Jump to content
 View Profile  See their activity

  • Posts

    11,589

  • Joined

  • Last visited

Patient Safety Learning

Administrators

 Content Type 

Everything posted by Patient Safety Learning

  1. Content Article
    Safety Management System (SMS) is a collection of structured, company-wide processes that provide effective risk-based decision-making for daily business functions. A SMS helps organisations offer products or services at the highest level of safety and maintain safe operations. This article explains more.
  2. Event
    This National Virtual Summit focuses on the New National NHS Complaint Standards. Through national updates, practical case studies and in depth expert sessions the conference aims to improve the effectiveness of complaints handling within your service, and ensure that complaints are welcomed and lead to change and improvements in patient care. The conference will also reflect on managing complaints regarding Covid-19 – understanding the standards of care by which the NHS should be judged in a pandemic and in particular responding to complaints regarding delayed treatment due to the pandemic. For further information and to book your place visit www.healthcareconferencesuk.co.uk/conferences-masterclasses/nhs-complaints-summit or email kerry@hc-uk.org.uk Follow on Twitter @HCUK_Clare #NHSComplaints hub members can receive a 20% discount. Email info@pslhub.org for discount code.
  3. Event
    The new NHS Patient Safety Syllabus has brought education and training to the fore to push patient safety in healthcare. Based on the syllabus this masterclass will focus on how Human Factors and Red Teams can be improve Patient Safety. Red Teams are defined as a team that is formed with the objective of subjecting an organisation’s plans, programmes, ideas and assumptions to rigorous analysis and challenge. We will look at the use of Red Teaming taken from the Ministry of Defence for supporting staff and teams faced with different problems and challenges in healthcare. For further information and to book your place visit www.healthcareconferencesuk.co.uk/conferences-masterclasses/red-teams-patient-safety or email kerry@hc-uk.org.uk hub members can receive a 20% discount. Email info@pslhub.org for discount code.
  4. Content Article
    This programme from the Advancing Quality Alliance (Aqua) provides participants with the tools, skills and knowledge to oversee the successful implementation of a safety culture survey in organisations. Participants of this programme will develop a working knowledge of safety culture theory and the Agency for Healthcare Research and Quality (AHRQ) safety culture survey alongside the support that Aqua provides to enable deployment and analysis of the survey. This programme links directly to Aqua’ safety offers, including Psychological Safety, Human Factors and Improvement Practitioner programmes.
  5. Content Article
    This guideline from the National Institute for Health and Care Excellence (NICE) covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.
  6. News Article
    Excess deaths in the UK have continued to soar, as Covid deaths decreased for fourth week in a row, the latest data shows. A total of 10,942 deaths from all causes were registered in England and Wales in the week to 26 August, according to the Office for National Statistics. This is 16.6%above the five-year average, the equivalent of 1,556 “excess deaths” during this week. However, new figures show a continued downward trend in deaths involving Covid-19, which have fallen to the lowest level since the beginning of July. A total of 453 deaths registered in the seven days to August 26 mentioned coronavirus on the death certificate, according to the Office for National Statistics (ONS) – down 18 per cent on the previous week. Stuart Macdonald, from the Covid-19 actuaries’ response group, wrote: “There have been around 5,300 deaths with Covid-19 mentioned on the death certificate in the last ten weeks. Covid was the underlying cause for 3,400 of these and may also have contributed to others. Since Covid does not explain all the recent excess we need to look at other causes.” Mr Macdonald outlined a number of potential drivers of excess deaths which included increased risk of heart failure in people following Covid-19 infection, delays for urgent treatment within the NHS and missed or delayed diagnoses earlier in the pandemic. Read full story Source: The Independent, 6 September 2022
  7. News Article
