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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Nurses in England, Wales and Northern Ireland will strike today in an ongoing dispute with the government about pay and concerns about patient safety. Up to 100,000 members of the Royal College of Nursing (RCN) will take part after it balloted its members in October. It has said that low pay is the cause of chronic understaffing that is putting patients at risk and leaves NHS staff overworked. It will be the second day of strikes in December, after an initial day of industrial action on 15 December, the RCN’s biggest in its history. It meant the cancellation of thousands of outpatient appointments and non-urgent operations. More strikes have been threatened for January unless talks between union negotiators and the government takes place before Thursday, 48 hours after the strike on Tuesday. The RCN’s general secretary and chief executive, Pat Cullen, said: “For many of us, this is our first time striking and our emotions are really mixed. The NHS is in crisis, the nursing profession can’t take any more, our loved ones are already suffering. “It is not unreasonable to demand better. This is not something that can wait. We are committed to our patients and always will be.” Read full story Source: The Guardian, 20 December 2022
  2. News Article
    Nine ambulance trusts in England and Wales are expected to be affected by industrial action on Wednesday, coordinated by the GMB, Unison and Unite unions. The ambulance strikes will involve paramedics as well as control-room staff and support workers. The threat to patient safety on Wednesday will be exceptional. Under trade union laws, life-preserving care must be provided during the strikes. But there remains a lack of clarity about what will be offered. Even at this late stage, NHS leaders say negotiations are continuing between unions and ambulance services to agree which incidents will be exempt from strike action. All category 1 calls – the most life-threatening cases – will be responded to, while some ambulance trusts have agreed exemptions with unions for specific incidents within category 2 calls. However, in some cases, elderly people who fall during the strikes may not be sent help until they have spent several hours on the floor. Heart attack and stroke patients may get an ambulance only if treatment is deemed “time critical”. There is no doubt that many of those patients making 999 calls on Wednesday will not get the care they need. Some will probably die as a result. NHS leaders believe Wednesday’s strike will present a completely different magnitude of risk. Quite simply, patients not getting emergency treatment quickly enough can mean the difference between life and death. Read full story Source: The Guardian, 19 December 2022
  3. News Article
    Private menopause clinics are prescribing HRT at "twice the recommended dose", an investigation has revealed. The investigation by The Pharmaceutical Journal has revealed that patients attending private menopause clinics are subject to “unorthodox prescribing” by providers. Many are receiving oestrogen at up to double the recommended dose placing them at higher risk of cancer and vaginal bleeding. Nuttan Tanna, a pharmacist consultant in women’s health at London North West University Healthcare NHS Trust, said she had seen referrals for “bleeding investigations” and then found the patient was on "very large doses [of oestrogen] prescribed previously by private providers”. Brendon Jiang, a senior clinical pharmacist for North Oxfordshire Rural Alliance Primary Care Network, said that his team were increasingly getting letters from private clinics requesting for patients to be prescribed doses of oestrogen that are off-label or exceed licensed recommendations. He also raised concerns that patients were not taking enough progesterone alongside increased doses of oestrogen. Taking increased doses of oestrogen alone can increase the risk of womb cancer but progesterone protects against that risk and therefore the two hormones should be taken together. Read full story (paywalled) Source: The Telegraph, 19 December 2022 Further reading on the hub: Surgical menopause: a toolkit for healthcare professionals (British Menopause Society) Menopause Support - Getting the most out of your doctor’s appointment World Menopause Day 2022: Raising awareness of surgical menopause All-Party Parliamentary Group on Menopause: Inquiry to assess the impacts of menopause and the case for policy reform - conclusions
  4. News Article
    NHS trusts in England lost more than a million working days to long-Covid absences last year, analysis suggests. Thousands of doctors, nurses and other health professionals have been forced to take long periods off work because of the lingering effects of coronavirus infection. Data released to the all-party parliamentary group on coronavirus suggests that long-Covid absences are now higher than they were a year ago. Layla Moran, who chairs the group, said: “Long Covid has upended the lives of millions and these figures suggest that the deeply damaging impact it is having on our economy and public services is only getting worse.” Read full story (paywalled) Source: The Times, 19 December 2022
  5. Content Article
    Patient Innovation is an online platform where patients and caregivers around the world connect to share the solutions they developed themselves or had the help from collaborators to cope with a health-related problem.
  6. Content Article
    Weaknesses resulting from a patchwork of patient safety processes developed by individual healthcare organisations over the past quarter-century, exposed by the Covid-19 pandemic, can be remedied through both local systems design support and widespread best practices uniformity.
