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Patient Safety Learning

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  1. Patient Safety Learning
    New digital prescriptions mean NHS App users in England can now collect medication from a pharmacy without having to visit a GP or health centre.
    The usual paper slip given by doctors has been replaced by an in-app barcode, which can be scanned at any pharmacy.
    Users can already request repeat prescriptions on the app - and every digital order fulfilled will save the GP three minutes, NHS Digital says.
    It comes after a trial last year, involving more than a million users.
    Patients can use the app to check what medicines they have been prescribed, and when.
    Anyone who has a nominated pharmacy can continue to collect medication without a paper prescription or barcode, as the details are sent to their pharmacy electronically.
    Read full story
    Source: BBC News, 30 January 2024
  2. Patient Safety Learning
    Physician associates have attempted to illegally prescribe drugs at dozens of NHS trusts and missed life-threatening diagnoses, a dossier claims. 
    Doctors working across the country claim patients’ lives have been put at risk by physician associates (PAs) who they say have failed to respond appropriately to medical emergencies – alleging more than 70 instances of patient harm and “near misses”.
    The Telegraph has seen responses from more than 600 doctors to a survey on PAs run by Doctors’ Association UK (DAUK), a campaign group.
    The data suggest that at over half of England’s hospital trusts, doctors are being replaced by PAs on the rota, despite associates only completing a two-year postgraduate course and having no legal right to prescribe.
    A spokesperson from the Department of Health said their role “is to support doctors, not replace them”.
    The Telegraph has interviewed more than a dozen surveyed doctors, as well as other clinicians worried about patient safety.
    At Dudley Group NHS Trust, one junior doctor said a PA had missed an “obvious heart attack” on an ECG, having “just signed it as if it was normal”.
    A clinician in primary care alleged PAs repeatedly misdiagnosed a patient’s metastatic cancer as muscle ache – despite blood results that were “tantamount” to a cancer diagnosis.
    They said: “The patient could have been saved eight months of pain; their life could have been prolonged.”
    Read full story (paywalled)
    Source: The Telegraph, 27 January 2024
  3. Patient Safety Learning
    Serious concerns about maternity services at an NHS trust have been revealed by BBC Panorama.
    Midwives say a poor culture and staff shortages at Gloucestershire Hospitals NHS Trust have led to baby deaths that could have been avoided.
    A newborn baby died after the trust failed to take action against two staff, the BBC has been told.
    The trust says it is sorry for its failings and is determined to learn when things go wrong.
    Concerns about two staff members, both midwives, had been raised by colleagues at the Cheltenham Birth Centre after another baby died 11 months earlier.
    The birth centre allowed women with low-risk pregnancies the choice of giving birth there under the care of midwives - there were no emergency facilities in the centre.
    In the event of complications, women should have been transferred to the Gloucestershire Royal Hospital, which is part of the same trust and about a 30-minute drive away.
    But on both occasions, the two midwives did not get their patients transferred quickly enough.
    The two midwives on duty for both deaths are now being investigated by their regulator, the Nursing and Midwifery Council.
    Read full story
    Source: BBC News, 29 January 2024
  4. Patient Safety Learning
    Tens of thousands of sexual assaults and incidents have been reported in NHS-run mental health hospitals as a “national scandal” of sexual abuse of patients on psychiatric wards can be revealed.
    Almost 20,000 reports of sexual incidents in the last five years have been made in more than half of NHS mental health trusts, according to exclusive data uncovered in a joint investigation and podcast by The Independent and Sky News.
    The shocking findings, triggered by one woman’s dramatic story of escape following a sexual assault in hospital revealed in a podcast, Patient 11, show NHS trusts are failing to report the majority of incidents to the police and are not meeting vital standards designed to protect the UK’s most vulnerable patients from sexual harm.
    Throughout the 18-month investigation, multiple patients and their families spoke to The Independent about their stories of sexual assault and abuse while locked in mental health units.
