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Patient Safety Learning

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  1. Patient Safety Learning
    One in 10 patients undergoing fertility treatment experience suicidal thoughts “all the time”, a survey suggests.
    Fertility Network UK, which carried out the poll, said the findings reveal the “far-reaching trauma” of experiencing infertility and undergoing IVF in the UK.
    Four in 10 respondents - 98% of whom were women - said they had experienced suicidal feelings.
    Gwenda Burns, chief executive of Fertility Network UK, said: “Fertility patients encounter a perfect storm: not being able to have the child you long for is emotionally devastating.
    "But then many fertility patients face a series of other hurdles, including potentially paying financially crippling amounts of money for their necessary medical treatment, having their career damaged, not getting information from their GP, experiencing their relationships deteriorate, and being unable to access the mental support they need."
    “This is unacceptable. Infertility is a disease and is as deserving of medical help and support as any other clinical condition.”
    Three in four patients said their GP did not provide sufficient information about fertility problems and treatment.
    Read full story (paywalled)
    Source: The Telegraph, 31 October 2022
  2. Patient Safety Learning
    The Covid public inquiry has asked to see Boris Johnson's WhatsApp messages during his time as prime minister as part of its probe into decision-making.
    Counsel for the inquiry, Hugo Keith KC, said the messages had been requested alongside thousands of other documents.
    He said a major focus of this part of the inquiry was understanding how the "momentous" decisions to impose lockdowns and restrictions were taken.
    The revelations came as he set out the details of how this module will work. The inquiry is being broken down into different sections - or modules as they are being called.
    The preliminary hearing for module one, looking at how well prepared the UK was, took place last month.
    Monday marked the start of the preliminary hearing for module two, which is looking at the political decision-making.
    Mr Keith said this allowed the inquiry to take a "targeted approach". He said it would look at whether lives could have been saved by introducing an earlier lockdown at the start of 2020.
    Read full story
    Source: BBC News, 31 October 2022
  3. Patient Safety Learning
    The largest expansion of medical training posts has been announced the day after Scotland’s health secretary warned that the NHS was facing up to its most challenging winter.
    Humza Yousaf yesterday confirmed that 152 more places for trainee doctors would be created next year.
    He hailed it as the “most significant increase in medical training places to date” and an increase on the 139 places created last year. The announcement comes after ministers were urged to fund the creation of additional training places in key specialities including general practice, core psychiatry, oncology, emergency medicine, intensive care medicine and anaesthetics.
    “These additional training places highlight the Scottish government’s continued commitment to ensure that our health service is resilient and can continue delivering high quality care to those who need it,” Yousaf said. “This record expansion will support a wide range of medical specialties, many of which are under increased pressure as a result of growing demand.
    “We will continue to monitor the number of available training places in collaboration with NHS Education for Scotland to help make sure the NHS is equipped to meet the country’s current and future needs.”
    Read full story (paywalled)
    Source: The Times, 1 November 2022
  4. Patient Safety Learning
    Insulin rights activists and those who live with diabetes are calling for meaningful action to address the high costs of insulin in the United States as a new study shows the widespread habit of rationing the life-saving medicine.
    A study published on 18 October in the Annals of Internal Medicine by researchers at Harvard Medical School, the City University of New York’s Hunter College and Public Citizen, found that 1.3 million Americans rationed insulin due to the high costs of insulin in 2021. The staggering number represents an estimated 16.5% of the US population with diabetes.
    The study found insulin rationing was most commonly reported by those without health insurance coverage and individuals under the age of 65 not eligible for Medicare. Black insulin users were more likely to report rationing insulin, at 23.2%.
    The impact of the practice can be terrible.
    Janelle Lutgen of Dubuque county, Iowa, lost her 32-year-old son Jesse, a type 1 diabetic, after he started rationing his insulin because he lost his job and with it his health insurance and died in early 2018 from diabetic ketoacidosis.
    Without health insurance, Lutgen said over-the-counter insulin costs more than $1,000 (£865) a month, and that her son couldn’t afford the high cost of healthcare coverage in the marketplace without a job and wasn’t eligible for Medicaid coverage because his income from when he was working was too high.
    “It would probably be impossible to really know exactly all the harm that’s been done with high insulin prices,” said Lutgen, who explained that individuals who ration insulin because of the cost, if they do survive, can still experience other health impacts such as neuropathy, or losing toes or feet. “It seems like we can’t get it through legislators’ heads that we have to make sure everyone who needs insulin can get it, not just people who have insurance or people on Medicare – everybody. The only way to do that is to go to the root of the problem, big pharma.”
