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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Cold homes will damage children’s lungs and brain development and lead to deaths as part of a “significant humanitarian crisis” this winter, health experts have warned. Unless the next prime minister curbs soaring fuel bills, children face a wave of respiratory illness with long-term consequences, according to a review by Sir Michael Marmot, the director of University College London’s Institute of Health Equity, and Prof Ian Sinha, a respiratory consultant at Liverpool’s Alder Hey children’s hospital. Sinha said he had “no doubt” that cold homes would cost children’s lives this winter, although they could not predict how many, with damage done to young lungs leading to chronic obstructive pulmonary disease (COPD), emphysema and bronchitis for others in adulthood. Huge numbers of cash-strapped households are preparing to turn heating systems down or off when the energy price cap increases to £3,549 from 1 October, and the president of the British Paediatric Respiratory Society, also told the Guardian that child deaths were likely. “There will be excess deaths among some children where families are forced into not being able to heat their homes,” said Dr Simon Langton-Hewer. “It will be dangerous, I’m afraid.” Read full story Source: The Guardian, 1 September 2022
  2. News Article
    Medically fit patients are waiting up to nine months to be discharged from some NHS hospitals as increasing numbers of working age people develop more complex conditions amid ongoing social care shortages, HSJ can reveal. Trust data obtained by HSJ suggests patients at the hospitals which have struggled most with delayed discharges can face delays of many months after a decision has been made that they are fit to leave hospital. HSJ obtained data from seven trusts which have consistently reported high numbers of delayed discharges through a freedom of information request. At North Bristol Trust, one patient waited more than nine months to be discharged, while another waited around eight months. David Maguire, a senior analyst at The King’s Fund think tank, said lengthy delayed discharges often involve patients with highly complex needs, elderly and frail patients, or people with mental health conditions or learning difficulties. But he said there is also a growing number of working age people with chronic and more complex conditions. He added: “There has always been a large number of older people who will access health care and hospital services. But over the last few years we have seen a growing number of working age people requiring hospital care and social care services. That’s a growing part of the demand which will flow through into who needs discharge from hospital settings. Read full story (paywalled) Source: HSJ, 31 August 2022
  3. News Article
    More than two-thirds of trusts have been forced to suspend or pause a high-profile service improvement aimed at reducing neonatal and maternal deaths, because of widespread staffing shortages. HSJ research revealed a majority of trusts have been unable to implement the continuity of carer maternity model, after they were told to look again at whether it could be safely implemented. The model intends to give women “dedicated support” from the same midwifery team throughout their pregnancy, with a 2016 review saying it would reduce infant and maternal mortality rates and improve care more generally. It is particularly aimed at improving care for patients from minority ethnic groups and those with other risk factors, and has been championed by Jacqueline Dunkley-Bent, NHS England’s chief midwifery officer. Key targets around the model were included in the 2019 NHS long-term plan. However, there is consensus nationally that it can only be rolled out safely where there are adequate numbers of staff to do so – otherwise the risks outweigh the benefits. Earlier this year, the final Ockenden report into maternity care failings at Shrewsbury and Telford Hospital Trust was critical of the model, and said it should be suspended until trusts have enough staff to meet “safe minimum requirements on all shifts”. Read full story (paywalled) Source: HSJ, 30 August 2022 Read more about the continuity of care maternity model on the hub
  4. News Article
    Vaccine coverage continued to decline worldwide in 2021, with 25 million children missing out on lifesaving vaccines, according to data published by the World Health Organization and UNICEF. "The largest sustained decline in childhood vaccinations in approximately 30 years has been recorded," the organisations have said. Between 2019 and 2021, there was a 5-point drop in the percentage of children who got three doses of DTP3, the vaccine against diphtheria, tetanus and pertussis. This took the coverage down to 81%. DTP3 coverage is used as a marker for broader immunization coverage, WHO and UNICEF said. "As a result, 25 million children missed out on one or more doses of DTP through routine immunization services in 2021 alone. This is 2 million more than those who missed out in 2020 and 6 million more than in 2019, highlighting the growing number of children at risk from devastating but preventable diseases," they said. Eighteen million of these children didn't get a single dose of the vaccine, the majority of whom lived in low- and middle-income countries. Other decreases were seen in HPV, with which over a quarter of the coverage achieved in 2019 was lost, and measles, with which first-dose coverage dropped to 81% in 2021. WHO notes that this is the lowest level since 2008 and means 24.7 million children missed their first dose in 2021. Read full story Source: CNN, 14 July 2022