  7. News Article
    Patients should “make their own way to hospital” if they can do so during Wednesday’s strike by ambulance workers, a cabinet minister said yesterday, as the government warned that the industrial action would put lives at risk. Senior government figures said that ambulance unions had still not agreed national criteria for what conditions would be considered life threatening and responded to during the strike. Steve Barclay, the health secretary, is understood to be writing to all striking unions, including nurses, seeking discussions on patient safety. Yesterday Oliver Dowden, the Cabinet Office minister, said people should still call 999 in an emergency but might in less serious cases have to make their own way to hospital. “We are working to ensure that if you have a serious injury, in particular a life-threatening injury, you can continue to rely on the ambulance service, and we would urge people in those circumstances to dial 999,” he told Sunday with Laura Kuenssberg on BBC1. “If it is the case that you have less serious injuries, you should be in touch with 111, and you should seek to make your way to hospital on your own if you are able to do so.” Read full story (paywalled) Source: The Times, 19 December 2022
  8. News Article
    Asystemic failure to provide basic physical care on NHS mental health wards is killing patients across the country, despite scores of warnings from coroners over the past decade, The Independent can reveal. An investigation has uncovered at least 50 “prevention of future death” reports – used by coroners to warn health services of widespread failures – since 2012, involving 26 NHS trusts and private healthcare providers. Cases include deaths caused by malnutrition, lack of exercise, and starvation in patients detained in mental health facilities. Experts warn that poor training and a lack of funding are factors in the neglect of vulnerable patients. The Independent investigation uncovered: Staff failing to carrying out basic health checks, such as assessment for risk of blood clots. Cases of nurses and care assistants without adequate CPR training. Doctors unable to carry out emergency response procedures. Patients not treated for side effects of antipsychotic medication. Rapidly deteriorating health going unnoticed and untreated. Coroners have exposed multiple cases of mental health patients receiving inadequate treatment in general hospitals, with their illness being mistaken for a psychiatric problem. Read full story Source: The Independent, 18 December 2022
  9. News Article
    Hospital staff in Nottingham have said they are keen to build on the success of its menopause support scheme. Nottingham University Hospitals Trust (NUH) said 24% of its staff were aged 45-55, the most common age for the condition. Staff can ask for lighter uniforms, shift changes, more time to complete tasks or access to fans in offices. Advice, awareness training and access to specialist staff are also part of the scheme. The staff wellbeing team at NUH said they were "inundated" with messages from colleagues who were struggling. Jenny Good, NUH Staff Wellbeing Lead, said: "We strongly believe that menopause is an issue for everybody. Everyone knows somebody who will go through it. "We wanted to equip everyone who works at NUH with an awareness of what menopause is. "We're really proud that we're the first NHS trust to get the accreditation. "The conversation has opened up." Read full story Source: BBC News, 18 December 2022
  10. News Article
    Patients are spending an extra day in hospital on average when admitted as an emergency compared to before covid, consuming millions of additional ‘bed days’, HSJ analysis has found. The finding explains in part why fewer people are being treated in hospitals, but more resources are being consumed to do so. This has prompted concerns about an apparent big drop in productivity. NHS England chief finance officer Julian Kelly told HSJ the marked increase in length of stay meant hospitals needed to focus on “discharge and decongest” of emergency care, to help recover activity rates and productivity in elective care. The NHS also needs to create more elective capacity insulated from emergency care, he said, and for “local leadership [to] keep people focused”. Read full story (paywalled) Source: HSJ, 19 December 2022
  11. News Article
    The US Joint Commission will hold a safety briefing with healthcare organisations at the start of every accreditation survey starting in 2023, the organisation has said. Site surveyors and staff members preselected by the healthcare organisation will conduct an informal, five-minute briefing to discuss any potential safety concerns — such as fires, an active shooter scenario or other emergencies — and how surveyors should react if safety plans are implemented while they are on site. The change takes effect 1 January 2023 and applies to all accreditation surveys performed by the organisation. Read full story Source: Becker's Hospital Review, 13 December 2022
  12. Content Article
    Elizabeth Holmes, the 38 year old founder of failed diagnostic start-up Theranos, was sentenced to more than 11 years in prison this November. The sentence was handed down nearly a year after she was found guilty of defrauding investors about her finger prick blood testing devices, and seven years after the Wall Street Journal published its first investigation exposing the company’s struggles. Theranos’ customers received false laboratory test results indicating life threatening conditions such as cancer and HIV. Patients were left to wait anxiously while traditional laboratories repeated the tests, and at least one customer stopped taking his medication on the basis of erroneous results. Holmes was ultimately not convicted of charges relating to patient harm, instead she will be locked up for misleading wealthy investors.
