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Patient Safety Learning

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  1. Patient Safety Learning
    Bosses at struggling trusts must sign new commitments to national leaders about how they are approaching the task of clearing their elective and cancer backlogs, under a new protocol drawn up by NHS England.
    National leaders have written to CEOs and chairs of trusts in NHSE’s bottom two “tiers” for elective and cancer performance, telling them they must fill out a new “board self certification” by 11 November.
    It requires them to sign that they have carried out a list of 12 separate actions to try to improve.
    In addition to some fundamental administrative requests, these include increased scrutiny around issues such as theatre productivity, list validation, especially for non-admitted lists, and cancer pathway redesign.
    Read full story (paywalled)
    Source: HSJ, 28 October 2022
  2. Patient Safety Learning
    Just a “fraction” of people with Long Covid is getting the help they need, with a third of them waiting more than three and a half months to be assessed after a GP referral, rising to almost half in some areas.
    More than 60,000 people in England had a first assessment for post-Covid syndrome in an NHS specialist service between July 2021 and August 2022.
    But the latest estimates released by the Office for National Statistics (ONS) show that about 277,000 people with Long Covid in England report that the disease has limited their day-to-day activities “a lot”. These are the people that experts would expect to be referred for an assessment; however, the numbers who have been seen are far lower.
    Dr Helen Salisbury, a GP and columnist for the BMJ, said: “A fraction of the people who have got this problem are actually being seen” within the existing services.
    She said reasons could include patients not realising that the help is available to them; GPs not recognising Long Covid in those who do not self-label as having the condition; and a lack of knowledge of, and local access to, specialised clinics.
    While Salisbury conceded that there was no current cure for long Covid, she added that patients require treatment that involves symptom management, psychology and knowing they are not alone in their diagnosis.
    Ondine Sherwood, a co-founder of the advocacy charity Long Covid SOS, said many people with long Covid “are struggling to get any healthcare. Many are not getting any treatment at all.”
    She said public misconceptions around long Covid made it harder for sufferers to ask for and get help. “There was a lack of preparedness for the potential long-term morbidity which was not conveyed to healthcare professionals and this has contributed to the lack of care for long Covid.”
    Read full story
    Source: The Guardian, 27 October 2022
  3. Patient Safety Learning
    Senior staff have questioned why a major hospital did not seek support from neighbours when emergency patients were left waiting more than 60 hours to be admitted to a bed.
    Cambridge University Hospitals Foundation Trust’s emergency department came under severe pressure last week, with patients being bedded down in corridors and facing very long waits to be admitted to a ward.
    Senior sources told HSJ there were two cases where patients were waiting more than 60 hours last Monday, and the trust declared an internal incident.
    But the sources felt the trust should have escalated its alert level to “Opel 4”, which prompts calls for external support when trusts are under the most severe levels of operational pressure. This can include diverting ambulances to other hospitals.
    The trust apologised to patients who had been kept “waiting for a long time” but that the required threshold for Opel 4 had not been reached.
    Read full story (paywalled)
    Source: HSJ, 25 October 2022
  4. Patient Safety Learning
    A medical expert has told the trial of nurse Lucy Letby how he noticed a "quite disturbing and quite unusual" pattern in the deaths of babies she is accused of murdering.
    Ms Letby is charged with killing seven babies and attempting to murder 10 others at the Countess of Chester Hospital in 2015 and 2016.
    Expert Dr Dewi Evans was approached by the National Crime Agency to review the case in 2017.
    Giving evidence at Manchester Crown Court, Dr Evans said: "The concern was that there had been a number of deaths in the Countess of Chester that had been unusual.
    "There were far more deaths than they would expect. There was collapses in babies that were otherwise quite stable, but in many of the cases resuscitation was not successful."
    It is alleged Ms Letby injected air into the bloodstream of a baby referred to in court as Child A, shortly after she came on shift in June 2015, just over 24 hours after his premature birth.
    The prosecution alleges she used the same method to attack his sister, Child B, on the following night shift.
    Dr Evans told the court that a review of Child A's records showed that the baby boy was in a "stable condition" before his collapse.
    He said: "He was as well as could be expected, all the markers of wellbeing were very satisfactory.
