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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    The UK is considered one of the safest health systems in the world, with dedicated teams of healthcare professionals delivering high standards of care. But with healthcare rates of avoidable harm stubbornly not reducing at the rate we all want, for the benefit of patients we need to strive to achieve more. This extends to how we source, supply and monitor the use of healthcare equipment and products. Procurement and supply chains can be complex and may involve many organisations, with patient safety concerns manifesting themselves in a range of diverse ways. Using value-based procurement (VBP) is one way we can achieve safer care.
  2. Content Article
    The NHS often appears to be in a state of permanent crisis. Recently, there've been headlines about long waiting times for ambulances and the huge backlog for routine surgery. Before that, the NHS faced a two-year pandemic which may rear its head again this winter. But the NHS also has a big underlying problem that it has tens of thousands of vacancies for doctors, nurses and other medical workers – and that makes all the other pressures on the NHS even harder to handle. So why does the NHS have a staffing problem? And what can be done to fix it?
  3. News Article
    Former patients and families of those affected by some of Northern Ireland's worst health scandals have called for accountability at every level of the health service. The collective of campaigners gathered at Stormont in protest on Saturday. They have demanded change, saying "enough is enough". They included those affected by systemic failures identified in neurology, urology, care homes and hyponatraemia. Danielle O'Neill, a former patient of the neurologist Dr Michael Watt, whose practice led to Northern Ireland's largest patient recall, was among them. "It's important for us to stand here today as a collective with all of the other scandals to show that we demand an individual duty of candour," she said. "We demand accountability, we demand justice. "There have been far too many health scandals in our health service." Read full story Source: BBC News, 4 September 2022
  4. News Article
    A doctor who was sacked for raising patient safety concerns has won a case against England's hospital regulator, the Care Quality Commission (CQC). Orthopaedic surgeon Shyam Kumar worked part-time for the CQC as a special adviser on hospital inspections, but Manchester Employment Tribunal found that he was unfairly dismissed. Between 2015 and his dismissal in 2019, Mr Kumar wrote to senior colleagues at the CQC with a number of serious concerns. They included a hospital inspection, at which he claims patient safety was significantly compromised when a group of whistleblowing doctors was prevented from discussing their concerns. Mr Kumar said, on many occasions, he reported concerns about a surgeon at his own trust, Morecambe Bay, who had carried out operations that were "inappropriate" and of an "unacceptable" quality and harmed patients. He warned the CQC that the trust management wanted to bury it "under the carpet". The tribunal noted that his concerns were found to be justified and the surgeon eventually had conditions placed on his licence to practise. The CQC "accepted the findings". Mr Kumar, who has been awarded compensation, says his concerns were ignored. "The whole energy of a few individuals in the CQC was spent on gunning me down, rather than focusing on improvement to patient safety and exerting the regulatory duties," he said. Read full story Source: BBC News, 5 September 2022
  5. News Article
    When the new Royal Liverpool Hospital opens its doors in October, every patient will have a single room with an en-suite bathroom. That set-up is unusual for acute hospitals in England, but many feel it is the future for all new buildings. "There's the privacy and dignity from the patient's point of view," says Jacqui Stamper, the hospital's associate chief nurse. "If they're in the room and talking to the doctors or the nurses, there isn't somebody just the other side of a curtain listening." "And then there's the infection prevention side of it as well. "It's absolutely the state of the art way of hospital care really." The new system will require staff to work differently, so patients can be properly monitored. Each ward has been broken up into smaller zones of between six and eight beds, and each zone has its own base where the nurses will sit. The trust which runs the hospital is currently running workshops to get staff used to the layout. "Nursing staff will be used to working in a bigger team than a couple of people, so it is a different way of working," Ms Stamper says. "We're listening to our staff and their concerns and answering those to see how we can address them going forward." Read full story Source: BBC News, 2 September 2022
  6. Content Article
    Making the Patient Tracking List (PTL) available to general practice in North Central London (NCL) is proving to be an effective approach. When thinking about how best to address the backlog of patients, it’s natural to only consider the locations where the patients will be treated, but Amy Bowen, director of system improvement for NCL, says her team saw the value of involving primary care in the conversation. “Initially, everyone considered the PTL from secondary care, but we thought ‘let’s flip it on its head’,” she says. The approach uses funding from the NHS’s elective accelerator sites initiative to form multi-disciplinary Proactive Integrated Teams (PITs) that can access the PTL using the elective recovery dashboard in the Cerner population health platform, HealtheIntent®. Find out more in this article in the Integrated Care Journal.