  5. News Article
    NHS nurses will wear “smart goggles" as part of efforts to see more patients under a £400,000 pilot scheme. Health chiefs said the virtual reality headsets would mean details of a consultation could be directly transcribed, reducing the amount of time spent filling in patients’ notes. The technology will also allow live footage to be streamed to hospital specialists for second opinions, so patients do not have to have extra appointments in hospitals. The intention is to give nurses more time for clinical duties such as checking blood pressure, dressing wounds and assessing a patient’s health needs. Dr Tim Ferris, NHS director for transformation, said: “These new smart glasses are the latest pioneering tech and really show us what the future of the NHS could look like. “They are a win-win for staff and patients alike, freeing up time-consuming admin for nurses, meaning more time for patient care.” Read full story (paywalled) Source: The Telegraph, 20 August 2022
  6. Content Article
    Information on waiting times for local health boards and specialties in Scotland. This site shows information on waiting times for planned (elective) care. This site does not show information for emergency (unscheduled) care. The statistics shown here relate only to any treatment as an inpatient or day case covered by the Treatment Time Guarantee (TTG). A small number of specialist treatments are not covered by the TTG.
  7. Content Article
    Over the last four years, Health Education England (HEE) has led a collaborative effort, on behalf of patients, the profession and the NHS, to co-create reforms across medical education and training. HEE launched the Future Doctor Programme last year, linked to work on the NHS People Plan, to inform and galvanise change in medical education and training to achieve the vision for future healthcare as set out in the NHS Long Term Plan. The Future Doctor Programme provides a clear view of what the NHS, patients and the public require from future doctors within a transformed multi-professional team. This co-created vision for the future has also identified much of what is required to respond to the projected demands and needs of the workforce in the future.
  8. News Article
    Nearly 38,000 vital follow-up appointments with mental health patients were missed at the time when they were most at risk of suicide, the Royal College of Psychiatrists has said. The medical body has called for “urgent action” to ensure more people are seen for follow-ups within 72 hours of their discharge from inpatient care, to prevent them from falling “through the cracks when they are so vulnerable”. The risk of suicide is highest on the second and third days after leaving a mental health ward, but 37,999 follow-up appointments with patients were not made within this timeframe in England between April 2020 and May 2022. According to NHS data, of the 160,430 instances when patients were eligible for follow-up care within 72 hours after discharge from acute adult mental health care, only three-quarters (76%) took place within that period. The Royal College of Psychiatrists is calling for more trained specialists to check on those perceived to be at risk, which they say requires more staffing and funding. The president of the Royal College of Psychiatrists, Dr Adrian James, said: “We simply can’t afford to let people fall through the cracks at a time when they are so vulnerable. It’s vital that our mental health services are properly staffed and funded to offer proper follow-up care and help prevent suicides. “Staff are working as hard as they can to provide high-quality care, but it’s clear that current resources are not enough to meet these targets. We need urgent action to tackle the workforce crisis and achieve the suicide prevention goals set out in the NHS long-term plan.” Read full story Source: The Guardian, 22 August 2022
  9. News Article
    A black NHS worker has launched legal action against the health service’s blood and transplant authority after witnessing years of alleged racism within the service. Melissa Thermidor, 40, from Bushey, Hertfordshire, has lodged an employment tribunal claim against NHS Blood and Transplant (NHSBT) and two executives who have since left the authority. Betsy Bassis and Millie Banerjee, who were the chief executive and chairwoman, have denied the allegations and intend to fight the tribunal claims. One colleague allegedly said: “White donors are more likely to shop at Waitrose and black donors at Tesco.” At subsequent meetings, the phrase “Tesco donors” was used. Staff also allegedly referred to “you people” when speaking to black members of the team. Thermidor claims she was constructively dismissed after whistleblowing about racism within NHSBT. The health authority, which supported 3,386 organ donations in the year to March last year as well as collecting blood from 761,000 donors, has been embroiled in allegations of bullying, racism and poor culture under Bassis and Banerjee’s leadership. Read full story (paywalled) Source: The Times, 21 August 2022 Read NHS Blood and Transplant's response to the article.
