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Patient Safety Learning

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  1. Patient Safety Learning
    Early results from trials of a Covid vaccine developed in Russia suggest it could be 92% effective.
    The data is based on 20 cases of COVID-19 from 16,000 volunteers given the Sputnik V vaccine or a dummy injection.
    While some scientists welcomed the news, others said the data had been rushed out too early. It comes after Pfizer and BioNTech said their vaccine could prevent 90% of people getting Covid-19, based on a study of 43,500 people.
    Although the Sputnik data is based on fewer people being vaccinated and fewer cases of Covid developing during the trial, it does confirm promising results from earlier research.
    The Sputnik V vaccine, developed at the National Research Centre for Epidemiology and Microbiology in Moscow, is currently going through phase III clinical trials in Belarus, UAE, Venezuela and India.
    So far there are no safety issues, with Russian researchers saying there were "no unexpected adverse events" 21 days after volunteers received their first of two injections.
    Read full story
    Source: BBC News, 11 November 2020
  2. Patient Safety Learning
    A Tory peer has attacked the Department of Health and Social Care’s ‘woeful’ response to the patient safety review she authored and has revealed she intends to create a cross-party group to force action.
    Baroness Julia Cumberlege - who led the “First Do No Harm” report on device and medicine safety– has said she has “not had a whisper” from the department over the report’s key recommendations since it was published in July.
    She told HSJ’s Patient Safety Congress she is setting up a cross-party parliamentary group to “pressure” the department to adopt the report’s recommendations.
    The report arose from The Independent Medicines and Medical Devices Safety Review, which spoke to more than 700 people, mostly women, who suffered avoidable harm from surgical mesh implants, pregnancy tests and the anti-epileptic drug sodium valproate.
    The report discovered “a culture of dismissive and arrogant attitudes” including the unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. It concluded that the NHS has “either lost sight of the interests of all those it was set up to serve or does not know how best to do this.”
    Health and social care secretary Matt Hancock and minister Nadine Dorries have apologised to the women who were harmed but the department has so far not responded to the report’s other eight recommendations in detail.
    Baroness Cumberlege said the cross party group would “[try] to open up a firmly shut departmental door. A department that doesn’t seem to get it.” She said: “We have been disappointed [in the department’s response] because we hoped by now we would have some sort of inclination about what’s going on."
    “The response from the department on the other key recommendations has been woeful. The reason they give is ‘there is a terrible amount of work to do’”.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  3. Patient Safety Learning
    Planning around what the NHS can deliver this winter must be based on how many nursing staff are available and the workload they can safely take on, the Royal College of Nursing (RCN) has warned.
    Amid widespread nursing shortages, the union has called on the government to “be honest” about nurse vacancies and address what steps need to be taken to keep staff and patients safe.
    “It is essential that learning is applied to planning for this winter, including what service can be delivered safely with the workforce available”
    Last week NHS England moved to its highest level of emergency preparedness. But the RCN warned it still had grave concerns around how services would be safely staffed, claiming it was too late to find the nurses needed to meet the anticipated demands of the incoming winter.
    Despite an increase in the number of nurses registered with the Nursing and Midwifery Council this year, the college said there were still around 40,000 nurse vacancies in the NHS in England alone.
    These shortages, which were felt across all areas of nursing, had been exacerbated because of staff self-isolating or being off sick because of COVID-19, the RCN noted.
    The impacts of workforce shortages meant there was “enormous responsibility” on the nurses working and “intolerable pressure” on senior nursing leaders, it said. Unless local staffing plans prioritised safe and high-quality care, the few nurses in post were at risk of “burn out” this winter, the college added.
    Read full story (paywalled)
    Source: Nursing Times, 9 November 2020
  4. Patient Safety Learning
    A controversial exercise technique used to manage chronic fatigue syndrome is no longer being recommended by National Institute for Health and Care Excellence (Nice).
    The decision to stop recommending graded exercise therapy (GET) – which involves incremental increases in physical activity to gradually build up tolerance – represents a crucial win for patient advocates who have long said the practice causes more harm than good.
    Patient groups have argued that the use of exercise therapy suggests that those with chronic fatigue syndrome (also known as ME) have no underlying physical problem but are suffering symptoms due to inactivity.
