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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    This paper from Claire Su-Yeon Park aims to propose Park's sweet spot theory-driven implementation strategy, which makes optimal safe staffing policy really work in nursing practice.
  2. News Article
    One in twenty people in the UK who are neither employed nor seeking paid work are suffering from Long Covid, with the figure more than doubling in the past year, official data has revealed. The proportion is far higher than for the 1 in 29 people who are unemployed but seeking work who have long Covid symptoms, or the one in 30 employed people who are sufferers, data released by the Office for National Statistics (ONS) shows. Individuals who are not employed and are not looking for paid work are classified as being economically inactive. The data suggests the long-term impacts of the virus could be driving people into this category, or into retirement. Read full story Source: The Guardian, 4 August 2022
  3. News Article
    A large private provider says it is finding it harder than ever to fill its staffing vacancies, but is optimistic that its investment in nursing apprenticeships and overseas recruitment can help expand NHS-commissioned capacity. In an interview with HSJ, Shelley Thomas, group HR director for Spire Healthcare, said the company is facing the same staffing difficulties as NHS providers. She said: “We’re all feeling the same things at the moment… high sickness absence, high holidays, teams that are worn out. We’re all… experiencing the same from a workforce perspective.” However, she said Spire is “working harder than ever” to fill vacancies, and now has a “really robust pipeline” of apprentices and oversees recruits. Despite the waiting list backlogs which have ballooned since the pandemic began, and a £10bn framework in place for the NHS to utilise private sector capacity, analysis suggests NHS activity undertaken by private hospitals has been below pre-covid levels in almost all specialities. Ms Thomas suggested the staffing difficulties had been a factor in that, but acknowledged there were more conversations to be had locally about how the private sector could undertake more activity. She said the pandemic was a “huge catalyst for stronger working partnerships” between the NHS and the private sector and that relationships are “stronger than they’ve ever been”. Read full story (paywalled) Source: HSJ, 4 August 2022
  4. News Article
    "Bolder government action" is needed to address inequalities in dementia risk, the charity Alzheimer's Research UK has warned this week. The comments come in response to findings from four new studies presented at the Alzheimer's Association International Conference (AAIC) which link socio-economic deprivation with increased risk of dementia and cognitive decline. Dr Susan Mitchell, head of policy at Alzheimer’s Research UK, said: "These findings are a stark reminder of the health gap between the most and least deprived in society, with the most deprived at a higher risk of developing dementia. "Ultimately, these inequalities are profoundly unfair, but they are also avoidable. The Government has a key role in addressing inequalities through a range of measures to improve poverty, employment, housing and education." She added: "We urge Government to make dementia prevention a key priority in its aim to level up healthcare across the country, and hope the forthcoming health disparities white paper lays the foundation for a fairer, healthier nation." Read full story Source: Medscape, 5 August 2022
  5. Content Article
    The pandemic has emphasised the high risk of avoidable harm to patients, health workers, and the general public, and has identified a range of safety gaps across all core components of health systems at all levels. The World Health Organization (WHO)'s rapid review ‘Implications of the COVID-19 pandemic for patient safety’ explores impacts that the COVID-19 pandemic did have on patient safety in terms of risks and avoidable harm, specifically in terms of diagnostic, treatment and care management related issues as well as highlights the main patterns of these implications within the broader health system context.
  6. Content Article
    This report provides a review of the Healthcare Safety Investigation Branch (HSIB) maternity investigation programme during 2021/22, including an overview of activity during this period, themes arising from investigations and plans for the future. It is intended for healthcare organisations, policymakers and the public to understand the work HSIB have undertaken.