  7. News Article
    Health secretary Steve Barclay says trust chief executives should be held accountable for ambulance handover delays in a ‘fair’ way that recognises factors outside their control. Mr Barclay made a wide ranging speech at a Policy Exchange event on Thursday. However, the content of the speech was much less radical than earlier press reports in which it was suggested he would tell the NHS to “scrap targets”, “declare war on pointless pen-pushers”, and deprioritise “cancer, maternity and mental health”. Last month, the health secretary summoned the chief executives of six of the NHS trusts which are recording the longest waits for ambulance handovers at their emergency departments. Mr Barclay was asked by HSJ what the consequences would be for leaders who failed to improve the situation. He said: “It’s not about blaming the chief executives, it’s about understanding what are their challenges and how do we then get clarity on that. “Once we’ve agreed on that, then you can have performance management to hold individual chiefs to [account on] the bits that are within their control, distinct from bits that may be the ambulance trust’s or others in the system.” He said the government and NHS England would ask what was “within the chief exec’s control” and how a trust’s performance compared to that of its peers? Trusts would be asked to “comply” with best practice or explain why they were not. The Department of Health and Social Care and NHSE would then be able to decide “what are the things where it [the trust] needs wider support?” Read full story (paywalled) Source: HSJ, 2 September 2022
  8. News Article
    An estimated 430,000 Britons were still suffering from Long Covid two years after first contracting the virus, according to data released by the Office for National Statistics (ONS). One in every 32 people in the UK was estimated to have some form of Long Covid at the end of July, equivalent to 2 million people. Of those, around 1.5 million said their symptoms were adversely affecting their daily activities, while 384,000 said their ability to undertake daily activities had been “limited a lot”. Fatigue continues to be the most common symptom reported by individuals with long Covid, with 62% reporting weakness or tiredness. More than a third, 37%, of those surveyed reported shortness of breath as one of their symptoms, while difficulty concentrating (33%) and muscle ache (31%) were the next most cited symptoms. Kelly Fearnley, a foundation doctor at Bradford Royal Infirmary, said: “Long Covid is not only crippling the health of the nation, it is destroying the health of our economy. “Research efforts so far have been slow and underfunded, and fail to reflect the scale and urgency of the problem. “Not only are some people not recovering, they are deteriorating. People have not only lost their health and independence, they are losing their jobs, financial security and homes.” Read full story Source: The Guardian, 1 September 2022
  9. News Article
    On a Thursday in mid-August, the doors of a hospital's emergency department two hours west of Toronto were shut. A note posted on the front said the ER was closed for the day. It would reopen the following morning at 08:00, but close again for the evening. Patients who needed urgent care were asked to go to nearby hospitals - a 15- to 35-minute drive away. It was the ninth time since April that the Huron Public Healthcare Alliance - a network of four hospitals serving around 150,000 people in western Ontario - had to temporarily close or cut back hours at one of its emergency departments. Canada is one of the richest countries in the world. Its universal publicly funded healthcare system has been touted by progressive politicians in the US, the country's southern neighbour, who see it as a needed alternative to an American system where millions remain uninsured. But in recent months, Canada's system has been described by workers and hospital executives as being in a state of "crisis". That includes struggling emergency rooms. Toronto ER physician Dr Raghu Venugopal said he has seen stretchers lining the hallways, occupied by patients suffering from ailments like a broken hip or abdominal pains. On some days, those patients may wait anywhere from two to four days to be admitted to hospital, all while a team of two nurses tends to a total of 50 to 60 patients on the unit. Other patients are being examined in the waiting room because the lack of staff has forced parts of the ER to close, meaning there is limited space for doctors to see them privately. "We are in a standard-less void where anything goes, and it is shocking," Dr Venugopal said. Read full story Source: BBC News, 2 September 2022
  10. News Article
    Ongoing research underway at The University of Queensland in Australia is focusing on stopping children undergoing chemotherapy from feeling pain and other debilitating side effects. Dr Hana Starobova from UQ’s Institute for Molecular Bioscience has been awarded a Fellowship Grant from the Children’s Hospital Foundation to continue her research to relieve children from the side effects of cancer treatments. “Although children have a higher survival rate than adults following cancer treatments, they can still be suffering side-effects well into their adulthood,” Dr Starobova said. “A five-year-old cancer patient could be suffering severe pain, gastrointestinal problems or difficulty walking 20 years on from treatment. “There has been a lack of studies on children, which is an issue because they are not just small adults — they suffer from different cancers, their immune systems work differently and they have a faster metabolism, all of which affect how treatments work. “Our aim is to treat children before the damage happens so that the side-effects are dramatically reduced or don’t occur