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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    The government has failed to meet most of its own deadlines for commitments to improve how the NHS uses data, including developing a cybersecurity strategy, HSJ can reveal. The delays include work to store and analyse patient data more securely, building public trust in the NHS’ use of patient data, and agreeing national strategies on cybersecurity and cloud technology. The strategy and its commitments were published following the Goldacre Review, which called for an overhaul of how NHS patient data is collected, stored and used. It came after the government was forced to indefinitely halt a controversial plan to collect all GP-held patient data in 2021, which resembled the fate of a similar data scheme in 2016. Several data projects have also come under scrutiny from doctors and campaigners in recent years, such as NHS England’s procurement of a new Federated Data Platform and a much-criticised trust’s data-sharing scheme with a credit rating company. Read full story (paywalled) Source: HSJ, 28 February 2023
  2. News Article
    Over half of men with an eating disorder have never had any treatment, according to new research. Despite typically being linked with females, males account for a quarter of all eating disorder cases – and many are not getting any support, the eating disorder charity Beat is highlighting “Eating disorders affect 1.25 million people in the UK, and we estimate one in four of those are men,” says Tom Quinn, Beat’s director of external affairs – speaking to mark this year’s Eating Disorders Awareness Week (February 27 – March 5). “We surveyed men across the UK about their experiences of an eating disorder and, alarmingly, we discovered over half have never had treatment for their eating disorder, and one in three have never tried to get treatment in the first place. “There’s a harmful misconception that eating disorders are female illnesses, which creates a great deal of shame and can entrench harmful behaviours for men who are unwell,” Quinn adds. Read full story Source: The Independent, 27 February 2023 Further reading on the hub: Top picks: Eight resources on eating disorders
  3. News Article
    The state of clinical trials in the NHS is “much worse than it has been in years” with patients losing access to cutting-edge cancer and dementia treatments, one of the UK’s most senior clinicians has warned. Sir John Bell, the regius professor of medicine at the University of Oxford and a government life sciences adviser, said the UK’s approach needed “a full overhaul, top to bottom” to prevent a collapse in the number of clinical trials being conducted in the NHS. “I don’t think there’s any doubt that companies are choosing not to evaluate their drugs in the UK,” he said. “The risks [to patients] are much bigger than have been alluded to.” The intervention comes after the government launched an independent review led by the former health minister James O’Shaughnessy into why the NHS had seen a 44% drop in participants recruited to commercial clinical trials in the past five years. The UK is rapidly losing ground to countries such as Spain, Poland and Australia, falling from fourth to 10th internationally for phase III trials. Reduced access to trials is particularly concerning for patients with limited routine treatment options, such as the roughly 3.5 million people living with rare diseases and patients with dementia and advanced cancer. Read full story Source: The Guardian, 27 February 2023
  4. Content Article
    In light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
  5. News Article
    Race should be made a central part of the UK's independent public inquiry into the pandemic, campaigners say. A letter seen by BBC News, sent to the chairwoman of the Covid-19 inquiry, calls for it to look at "racism as a key issue" at every stage. Ethnic minorities were significantly more likely to die with Covid-19, according to official figures. An inquiry spokesperson said the unequal impacts of the pandemic would be at the forefront of its work. People from ethnic minority backgrounds who lost loved-ones during the pandemic also told BBC News they felt "sidelined" by the process so far. The letter to Baroness Hallett, who is chairing the inquiry, has been co-ordinated by the group Covid-19 Bereaved Families for Justice and race equality think tank Runnymede. It calls for ethnic minority communities to be "placed firmly at the centre" of the inquiry. Read full story Source: BBC News, 28 February 2023
  6. News Article