    Read full story
    Source: BBC News, 25 October 2022
     
  5. Patient Safety Learning
    A Harley Street doctor suspended for working while testing positive for Covid at the height of the pandemic has said that his patient’s cancer treatment took priority.
    Dr Andrew Gaya was found to have “blatantly disregarded” the rules by going to work at a centre for patients with brain tumours after he tested positive for the disease.
    The “highly regarded” consultant oncologist “dishonestly” misled colleagues that he was safe to work by keeping his positive test secret, a tribunal found.
    Dr Gaya, whose work is at the forefront of tumour care and has been described as “world class”, said he defied Covid-19 rules because he believed “the risk of harm to his patient” in delaying treatment was “greater than the risk he posed”.
    Now, the doctor of 27 years has been suspended for three months at a Medical Practitioners’ Tribunal.
    Read full story (paywalled)
    Source: The Times, 20 Ocotober 2022
  6. Patient Safety Learning
    The “social prescribing” of gardening, singing and art classes is a waste of NHS money, a study suggests.
    Experts found that sending patients to community activity groups had “little to no impact” on improving health or reducing demand on GP services.
    The research calls into question a major drive from the NHS and Department of Health to increase social prescribing as a solution to the shortage of doctors and medical staff.
    In 2019 the NHS set a target of referring 900,000 patients for such activities via their GP surgeries within five years.
    Projects receiving government funding include football to support mental health, art for dementia, community gardening and singing classes to help patients to recover from Covid.
    However, the study, published in the journal BMJ Open, said there was “scant evidence” to support the mass rollout of so-called “social prescribing link workers”.
    Read full story (paywalled)
    Source: The Times, 18 October 2022
  7. Patient Safety Learning
    A quarter of services the Care Quality Commission has recently inspected required enforcement action from the regulator, its chief executive has revealed. 
    Speaking at the launch of the regulator’s annual State of Care report, Ian Trenholm called for a “long-term, sustainable funding solution” from the government to aid a service that was ”genuinely struggling to cope”.
    Mr Trenholm said “about a quarter of the services” the CQC has inspected in 2022 had resulted in it having to take “enforcement action”.
    Examples of action taken against NHS trusts in the last year included enforcement measures placed on Nottingham University Hospitals, University Hospitals Sussex, and Princess Alexandra Hospital.
    In response to a question from HSJ about the robustness of the CQC’s inspection regime following further care quality and safety scandals, Mr Trenholm said observers should not focus solely on the ratings given to trusts by the CQC as there was a lot ”work going on in the background, whether that’s enforcement or otherwise”.
    He added the CQC had significantly increased the amount of information it was gathering in relation to concerns about services.
    Read full story
    Source: HSJ, 21 October 2022
     
  8. Patient Safety Learning
    Parents are being told to urgently bring their children forward for flu vaccinations as new data reveals the rate of hospitalisation and ICU admission for people with the virus is rising fastest among those under five years old.
    New figures published in the UK Health Security Agency’s (UKHSA) National flu and Covid-19 surveillance report show that cases of flu have climbed quickly in the past week, indicating that the season has begun earlier than normal.
    According to the UKHSA, vaccination for flu is currently behind last season for pre-schoolers (12.1% from 17.4% in all two-year-olds and 12.8% from 18.6% in all three-year-olds).
    It has also fallen behind in pregnant women (12.4% from 15.7%) and under 65s in a clinical risk group (18.2% from 20.7%).
    Dr Mary Ramsay, director of public health programmes at the UK Health Security Agency, said: “Our latest data shows early signs of the anticipated threat we expected to face from flu this season.
    “We’re urging parents in particular not to be caught out as rates of hospitalisations and ICU admissions are currently rising fastest in children under 5.
    “This will be a concern for many parents and carers of young children, and we urge them to take up the offer of vaccination for eligible children as soon as possible.”
    Read full story
    Source: The Independent, 20 October 2022
  9. Patient Safety Learning
    The families of three patients who all died after undergoing the same specialised endoscopy procedure have accepted damages from an NHS trust.
    The patients all died after a procedure called an endoscopic retrograde cholangiopancreatography (ERCP) at Nottingham University Hospitals NHS Trust.
    Following their deaths, a coroner issued a report calling for changes. The trust said improvements had been made.
