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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    Governments in England, Scotland and Wales recently withdrew covid sick leave for NHS staff. These changes to sick pay provision for staff on Covid-related sick pay is hard to understand at a time when Covid-19 infections are going up exponentially and many NHS organisations are reporting increasing numbers of staff off sick. Evidence is emerging that your chances of on-going issues (Long Covid) following a covid infection increase with each re-infection. Given this you might expect that NHS organisations were ensuring their infection control guidelines guaranteed staff were fully protected against Covid-19. However, in many Trusts this does not appear to be the case. Throughout the pandemic many NHS organisations seem to have focused on following Government guidelines about PPE requirements and ignored their obligations under Health and Safety Legislation. This has resulted in on-going shortcomings in protecting staff at work. This is discussed by Professor Raymond Agius and colleagues in a BMJ blog.
  2. Community Post
    @AmaniKrayem Thanks for posting. We will share on social media.
  3. News Article
    Doctors and nurses often “weight-shame” people who are overweight or obese, leaving them feeling anxious, depressed and wrongly blaming themselves for their condition, research has found. Such behaviour, although usually the result of “unconscious weight bias”, leads to people not attending medical appointments, feeling humiliated and being more likely to put on weight. Dr Anastasia Kalea and colleagues at University College London analysed 25 previous studies about “weight stigma”, undertaken in different countries, involving 3,554 health professionals. They found “extensive evidence [of] strong weight bias” among a wide range of health staff, including doctors, nurses, dieticians, psychologists and even obesity specialists. Their analysis found that a number of health professionals “believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”, said Kalea, an associate professor in UCL’s division of medicine. She added: “Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and we know this acts as a barrier to the services and treatments that can help people manage weight. “An example is a GP that will unconsciously show that they do not believe that the patient complies with their eat less/exercise more regime they were asked to follow as they are not losing weight." “The result is that patients are not coming back or they delay their follow-up appointments, they avoid healthcare prevention services or cancel appointments due to concerns of being stigmatised due to their weight.” Read full story Source: The Guardian, 10 August 2022
  4. News Article
    Half of UK adults with a possible cancer symptom do not contact their GP within six months, despite spotting changes to their body, research suggests. A YouGov poll of 2,468 people for Cancer Research UK found that just 48% of those who had experienced a red flag symptom – including coughing up blood, unexplained weight loss and a new or unusual lump – contacted their GP within half a year. Not telling a doctor about unusual health changes or possible cancer symptoms reduces the chances of an early cancer diagnosis, leading to potentially devastating outcomes. Cancer Research UK’s chief executive Michelle Mitchell said: “Spotting cancer early is vital if more people are to survive, and the first step in that process is getting help for a possible cancer symptom. “It’s really worrying to see such a large gap in accessing services between the UK’s most and least deprived groups. “Earlier this year, the Government announced among its top priorities were improving early diagnosis of cancer and tackling health disparities. “Cancer must remain a top priority and with the upcoming Health Disparities White Paper and 10-Year Plan for England, the new Health and Social Care Secretary has a huge opportunity to transform cancer survival with a clear and strong plan that works for all.” Read full story Source: The Independent, 10 August 2022
  5. News Article
    A trust which rented 1,100 lone worker alarms has found just four were in use after a year. Sussex Partnership Foundation Trust rented the system for five years, with the contract starting in early 2021. But a year later only 51 of the units were assigned to a user, and just four were being used. Most of the users had not completed their training and 19 had not even logged into the system to set up a profile, according to an annual health and safety report covering 2021-22. The health and safety report said: “Unfortunately the system has yet to demonstrate value for money as the uptake within services across the trust is very poor, despite the extensive work by the health and safety team to encourage uptake.” This had included demonstrating the system at multiple meetings and trying to raise awareness. A spokesperson from Sussex Partnership Foundation Trust said: “The lone worker system is one of the ways we ensure the safety of our staff who work alone. It has taken time to embed the new system due to the changes in working practices during the pandemic. However, in recent months we have seen the number of staff actively using the system increasing." “There is more we are doing to ensure wider take-up and implementation, through a programme of engagement and training.” Read full story (paywalled) Source: HSJ, 9 August 2022
