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Patient Safety Learning

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  1. 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
  2. Patient Safety Learning
    A Mississippi prison denied medical treatment to an incarcerated woman with breast cancer, allowing her condition to go undiagnosed for years until it spread to other parts of her body and became terminal, according to a lawsuit filed on Wednesday.
    Susie Balfour, 62, alleges that Mississippi department of corrections (MDOC) medical officials were aware she might have cancer as early as May 2018, but did not conduct a biopsy until November 2021, one month before she was released from prison. It was not until January 2022, after she left an MDOC facility, that a University of Mississippi Medical Center doctor diagnosed her with stage four breast cancer, according to her federal complaint.
    Her lawsuit and medical records paint a picture of a prison healthcare system that deliberately delayed life-saving healthcare and for years repeatedly failed to conduct follow-up appointments that the MDOC’s contracted clinicians recommended.
    Read full story
    Source: The Guardian, 14 February 2024
  3. Patient Safety Learning
    The doctor in charge of medical training for NHS England has apologised unreservedly to the family of a medic who took her own life.
    Dr Vaish Kumar, a junior doctor, left a suicide note blaming her death entirely on the hospital where she worked, her family revealed last year.
    Dr Kumar, 35, was wrongly told she needed to do a further six months of training before starting a new role.
    It meant she was forced to stay at Queen Elizabeth Hospital (QE) in Birmingham, where she had been belittled by colleagues, an inquest heard.
    In a letter to Dr Kumar's family, seen by the BBC, NHS bosses admitted she did not need to do the extra training.
    Dr Navina Evans, chief workforce and training education officer for England, told the family in the letter: "I wish to unreservedly apologise for these mistakes and for the impact they would have had.
    "As an organisation we are determined to learn... not only across the Midlands but across England as a whole."
    Read full story
    Source: BBC News, 13 February 2024
  4. Patient Safety Learning
    A woman who described the time in her life after a pelvic mesh implant as "soul destroying" said proposed government compensation was "disappointingly low".
    Claire Cooper, from Uckfield, is one of around 100,000 women across the UK who had transvaginal mesh implants.
    England's patient safety commissioner suggested compensation could start at around £20,000.
    Ms Cooper, 49, was originally given the mesh implant as a treatment for incontinence after childbirth.
    However, after struggling with pain following the operation, Ms Cooper claimed doctors treated her as if she were "psychotic" and "a nuisance".
    She said her experience was one of being "mocked".
    "It was just soul destroying," Ms Cooper told BBC Radio Sussex. "I lost my fight because I was met at every turn with resistance so I just lost the ability to advocate for myself."
    Ms Cooper eventually had surgery to remove the mesh, which she said one doctor compared to "cheese cutting wire". She is still living with chronic pain.
    Read full story
    Source: BBC News, 15 February 2024
    Further reading on the hub:
    Doctors shocking comments to women harmed by mesh
     
  5. Patient Safety Learning
    More than 100 patients who had eggs and embryos frozen at a leading clinic have been told they may have been damaged due to a fault in the freezing process.
    The clinic, at Guy's Hospital in London, said it may have unwittingly used some bottles of a faulty freezing solution in September and October 2022.
    But it said it did not know the liquid was defective at the time.
    One patient at a second clinic, Jessop Fertility in Sheffield, has also been affected, the BBC has learned.
    The fertility industry regulator, the Human Fertilisation and Embryology Authority (HFEA), said it believes the faulty batch was only distributed to those two clinics.
    It is believed that many of the patients affected have subsequently had cancer treatment since having their eggs or embryos frozen, which may have left them infertile. This means they now may not be able to conceive with their own eggs.
    Guy's Hospital's Assisted Conception Unit is now being investigated by the HFEA, because of a delay in informing people affected.
    Read full story
    Source: BBC News, 14 February 2024
  6. Patient Safety Learning
    The family of a man who needlessly died after a 12-hour delay in surgery have called for changes at a troubled NHS trust as regulators expressed alarm about patient safety and waiting times.
    The Care Quality Commission (CQC) upgraded the surgery department at the Royal Sussex county hospital in Brighton from “inadequate” to “requires improvement” at a time when it is at the centre of a police investigation into dozens of patient deaths, allegations of negligence and cover-up.
