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Patient Safety Learning

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  1. Patient Safety Learning
    Hospitals and care homes are failing to properly investigate incidents before referring nurses to their regulator, fuelling a blame culture and repeat failures, the head of the nursing watchdog has told The Independent.
    In her first national interview, Andrea Sutcliffe, head of the Nursing and Midwifery Council (NMC) said some employers were referring nurses without any investigation at all, while half of initial enquiries to the NMC were rejected or required further work.
    She told The Independent this emphasis on blaming the individual meant underlying causes of safety errors were being missed and so they were likely to be repeated. Her ambition is to transform the nursing regulator, which oversees 725,000 nurses and midwives across the UK, into a more forceful watchdog that will flag systemic issues of concern with NHS trusts and care homes.
    In a wide-ranging interview, Ms Sutcliffe called on ministers to ensure that planned legislation to reform the way clinicians are regulated be made transparent and maintain the public’s confidence. She also stressed that the impact of coronavirus on nurses mental health meant rushing to restart routine operations in the NHS had to be carefully planned to avoid driving nurses out of the health service.
    Read full story
    Source: The Independent, 16 March 2021
  2. Patient Safety Learning
    Lasting effects of infection from coronavirus are more common in women and children than expected, with at least 10% of people infected suffering persistent symptoms for months, a new review has found.
    Experts at the National Institute for Health Research (NIHR) examined more than 300 separate scientific studies for the analysis. It found many patients reported struggling to access testing and help from the NHS to treat their symptoms, which varied between patients, suggesting long Covid is a group of four possible syndromes affecting patients differently.
    The report said: “Long Covid appears to be more frequent in women and in young people (including children) than might have been expected,” adding other sufferers could be experiencing an active disease, impacting on their organs and causing debilitating symptoms that would need ongoing treatment. In some patients, the effects included neurological changes in their brains while others showed signs of blood clotting and inflammation. Other patients reported anxiety, fatigue and damage to their lungs and heart.
    It also warned there was evidence some long Covid patients could actually be getting worse, underlining the need to invest in services that will be needed to cope with what could be a long term problem.
    Read full story
    Source: The Independent, 16 March 2021
  3. Patient Safety Learning
    A group of 47 cancer charities says that without urgent action, the UK's cancer death rate will rise for the first time in decades.
    NHS figures suggest tens of thousands fewer people started cancer treatment since the first lockdown compared to normal times. One Cancer Voice says that the NHS needs more resources.
    The government says cancer treatment remains a top priority and urges people to see their GP if they have symptoms.
    Radio 1 Newsbeat has spoken exclusively to One Cancer Voice about the impact of coronavirus on cancer care. The group of charities wants to see more staff available to diagnose and treat cancer, with greater NHS access to private facilities in order to "clear the backlog".
    "We are calling on the government to invest more money in ensuring the backlog of cancer cases is reduced and eliminated," says Michelle Mitchell, the boss of Cancer Research UK, which heads up One Cancer Voice.
    "We could face, in this country today, the prospect of cancer survival reducing for the first time in decades. That's why urgent action is required by the government."
    Read full story
    Source: BBC News, 16 March 2021
  4. Patient Safety Learning
    Stories about people getting blood clots soon after taking the Oxford/AstraZeneca vaccine have become a source of anxiety among European leaders.
    After a report on a death and three hospitalisations in Norway, which found serious blood clotting in adults who had received the vaccine, Ireland has temporarily suspended the jab. Some anxiety about a new vaccine is understandable, and any suspected reactions should be investigated. But in the current circumstances we need to think slow as well as fast, and resist drawing causal links between events where none may exist.
    As Ireland’s deputy chief medical officer, Ronan Glynn, has stressed, there is no proof that this vaccine causes blood clots. It’s a common human tendency to attribute a causal effect between different events, even when there isn’t one present: we wash the car and the next day a bird relieves itself all over the bonnet. Typical. Or, more seriously, someone is diagnosed with autism after receiving the MMR vaccine, so people assume a causal connection – even when there isn’t one. And now, people get blood clots after having a vaccine, leading to concern over whether the vaccine is what caused the blood clots.
    Read full story
    Source: The Guardian, 15 March 2021
  5. Patient Safety Learning
    The pandemic has been a catalyst for innovation in the NHS and some changes will have a lasting effect, says Dr John Wright of Bradford Royal Infirmary.