  10. News Article
    Thousands of vulnerable people are suffering inadequate care as severe staffing shortages in previously good care homes push operators to break rules and put residents at risk. A wave of inspections has revealed the human impact of a worsening nationwide staffing crisis, with people being left in their rooms 24 hours a day, denied showers for over a week, enduring assaults from fellow residents, and left soaking in their own urine. Stretched staff have described scrambling to help residents with buzzers going off and fear the squeeze on their time is dangerous. Analysis by the Guardian revealed that staff shortages were identified as a key problem in three-quarters of all the care homes in England where the Care Quality Commission regulator had cut their rating from “good” before Covid-19 to “inadequate” this summer. A further 10% of homes whose rankings slumped had enough staff, but failed to recruit safely, either not taking references properly, carrying out criminal records checks, or training staff adequately. Families said the staffing shortages had reached “crisis point”. “Older people are paying a heavy price for these failings, as poor care robs them of their dignity, breaks their will and makes them feel unsafe in their own home,” said Helen Wildbore, director of the Relatives and Residents Association. “Older people need much more than empty slogans from the next prime minister about ‘fixing social care’.” Read full story Source: The Guardian, 21 August 2022
  11. News Article
    A study of over 1,000 health and social care workers, conducted by Florence, the tech platform providing health & social care workers access to available shifts, found that almost a third of healthcare workers admit to feeling overwhelmed at least once a week, with 17% feeling burnt-out every day. A staggering 97% believe the cost-of-living crisis has caused further stress or burnout among healthcare professionals. It comes after more than half of healthcare workers (56%) admit to working more than 2-3 times a week over their contracted hours, with 7% working overtime every day. Not having enough staff is causing the most pressure in their role (50%), followed by low pay (39%) and high workload (35%). The study revealed nine in ten NHS and social care workers state chronic staff shortages are affecting the quality of care. Analysing this deeper, three quarters of respondents stated that the quality of care is already being ‘severely’ impacted as high vacancy rates sweep across the industry. Dr Charles Armitage, Former NHS doctor and CEO and Founder of Florence, observed: “If you’ve got fewer people there on-shift to look after people, the quality of care decreases because the people that are there are overstretched, they’re trying to do too many things and are suffering from severe burnout. As a result, mistakes are made as they’re not able to just spend as much time with people and provide that really important patient-centred care.” Read full story Source: Hospital Times, 17 August 2022
  12. News Article
    The families of any NHS and social care staff who died from Covid in the most recent waves will not be eligible for the Covid death assurance scheme launched at the start of the pandemic, it has emerged. The scheme closed on 31 March, despite pleas from the Royal College of Nursing (RCN) to keep it open. Since it was set up in April 2020, it has paid out £60,000 lump sums to the estates of 688 workers. A further 42 cases have been declined and 29 applications are still being processed. The RCN wrote to then health and social care secretary Sajid Javid on 30 March, calling for the scheme to be extended. General secretary and chief executive Pat Cullen wrote: “The over-riding principle must be that no member of nursing staff who loses their life this year should be afforded any less respect and family support than one who died in 2020 or 2021… “With a distinct possibility of new variants at any point, staff deserve assurance that they and their loved ones will not go unnoticed should they contract and ultimately lose their life to covid.” Read full story (paywalled) Source: HSJ, 19 August 2022
  13. News Article
    Mental health trusts continue to suffer much disruption after a cyber attack left them unable to access their electronic patient records. Several trusts which use Advanced’s CareNotes EPR are grappling with the system being down, although the company said on Friday some progress had been made to restore the EPR. One source at an affected mental health trust said there had been “not much in the way of improvements”, while another said they feared it could be “months” before they can fully access the EPR. NHS England’s mental health director Claire Murdoch is regularly raising issue nationally, HSJ was told, as response teams work with Advanced to investigate and restore IT systems, which were taken offline after the company was hit by a cyber attack two weeks ago. Hereford and Worcestershire Health and Care Trust has told its patients they might have to “provide more detail on your medical history to ensure clinicians have the most up-to-date information”, while Oxford Health Foundation Trust warned the technical issues could cause delays to patient care. Read full story (paywalled) Source: HSJ, 21 August 2022
  14. Content Article
    Presentation from Professor Mark Brinell, Vice Chair and Global Healthcare Expert at KMPG, on lessons we can learn from integrated care systems across the globe.