    Dr Lade Smith, president of the Royal College of Psychiatrists, called the findings “horrendous”, while shadow health secretary Wes Streeting said it was a “wake-up call” for the government.
    Dr Smith told The Independent: “There is no place for sexual violence in society, which has a profound and long-lasting negative impact on people’s lives. Today’s horrendous findings show that there is still much to do to make sure that patients and staff in mental health trusts are protected from sexual harms at all times.
    “It is deeply troubling to see that so many incidents in mental health settings go unreported.”
    Read full story
    Source: The Independent, 29 January 2024
  5. Patient Safety Learning
    Rebecca McLellan, a trainee paramedic, pursuing the job she had dreamed of as a child, took her own life at the age of 24.
    Amid the devastation felt by her loved ones, serious questions have now emerged about the standard of care she received at Norfolk and Suffolk NHS Foundation Trust (NSFT).
    In notes recorded before her death last November, McLellan said that Norfolk and Suffolk NHS Foundation Trust (NSFT) had “abandoned” her in a time of need. An internal investigation has now been launched by the mental health trust, which has been dogged by safety concerns for more than a decade.
    Relatives of McLellan, who lived in Ipswich, Suffolk, and was being treated for bipolar disorder, are among hundreds of bereaved families who believe their loved ones were failed under the care of the trust. Her mother, Natalie McLellan, 48, said it was clear that some of her daughter’s feelings of helplessness in her final months were “shaped by their inadequacy”.
    “She was somebody that had it all,” said Natalie. “She had a supportive family, she had a nice flat, she had a nice car, she was doing exactly what she wanted to do in life. She had a voice, she was able to speak and advocate for herself as a medical professional. If she can’t get help, what the hell hope is there for anybody else?
    Recent months have seen calls for a public inquiry and criminal investigation into NSFT after bosses last year admitted to losing count of the number of patients that had died on its books. Campaigners describe the mismanagement of mortality figures as “the biggest deaths crisis in the history of the NHS”.
    The Times has spoken to trust staff, bereaved relatives and MPs who say that despite repeated promises of improved care the trust’s overstretched services remain unsafe and require urgent reform.
    Read full story (paywalled)
    Source: The Times, 26 January 2024
  6. Patient Safety Learning
    Hospitals in England are being hit with disruptions to patients’ care more than 100 times every week because of fires, leaks and problems created by outdated buildings, NHS figures reveal.
    There have been 27,545 “clinical service incidents” over the past five years – an average of 106 a week – data compiled by the House of Commons library shows.
    They are incidents the NHS says were “caused by estates and infrastructure failure related to critical infrastructure risk” and are linked to the service’s massive backlog of maintenance, the bill for which has soared to £11.6bn. All the incidents led to “clinical services being delayed, cancelled or otherwise interfered with” for at least five patients for a minimum of 30 minutes.
    That means the 27,545 incidents between 2018-19 and 2022-23 disrupted the care of at least 137,725 patients, according to an analysis of NHS data by the Commons library commissioned by Ed Davey, the leader of the Liberal Democrats.
    “These findings are shocking but sadly not surprising, given the dilapidated, and in some cases dangerous, state of so many NHS facilities,” said Saffron Cordery, the deputy chief executive of NHS Providers, which represents health service trusts.
    The “unacceptable impact on patients” should spur ministers into increasing the NHS’s capital budget so trusts can urgently overhaul their estates, she said.
    Read full story
    Source: The Guardian, 26 January 2024
  7. Patient Safety Learning
    Paramedics are "watching their patients die in the back of ambulances because they can't get them into A&E", according to the health union, Unison.
    It was commenting on data showing 2,750 hours were lost by ambulance crews waiting to hand over patients at Hull Royal Infirmary in October 2023.
    One crew was stuck outside A&E for 10 hours and 27 minutes.
    Hull University Teaching Hospitals said it was "confident" a new urgent treatment centre on the hospital site would "improve overall waiting times" and lost ambulance hours had "reduced notably" this month.
