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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Eighteen people died at two Teesside hospital trusts following patient safety lapses over a 12-month period. Sixteen such deaths were recorded at the South Tees Hospitals NHS Foundation Trust, with two at the North Tees and Hartlepool NHS Foundation Trust. Examples of patient safety lapses include a failure to provide or monitor care, a breakdown in communication, an out-of-control infection in a hospital, insufficient staffing or a missed diagnosis. NHS England figures show that, between April 2021 and March this year, there were 16,557 incidents at the South Tees Trust, which operates James Cook University Hospital in Middlesbrough, and Northallerton's Friarage Hospital. Thirty-four resulted in "severe" harm. Middlesbrough MP Andy McDonald told the Local Democracy Reporting Service the figures were a concern and that he planned to take them up with the South Tees Trust's chief executive. He said NHS staff worked under "the most demanding of conditions" but added: "Every person going into hospital rightly expects to receive the best treatment. Patient safety is paramount and no family wants to see a loved one suffer." Dr Mike Stewart, the trust's chief medical officer, said: "We encourage an open and transparent culture and promote the reporting of all patient safety incidents, even when there is uncertainty over a direct link between any problems in care and incidents of severe harm or death. "In the last year there were no deaths graded as definitely preventable due to a problem in the care delivered by the trust. "While our reporting has increased consistently over the last three years, the number of serious incidents has not risen, which is strong evidence of a positive safety culture." Read full story Source: BBC News, 30 October 2022
  2. News Article
    Hospitals and care homes have not received a single penny of a £500m emergency fund promised by the government to prevent the NHS becoming overwhelmed this winter, the Guardian has learned. Ministers announced they were injecting the cash into the health and social care system last month, to help get thousands of medically fit patients out of hospital into either their own home or a care home as soon as possible in an effort to better prepare the NHS for the coming months. “At the moment, one of the key challenges is discharging patients from hospital into more appropriate care settings to free up beds and help improve ambulance response times,” Thérèse Coffey, the then health and social care secretary, said on 22 September. “To tackle that, I can announce today that we are launching a £500m adult social care discharge fund for this winter.” However, the Guardian has been told that none of the funding has materialised. Senior health and social care sources described the government’s failure to release the promised cash as “inexplicable” and “outrageous”. More than 13,000 of the 100,000 NHS hospital beds in England currently contain “delayed discharge” patients, which has led to A&E units becoming heavily congested and long delays in ambulance handovers. As a direct result, thousands of 999 patients are suffering potential “severe harm” every month because ambulances are stuck outside hospitals. “Leaders across the NHS and local authorities are yet to see a single penny of this investment or any official detail on how it will be allocated,” said Matthew Taylor, the chief executive of the NHS Confederation. “Currently, only two-fifths of patients in hospital are able to leave when they are ready to do so, including due to problems accessing social care, yet health leaders still do not know how and when the £500m will be released to the system. So close to winter, this is unbelievable. Read full story Source: The Guardian, 31 October 2022
  3. Content Article
    The aim of this paper is to raise awareness of the impact menopause is having on the workforce, as well as to issue recommendations and help healthcare organisations, managers, and employers to better support health care workers so that they do not leave the workforce or suffer in silence if they struggle with managing menopause symptoms.
  4. Content Article
    The Covid-19 pandemic has, in many ways, been healthcare’s finest hour. Clinicians performed miracles as they battled to understand a new disease, learning as they went along the techniques and approaches that gave patients the best chance of survival. But, for all this quiet heroism, the crisis also turned a harsh spotlight on the deficiencies of health systems, writes Sarah Neville in this Financial Times article.
  5. Content Article
    Earlier this year The King’s Fund and The Nuffield Trust published the results of the 2021 British Social Attitudes survey, which asked members of the public about their views on health and care services. The results were stark, with unprecedented drops in satisfaction across the board. But can we conclude that there has been a fundamental rupture in the relationship between the NHS and the public?  