in the first place.” Dr Starobova is currently analysing how specific drugs could prevent a cascade of inflammation caused by chemotherapy drugs, which lead to tingling and numbness in hands and feet, and muscle pain and weakness that makes everyday tasks, like walking and doing up buttons, a challenge. She is focusing on Acute lymphoblastic leukaemia, one of the most frequently diagnosed cancers in children, with over 700 children diagnosed in Australia each year. “We are studying the most commonly used chemotherapy treatment for children, which is a mix of drugs that are very toxic, but have to be used to treat cancer fast and stop it becoming resistant to the drugs,” Dr Starobova said. “It’s a fine balance — too little chemotherapy and cancer won’t be killed but sometimes the side effects are so bad, patients have to stop the therapy. “I hope that by having a treatment to reduce side-effects, it will be one less thing for these kids and their families to worry about.” Read full story Source: The Print, 15 August 2022
  11. Content Article
    The Women’s Health Strategy promises to address the poor experiences and worse health outcomes that women endure. The underlying cause of these issues is that the health system has historically been built by men for men. Consequently, women are often not listened to or believed by the health and care system. So, the crucial question is, will this strategy change the culture in the NHS of women not being listened to about their health and wellbeing?
  12. Content Article
    The results of NHS Providers’ annual survey on regulation offer a strong endorsement of the change in approach that regulators’ are trying to make to reflect a new context of system – but the survey also reflects the fact that trusts’ experience of regulation over the past year still doesn’t match the vision the national bodies have set out. In this HSJ article, Mariya Stamenova emphasises the importance of implementing regulations to ensure systematic and efficient functioning within the NHS Framework.
  13. News Article
    Half of healthcare facilities worldwide lack basic hygiene services with water and soap or alcohol-based hand rub where patients receive care and at toilets in these facilities, according to a new report by WHO and UNICEF. Around 3.85 billion people use these facilities, putting them at greater risk of infection, including 688 million people who receive care at facilities with no hygiene services at all. “Hygiene facilities and practices in health care settings are non-negotiable. Their improvement is essential to pandemic recovery, prevention and preparedness. Hygiene in health care facilities cannot be secured without increasing investments in basic measures, which include safe water, clean toilets, and safely managed health care waste,” said Dr Maria Neira, WHO Director, Department of Environment, Climate Change and Health. “I encourage Member States to step up their efforts to implement their 2019 World Health Assembly commitment to strengthen water, sanitation and hygiene (WASH) services in health care facilities, and to monitor these efforts.” The latest report, “Progress on WASH in health care facilities 2000–2021: special focus on WASH and infection prevention and control”, has for the first time established this global baseline on hygiene services – which assessed access at points of care as well as toilets – as more countries than ever report on critical elements of WASH services in their hospitals and other health centres. For hygiene, data are now available for 40 countries, representing 35% of the world’s population, up from 21 countries in 2020 and 14 in 2019. The newly established global estimate reveals a clearer and more alarming picture of the state of hygiene in health care facilities. Though 68% of health care facilities had hygiene facilities at points of care, and 65% had handwashing facilities with water and soap at toilets, only 51% had both and therefore met the criteria for basic hygiene services. Furthermore, 1 in 11 (9%) of health care facilities globally have neither. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF Director of WASH and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children. Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty – even more so as their deaths are preventable.” Read full story Source: WHO, 30 August 2022
  14. Content Article
    In March 2018, the Secretary-General of the United Nations launched a global call to action for WASH in all healthcare facilities, noting that healthcare facilities are essential tools in reducing disease, and that without basic WASH services, healthcare facilities can instead contribute to more infections, prolonged hospital stays and preventable deaths, including of mothers and babies. This call was answered in a May 2019 World Health Assembly resolution calling on countries to conduct comprehensive assessments of WASH and IPC in health care facilities, and to take steps to improve WASH and IPC conditions where necessary. In May 2022, the World Health Assembly passed a resolution calling for WHO to draft a global strategy on infection prevention and control. The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), through the WHO/ UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) release progress updates on WASH in households, WASH in schools and WASH in health care facilities every two years. This 2022 update presents national, regional and global estimates for WASH in healthcare facilities up to the year 2021, with a special  focus on the linkages between WASH and infection prevention and control (IPC).  Achieving universal access to WASH in health care facilities requires political will and strong leadership at both national and facility levels, but is highly cost-effective, and would yield substantial health benefits. 