    The figures, obtained by the BBC through a freedom of information request, showed on 9 October 2023 ambulance crews lost 144 hours and 18 minutes, the equivalent to one crew being out of action for six full days and nights.
    Megan Ollerhead, Unison's ambulance lead in Yorkshire, said paramedics were "literally watching their patients die in the back of these ambulances because they can't get into A and E."
    "I talk to a lot of the people who receive the 999 calls in the control rooms and they're just listening to people begging for ambulances and they know there are none to send."
    Read full story
    Source: BBC News, 26 January 2024
  8. Patient Safety Learning
    Diabetes patients have told the BBC they are struggling without what they have called a "wonder drug".
    Experts estimate about 400,000 people with Type 2 diabetes could have been affected by a national supply shortage caused by rising demand.
    The new generation of medicines - GLP-1 receptor agonists - mimic a hormone that not only controls blood sugar levels but also suppresses appetite.
    The government said it was trying to help resolve the supply chain issues.
    NHS England has issued a National Patient Safety Alert for the drugs.
    The NHS alerts require action to be taken by healthcare providers to reduce the risk of death or disability.
    The diabetes medicines in short supply are Ozempic, Trulicity, Victoza, Byetta, and Bydureon. They work via injections instead of tablets.
    The group of medicines has been used by the NHS for diabetes for around a decade but in recent years there has been a growth in private clinics prescribing the same drugs for weight loss for people who do not have diabetes, pushing up demand.
    Novo Nordisk, which manufactures Ozempic and Victoza, told the BBC it was experiencing shortages of its medicines for people in the UK with Type 2 diabetes due to "unprecedented levels of demand".
    Read full story
    Source: BBC News, 26 January 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.
  9. Patient Safety Learning
    The EU is to stockpile key medicines that will worsen the record drug shortages in the UK, with experts warning that the country could be left “behind in the queue”.
    The EU is seeking to safeguard its supplies by switching to a system in which its 27 members work together to secure reliable supplies of 200 commonly used medications, such as antibiotics, painkillers and vaccines.
    But the bloc’s move to insulate itself from growing drug shortages threatens to exacerbate the increasing scarcity of medicines facing the NHS, posing serious problems for doctors.
    “Europe is securing access to key drugs and vaccines as a single region, with huge influence and buying power. As a result of Brexit the UK is now isolated from this system, so our drug supplies could be at risk in the future,” said Dr Andrew Hill, an expert on the pharmaceutical trade.
    Britain is experiencing a record level of drug shortages, with more than 100 – including treatments for cancer, type 2 diabetes and motor neurone disease – scarce or impossible to obtain.
    Mark Dayan, the Brexit programme lead at the Nuffield Trust health thinktank, said the EU’s decision to act as a buying cartel could seriously disadvantage Britain.
    “There is a real risk that measures in such a large neighbour, which is now a separate market due to Brexit, will leave the UK behind in the queue when shortages strike,” Dayan said.
    It also has an initiative for member states to transfer stocks of medicine to cover shortages in others. These measures could shut UK purchasers out in certain scenarios.
    “This would risk worsening shortages from a starting point where they are already exceptionally severe for the UK and other countries, with a mounting impact in terms of costs and wasted time for the NHS, and in terms of patients struggling to get what their doctors have said they need.”
    Read full story
    Source: The Guardian, 25 January 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.
  10. Patient Safety Learning
    NHS England said it had opened a tender worth £16 million to support provider organisations as they seek to improve their digital maturity and get electronic patient records in place by the end of March 2026. 
    NHSE said its frontline digitisation programme is working with NHS secondary care trusts providing acute specialist, community, mental health and ambulance services to help them reach a minimum level of digital capability as defined by the Digital Capabilities Framework. 
    To fulfil this ambition, NHSE is seeking a partner to create an experienced, multi-skilled, rapid response intervention service, also known as a Tiger Teams service, capable of supporting EPR delivery across England.