    The Covid pandemic has transformed our hospitals. Car parks are empty, once-bustling corridors are quiet, and these days you won't see any staff making fashion statements - we're all in scrubs and masks.
    Dr Wright says changes made to reduce spread of infection are here to stay and will help us live with future outbreaks of Covid and other infectious diseases. But there is also much to learn from how we have adapted to non-Covid care - with drive-through PCR swabs and blood tests, for example, or the use of oximeters to monitor oxygen levels in the blood of Covid patients in their homes, providing warning if they need to be admitted to hospital.
    But the biggest change has been in the way hospital consultations are carried out. Before the pandemic nearly all appointments took place face-to-face. Last year probably 90% occurred via telephone or video call, and most of my colleagues at Bradford Royal Infirmary are still running remote clinics today.
    This is much more convenient for patients. In the past a typical consultation might have involved a half-day of travel, the search for a parking place, and then sitting in a waiting room. However, remote consultations do have their drawbacks. Patients tend to underplay their symptoms on the phone and it is easier to avoid discussing challenging issues. Life-changing diagnoses require sensitive, face-to-face communication. Another problem is that some patients struggle with technology. 
    The main drawback, though, is that clinicians are unable to undertake physical examination remotely. Clinical histories are the yin of the consultation but physical examinations are the yang, and video consultations only provide half the picture.
    Read full story
    Source: BBC News, 15 March 2021
  6. Patient Safety Learning
    NHS England’s cancer director has said it could take another year for the level of cancer treatments and diagnosis carried out to return to normal, after being impeded by COVID-19.
    National cancer director Dame Cally Palmer told HSJ’s national cancer forum event last week that activity over the past 12 months had been 89% of the previous year, but the service was committed to getting “fully reset” to 2019 levels by March 2022.
    She shared information showing that, by December 2020, the amount of treatment being carried out following an urgent referral, for most cancers, exceeded December 2019 levels, but that there are still significant treatment backlogs.
    And, for lung cancer patients, the number of treatments carried out in December 2020 was only 73% of that a year earlier — a decrease from September and October 2020 levels — as covid pressures rose during the third wave. Lung cancer is one of the most amenable to treatment if picked up early.
    Other areas of diagnostics and treatment have also been severely impeded because of requirements to change practice to reduce the risk of spreading covid, particularly to vulnerable patients.
    Dame Cally, also chief executive of the Royal Marsden Foundation Trust, said the service was committed to returning to at least normal levels of activity across the board by March next year.
    Read full story (paywalled)
    Source: HSJ, 12 March 2021
  7. Patient Safety Learning
    As the UK looks to mark the first anniversary of the first COVID-19 lockdown on 23 March, Sky News has spoken to one family who say they have lived constantly with the after effects of the virus for a year.
    Charlie, 37, her husband Zed, 41, and their five children – Nico, 15, Beck, 12, Indiana, 10, Emmett, 8, and Mimi, 5 – fell ill with the virus in March last year.
    All of them – particularly the children – have been suffering ever since.
    Charlie said the list of symptoms is "extensive", including headaches, eye issues, nose bleeds, body rashes, horrific tummy pains, gastric issues, severe lethargy, allergic reactions, peeling hands, and feet and mouth ulcers.
    "It's such a long list that at times you can't believe that they've all been related to this illness," Charlie said.
    The family have been getting help from a support group, Long COVID Kids, which wants specialist clinics to be set up for children with the condition.
    Charlie said the ordeal the family has been through "really made me question my sanity at times". She added: "Long COVID centres are being set up, but they're not for children, so there is nowhere for them to be referred to. I'm really worried about the long-term health issues."
    Read full story
    Source: Sky News, 13 March 2021
  8. Patient Safety Learning
    Professor Sir Ian Diamond, head of the Office for National Statistics (ONS), has said there will “no doubt” be another wave of coronavirus infections in the autumn.
    Speaking on Sunday, Sir Ian acknowledged the impact of the “wonderful” vaccine rollout though cautioned “we need to recognise that this is a virus that isn’t going to go away.”
    "And I have no doubt that in the autumn there will be a further wave of infections," he told The Andrew Marr Show on BBC One.