    William - known as Bill - Doleman, 76, Anita Burkey, 85, Peter Sellars, 72, and Carol Cole, 53, died in the space of about six months after undergoing the procedures.
    An inquest found they died as a result of complications of the ERCP - where a tube is passed through a patient's throat to examine and treat possible gallstones and other conditions.
    The families said they had accepted undisclosed damages from the trust over the deaths.
    Read full story
    Source: BBC News, 21 October 2022
  10. Patient Safety Learning
    Indonesia has temporarily banned all syrup-based and liquid cough medicines after the death of nearly 100 children from acute kidney failure since the start of this year.
    Most of those affected are said to be below the age of six.
    Muhammad Syahril Mansyur, the country’s health ministry spokesman, said: “Until today, we have received 206 reported cases from 20 provinces with 99 deaths.”
    He added: “As a precaution, the ministry has asked all health workers in health facilities not to prescribe liquid medicine or syrup temporarily … we also asked drug stores to temporarily stop non-prescription liquid medicine or syrup sales until the investigation is completed.”
    The ban, announced by the health ministry on Wednesday, applies to prescription and over-the-counter medicines. It comes after nearly 70 children died of acute kidney failure this year in the Gambia, linked to four brands of paracetamol cough syrup manufactured by India’s Maiden Pharmaceuticals.
    Read full story (paywalled)
    Source: The Times, 20 October 2022
  11. Patient Safety Learning
    Russell-Cooke personal injury and clinical negligence partner Grant Incles recently represented Mrs Karen Preater in a clinical negligence case over vaginal mesh surgery performed on her at a hospital in north Wales in 2014. 
    Wrexham County Court found in favour of Mrs Preater, and roundly dismissed allegations made by the defendant in this case, the Betsi Cadwaladr University Health Board, that the claimant had lied in the presentation of her case, as part of a Fundamental Dishonesty defence. 
    Mrs Preater underwent vaginal mesh surgery in January 2014 - to which she had not been properly consented. The surgery itself was performed negligently and as a result she suffered a life-changing chronic pain condition. In late 2020, the defendant carried out intrusive video surveillance of Mrs Preater and trawled through her life on social media, proceeding to launch a defence of Fundamental Dishonesty pursuant to S.57 of the Criminal Justice and Courts Act 2015.
    The defendant alleged that the claimant was seeking to lie to the Court about her ability to work and need for care and assistance which, if found to be correct by the Court, would have meant that Mrs Preater would have lost all of her claimed compensation, and which may well have led to an application by the defendant to have her committed to prison for her alleged dishonesty.
    The case was fought to trial over seven days in July 2022. HHJ Howells found that Mrs Preater had not sought to deceive any party at any time and should be fully compensated for her grave suffering since being injured over eight years ago. 
    Read full story
    Source: Russell-Cooke, 4 August 2022
    Court judgement:
    22081101.Preater v BCUHB approved judgment dated 4 August 2022.pdf
  12. Patient Safety Learning
    Tracey Fletcher, chief executive of East Kent Hospitals, said: "I want to say sorry and apologise unreservedly for the harm and suffering that has been experienced by the women and babies who were within our care, together with their families, as described in today’s report.
    "These families came to us expecting that we would care for them safely, and we failed them.
    "We must now learn from and act on this report; for those who have taken part in the investigation, for those who we will care for in the future, and for our local communities. I know that everyone at the Trust is committed to doing that.
    "In the last few years we have worked hard to improve our services and have invested to increase the numbers of midwives and doctors, in staff training, and in listening to and acting on feedback from the people who receive our care.
    "While we have made progress, we know there is more for us to do and we absolutely accept that. Now that we have received the report, we will read it in full and the Board will use its recommendations to continue to make improvements so that we are providing the safe, high-quality care our patients expect and deserve.
    "I want every family – whether they contributed to the investigation or not – to know I am here to listen to them, to learn and to lead our Trust in acting on this report. 
    "I would like to thank Dr Bill Kirkup and the investigation team for their work. Today, our thoughts remain with those who have shared their experiences. We are grateful to them.”
    Source: NHS East Kent Hospitals, 19 October 2021
  13. Patient Safety Learning
    Jeremy Hunt has been told that any cuts to the health budget will in effect “kill” dental services across the UK and deny millions of patients access to a dentist on the NHS.