    “We have been so widely dismissed and had our suffering at the hands of this condition constantly diminished by the inappropriate and damaging guidance/notion that we can simply exercise or think our way out of a physical illness none of us asked for nor deserve,” said ME patient Glen Buchanan.
    Chronic fatigue syndrome is thought to affect about 250,000 people in the UK and has been estimated to cost the economy billions of pounds annually. One in four are so severely affected they are unable to leave the house and, frequently, even their bed.
    Read full story
    Source: The Guardian, 10 November 2020
  5. Patient Safety Learning
    A new NHS treatment programme targeting young people with eating disorders has been launched amid a rise in numbers needing treatment during the coronavirus pandemic.
    Recent NHS data showed record numbers of children and young people are currently being treated across England for eating disorders while waiting times in some places are dangerously long.
    On Monday, children’s charity NSPCC warned that counselling sessions for eating and body image disorders rose by 32% after lockdown was introduced in March. The new scaling up of intervention services for those with eating disorders such as anorexia and bulimia will mean young people can gain access to rapid specialist NHS treatment across England.
    The service will be rolled out to 18 sites, building on a successful trial model at King's College London, where one patient described the treatment as the “gold standard” of care.
    Nadine Dorries, Minister for Health, said: “Eating disorders can have a devastating impact on individuals and their families – and can very sadly be fatal. I am committed to ensuring young people have access to the services and treatment they need which can ultimately save lives."
    Read full story
    Source: The Independent, 10 November 2020
  6. Patient Safety Learning
    Older women could be less likely to receive ovarian cancer treatment.
    A new report analysed data from more than 17,000 cases of ovarian cancer diagnosed across England between 2016 and 2018. Three in five (60%) of women with ovarian cancer over the age of 79 did not receive either chemotherapy or surgery, while 37% of women over the age of 70 did not receive any treatment.
    The nature of ovarian cancer means surgery is essential in the large majority of cases to remove the tumour.
    The researchers cautioned that with an ageing population it is vital that women of all ages have access to the best possible treatments.
    Researchers also examined the various rates of treatments for ovarian cancer among women in different parts of England.
    They found the probability of receiving any treatment fell below the average in the East Midlands, the East of England, Greater Manchester and Kent and Medway.
    The report was jointly funded by The British Gynaecological Cancer Society, Ovarian Cancer Action, Target Ovarian Cancer and delivered by analysts at the National Cancer Registration and Analysis Service.
    Commenting on the report, Cary Wakefield, chief executive of Ovarian Cancer Action, said: "Neither your age nor location should decide your chance of survival if you are diagnosed with ovarian cancer."
    "Our audit is the first step in addressing the health inequalities women across England face, so we can begin to dismantle them."
    Read full story
    Source: The Independent, 11 November 2020
  7. Patient Safety Learning
    Keyhole surgery can allow complicated procedures to be carried out with just a few access cuts, helping to reduce patient recovery times and potential risk of infection.
    But the remote controlled robots that can perform this type of surgery are often very large, expensive and not widely available.
    Now a new robo-surgeon with a modular design could be about to change that.
    View video
    Source: BBC News, 9 November 2020
  8. Patient Safety Learning
    Several NHS trusts are offering a ‘treatment’ for birth trauma which uses a technique which lies outside national guidelines and which is criticised by specialists as potentially causing ‘more harm than good’.
    The ‘Rewind’ technique is promoted as a fast treatment for post-natal post-traumatic stress disorder (PTSD) – also known as birth trauma - which involves the “reprocessing” of painful memories.
    HSJ has learned of several trusts, including East and North Herts Trust, Chelsea and Westminster Hospital Foundation Trust and James Paget University Hospital FT, where the therapy is being offered. It is thought there are other trusts which are providing it or have explored it. Typically, it is provided by midwives who have undergone training in the technique.
    But Nick Grey, a clinical psychologist who was on the National Institute for Health and Care Excellence panel which looked at PTSD, said it was “absolutely clear cut” that it was bad practice to offer the technique as a branded therapy for PTSD, although he said it could be embedded as part of other treatments.
    He told HSJ: “It should not be offered to mothers with PTSD… they are being done a disservice if they are not given evidence-based treatment. There is no evidence that this [provides] treatment for sub-clinical PTSD or trauma,” he said.