  6. Content Article
    We need urgent radical solutions for the crisis in social care, to prevent the collapse not just of the NHS but of the entire UK economy. Social care is facing extreme difficulties with funding and workforce shortages. Staff are poorly paid, and 10% of posts are vacant. The situation is about to get worse: 19% of the UK population is over 65. In Northern Ireland the number of people over 65 more than doubled between the censuses in 2011 and 2021. Projections show that each person will need an average of 10 years of social care. We must, then, focus on prevention. The need for social care is not inevitable. Ageing does not have to be associated with a loss of fitness. Exercise and strength training can restore muscle and balance and are proved to reduce the impact of falls and fractures. 
  7. Event
    This Westminster conference will discuss the future for Long Covid research, services, and care. It will be an opportunity to assess Long Covid: the NHS plan for improving Long Covid services and how its ambitions for improving access to services, patient experience and outcomes for patients can be achieved. Further sessions examine priorities for research and improving understanding of Long Covid, looking at implementing the latest developments in research to improve services, and the long-term health implications of Long Covid. There will also be discussion on addressing concerns around inequalities, capacity and wait times for Long Covid services, as well as the primary care referral system, and utilisation of investment. Sessions in the agenda include: latest developments: trends - key issues - assessing the NHS plan for improving long COVID services. clinical research: taking forward the understanding of Long Covid - advancing clinical trials - utilising data - funding and investment. improving patient outcomes, prediction and prevention - accelerating the development of effective treatments - areas for focus, such as cardiology. examining the increased risk of long-term health conditions and impacts of reinfection for Long Covid patients. improving specialist Long Covid services: progress made so far and priorities for moving forward. options for increasing capacity - addressing inequalities in provision, access to services and information - applying latest developments from research. children’s Long Covid services: assessing delivery - implications for child development and attainment. primary care: tackling key challenges for diagnosis and referral. the workforce: priorities for education and training - support for long COVID patients in the workforce. Register
  8. Content Article
    The Healthcare Safety Investigation Branch (HSIB) third annual conference took place on 21 September 2022. Presentations and videos from the day are now available to view and download below. Although it tied in with the World Health Organization’s World Patient Safety Day theme of medication safety, our speakers also covered: how we can drive system level change practical sessions based on our HSIB investigation education courses maternity safety insights themed around inclusivity of care opportunities for sharing and learning from Norway’s healthcare safety investigation body, UKOM.
  9. News Article
    NHS England has launched the first substantive consultation on changes to the NHS provider licence since 2013. Licences set out the requirements providers must meet and are the legal mechanism NHS England can use to take enforcement action. Having a licence has long been mandatory for foundation trusts and independent providers, and will become so for trusts. The intention is for the proposals to take effect from next year. Most of the changes to the licence regime have been made to bring it into line with this year’s Health and Care Act and accompanying policy changes. For example, trusts will be required to collaborate with other providers and work effectively as part of their integrated care system. This extends to trusts delivering agreed financial plans decided at a system level. The aim is to provide “mutual accountability” and ensure each provider does not use “more than their fair share of NHS resources”.' Read full story (paywalled) Source: HSJ, 28 October 2022
  10. News Article
    Steve Barclay is back as England's health secretary, just as the NHS prepares for what its chief executive Amanda Pritchard says could be a "very, very challenging winter". The government has said "intensive work" is under way in the 15 most under-pressure hospital trusts in England, to speed up ambulance delays, free up beds and reduce waiting times in A&E. Emergency departments across the UK are struggling to quickly treat patients. Only 57% of people who turned up at major A&E departments in England last month were seen, admitted or discharged within four hours, well below the 95% national target. The latest figures from Gloucestershire Royal show it performs slightly worse than average, with 55% dealt with in four hours. One medic, speaking anonymously to the BBC, said: "I wouldn't bring a member of my family to this hospital. And winter is going to be worse unless something changes fast." Read full story Source: BBC News, 28 October 2022
  11. Content Article
    There are over 850 Freedom to Speak Up guardians in NHS primary and secondary care and independent sector organisations, national bodies and elsewhere who work to ensure workers can speak up about any issues which have an impact on their ability to do their job. For Speak Up month, the National Guardian Office find out more about the people behind the role in the 'Stuck in a lift' interviews.
  12. Content Article
    Recording of the recent All-Party Parliamentary Group (APPG)Coronavirus evidence session on Long Covid.
