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Patient Safety Learning

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  1. Event
    This National Virtual Summit focuses on the National NHS Complaint Standards published by the Parliamentary and Health Service Ombudsman. Through national updates, practical case studies and in depth expert sessions the conference aims to improve the effectiveness of complaints handling within your service, and ensure that complaints are welcomed and lead to change and improvements in patient care. The conference will also reflect on managing complaints regarding Covid-19 – understanding the standards of care by which the NHS should be judged in a pandemic and in particular responding to complaints regarding delayed treatment due to the pandemic. For further information and to book your place visit see https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/nhs-complaints-summit or email kate@hc-uk.org.uk. hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #NHSComplaints
  2. Content Article
    This download is the third of three chapters of a book which complements the Chartered Institute of Ergonomics and Human Factors' Healthcare Learning Pathway and is intended as a practical resource for students The book aims to provide well-founded, practical guidance to those responsible for leading and implementing human factors programmes and interventions in health and social care.
  3. News Article
    Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds. Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating. The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a new report It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions. Read full story Source: The Guardian, 17 February 2023
  4. Content Article
    A new in-depth report from the Charity Age UK, ‘Fixing the Foundations’, reveals how our under-funded and overstretched NHS and social care system is struggling and sometimes failing to cope with the needs of older people.  The report provides a first-hand account of older people’s difficulties in getting the good, joined up health and social care they need to manage at home, leaving them at risk of crisis which often results in being admitted to hospital. Yet the evidence is clear that with the right care at the right time many of these admissions could have been avoided. The report also includes perspectives from professionals and unpaid carers. It also shows how living with multiple long-term health conditions, as a significant proportion of older people do, including more than two-thirds of those aged over 85, makes it especially hard to navigate health services which are still usually organised around individual illnesses and diseases. Meanwhile social care was often inadequate or absent in these older people’s lives. Age UK estimates that astonishingly, over 1.6 million older people have some level of fundamental care and support need, such as help to get dressed, washed or getting out of bed, that is not being fully addressed.
  5. News Article
    Two health watchdogs have issued safety warnings after junior staff were left to work unsupervised on maternity wards previously criticised after a baby’s death. Training regulator, Health Education England (HEE), criticised the “unacceptable” behaviour of consultants who left junior doctors to work without any superiors at South Devon and Torbay Hospital Foundation Trust’s wards. The maternity safety watchdog Healthcare Safety Investigation Branch (HSIB) also raised “urgent concerns” over student midwives and “unregistered midwives” providing care without supervision. The latest criticism comes after the trust was condemned over the death of Arabella Sparkes, who lived just 17 days in May 2020 after she was starved of oxygen. According to a report from December 2022, seen by The Independent, the HEE was forced to review how trainees were working at the trust’s maternity department after concerns were raised to the regulator. It was the second visit carried out following concerns about the department, and reviewers found there had been “slow progress” against concerns raised a year earlier. Read full story Source: The Independent, 16 February 2023
  6. News Article
    Nurses will walk out of emergency departments, intensive care units and cancer care services for the first time in the next wave of strike action. The Royal College of Nursing (RCN) has announced its members will strike for 48 hours, from 6am on 1 March until 6am on 3 March and that a range of derogations will be removed, including emergency care cover. More than 120 NHS organisations — covering all types of providers, integrated care systems and national organisations (see map below) — will be affected by the RCN’s walkout next month as it represents the most significant escalation of strike action yet by nurses. Previously, quite extensive exemptions (known as “derogations”) have been agreed, but the RCN has this time indicated they will be much more limited. HSJ asked the RCN what services will remain subject to national derogations, but a spokesman said discussions are continuing at a national level as part of a commitment to “life and limb care”. He added services will be reduced to an “absolute minimum” and hospitals will be asked to rely on members of other unions and clinical professions instead. Read full story (paywalled) Source: HSJ, 16 February 2023
  7. News Article
    A training programme is providing people with the skills to care for loved ones suffering from serious conditions at home in their final days. Sarah Bow's partner Gary White, from Somerset, was 55 when he was diagnosed with motor neurone disease in 2021. A team from NHS Somerset provided personalised training to Ms Bow which allowed the couple to spend the final 13 months of his life together at home. The Somerset NHS Foundation Trust social care training team made visits to the couple's home as Mr White's condition progressed, to provide advice and guidance to Ms Bow. The service was set up in November 2021 to provide free NHS standardised training and competency assessments in clinical skills to people involved in social care. Ms Bow said the scheme had helped them spend more time together doing the things Mr White enjoyed. "Being able to care for him meant we could have so many precious moments before he died," she said. The training in a variety of skills including like catheters and injections, aims to reduce hospital admissions and improve patient discharge times. Read full story Source: BBC News, 17 February 2023
  8. News Article
    Hospitals in England have recorded more than 450 sewage leaks in the last 12 months, data shows, putting patients and staff in danger and prompting warnings that the NHS estate is “falling apart” after a decade of underinvestment. Freedom of information requests to NHS trusts by the Liberal Democrats found alarming examples of sewage leaking on to cancer wards, maternity units and A&E departments. The investigation also uncovered multiple cases of urine and faeces flowing into hospital rooms and on to general wards. Health officials called the revelations shocking. In some instances, sewage leaks made entire hospital departments unsafe for patients and led to staff struggling to work because they felt nauseous and had headaches. Ed Davey, the Liberal Democrat leader, said: “This is a national scandal. Our country’s hospitals are falling apart after years of underinvestment and neglect. Patients should not be treated in these conditions and heroic nurses should not have the indignity of mopping up foul sewage.” “At every turn, our treasured NHS is crumbling, from hospital buildings to dangerous ambulance wait times. The government needs to find urgent funds to fix hospitals overflowing with sewage. Patient and staff safety is a risk if ministers fail to act,” he said. Read full story Source: The Guardian, 17 February 2023
  9. Content Article
    System working (which includes health and care) is the only way the NHS can address the interlinked problems of struggling primary care, elective backlog, ambulance and emergency department overload, and delayed discharge. In this HSJ article, Len Richards explains how system working grows from the right culture, clinical leadership and systemwide joined up, real-time data.