    Read full story (paywalled)
    Source: HSJ, 11 November 2020
  9. Patient Safety Learning
    The mutated strain of coronavirus from Danish mink could have “grave consequences”, Matt Hancock warned today.
    The Health Secretary said the new variant was a “significant development”. And he told MPs the new form of the virus “did not fully respond to Covid-19 antibodies” - hinting it might not respond in the same way to a vaccine.
    The UK banned travel and freight from Denmark on Saturday, going further than the current 14-day quarantine system.
    Those who had already passed from Denmark to Britain in the previous 14 days must isolate for two weeks.
    Updating the House of Commons, Mr Hancock said: “We’ve been monitoring the spread of coronavirus in European mink farms for some time, especially the major countries for mink farming like Denmark, Spain, Poland and the Netherlands.
    “On Thursday evening last I was alerted to a significant development in Denmark of a new evidence that the virus had spread back from mink to humans in a variant form that did not fully respond to Covid-19 antibodies.
    “Although the chance of this variant becoming widespread is low, the consequences should that happen would be grave.”
    Read full story
    Source: The Mirror, 10 November 2020
  10. Patient Safety Learning
    The NHS is ready to start providing the new coronavirus vaccine "as fast as safely possible", Health Secretary Matt Hancock has said.
    Asked whether it could be available by Christmas, he said that was "absolutely a possibility" - but he expected the mass roll-out "in the first part of next year".
    He said vaccination clinics would be open seven days a week, and he was giving GPs an extra £150m.
    On Monday, early results from the world's first effective coronavirus vaccine showed it could prevent more than 90% of people from getting Covid. The vaccine has been developed by pharmaceutical companies Pfizer and BioNTech and is one of 11 vaccines that are currently in the final stages of testing.
    The UK has already ordered 40 million doses - enough to vaccinate up to 20 million people as each person will need two doses for it to work effectively.
    Asked how many people would need to be vaccinated before life can return to normal, Matt Hancock said: "Well the answer to that is we just don't know."
    "So the trials can tell you if a vaccine is clinically safe and if it's effective at protecting an individual from the disease. What we can't know, until we've vaccinated a significant proportion of the population, is how much it stops the transmission of the disease."
    Mr Hancock told BBC Radio 4's Today programme it would be "a mammoth logistical operation" and highlighted some of the challenges, including getting it from Belgium to the UK while not removing from a temperature of -70C more than four times.
    Older care home residents and care home staff are at the top of a list from government scientific advisers of who would get immunised first, followed by health workers. Mr Hancock said NHS staff would go into care homes to vaccinate residents, as well as setting up vaccination venues. Children would not be vaccinated, he said.
    However, Prof Sir John Bell from Oxford University said: "I would worry about not giving this to as wide a percentage of the population as we can."
    "I'm more of the view that we need to vaccinate further into the population and vaccinate younger people as well, partly because we don't really know what the long term effects of this disease are."
    The vaccine will not be released for use until it passes final safety tests and gets the go-ahead from the Medicines and Healthcare products Regulatory Agency.
    Read full story
    Source: BBC News, 10 November 2020
  11. Patient Safety Learning
    In small room in the Royal Derby Hospital, there's a table bearing a laminated sign. "You are not alone," it says. It continues: "Kindness will get you through. Embrace the challenge. Look after each other. You are stronger than you think."
    This is the "wobble room", set aside not for patients but for front-line staff to get them away - briefly - from the intense pressure and strain experienced in the first wave of COVID-19.
    "We made a wobble room because that's what we needed," Kelly-Ann Gurney, an intensive-care nurse, told the BBC. "It's a room where staff could just go and sit and cry if they needed to and get it all out and then come back and 'put their face on' and get back into it again."
    Now the second wave is hitting the hospital, and the need for the room is just as great.
    Concerns are growing about the physical and mental health of front-line NHS staff. There has been no lull since the April peak of the virus as normal treatments and operations, postponed during the crisis, have returned to hospitals.
    Caroline Swan, a senior sister and manager of the intensive care unit at the Royal Derby, says she is ready to face what is ahead but feels very tired. "I am also very concerned. My staff are very tired and stressed out. We have a lot of sickness either due to burnout or they are unwell," she says.