  13. Content Article
    If you want to find out what the new Patient Safety Incident Response Framework is all about, and how it will support the NHS to learn and improve, this video provides a helpful introduction.
  14. Content Article
    This Care Quality Commission (CQC) survey looks at the experiences of people who use community mental health services. The 2022 community mental health survey received feedback from 13,418 people. Those aged 18 and over were eligible to take part if they were receiving specialist care or treatment for a mental health condition between 1 September 2021 and 30 November 2021.
  15. News Article
    Five promising technologies that could help improve symptoms and quality of life for people with Parkinson’s disease have been conditionally recommended by NICE. The wearable devices have sensors that monitor the symptoms of people with Parkinson’s disease while they go about their day-to-day life. This information may more accurately record a person’s symptoms than a clinical assessment during in-person appointments and help inform medication decisions and follow up treatment such as physiotherapy. Parkinson's disease is an incurable condition that affects the brain, resulting in progressive loss of coordination and movement problems. It is caused by loss of the cells in the brain that are responsible for producing dopamine, which helps to control and coordinate body movements. Mark Chapman, interim director of Medical Technology at NICE, said: “Providing wearable technology to people with Parkinson’s disease could have a transformative effect on their care and lead to changes in their treatment taking place more quickly. “However there is uncertainty in the evidence at present on these five promising technologies which is why the committee has conditionally recommended their use by the NHS while data is collected to eliminate these evidence gaps. “We are committed to balancing the best care with value for money, delivering both for individuals and society as a whole, while at the same time driving innovation into the hands of health and care professionals to enable best practice.” Read full story Source: NICE, 27 October 2022
  16. News Article
    Children say they were "treated like animals" and left traumatised as part of a decade of “systemic abuse” by a group of mental health hospitals, an investigation by The Independent and Sky News has found. The Department of Health and Social Care has now launched a probe into the allegations of 22 young women who were patients in units run by The Huntercombe Group, which has run at least six children’s mental health hospitals, between 2012 and this year. They say they suffered treatment including the use of “painful” restraints and being held down for hours by male nurses, being stopped from going outside for months and living in wards with blood-stained walls. They also allege they were given so much medication they had become “zombies” and were force-fed. But despite reports to police and regulators dating back seven years, and findings by the Care Quality Commission (CQC) that the units were inadequate, the NHS has still handed Huntercombe nearly £190m since 2015-16 to admit children to its mental health beds. Through witness testimony, documents obtained by Freedom of Information request and leaked reports, the investigation has uncovered: The CQC has received more than 700 whistleblowing and safeguarding reports, including “incidents of concern” and several “sexual safety” concerns. NHS England was notified of 195 safeguarding reports between 2020 and 2021. A 2018 internal report at Meadow Lodge hospital in Newton Abbot (now closed) found staff members using sexually inappropriate language in front of patients. 160 reports investigated by Staffordshire police about Huntercombe Staffordshire between 2015 and 2022. Between March 2021 and 2022, the CQC gave permission for 29 patients to be admitted to Maidenhead hospital after it was placed in special measures. Read full story Source: The Independent, 27 October 2022
  17. News Article
    A trust chief executive says the Care Quality Commission’s (CQC) inspection regime is still overly focussed on individual organisations, rather than systems, and this is driving the “risk aversion” which is partly responsible for the emergency care crisis. Mid Yorkshire Hospitals Trust CEO Len Richards acknowledged the CQC has started to scrutinise system-wide issues but suggested the “heat” of its regulation is still on individual providers. Mr Richards told the House of Lords’ public services committee on Wednesday that care homes and nursing homes in his area have declined to take patients ready to be discharged from hospital, due to concerns it would put their CQC accreditation at risk. He said: “[Last winter] we asked nursing homes and care homes to take patients and they couldn’t take them beyond a certain limit because it would put their accreditation at risk. “We went to the CQC to try and create some flexibility. Their perspective was very much of an independent regulatory body that would look at the organisation and not look at the system. I think we’ve got an awful long way to go there. “I think regulation does drive risk aversion… [and] the heat of regulation right at the moment is on individual organisations. “Therefore, when the CQC come and look at my organisation, they will talk about congestion in the A&E department. They won’t talk about the assessment that we made around there being a greater risk in the community if we didn’t offload ambulances.” Read full story (paywalled) Source: HSJ, 28 October 2022