  10. Content Article
    Dr Nabarro’s recent comment made on Independent Sage 2 December, that Covid-19 is primarily a droplet-borne infection, flies in the face of overwhelming international scientific consensus that the pandemic is driven by airborne transmission of the SARS-CoV-2 virus. Despite airborne transmission being accepted as the dominant mode of spread in almost every other arena, within official infection prevention and control (IPC) bodies in the World Health Organization (WHO) and many national authorities including the UK, there is denial or minimising of airborne spread, and continuing adherence to the droplet theory of transmission. This has meant rejection of airborne mitigations within healthcare, with profound consequences for the lives and health of healthcare workers, as well as for patients in hospitals and care homes. It is now clear that the IPC authorities will not be persuaded, no matter how much evidence is presented to them that SARS-CoV-2 is primarily airborne, and that efforts by aerosol scientists, engineers and health experts to provide further evidence of this, are futile.  This statement from Doctors in Unite explores these issues in detail, and highlights the disastrous record of droplet-only precautions in our hospitals and care homes. It also asks why the critically important “precautionary principle” was not applied throughout healthcare from the outset, to keep workers and patients safe, while the mode of transmission of the virus was being fully elucidated, despite this being official WHO policy. 
  11. News Article
    Workforce problems in US hospitals are troublesome enough for the American College of Healthcare Executives to devote a new category to them in its annual survey on hospital CEOs' concerns. In the latest survey, executives identified "workforce challenges" as the number one concern for the second year in a row. Although workforce challenges were not seen as the most pressing concern for 16 years, they rocketed to the top quickly and rather universally for US healthcare organisations in the past two years. Most CEOs (90%) ranked shortages of registered nurses as the most pressing within the category of workforce challenges, followed by shortages of technicians (83%) and burnout among non-physician staff (80%). Read full story Source: Becker Hospital Review, 13 February 2023
  12. News Article
    Thousands of severely disabled children's lives are at risk because of long waits for ambulances, doctors and other experts have warned. Emergency care is a vital part of their everyday lives, the British Academy of Childhood Disability says. Almost 100,000 children have life-limiting conditions or need regular ventilator support in the UK. They often rely on ambulances as part of their healthcare plan, because their condition can become life-threatening in an instant. Dr Toni Wolff, who chairs the British Academy of Childhood Disability, told BBC News some families with severely disabled children had "what are essentially high-dependency units" of medical equipment at home. "As part of their healthcare plan, we would normally say, 'If the child starts to deteriorate, call for an ambulance and it will be there within 10 or 20 minutes,'" she said. "Now, we can't give that reassurance." Despite their child being classed as a priority, parents have told BBC News they face the difficult decision to wait for an ambulance or take them, often in a life-threatening condition, to hospital themselves - a risk because of the huge amounts of equipment needed to keep them alive, Read full story Source: BBC News, 16 February 2023
  13. News Article
    Most health claims on formula milk products have little or no supporting evidence, researchers have said, prompting calls for stricter marketing rules to be introduced worldwide. Millions of parents use formula milk in what has become a multibillion-dollar global industry. But a study published in the BMJ has found most health and nutritional claims about the products appear to be backed by little or no high-quality scientific evidence. “The wide range of health and nutrition claims made by infant formula products are often not backed by scientific references,” said Dr Ka Yan Cheung and Loukia Petrou, the joint first co-authors of the study. “When they are, the evidence is often weak and biased.” Dr Daniel Munblit and Dr Robert Boyle, senior co-authors for the study, added: “There is a clear need for greater regulation and oversight to ensure that these claims are supported by sound scientific evidence and to protect the health and wellbeing of our youngest and most vulnerable populations.” Read full story Source: The Guardian, 15 February 2023
  14. Content Article
    The only NHS service in England to offer gender identity services to children announced it would be closing down last year - after years of whistleblowers who worked there trying to raise the alarm about a scandal in their midst: a failure to safeguard some of the country's most vulnerable young adults. What went wrong? And how much did the toxic political climate at the time over trans issues contribute to a work practice that was not fit for purpose. Investigative reporter Hannah Barnes reflects her years spent talking to those involved - the staff, the families and most importantly, the children themselves.