    Mental health trusts are exploring wider use of CCTV to review incidents of seclusion or restraint in response to high-profile abuse scandals, HSJ has learned. All providers of mental health, learning disability and autism services were ordered to review safety and asked to feed back to NHS England’s national team. The request was made in a letter from national director Claire Murdoch sent in response to abuse allegations aired by BBC Panorama and Channel 4’s Dispatches. The review is taking place alongside NHSE’s launch of a £36m three-year quality programme. This aims to identify providers and systems needing support, commission a culture and leadership development programme for all trusts, and produce a new model for safe inpatient care. Results of trust-level reviews, seen by HSJ, show at least five providers aim to use CCTV more “pro-actively”, as a tool for boosting safety. Read full story (paywalled) Source: HSJ, 27 February 2023
  7. News Article
    One patient is dying every 23 minutes in England after they endured a long delay in an A&E unit, according to analysis of NHS figures by emergency care doctors. In all, 23,003 people died during 2022 after spending at least 12 hours in an A&E waiting for care or to be admitted to a bed, according to the Royal College of Emergency Medicine (RCEM). That equates to roughly 1 every 23 minutes, 63 every day, 442 a week or 1,917 each month. The college said its findings, while “shocking”, were also “unsurprising” and reflected the fact that emergency departments are often overwhelmed and unable to find patients a bed in the hospital. Rosie Cooper, the Liberal Democrats’ health spokesperson, said “patients are now dying in their droves” due to successive Conservative governments neglecting the NHS, and added that the lives lost due to A&E snarl-ups constituted a “national disaster”. “Long waiting times are associated with serious patient harm and patient deaths,” said Dr Adrian Boyle, RCEM’s president. “The scale shown here is deeply distressing.” Read full story Source: The Guardian, 28 February 2023
  8. News Article
    A criticised maternity service needs 37 more midwives, about a fifth of its total midwifery workforce. The Care Quality Commission has said Northampton General Hospital did not always have enough qualified and experienced staff to keep women safe from avoidable harm. Figures obtained by the BBC show that 49 serious incidents have occurred in its maternity services in four years. The hospital said it had undertaken "a lot of work" in the past 18 months and a recruitment process was under way. According to a Freedom of Information Act response, between November 2018 and November 2022, the hospital had 278 serious incidents, with the highest level coming across maternity services, including gynaecology and obstetrics. There are currently 37 vacancies for midwives but the trust said it manages staffing levels "closely and ensure that all shifts are covered by bank or midwives working altered shift patterns, to ensure that we are able to provide a safe maternity experience". Read full story Source: BBC News, 27 February 2023
  9. News Article
    Urgent action is needed to prevent people dying from eating disorders, the parliamentary and health service ombudsman for England has warned, as he said those affected are being “repeatedly failed”. The NHS needs a “complete culture change” in how it approaches the condition, while ministers must make it a “key priority”, according to Rob Behrens. Little progress has been made since the publication of a devastating report by his office in 2017, which highlighted “serious failings” in eating disorder services, he said. Lives continue to be lost because of “the lack of parity between child and adult services”, and “poor coordination” between NHS staff involved in treating patients. There remain issues with the training of medical professionals, Behrens added. “We raised concerns six years ago in our ignoring the alarms report, so it’s extremely disappointing to see the same issues still occurring,” he said. “Small steps in improvements have been taken, but progress has been slow, and we need to see a much bigger shift in the way eating disorder services are delivered." Read full story Source: The Guardian, 27 February 2023
  10. News Article
    Ministers have spent only £15m in five years on research into tackling brain tumours, the biggest killer of adults and children under 40, while boasting about delivering £40m, MPs have found. The revelation emerged in a damning report seen by the Guardian that is due to be published this week by the all-party parliamentary group (APPG) on brain tumours after a two-year inquiry. The research system is “unfit for purpose”, patients are being denied access to clinical trials, and families have been let down by promises of “millions of pounds of investment which hasn’t materialised”, the report says. The APPG report also highlights a “valley of death” in which potential new treatments developed in the laboratory “fail to reach patients” because of unnecessary red tape. Some children are being denied access to clinical trials, and the national brain tumour research database is “not reliable”. Read full story Source: The Guardian, 27 February 2023
  11. Content Article
    Dr Henrietta Hughes, Patient Safety Commissioner for England, sheds light on the disconnect between the executive corridor and what patients experience.
