of them in the later stages of labour.
    Read full story
    Source: BBC News, 18 March 2021
  25. Patient Safety Learning
    An 86-year-old man died after lying in the road waiting more than four hours for an ambulance, his family have said.
    George Ian Stevenson was hit by a car near his home in Johnstown, Wrexham county, last Wednesday. His family said the first 999 call was made at 19:31 GMT, and the ambulance did not arrive until 23:37 GMT.
    The Welsh Ambulance Service is looking into the incident, but said that at the time of the call, all its vehicles were already committed to other patients.
    Two off-duty paramedics stopped to help, but were reluctant to move him in case they caused further injury.
    Mr Stevenson's granddaughter, Ellie Williams said on the night of the accident it was raining, freezing and foggy.
    She said: "Left there for four hours, begging for help, waiting for help. And that makes us so sad.
    "A hard-working man who has paid his taxes all his life and paid into the system has been let down when he's needed them the most, and I just can't quite comprehend what has happened to him."
    Read full story
    Source: BBC News, 8 March 2022
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