    This service will be an expansion to an existing comprehensive support offer available to providers, designed to support the national demand for resource, expertise, and information necessary to successfully rollout EPRs. 
    NHSE said: “Often during EPR delivery, there is a requirement for either a planned, or unplanned, specific, time-bound skill set, capable of providing a set of deliverables, problem rectification or other specialist intervention for an element of the EPR Programme.
    “Trusts are finding it increasingly challenging to obtain good quality, skilled short-term resources, both from the recruitment and contingent labour market.” 
    Read full story
    Source: Digital Health, 22 January 2024
  11. Patient Safety Learning
    A "significant deterioration" in leadership at an NHS trust probably had a "knock-on effect" on its standard of services, a watchdog has found.
    Inspectors found staff felt encouraged to "turn a blind eye" to bullying in hospitals run by the Newcastle Hospitals NHS Foundation Trust.
    The Care Quality Commission (CQC) downgraded the trust's overall rating to "requires improvement".
    The trust said it "fully accepts" the report and that recommendations were being worked on "as a matter of urgency".
    Ann Ford, CQC's director of operations in the north, said: "We found a significant deterioration in how well the trust was being led.
    "Our experience tells us that when a trust isn't well led, this has a knock-on effect on the standard of services being provided to people.
    "Some staff told us that bullying was a normal occurrence, and they were encouraged to 'turn a blind eye' and not report this behaviour.
    "This is completely unacceptable."
    Read full story
    Source: BBC News, 25 January 2024
  12. Patient Safety Learning
    The Health and Social Care Committee has launched a new inquiry to examine leadership, performance and patient safety in the NHS.
    Inquiry: NHS leadership, performance and patient safety
    MPs will consider the work of the Messenger review (2022) which examined the state of leadership and management in the NHS and social care, and the Kark review (2019) which assessed how effectively the fit and proper persons test prevents unsuitable staff from being redeployed or re-employed in health and social care settings.
    The Committee’s inquiry will also consider how effectively leadership supports whistleblowers and what is learnt from patient safety issues.
    An ongoing evaluation by the Committee’s Expert Panel on progress by government in meeting recommendations on patient safety will provide further information to the inquiry.
    Health and Social Care Committee Chair Steve Brine MP said:
    “The role of leadership within the NHS is crucial whether that be a driver of productivity that delivers efficient services for patients and in particular when it comes to patient safety.
    Five years ago, Tom Kark QC led a review to ensure that directors in the NHS responsible for quality and safety of care are ‘fit and proper’ to be in their roles. We’ll be questioning what impact that has made.
    We’ll also look at recommendations from the Messenger review to strengthen leadership and management and we will ask whether NHS leadership structures provide enough support to whistleblowers.
    Our Expert Panel has already begun its work to evaluate government progress on accepted recommendations to improve patient safety so this will build on that. We owe it to those who rely on the NHS – and the tax-payers who pay for it – to know whether the service is well led and those who have been failed on patient safety need to find out whether real change has resulted from promises made.”
    Terms of Reference
    The Committee invites written submissions addressing any, or all, of the following points, but please note that the Committee does not investigate individual cases and will not be pursuing matters on behalf of individuals.   Evidence should be submitted by Friday 8 March. Written evidence can be submitted here of no more than 3,000 words.   How effectively does NHS leadership encourage a culture in which staff feel confident raising patient safety concerns, and what more could be done to support this? What has been the impact of the 2019 Kark Review on leadership in the NHS as it relates to patient safety? What progress has been made to date on recommendations from the 2022 Messenger Review? How effectively have leadership recommendations from previous reviews of patient safety crises been implemented? How could better regulation of health service managers and application of agreed professional standards support improvements in patient safety? How effectively do NHS leadership structures provide a supportive and fair approach to whistleblowers, and how could this be improved? How could investigations into whistleblowing complaints be improved? How effectively does the NHS complaints system prevent patient safety incidents from escalating and what would be the impact of proposed measures to improve patient safety, such as Martha’s Rule? What can the NHS learn from the leadership culture in other safety-critical sectors e.g. aviation, nuclear? Read full story
    Source: UK Parliament, 25 January 2024
  13. Patient Safety Learning
    Researchers have found the costs of treating patients in a 40-bed virtual ward were double that of traditional inpatient care.