    "A lot of staff have to self-isolate at home - and that puts a lot of strain on staffing here."
    Dr Magnus Harrison, medical director of the University Hospitals of Derby and Burton NHS Trust, says managing rotas is getting harder due to staff sickness and the need for some to self-isolate if family members are infected.
    "It is worth acknowledging what staff did in the first wave. They behaved tremendously and worked incredibly hard, and we're expecting them to do it again in winter - and Covid numbers could be higher than in the first wave. People are tired out."
    Read full story
    Source: BBC News, 10 November 2020
  12. Patient Safety Learning
    One in five COVId-19 patients were diagnosed with a mental illness for the first time within three months of their infection, a study has shown.
    Mental health experts said the findings, which were based on an analysis of the electronic medical records of 69 million people in the US, suggest that coronavirus survivors could have an increased risk of developing psychiatric disorders.
    Of the almost 70 million people whose records were examined in the study, 62,354 individuals had confirmed COVID-19 cases.  
    Researchers at the University of Oxford and the NIHR Oxford Health Biomedical Research Centre found that one in five of these patients went on to receive a first time diagnosis of anxiety, depression or insomnia within 90 days of testing positive for the virus. This was roughly twice as high as the figure for other individuals over the same time frame, according to the researchers.
    People with a history of mental health disorders who contracted the virus were also discovered to be more likely to have new psychiatric diagnoses.
    Paul Harrison, a psychiatry professor at the University of Oxford who led the research, said: "People have been worried that COVID-19 survivors will be at greater risk of mental health problems, and our findings in a large and detailed study show this to be likely.
    Read full story
    Source: The Independent, 10 November 2020
  13. Patient Safety Learning
    The NHS will rollout twice-weekly asymptomatic testing for all patient-facing staff by the end of next week, according to a letter from NHS medical director Stephen Powis.
    Government said only last week that universal asymptomatic staff testing would start in December, but government has now agreed it will bring this forward to this week for a first tranche of 34 trusts; and all others next week.
    The tests at 34 trusts this week will cover “over 250,000 staff,” Professor Powis said. He set out plans for the new testing regime in a letter to Commons health and social care committee chair Jeremy Hunt who has been pressing the government for routine staff testing since the summer.
    “Staff will be asked to test themselves at home twice a week with results available before coming into work,” Professor Powis said. The new testing regime can start following “further scientific validation of the lateral flow testing modality last week, and confirmation over the weekend from Test and Trace that they can now supply the NHS with sufficient test kits”.
    Read full story
    Source: HSJ, 9 November 2020
  14. Patient Safety Learning
    Pfizer and BioNTech have said that their coronavirus vaccine may be more than 90% effective, after the two pharmaceutical firms released interim data from their ongoing large-scale trial.
    Preliminary analysis, conducted by an independent data monitoring board, looked at 94 infections recorded so far in the vaccine’s phase 3 study, which has enrolled nearly 44,000 people in the US and five other countries.
    Of those participants who were infected with COVID-19, it is currently unclear how many had received the vaccine versus those who had been given a placebo. The current efficacy rate, which is much better than most experts expected, implies that no more than eight volunteers will have been inoculated.
    The data have yet to be peer-reviewed, and Pfizer said the initial protection rate might change by the time the study ends. The longevity of the immune response provoked by the mRNA-based vaccine also remains unknown.
    However, the findings are the most promising indication to date that a vaccine will be effective in preventing disease among infected individuals, handing humanity a crucial tool in tackling the pandemic.
    Pfizer and its German partner BioTech will continue with the phase 3 trial until 164 infections have been reported among volunteers - a figure that will give regulatory authorities a clearer idea of the vaccine’s efficacy.
    This number is expected to be reached by early December in light of the rising US infection rates, Pfizer said.
    The two companies said they have so far found no serious safety concerns and expect to seek US emergency use authorisation later this month.
    Read full story
    Source: The Independent, 9 November 2020
  15. Patient Safety Learning
    As many as 2,000 people could die because of Covid-related delays in the Welsh NHS, a cancer expert has said. With virus cases rising, Prof Tom Crosby, of the Wales Cancer Network, fears cancer cases missed in the first lockdown may now be harder to treat.