  6. News Article
    Action rather than reports is needed to tackle healthcare inequalities faced by black people in Birmingham, a charity says. It follows a report which found people from black communities continued to face racism and discrimination when accessing treatment. The city's director of public health said he was "horrified" by the finding. Dr Justin Varney said the system must be adapted to meet the needs of all. Charity The First Class Foundation wants to see implementation of changes and says among the healthcare problems in need of tackling are "microaggressions" faced by communities. The publication of the Birmingham and Lewisham African Health Inequalities Review followed an 18-month study commissioned by the areas' local authorities. It found disadvantages among the communities in housing, pollution and availability of green space had "all contributed to worse health". The report additionally highlighted how the communities were "exposed to structural racism and discrimination which leads to... chronic stress and trauma". Read full story Source: BBC News, 10 August 2022
  7. Content Article
    Health inequalities are not inevitable and are unfair. Many people from different backgrounds across our society suffer health inequalities which can negatively impact the whole community, not just those directly affected. Birmingham and Lewisham African Caribbean Health Inequalities Review (BLACHIR) set out to urgently reveal and explore the background to health inequalities experienced by the Black African and Black Caribbean communities. Birmingham is home to 8% of the Black African and Black Caribbean populations in England and 23% of Lewisham’s population is Black African or Black Caribbean (ONS 2011). The main aim of the Review is to improve the health of Black African and Black Caribbean people in the communities by listening to them, recognising their priorities, discussing, and reflecting on the findings and coproducing recommended solutions for the Health and Wellbeing Board and NHS Integrated Care Systems to consider and respond to.
  8. News Article
    The medical body at Norfolk and Suffolk Foundation Trust has written to the trust’s chair saying that it is unable to provide safe care and expressing a lack of confidence in the board. The letter, which has been seen by HSJ, is signed by 140 of doctors at the mental health provider. It claims the trust’s “clinical services are unable to provide good basic care and are unsafe”. Significant criticism is reserved for the trust’s senior management, with the letter stating “there is a general dysfunction with perpetual changes of key staff in executive posts and ever increasing layers of management” and that “major decisions are frequently made by a handful of people at an executive level without clinical consultation”. The letter continues: “Doctors are by and large used as clinical workhorses. Many carrying huge workloads and holding unacceptable clinical risks”. The letter, first revealed by BBC Look East, asks for an urgent meeting with the chair and states that the medical body “lacks confidence in the executive board to resolve the plight of NSFT”. Read full story (paywalled) Source: HSJ, 10 August 2022
  9. Content Article
    In this British Journal of Nursing article, John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent reports on the duty of candour and shared decision-making.
  10. Content Article
    The NHS is in trouble today due to an utter failure of leadership in response to the challenge of increasing demand, writes Dr John Carlisle. The Health and Social Care Act was the most extensive reorganisation of the NHS ever. The plan emerged in 2010 when Health Secretary Andrew Lansley began to prepare the new bill, just as the NHS public satisfaction with the NHS was at its highest ever in a polling series that ran back to 1983. Now, ask yourselves, what fool would interfere with any organisation that had such ‘consumer confidence’? Never has the phrase, ‘if it ain’t broke, don’t fix it’ been more apt, particularly for an organisation that employs over a million staff and whose work is critical, and is respected around the world. But Lansley, ignoring international experts like Dr Don Berwick, pushed his own theory (which is all it was) into practice and created the conditions for Jeremy Hunt and his Oxford chum, Simon Stevens, to run the organisation down. Needless to say, the act worked out badly for the poor NHS. By 2018 public satisfaction had dropped to its lowest in 11 years as Hunt and Stevens tried to cobble together the ‘new’ NHS. Just how did this happen?