    The study’s authors said the findings should raise concerns over a flagship NHS England policy, which has driven the establishment of 10,000 virtual ward beds.
    Virtual wards, sometimes described as “hospital at home”, are cited as a safe way to reduce pressure on hospitals, by reducing length of stay and enabling quicker recovery.
    The study at Wrightington Wigan and Leigh Teaching Hospitals, in Greater Manchester, found a clear reduction in length of stay but also found higher rates of readmission.
    The authors said this led to additional costs, with the cost of a bed day in the virtual ward estimated at £1,077, compared to £536 in a general inpatient hospital bed. 
    “This raises concerns [over] the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management. This evidence should be taken into consideration by [the] NHS in planning the next large deployment of virtual wards within the UK…
    “Virtual wards must be cost effective if they are to replace traditional inpatient care, the costs must be comparable or lower than the costs of hospital stay to be economically sustainable in the medium to long terms.”
    To break even, the paper said the virtual ward would need to double its throughput, but warned this would risk lowering the standard of care.
    Read full story (paywalled)
    Source: HSJ, 25 January 2024
  14. Patient Safety Learning
    A group of doctors with Long Covid are preparing to launch a class action for compensation after contracting SARS-CoV-2 at work.
    The campaign and advocacy group Long Covid Doctors for Action (LCD4A) has engaged the law firm Bond Turner to bring claims for any physical injuries and financial losses sustained by frontline workers who were not properly protected at work.
    On 25 January Bond Turner, which specialises in negligence cases, complex litigation, and group actions, launched a call to action inviting doctors and other healthcare workers in England and Wales to make contact if they believe that they contracted covid-19 as a result of occupational exposure.1
    Sara Stanger, the firm’s director and head of clinical negligence and serious injury claims, said that the ultimate aim was to achieve “legal accountability and justice for those injured.”
    She told The BMJ, “I’ve spoken to hundreds of doctors with long covid, and many of them have had their lives derailed. Some have lost their jobs and their homes; they are in financial ruin. Their illnesses have had far reaching consequences in all areas of their lives.”
    Read full story
    Source: BMJ, 25 January 2024
    Nurses, midwives, and any other healthcare workers who are suffering with Long Covid and which they believe they contracted through their work and who wish to join the action should visit the Bond Turner website here: https://www.bondturner.com/services/covid-group-claim/. Although this action has been initiated by doctors in the first instance, it is not limited to doctors.
    Further reading on the hub:
    Questions around Government governance My experience of suspected 'Long COVID' How will NHS staff with Long Covid be supported?  
  15. Patient Safety Learning
    Doctors "failed to realise" that a first-time mother's pregnancy had become "much higher risk" because crucial warning signs were not properly highlighted in her medical records, an inquiry has heard.
    Nicola McCormick was obese and had experienced repeated episodes of bleeding and reduced foetal movement, but was wrongly downgraded from a high to low risk patient weeks before she went into labour.
    Her daughter, Ellie McCormick, had to be resuscitated after being born "floppy" with "no signs of life" at Wishaw General hospital on March 4 2019 following an emergency caesarean.
    She had suffered severe brain damage and multi-organ failure due to oxygen deprivation, and was just five hours old when her life support was switched off.
    A fatal accident inquiry (FAI) at Glasgow Sheriff Court was told that Ms McCormick, who was 20 and lived with her parents in Uddingston, should have been booked for an induction of labour "no later" than her due date of 26 February.
    Had this occurred, she would have been in hospital for the duration of the birth with Ellie's foetal heartbeat "continuously" monitored.
    In the event, Ms McCormick had been in labour for more than nine hours by the time she was admitted to hospital at 8.29pm on 4 March.