    Health Secretary Vaughan Gething said it would be "foolish" to have a plan for backlogs before the pandemic is over. But he said work was under way to address the issue with health boards.
    Alongside the spread of the virus, medical professionals are very worried about deaths that could occur not because of Covid, but due to the backlog of appointments and surgery it is causing.
    BBC Wales Investigates has been uncovering the full extent of the looming problem facing the NHS. 
    Delays caused by the pandemic are a serious concern to Prof Crosby, who is medical director at the Wales Cancer Network. He said when the pandemic first hit, acute COVID-19 cases became the focus in hospitals at the expense of cancer, cardiac and orthopaedic appointments.
    "Some of the conversations we've had with patients in the clinic have been really, really challenging," he said.
    "Then there are thousands of patients who have not come through to the system that usually would have. Some of those are going to have had cancer, and they will not have been diagnosed now."
    Prof Crosby has been looking at possible outcomes for cancer patients because of delays in diagnosis and treatment.
    "We have done some modelling work with England, and it has suggested that between 200 and 2,000 excess deaths will occur as a result of undiagnosed or untreated cancer in Wales," he said.
    "I think the effects on cancer services are going to be here for two to three years."
    Read full story
    Source: BBC News, 9 November 2020
  16. Patient Safety Learning
    Some disabled people in the UK have been struggling to obtain essentials such as medication and breathing equipment during the Covid pandemic, research for the BBC suggests.
    Some 60% of those who rely on social care told a YouGov survey they were finding it hard to obtain at least one of their necessities.
    Charity WellChild said people felt more "forgotten than they ever have been".
    But ministers say the needs of disabled people were being considered. The Department of Health and Social Care says it has sufficient stocks and patients should contact their local care provider.
    Like one in 20 of those survey respondents who receive social care, Fi Anderson, a mother of two with muscular dystrophy from Bolton in Greater Manchester, said she has faced problems obtaining breathing apparatus. Her local hospital told her to re-use the filter for her portable ventilator, recommending she boil it, because supplies were so short.
    Disabled people who rely on social care - which funds equipment and other support to allow them to live independent lives - also said they had struggled to obtain personal protective equipment (PPE) such as face masks. Many of them receive funding directly to employ carers in their home, so they also need to provide them with PPE during the coronavirus crisis.
    The survey, which the BBC commissioned to mark the 25th anniversary of the Disability Discrimination Act, asked more than 1,000 people about life in the UK with a disability and how it has changed in the shadow of a pandemic.
    More than 65% felt their rights had regressed, and 71% said disabled people's needs had been overlooked.
    The Coronavirus Act, which granted the government emergency powers, gave local councils the ability to reduce care, education and mental health provision for disabled people if it became necessary during the pandemic.
    According to the latest figures from the Office for National Statistics, nearly six out of 10 deaths from COVID-19 were of disabled people.
    Read full story
    Source: BBC News, 
  17. Patient Safety Learning
    Nurses will be allowed to look after two critically ill COVID-19 patients at the same time after NHS bosses relaxed the rule requiring one-to-one treatment in intensive care as hospitals come under intense strain.
    NHS England has decided to temporarily suspend the 1:1 rule as the number of people who are in hospital very sick with Covid has soared to 11,514, of whom 986 are on a ventilator.
    The move comes amid concern that intensive care units, which went into the pandemic already short of nurses, are being hit by staff being off sick or isolating as a result of Covid. It follows a warning last week by Prof Chris Whitty, England’s chief medical officer, that the Covid resurgence could overwhelm the NHS.
    Dr Alison Pittard, the dean of the Faculty of Intensive Care, which represents doctors in ICUs, welcomed the shift to a more “flexible” nurse/patient staffing ratio in critical care. But she said it must be used only for as long as the second wave is putting units under serious pressure.
    “Covid has placed the NHS, and critical care in particular, in an unenviable position and we must admit everyone for whom the benefits of critical care outweigh the burdens. This means relaxing the normal staffing ratios to meet this demand in such a way that delivers safe care, but also takes account of the impact this may have on staff health and wellbeing."
    “The 1:2 ratio is a maximum ratio, to be used only to support Covid activity, [and] not for planned care, and is not sustainable in the long term. This protects staff and patients”, she said.