    The chancellor has told members of the cabinet that “everything is on the table” as he seeks to find tens of billions of pounds in savings after ditching the economic plan of Liz Truss, who said on Thursday she was standing down as prime minister. Health is one key area expected to be hit.
    But in an email to Hunt seen by the Guardian, the head of the British Dental Association (BDA) said in plain terms that because NHS dentistry had already “faced cuts with no parallel anywhere in the health service” over the last decade, any further reduction in funding could trigger its collapse.
    “In blunt terms, NHS dentistry is approaching the end of the road,” Martin Woodrow, the BDA chief executive, wrote in the memo. “There is simply no more fat to trim, short of denying access to an even greater proportion of the population.”
    In the memo to Hunt, Woodrow wrote: “Recent NHS England board papers confirm officials are euphemistically ‘taking steps to maximise access from existing resources’. We know what that means. Yes, we recognise the unparalleled pressures on public spending. Equally, we cannot escape the hard fact that a service millions depend on materially lacks the resources to underpin any rebuild.
    “You have also spoken of the need for all departments to seek ‘efficiency savings’. Since the financial crash, NHS dentistry has faced cuts with no parallel anywhere in the health service, going into the pandemic with lower government contributions – in cash terms – than it saw a decade ago.
    Read full story
    Source: The Guardian, 21 October 2022
  14. Patient Safety Learning
    Two out of five maternity units in England are providing substandard care to mothers and babies, the NHS watchdog has warned.
    “The quality of maternity care is not good enough,” the Care Quality Commission (CQC) said in its annual assessment of how health and social care services are performing.
    It published new figures showing it rated 39% of maternity units it inspected in the year to 31 July to “require improvement” or be “inadequate” – the highest proportion on record.
    Ian Trenholm, the CQC’s chief executive, said maternity services were deteriorating, substandard care was unacceptably common and failings were “systemic” across the NHS.
    Its latest state of care report said: “Our ratings as of 31 July 2022 show that the quality of maternity services is getting worse, with 6% of NHS services (nine out of 139) now rated as inadequate and 32% (45 services) rated as require improvement.
    “This means that the care in almost two out of every five maternity units is not good enough.”
    The report said: “The findings of recent reviews and reports … show the same concerns emerging again and again. The quality of staff training, poor working relationships between obstetric and midwifery teams and a lack of robust risk assessment all continue to affect the safety of maternity services. These issues pose a barrier to good care.”
    Staff not listening to women during pregnancy and childbirth is a recurring problem, Trenholm said. Their concerns “are not being heard” by midwives and obstetricians “in the way that they should”.
    Read full story
    Source: The Guardian, 21 October 2022
  15. Patient Safety Learning
    Women waiting for breast reconstruction surgery on the NHS in England face a “postcode lottery” of care, with some forced to wait more than three years, a damning report warns.
    Two in five women (40%) waiting for breast reconstruction during the pandemic after having their breasts removed due to cancer faced a delay of 24 months or longer, according to research involving 1,246 women who either underwent reconstruction surgery or were waiting for it.
    The report by charity Breast Cancer Now also warned that some breast reconstruction services are still not operating at full capacity after temporarily pausing at the start of the Covid-19 pandemic.
    It says there was a 34% drop in breast reconstruction activity in England in 2021-22 compared with 2018-19. The charity added that on top of the delays, women face a “postcode lottery” of care, with some women offered certain types of reconstruction while others are denied the same operation.
    Breast Cancer Now called on NHS England to develop a plan to address the backlog of breast reconstruction services.
    One woman told the authors of the report she waited for three and a half years for breast reconstruction surgery, while another said she “wants to move on with my life” but has no idea when her surgery will go ahead.
    Baroness Delyth Morgan, the chief executive of Breast Cancer Now, said: “For women who choose breast reconstruction, it is a core component of their recovery – far from a solely aesthetic choice, this is the reconstruction of their body and indeed their identity after they have been unravelled by breast cancer treatment and surgery.
    “We hear of patients affected by delays to reconstruction surgery and the significant emotional impact this has on them, including altered body confidence, loss of self-esteem and identity, anxiety and depression, and hindering their ability to move forward with their lives, knowing their treatment is incomplete."