    The UK’s national statistician pointed toward regional variations in terms of how many people have antibodies. “There is a lot of regional variation, so we find 30 per cent of London have antibodies whereas only 16 per cent in the South West, so we need to recognise that as well,” he told the programme.
    This comes after Professor Chris Whitty, England’s chief medical officer, said he would “strongly advise” against any rapid easing of coronavirus restrictions.
    Read full story
    Source: The Independent, 14 March 2021
  9. Patient Safety Learning
    Public Health Scotland are evaluating the roll-out of the COVID-19 vaccination programme to understand if, how, and why different models of service delivery achieve different uptake rates for different population groups. An important part of this work is exploring the attitudes and experiences of people who have been offered a COVID-19 vaccine (even if they have not yet attended).
    You are invited to take part in an anonymous survey looking at health and social care worker views, intentions and experiences of the COVID-19 vaccination programme. You are eligible to participate in this survey if you work in Scotland in a frontline health or social care worker role (i.e. a role where you have direct contact with patients, service users, or clients).
    This survey will help to gather feedback on what was good and less good about your experience, to help inform improvements to this and future vaccination programmes, and remove barriers to attendance and reach more people. 
    The survey should take around 10 minutes to complete and will be open until 19 March 2021.
    Further information
  10. Patient Safety Learning
    The Care Quality Commission (CQC) has ordered ‘significant improvements’ from a mental health trust which has been criticised over the deaths of vulnerable patients.
    The watchdog has warned Tees, Esk and Wear Valleys Foundation Trust (TEWV FT) it has “serious concerns” about risk management processes at its inpatient wards following inspections of three of its hospitals in January. It follows a string of severe problems in child and adolescent services run by the trust. 
    In a formal letter and a separate warning notice to TEWV FT, the CQC ordered the trust to carry out “significant improvements” to the safety of adult acute wards, and psychiatric intensive care, after a visit to Roseberry Park, West Park and Cross Lane hospitals on the week of 18 January.
    Sources have told HSJ the trust’s leadership is working towards a May deadline to make sufficient improvements or it could potentially risk further enforcement action. However, neither the trust nor the CQC have confirmed this.
    Families and campaigners — including Labour MP Andy McDonald, who represents Middlesbrough — have called for a public inquiry into alleged “systematic failures” at the trust following the deaths of around 14 patients under the trust’s care within two years.
    Read full story (paywalled)
    Source: HSJ, 12 March 2021
  11. Patient Safety Learning
    An inquiry into dozens of baby deaths at an NHS trust will examine failings from “ward to board” covering a period of more than a decade, it has emerged.
    The independent inquiry into poor maternity care at East Kent Hospitals University Trust published its terms of reference and scope for how it will carry out its work on Thursday.
    The probe, led by Dr Bill Kirkup, was commissioned by the government after The Independent revealed more than 130 infants suffered brain injuries during birth at the trust over several years.
    The scandal was exposed by the family of baby Harry Richford who died after a catalogue of errors by maternity staff in November 2017. A coroner ruled his death was the result of neglect and “wholly avoidable”.
    Several other families have also spoken out over the deaths of their babies, with evidence emerging the trust’s managers were warned about safety concerns but failed to take action.
    In October, the Care Quality Commission (CQC) said it intended to prosecute the trust over the death of Harry Richford.
    It is understood that since the inquiry was launched, a significant number of families have come forward with concerns but the inquiry has refused to say what the total number of cases is.
    Read full story
    Source: The Independent, 11 March 2021
  12. Patient Safety Learning
    The Covid surge in January hit key services including cancer and routine surgery, NHS England figures show.
    Less than half the expected number of operations were done, pushing the waiting list to a record-high of 4.6m. More than 300,000 of those have been waiting more than a year for treatment - compared to 1,600 before the pandemic began.
    Surgeons described it as a dire situation which would take a long time to turnaround.
    Tim Mitchell, of the Royal College of Surgeons of England, said: "Behind today's statistics are people waiting in limbo. Many will be in considerable pain, others will have restricted mobility and be at risk of isolation and loneliness."
    "Dealing with this daunting backlog will take time, and also sustained investment in the NHS," he said.
    Similar problems are also being seen in Scotland where 39,000 people have been waiting over a year for treatment.
