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Patient Safety Learning

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  1. Patient Safety Learning
    A new patient safety chief should be appointed in each of the four UK nations to oversee health and social care and tackle the currently “fragmented and complex” system, experts have urged.
    The Professional Standards Authority for Health and Social Care (the body that oversees the 10 statutory bodies that regulate health and social care professionals in the UK, including the General Medical Council) has called for what it described as a radical rethink to improve safety in care. In a report published last week, it recommended the appointment of an independent health and social care safety commissioner (or equivalent) for each UK country.
    These commissioners would identify current and potential risks across the whole health and social care system, it said, and instigate necessary action across organisations. 
    Read full story (paywalled)
    Source: BMJ, 6 September 2022
    Related reading
    Working together to achieve safer care for all: a blog by Alan Clamp (chief executive of the Professional Standards Authority) Joining up a fragmented landscape: Reflections on the PSA report ‘Safer care for all’ (a blog from Patient Safety Learning
  2. Patient Safety Learning
    NHS trusts will draw on billions of pounds of cash reserves built up during the pandemic to help fund their costs this year, while using aggressive accounting treatments to stop the spending hitting the bottom line.
    HSJ analysis reveals trusts’ balance sheets are in a far stronger position than before the pandemic, with cash levels reaching around £18bn – three times higher than in March 2020.
    There have been increasing concerns around the financial outlook for the health service, with funding levels falling in real terms due to spiralling inflation.
    NHS England has warned of service cuts being needed to balance the accounts, while local leaders have warned of “impossible choices” after being told to deliver “cost improvement plans” of around 5 per cent.
    However, sources said the strong cash position offers significant headroom to avoid service cuts in the short term, by using the cash reserves built up during covid. But to avoid this impacting on the reported bottom line in the NHS accounts, which would risk a budget breach, they will deploy accounting treatments which reduce reported expenditure.
    Read full story (paywalled)
    Source: HSJ, 12 September 2022
  3. Patient Safety Learning
    The NHS is trialling a fleet of electric vehicles to help relieve pressure on ambulance services while also helping the NHS cut its carbon footprint.
    The vehicles are part of a £2.1m investment as the NHS becomes the first health service in the world to commit to reaching net zero by 2040, said NHS England, with eight ambulance trusts trialling 21 zero-emission vehicles of various types.
    Six of these new green vehicles are "dedicated to mental health response in the community", NHS England said. It emphasised that it hoped this development will "cut emergency response times for people with mental health needs and help reduce demand on traditional double-crewed ambulances".
    The new dedicated mental health response vehicles differ in design from traditional ambulances by having fewer fluorescent markings and a much less clinical interior, to help put patients at ease. However, they still carry the equipment needed to respond to the most serious life-threatening emergencies.
    NHS England highlighted that the all-electric vehicles can be deployed as a rapid response vehicle when someone is experiencing a mental health crisis, "providing a safe space for healthcare workers to support patients with mental health needs".
    Claire Murdoch, national director for mental health, NHS England explained that the mental health response vehicles are an important addition to mental health care, and added: "we have a double win of being able to improve the experience of patients in crisis whilst also caring for the planet".
    Read full story
    Source: Medscape, 6 September 2022
  4. Patient Safety Learning
    Liz Truss has been warned against “fantasy predictions” that the NHS can return to normal without radical change and was told that “unacceptable standards” are being normalised.
    In a rare political intervention, the professional standards body for the UK’s 220,000 doctors agreed that the NHS was routinely letting down patients. The Academy of Medical Royal Colleges said politicians must be prepared for radical changes to save the health service. Closing smaller hospitals, accepting that routine dentistry cannot be free for everyone and a return of Covid volunteers to allow doctors to treat more patients were all suggested by the head of the academy.
    The academy released a report that declared the NHS was in crisis, writing: “The system is providing increasing proportions of care or services which are sub-standard, threaten patient safety, and should not be acceptable in a country with the resources that we have in the United Kingdom. If we do not act with urgency, we risk permanently normalising the unacceptable standards we now witness daily.”
    The report sets out a series of recommendations for reform, including boosting staff numbers, reforming social care and spending more on technology.