    Read full story
    Source: The Guardian, 19 October 2022
  16. Patient Safety Learning
    A series of chairs and chief executives at an acute trust were ‘wrong’ to believe the organisation was providing acceptable care over an 11-year period and should be held accountable for one of NHS’s largest maternity care scandals, an inquiry concluded today.
    Bill Kirkup’s inquiry into East Kent Hospitals University Foundation Trust found 45 of the 65 deaths of babies examined could have been prevented. It also concluded the overall outcome of 48% of 202 cases investigated could have been different, if care had matched nationally recognised standards. 
    It also warned that the unjustified belief that things “would get better” as a result of management changes still continued at the trust.
    The report added that problems in the service were visible to senior managers and the board through a succession of reports, dating back to 2009. 
    The report stated: “We have concluded that accountability lies with the successive trust boards and the successive chief executives and chairs. They had the information that there were serious failings, and they were in a position to act; but they ignored the warning signs and strenuously challenged repeated attempts to point out problems. This encouraged the belief that all was well, or at least near enough to be acceptable. They were wrong.”
  17. Patient Safety Learning
    University College London Hospitals (UCLH) is to host to a new collaboration researching patient safety, after being awarded £3 million in funding from the National Institute for Health and Care Research.
    The NIHR Central London Patient Safety Research Collaboration (PSRC) aims to improve safety in Surgical, Perioperative, Acute and Critical care (SPACE) services, which treat more than 25 million NHS patients annually. Perioperative care is care given at and around the time of surgery.
    Amongst the highest risk clinical settings are SPACE services because of the seriousness of the patients’ conditions and the complex nature of clinical decision making.
    Further risks arise at the transitions of care between SPACE services and other parts of the health and social care system. 
    The research team led by UCLH and UCL will develop and evaluate new treatments and care pathways for SPACE services.  This will include new interventions such as surgical and anaesthetic techniques, and new approaches to predicting and detecting patient deterioration. They will also help the NHS become safer for patients through the development of innovative approaches to organisational learning, and to how clinical evidence is generated. The PSRC’s learning academy will support the next generation of patient safety researchers through a comprehensive programme of funding, mentoring and peer support.
    The team includes frontline clinicians, policy makers and world-leading academics across a range of scientific disciplines including social and data science, mechanical and software engineering. Patients and the public representing diverse backgrounds are key partners in the collaboration.
    Professor Moonesinghe said: “We have a great multidisciplinary, multiprofessional team ready to deliver a truly innovative programme to improve patient safety in these high-risk clinical areas. As a uniquely rich research environment, UCLH and UCL are well placed to lead this work, and we are looking forward to collaborating with clinicians and patients across the country to ensure impact for the whole population which the NHS serves.”
  18. Patient Safety Learning
    More than a third of the 3143 counties in the US are maternity “deserts” without a hospital or birth centre that offers obstetric care and without any obstetric providers—and the situation is getting worse, says a report from the March of Dimes organisation.
    Maternity deserts have increased by 2% since the 2020 report, said the organisation which seeks to improve the health of women and babies. Care is diminishing where it is needed most—especially in rural areas. It affects nearly seven million women of childbearing age and about half a million babies.
    Read full story (paywalled)
    Source: BMJ, 17 October 2022
  19. Patient Safety Learning
    A major trust’s former chief executive and medical director have been cleared, after being accused of failing to protect breast patients from a rogue surgeon.
    The Medical Practitioners Tribunal Service has ruled neither Mark Goldman nor Ian Cunliffe’s fitness to practise was impaired, in a case brought by the General Medical Council. 
    Mr Goldman was chief executive of the Heart of England Foundation Trust from 2001 until 2010, while Dr Cunliffe served as HEFT medical director between 2006 and 2010. Both held roles at HEFT while Ian Paterson was there.
    Mr Paterson was jailed for 20 years in 2017 after being convicted of 17 offences of wounding with intent while being employed at HEFT, while a later inquiry concluded he may have conducted up to 1,000 botched and unnecessary operations over a 14-year period.
    Mr Goldman and Dr Cunliffe are now pursuing the GMC for the costs of the case, which is expected to be heard over five days in January 2023.