  13. Content Article
    Letter from Sir David Sloman Chief, Operating Officer NHS England, Professor Sir Stephen Powis, National Medical Director NHS England, and Dame Ruth May, Chief Nursing Officer, to ICBs and Trusts regarding the upcoming ambulance industrial action.
  14. Content Article
    Tracey Herlihey, head of patient safety incident response policy, in the NHS England national patient safety team, is joined by Vicky Ainsworth, a communications lead at Manchester University NHS Foundation Trust and Stuart Kaill, from Health Innovation Manchester, to discuss ways of communicating about large scale change projects in NHS organisations. The podcast explores Vicky’s experience of leading on communications for a large scale change project in Manchester, with a specific focus on sharing advice and suggestions relating to communicating the changes related to the Patient Safety Incident Response Framework (PSIRF). It includes expert tips on how to communicate large scale change to different audiences as well as within both large and small organisations.
  15. News Article
    The Conservatives have been accused of “failing women” as analysis reveals gynaecology waiting times have trebled in the past decade, with more than 540,000 waiting for NHS care. NHS England data shows that in October 2012, the average waiting time to see a gynaecologist was 4.8 weeks. By October 2022, the most recent month for which figures are available, that figure had increased by 225% to 15.6 weeks. Many of the conditions experienced by women waiting to see a gynaecologist are progressive. Left untreated, they can need more complex or invasive surgery. Thousands are living in extreme pain as a result of the long waits, doctors, health experts and charities told the Guardian. The figures reveal that 38,231 women have been waiting more than a year. Ten years ago there were 15 women in England waiting longer than 12 months – and no one waiting two years. Today, 69 women have been waiting more than 24 months. Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists, said: “This new analysis adds to our own research that gynaecology waiting lists were outstripping other specialities long before the pandemic, and they continue to grow rapidly. “Shockingly, the fact we can now track this pattern back 10 years, shows how long overdue action is to address the unequal growth in waiting lists.” Thakar added: “Women’s health has been consistently deprioritised. Gynaecology waiting times are currently the longest we’ve seen since waiting list targets were introduced, leaving thousands of women with symptoms including extreme pain, heavy menstrual bleeding and incontinence.” Read full story Source: The Guardian, 19 December 2022
  16. News Article
    Unions must ensure there will be "sufficient" staffing during this week's ambulance strike to protect patients, the health secretary says. Workers in England and Wales will walk out on Wednesday in a dispute over pay, but life-threatening emergencies will be responded to. Unions say discussions were still taking place with ambulance trusts to draw up detailed plans for cover. Steve Barclay said there is a lack of clarity about what is being offered. He said it was for the unions to ensure they "meet their obligations" for emergency cover so that people in crisis get the care they need. But Unite leader Sharon Graham, whose union is co-ordinating the ambulance strikes with Unison and GMB, said Mr Barclay will "have to carry the can if patients suffer". The ambulance walkouts will involve paramedics as well as control room staff and support workers. The action by the three main ambulance unions - Unison, GMB and Unite - will affect non-life threatening calls, meaning those who suffer trips, falls or other injuries may not receive treatment. Read full story Source: BBC News, 19 December 2022
  17. News Article
    Just over half of the 7,000 new virtual ward beds opened under the new national programme are occupied by patients, according to recent internal figures seen by HSJ. NHS England director for community transformation Stephanie Sommerville told a recent NHSE webinar that occupancy stood at around 52%. Although it is understood programme directors are pleased with the 43% growth in virtual beds since May, Ms Sommerville said it “demonstrate[s] we have a way to go to make sure our virtual wards are really well utilised. Of course, one of the big contributions to delivering more activity to our virtual wards is getting the referrals and admissions process right.” While the concept of remotely monitoring patients at home has been around for more than 20 years, NHSE has made expanding remotely monitored care a key ambition in order to tackle the capacity and demand challenges facing the NHS. Read full story (paywalled) Source: HSJ, 16 December 2022
  18. News Article
    The collaboration seen between the independent sector and the NHS during the peaks of the pandemic “doesn’t exist any more”, the boss of one of the UK’s largest private hospital companies has said. Mr Justin Ash, chief executive of Spire Healthcare and a member of the government’s recently convened elective recovery task force, whose purpose is to ”focus on how the NHS can [better] utilise independent sector to cut the backlog’.” He told the Westminster Health Forum earlier this week: “In spirit there is collaboration but in practice, it doesn’t exist anymore. There is no more commissioning by trust[s]”. Mr Ash told the conference Spire had previously had administrative teams working at 39 different NHS hospitals examining which NHS patients could be treated at one of its facilities. That number was now three, a decline which he described as “a shame”. He said: “There has to be a mindset change. We have people say ‘you have our nurses and consultants working for you’. “[But] just like patients, nurses and consultants should be able to move around the system [as] one workforce.” Read full story (paywalled) Source: HSJ, 16 December 2022
  19. News Article
    With the distressing spate of news reports about mums and ­babies who weren’t kept safe in hospital, an initiative in the Midlands to improve patient safety in maternal and acute care settings comes as a relief. The newly announced Midlands Patient Safety Research Collaboration will bring together NHS trusts, ­universities and private business to evaluate how digital tools can help clinical decision making and reduce danger for patients. Problems can arise if communication is poor between medics when patients move between departments. Professor Alice Turner of Birmingham University said: “The power of new technology available to us means that we can address one of the ongoing areas of risk for patients, which is effective communication and clinical decision making. “The new collaboration will be looking at how digital tools can make a real difference to reduce risks and support patient safety in the areas of acute medicine and maternal health.” Digital decision-making tools could improve prescribing and personalised management for patients needing emergency care. Importantly, these tools should provide a smoother flow of information between healthcare professionals in acute care between hospitals, doctors and the West Midlands Ambulance Service, and hopefully reduce risks of patient harm at key points during acute care. Read full story Source: The Mirror, 18 December 2022
  20. Content Article
    In this blog, Patient Safety Learning’s Chief Executive Helen Hughes reflects on some of the key patient safety issues and developments over the past 12 months and looks ahead to 2023.