  18. News Article
    Nurses are working the equivalent of one day a week for nothing, according to a study. Researchers from London Economics were commissioned by the Royal College of Nursing (RCN) to look at pay in England, Wales, Scotland and Northern Ireland since 2010. They found that the salary of an experienced nurse had fallen by 20% in real terms, based on a five-day week. Experienced nurses in England, Wales, and Northern Ireland would need a nominal pay rise of 45% by 2024-25 just to return their salaries to levels seen in 2010-11 in real terms, the research said. And such a pay rise would actually help the NHS save money in the long term, as it would be cheaper than hiring staff from overseas, according to the study. Dr Gavan Conlon, who oversaw the research, said that bringing staff in from overseas costs approximately £16,900 more annually than retaining a nurse, while using agency workers costs around £21,300 more per year. He said that about 32,000 nurses leave the NHS every year, many due to the failure of their pay to keep up with the rising cost of living. The RCN is balloting its 300,000 members for strike action, calling for higher pay and an effort by government to fill the hundreds of thousands of nursing vacancies across the country. Read full story Source: Sky News, 28 October 2022
  19. News Article
    A new report published by the NHS AI Lab and Health Education England (HEE) has advocated for training and education for providers in how they deliver and develop AI guidance for staff. The report, entitled ‘Developing healthcare workers’ confidence in AI (Part 2)’, is the second of two reports in relation to this research and follows the 2019 Topol Review recommendation to develop a healthcare workforce “able and willing” to use AI and robotics. It is also part of HEE’s Digital, AI and Robotics Technologies in Education (DART-ED) programme, which aims to understand the impact of advances of these technologies on the workforce’s education and training requirements. In the previous report, the AI Lab and HEE found that many clinicians and staff were unaccustomed to the use of AI technologies, and without the suitable training patients would not be able to experience and share the advantages. The new report has set out recommendations for education and training providers in England to support them in planning, resourcing, developing and delivering new training packages in this area. It notes that specialist training will also be required depending on roles and responsibilities such as involvement in implementation, procurement or using AI in clinical practice. Brhmie Balaram, Head of AI Research and Ethics at the NHS AI Lab, added: “This important new research will support those organisations that train our health and care workers to develop their curriculums to ensure staff of the future receive the training in AI they will need. This project is only one in a series at the NHS AI Lab to help ensure the workforce and local NHS organisations are ready for the further spread of AI technologies that have been found to be safe, ethical and effective.” Read full story Source: Health Tech Newspaper, 25 October 2022
  20. News Article
    General practices should delay rolling out the accelerated citizens’ access programme, due to go live on 1 November, if they have concerns over safety, the BMA has said. In guidance published on 25 October the BMA’s General Practitioners Committee said that while many practices would be able to implement the scheme before the deadline some would need more time to prepare, to ensure that they can roll it out in line with the Data Protection Act and safeguarding measures. The access scheme, led by NHS England, will automatically give patients the ability to see any new entries to their GP medical record through the NHS App. As part of safeguarding practices it will require GPs to review each record to identify any safety concerns related to providing patient access, such as in cases of domestic violence or coercive relationships. Where there are safeguarding concerns, practices can prevent patients from having automatic access by adding a specific SNOMED code to the patient’s record before 1 November 2022. David Wrigley, deputy chair of the BMA’s GP Committee for England, said, “We have a duty of care to speak up when patient safety is at risk, which is why we encourage practices even slightly unsure about whether they can deliver this programme before the start of November, to refer to our guidance. Our patients are at the heart of what we do, and we will always act in their best interests.” Read full story Source: BMJ, 26 October 2022
  21. News Article