    The NHS Confederation has warned the true picture could be much worse with nearly 6 million fewer referrals made by GPs in England for routine treatments, which includes operations such as knee and hip replacements, last year, suggested there was an additional hidden backlog. The organisation, which represents hospitals, said it was likely people have not sought help or found it difficult to access services during the pandemic.
    Read full story
    Source: BBC News, 11 March 2021
  13. Patient Safety Learning
    The proportion of NHS staff in England who reported feeling unwell as a result of work-related stress increased by nearly 10% last year as the Covid pandemic took its toll, according to the health service’s 2020 survey.
    The survey found that 44% reported feeling unwell as a result of work-related stress in the previous 12 months, compared with 40.3% in 2019. The proportion has steadily increased since 2016 (36.8%).
    In a year like no other for the health service, the 2020 survey also found a slight reduction in respondents who said they often or always looked forward to going to work, and a bigger fall in those who said they were often or always enthusiastic about their job.
    Nevertheless, the survey – which was carried out before Boris Johnson announced plans to give NHS England healthcare workers a 1% pay rise next year, prompting widespread fury – found that the proportion of staff who were thinking of leaving the NHS fell from 19.6% to 18.2%.
    In a year in which ethnic minorities were heavily represented in the death toll of healthcare workers, and concerns were raised about being more likely to be pushed into frontline roles and about access to personal protective equipment, the responses relating to equality, diversity and inclusion were not so positive.
    The proportion of staff who said their employer provided equal opportunities fell compared with 2019, with a decrease among black and minority ethnic staff from 71.2% to 69.2%.
    Danny Mortimer, the chief executive of the NHS Confederation, said the overall picture was encouraging in the circumstances, adding: “There are, though, significant areas of concern, and the recent data on the continued poorer experience of ethnic minority staff starkly reminds NHS leaders that staff experience varies unacceptably in their organisations."
    Read full story
    Source: The Guardian, 11 March 2021
  14. Patient Safety Learning
    Homeless people will be prioritised for coronavirus vaccinations alongside adults in at-risk groups, the government has said.
    Matt Hancock, the health secretary, said the decision would “save more lives among those most at risk in society”.
    It comes after the Joint Committee on Vaccination and Immunisation, which said those experiencing rough-sleeping or homelessness were likely to have underlying health conditions and should be offered vaccinations alongside those in priority group six.
    "People experiencing homelessness are likely to have health conditions that put them at higher risk of death from COVID-19.
    He added: "This advice will help us to protect more people who are at greater risk, ensuring that fewer people become seriously ill or die from the virus."
    Read full story
    Source: The Independent, 11 March 2021
  15. Patient Safety Learning
    Women are being encouraged to share their experiences of the health and care system via a call for evidence aimed at improving healthcare for women.
    Launching to coincide with International Women’s Day, the call for evidence will form the basis of a landmark government-led Women’s Health Strategy, to improve the health and wellbeing of women across England and place women’s voices at the centre of their care.
    By better understanding women’s experiences, the government can ensure key parts of the health service are meeting women’s needs as they should be.
    Matt Hancock, Health and Social Care Secretary, said: "The healthcare system needs to work for everyone, and we must address inequalities which exist within it. Improving women’s health, especially at older ages, is critical for a fair health and care system in the future." 
    "To build this strategy, we need to hear from those who it directly impacts. I urge all women, and those who have experiences or expertise in women’s health, to come forward and share their views with us to inform the future of this important strategy."
    Nadine Dorries, Minister for Women’s Health, said: "Women’s experiences of health care can vary and we want to ensure women are able to access the treatment and services they need. It’s crucial women’s voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes."
    "I urge every woman, and anyone who cares for women, to feed into this call for evidence and help shape the future of women’s health."
    Read press release
    Complete survey (consultation closes at 11:45pm on 30 May 2021)
    Source: GOV.UK, 6 March
  16. Patient Safety Learning
    People will be able to check if they have bowel cancer by swallowing a tiny capsule containing miniature cameras, in an extension of patient self-care.
    In what experts described as a trend towards more NHS at-home care, hastened by the COVID-19 pandemic, thousands of people in England will be able to avoid the discomfort of having a camera inserted into their bowel by instead swallowing a capsule the size of a cod liver oil tablet.