    Helen Stokes-Lampard, the academy’s chairwoman, said patients were facing a “dismal winter” and that politicians must take difficult decisions. “If we don’t make changes it will inevitably deteriorate further,” she said. “The demand isn’t going away, the pressure isn’t going away, which is why the challenge for our government and for our whole society is to confront these issues and have a difficult conversation.”
    Read full story (paywalled)
    Source: The Times, 9 September 2022
  5. Patient Safety Learning
    There is a "toxic" culture of bullying and blame in the Isle of Man's emergency department at Noble's Hospital, an inspection has found.
    The Care Quality Commission's report said it was a "significant concern" along with "ineffective" staff training and medicine storage systems.
    It found a "significant disconnect" between nursing and medical staff had the potential to "cause or contribute to patient harm".
    During inspectors' four-day visit in June, some staff said the attitude and behaviour of senior medics was "feral".
    Manx Care's director of nursing Paul Moore said the understaffed department had been "really struggling" at times.
    He warned efforts to change governance and culture would take time.
    Mr Moore said on average the emergency department had about 50% of the required staff over a given month, and recruitment was the "number one priority" to help make lasting changes.
    "The bottom line is I have to put staff in front of patients before other considerations, especially when we're short", he added.
    Read full story
    Source: BBC News, 8 September 2022
  6. Patient Safety Learning
    NICE has rubber-stamped guidance on self-harm that said GPs should ‘regularly review’ patients and offer a ‘specific CBT intervention’.
    The guidance is the first to be drawn up in 11 years and emphasises the importance of referring patients to specialist mental health services but stresses that, for patients who are treated in primary care, continuity is crucial.
    The final guideline mirrors the draft guidance in advising that self-harming patients, when treated in primary care, must receive:
    regular follow-up appointments; regular reviews of self-harm behaviour; a regular medicines review. GPs must also provide care for co-existing mental health issues, including referral to mental health services where appropriate, as well as information, social care, voluntary and non-NHS sector support and self-help resources, it said.
    The guidance said that referring people to mental health services would ‘ensure people are in the most appropriate setting’.
    Read full story
    Source: Pulse, 8 September 2022
  7. Patient Safety Learning
    Scientists have developed a virus-killing plastic that could make it harder for bugs, including Covid, to spread in hospitals and care homes.
    The team at Queen's University Belfast say their plastic film is cheap and could be fashioned into protective gear such as aprons.
    It works by reacting with light to release chemicals that break the virus.
    The study showed it could kill viruses by the million, even in tough species which linger on clothes and surfaces.
    The research was accelerated as part of the UK's response to the Covid pandemic.
    Studies had shown the Covid virus was able to survive for up to 72 hours on some surfaces, but that is nothing compared to sturdier species. Norovirus - known as the winter vomiting bug - can survive outside the body for two weeks while waiting for somebody new to infect. 
    "This is the first time that anything like this has been developed," said Prof Andrew Mills, from the university's chemistry department.
    He added: "This film could replace many of the disposable plastic films used in the healthcare industry as it has the added value of being self-sterilising at no real extra cost."
    He said current personal protective equipment used in hospitals did a good job, but "infections can take place when you take off or put on the PPE, so this can help".
    Read full story
    Source: BBC News, 8 September 2022
  8. Patient Safety Learning
    NHS trusts again recorded a month-on-month reduction in the number of patients waiting over 78 weeks for treatment, although the flagship target to eliminate this cohort by March remains a tall order, with winter pressures set to crank up.
    The overall waiting list rose from 6.7 to 6.8 million between June and July, a record high, with the number of those who have waited over a year rising from around 356,000 to around 378,000.
    However, the 78-week breach figure fell from 53,911 in July from 51,838 in June. It had stood at nearly 60,000 in May.
    This represents a significant achievement given the unprecedented pressures currently on the system.
    Read full story (paywalled)
    Source: HSJ, 8 September 2022
  9. Patient Safety Learning
    Nurses in North Carolina, USA, can now be sued for patient harm that results from them following physicians' orders, the state Supreme Court ruled last month. 
    The 19 August ruling strikes down a 90-year-old precedent set by the 1932 case Byrd v. Marion General Hospital, which protected nurses from culpability for obeying and executing orders from a physician or surgeon, unless the order was obviously negligent. 