  15. Content Article
    NHS England recently published its Delivery Plan for Recovering Urgent and Emergency Care Services, with goals and actions for the next two years. David Oliver, consultant in geriatrics and acute general medicine, gives his opinion on the plan.
  16. Event
    Understanding human factors will allow surgical teams to enhance performance, culture and organisation of operating theatres. This one day masterclass will concentrate on human factors within the operating room. This is aimed at all theatre staff. It will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This Masterclass will focus on systems to improve patient safety as well as looking at never events and how to learn from them using a human factors approach. Key learning objectives: Safety culture Human factors Leadership Never events This masterclass is aimed at all theatre staff. Register hub members receive 20% discount using code hcuk20kh.
  17. Event
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    Switzerland will host the 5th Global Ministerial Summit and is committed to address the key challenges of ensuring sustainable implementation, according to the slogan "Less harm better care – from resolution to implementation". The Summit in Montreux will bring together ministers, high-level representatives and experts from all over the world, thus reviving the strong momentum created by the previous Summits. It will mark another milestone in the joint endeavour, the global strengthening of Patient Safety. Further information For those interested in the event but not able to be present in person, some of the sessions will be broadcast live and you can follow the event online at: Online Participation – Global Ministerial Patient Safety Summit 2023
  18. News Article
    A government review into mental health hospitals will fail to prevent the “appalling” treatment of patients, campaigners have warned. The urgent inquiry into inpatient mental health services will focus solely on data, the government said on Tuesday. The “rapid review”, launched following investigations by The Independent into “systemic abuse” across a group of children’s mental health hospitals, will last 12 weeks and is being led by a former national NHS mental health director Dr Geraldine Strathdee. In an outline of what it will cover, the Department for Health and Social Care said it would look at what data is collected by the NHS on inpatient mental health services and whether it is used effectively to identify patient safety problems. It will also look at the quality of data and identify good examples of care but it won’t look at individual cases of abuse or community services. Major mental health charity Mind has warned the review “is not enough” and will not provide any learnings on how to prevent poor care. The charity is instead calling for a national statutory public inquiry into inpatient mental health services. Read full story Source: The Independent, 15 February 2023
  19. News Article
    "It would be much better if I was out there than in here," said Roger. The 69-year-old looked wistfully across Newport from the window next to his bed at the Royal Gwent Hospital in Wales. He has been here for three weeks after being admitted with an infection and although he is now well enough to leave, and desperate to do so, he can't. Roger has cerebral palsy and the impact of his recent illness means he needs extra care to be arranged before he can safely go home. Roger is not alone. "At least a quarter of patients in our care of the elderly beds are in a similar position," explained Helen Price, a senior nurse at the hospital. "It is very much a waiting game for that care to be available," she said. Hospitals in Wales are fuller than ever, according to the latest statistics. In the final week of January more than 95% of all acute beds in the Welsh NHS were occupied, which is the highest figure ever recorded. Paul Underwood, who manages urgent care in Aneurin Bevan University Health Board, said there are well over 350 patients medically fit enough to leave hospital. "Roughly a third of patients do not need to be accommodated on those sites and that's extremely difficult," he said. Read full story Source: BBC News, 16 February 2023
  20. News Article
    The number of overheating incidents in clinical areas reported by NHS trusts has almost doubled over the last five years, with directors saying ageing estates make them vulnerable to extreme weather events. Providers reported that temperatures went above 26°C – the threshold for a risk assessment – more than 5,500 times in 2021-22, according to official data. Overheating looks set to become an increasingly significant issue for NHS estates, HSJ was told, as climate change makes extreme weather events more frequent and more intense. Janet Smith, head of sustainability at Royal Wolverhampton and Walsall Healthcare Trusts, said: “We’re feeling it now. And it’s not going to change unless we do something about it. We need a climate resilient estate to actually deliver sustainable care.” An overheating incident is when the temperature surpasses 26°C in an occupied ward or clinical space in a day, with each area counting as a separate incident. When this happens, trusts should carry out a risk assessment and take action to ensure the safety of vulnerable patients. Read full story (paywalled) Source: HSJ, 16 February 2023
  21. News Article