    Pictures transmitted from inside their body during the painless procedure will help doctors judge whether the person has bowel cancer, the second deadliest form of the disease in the UK.
    The boss of the NHS in England said the procedure, known as a colon capsule endoscopy, is an example of “sci-fi” medicine increasingly deployed to improve care. One of the country’s top doctors said the capsules illustrated a major shift of healthcare out of hospitals that will see more and more diagnosis and treatment of illness done at home.
    Prof Martin Marshall, chair of the Royal College of GPs, said: “We’re aware that some patients are reluctant to seek help for certain cancers because the diagnostic tests available can be invasive, so this is a fascinating development and we will be very interested to see the results of the trial.
    “GPs are preparing for an upsurge in cases of suspected cancer cases post-Covid, and the capsule cameras and new test for cervical cancer are welcome developments that could enable more patients to monitor and manage their own health at home without embarrassment or discomfort.”
    Read full story
    Source: The Guardian, 11 March 2021
  17. Patient Safety Learning
    Former staff at a Midlands acute trust have raised concerns over a ‘toxic management culture’ and ‘unsafe’ staffing levels within its maternity services, HSJ has learned.
    Two clinicians who recently worked within Sandwell and West Birmingham Hospital Trust’s maternity department have sent a letter to the Care Quality Commission outlining a series of concerns.
    The letter, seen by HSJ, claimed there was a “toxic management culture alongside poor leadership” within the trust’s senior midwifery team.
    It added: “This had led to 100 per cent turnover in staff within the middle management line… There is no confidence in the current leadership structure and no confidence that staff will be listened to and heard.”
    HSJ also understands there are also concerns around the service within the trust’s management.
    Although they do not raise direct patient safety concerns, the clinicians said the problems were “mostly long-standing” and had “deteriorated to the point where there is now a risk to patient safety”.
    They added: “We are raising these concerns now with the CQC as we feel we have not been listened to and changed effected in a timely manner.”
    Read full story (paywalled)
    Source: HSJ, 10 March 2021
  18. Patient Safety Learning
    Cancer patients are much less protected against COVID-19 than other people after one dose of the Pfizer vaccine, the first real-world study in this area suggests.
    With a 12-week wait for the second dose this could leave them vulnerable, says the King's College London and Francis Crick Institute research team. An early second dose appeared to boost cancer patients' protection.
    Cancer charities are calling for the vaccine strategy to be reviewed.
    But Cancer Research UK said the small study had not yet been reviewed by other scientists and people undergoing cancer treatment should continue to follow the advice of their doctors.
    The government said it was focused on "saving lives" and the antibody response "was only part of the protection provided by the vaccine".
    About 1.2 million people at very high risk of being seriously ill with COVID-19 were prioritised for a first vaccine dose in the first phase of the UK rollout, which includes people with specific cancers.
    The UK government decided to extend the gap between first and second jabs from three to 12 weeks in late December to give more people some protection as soon as possible.
    Dr Sheeba Irshad, oncologist and senior study author from King's College London, said the findings were "really worrying" and recommended an urgent review of the timing of doses for people in clinically extremely vulnerable groups.
    "Until then, it is important that cancer patients continue to observe all public health measures in place such as social distancing and shielding when attending hospitals, even after vaccination," she said.
    The study, which recruited 205 people, included 151 with solid cancers, such as lung, breast and bowel, or blood cancers. The researchers tested volunteers for antibodies and T-cells in their blood, which signals that the immune system can protect against illness from the virus in the future.
    Three weeks after one dose, an antibody response was found in 39% of people with solid cancers, 13% of people with blood cancer and 97% of people with no cancer.
    Following a second dose three weeks after the first, which some cancer patients received, there was a sharp rise in their antibody response against the coronavirus, to 95%. However, among those who had to wait longer for their second dose, there was no real improvement in protection.
    Read full story
    Source: BBC News, 11 March 2021
  19. Patient Safety Learning
    A doctor told a panel investigating an NHS trust there has been a "cultural shift" in the way staff communicate with patients and their families.
    Southern Health NHS Foundation Trust is being investigated after failures in its care of five patients who died between 2011 and 2015.
    Dr Susie Carman said staff went through a "rough patch" when they "felt worried about doing the wrong thing". She said there was "more confidence" among staff to communicate better.