    Over 50 new surgical hubs will open across the country to help bust the Covid-19 backlogs and offer hundreds of thousands more patients quicker access to vital procedures, Steve Barclay, has announced. These hubs will provide at least 100 more operating theatres and over 1,000 beds so people get the surgery they need. And they will deliver almost two million extra routine operations to reduce waiting lists over the next three years, backed by £1.5billion in government funding. They will focus mainly on providing high-volume, low-complexity surgery, as previously recommended by the Royal College of Surgeons of England, with particular emphasis on ophthalmology, general surgery, trauma and orthopaedics, gynaecology, ear nose and throat, and urology. Located on existing hospital sites, the surgical hubs will bring together skills and expertise of staff under one roof – reducing waiting times for some of the most-common procedures such as cataract surgeries and hip replacements. Improving quality and efficiency will mean patients have shorter waits for surgery, will be more likely to go home on the same day, and will be less likely to need additional treatment. And, as the hubs are separated from emergency services, surgical beds are kept free for patients waiting for planned operations, reducing the risk of short-notice cancellations and improving infection control. Read full story Source: Building Better Healthcare, 5 September 2022
  8. News Article
    The NHS needs to do more to support care homes and people who have fallen with alternatives to ambulance calls and hospital admissions, the NHS England chief executive has said. Speaking at the Ambulance Leadership Forum, Amanda Pritchard acknowledged this winter would be a difficult one for the health service, saying: “The scale of the current and potential challenge mean that we do need to continue to look further for what else we can do… We need to pull out all the stops to make sure that they [patients] get that treatment as safely as possible and as quickly as possible.” She added one area of focus should be making sure certain patient groups can access other – more appropriate – forms of care, rather than calling an ambulance by default and often resulting in hospital admission. On care homes, she said: “Can we wrap around even more care for these care homes so they get to the point where they don’t need to call for help at all or, if they do, there are alternatives pathways [to the emergency department]?” She suggested another area where responses could be made more consistent was for patients who had fallen but without serious injuries, which she said made up a “really significant part of activity”. These patients took a long time to reach and, if admitted to hospital, risked long admissions, she said. Some areas were working to find other ways of responding to non-injury falls patients and trying to keep them away from hospital, she said. Read full story (paywalled) Source: HSJ, 6 September 2022
  9. News Article
    A nurse who was racially abused at work has urged Health Minister Robin Swann to take action on racism towards healthcare staff. Beverly Simpson, a nurse for more than 25 years, said she was subjected to hours of abuse while working last weekend. The incident at the weekend took place in a private healthcare setting, Ms Simpson told BBC Radio Foyle. She said she was called racist slurs by a patient for several hours. "I want to do nursing, I have always been a nurse," she said. "I never realised that I would be placed in such a vulnerable position and I actually question myself if I should walk away." Ms Simpson said she wanted to speak publicly to make sure "any other nurse from a black or minority ethic group did not feel alone". "There is abuse going on, it's something that is happening," she said. "I felt, for the first time in a long while, about quitting. I asked myself: 'What is the point?' "I understand that when people are sick their defences may be down, they're more vulnerable and they may say things they shouldn't, but there was a nastiness to it." In a statement, the Department of Health said racism was not something that any colleague in Health and Social Care (HSC) should have to endure. "We want to send a clear message, from the very top of our health and social care system, that such behaviour is totally unacceptable and will not be tolerated," the department said. "We fully recognise and respect the hard work, commitment and dedication of HSC staff from within the BAME [black, Asian and minority ethnic] community." Read full story Source: BBC News, 6 September 2022
  10. News Article
    Thérèse Coffey has been appointed as the new health and social care secretary. Ms Coffey, previously work and pensions secretary, has been appointed to the role by the new prime minister, Liz Truss. A close ally of Ms Truss, Ms Coffey has also been appointed as her deputy prime minister. The new prime minister, in her first speech in the role, said that putting “our health service on a firm footing” was one of her “three early priorities”. She pledged to improve access and build “hospitals”. Ms Coffey said this evening her priorities were “ABCD”, representing “ambulances, backlogs, care, doctors and dentists”. Read full story (paywalled) Source: HSJ, 6 September 2022
  11. Content Article
    Medical litigation claim and costs in UK are rising. This study from Lane, Bhome and Somani analysed the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19.The authors concluded that addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.