    Rising numbers of patients in England are failing to collect their medicines or asking pharmacists which ones they can “do without” because they cannot afford prescription charges, a survey shows. NHS prescriptions are free in Scotland, Wales and Northern Ireland. In England there are exemptions for certain items, medical conditions and specific parts of the population, but most adults have to pay. The current prescription charge is £9.35 an item. “We are deeply concerned that people are having to make choices about their health based on their ability to pay,” said Thorrun Govind, a pharmacist and chair of English pharmacy board of the Royal Pharmaceutical Society (RPS), which conducted the survey. “No one should have to make choices about rationing their medicines and no one should be faced with a financial barrier to getting the medicines they need.” The findings, from a survey of 269 pharmacies, prompted the RPS to renew its call for patients with long-term conditions in England to get free prescriptions. Charges create a financial barrier to accessing medicines needed to stay well, it said. Read full story Source: The Guardian, 13 February 2023
  22. News Article
    A new way of screening ambulance calls is to be introduced across England in an effort to improve response times. NHS England is asking ambulance crews to review which emergency calls other than those classed as immediately life threatening can be treated elsewhere. The calls - known as category two - include emergencies such as heart attacks and strokes. But the category also covers some that may not need such a fast response, such as burns and severe headaches. About 40% of these lower priority calls classed as category two by call handlers will now receive callbacks from a doctor, nurse or paramedic to see whether there is an alternative to sending an ambulance. In trials in London and across the West Midlands, nearly half of those receiving a callback were advised to go instead to an urgent treatment clinic, their GP or a pharmacist. NHS England is now asking the other eight ambulance services in England to adopt the approach. Read full story Source: BBC News, 16 February 2023
  23. News Article
    The NHS has signed a £20m deal to enable health-service organisations to deploy technology to help better manage the spread of infections. The contract – awarded to US-based healthcare giant Baxter – is intended to offer NHS trusts a means through which they can buy a comprehensive infection-control platform. According to newly published commercial information such a system would, in many cases, replace various specialist software programmes used by NHS trusts to collect and process data, alongside spreadsheets and paper documents. “The system will support infection prevention and control activities to identify critical issues, proactively respond to improve the quality of care and streamline processes to reduce time spent on administrative and reporting tasks,” the contract notice said. “Most NHS Trusts tend to manage infection control surveillance through the use of various systems, collating laboratory, patient and surgery data and manually searching through the data to identify patients of interest or complex scenarios. Paper and excel spreadsheets are also used to record and manage surveillance. This process is time consuming and risk of error. NHS trusts are finding that they do not have a robust infection control system to monitor and manage their patients.” Read full story Source: Public Technology, 15 February 2023
  24. Content Article
    Urinary tract infections (UTIs) exert a significant health and economic cost globally. Approximately one in four people with a previous history of UTI continue to develop recurrent or chronic infections. This review aims to present a novel perspective on chronic UTI by linking microbiology with immunology, which are commonly divergent in this field of research. It also describes the challenges in understanding chronic UTI pathogenesis and the human bladder immune response, largely conjectured from murine studies. Lastly, it outlines the shortcomings of current diagnostic methods in identifying individuals with chronic UTI and consequently treating them, potentially aggravating their disease due to mismanagement of prior episodes. This discourse highlights the need to consider these knowledge gaps and encourages more relevant studies of UTI in humans.
  25. News Article
    About 2 million people die a year as a result of a core group of fungi, and the WHO is concerned we are unprepared for the future. In October, the World Health Organization released its fungal priority pathogens list, the first global effort to create a mycological “most wanted” list of the 19 fungi most dangerous to humans . “Despite posing a growing threat to human health, fungal infections receive very little attention and resources globally,” the report said. “This all makes it impossible to estimate the exact burden of fungal infections, and consequently difficult to galvanise policy and programmatic action.” Fungi are the most populous life form on the planet, with an estimated 12 million species existing worldwide. Only a fraction of these species infect humans, but they are responsible for roughly a billion infections each year. “Most of those are superficial things like athlete’s foot, that no one’s particularly bothered about, but there is a core group that causes life-threatening infections, and particularly in susceptible populations such as the very old or young, and those with immune systems that don’t work properly,” says Mark Ramsdale, an associate professor of mycology at the MRC Centre for Medical Mycology in Exeter. About 1.5 million people die a year as a result of these infections, says Ramsdale – although that may be an underestimation, because fungi predominantly infect people who already have major health problems. “The primary cause of death will probably be leukaemia or heart transplant, or whatever,” he says. “But the thing that actually kills the patient is a fungal infection, so there is a strong element of underreporting going on.” Underestimating them would be a mistake. Read full story Source: The Guardian, 10 February 2023
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