    Read full story (paywalled)
    Source: HSJ, 18 October 2022
  20. Patient Safety Learning
    More than 200 families in south-east England will learn today the results of a major inquiry into the maternity care they received from a hospital trust. The investigation into East Kent Hospitals NHS Trust follows dogged campaigning by one determined bereaved grandfather.
    Derek Richford's grandson Harry died at East Kent Hospitals after his life support system was withdrawn.
    Sixty one-year-old Derek had never campaigned for anything in his life. His initial approach was to wait for East Kent Hospitals Trust to investigate the death, as it had promised.
    However, one nagging issue that was to become central to Derek's view of the trust, was the hospital's continual refusal to inform the coroner of Harry's death. The family repeatedly requested it, but the trust said it was unnecessary as it knew the cause, namely the removal of the life support system.
    The hospital also recorded Harry's death as "expected" - again because his life support system had been withdrawn. On both points, the family were left confused and increasingly angry.
    In early March 2018, some four months after Harry's death, the family finally received the outcome of the trust's internal investigation - known as the Root Cause Analysis (RCA). The RCA indicated multiple errors had been made in Harry and Sarah's care and treatment, and his death was "potentially avoidable".
    Prior to the meeting, Derek wrote to the Kent coroner's office outlining in general the circumstances of Harry's case, asking if that was the type they would expect to be notified of. The email response from the coroner's office was clear. It said: "Based on the facts you have presented, this death should have been reported to the coroner."
    Despite this, at the meeting with the trust, the lead investigator into Harry's death told the family: "If we have a clear cause of death by and large we do not involve the coroner."
    The family's insistence eventually paid off - five weeks after that meeting, the trust informed the coroner of Harry's death.
    While his son and daughter-in-law started trying to recover from the trauma of losing Harry, Derek turned his attention to investigating East Kent, one of the largest hospital trusts in England.
    "When I started investigating what was going on with Harry, it was very much like peeling back an onion. 'Hang on a minute, that can't be right, that doesn't add up.' Ever since I was a small kid, justice has been so important to me.
    "What I found was that, up to that point, no-one had ever joined the dots. And that's so important. I think this had to happen, someone had to do it. There will be families before us that wish they did it. We will be saving a level of families after us."
    Read full story
    Source: BBC News, 19 October 2022
  21. Patient Safety Learning
    The former lead governor of East Kent Hospitals University Foundation Trust has resigned this morning, claiming there is “a cancer at the top of the organisation” and that its services won’t be safe until the government provides funding for critical estates work.
    His resignation as a governor came hours before the publication of what is expected to be a “harrowing” report into maternity services at the trust from an independent review led by Sir Bill Kirkup. He is also expected to raise concerns about national progress on maternity services safety in recent years.
    Alex Lister, who is chair of the council of governors’ membership engagement and communications committee, said in the letter: “I believe officials on six-figure salaries continue to mislead, obfuscate, bully and conceal vital information. I consider the way the trust communicates internally and externally to be completely unacceptable and utterly untrustworthy.
    “Without the valiant efforts of the brave families caught up in a tragedy of the trust’s making, the world may never have found out about the disastrous health failings at our trust.”
    In the letter to chair Niall Dickson, Mr Lister says he has seen a continuation “of the same apparent policy of manipulation and discrediting dissenting voices that existed prior to the scandal”.
    Read full story (paywalled)
    Source: HSJ, 19 October 2022
  22. Patient Safety Learning
    The NHS is setting up “war rooms” as it prepares for one of the toughest winters in its history, officials have announced.
    In a letter to staff, health leaders in England set out “winter resilience plans”, which include new system control centres that are expected to be created in every local area.
    These centres will be expected to manage demand and capacity across the entire country by constantly tracking beds and attendances.
    They will be operated by clinicians and experts who can make quick decisions about emerging challenges in the health service, NHS England said.
    The data-driven centres will be able to spot when hospitals are near capacity and could benefit from mutual aid. Where A&Es are especially busy, ambulances will be diverted to nearby hospitals with more space.
    Meanwhile, NHS England announced plans to expand falls response services so people are treated in their homes, avoiding unnecessary trips to hospital where possible.