  15. News Article
    Guidelines for confirming death in very young babies are being reviewed amid concerns about a case in which a baby boy started to breathe after a diagnosis of brain stem death. Guy’s and St Thomas’ NHS Foundation Trust applied to the High Court in June for a declaration that A, who was born in April, was dead and for authorisation to withdraw his ventilation, ancillary care, and treatment. Aged 2 months, he had sustained a profound hypoxic ischaemic brain injury after a cardiac arrest that happened shortly after he was found limp in his cot with abnormal breathing. But before the case came to court a nurse observed him breathing spontaneously, and the trust rescinded the declaration of brain stem death. Read full story (paywalled) Source: BMJ, 31 August 2022
  16. News Article
    The number of posts lying vacant across the NHS in England has reached a “staggering” record high of 132,139 – almost 10% of its planned workforce. The number at the end of June was up sharply from three months earlier when there were 105,855 vacancies, quarterly personnel figures show. NHS leaders said the huge number of empty posts showed why the health service is in a state of deepening crisis, with patients facing long waits for almost every type of care. The previous highest number of vacancies for full-time-equivalent staff was 111,864, recorded at the end of June 2019. The new number represents 9.7% of the NHS’s planned staffing levels – a new high. As recently as March 2021 there were 76,082 vacancies. Danny Mortimer, the chief executive of NHS Employers, said: “These figures paint a bleak picture. A jump in nearly 30,000 staff vacancies – equivalent to the entire staffing of a large NHS hospital – show an alarming trend across the NHS of rising levels of vacancies.” Read full story Source: The Guardian, 1 September 2022
  17. News Article
    A troubled acute trust has been sent a further warning notice after inspectors found severe shortages of midwives were causing dangerous delays to labour inductions. During one day in June, the Care Quality Commission found eight high-risk women at Blackpool Victoria Hospital had waited prolonged time periods for their labour to be induced. They said one woman had waited five days, while another who was forced to wait more than two days despite her waters having broken on the ward. Delays to labour induction can lead to serious safety risks for mothers and babies. The hospital’s maternity services, previously rated “good” for safety, have now been rated “inadequate” in this domain. The overall rating for maternity has dropped to “requires improvement”. The problems were caused by severe shortages of midwives at the hospital, which had struggled to bring in agency staff due to a lack of availability in the area. However, inspectors also said there was a lack of any discussion or attention to the issues within the trust, despite the Healthcare Safety Investigation Branch previously highlighting concerns. Read full story (paywalled) Source: HSJ, 1 September 2022
  18. News Article
    Responding to the Ofgem announcement on the energy price cap, Jo Bibby, Director of Health at the Health Foundation said: 'Today’s announcement confirms the mounting financial pressures facing people this winter. 'Cold, damp homes make people ill. When people are having to make a choice between heating and eating, their health is going to suffer. Many will face the stress of managing debt and, in the long run, the price will be paid in poorer health, more pressure on the NHS, and fewer people in work. 'The cost-of-living crisis should be a spur for action for the new government – bringing forward the Health Disparities White Paper. In particular, it must deliver significant emergency support in the autumn, targeted at lower-income families who are most at risk of poorer health. Without the speed and scale of action we saw through the pandemic, there is a risk the cost-of-living crisis becomes another health crisis.' Read full story Source: The Health Foundation, 26 August 2022
  19. Content Article
    The Canadian Institute of Safe Medication Practice's bulletins. Learn about strategies to mitigate harm and to prevent medication errors based on analyses of medication incident reports from Canadian healthcare providers, facilities, pharmacies, organisations and consumers.