    Read full story
    Source: The Guardian, 1 November 2022
  5. Patient Safety Learning
    The number of people under 40 in the UK being diagnosed with type 2 diabetes is rising at a faster pace than the over-40s, according to “shocking” and “incredibly troubling” data that experts say exposes the impact of soaring obesity levels.
    The UK ranks among the worst in Europe with the most overweight and obese adults, according to the World Health Organization. On obesity rates alone, the UK is third after Turkey and Malta.
    The growing numbers of overweight and obese children and young adults across the UK is now translating into an “alarming acceleration” in type 2 diabetes cases among those aged 18 to 39, analysis by Diabetes UK suggests.
    There is a close association between obesity and type 2 diabetes. There is a seven times greater risk of type 2 diabetes in obese people compared with those of healthy weight, and a threefold increase in risk for those just overweight.
    “This analysis confirms an incredibly troubling growing trend, underlining how serious health conditions related to obesity are becoming more and more prevalent in a younger demographic,” Chris Askew, the chief executive of Diabetes UK, said.
    He added: “While it’s important to remember that type 2 diabetes is a complex condition with multiple other risk factors, such as genetics, family history and ethnicity, these statistics should serve as a serious warning to policymakers and our NHS.
    “They mark a shift from what we’ve seen historically with type 2 diabetes and underline why we’ve been calling on the government to press ahead with evidence-based policies aimed at improving the health of our nation and addressing the stark health inequalities that exist in parts of the UK.”
    Read full story
    Source: The Guardian, 1 November 2022
  6. Patient Safety Learning
    A trust has called for ministers to make an ‘urgent’ decision on funding for a new hospital, as a raft of maintenance problems such as leaking roofs and overflowing sewage pipes are hampering efforts to tackle waiting list backlogs.
    There was a surge in estates’ incidents reported by Princess Alexandra Hospital Trust last year — to an average of nearly 12 each week — and the Essex trust is calling for clarity on whether it will be given the green light to build a new hospital.
    The trust is one of eight given priority status under the government’s new hospitals programme, but there has been speculation in recent weeks the programme could be scaled back as departments are told to find spending cuts.
    Michael Meredith, estates director at Princess Alexandra Hospital, said patients still received good care, but admitted the problems – which include sewage overflow, outdated electrics and theatre roofs leaking – were “absolutely” affecting the hospital’s ability to recover elective care.
    He told HSJ: “It means you have to cancel some of your elective work. And at the moment that is critical, because we know [we’ve] got a long waiting list, we know we need to recover, we know we’ve got people waiting longer than they need to…
    “That has a real impact on our staff morale, and a real impact on patients waiting to be seen.”
    Read full story (paywalled)
    Source: HSJ, 1 November 2022
  7. Patient Safety Learning
    Results from the recently published Community Mental Health Survey highlight that issues with access to services and support, as evidenced in the 2020 and 2021 surveys, continue to persist. 
    The 2022 Community Mental Health Survey – coordinated by Picker for the Care Quality Commission – collected feedback from more than 13,400 people in contact with services between September and November 2021. The survey is an important source of information to help us understand the quality of person-centred care provided to mental health service users.
    A key feature of a high-quality person centred mental health service is timely access to care. The survey shows that there is more to be done here to ensure that service users have a good experience as nearly a third (31%) reported not being told who was in charge of organising their care and services – up from 28% in 2021. In parallel with this, 30% of service users said that they had not seen NHS mental health services enough in the last 12 months (compared to 27% in 2021 and 24% in 2020) and only 55% said they were given enough time to discuss their needs and treatment.
    Just over half of service users (51%) said that they did not receive any help or advice with finding support for financial advice or benefits – a 3% point increase from last year’s survey. When asked a similar question regarding support for finding or keeping work, 50% said they did not receive help or advice but would have liked it. With the financial worries that the increased cost of living is causing for many people, signposting support and advice for employment, managing money, and claiming benefits are vital for helping people maintain good mental health.
    Commenting on the results, Jenny King, Picker’s Chief Research Officer, said:
    “On the 22nd September 2022, the Secretary of State for Health and Social Care and Deputy Prime Minister at the time, Thérèse Coffey, announced the UK government’s Our plan for patients. Whilst it notes that work will continue to improve the availability of mental health support through expansion of services, there was little detail on how this would be achieved and how backlogs of care in mental health services would be resolved.