    A midwife raised the alarm after detecting a dangerously low foetal heartbeat, and Ms McCormick was rushed into theatre for an emergency C-section.
    Dr Rhona Hughes, a retired consultant obstetrician who gave evidence as an expert witness, told the FAI that Ellie might have survived had there been different guidelines in place in relation to the dangers of bleeding late in pregnancy, or had her medical history been more obvious in computer records.
    Read full story
    Source: The Herald, 24 January 2024
  16. Patient Safety Learning
    The Department of Education has recently provided an update to the national framework for Children’s Social Care. The key point to be aware of is the increased focus on sharing responsibility and strengthening multi-agency working to safeguard children.
    This change is likely to impact a wide variety of stakeholders involved in children’s care, including NHS Trusts, ICBs, education partners, local authorities, voluntary, charitable and community sectors and the police. 
    The focus continues to be on a child-centred approach with the intention of keeping children within the care of their families wherever possible; this collaborative working may include working with parents, carers or other family but the wishes and feelings of the child alongside what is in the child’s best interests remain paramount. Joined up working is to be viewed as the norm.
    For health professionals, you will be expected to have lead roles for children with health needs, such as children who are identified as having special educational needs or disabilities. 
    Read full story
    Source: Bevan Brittan, 23 January 2024
  17. Patient Safety Learning
    The rate at which people are dying early from heart and circulatory diseases has risen to its highest level in more than a decade, figures show.
    Data analysed by the British Heart Foundation (BHF) shows a reverse of previous falling trends when it comes to people dying from heart problems before the age of 75 in England.
    Since 2020, the premature death rate for cardiovascular disease has risen year-on-year, with the latest figures for 2022 showing it reached 80 per 100,000 people in England in 2022 – the highest rate since 2011 when it was 83.
    This is the first time there has been a clear reversal in the trend for almost 60 years.
    Between 2012 and 2019 progress slowed and, from 2020, premature death rates began to clearly rise, the data reveals.
    Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist, said: “We’re in the grip of the worst heart care crisis in living memory.
    “Every part of the system providing heart care is damaged, from prevention, diagnosis, treatment, and recovery; to crucial research that could give us faster and better treatments.
    “This is happening at a time when more people are getting sicker and need the NHS more than ever.
    “I find it tragic that we’ve lost hard-won progress to reduce early death from cardiovascular disease.”
    Read full story
    Source: Medscape, 22 January 2024
  18. Patient Safety Learning
    Hundreds of rheumatology patients have stopped receiving drugs they did not need or had their diagnosis changed after a damning review of the service found the standard of care was “well below” what would be considered acceptable.
    Jersey’s Health and Community services department has said it will be contacting some of the affected patients “over the coming weeks” and would also be seeking legal advice on “an appropriate approach to compensation”.
    The independent review by the Royal College of Physicians also noted there was “no evidence” of standard operating procedures for most aspects of routine rheumatological care and, in some cases, “no evidence of clinical examinations”.
    It also found that there had been incorrect diagnosis and wrongly prescribed drugs, describing the standard of care as “well below what the review team would consider acceptable” for a contemporary rheumatological service.
    The review was commissioned by HCS medical director Patrick Armstrong, following concerns raised by a junior doctor in January 2022.
    Read full story
    Source: Jersey Evening Post, 22 January 2024
  19. Patient Safety Learning
    The availability of ambulances to transfer patients to specialist units is a "matter of concern", a coroner has warned.
    Darren Stewart, area coroner for Suffolk, made the comments in a Prevention of Future Deaths report.
    It followed the death of 84-year-old Dennis King, who waited three hours to be transferred from West Suffolk Hospital to Royal Papworth in 2022.
    Mr King had made his own way to the West Suffolk Hospital's accident and emergency department in December 2022, after being told an ambulance could take six hours to arrive at his home due to high demand in the area, the report said.
    His call had been graded as category two, which should have led to a response within 40 minutes - or a target of 18 minutes.