    Read full story
    Source: The Guardian, 8 November 2020
  18. Patient Safety Learning
    Not a single resident has contracted the coronavirus at Goodwin House’s small residential facility in Northern Virginia, USA, where about 80 seniors live in homey apartments and keep their own sleeping and meal schedules. There’s been just one case at the Woodlands at John Knox Village in Broward County, Fla., where all 140 residents live in private rooms and are cared for by nurses who earn enough not to take a second job.
    These facilities, part of a national movement in the US to create less-institutionalised long-term care, stand out in a pandemic that has killed more than 61,000 nursing home residents in the US since March. At “Green House” homes, the best-known nontraditional model, residents are one-fifth as likely to get the coronavirus as those who live in typical nursing homes — and one-twentieth as likely to die of the disease it causes.
    The model has been praised by academics and doctors and seems far better suited than traditional facilities to stave off the spread of infection and the isolation that has devastated the elderly in recent months. But it remains on the fringes of a $137 billion industry.
    Read full story
    Source: The Washington Post, 3 November 2020
  19. Patient Safety Learning
    Trusts in more than half English local authorities still do not have an agreed safe place to discharge recovering covid patients to, despite the government asking councils to identify at least one such ‘designated setting’ by the end of October.
    The situation is leading to an increase in delayed discharges from hospital just as the service comes under increased pressure from the second covid wave and returning elective and emergency demand. 
    In a letter last month, the government told local authorities to identify at least one “designated setting” – typically a care home – which hospitals could discharge covid positive patients to when they no longer need secondary care. The designated setting would also take discharged patients who had not received a negative covid test.
    The plan is designed to protect residents in other homes, after thousands of care home residents died due to outbreaks of the virus in the spring.
    But a well-placed source in the care sector told HSJ less than half of the 151 upper tier councils met the 31 October deadline, due to a range of reasons including insurance costs, fear of high mortality rates and reputational damage to the designated homes.
    It means that in many parts of the country, there are a lack of options when it comes to discharging patients, which is causing a rise in delayed discharges.
    Read full story (paywalled)
    Source: HSJ, 5 November 2020
  20. Patient Safety Learning
    The NHS has been returned to the highest level of risk on its emergency preparedness framework, a move which allows national leaders tighter control over local resources and decision making.
    NHS England chief executive Sir Simon Stevens announced the decision at a press conference this morning.
    He said: “Unfortunately, again we are facing a serious situation [due to rising coronavirus infections and hospital admissions]. That is the reason why at midnight tonight the health service in England will be returning to its highest level of emergency preparedness, EPPR level 4, which of course we had to be at from the end of January to the end of July.”
    Placing the NHS on level 4 of Emergency Preparedness Reslience and Response framework allows system leaders to take control of decisions over mutual aid and other local priorities.
    Sir Simon was joined by NHSE/I medical director Steve Powis and Alison Pittard, dean of the Faculty of Intensive Care Medicine. They used the press conference to stress the threat the NHS faced from the second covid peak, but also set out more positive news on the covid vaccine programme.
    Read full story
    Source: HSJ, 4 November 2020
  21. Patient Safety Learning
    A woman has been arrested after attempting to take her 97-year-old mother out of a care home for lockdown.
    Qualified nurse Ylenia Angeli, 73, wanted to care for her mother, who has dementia, at home. But when she told staff at the care home, they called the police who then briefly arrested Ms Angeli.
    The family have not been able to see their elderly relative for nine months, and decided to act ahead of the second national lockdown.
    Assistant Chief Constable Chris Noble, from Humberside Police, said: "These are incredibly difficult circumstances and we sympathise with all families who are in this position."
    "We responded to a report of an assault at the care home, who are legally responsible for the woman's care and were concerned for her wellbeing. We understand that this is an emotional and difficult situation for all those involved and will continue to provide whatever support we can to both parties."
    The incident came to light on the day the government announced new rules for families wishing to visit their loved ones in care homes.
    Under the guidance, issued hours before lockdown, families can meet relatives through a window or in a secure outdoor setting. Visits will need to be booked in advance, but the Department of Health and Social Care advice said care homes "will be encouraged and supported to provide safe visiting opportunities".
    All care home residents are allowed to receive visits from friends and family during the second national lockdown.