  11. Event
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    As this year's theme of World Patient Safety Day 2022 is "Medication safety" and increasing awareness about safe medication usage in clinical practice, the Peerless Hospital, Kolkata, India, are organising a one day conference " MediSafeCon" dedicated to increasing awareness about patient safety and medication safety in clinical practice among pharmacists, nurses and doctors. The following sessions by leading doctors, pharmacists, nurses and medicolegal experts of West Bengal and India: 1. Medication safety issues in Critical Care practice 2. Medication safety issues in Pediatric practice 3. Medication safety issues in Oncology practice 4. Medication safety issues in Gastroenterology practice 5. Medication safety issues in Surgical practice 6. Medication safety issues in Domiciliary care 7. Medication safety issues in Telemedicine services 8. Medication errors and Medicolegal implications. Information brochure Medisafecon_brochure.pdf
  12. News Article
    Specialist nurses at an NHS hospital have been told they may be taken off clinical shifts to help clean wards, it has emerged. Bedfordshire Hospitals NHS Foundation Trust has said it asked nursing staff to help clean wards as the hospital faced the “most challenging circumstances” it has ever faced. Clinical specialist nurses, who are advanced nurses and can usually have hundreds of patients under their care, were among those asked to spend entire shifts helping other wards “cleaning”, “tidying” and “decluttering”. The news has prompted criticism from unions, however, multiple nurses have reported that the requests happen “often” during winter. Alison Leary professor of healthcare and workforce at South Bank University warned that asking specialist nurses to drop their work was “very risky”. She said: “This problem keeps cropping up-as soon as there is pressure on wards they are expected to abandon their patients. It usually happens in winter and so it’s concerning that it has now started to happen in summer. “This also shows very little respect for nursing generally and will not help retention. Trusts need to plan workforces accordingly and should ensure they have the right amount of cleaning, administrative and housekeeping staff-all staff groups which contribute to patient safety and care quality." Read full story Source: The Independent, 8 August 2022
  13. News Article
    Patients at trusts with long waiting lists should no longer think ‘they have to go to their local hospital’ for outpatient appointments, but should instead be offered virtual consultations elsewhere in the country where there is greater capacity, Sir Jim Mackey has told HSJ. The NHS England elective chief said recent efforts to abolish two-year waiters by July had meant a “very big” surgical focus. However, the next phase of the elective recovery plan would see a major shift of emphasis onto reducing the wait for outpatient appointments. Sir Jim said: “Providers have been split into tiers again with tier one having national oversight and tier two, regional oversight. Behind that we will be pairing up organisations so that organisations with capacity can help those with the biggest challenges from a virtual outpatient perspective. He added: “There still is a lot to work through [on virtual outpatients], we’re going to be testing the concept… We need to work through how all the wiring and plumbing needs to work. For example, what happens if the patient needs a diagnostic locally, having seen a clinician virtually in another part of the country? “It would be great also to try and stimulate more of a consumer drive on this – encouraging patients to ask about virtual outpatients when the waits locally may be too long, so they don’t just think they have to go to their local hospital. I think this could really help shift the model if we can get it right.” Read full story (paywalled) Source: HSJ, 9 August 2022
  14. News Article
    A health official in New York State has told the BBC there could be hundreds or even thousands of undiagnosed cases of polio there. It follows an announcement last month that an unvaccinated man had been paralysed by the virus in Rockland County, New York. His case has been linked genetically to traces of polio virus found in sewage in London and Jerusalem. Developed countries have been warned to boost vaccination rates. Dr Patricia Schnabel Ruppert, health commissioner for Rockland County, said she was worried about polio circulating in her state undetected. "There isn't just one case of polio if you see a paralytic case. The incidence of paralytic polio is less than 1%," she said. "Most cases are asymptomatic or mildly symptomatic, and those symptoms are often missed. So there are hundreds, perhaps even thousands of cases that have occurred in order for us to see a paralytic case." "This is a very serious issue for our global world - it's not just about New York. We all need to make sure all our populations are properly vaccinated," she said. Read full story Source: BBC News, 9 August 2022
  15. Content Article
    Successful adoption of novel noncontact physiological measurement and physical monitoring requires analysis of how they support patient care. Lloyd-Jukes et al. review available technologies and present their vision-based patient monitoring and management system, supported by a framework enabling its integration within clinical workflows. The framework links tasks such as assessing patients to elements of the patient journey (eg, risk factors and early warning signs). The system enabled insights from patient activity reports and noncontact vital sign measurements. It supports staff in ensuring patients' health follows desired trajectories, avoiding adverse events, making observations without disrupting patients' rest, intervening proactively, and learning from incidents.