    After tests at West Suffolk Hospital showed Mr King had suffered a STEMI heart attack, emergency clinicians liaised with experts from the regional heart unit and decided he needed an urgent transfer to Royal Papworth in Cambridgeshire.
    The report said a matron at West Suffolk told ambulance call handlers they needed an urgent transfer - but because Mr King was classed as being in a "place of safety", control room staff said the delay would be "several hours".
    Mr Stewart said: "the availability of ambulances to carry out transfers in a timely manner, in urgent cases" was "a matter of concern".
    In the report, Mr Stewart said the circumstances of the case "raised concerns about the NHS approach to centralising care in regional centres" if the means to deliver it were "inadequate".
    Read full story
    Source: BBC News, 23 January 2024
  20. Patient Safety Learning
    A blood test for detecting Alzheimer’s disease could be just as accurate as painful and invasive lumbar punctures and could revolutionise diagnosis of the condition, research suggests.
    Measuring levels of a protein called p-tau217 in the blood could be just as good as lumbar punctures at detecting the signs of Alzheimer’s, and better than a range of other tests under development, experts say.
    The protein is a marker for biological changes that happen in the brain with Alzheimer’s disease.
    Dr Richard Oakley, an associate director of research and innovation at the Alzheimer’s Society, said: “This study is a hugely welcome step in the right direction as it shows that blood tests can be just as accurate as more invasive and expensive tests at predicting if someone has features of Alzheimer’s disease in their brain.
    “Furthermore, it suggests results from these tests could be clear enough to not require further follow-up investigations for some people living with Alzheimer’s disease, which could speed up the diagnosis pathway significantly in future. However, we still need to see more research across different communities to understand how effective these blood tests are across everyone who lives with Alzheimer’s disease.”
    Read full story
    Source: The Guardian, 23 January 2024
     
  21. Patient Safety Learning
    Boston-based Massachusetts General Hospital is requesting permission from the state to add more than 90 inpatient beds amid what it says is an "unprecedented capacity crisis." 
    The hospital's emergency department has experienced critical levels of overcrowding nearly every day for the past six months, Massachusetts General said in a news release. The hospital boards between 50 to 80 ED patients every night who are waiting for a hospital bed to open. On 11 January, Massachusetts General had 103 patients boarding in the ED, representing one of the most crowded days in the hospital's more than 200-year history.
    "While hospital overcrowding has significantly affected patient care for many years, COVID-19 and the post-pandemic demand for care has escalated this challenge into a full-blown crisis – for patients seeking necessary emergency care, as well as for staff who are required to work under these increasingly stressful conditions," David F.M. Brown, president of Massachusetts General, said in a news release.
    Massachusetts General's request comes as hospitals across the state grapple with capacity issues, workforce shortages and a jump in respiratory illnesses this winter. On 9 January. the Massachusetts Department of Public Health issued a memo urging hospitals to expedite discharge planning amid the capacity crunch. Some health plans have also waived the need to obtain prior authorisation for short stays in post-acute care facilities. 
    Read full story 
    Source: Becker Hospital Review, 19 January 2024
  22. Patient Safety Learning
    Women with endometriosis who have endured years of excruciating pain are being “fobbed off” by doctors and told their symptoms are “all in their head”, leading them to give up seeking NHS treatment, new research has found.
    A study carried out by academics at Manchester Metropolitan University found women with the disease felt “gaslit” by doctors due to their lack of understanding of the condition.
    The paper, due to be published in the Journal of Health Communication later this month, also found that treatment was subject to a postcode lottery. Patients in rural areas reported travelling for hours to access a specialist with full training in the complex gynaecological condition.
    Endometriosis is a painful condition in which tissue similar to the lining of the womb grows around other organs inside the abdomen. It affects 1.5 million women in the UK. The study looked at the experiences of treatment and diagnosis of 33 patients and revealed how doctors’ lack of understanding of the symptoms meant women often spent years in pain before their condition was diagnosed. During this period participants were told they were exaggerating their symptoms, or their pain was dismissed as psychological.