    The inquiry, which is due to last six weeks, is probing how the trust currently handles complaints, communicates with families of patients, and carries out investigations.
    It follows a report by Nigel Pascoe QC that found Southern Health, one of the biggest psychiatric trusts in England, acted with "disturbing insensitivity and a serious lack of proper communication" to family members.
    Dr Carman said there had since been a "genuine culture shift from the top of the organisation".  She believed the trust could "still do things better" in its communication methods but said there was "more will about understanding why it (communication) is so important".
    The inquiry heard that a patient's "consent to share" information or not could present an "obstacle" in communicating with families and carers.
    Ahead of the inquiry, the bereaved families decided to withdraw from the process after they claimed to have been "misled, misrepresented and bullied" by the NHS.
    Read full story
    Source: BBC News, 10 March 2021
  20. Patient Safety Learning
    Joanna Herman, a consultant in infectious diseases, had high hopes when Boris Johnson announced £10m for long Covid clinics. Five months on, she is yet to be referred to one.
    "Despite the government recently giving £18.5m research funding for the disease, it feels as though all focus is now on the vaccine and the lifting of lockdown, while those living with long Covid have been largely forgotten," says Joanna.
    Her initial illness was, by definition, a mild case of Covid: no hospital admission and no risk factors for severe disease. Months later she found herself experiencing crashing post-exertional fatigue, sporadic chest pains and a brain that felt it was only half functioning. And she is not alone. According to a study published last September from researchers at King’s College London, 60,000 people in the UK were likely to have been suffering from long Covid. The actual number is now probably far higher.
    There are now 69 long Covid clinics up and running across the country, according to the NHS England website. Yet Joanna has not been able to access one – and neither have others she knows with long Covid.
    Joanna asked doctors in her field what was happening with long Covid clinics in their local areas. She contacted 18 infectious disease colleagues based in teaching hospitals around the country. Of the 16 who responded, 6 had formal long Covid clinics. Some said that provision for the disease was woefully inadequate, while others reported they only saw only patients who had been admitted to hospital with acute COVID-19. In her own local teaching hospital, funding for long Covid patients is scattered across various departments and there is no dedicated team for these patients.
    "...it feels as though many long-haulers remain in a post-viral sea, looking for a mooring in the hope that something can be offered. We’ve known about this disease since last summer, and it has been officially recognised since October, but we’re only just starting to understand how to support those living with it"
    Read full story
    Source: The Guardian, 10 March 2021
  21. Patient Safety Learning
    Scientists are questioning the reliability of algorithms used to trawl through patients’ health records and flag those who should be asked to shield and prioritised for vaccination.
    GPs have reported being contacted by young, healthy patients confused as to why they have been told they are at high risk, or have been invited for a COVID-19 jab.
    The Joint Committee on Vaccination and Immunisation (JCVI) has defined nine priority groups for vaccination, including everyone aged over 50, plus frontline health and social care workers and people aged 16–64 with serious health conditions.
    The QCovid risk prediction algorithm, introduced last month, combines various characteristics, including age, sex, ethnicity and body mass index (BMI), to estimate the risk of catching, being admitted to hospital, or dying from Covid-19.
    However, the algorithm appears to throw up certain inconsistencies. For example, if a patient’s weight or ethnicity are not recorded on their health records, QCovid automatically ascribes them a BMI of 31 (obese) and the highest risk ethnicity (black African), meaning they are more likely to be invited for a vaccine. One York-based GP, Dr Abbie Brooks, has identified 110 seemingly healthy individuals who were added to the shielding list and invited to book a vaccine last month.
    Although it will not harm younger, healthier individuals to receive a jab before their peers, it may mean more vulnerable people have to wait longer for their doses.
    “I can see that they don’t want to miss out people, which may be why they’re taking this conservative approach, but the problem is that when you make that prioritisation, you are pushing others further down the line,” Irene Petersen, professor of epidemiology and health informatics at University College London, said.
    Read full story
    Source: The Guardian, 9 March 2021
  22. Patient Safety Learning
    A long-delayed review into West Suffolk Foundation Trust board members’ alleged bullying of whistleblowers is now due to be published ‘by the spring’, senior figures familiar with the process have told HSJ.
    The news comes amid calls from senior medics and a campaign group for the review — originally due for publication in April 2020 — to be published as soon as possible.