    Read full story
    Source: Sky News, 5 November 2020
  22. Patient Safety Learning
    The Medicines and Healthcare products Regulatory Agency (MHRA) has received its one millionth Yellow Card. The Yellow Card scheme is the UK’s system for reporting suspected side effects to medicines and adverse events with medical devices. This major milestone coincides with the launch of the 5th annual #MedSafetyWeek (2-8 November), which highlights the value of the Yellow Card scheme to the nation’s health, and the importance of reporting suspected side effects from medicines.
    The MHRA has seen an increased rate of Yellow Card reports and would like to continue to encourage more reporting this #MedSafetyWeek.
    MedSafetyWeek is a global campaign, with over 70 countries participating, worldwide. This year, the theme is ‘every report counts’. The MHRA will be calling upon patients and carers, as well as healthcare professionals and their organisations to report suspected side effects from medicines.
    Reporting helps to identify new side effects, as well as unexpected and serious safety problems. It also adds to existing information about known effects. By reporting, patients and the public can help the safe use of medicines for everyone. 
    Read press release
    Source: GOV.UK, 2 November 2020
  23. Patient Safety Learning
    Vulnerable patients at a major NHS hospital at the centre of England’s coronavirus second wave have been left without help to eat or drink because wards are so dangerously understaffed, The Independent can reveal.
    Dozens of safety incidents have been reported by doctors and nurses at the Liverpool University Hospitals Trust since April, citing the lack of nurses as a key patient safety risk.
    Across several wards, just two registered nurses per ward were being expected to look after dozens of sick patients – a ratio of nurses to patients far below recommended safe levels.
    On one ward there were 36 patients to two registered nurses – with the nurse in charge of the ward having only qualified six months earlier.
    The safety concerns also include a diabetic patient – where there was no evidence nurses had monitored their blood glucose levels and insulin medication, which if left unchecked could prove fatal.
    Other patients have been forced to eat food and drink which has gone cold by the time staff are ready to help them.
    The hospital is among the worst affected by the surge in coronavirus cases in the north of England. It’s medical director warned on Friday that it was at 100 per cent capacity and unable to maintain standards of care.
    Read full story
    Source: The Independent, 5 November 2020
  24. Patient Safety Learning
    Over a third (35%) of healthcare professionals say they have suffered verbal or physical abuse from patients, or patients’ relatives during COVID-19, according to a survey by Medical Protection.
    The Medical Protection survey of 1250 doctors in the UK, also showed that a further 7% have experienced verbal or physical abuse from a member of the public outside of a medical setting, with some saying they have been sworn at for using the NHS queue at the supermarket.
    This follows reports that GP’s are facing abuse and complaints from patient’s who believe they aren’t offering enough face-to-face appointments, despite face-to-face appointments increasing in recent months. 
    Medical Protection said the abuse presents yet another source of anxiety for doctors at the worst possible time. In the same survey, 2 in 5 doctors say their mental wellbeing is worse compared to the start of the pandemic.
    “I have been sworn at for using the NHS queue at the supermarket.”
    “I have had more unpleasantness from patients in the last 6 months than in all my previous 50 years in healthcare.I am almost at the point of stopping all clinical practice.”
    “There is too much verbal abuse to mention but the most upsetting is patients believing that we haven`t been open – we are all on our knees.”
    Read full story
    Source: Medical Protection, 31 October 2020
     
  25. Patient Safety Learning
    An NHS hospital where a woman bled to death in childbirth has been given an "urgent" deadline to keep patients at its maternity unit safe.
    A letter seen by the BBC reveals the Care Quality Commission (CQC) found unsafe staffing levels at the unit at Basildon Hospital throughout August. The CQC said the trust that runs it had until next Monday to implement appropriate measures.
    The trust said it had a "robust improvement plan in place".
    The seven-page document, sent by the CQC on 7 October, puts the Mid and South Essex NHS Foundation Trust on notice that it has to "implement an effective governance system", among other measures.
    Consequences for missing the deadline were not stated, but the CQC said it was using its powers under the Health and Social Care Act to impose conditions on the trust's registration.
    The Act does allow the CQC to temporarily close health services.
    Read full story
    Source: BBC News, 3 November 2020
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