  16. News Article
    NHS patients will wait longer for routine checks as part of a national drive to clear record backlogs. Health officials have instructed hospitals to “repurpose” resources to focus on those waiting the longest, who are yet to have their first appointment. Today the NHS claimed it had “virtually eliminated” two year waits, with less than 3,000 people enduring such delays, down from 22,500 at the end of January. Hospitals are being urged to prioritise those waiting 18 months or more, with pledges to get rid of such waits by April next year. NHS chiefs have instructed hospitals to focus on outpatient first appointments, rather than patients who have already had treatment, and are waiting for follow-up checks. Senior officials have said many such appointments are a “a waste of time” saying there should be more use of systems where routine slots are scrapped, and patients instead told to contact their medical team if they have particular concerns. The drive - which health chiefs dubbed “Super September” - will see priority given to tackling the longest waits. Read full story (paywalled) Source: The Telegraph, 9 August 2022
  17. News Article
    One in 25 people who die of a heart attack in the north-east of England could have survived if the average cardiologist effectiveness was raised to the London level, research shows. The research, undertaken by the Institute for Fiscal Studies (IFS), looked at the record of over 500,000 NHS patients in the UK, over 13 years. It highlights the stark “postcode lottery” of how people living in some parts of the country have access to lower quality healthcare. The results found that while cardiologists treating patients in London and the south-east had the best survival rates among heart attack patients, patients being treated in the north-east and east of England had the worst. Among 100 otherwise identical patients, an additional six patients living in the north-east and east of England would have survived for at least a year if they had instead been treated by a similar doctor in London. Furthermore, if the effectiveness of doctors treating heart attacks in these areas of the country were just as effective as the cardiologists in London, an additional 80 people a year in each region would survive a heart attack. The research also revealed a divide between rural and urban areas of England, with patients living in the former typically receiving treatment from less effective doctors compared with those in more urban areas. Read full story Source: The Guardian, 9 August 2022
  18. News Article
    Deaths, staff shortages and a culture of life-threatening self-harm are exposing deep fears about the quality of mental health care in hospitals for children and young people. Since 2019, at least 20 patients aged 18 or under have died in NHS or privately-run units, the BBC has found. A further 26 have died within a year of leaving units, amid claims of a lack of ongoing community support. The NHS said it had "invested record amounts... to meet record demand". Child and Adolescent Mental Health Services (CAMHS) units look after about 4,000 patients with many different diagnoses each year. The aim is to help them recover over a period of weeks or months through specialist care. Some patients are in and out of the units for years. The BBC has also heard serious claims regarding the unsafe discharge of patients sent home from CAMHS hospitals. Several former patients told the BBC they had serious self-harm incidents or tried to take their own life within days of returning home. Parents have described being on "suicide watch" 24 hours a day, to ensure their child's safety. Read full story Source: BBC News, 9 August 2022
  19. News Article
    The backlog of people waiting more than two years for a routine operation in England has shrunk from 22,500 at the start of the year to fewer than 200. NHS England figures show the number of patients waiting that length of time has fallen to just 168, excluding more complex cases. Staff have been praised for carrying out the NHS elective recovery plan, published this year to tackle backlogs built up during the coronavirus pandemic. At the start of the year, more than 22,500 people had been waiting two years or longer for scans, checks and surgery. A further 51,000 who would have passed the two-year mark by the end of July have also been treated, figures show. The NHS England chief executive, Amanda Pritchard, said: “It has only been possible because the NHS has continued to reform the way we deliver care, using innovative techniques and adopting pioneering technology like robot surgery, and through building new relationships and mutual aid arrangements across systems to offer patients the opportunity to be transferred elsewhere and get the care they need as quickly as possible. “The next phase will focus on patients waiting longer than 18 months, building on the fantastic work already done, and, while it is a significant challenge, our remarkable staff have shown that, when we are given the tools and resources we need, the NHS delivers for our patients.” Read full story Source: The Guardian, 9 August 2022