    In their report, the regulator expressed concern about already long and lengthening waiting times, repeated cancelled operations and staff shortages that could compromise safety.
    The inspection report comes as the Guardian can reveal the trust apologised and settled with the family of Ralph Sims, who died aged 65 after heart surgery in April 2019 when doctors failed to act appropriately to a drop in his blood pressure.
    Sims, who was a keen runner, suffered a drop in blood pressure and developed an irregular heart rhythm eight hours after surgery to replace an aortic valve at the hospital.
    An internal investigation into Sims’ treatment acknowledged that hospital staff failed to “recognise the significance of the fall in blood pressure”.
    University Hospitals Sussex NHS foundation trust, which runs the hospital, accepted that the father of three should have returned to surgery to identify the cause of his deterioration. Instead, medics decided that he should be observed overnight.
    Due to another emergency case, an angiogram was not carried out on Sims until just before noon the following day – 12 hours after the drop in pressure. The delay caused irreversible – and avoidable – heart muscle damage, leading to his death five weeks later.
    The family said: It added: “Whilst the trust has apologised to our family it feels hollow. Ralph’s death was entirely unnecessary, and despite the issues in his care, it took the trust several years to apologise.”
    Read full story
    Source: The Guardian, 14 February 2024
  7. Patient Safety Learning
    England’s largest hospital trust has written to GPs warning their patients face 15-week waits for routine MRIs, ultrasound and CT scans.
    Guy’s and St Thomas’ Foundation Trust in central London said it was prioritising suspected cancer and other “urgent cases”, meaning “unfortunately waiting times for routine patients are now an average of 15-16 weeks for an appointment against a target of six weeks”.
    This is much worse than national averages, which December figures showed were 3.2 weeks, 2.5 weeks and 3.3 weeks for MRI, CT and ultrasound waits respectively.
    It its letter to GPs in Lambeth and Southwark – its main patches – GSTT said: “Current imaging referral demand outstrips capacity, despite these services consistently delivering near 120 per cent levels of activity compared to 2019-20.
    “The radiology service is exploring multiple routes to increase imaging capacity, including increased weekend working, insourcing and outsourcing contracts, but there is still a significant shortfall of slots every week.”
    In particular, it said primary care staff should expect long waits for the reporting of routine MRI scans.
    Read full story (paywalled)
    Source: HSJ, 13 February 2024
  8. Patient Safety Learning
    Hundreds of frontline NHS staff are treating patients despite being under investigation for their part in an alleged “industrial-scale” qualifications fraud.
    More than 700 nurses are caught up in a potential scandal, which a former head of the Royal College of Nursing said could put NHS patients at risk.
    The scam allegedly involves proxies impersonating nurses and taking a key test in Nigeria, which must be passed for them to become registered and allowed to work in the UK.
    “It’s very, very worrying if … there’s an organisation that’s involving themselves in fraudulent activity, enabling nurses to bypass these tests, or if they are using surrogates to do exams for them because the implication is that we end up in the UK with nurses who aren’t competent,” said Peter Carter, the ex-chief executive of the RCN and ex-chair of three NHS trusts.
    He praised the Nursing and Midwifery Council (NMC) for taking action against those involved “to protect the quality of care and patient safety and the reputation of nurses”.
    Nurses coming to work in the UK must be properly qualified, given nurses’ role in administering drugs and intravenous infusions and responding to emergencies such as a cardiac arrest, Carter added.
    Forty-eight of the nurses are already working as nurses in the NHS because the NMC is unable to rescind their admission to its register, which anyone wanting to work as a nurse or midwife in Britain has to be on. It has told them to retake the test to prove their skills are good enough to meet NHS standards but cannot suspend them.
    The 48 are due to face individual hearings, starting in March, at which they will be asked to explain how they apparently took and passed the computer-based test (CBT) of numeracy and clinical knowledge taken at the Yunnik test centre in the city of Ibadan. The times recorded raised suspicions because they were among the fastest the nursing regulator had ever seen.
    Read full story
    Source: The Guardian, 14 February 2024
  9. Patient Safety Learning
    More than 100 families looking after severely disabled adults and children outside hospital, have told the BBC that the NHS is failing to provide enough vital support.
    The NHS says help is based on individual needs and guidelines ensure consistency across England and Wales. However, some families describe the system as adversarial.