  12. Content Article
    On 22 February 2001, eighteen-month-old Josie King died from medical errors. More than 250,000 people die every year from medical errors, making it the third leading cause of death in the United States. The Josie King Foundation’s mission is to prevent patients from dying or being harmed by medical errors. By uniting healthcare providers and consumers, and funding innovative safety programs, we hope to create a culture of patient safety, together.
  13. News Article
    Liz Truss’s desire to talk about cutting management in the NHS will get in the way of more important conversations about the future operating model of the health service, a respected system leader has said. In an interview with HSJ, Rob Webster, chief executive of the West Yorkshire integrated care system, said NHS managers have been a “fundamental” part of the response to the pandemic and that they have a “good record of delivering” when backed by coherent plans. His comments come after Ms Truss, who was confirmed as the new prime minister today, said during the Conservative Party leadership contest she was planning “fewer levels of management” in the NHS. When asked about the comments made by Mrs Truss, as well as similar statements from health secretary Steve Barclay, Mr Webster said: “This is part of the reality of the NHS being a political issue, that you will get this sort of debate. “And I think if you want to enter debate about the NHS being over-managed, you can look at any one of a number of independent publications that demonstrate that it’s not, from the Kings Fund, the Nuffield trust, and various others…" Mr Webster said many patients in the NHS are still receiving good, safe and timely care, but at the same time many people are waiting too long to access services while staff have faced “incredible pressure” for an extended period. “What we need to do is to work our way out of this,” he said. “And we can only do that with a coherent plan which is politically led nationally, politically owned locally, and led by people in the system collectively.” Read full story (paywalled) Source: HSJ, 6 September 2022
  14. News Article
    Unfilled specialised medical consultant roles and an over-reliance on overworked, internationally trained graduates for non-consultant hospital doctors are among key risks to patient safety identified by the Irish Medical Council. The council, which is the regulatory body for the medical profession, sets out the risks to healthcare for the first time in its workforce intelligence report that breaks down the make-up of the medical register and explains why doctors are leaving the health system. More than a third of all clinically active doctors are on the general register, which is a key risk to patient safety because consultant and specialist roles are not being filled and “a considerable proportion” of non-consultant hospital doctors are required to perform the duties of consultants. The report found that the majority of non-consultant hospital doctors are trained overseas and that the health system overly relied on these doctors who reported being “overworked, undervalued, experiencing discrimination and unable to access specialist training.” “Aside from the individual impact on the doctors, the treatment of international medical graduates has serious implications for patient safety,” the council said. In another risk identified by the regulatory body, more than a quarter of doctors reported working more than 48 hours a week, in breach of the European Working Time Directive. This has further serious implications for patient safety,” the council said. Read full story Source: Irish Times, 1 September 2022
  15. News Article
    NHS trusts across London are set to start moving patients from A&E onto wards “irrespective” of whether there are beds available, The Independent has learned. The new model, which involves moving patients every two hours out of A&E and onto wards called acute medical units, has prompted concerns that patients could be “double lodged” on hospital wards. The move follows the trial of a new system by North Bristol NHS Trust last month, which said it would be moving three patients every hour from A&E onto wards in a bid to address severe ambulance handover delays. On Thursday, health secretary Steve Barclay said that the “number one” priority for the NHS currently is tackling ambulance handover delays, with a “small” number of trusts accounting for half of all delays. In a memo seen by The Independent, NHS clinicians in one hospital were told that London trusts would be rolling out the North Bristol model at “pace” ahead of winter. The system involves moving one patient from A&E onto a ward every two hours “irrespective of bed availability”. Speaking to The Independent, one NHS director said the move would lead to “double lodging” patients, which means squeezing more patients into wards, and that this could be “dangerous” for patients. However, A&E doctors told The Independent that the move should be welcomed, as it spreads the crowding and risk for patients across hospital departments rather than confining it to A&E. Read full story Source: The Independent, 4 September 2022