    The review was set up to investigate the “handling and circumstances surrounding concerns raised in a letter that was sent in October 2018, to the relative of a patient who had died in the Suffolk hospital”.
    The letter was sent to the family of Susan Warby, 57, who died at West Suffolk Hospital in August 2018 after suffering multi-organ failure and other complications. The letter’s anonymous author raised serious concerns about her treatment by the trust.
    The trust launched an investigation, involving fingerprinting and handwriting experts, to find the letter’s author. The process, led by the trust’s senior management, prompted staff to report they felt harassed and bullied, and unions to label the process a “witch hunt” (See box below: Timeline of West Suffolk bullying allegations).
    NHS England and Improvement is overseeing the probe, which was ordered by ministers in January 2020. The coronavirus pandemic caused publication to be pushed back until December, but no official reasons have been given for the further delay.
    Read full story (paywalled)
    Source: 9 March 2021
  23. Patient Safety Learning
    NHS clinics were still seeing just two-thirds of the number of chronic pain patients they normally would by the end of last year, with some patients having waited a year or more.
    In Ayrshire and Arran, 94 of the 112 chronic pain patients seen between October and December – equivalent to nearly 84% – had been on the waiting list for their first appointment for 52 weeks or longer. Only nine were seen within the 18-week target.
    This was by far the worst performance for any health board in Scotland.
    Pain relief clinics across NHS Scotland were paused for four months at the beginning of the pandemic, leading to reports that some patients with problems such as nerve damage and arthritis were paying thousands of pounds to travel to private facilities in England for medical infusions or injections to ease their symptoms.
    In a statement at the end of last year, Joanne Edwards, the director of acute service at NHS Ayrshire and Arran, apologised for the delays, saying the coronavirus pandemic "has had a significant impact on the capacity of the chronic pain service".
    Ms Edwards said the health board was increasing the number of face to face and telephone clinics that the chronic pain team can undertake, adding that an "enhanced clinical review" of the waiting list was also being carried out to prioritise patients for appointment based on clinical need.
    Read full story
    Source: The Herald, 10 March 2021
  24. Patient Safety Learning
    The NHS Covid symptom checker has been criticised by a study which found it may not pick up some people who are seriously ill. By being told to stay at home rather than consult a doctor, they may not receive treatment quickly enough.
    NHS Digital says the 111 online service, used more than 3.9 million times in the past year, is not a diagnostic tool. The symptom checker has been constantly revised and updated, it adds.
    The NHS 111 online Covid symptom checker asks a series of set questions about symptoms in order to offer people advice on their condition and what to do next.
    The study, in BMJ Health and Care Informatics, used 50 simulated cases to compare online checkers used during the pandemic from four countries - UK, US, Japan and Singapore.
    It found the symptom checkers used by the UK and US were half as likely to advise people to consult a doctor as the systems used in Japan and Singapore. Japan and Singapore also had the lowest case fatality rates of the four nations.
    Despite improvements in the safety of the NHS 111 symptom checker since the research was carried out in April, the researchers said they still have "ongoing concerns".
    Read full story
    Source: BBC News, 9 March 2021
  25. Patient Safety Learning
    Patients with coronavirus have been discharged from a hospital and infected family members, a councillor claimed.
    Heather Kidd,  a Liberal Democrat member of Shropshire Council, said a woman in south Shropshire told her that her husband had been "sent home with Covid". 
    She initially found evidence of four cases but said those were the "tip of the iceberg" with more coming to light.
    The medical director of Shrewsbury and Telford Hospital NHS Trust (SaTH) said they were following guidelines, but would look into the "concerning" cases.
    Ms Kidd said since she first spoke out, she had been contacted by a number of people who have had Covid-positive family members discharged from the Royal Shrewsbury Hospital and the Princess Royal in Telford back into their homes.
    Arne Rose, the medical director at SaTH, said there was now a "special swab squad" testing patients every 24 hours as opposed to every 48 hours. He said some patients, who after 28 days of their first positive Covid test were no longer considered infectious, would be the subject of a "careful risk assessment".  They could then be discharged with advice on self-isolating at home.
    "The cases... sound concerning," Mr Rose said, adding he would investigate to "learn if anything went wrong."
    Read full story
    Source: BBC News, 7 March 2021
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