    NHS England’s chief executive, Amanda Pritchard, said: “Winter comes hot on the heels of an extremely busy summer – and with the combined impact of flu, Covid and record NHS staff vacancies – in many ways, we are facing more than the threat of a ‘twindemic’ this year.
    “So it is right that we prepare as much as possible – the NHS is going further than it ever has before in anticipation of a busy winter, and today we have set out further plans to step up these preparations – building on our existing plans to boost capacity set out in August this year."
    Read full story
    Source: The Guardian, 19 October 2022
  23. Patient Safety Learning
    Shortages and rising costs of medicines could result in patients not receiving important prescriptions, community pharmacists have warned.
    Commonly prescribed drugs used to treat conditions such as osteoporosis, high blood pressure and mental health are among those affected.
    The Department of Health (DoH) said a support package worth £5.3m for the sector is being finalised. But Community Pharmacy NI said this "falls way short of what is needed".
    David McCrea from Dundela Pharmacy said the price of some medicines had been raised "fiftyfold".
    "As a community pharmacist for over 30 years, I have never witnessed the price of medicines rise this sharply," Mr McCrea said.
    "It is becoming increasingly hard for us to afford to buy the medicines from wholesalers because we are not being paid the full cost of these drugs by the department."
    Mr McCrea added the current situation was causing "financial stress" and was becoming unsustainable.
    "The bottom line is that we are now facing the situation where we will not be able to afford to supply our patients with essential medicines, within weeks."
    Read full story
    Source: BBC News, 18 October 2022
  24. Patient Safety Learning
    The NHS faces a record £90 billion maternity bill, The Telegraph can reveal ahead of a “harrowing” report into failings at East Kent Hospitals Trust.
    Official figures show the number of claims have risen by almost one quarter in just two years following a series of scandals. 
    The data show 1,243 maternity negligence claims in 2021/22 - up from 1,015 in 2019/20. 
    Safety campaigners said the figures were “staggering” - with £90 billion now set aside to cover the costs of claims.
    It means that in total, 70% of total liability provision for NHS negligence is associated with failings in pregnancy and childbirth, amid rising claims. 
    The figure - equivalent to two-thirds of the NHS annual budget - represents an estimate for the total costs if all claims it expects to settle were paid out, at today’s prices.
    An NHS spokesperson said: “Despite improvements to maternity services over the last decade – with significantly fewer stillbirths and neonatal deaths – we know that further action is needed to ensure safe care for all women, babies and their families.
    “The NHS is ensuring that work is already underway to make these improvements, including a £127 million investment this year to boost the maternity workforce, strengthen leadership and increase neonatal cot capacity – which is on top of an annual boost of £95 million for staff recruitment and training announced last year.”
    Read full story (paywalled)
    Source: The Telegraph, 18 October 2022
  25. Patient Safety Learning
    People could die because of Thérèse Coffey’s “ultra-libertarian ideological” reluctance to crack down on smoking and obesity, a Conservative ex-health minister has warned.
    The strongly worded criticism of the health secretary came from Dr Dan Poulter, a Tory MP and NHS doctor who served as a health minister in the coalition government from 2012 to 2015.
    Poulter claims Coffey’s “hostility to what the extreme right call ‘nanny statism’” is stopping her from taking firm action against the “major killers” of tobacco and bad diet.
    His intervention – in an opinion piece for the Guardian – was prompted by Coffey making clear that she opposed banning adults from smoking in cars containing children, even though the practice was outlawed in 2015 and is credited with reducing young people’s exposure to secondhand smoke.
    The government’s widely anticipated scrapping of measures to curb obesity such as the sugar tax and ditching of the tobacco control plan and health inequalities white paper – both of which previous health ministers had promised to publish – have led Poulter to brand Coffey’s stance “deeply alarming”.
    He writes: “More smoking and more obesity means more illness, more pressure on the NHS and shorter lives, particularly amongst the poorest in society.
    “I am acutely concerned that the health secretary’s ideological hostility to what history shows is government’s potentially very positive role in protecting us against these grave threats to our health will exacerbate the problems they already pose.
    “At its worst such a radically different approach to public health could cost lives, as it will inevitably lead to more people smoking and becoming dangerously overweight.”
    Read full story
    Source: The Guardian, 18 October 2022

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