  15. Content Article
    Louise Greenwood is joined by:  Sarah Kay, GP Clinical Lead for Patient Safety at NHS Dorset Jaydee Swarbrick, Patient Safety Specialist at NHS Dorset to discuss the importance of patient safety at this time of significant pressure across the NHS. Patient safety is about maximising the things that go right and minimising the things that go wrong. It is integral to the NHS’ definition of quality in healthcare, alongside effectiveness and patient experience.
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  17. Content Article
    Gender is emerging as a significant factor in the social, economic, and health effects of COVID-19. However, most existing studies have focused on its direct impact on health. Here, we aimed to explore the indirect effects of COVID-19 on gender disparities globally. The most significant gender gaps identified in our study show intensified levels of pre-existing widespread inequalities between women and men during the COVID-19 pandemic. Political and social leaders should prioritise policies that enable and encourage women to participate in the labour force and continue their education, thereby equipping and enabling them with greater ability to overcome the barriers they face.
  18. News Article
    Rising numbers of people will fall sick and see their health worsen unless the government takes further action to limit energy price rises, the NHS says. The NHS Confederation said the UK was facing a "humanitarian crisis". The group, which represents health bosses, said many people would face the awful choice between skipping meals to heat their homes or having to live in cold and damp conditions. But ministers said action was already being taken and the NHS supported. This includes £400 payments to every household this autumn to help pay energy bills. However, in a letter to ministers, NHS leaders said that rapidly rising energy prices, along with other cost-of-living pressures, will still leave individuals and families facing impossible choices. They warn that if people are forced to live in cold homes and cannot afford nutritious food, then their health will quickly deteriorate and the NHS will be left to pick up the pieces. Cold conditions can lead to a rise in respiratory conditions, and in older people can also increase the risk of heart attacks, strokes and falls. Cold homes are already linked to 10,000 deaths a year, the NHS Confederation said. The group warned the risk of ill-health linked to the energy crisis would come on top of what many expect to be one of the toughest winters on record because of the combination of flu, norovirus and Covid outbreaks. As well as leading to more sickness and illness, the NHS Confederation said it would also have a major impact on mental health and well-being. Read full story Source: BBC News, 20 August 2022
  19. News Article
    GPs around England are to prescribe patients activities such as walking or cycling in a bid to ease the burden on the NHS by improving mental and physical health. The £12.7m trial, which was announced by the Department for Transport and will begin this year, is part of a wider movement of “social prescribing”, an approach already used in the NHS, in which patients are referred for non-medical activities. Minister for health, Maria Caulfield, said the UK is leading the way in embedding social prescribing in the NHS and communities across the country. “Getting active is hugely beneficial for both our mental and physical health, helping reduce stress and ward off other illness such as heart disease and obesity,” she said. Paul Farmer, chief executive of the mental health charity Mind, said he welcomed news of the extra investment, enabling the NHS to try new ways of supporting mental health, such as through social prescribing schemes. But, he added, prescribing exercise is not a miracle cure for treating mental health problems. “What we urgently need to see is proper investment into our country’s mental health services,” he said. “Only that will enable us to deliver support to the 1.6 million people currently sat on waiting lists, and the 8 million people who would benefit from mental health support right now but are deemed by the system not to be unwell enough to access it.” Read full story Source: The Guardian, 22 August 2022
  20. News Article
    Some acute trusts have kept more than half of their executive directors over a five-year period – whereas others have seen all of them change, according to HSJ analysis of top-level managerial stability. HSJ looked at the number of executive directors who had been in place between April 2017 and April 2022, by examining annual reports and board papers. One trust – Southport and Ormskirk – had five CEOs during the five year period, and three other trusts had four. The national average was more than two different CEOs at each trust across the five years. Thirty-one trusts (out of 108 listed) had three different CEOs during the period, and just 23 trusts had one. NHS Providers interim chief executive Saffron Cordery said: “This analysis underlines the value of long-term investment in NHS trust leadership. It highlights too the danger of chopping and changing leaders amid longstanding financial, capacity, workforce and other structural pressures on the health system. “It is vital to invest in people alongside operational priorities. More must be done to guarantee a robust and diverse pipeline of leaders, equipped to take on crucial roles.” Read full story (paywalled) Source: HSJ, 22 August 2022