    Only those living outside hospital with life-limiting conditions, or at risk of severe harm if they don't have significant support, get this help from the NHS.
    It is provided through a scheme called Continuing Healthcare (CHC) for adults, and its equivalent for under-18s, Children and Young People's Continuing Care.
    Cases in England are decided by NHS Integrated Care Boards (ICBs) - panels responsible for planning local health and care services. In Wales, they are overseen by local health boards.
    The BBC has heard from 105 families who described serious concerns with how the two schemes are working - with most calling for reform.
    One young man with 24-hour needs hasn't received any CHC help despite being eligible since February 2023 - his parents, who first applied for support on his behalf nearly two years ago, currently provide round-the-clock care
    Another family were told overnight care for their teenage child - who is non-verbal, has severe mobility issues and requires 24/7 support - would be reduced from seven down to three nights a week, without a reason being given.
    Read full story
    Source: BBC News, 14 February 2024
  10. Patient Safety Learning
    There was an “unacceptable delay” and “failure to act with candour” in how a trust responded to a serious risk from staff nitrous oxide exposure, an independent investigation has found.
    Mid and South Essex Foundation Trust found levels of nitrous oxide far above the workplace exposure limit at Basildon Hospital’s maternity unit during routine testing in 2021. However, staff were only notified and a serious incident declared more than a year later.
    The exposure related to a mixture of nitrous oxide and oxygen, commonly known as gas and air, used during births. While short-term exposure is considered safe, prolonged exposure to nitrous oxide could lead to potential health issues.
    Chief executive Matthew Hopkins has apologised, after a report by the Good Governance Institute said: “The inquiry found that there was an unacceptable delay in responding to and mitigating a serious risk that had been reported… As a result of this failure to act on a known risk, midwives and staff members on the maternity unit were exposed to unnecessary risk or potential harm from July 6 2021 to October 2022."
    Read full story (paywalled)
    HSJ, 14 February 2024
  11. Patient Safety Learning
    Community Pharmacy Scotland (CPS) is calling for all pharmacy staff to be allowed to prepare and assemble medication without requiring supervision from a pharmacist or pharmacy technician.
    Its comments came in its response to a Department of Health and Social Care consultation on pharmacy supervision, published on 7 December 2023, which sets out proposals to amend the Medicines Act 1968 and The Human Medicines Regulations 2012.
    The consultation includes proposals to enable pharmacists to authorise pharmacy technicians to carry out, or supervise others carrying out, the preparation, assembly, dispensing, sale and supply of medicine; to enable pharmacists to authorise any member of the pharmacy team to hand out checked and bagged prescriptions in the absence of a pharmacist; and to allow pharmacy technicians to supervise the preparation, assembly and dispensing of medicines in hospital aseptic facilities
    In its response, the CPS disagreed with the first of these proposals, arguing that “the preparation and assembly of [pharmacy] and [prescription-only] medications can be safely carried out from a registered pharmacy premises, without requiring supervision by a Responsible Pharmacist or an authorised pharmacy technician”.
    CPS also said there is “a major flaw in the logic” of the government proposal because “it relies heavily on individuals rather than on safe systems”, making the proposed new way of working “vulnerable to changes in personal circumstance”.
    “The environment, technology, training, conditions and [standard operating procedures] in the community pharmacy setting have a bigger effect on safety of preparation and assembly than supervision by an individual,” the response said.
    Read full story
    Source: The Pharmaceutical Journal, 12 February 2024
  12. Patient Safety Learning
    Dozens of new allegations of sexual assault and abuse, including claims of rape and of patients being made pregnant, have emerged following an investigation into Britain’s mental health wards.
    One patient with a mental health disorder became pregnant by a member of staff. Allegations of rape, and of children being groomed by healthcare assistants, were among the 40 horrifying new reports of abuse made against rogue NHS Trusts.
    The investigation, conducted by The Independent, alongside Sky News, revealed more than 20,000 allegations of sexual assault and harassment across more than 30 NHS England mental health trusts since 2019.
    Several patients, who have come forward with their own harrowing stories, had allegedly been harmed by healthcare assistants, who currently are not regulated.
    Natalie, whose name has been changed, was one of several patients groomed and asked to share sexually explicit photos by a healthcare assistant working at a children’s mental health ward in 2020.