  20. News Article
    After lockdown raided the savings of hairdresser and gym instructor Lucie Wilby, a lengthy wait for a hip replacement dealt another blow to her family’s finances. “We’re in a lot of debt because of it and that’s a combination of Covid and obviously surgery [and] waiting times,” the 53-year-old mother from Cornwall says. “If I hadn’t had to wait six months, we’d be nowhere near this issue.” Like many of the 6.6 million people on an NHS waiting list, work had become painful and eventually impossible for Wilby as the backlog in treatment forces people to cut their hours or stop employment altogether. “By the time of the operation, I was barely walking and I’m self employed,” she says. “It took about three years to get diagnosed. That’s one of the major problems – it’s not just the waiting time for the operation once you’re on the list, it’s the waiting time for diagnosis.” While tax cuts and even trans issues may have stolen the limelight in the Tory leadership race, the struggle to get a grip of record NHS backlogs post-Covid is having a huge economic, as well as human, cost. Read full story (paywalled) Source: The Times, 7 August 2022
  21. News Article
    A 27-year-old man died from complications linked to diabetes after GPs failed to properly investigate his rapidly deteriorating health. Lugano Mwakosya died on 3 October 2020 from diabetic ketoacidosis, a build-up of toxic acids in the blood arising from low insulin levels, two days before he could see a GP in person. His mother, Petronella Mwasandube, believes his death could have been avoided if doctors at Strensham Road Surgery, in Birmingham, had given “adequate consideration” to Lugano’s diabetic history and offered face-to-face appointments following phone consultations on 31 July and 16 and 30 September. An independent review commissioned by NHS England found two doctors who spoke to Lugano did not take into account his diabetes or “enquire in detail and substantiate the actual cause of the patient’s symptoms”. The review raised concern over the “quality and brevity” of the phone assessments and said the surgery should have offered Lugano an in-person appointment sooner. Read full story Source: The Independent, 7 August 2022
  22. Content Article
    Clinicians at Guy's & St Thomas' Foundation Trust in London are preparing to publish the results of 15 one-day HIT lists between February 2021 and August 2022, involving 300 patients across eight different specialties, in which they claim they have been able to carry out four times as many operations as they would normally expect to complete in a month using conventional lists.
  23. News Article
    People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said. Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire. North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen. The report said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand". Many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers. However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients, including: Doctors were left to "come across" high-risk patients instead of being alerted to them. Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk. Children were at serious risk of harm as the public could enter the paediatric area unchallenged. Inspectors found evidence of children leaving unseen or being discharged against medical advice. Betsi Cadwaladr health board said it was committed to improvements. Read full story Source: BBC News, 8 August 2022
  24. Content Article
    Decision support tools, also called patient decision aids, support shared decision making by making treatment, care and support options explicit. They provide evidence-based information about the associated benefits/harms and help patients to consider what matters most to them in relation to the possible outcomes, including doing nothing. NHS England has just published a suite of eight decision support tools that will help people with their healthcare professionals in clinical consultations, about their treatment choices for their condition through shared decision making. NHS England has worked with patients, patient charities health professionals and research teams over several months to develop the tools in line with NICE guidance on shared decision making standards.
  25. Content Article
    With the number of outpatient hospital appointments in England recently as high as 125 million per year and a huge elective care backlog following the Covid-19 pandemic, patient-initiated follow-up on outpatient appointments has been touted as a potential solution in appropriate cases. But can it free up much-needed capacity while maintaining quality of patient experience and outcomes? As the NHS begins to expand its use of the approach, the NIHR RSET research team has conducted a first review of the available evidence.
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