    As one 27-year-old participant reported: “I feel a lot of mistrust towards the healthcare system in general, simply because I have been told that the pain was in my head, that I must have a low pain threshold or that I was in pain because I was fat.”
    Read full story
    Source: The Guardian, 21 January 2024
    Share your experience of endometriosis: The Guardian newspaper would like to hear how you have been affected by endometriosis and your experience of being diagnosed and treated.
  23. Patient Safety Learning
    A national shortage of epilepsy medication is putting patients' safety at risk, consultants have said.
    Medical professionals are becoming genuinely concerned as ever more frequent supply issues continue to bite tens of thousands of sufferers.
    According to the Epilepsy Society charity, over 600,000 people in the UK have the condition, or about one in every 100 people.
    Among them is Charlotte Kelly, a mother of two living in London who has had epilepsy for over 20 years. She must take two tablets a day to manage her condition but issues with supply have forced her to start rationing her medication.
    Speaking to Sky News, Ms Kelly told us of the fear surrounding the restricted access to the medicate she needs to survive.
    "I'm scared. If I'm truly honest, I'm scared knowing that I might not get any medication for a few weeks, or a couple of months, I just don't know when.
    "It's scary to know that I have to worry about getting hold of medication. I do believe that something needs to happen very quickly because even if it's pre-ordered there's no guarantee you're going to get it.
    Speaking to Sky News, Professor Ley Sander, director of medical services at the Epilepsy Society, says the supply concern is not just on the minds of patients but those in the industry too.
    "It might be that we need a strategic reserve for storage of drugs, we might have to bring drugs over from other parts of the world to avoid this from recurring.
    "We're not at that point yet, but this is an urgent issue."
    Read full story
    Source: Sky News, 21 January 2024
  24. Patient Safety Learning
    To help patients with high-risk pregnancies receive care at hospitals that are staffed and equipped to deliver care appropriate to their needs, the Department of Public Health will require licensed birthing hospitals to use a system called Levels of Maternal Care. The system classifies hospitals based on their capacity to meet the needs of patients with a range of potential complications during childbirth.
    The impetus is the rising levels of severe maternal morbidity, large racial disparities in outcomes, and concerns that higher-risk patients who deliver in hospitals that over-estimate the level of care they are able to provide are more likely to experience complications.
    Levels of care describe a hospital’s physical facilities, capabilities and staffing, indicating its ability to serve people giving birth across a range of medical needs. For example, Level 1 is appropriate for low-risk patients with uncomplicated pregnancies, including twins and labor after cesarean delivery. To that group, Level II adds patients with poorly controlled asthma or hypertension and other higher-risk conditions. Subsequent levels include patients at increasingly high risk of complications, up to Level IV, which is appropriate for patients with severe cardiac disease, those who need organ transplant and others.
    Established by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine in 2015, the classification system is one tool used by states across the country to improve maternal health and birthing outcomes.
    Read full story
    Source: Betsy Lehman Center. 17 January 2024
  25. Patient Safety Learning
    Patients have suffered cardiac arrests while waiting in A&E departments or in ambulances queueing outside because Scottish hospitals are overwhelmed, doctors have warned.
    At least three cases in which patients’ hearts stopped beating while they were waiting for care have been reported to the Royal College of Emergency Medicine in Scotland. Some of the incidents, the college said, may have been preventable.
    One frontline doctor told The Times that a patient with heart problems had died waiting in a queue of ambulances outside an emergency department. Staff could not take the patient inside because there was no capacity.
    JP Loughrey, vice-president of the college and an A&E consultant in the west of Scotland, said that people who should be in resuscitation rooms with a team of experts and equipment to monitor their vital signs were instead lying in ambulances outside hospital buildings. He also said that tensions were growing between frontline staff and NHS managers in large hospitals because doctors and nurses, who were already struggling to cope, were under increasing demands to work harder to process more patients.
    Read full story
    Source: The Times, 19 January 2024
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