    Natalie, who was 16 at the time, told The Independent: “The first few conversations [after I was discharged] were very innocent. However after weeks and months, he started speaking in a sexual nature, asking me to send explicit photos of myself, posting explicit photos of himself and asking to meet up for sexual advances, I didn’t realise it at the time, but he was grooming me; this was all over Snapchat.
    “I feel and still feel very small, and that I wasn’t looked at as a person [by the hospital], and they only saw me as a patient with no feelings that mattered. It felt like another incident at ... that just got swept under the rug.”
    Read full story
    Source: The Independent, 10 February 2024
  13. Patient Safety Learning
    The trusts where maternity care has deteriorated the most according to patient surveys have been identified by the Care Quality Commission.
    The regulator collected responses from 25,515 patients about their experiences of antenatal care, labour, birth and postnatal care across 121 trusts in February 2023. 
    It then analysed where experiences of care were substantially better or worse overall when compared with survey results across all trusts in England.
    Survey responses also painted a deteriorating picture of maternity care nationally, with answers to 11 questions showing a statistically significant downward trend compared to five years ago.
    Five trusts were categorised as “worse than expected”, where patients’ experiences of using their services were substantially worse than the average.
    Read full story (paywalled)
    Source: HSJ, 12 February 2024
  14. Patient Safety Learning
    NHS England is in negotiations with ministers to formally push back the target to eliminate 65-week waiters, HSJ has learned.
    Discussions about the target are on-going as part of negotiations around the delayed 2024-25 planning guidance. It has been clear for months the March deadline to virtually eliminate 65-week waiters would be missed.

    It has emerged some trusts with the largest waiting lists already appear to be working to a September deadline.
    The news follows prime minister Rishi Sunak being forced to finally admit this week that his flagship NHS pledge from last January, that the waiting list would be falling by this year, had failed. This was something NHS bosses have warned of since summer.
    Read full story (paywalled)
    Source: HSJ, 9 February 2024Choose Single File...
  15. Patient Safety Learning
    ‘This is a very painful thing to admit,” says Emily Roberts, a 47-year-old teacher from south London, “but my entire adult life has been shaped by trying to survive what has been done to me.”
    Roberts (not her real name) is one of hundreds of British people who believe that they have been unintentionally maimed by orthodontists — dentists who specialise in irregular teeth and jaws. Along with thousands of others around the world, they share their experiences and post photographs and x-rays on Facebook groups. They say that lifelong damage was done to them as children — not by shady backstreet operators but by regular high street practitioners. Many say that as a result their adult lives have been blighted by painful and debilitating symptoms.
    “I’ve spent my entire adult life working on my body to try to get my posture right or get out of pain,” Roberts says. She has seen neurologists, osteopaths, pain-management specialists. Nothing has worked. 
    She considered taking legal action against the orthodontist who initially treated her — for seven years in total — but the UK’s statute of limitations states that claims for dental negligence must be made within three years of the treatment and the time limit elapsed while she was still considering her options. 
    Lauren Packham, 36, was 12 years old when she had four premolar teeth removed to correct an overbite that she says “wasn’t even that bad”. She then wore fixed braces and elastics to retract her teeth. In her twenties she had three wisdom teeth removed after they became painful. “If I knew what I know now, I wouldn’t have had them out,” she says.
    In the past few years Packham, who lives in Plymouth, has suffered worsening jaw pain and migraines. She has also experienced sleep problems since her late teens. “If I sleep on my back, my breathing just cuts off. I’ve since had a diagnosis of sleep-disordered breathing.”
    A Harley Street sleep specialist doctor she saw privately pointed to her orthodontic treatment as the likely cause of her health issues.
    Read full story (paywalled)
    Source: The Times, 11 February 2024
    Further reading on the hub:
    “I’ve been mocked, scolded and gaslighted”: a harmed patient’s experience of orthodontic treatment A patient harmed by orthodontic treatment shares their story Share your experience of orthodontist and dentistry services
  16. Patient Safety Learning
    Lawyers and charities tell of mothers told to ‘labour at home as long as they can’, dangerously few midwives and ‘lies’ during natal care.
    As Rozelle Bosch approached her due date she had every reason to expect a healthy baby. Neither she, her husband nor the midwives knew that the child was in the breech position at 30 weeks.