  21. Content Article
    In this article, Roger Kline, Research Fellow at Middlesex University, explains what caused the sinking of the Herald of Free Enterprise ferry. The sinking of the Herald of Free Enterprise on March 6 1987 with the loss of 198 lives was an accident waiting to happen, highlighting the devastating consequences of abandoning safe working practices in the name of financial savings. Human factors science learned from the Herald disaster is widely applied in sectors as diverse as nuclear power stations and healthcare.
  22. Content Article
    With the winter season bringing extra challenges on our levels of fatigue, the Royal College of Paediatrics and Child Health (RCPCH) bring together a few recent articles around sleep, fatigue and wellbeing, touching upon the responsibility of employers, NHS organisations and Government as well as a range of resources sharing advice and practical tips.
  23. News Article
    Four out of five Britons are worried about the NHS’s ability to provide safe care for patients during strikes by nurses and ambulance workers, a new poll has found. While around half of those surveyed said they support the planned industrial action, the majority expressed concern about the impact on patient safety. The Ipsos poll of 1,100 adults found that 80% were very or fairly concerned about the ability of the NHS to provide safe care for people during the nurses’ strike, which began on Thursday. Meanwhile, 82% of those questioned in the survey said they are very or fairly concerned about patient safety during the ambulance workers’ industrial action, with the first strike planned for 21 December. The new poll comes as the NHS continues to face high demand and widespread staffing gaps, with health leaders fearing this winter will be the most difficult in the health service’s history. Ambulances have been struggling to meet response times targets, while new data published on Thursday shows handover delays at hospitals in England have hit a new high. But the Ipsos survey suggests that, nevertheless, more people are supportive of the industrial action than are opposed to it. Some 50% of those questioned said they either strongly support or tend to support the industrial action by nurses, while 47% are supportive of the ambulance worker strikes. Read full story Source: The National, 15 December 2022
  24. News Article
    The reform of the UK’s Medical Device regulation offers a golden opportunity to drive innovation and growth in the UK’s Life Science sector while ensuring patient safety remains at the heart of the regulatory approach. But there is an urgent need for action to ensure we do not lose this opportunity. Senior members of the Life Sciences Council, Will Quince MP, Minister of State at the Department of Health and Social Care, Dr June Raine, CEO, Medicines and Healthcare products Regulatory Agency (MHRA) and Peter Ellingworth, CEO, Association of British HealthTech Industries (ABHI) have today announced a new agreement to accelerate the delivery of the future UK HealthTech regulatory system. Acknowledging the Chancellor’s priorities of stability and growth supported by regulatory reforms, and the importance of the success of the system to UK patients and the Life Science sector, they have formed an advisory group on behalf of the Life Sciences Council to drive the delivery of the ambition of the Life Sciences Vision to have a best in class regulatory system. The advisory group has agreed that aligned proposals will be published on three priority areas: international recognition routes for innovation system capacity. Read full press release Source; Gov.UK, 16 December 2022
  25. Content Article
    Patients are facing increased delays at almost every stage of their NHS treatment, as the health system struggles to find the resources to deal with demand. The latest data shows waiting lists across England have surpassed record highs every month for two years running, one of many major challenges currently facing the NHS. But what impact does this have on ordinary people trying to access the NHS in 2022? Through a combination of interviews with health professionals and analysis of official data, the Guardian has plotted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment and recovery.
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