  16. Content Article
    GPOnline Editor, Emma, speaks with Dr Carey Lunan, a GP in Edinburgh and chair of the Deep End GP Group in Scotland, and Dr David Blane a GP in Glasgow and clinical research fellow in General Practice, University of Glasgow, who is the academic lead of the Deep End GP Group. The Deep End Group covers the 100 most deprived practices in Scotland and the discussion highlights what the group is doing to tackle health inequalities, the impact of COVID-19 and what other practices can learn from their work.
  17. Event
    until
    Join respiratory specialists, Dr Daryl Freeman and Dr Vincent Mak, for this interactive webinar. This 1-hour, interactive webinar will cover: Community ‘hublets’. The outpatient transformation workstream. Community Diagnostic Centres (CDCs) and Primary Care Networks (PCNs). Quality assurance and interpretation of spirometry. Register
  18. News Article
    Trying to strike a balance between free speech and public health, California’s Legislature on Monday approved a bill that would allow regulators to punish doctors for spreading false information about Covid-19 vaccinations and treatments. The legislation, if signed by Gov. Gavin Newsom, would make the state the first to try to legislate a remedy to a problem that the American Medical Association, among other medical groups and experts, says has worsened the impact of the pandemic, resulting in thousands of unnecessary hospitalisations and deaths. The law would designate spreading false or misleading medical information to patients as “unprofessional conduct,” subject to punishment by the agency that licenses doctors, the Medical Board of California. That could include suspending or revoking a doctor’s license to practice medicine in the state. While the legislation has raised concerns over freedom of speech, the bill’s sponsors said the extensive harm caused by false information required holding incompetent or ill-intentioned doctors accountable. “In order for a patient to give informed consent, they have to be well informed,” said State Senator Richard Pan, a Democrat from Sacramento and a co-author of the bill. A paediatrician himself and a prominent proponent of stronger vaccination requirements, he said the law was intended to address “the most egregious cases” of deliberately misleading patients. Read full story (paywalled) Source: New York Times, 29 August 2022
  19. News Article
    Record NHS waiting lists cannot be attributed to the pandemic as the health service has been “steadily declining” for a decade, a report says. The number of people waiting for routine hospital treatment in England has almost tripled from 2.5 million in April 2012 to 6.78 million, after reaching 4.6 million in February 2020. While Covid accelerated this trend, analysis suggests that even without the pandemic waiting lists for elective care would stand at 5.3 million. The Quality Watch report, by the Nuffield Trust and Health Foundation think tanks, says the NHS was “already stretched beyond its limits” before Covid struck. Analysis of performance figures show waiting times for scans, A&E and cancer care have been increasing for many years amid chronic staff shortages. This deterioration means thousands of cancer patients each month face unacceptably long waits for treatment — damaging their survival chances. The report found waiting times for 15 key diagnostic tests, such as MRI or CT scans, had also rocketed. In April 2012 632,236 patients were on waiting lists for these tests. This backlog increased to one million by February 2020 before hitting 1.6 million this year. Read full story (paywalled) Source: The Times, 5 September 2022
  20. Content Article
    On 3 September 2021 assistant coroner Jonathan Stevens commenced an investigation into the death of Martha Mills, aged 13 years. Martha sustained a handlebar injury whilst cycling on a family holiday in Wales. She was transferred to King’s College Hospital London and died approximately one month later. Her medical cause of death was: 1a refractory shock 1b sepsis 1c pancreatic transection (operated) 1d abdominal trauma.
  21. Content Article
    Medication errors are any Patient Safety Incidents (PSI) where there has been an error in the process of prescribing, preparing, dispensing, and administering, monitoring or providing advice on medicines. Medication errors can occur at many steps in patient care, from ordering the medication to the time when the patient is administered the drug. From April 1 2015 to 31 March 2020 NHS Resolution received 1,420 claims relating to errors in the medication process. Of those claims, 487 claims settled with damages paid, costing the NHS £35 million (excluding legal costs). NHS Resolution initial data for medication errors indicates that anticoagulants, opioids, antimicrobials, antidepressants, and anticonvulsants are the most common medications to be implicated in incidents.