    When her waters broke a fortnight early, Bosch and her husband, Eckhardt, both first-time parents, had been reassured by NHS Lanarkshire that all was well and that the mother was “low risk”. They were sent home from Wishaw hospital and told to monitor conditions until the pregnancy became “active”.
    Shortly before 11pm on 1 July 2021, her husband called an ambulance saying that Bosch was in labour and was giving birth. 
    Bosch was in an upstairs bedroom on her knees and paramedics noted that “the baby was pink”. They soon asked the control room for a doctor or midwife to attend but none were available. By the time the ambulance took the family to hospital, the baby had turned blue.
    Within two days, baby Mirabelle had died. She had become trapped with only her feet and calves delivered while the couple were still at home. A post-mortem has found that Mirabelle suffered oxygen deprivation to the brain from “head entrapment” during delivery.
    Last month, her father explained to a fatal accident inquiry (FAI) at Glasgow sheriff court: “We were told Rozelle was healthy and Mirabelle was healthy. I think this was a lie and the consequences have me standing here today.”
    The way that the tragedy unfolded is striking, not just because of the devastating consequences, but because it is not an entirely isolated case.
    The same FAI is examining the deaths of two other newborns, Ellie McCormick and Leo Lamont, who also died in NHS Lanarkshire less than a month apart in 2019. Experts say it is rare for the Crown and Procurator Fiscal Service to group investigations in this way.
    Darren Deery, the McCormicks’ lawyer and a medical negligence specialist with Drummond Miller, said he had noticed a “considerable increase” in parents contacting the law firm in the past three years.
    Read full story (paywalled)
    Source: The Times, 11 February 2024
  17. Patient Safety Learning
    An investigation has been launched after a woman died days after being found unconscious underneath her coat while waiting in A&E for seven hours.
    The 39-year-old woman is understood to have first attended A&E at Queen’s Medical Centre in Nottingham on the evening of 19 January complaining of a severe headache. She was triaged and then observed by nurses three times. Her case was escalated but she was not seen by a doctor before being discovered.
    When the woman was called to see a doctor, she did not respond. It was assumed that she had left A&E because she had waited so long. She was discovered and transferred to intensive care but died three days later on 22 January.
    A source familiar with the hospital told LBC, which first reported the incident, that the A&E department could have up to 80 patients waiting at a single time and that wait times could be as long as 14 hours.
    Dr Keith Girling, the medical director at Nottingham university hospitals NHS trust, said: “I offer my sincere condolences to the family at this difficult time. An investigation, which will involve the family, will now take place and until this has been concluded, we are unable to comment further.”
    Read full story
    Source: The Guardian, 10 February 2024
  18. Patient Safety Learning
    The first time she was groped at work, Freya says she was 24 years old, a newly qualified paramedic, and was cleaning out the cupboards of the ambulance station crew room.
    "He came behind me without me realising. I was cleaning away, and he put his hands around my body and grabbed my breasts," said Freya, which is not her real name.
    "Then he said, 'Well, I won't bother doing that again'.
    "People just laughed, some didn't even look up from the TV. Like it was nothing, completely normal."
    Her story mirrors that of other current and former paramedics who, in several interviews with Sky News, painted a picture of widespread sexual harassment and a toxic culture of misogyny.
    The head of the College of Paramedics, Tracy Nicholls, said: "Problems exist in every [NHS] trust, across all four countries in the United Kingdom."
    NHS England told Sky News that any form of sexual misconduct was "completely unacceptable" and every trust had committed to an action plan to improve sexual safety.
    Laura - not her real name - is currently a paramedic for a different ambulance service.
    She describes sexual harassment as "incessant" in the profession. She says students and new recruits are routinely referred to as "fresh meat", subjected to sexual comments, questions and jokes - even in front of patients - and are continually sexualised by some male colleagues.
    "It's exhausting," she said. "You come to work wanting to help your patients but every day you're dealing with inappropriate behaviour and sexual comments."
    Read full story
    Source: Sky News, 8 February 2024
  19. Patient Safety Learning
    The number of patients waiting more than 12 hours in A&E hit a record in January of almost 180,000 people.
    Worsening pressures on A&E come as prime minister Rishi Sunak has officially missed his pledge, made in January last year, to cut the NHS waiting list.