    The North Carolina Supreme Court overturned this ruling in a 3-2 opinion as part of a separate case involving a young child who experienced permanent anoxic brain damage during an ablation procedure at a North Carolina hospital in 2010. The ruling means the certified registered nurse anaesthetist involved in the ablation could be held liable for the patient's harm. 
    "Due to the evolution of the medical profession's recognition of the increased specialization and independence of nurses in the treatment of patients over the course of the ensuing ninety years since this Court's issuance of the Byrd opinion, we determine that it is timely and appropriate to overrule Byrd as it is applied to the facts of this case," Justice Michael Morgan wrote in the opinion. 
    Read full story
    Source: Becker's Hospital Review, 6 September 2022
  10. Patient Safety Learning
    NHS England’s chief strategy officer has called for a “reset” of the current “overwhelmingly negative narrative” about the health service.
    Chris Hopson said there was a collective responsibility to present a more balanced picture, while still being honest about problems.
    The service should do more to emphasise successes, improvements and where there is good performance, he said.
    He acknowledged there were too many instances where good quality care could not be delivered due to current pressures on the service. But they were being addressed and improvements being made.
    “We need to make sure that our staff, our patients but also the taxpayers hear that more balanced narrative,” he said at the Ambulance Leadership Forum event on Wednesday. Ambulance services – whose response times have sky-rocketed, well beyond their targets, over the past 18 months – have been at the centre of much recent negative coverage.
    Mr Hopson argued that the constantly negative narrative was having an impact on staff – whose work was not being recognised – and creating a sense that the NHS was broken.
    “That narrative is partly being driven by opponents of the NHS and also [those] who want to attack the government,” Mr Hopson said, although he acknowledged that it also reflected genuine instances of staff and patient experience.
    Read full story (paywalled)
    Source: HSJ, 8 September 2022
  11. Patient Safety Learning
    Liz Truss has received a stark insight into the dire state of the NHS after new figures showed millions of people in England were facing often record delays to access vital healthcare.
    One leading NHS expert said the long waits for care, diagnostic tests and hospital beds showed that Britain’s new prime minister “inherits an NHS in critical condition”.
    The total number of people in England waiting for hospital treatment rose again to a record high of 6.8 million at the end of July – almost one in eight of the population.
    Patients are also facing long waits for accident and emergency care, cancer treatment, such as surgery or chemotherapy, and for an ambulance to arrive after a 999 call.
    Of the 6.8 million people on NHS England’s “referral to treatment” waiting list, 2,665,004 had been waiting for more than 18 weeks, which is the supposed maximum waiting time for procedures such as a joint replacement, hernia repair or cataract removal.
    In addition, 377,689 had been waiting more than a year to start their treatment, almost 22,000 more than a month before, according to the latest monthly performance data published by NHS England.
    The data showed that ministers and NHS bosses had failed to fulfil their pledge to eradicate two-year waits by the end of July; 2,885 such cases had not been resolved by then, despite major efforts by hospitals to meet the target.
    Read full story
    Source: The Guardian, 8 September 2022
  12. Patient Safety Learning
    Every year, air pollution causes up to 36,000 deaths in the UK.  The World Health Organization and the UK Government recognise that air pollution is the largest environmental health risk we face today. 
    Millions of people around the world breathe polluted air that puts their respiratory and cardiovascular health, and in some cases even their lives, at risk. Phasing out fossil fuels would be a major step in protecting health for current and future generations.
    More than a thousand health professionals have already endorsed the call for a treaty. 
    Add your name to endorse the call for a treaty.
    Next week, the Global Climate and Health Alliance are planning a major press launch of the health community's letter calling for a Fossil Fuel Non-Proliferation Treaty and want to secure as many signatures as possible. They are encouraging healthcare professionals to help to build momentum by inviting two—or more—of your health colleagues to sign the health letter before the launch on 14 September.
    Invite your colleagues to sign the health letter
    By clicking the link above, you'll be taken to a form where you can send a short note of invitation to a colleague to sign the letter. They will be sent your note, as well as a link to some additional information about the Fossil Fuel Non-Proliferation Treaty. The form can only send one email at a time, but you use the form as many times as you wish.
  13. Patient Safety Learning
    Previously offered as prescription only, estradiol tablets, sold under the brand name Gina10, will now be available to women over the age of 50 who have not had a period for more than a year, as part of hormone replacement therapy treatment (HRT).
    Pharmacists have been offered training to identify who needs the tablets.