  20. News Article
    Hospital trusts in England face “eye-watering” rises in energy bills of £2m a month each due to the fuel price surge, with NHS leaders saying patients may face longer waiting times or even see their care “cut back” as a result. NHS trusts are concerned they will have to make critical choices on staff levels and the services they provide in order to keep operating, with energy costs predicted to be as much as three times higher than a year ago. The BMJ surveyed NHS trusts in England for details of their recent and predicted future energy bills and how they expected to operate this coming winter when taking into account the additional energy charges on the way. Most said they expected their energy bills to double at least. Rory Deighton, senior acute lead at the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland, said: “This isn’t an abstract problem, as the gap in funding from rising inflation will either have to be made up by fewer staff being employed, longer waiting times for care, or other areas of patient care being cut back." Read full story Source: The Guardian, 1 September 2022
  21. News Article
    Covid vaccination advice in pregnancy has not changed, contrary to false social media posts, UK health agencies have clarified. Inaccurate messages shared by thousands claimed that pregnant or breastfeeding women were now recommended not to take the vaccine. In fact, the NHS says the vaccine is both safe and strongly recommended for this group. The misleading claim came from a now out-of-date document from 2020. The document went viral after a Twitter user - whose account has since been suspended - shared a post stating incorrectly that the UK government had, "quietly remove[d] approval for use of Covid vax in pregnant and breastfeeding women". She linked to a report from December 2020 which said, "reassurance of safe use of the vaccine in pregnant women cannot be provided at the present time", because of an absence of data and that, "women who are breastfeeding should also not be vaccinated". This was true at the time, but since then data has been gathered finding no link between the vaccine and problems in pregnancy or birth. In fact, the Covid vaccine seems to reduce the risk of still-birth and pre-term delivery. And unvaccinated pregnant women are more likely to need hospital treatment if they catch Covid, especially in the third trimester. This evidence led to the recommendation being changed - so the statement found in this report no longer stands. Read full story Source: BBC News, 1 September 2022
  22. Content Article
    Wessex LMCs podcasts share good ideas, challenge your thoughts and introduce you to interesting people and projects all to support you in your work in general practice.
  23. Content Article
    “The National Health Service and the adult social care sector are facing the greatest workforce crisis in their history”, said Parliament’s Health and Social Care Select Committee in July. The aspirations to rebuild services post-Covid, and tackle rising waiting times and other access challenges, are limited by the same challenge: there are simply not enough staff, writes Richard Murray in this article for the Independent.
  24. News Article
    Doctors say it could take months to process mounting piles of medical paperwork caused by a continuing cyber-attack on an NHS supplier. One out-of-hours GP says patient care is being badly affected as staff enter a fourth week of taking care notes with pen and paper. The ransomware attack against software and services provider Advanced was first spotted on 4 August. The company says it may take another 12 weeks to get some services back online. Dr Fay Wilson, who manages an urgent-care centre in the West Midlands, says the main choke point for her team is with patient records. She said it could affect patient care "because we can't send notifications to GP practices, except by methods that don't work because they require a lot of manual handling, and we haven't got the staff to actually do the manual handling". Read full story Source: BBC News, 31 August 2022
  25. Content Article
    Social movements are behind the most powerful changes around the world. From voting rights, to political upheavals and the fight for racial equality – social movements can change mindsets, enact laws and shift policies. But only if they succeed. So what are the features of a movement that can hold the attention of leaders and involve millions of participants? This episode of 'Experts Explain', with Hahrie Han, Professor of Political Science at Johns Hopkins University, delves into how to make a social movement succeed.
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