    NHS England began publishing previously-hidden data on patients waiting 12 hours or more last year, after reports by The Independent.
    The latest figures for January show 178,000 people were waiting this long to be seen, treated or discharged after arriving from A&E – a record since February 2023 when the data was first published. In that month, 128,580 people waited more than 12 hours, and in December there were 156,000.
    The number waiting at least four hours from the decision to admit to actual admission has also risen, from 148,282 in December to 158,721 last month – the second-highest figure on record.
    Dr Tim Cooksley, past president of the Society for Acute Medicine, warned: “Degrading corridor care and prolonged waits causing significant harm is tragically and increasingly the expected state in urgent and emergency care.”
    Read full story
    Source: The Independent, 8 February 2024
  20. Patient Safety Learning
    Cancer waiting times for 2023 in England were the worst on record, a BBC News analysis has revealed.
    Only 64.1% of patients started treatment within 62 days of cancer being suspected, meaning nearly 100,000 waited longer than they should for life-saving care. The waits have worsened every year for the past 11.
    Macmillan Cancer Support chief executive Gemma Peters called the figures "shocking".
    "This marks a new low and highlights the desperate situation for people living with cancer," she said.
    "Behind the figures are real lives being turned upside down, with thousands of people waiting far too long to find out if they have cancer and to begin their treatment, causing additional anxiety at what is already a very difficult time.
    "With over three million people in the UK living with cancer and an ageing population, this is only set to rise."
    The records go back to 2010, shortly after the cancer target was introduced.
    However, improvements have been made over the course of 2023 in how quickly patients are diagnosed with 72% told whether they have cancer or not within 28 days of an urgent referral.
    Read full story
    Source: BBC News, 8 February 2024
  21. Patient Safety Learning
    A senior surgeon has raised concerns about the way whistleblowers are dealt with, claiming he was sacked after speaking out.
    Serryth Colbert told the BBC that following attempts to "stop wrongdoing", he was investigated by the trust at Bath's Royal United Hospital.
    As a result, he said he was dismissed for gross misconduct in October 2023.
    The RUH said it has "never dismissed anybody for raising concerns and never will".
    It added that Mr Colbert's dismissal related to "significant concerns about bullying" and its investigation into his conduct was "thorough" and "robust".
    Mr Colbert said he raised safety concerns without regard for the impact it might have on his career.
    "It was never a question in my mind. This is wrong. I'm stopping the wrongdoing. I stand for justice. I stand to protect patients," he said.
    The BBC has seen no evidence his most serious concern was ever investigated and Mr Colbert is now taking the RUH to an employment tribunal.
    Read full story
    Source: BBC News, 9 February 2024
  22. Patient Safety Learning
    Doctors have warned of the risks of “freebirthing” – where a woman gives birth without the help of a medic or midwife.
    Unassisted births, or “freebirths”, are thought to have been on the increase since the start of the Covid pandemic, when people may have been worried about attending hospitals and home births were suspended in many areas.
    The practice is not illegal and women have the right to decline any care during their pregnancy and delivery. Some women hire a doula to support them during birth.
    The Royal College of Obstetricians and Gynaecologists (RCOG) said women should be supported to have the birth they choose, but “safety is paramount” and families need to be aware of the risks of going it alone.
    The Nursing and Midwifery Council (NMC) said it is in the early stages of collaboration with the Chief Midwifery Officer’s teams, the Royal College of Midwives (RCM) and the Department of Health to better understand professional concerns about freebirthing and what organisations may need to do.
    Its statement on unassisted births supports women’s choice, but notes that “midwives are understandably concerned about women giving birth at home without assistance, as it brings with it increased risks to both the mother and baby”.
    It also states that women need to be informed that a midwife may not be available to be sent out to their home during labour if they change their mind and wish to have help.
    Read full story
    Source: The Independent, 8 February 2024
  23. Patient Safety Learning
    Harold Chugg spent much of early 2023 in a hospital bed because of worsening heart failure. During his most recent admission in June, the 75-year-old received several blood transfusions, which led to fluid accumulating in his lungs and tissues.
    Ordinarily, he would have remained in hospital for further days or weeks while the medical team got his fluid retention under control. But Harold was offered an alternative: admission to a virtual ward where he would be closely monitored in the comfort of his own home.