    The Medicines and Healthcare products Regulatory Agency (MHRA) made the decision as part of a strategy to make menopause treatment more accessible for women.
    Estradiol tablets treat vaginal symptoms caused by a lack of oestrogen, such as dryness, soreness, itching, burning and uncomfortable sex.
    The product is inserted into the vagina rather than taken by mouth.
    MHRA chief healthcare quality and access officer Dr Laura Squire called the move a "landmark reclassification for millions of women in the UK".
    "In reaching this decision, we have seen positive support from a wide range of people, including many women aged 50 years and above who could benefit from this decision," she said.
    The MHRA hopes the move will relieve pressure on front-line NHS services and give women more freedom in choosing treatments that work for them.
    Read full story
    Source: BBC News, 8 September 2022
  14. Patient Safety Learning
    GPs have warned of a ‘tsunami of demand’ this winter as patient contacts surged 200% during the pandemic.
    One of the largest GP providers in the UK, Modality Partnership, told The Independent it received 4.8 million calls from patients in one year alone with around a quarter going unanswered every day.
    The provider, which covers 500,000 patients across the country, said its practices were now working above “safe levels” with 50 appointments a day per GP, far higher than the 35 advised by the British Medical Association.
    Speaking with The Independent, Vincent Sai, chief executive and partner at Modality said the new health secretary Therese Coffey must “not point fingers” and “not find a scapegoat” as “every part of the system is under pressure. Every player in the health system is under the cosh.”
    Dr Sai said: “We believe patient contacts have increased 200 per cent, over the last few years. The expectation is that GP practices have maybe four to five patient contacts per year, but if you just look at just the number of phone calls alone, it’s showing that it’s much more now.
    “So something is broken somewhere...there’s more work, there are fewer people. People say I can’t get access to my GP and the hypothesis is they’re just lazy and not working, but it’s not the case.”
    Read full story
    Source: The Independent, 7 September 2022
  15. Patient Safety Learning
    A malaria vaccine created by Oxford researchers “is really exciting” and could contribute towards drastically reducing the number of children who die from the infection, experts suggest.
    A new study reports on the effectiveness of a malaria booster vaccine which shows long-lasting high efficacy in African children, meeting the World Health Organisation (WHO) specified 75% efficacy goal.
    The research found that a vaccine booster dose one year after children received three doses as their primary vaccination regime maintained high efficacy against malaria.
    Adrian Hill, director of the Jenner Institute and Lakshmi Mittal and Family Professor of Vaccinology, University of Oxford, said: “We think these data are the best data yet.
    “And very importantly, this is a vaccine that we think can be manufactured and deployed, very widely.”
    He added that the vaccine could be produced for a few dollars a dose, and together with existing measures, like mosquito nets and sprays, could help save children’s lives.
    Read full story
    Source: The Independent, 8 September 2022
  16. Patient Safety Learning
    A group of top researchers, clinicians and patients have stepped up efforts to combat Long Covid, launching a new billionaire-backed initiative to search for drivers of the poorly understood condition and ultimately find treatments to help the millions of people around the world living with the disease.
    The Long Covid Research Initiative (LCRI) hopes to accelerate efforts to understand and treat Long Covid, a sometimes disabling condition that lingers for months or years after infection with SARS-CoV-2, the virus that causes Covid-19.
    The group’s first goal—supported by $15 million dollars in funding from Balvi, a scientific investment fund led by crypto billionaire and Ethereum co-founder Vitalik Buterin—will be to investigate the causes Long Covid, with a particular focus on whether the virus stubbornly persists in the body after initial infection.
    Dr. Amy Proal, a microbiologist at the PolyBio Research Foundation and LCRI’s chief scientific officer, told Forbes the research is not just geared towards identifying the presence of the virus in the body but is also aimed at understanding the downstream impact it has on things like blood clotting and the immune system.
    Proal said another key aim of LCRI’s research program is to identify measurable features of Long Covid that could form the backbone of clinical trials and help develop much-needed treatments for the condition.
    LCRI has already secured a commitment for further funding from the Chan Soon-Shiong Family Foundation, led by biotech billionaire Dr. Patrick Soon-Shiong (the final amount has yet to be settled), and Scott-Green said the group is aiming to raise $100 million in order to help patients as soon as possible.