  21. News Article
    On Monday, September 20, 2021, Michael Wysockyj felt unwell and did what any gravely sick person would do: he put his life in the hands of the ambulance service. The 66-year-old from Norfolk was whisked by paramedics to the Queen Elizabeth hospital in King’s Lynn at 6.28pm. Nearly four hours later, he was still trapped inside the vehicle. The hospital was too full to take him. He died at 4.42am. So great were the concerns of the coroner, Jacqueline Lake, that she took the unusual step of issuing a “prevention of future death” notice. “The emergency department was busy at the time and unable to offload ambulances,” she said in her report. “An x-ray cannot be carried out in an ambulance and must wait until the patient is in [the emergency department].” This episode should be an anomaly in the failure of emergency services. It is not. The crisis is “heartbreaking”, according to Dr Ian Higginson, vice-president of the Royal College of Emergency Medicine. “If you call for an ambulance and you’re waiting many hours for one and you have a serious condition, that is going to have an impact on your outcome. It would be reasonable to assume the long delays that patients are subjected to waiting for ambulances at the moment will filter through into excess mortality.” Read full story (paywalled) Source: The Times, 21 August 2022
  22. Content Article
    Safety reporting systems are widely used in healthcare to identify risks to patient safety. But, their effectiveness is undermined if staff do not notice or report incidents. Patients, however, might observe and report these overlooked incidents because they experience the consequences, are highly motivated, and independent of the organsation. Online patient feedback may be especially valuable because it is a channel of reporting that allows patients to report without fear of consequence (e.g., anonymously). Harnessing this potential is challenging because online feedback is unstructured and lacks demonstrable validity and added value.
  23. Content Article
    Earlier this year in March, a nurse from Vanderbilt University, RaDonda Vaught, was found guilty of criminally negligent homicide and gross neglect of a patient. In 2017, Vaught gave 75-year-old Charlene Murphey the incorrect medication. Murphey died as a result. Charlene Murphey’s tragic death highlights the failures of healthcare organisations and their leadership to be trustworthy as well as a fractured and weakened accountability system for patient safety in the United States.
  24. Content Article
    On the 21 July 2022 NHS Resolution’s Safety and Learning team, in partnership with the National Infusion and Vascular Access Society, hosted a virtual forum on extravasation injury claims. The intention of this event was to raise awareness of these injuries and help spread learning and process review across health providers.
  25. News Article
    The NHS is to launch a campaign urging the public to avoid A&E in an echo of appeals to protect the health service during the Covid pandemic. The head of the NHS has instructed hospitals to prepare a public awareness campaign calling for people to “minimise” pressures on urgent and emergency services. Such an instruction has never been issued so early in the year, and comes amid concerns that hospitals and ambulance services are already facing strains usually seen in the depths of winter. People suffering a genuine emergency will still be encouraged to go to A&E, but on Friday night there were warnings that the campaign risks exacerbating the problems caused by patients staying away from the health service during Covid. Prof Carl Heneghan, an urgent care doctor and professor of evidence-based medicine at the University of Oxford, said the NHS needed to be very careful about trying to dissuade the public from using services. “The NHS seems to be the only business I know that doesn’t know how to deal with demand, and work with the needs of its customers,” he said. “As an urgent care doctor, I need to be in front of the patient to do my job. It’s often too difficult for the new mum to know when it’s appropriate to turn to emergency services. These decisions are difficult – it’s the job of a doctor. “Too often I see elderly patients who apologise for taking my time and I say ‘don’t apologise – you could have been 24 hours away from death’.” Read full story (paywalled) Source: The Telegraph, 19 August 2022
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