    Armed with a computer tablet, a Bluetooth-enabled blood pressure cuff and weighing scales, Harold returned to his farm near Chulmleigh in north Devon and logged his own symptoms and measurements daily, which were reviewed by a specialist nurse in another part of the county.
    Virtual wards provide hospital-level care in people’s homes through the use of apps, wearables and daily “virtual ward rounds” by medical staff, who review patient data and follow up with telephone calls or home visits where necessary.
    More than 10,000 such beds are already available across England and at least a further 15,000 are planned. Scotland, Wales and Northern Ireland are also funding their expansion.
    But while proponents claim patients in virtual wards recover at the same rate or faster than those treated in hospital, and that the wards’ provision can help cut waiting lists and costs, some worry that their rapid expansion could place additional strain on patients and caregivers while distracting from the need to invest in emergency care.
    “Virtual wards, if they deliver hospital-level processes of care, are just one part of the solution, not a panacea,” said Dr Tim Cooksley, a recent ex-president of the Society for Acute Medicine.
    Read full story
    Source: The Guardian, 7 February 2024
  24. Patient Safety Learning
    Campaigners have accused the UK government of betraying them after a review of redress for victims of health scandals excluded families who may have been affected by the hormone pregnancy test Primodos.
    A report published on Wednesday by the patient safety commissioner, Dr Henrietta Hughes, found a “clear case for redress” for thousands of women and children who suffered “avoidable harm” from the epilepsy treatment sodium valproate and from vaginal mesh implants.
    But despite the commissioner wanting to include families affected by hormone pregnancy tests in her review, the Department of Health and Social Care (DHSC) told her they would not be included.
    Primodos was an oral hormonal drug used between the 1950s and 70s for regulating menstrual cycles, and as a pregnancy test. Hormone pregnancy tests stopped being sold in the late 1970s and manufacturers have faced claims that such tests led to birth defects and miscarriages. Last year, the high court dismissed a case brought by more than 100 families to seek legal compensation owing to insufficient new evidence.
    The Hughes report states: “Our terms of reference did not include the issue of hormone pregnancy tests. This was a decision taken by DHSC and should not be interpreted as representing the views of the commissioner on the avoidable harm suffered in relation to hormone pregnancy tests or the action required to address this.
    “The patient safety commissioner wanted them included in the scope but, nevertheless, agreed to take on the work as defined by DHSC ministers.”
    Marie Lyon, the chair of the Association for Children Damaged by Hormone Pregnancy Tests, said the families of those who took the tests felt “left out in the cold” and betrayed that they were not included in the commissioner’s review.
    “I feel betrayed by the patient safety commissioner, by the IMMDS [Independent Medicines and Medical Devices Safety] review and by the secretary of state for health – all three have betrayed our families because, basically, they have just forgotten us. It’s a case of ‘it’s too difficult so we will just focus on valproate and mesh’,” Lyon said.
    Prof Carl Heneghan, a professor of evidence-based medicine at the University of Oxford, who led a systematic review of Primodos in 2018, said: “It’s unclear to me how the commissioner can keep patients safe if they are blocked and don’t have the power to go to areas where patient safety matters.”
    Read full story
    Source: The Guardian, 7 February 2024
  25. Patient Safety Learning
    Families of children left disabled by an epilepsy drug and women injured by pelvic mesh implants should be given urgent financial help, England's patient safety commissioner has said.
    Dr Henrietta Hughes has called on the government to act quickly to help victims of the two health scandals.
    It follows a review which found lives had been ruined because concerns about some treatments were not listened to.
    It is estimated that, since the early 1970s, about 20,000 babies have been born with disabilities after foetal exposure to sodium valproate, which can harm unborn babies if taken in pregnancy.
    Scientific papers from as early as the 1980s suggested valproate medicines were dangerous to developing babies, yet warnings about the potential effects were not added to some packaging until 2016.
    Some families affected have been campaigning for decades to raise awareness of the potential effects of the drug, with some calling for compensation and a public inquiry.
    Dr Hughes was asked by the government to look into a potential compensation scheme for those affected by that scandal, as well as the one involving some 10,000 women who were injured by their pelvic mesh implants - a treatment for pelvic organ prolapse (POP) and incontinence.
    Read full story
    Source: BBC News, 7 February 2024
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