  22. News Article
    Senior health officials are to face questioning over why pregnant women are still being prescribed sodium valproate despite its known risks as a cause of birth defects or developmental delays. Campaigners for families affected by the drug will also give evidence to the Health and Social Care Committee in a one-off session later this month. Alongside campaigners on sodium valproate, the Committee will also hear from campaigners from Association for Children Damaged by Hormone Pregnancy Tests and on behalf of “Sling the Mesh” campaign. MPs will examine government progress on recommendations made in the Independent Medicines and Medical Devices Safety (IMMDS) Review, which specifically looked into sodium valproate, hormone pregnancy tests and vaginal mesh. An update by Ministers on progress to implement the government’s response was due this summer. A Minister from the Department of Health and Social Care has been invited to appear before the Committee. The IMMDS Review’s report called for better communication to inform women of the risks of sodium valproate in pregnancy. Despite an NHS ‘valproate pregnancy prevention programme’, 247 women since April 2018 were found to have been prescribed the drug in a month in which they were pregnant, 25 as recently as April to September last year. Health and Social Care Committee Chair Jeremy Hunt MP said: “It is incredibly concerning to know that women of child-bearing age can still be prescribed the epilepsy drug sodium valproate despite its known risks as a cause of birth defects or developmental delays. It has been two years since Baroness Cumberlege called for urgent action to prevent this happening. However, dozens of pregnant women were prescribed the drug last year while data published last month has shown that safety requirements were not being fully met. We’re calling in a Minister and senior health officials as well as campaigners to address our concerns.” Read full story Source: UK Parliament, 2 September 2022
  23. News Article
    Ministers will introduce legislation as soon as parliament returns on Monday to tackle the NHS’s worsening staffing crisis by making it easier for overseas nurses and dentists to work in the UK. The move is part of a drive by the health secretary, Steve Barclay, to increase overseas recruitment to help plug workforce gaps in health and social care. Barclay believes thousands of extra health professionals will come as a result of new rules making it easier for medical regulators to register those who have qualified abroad. If the change proves successful it will help pave the way for more nurses and dentists coming to work in Britain from countries such as India, Sri Lanka, Kenya, the Philippines and Malaysia. However, critics claim the policy is a stop-gap that is no substitute for ramping up the supply of homegrown staff and risks worsening the lack of health workers in other countries that are struggling with shortages of their own. Read full story Source: The Guardian, 5 September 2022
  24. News Article
    A senior NHS leader has warned of a “life-threatening” situation in which clinically vulnerable people are being admitted to hospital after having their energy supplies disconnected. Sam Allen, chief executive of North East and North Cumbria Integrated Care Board (ICB), has written to Ofgem today to raise “serious concerns” that vulnerable people have seen their electricity or gas services disconnected as a result of non-payment. In the letter, which the ICB has published on its website, Ms Allen said the impact of energy supplies being cut off “will be life threatening for some people” and place additional demand on already stretched health and social care services. She wrote: “It has come to light that we are starting to see examples where clinically vulnerable people have been disconnected from their home energy supply which has then led to a hospital admission. “This is impacting on people who live independently at home, with the support from our community health services team and are reliant on using electric devices for survival. “An example of this is oxygen; and there will be many other examples. There is also a similar concern for clinically vulnerable people with mental health needs who may find themselves without energy supply. “Put simply, the impact of having their energy supply terminated will be life threatening for some people as well as placing additional demands on already stretched health and social care services.” Read full story (paywalled) Source: HSJ, 5 September 2022
  25. Content Article
    Sharing her story in the Guardian, Merope gives a heart breaking account of how her daughter, Martha Mills, was allowed to die, but also what happens when you have blind faith in doctors – and learn too late what you should have known to save your child’s life.
×
×
  • Create New...