  12. News Article
    The adoption of AI tools to simplify processes and workflows is slowly occurring across all industries, including healthcare — though patients largely disagree with clinicians using those tools when providing care, the Pew Research Center survey found. The potential for AI tools to diminish personal connections between patients and providers is a key concern, according to the survey, which included responses from over 11,000 adults in the USA collected in December. Patients also fear their health records could become less secure. Respondents, however, acknowledged potential benefits, including that AI could reduce the number of mistakes providers make. They also expressed optimism about AI’s potential impact on racial and ethnic biases in healthcare settings, even as the technology has been criticised for exacerbating those issues. Among respondents who believe racial biases are an issue in healthcare, about half said they think the tools would reduce the problem, while 15% said it would make it worse and about 30% said it would stay the same. Read full story Source: Healthcare Dive, 23 February 2023
  13. Content Article
    The new NHS recovery plan accepts that data on long delays in emergency departments must be published monthly to help improve patient care and hold systems to account, writes Katherine Henderson in this BMJ opinion piece.
  14. Content Article
    Patient safety continues to be a significant issue in healthcare and a focus of both quality improvement and academic research. The NHS published its first Patient Safety Strategy in July 2019. As part of this, it was agreed that the first NHS-wide Patient Safety Syllabus would support a transformation in patient safety education and training in the NHS. The Patient Safety Strategy includes ambitions to develop training in the fundamentals of patient safety that would be relevant to all NHS staff, clinical and non-clinical, as well as more detailed training and education that could be incorporated into clinical and non-clinical undergraduate and postgraduate healthcare education and continuing professional development. T The syllabus is designed for all NHS staff and is structured to provide both a technical understanding of safety in complex systems and a suite of tools and approaches that will: Build safety for patients. Reduce the risks created by systems and practices. Develop a genuine culture of patient safety. The patient safety syllabus comprises five sequential domains of safety and forms the basis of the detailed curriculum guidance designed for specific levels of the NHS.
  15. News Article
    British health officials are preparing plans to deploy lateral flow tests if signs emerge that avian flu has begun to spread from one person to another. The programme would provide rapid information about the dangers posed by the disease. The UK Health Security Agency (UKHSA) is also working on blood tests to detect antibodies against the virus and officials will analyse the disease’s genetic mutations to reveal data about the increased risk to human health from avian flu. The moves follow last week’s news that an 11-year-old girl in Cambodia has died from H5N1, the flu strain that is being spread around the globe by migrating birds and is infecting poultry farms. At present, evidence suggests the H5N1 virus does not pass easily to people although scientists have urged care and caution. “The risk to humans is still very low, but it’s important that we continue to monitor circulation of flu in both bird and mammal populations", said Prof Jonathan Ball, of Nottingham University. Read full story Source: The Guardian, 26 February 2023
  16. News Article
    When Amy Fantis gave birth to her first child two years ago, the labour was rapid, lasting only about four hours, and she was reliant on gas and air. Her second baby is due in just a few days — but the hospital has, like others around Britain, imposed a ban on the popular form of pain relief. Fantis, 36, from Broxbourne, Hertfordshire, is one of many women affected by the decision of several NHS trusts to suspend the use of the gas because of fears that midwives and doctors have been exposed to unsafe levels for prolonged periods. In some hospitals, levels of the nitrous oxide and oxygen mix are more than 50 times higher than the safe workplace exposure limits. In a survey of more than 16,600 women who gave birth last year, the Care Quality Commission found that 76% of respondents used gas and air at some point during labour. Although short-term use of the gas in childbirth is harmless to women and their babies, long-term exposure for midwives and doctors can affect the body’s ability to absorb vitamin B12, damaging nerves and red blood cells and causing anaemia. It is not believed that any NHS staff have become ill as a result of long-term exposure to gas and air. NHS England and the Health and Safety Executive recently warned other hospitals that they need to check the ventilation on maternity wards and ensure staff are kept safe. NHS England is planning to send out new guidance to trusts on the issue after a series of hospitals had to stop using the gas. Read full story (paywalled) Source: The Times, 25 February 2023