  7. News Article
    One in eight Covid-19 patients (12.7%) is likely to experience long term symptoms, a study from the Netherlands has reported. Using digital questionnaires, researchers collected data on the frequency of 23 symptoms commonly associated with Covid in an uninfected population and in people who had had a Covid diagnosis. The findings, published in the Lancet, found that 21.4% of adults who had had Covid experienced at least one new or severely increased symptom three to five months after infection when compared with before. This compared with only 8.7% of uninfected people followed over the same period. The core Long Covid symptoms highlighted by the researchers include chest pain, difficulties breathing, pain when breathing, painful muscles, loss of taste and smell, tingling extremities, lump in throat, feeling hot and cold, heavy arms or legs, and general tiredness. Read full story Source: BMJ, 4 August 2022
  8. Content Article
    Patients often report various symptoms after recovery from acute COVID-19. Ballering et al. aimed to analyse the nature, prevalence, and severity of long-term symptoms related to COVID-19, while correcting for symptoms present before SARS-CoV-2 infection and controlling for the symptom dynamics in the population without infection. They found persistent symptoms in COVID-19-positive participants at 90–150 days after COVID-19 compared with before COVID-19 and compared with matched controls included chest pain, difficulties with breathing, pain when breathing, painful muscles, ageusia or anosmia, tingling extremities, lump in throat, feeling hot and cold alternately, heavy arms or legs, and general tiredness. 
  9. News Article
    Prescribing potentially harmful antipsychotic drugs to people with dementia has increased by more than 50% on average in care homes during the pandemic, new research suggests. It found that the number of people with dementia receiving these prescriptions had soared from 18% to 28% since 2018 – with prescription rates of over 50% in a third of care homes. Professor Clive Ballard, who was part of a national campaign in 2009 to reduce antipsychotic prescribing by half, said: “Covid-19 put tremendous pressure on care homes, and the majority of them must be applauded for maintaining relatively low antipsychotic prescribing levels amid incredibly difficult circumstances." “However, there were very significant rises in antipsychotic prescribing in one third of care homes and we urgently need to find ways to prioritise support to prevent people with dementia being exposed to significant harms.” Antipsychotic drugs are used to treat some of the more distressing behavioural and psychological symptoms of dementia, such as agitation and psychotic episodes. They have only very limited, short-term benefits in treating psychiatric symptoms in people with dementia – but significantly increase the risk of serious side effects, including stroke, accelerated decline and death. Dr Richard Oakley, from the Alzheimer’s Society, added: “This study shows the shocking and dangerous scale of the use of antipsychotic drugs to treat people with dementia in care homes. “Alzheimer’s Society has been campaigning for a move away from the model of ‘medicate first’ and funded research into alternatives to antipsychotic prescriptions, focused on putting people living with dementia at the centre of their own care. “This drug-free, tailored care can help avoid the loss of lives associated with the harmful side effects of antipsychotic medications.” Read full story Source: The Independent, 4 August 2022
  10. News Article
    Sexual health charities and LGBT groups are calling for the government to step up efforts to control the monkeypox outbreak in the UK. In an open letter to Health Secretary Steven Barclay, they say that without a quicker and wider vaccine rollout, the virus could become "endemic". There have been more than 2,600 cases of monkeypox in the UK so far, mostly among men who have sex with men. The Department of Health & Social Care (DHSC) says it is working "rapidly" to vaccinate those at risk. The Terrence Higgins Trust, which co-wrote the letter, says the rollout needs to be speeded up across the UK to help combat "fear and anxiety" within the LGBT community. Trust head of policy Ceri Smith told BBC News: "We need to see far better co-ordination, increased vaccine procurement, improved delivery and a cash injection to sexual health services to treat monkeypox." The letter reads: "Without urgent action, we risk monkeypox becoming endemic in the UK. This poses a serious risk to health and will exacerbate the health inequalities already experienced by gay and bisexual men and other men who have sex with men. "Vaccinating those most at risk of monkeypox must be a priority if we are to stand a chance of preventing the virus from becoming endemic in the UK." Read full story Source: BBC News, 5 August 2022
  11. News Article