    Read full story
    Source: Forbes, 8 September 2022
  17. Patient Safety Learning
    The decision to reduce the number of children who are offered Covid jabs has prompted outcry from parent groups and academics.
    The UK Health Security Agency (UKHSA) said children who had not turned 5 by the end of last month would not be offered a vaccination, in line with advice published by the UK’s Joint Committee on Vaccination and Immunisation (JCVI) in February 2022. UKHSA said the offer of Covid jabs to healthy 5 to 11-year-olds was always meant to be temporary.
    UKHSA’s Green Book, which provides information on the vaccine rollout for public health professionals, states: “This one-off programme applies to those aged 5 to 11 years, including those who turn 5 years of age before the end of August 2022".
    “Subject to further clarification, on-going eligibility in 2022/23, after the one off-programme, is expected to be for children in the academic years where children are aged 11 or 12 years.”
    However, Prof Christina Pagel, of University College London, criticised the move.
    “JCVI itself considered there to be a benefit to young children to be vaccinated – even if most of them had already been infected,” she said.
    “There is also the additional benefit to children of providing additional protection from developing long Covid, missing school during the acute illness and reducing transmission to household members, other children and teachers.”
    Pagel said that at least one serious Covid wave was expected later this year, but that many children about to start school would now have to wait six years for vaccination, with likely relatively frequent infections in that time.
    “When we know there is a safe and effective vaccine available this seems unjustifiable to me,” said Pagel, adding that – while rare – children had died from Covid.
    Read full story
    Source: The Guardian, 6 September 2022
  18. Patient Safety Learning
    The backlog of urgent cancer referral patients who have waited 104 days or more for treatment has increased month-on-month again, internal NHS data reveals.
    Data obtained by HSJ shows the total backlog of NHS patients waiting over three months for their first treatment since referral grew by 10% month-on-month, from 10,361 as of 26 June, to 11,212 by 28 August.
    There are now nearly 341,000 patients are waiting to start their cancer treatment after being referred, the internal data also reveals.
    Under current NHS rules, the 104-day point marks a “backstop” – beyond which any patient waiting longer than this for treatment should be reviewed for potential harm. The NHS has not achieved this target since 2014.
    Read full story (paywalled)
    Source: HSJ, 7 September 2022
  19. Patient Safety Learning
    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
  20. Patient Safety Learning
    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
  21. Patient Safety Learning
    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
  22. Patient Safety Learning
    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
  23. Patient Safety Learning
    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
  24. Patient Safety Learning
    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
  25. Patient Safety Learning
    A 13-year-old girl who died after contracting sepsis in an NHS hospital probably would have survived if doctors had identified the warning signs and transferred her to intensive care earlier, a coroner has ruled.
    Martha Mills was the first ever child to die at King’s College hospital (KCH) with a pancreatic injury of the type she sustained in a fall from her bike on an off-road family trail in Wales while on holiday last year. She was transferred to the south London hospital because it is one of three national centres for the care of children with pancreatic trauma.
    An inquest at St Pancras coroner’s court, north London, heard that several opportunities were missed to refer Martha to intensive care, which probably would have saved her life.
    In an emotional witness statement, Martha’s mother, Merope, said that after their daughter contracted an infection on 21 August last year, she and her husband, Paul Laity, raised concerns about Martha’s deteriorating health a number of times but doctors sought to reassure them rather than escalate her care.
    Mills said in her statement that she explicitly raised her fears about Martha going into septic shock over the bank holiday weekend.
    On 29 August, Martha had high fever, low blood pressure, a racing heart and a rash, which was misdiagnosed by a junior doctor despite Mills voicing her concern that it was caused by sepsis. It was only the next day that Martha was admitted to paediatric intensive care.
    “I felt that my anxieties about all of Martha’s symptoms, and especially what they might mean when put together and considered in the round, weren’t given proper acknowledgement,” Mills told the court.
    Prof William Bernal, who produced a serious incident report on Martha’s death for KCH, said there were at least five occasions when she should have had a critical care review.
    He wrote that Martha’s chances of survival “would have been greatly increased” if she had been admitted to critical care earlier.
    The inquest heard that KCH was making changes in the wake of Martha’s death, including improving diagnostics and taking account of parents’ views.
    Read full story
    Source: The Guardian, 3 March 2022

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