  17. News Article
    NHS waiting times, staff shortages and service backlogs have been flagged as concerns in relation to dozens of patient deaths across England and Wales since the start of last year, the Observer can reveal, with coroners facing a succession of inquests concerning ambulance delays. Coroners issue prevention of future deaths reports (PFDs) when they believe preventive action should be taken, and send them to relevant individuals or organisations, which are expected to respond. Among 55 cases identified by the Observer are 24 patient deaths where coroners raised concerns about ambulance delays – all of them occurring before this winter’s ambulance crisis, when response times rocketed to their worst-ever levels. Wes Streeting, shadow health and social care secretary, said: “The NHS is in the biggest crisis in its history – and the crisis has a cost in lives. Patients are waiting for far longer than is safe, with terrible consequences.” But the issues highlighted by coroners in relation to patient deaths are wider than ambulance delays. They include: lengthy elective surgery backlogs; high referral thresholds and long waiting times for children’s mental health services; a national shortage of neurologists; long waiting times for psychological therapies; a lack of mental health beds and unfilled mental health staff vacancies; and a shortage of cardiologists compounded by a shortage of theatre capacity and beds. Read full story Source: The Guardian, 26 February 2023 Further reading on the hub - see a selection of Prevention of Future Deaths reports in our dedicated coroner's report section of the hub.
  18. News Article
    Women are being misled and manipulated about abortion by some crisis pregnancy advice centres in the UK, according to evidence from a BBC Panorama investigation. The centres operate outside the NHS and tend to be registered charities. Most say they don't refer women for abortions, but offer support and counselling for unplanned pregnancies. But the BBC's investigation reveals more than a third of these services give misleading medical information or unethical advice, and sometimes both. Pregnancy counselling is available through the NHS and regulated abortion providers, but searching online, Panorama identified 57 crisis pregnancy advice centres advertising. The BBC decided to investigate after hearing from women who had been to these centres. One said she had been "traumatised" and that the centre had tried to "manipulate" her into not having an abortion. Some 21 centres gave misleading medical information and/or unethical advice about abortion Seven centres said having a termination could lead to "post-abortion syndrome" - a mental health condition likened to post traumatic stress disorder, which is not recognised by the NHS. Eight centres linked abortion to infertility and problems carrying future pregnancies to term. Five centres linked abortion to an increased risk of breast cancer. Leading medic in the field of obstetrics, and director of an abortion provider, Dr Jonathan Lord, said women needed an "informed choice" which required "good quality unbiased information". Read full story Source: BBC News, 27 February 2023
  19. News Article
    The health safety watchdog has said that doctors, ambulance dispatchers and other NHS staff in England have faced "significant distress" and harm over the past year as a result of long delays in urgent and emergency care. The Healthcare Safety Investigation Branch (HSIB), which monitors safety in the health service in England, said many staff it interviewed for a national investigation "cried or displayed other extreme emotions" when asked about their working environment. "The bad sides [of my job] give me nightmares, flashbacks and fear, but they can also make me hyperactive, sleepless and sometimes not care about the danger I put myself in," one paramedic told the BBC. Sarah, not her real name, has worked in the ambulance service for more than a decade, but describes the last 12 months as the most difficult she can remember. "Over the winter I have witnessed and helped with cardiac arrests in the corridors of hospitals and in the back of ambulances," she said. "I spent four hours with an end-of-life patient. There was no hospice or district nurse available, so I had to make the choice to give them meds for a peaceful, expected death and prepare the family. "I felt ashamed that I could not stay till the end, but I had to move on to the next job as I had done all I could." The HSIB found NHS staff were reporting increased levels of stress, worry and exhaustion because they were not always able to help the sickest patients. HSIB has now urged trusts to do more to protect workers’ mental health, saying there is an “intrinsic link” between patient safety and staff wellbeing. Read full story Source: BBC News, 27 February 2023
  20. Content Article
    The Healthcare Safety Investigation Branch (HSIB) have published a third interim report for this investigation which focuses on staff wellbeing across the urgent and emergency care systems and the impact that this has on patient safety.