    The NHS in England is increasingly reliant on doctors and nurses recruited from outside the UK and EU, analysis has found. Some 34% of doctors joining the health service last year came from overseas, a rise from 18% in 2014. The government said overseas recruitment had always been part of its strategy, but unions have warned it is an unsustainable way of recruiting in the long-term. Patricia Marquis, Royal College of Nursing (RCN) director for England, said ministers must do more to reduce the "disproportionate reliance" on international recruits. The government is funding an additional 1,500 undergraduate medical school places each year for domestic students in England - a 25% increase over three years. However, last week a report by MPs concluded the large number of unfilled NHS job vacancies, about 110,000 in total, was posing a serious risk to patient safety. Danny Mortimer, chief executive of NHS Employers, said it was "high time for the government to commit to a fully-funded, long-term workforce plan for the NHS" to tackle "chronic workforce shortages". Read full story Source: BBC News, 5 August 2022
  12. News Article
    NHS England has called for a “deep dive” into local evacuation and shelter arrangements, amid ongoing concerns about outdated and unsafe estate. NHS England’s director of emergency preparedness, resilience and response Stephen Groves wrote to trusts: “Following the publication of the updated evacuation and shelter guidance for the NHS in England, and recent work driven by the heightened risk associated with reinforced autoclaved aerated concrete (RAAC), the 2022-23 EPRR annual deep dive will focus on local evacuation and shelter arrangements.” The letter, sent at the end of last week, comes amid growing concerns about NHS estate, including RAAC planks which were used in constructing public sector buildings in the 1960s, 70s and 80s. Areas to be examined in the deep dive vary by type of organisation. However, according to a self-assessment tool referenced in the letter, questions for providers include: whether they have “a process in place to triage patients in the event of an incident requiring evacuation and/or shelter of patients”; whether there are “effective arrangements in place to support partners in a community evacuation, where the population of a large area may need to be displaced”; and whether “evacuation and shelter arrangements include resilient mechanisms to communicate with staff, patients, their families and the public, pre, peri and post evacuation”. Read full story (paywalled) Source: HSJ, 5 August 2022
  13. Content Article
    This is the first in a new series of ‘In Conversation with’ podcasts from the All Party Parliamentary Group (APPG) on First Do No Harm. In this episode Lord Philip Hunt discusses the key achievements of the Health and Care Act 2022 of relevance to the APPG’s work, and the areas still left to address.  The APPG on First Do No Harm is a group of parliamentarians who are committed to raising awareness of and building support for the recommendations in First Do No Harm, the report of the Independent Medicines and Medical Devices Safety Review, and to ensure the implementation of the recommendations by the UK Government and others.
  14. News Article
    A 65-year-old man died after doctors failed to notice serious abnormalities on his X-ray, an investigation by the Parliamentary and Health Service Ombudsman (PHSO) has revealed. The investigation comes a year after a landmark report by the Ombudsman highlighted failings in how X-rays and scans are reported and followed up in the NHS. Mr B, who was admitted to University Hospitals Birmingham NHS Foundation Trust in May 2019, had been unwell for several days. He was admitted to hospital suffering from abdominal pain and vomiting. An X-ray of his abdomen was taken, which two doctors said did not show any apparent abnormalities. The following day the man’s condition deteriorated. He suffered a heart attack and died. A PHSO investigation found the Trust failed to notice a blockage in his intestine on the X-ray. Because of this failure, Mr B did not receive treatment that could have saved his life. Speaking on this case Ombudsman Rob Behrens said: “The case of Mr B highlights the devastating impact mistakes like this can have. If the Trust had picked up the abnormalities on his X-ray sooner, Mr B could still be with his family today. “As the NHS faces the challenge of rebuilding after the pandemic, it must not lose momentum in improving the way X-rays and scans are handled during a patient’s care.” Progress has been made by the NHS in implementing recommendations made by the Ombudsman in the report; however, Rob Behrens has said more needs to be done to protect patients from serious harm. “Attention and buy-in from the NHS’s senior leaders is crucial if we want to see sustained and meaningful change in how X-rays and scans are managed during a patient’s care. We need more collaboration across clinical specialties, looking at the whole patient journey once a scan has been carried out. "I want to see the NHS treating complaints as a source of insight to drive improvements in patient care. Not learning from mistakes will mean missed opportunities to diagnose patients earlier. In the most serious cases, like that of Mr B, it will mean a death which should never have happened.” Read full story Source: PHSO, 20 July 2022