    With the backdrop of the cost of living crisis and its impact on people’s mental health, the findings from this survey highlight the urgent need for more to be done to address accessibility issues. And not just in mental health services but across health and social care where, as highlighted by CQC’s 2021/22 State of Care report, people are waiting too long for appointments, assessments, and treatment. Without a plan for tackling the NHS’s workforce crisis, the ability to make sustainable service improvements to address the unmet need is severely restricted.”
    Read full story
    Source: Picker, 27 October 2022
  8. Patient Safety Learning
    A case of MRSA has been reported at the congested asylum processing centre at Manston in Kent, the Guardian has learned, after it emerged that Suella Braverman ignored advice that people were being kept at the centre unlawfully.
    The antibiotic-resistant bacteria was identified in an asylum seeker who initially tested positive for diphtheria. But the asylum seeker was moved out of the site in Ramsgate to a hotel hundreds of miles away before the positive test result was received, raising concerns about the spread of the infection.
    The Manston site is understood to now have at least eight confirmed cases of diphtheria, a highly contagious and potentially serious bacterial infection.
    Migrants are meant to be held at the short-term holding facility, which opened in January, for 24 hours while they undergo checks before being moved into immigration detention centres or asylum accommodation such as a hotel.
    But giving evidence to a committee of MPs last week, David Neal, the independent chief inspector of borders and immigration, said he had spoken to a family from Afghanistan living in a marquee for 32 days, and two families from Iraq and Syria sleeping on mats with blankets for two weeks. Conditions at the site left him “speechless”, he said.
    On a visit to the site on 24 October, Neal was told there were four confirmed cases of diphtheria. 
    Protective medical equipment for staff has now been brought on to the site. Although diphtheria is a notifiable disease, meaning cases must be reported to authorities, those at Manston have not appeared on weekly public health reports.
    A Home Office spokesperson said it was “aware of a very small number of cases of diphtheria reported at Manston”, and that proper medical guidance and protocols were being followed.
    Read full story
    Source: The Guardian, 30 October 2022
  9. Patient Safety Learning
    Scotland's NHS is in "a perilous situation" amid a staffing and funding crisis, according to the chairman of the doctors' union.
    Dr Iain Kennedy said urgent action was needed to tackle workload pressures ahead of a potentially "terrifying" winter period.
    It comes after Scotland's health secretary Humza Yousaf admitted NHS Scotland was not performing well. Mr Yousaf told BBC Scotland it would take at least five years to fix.
    Dr Kennedy, who is chairman of the industry body BMA Scotland, said it was good to hear Mr Yousaf being honest about the scale of the problems, but added that "frankly we cannot wait five years" for things to improve.
    He told BBC Radio's Good Morning Scotland programme: "The NHS in Scotland is in a perilous situation and we have a particular crisis around the workforce - we simply do not have enough doctors in general practice and in hospitals.
    "We need more urgent action because the pressures and the workload have really shot up."
    Dr Kennedy has called on the government to publish a "heat map" showing where NHS vacancies are unfilled across Scotland.
    He said: "The public need to see transparency on where the vacancies are. We think that there are probably 15% vacancies across hospital consultant posts across Scotland.
    "Even the government admits to 7% and that we are at least 800 GPs short in Scotland - and I, and others, suspect we are probably well over that figure now."
    Read full story
    Source: BBC News, 31 October 2022
  10. Patient Safety Learning
    Surgeons in a London hospital have performed a week’s worth of operations in a single day, pioneering a technique that could be used to help reduce the NHS backlog.
    The team at Guy’s and St Thomas’ hospital performed eight robot assisted radical prostatectomy operations in under ten hours, the highest number performed in a single day in the UK in one hospital.
    High Intensity Theatre lists (HIT) focus on one procedure at a time and seek to minimise the turnaround time between operations. Using two theatres, the surgeon can go between cases without having to wait for a patient to come in. This helps to cut the significant amount of time it takes for medics to anaesthetise a patient, set up equipment in the theatre and help them to recover – a process which sometimes takes longer than the operation itself.
    The team at Guy’s assembled a large team for the HIT list, which took place on 8 October. Each theatre had a team of around 1.5 times its usual size and staff were given very specific roles.
    By the time the list had reached the third patient, the turnaround time between operations had dropped as low as 32 seconds. Behind the scenes, staff in the control room used Proximie software to monitor activity in the theatre in real time.