  21. News Article
    A mental health trust is to be prosecuted after three patients died in its care. The Care Quality Commission (CQC) is bringing charges against the Tees, Esk and Wear Valleys (TEWV) NHS Trust. It is thought they relate to the deaths of Christie Harnett, 17, Emily Moore, 18, and a third person. The trust is said to have failed "to provide safe care and treatment" which exposed patients to "significant risk of avoidable harm". Both Christie Harnett and Emily Moore had complex mental health issues and took their own lives. The CQC said the trust "breached" the Health and Social Care Act, which relates to healthcare providers' responsibility to "ensure people receive safe care and treatment". In response, a spokesperson for the trust said: "We have fully cooperated with the Care Quality Commission's investigation and continue to work closely with them. "We remain focused on delivering safe and kind care to our patients and have made significant progress in the last couple of years." Read full story Source: BBC News, 25 February 2023
  22. Content Article
    Stephanie Longe first arrived in the UK from Switzerland in 2019 to work at the High Consequence Emerging Viruses Group at what is now the UK Health Security Agency. At the time, her project was focused on Ebola virus disease survivors. But Covid quickly changed plans. Stephanie and her colleagues had to use their skills to develop Covid treatments and new antivirals. Stephanie was involved in early research to study the Sars-CoV-2 infection, and test vaccine candidates. Then in June 2022, Stephanie had Covid and she is now one of the 2 million people who experience self-reported Long Covid symptoms in the UK.  She shares her experience of Long Covid and the research she is doing in this Guardian article.
  23. News Article
    Experts are assessing a very rare but potentially serious brain side effect of nasal decongestants bought on the High Street. Ones containing pseudoephedrine are being reviewed because they may cause vessels supplying the brain to contract or spasm, reducing blood flow. The concern is this could lead to seizures and even a stroke. However, drug regulators stress the likelihood of this happening is extremely low. The UK-wide review for pseudoephedrine was initiated after regulators in France alerted European drugs regulator the EMA, which is also conducting a review, about some recent, rare cases. Experts say anyone with concerns about medication should speak to a doctor or pharmacist. Read full story Source: BBC News, 23 February 2023
  24. News Article
    Only half the recommended number of medical staff were on duty at the O2 Brixton Academy on the night of a crush at the south-west London venue. Industry guidelines suggest there should have been medical cover of at least 10 people, including a paramedic and a nurse, but no paramedics or nurses were present. Rebecca Ikumelo, 33, and security guard Gaby Hutchinson, 23, died in hospital following the crowd surge on 15 December 2022 at the concert. The medical provider, Collingwood Services Ltd, said it was "fully confident" its team had "responded speedily, efficiently and with best practice". Two whistleblowers who regularly work for Collingwood Services Ltd at Brixton told BBC Radio 4's File on 4 programme that medical cover at the south London gig had been "inadequate". Neither of them was there when the crush happened, but one said he had spoken to colleagues who were. "[They] had two student paramedics, so they're basically unqualified," said one whistleblower. "They have to be supervised by a paramedic, not by anybody of a lower grade. They didn't have appropriate supervision." Read full story Source: BBC News, 23 February 2023
  25. Content Article
    Jill White is the practice manager of the Nightingale Practice and has been using Care Opinion since 2018. The Nightingale Practice signed up as part of the City & Hackney GP Confederation pilot of implementing Care Opinion online feedback as a way of gathering feedback from our patients instead of using paper-based surveys.
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