  15. News Article
    Mobile apps to track patients' health are keeping them out of hospital and could cut waiting times, experts have said. It follows a trial of a new app which heart patients are using through their mobile phones. The trial allows clinicians to change treatments quickly and uses video consultations, avoiding unnecessary hospital visits. Rhodri Griffiths is the innovation adoption director at Life Sciences Hub Wales, and is looking for more ways to introduce similar technology. He believes the pandemic accelerated the use and acceptance of digital solutions in healthcare, by patients and clinicians. "We really are looking at a big digital revolution within healthcare and there are an amazing myriad of things coming through," he said. He explained data collected by smartphones and watches can help predict who is likely to have a heart attack. "We can avoid that happening. So prevention is key but it's also looking at how some of this can impact on waiting lists," he said. "So, looking at how theatres are used, which patients can be prioritised? "In social care it's looking at how pain is managed by face recognition." Mr Griffiths said he believed the data collected could also identify wider problems: "It's combining these digital solutions with our genetic information - bringing big data together on a population level we can start spotting trends". Read full story Source: BBC News, 4 August 2022
  16. News Article
    Midwife numbers are reaching a dangerous level which could put lives at risk, as records show more staff leaving than joining the profession for the first time in a decade. As a record number suffer burnout and leave, the figures from NHS Digital for 2021/22 show almost 300 more staff abandoned midwifery than joined the service, with 3,440 leaving and only 3,144 coming in. Analysis of the data showed a record 551 resigned in 2021 because of a lack of work-life balance. Midwives working in NHS trust maternity units typically work 12-hour shifts, but many work longer for no additional pay to cover staff shortages and to keep services running. The Royal College of Midwives (RCM) says members are "at the end of their tether' and 'physically and emotionally burnt out" Joeli Brearley, chief executive of campaign group Pregnant Then Screwed, said: "We don't have enough midwives, and those we do have are underpaid, undervalued and overworked." "This is a problem that has been communicated to the Government repeatedly for years. It is putting the lives of women and their babies in danger and causing untold damage to their mental and physical health. The Government needs to get a grip of the situation urgently before there are more tragedies." Read full story Source: Daily Mail, 1 August 2022 .
  17. News Article
    Private and NHS ambulance services are reviewing safety procedures after the Care Quality Commission identified a series of risks to mental health patients being transported by non-emergency providers. The care watchdog wrote to all providers of non-emergency patient transport earlier in the summer, warning of concerns identified at recent inspections about use of restraints, sexual safety, physical health needs, vehicle and equipment safety standards, and unsafe recruitment practices. The letter, seen by HSJ, stated: “We know there are many independent ambulance providers providing a good standard of care. Unfortunately, our recent inspections suggest that this is not always the case." “We expect providers to deliver on their commitment to provide safe, high-quality care and we will do everything within our powers to ensure this happens.” Read full story (paywalled) Source: HSJ, 4 August 2022
  18. News Article
    The chief executive of a trust trialling the new emergency care standards being considered by the government has called for a new six-hour target to either move patients out of accident and emergency, or for them to receive treatment. North Tees and Hartlepool Foundation Trust chief executive Julie Gillon told HSJ a new target should be set as a “body of evidence” indicates patients are at risk of deterioration following A&E waits of six hours or more. The proposal is likely to be broadly welcomed by many clinicians, but could prove controversial in some quarters. NHS England did not include a six-hour target in the bundle of new A&E metrics being piloted, and the proposal could be interpreted by some as a watered-down version of the existing four-hour standard. However, Ms Gillon cited analysis by the Royal College of Emergency Medicine last year which revealed thousands of excess deaths resulting from overcrowding and long stays in A&Es. Read full story (paywalled) Source: HSJ, 4 August 2022
  19. News Article