    Patients from minority groups are facing longer wait times for potentially life-saving lung cancer treatment compared to their white counterparts, according to a study. Experts warn that disparities can have real consequences – the earlier treatment is initiated, the better the health outcomes for patients. Researchers at the University of Virginia (UVA) Cancer Centre reviewed data from more than 222,700 patients with non-small cell lung cancer across the US. The findings, published in the scientific journal Health Equity, showed that the mean time for radiation initiation was 61.7 days. Broken down by ethnicity, white patients had to wait only 60.9 days, while Black patients had a wait time of 65.9 days, meanwhile for Asian patients, it was 71.9 days. A single-week delay in treatment could lead to a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non-small cell lung cancer, respectively. “Our results suggest that non-white lung cancer patients have delayed time to cancer treatment compared with white patients, and this is not limited to a particular type of treatment facility,” said senior researcher Rajesh Balkrishnan, PhD, of UVA Cancer Center and the University of Virginia School of Medicine’s Department of Public Health Sciences. “Collaboration among providers and community stakeholders and organisations is much needed to increase accessibility and patient knowledge of cancer and to overcome existing disparities in timely care for lung cancer patients.” Scientists cite multiple reasons for the racial disparities, including health insurance – non-white patients are more likely to be uninsured, face greater socioeconomic barriers to care and may be perceived by doctors as being at risk for not following through with treatment plans. Read full story Source: The Independent, 26 October 2022
  22. News Article
    The World Health Organization has published its first ever list of lethal fungal infections that represent a threat to public health. Experts have noticed an increase in deadly fungal disease, with drug-resistant bacterial infections now responsible for roughly 1.27 million deaths every year. “Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment,” WHO said. The types of fungal infections listed often affect severely ill patients and those with significant underlying problems with their immune system, including people with cancer, HIV or AIDs, organ transplants, chronic respiratory disease or tuberculosis. “Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide,” said Dr Hanan Balkhy, WHO assistant director-general, antimicrobial resistance, said. In its new report, the WHO warns that there is only limited access to quality diagnostics and treatment for these developing fungal diseases. Medicines are often unavailable in low and middle income countries, leading to increased deaths among these populations. One deadly fungal pathogen, Candida auris, which is resistant to multiple drugs, is particularly difficult to eradicate from hospitals - even with intensive infection prevention measures, the WHO said. This means hospital wards often have to be shut down for prolonged periods of time when Candida auris is detected. Read full story Source: The Independent, 26 October 2022
  23. Event
    The UK continues to feel the consequences of the COVID-19 pandemic, both through its impact on the nation’s health, as well as the prolonged impact on the UK economy. Yet despite this, there isn’t enough attention on boosting population health, the NHS and social care to build resilience to future shocks and support economic recovery. For the 2022 REAL challenge lecture, Andy Haldane, Chief Executive of the RSA and former Chief Economist at the Bank of England, will explore the relationship between health and wealth. He will draw lessons from the pandemic and argue for a more holistic economic growth strategy where health and wealth are inextricably linked. The event will be chaired by Dr Jennifer Dixon, Chief Executive of the Health Foundation. Register
  24. Content Article
    This research is a collaboration between the NHS AI Lab and Health Education England. Its primary aim is to inform the development of education and training to develop healthcare workers’ confidence in artificial intelligence (AI).
  25. News Article
    Private companies are offering “misleading” home blood-testing kits that fuel health anxieties and pile pressure on the NHS, a report has suggested. There has been a boom in sales of the kits, which promise to reveal everything from cancer risk to how long patients can expect to live. But an investigation by the BMJ found these “unnecessary and potentially invasive tests” can be misleading and generate false alarms. The NHS is then left to “clear up the mess” as worried patients see GPs for reassurance or extra tests, piling more pressure on the overstretched service. One GP described patients coming in “clutching the results of private screening tests”, with doctors asked to review the results. The companies have been criticised for not providing sufficient follow-ups after the “poor quality and overhyped” tests, and for misleading results such as wrongly telling people their test levels are outside the “normal” range. Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, said: “Most of the online [tests] will send the results to the patient with at best a sort of asterisk next to the ones that are abnormal, with advice to either pay some more money to get some sort of health professional to speak about it or go and see your own GP.” Doctors are calling for the tests to be more tightly regulated by the health watchdog, the Care Quality Commission. Read full story (paywalled) Source: The Times, 27 October 2022
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