    Dr Ben Challacombe, a consultant urological surgeon who performed the operations with his surgical consultant colleagues Paul Cathcart, Christian Brown, and Prokar Dasgupta, told the Standard that the success of the HIT list had given staff a “huge” morale boost.
    “Everyone pulled together to do the job, it really helped to energise the team. Morale has been hit by Covid and other issues, but people feel galvanised by doing something different.”
    Read full story
    Source: Evening Standard, 29 October 2022
  11. Patient Safety Learning
    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
  12. Patient Safety Learning
    A surge in Covid cases over winter could lead to harsh visiting restrictions being reimposed in care homes and hospitals, MPs and campaigners have warned.
    Families are still facing a “postcode lottery” of Covid restrictions in care homes, with visiting times restricted and personal protective equipment (PPE) obligatory.
    However MPs are worried that some will reimpose even harsher measures if Covid cases rise this winter.
    Daily global Covid infections are projected to rise slowly to around 18.7 million by February, up from the current 16.7 million average daily cases this October.
    MPs are calling for the government to enact legislation that would enshrine the right for an essential care giver to be present with their loved ones in care settings.
    Liberal Democrat MP Daisy Cooper said that one of her constituents, Lynn, was not allowed into a hospital A&E ward to see her husband Andy when his dementia deteriorated over Christmas last year.
    The hospital refused to let Andy have any visitors for two weeks until Ms Cooper intervened. When she was allowed in, Lynn was distraught to find that Andy had lost a significant amount of weight in the weeks he was isolated.
    Ms Cooper continued: “We have come a long way since last Christmas, and since the start of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in Covid cases.
    “It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.”
    Read full story
    Source: Independent, 30 October 2022
    Further hub reading
    Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative Mother knows best – a blog by Dr Abha Agrawal
  13. Patient Safety Learning
    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
  14. Patient Safety Learning
    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
  15. Patient Safety Learning
    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
  16. Patient Safety Learning
    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. Patient Safety Learning
    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. Patient Safety Learning
    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. Patient Safety Learning
    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
  20. Patient Safety Learning
    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. Patient Safety Learning
    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
  22. Patient Safety Learning
    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
  23. Patient Safety Learning
    A hospital trust has been fined £200,000 for putting four babies at "serious risk"of harm.
    Staff at Rotherham Hospital failed to spot non-accidental injuries during admissions, Sheffield Magistrates' Court heard.
    District Judge Naomi Redhouse criticised failures in the hospital's systems and processes.
    Health watchdog, the Care Quality Commission (CQC), had earlier highlighted problems with safeguarding training at the trust prior to the babies' admissions between January 2019 and February 2020.
    The court was told how one eight-day-old baby was brought into the hospital on 23 December 2019 suffering from breathing difficulties and bleeding from the nose and mouth.
    It was only on the child's fifth visit to hospital - after a GP raised concerns - that a child safety examination took place, revealing rib and leg fractures that were deemed non-accidental.
    Ms Redhouse also heard how a month-old baby brought in with a mouth injury on 20 January 2019 was on a child protection plan but this was not spotted by the paediatric nurse who examined the baby.
    This child was twice released from hospital, with no safeguarding concerns, before a scan and other examinations revealed multiple fractures, the court heard.
    Prosecutor Ryan Donohue said failings had been identified in areas including policy implementation, training, reporting, auditing and governance.
    Eleanor Sanderson, mitigating for the trust, said: "The trust wishes to express to the court its deep regret for the circumstances which gave rise to these offences and the risk posed to those who required safeguarding."
    Read full story
    Source: BBC News, 26 October 2022
  24. Patient Safety Learning
    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
  25. Patient Safety Learning
    Regulators have told the agency that supplies blood to the NHS to develop a more inclusive culture, after hearing multiple reports of ethnic minority staff being ‘disrespected’ and discriminated against.
    “Many staff” at NHS Blood and Transplant also expressed fear of reprisal for raising issues and concerns, the Care Quality Commission (CQC) said.
    The CQC carried out a “well-led” inspection of the agency over the summer, after receiving concerns about its culture and the behaviour of some senior leaders.
    Chief executive Betsy Bassis resigned after the inspection, although the CQC report does not refer to any specific allegations made against her.
    NHSBT has acknowledged it needs to improve its culture, particularly around diversity and inclusion issues. An internal memo sent to staff last week, seen by HSJ, said executives and board members would receive one-to-one training in “inclusive leadership and understanding racism”.
    Read full story (paywalled)
    Source: HSJ, 27 October 2022

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