    Russell-Cooke personal injury and clinical negligence partner Grant Incles recently represented Mrs Karen Preater in a clinical negligence case over vaginal mesh surgery performed on her at a hospital in north Wales in 2014. Wrexham County Court found in favour of Mrs Preater, and roundly dismissed allegations made by the defendant in this case, the Betsi Cadwaladr University Health Board, that the claimant had lied in the presentation of her case, as part of a Fundamental Dishonesty defence. Mrs Preater underwent vaginal mesh surgery in January 2014 - to which she had not been properly consented. The surgery itself was performed negligently and as a result she suffered a life-changing chronic pain condition. In late 2020, the defendant carried out intrusive video surveillance of Mrs Preater and trawled through her life on social media, proceeding to launch a defence of Fundamental Dishonesty pursuant to S.57 of the Criminal Justice and Courts Act 2015. The defendant alleged that the claimant was seeking to lie to the Court about her ability to work and need for care and assistance which, if found to be correct by the Court, would have meant that Mrs Preater would have lost all of her claimed compensation, and which may well have led to an application by the defendant to have her committed to prison for her alleged dishonesty. The case was fought to trial over seven days in July 2022. HHJ Howells found that Mrs Preater had not sought to deceive any party at any time and should be fully compensated for her grave suffering since being injured over eight years ago. Read full story Source: Russell-Cooke, 4 August 2022 Court judgement: 22081101.Preater v BCUHB approved judgment dated 4 August 2022.pdf
  20. Content Article
    Presentation from Julia Wood given to the Patient Safety Manager Network (PSMN) on the importance of finding joy and happiness in work and how you can support your staff.
  21. Content Article
    This year World Patient Safety Day, due to take place on Saturday 17 September 2022, will focus on medication safety, promoting safe medication practices to prevent medication errors and reducing medication-related harm. This page links to resources to mark World Patient Safety Day from the official World Health Organization (WHO) website.
  22. News Article
    Fresh concerns have been raised about the treatment of whistleblowers by managers at a trust recently embroiled in a high-profile bullying scandal, the hospital’s workforce director has disclosed. A series of further accusations have been made against managers at West Suffolk Foundation Trust, where executives were recently judged to have led an “intimidating, flawed” hunt for a whistleblower, prompting a series of high-profile departures. The trust’s executive director for workforce detailed in a paper for the hospital’s July board meeting how managers had been hunting to identify staff who had raised concerns through supposedly confidential channels. The report, by executive director of workforce and communications, Jeremy Over, said: “Feedback has been given indicating that some people have had a poor experience when speaking up. “In two separate cases, where people spoke up in confidence, it was reported that the managers were then asking and wishing to find out who had spoken up making the individuals very uncomfortable. “Another case reported that the individual was ‘told off’ by their manager for ‘going about their heads’ [sic] and another where staff felt discouraged from raising any points or suggestions as these were taken [as] a personal offence [by] the senior staff. In a further case, the person speaking up was criticised [for] doing so.” Read full story (paywalled) Source: HSJ, 3 August 2022
  23. News Article
    More than 100,000 doses of the monkeypox vaccine have been acquired in order to combat the spread of the virus, the government has said. Last month the NHS stepped up its monkeypox vaccination programme in England as infections rose. Vaccines minister Maggie Throup said the majority of vaccines were being made available in London, with about 75% of confirmed cases in the capital. But she urged people to wait to be invited to receive their jabs. While anyone can get monkeypox, the majority of those with the virus are gay, bisexual and other men who have sex with men. The latest figures show that nationally there have been 2,436 confirmed cases, with 1,778 of those in London. Read full story Source: BBC News, 3 August 2022
  24. News Article
    Ministers have admitted a key NHS pledge to ensure that everyone who has been waiting at least two years for hospital care would be treated by last month has not been met. The then health secretary Sajid Javid made the promise in February when launching the NHS’s “elective recovery plan”. It was intended to tackle what is now a record 6.6 million-patient backlog in England for those awaiting a procedure such as a joint replacement or cataract removal and included a series of treatment milestones the health service had to hit. “No one will wait longer than two years by July,” Javid said. However, the Department of Health and Social Care has now admitted that it will miss that target and that “a small number of patients” will have remained untreated by that deadline. The health minister Maria Caulfield told Wes Streeting, the shadow health secretary, in a written parliamentary answer on 18 July that while “no formal estimate has been made … engagement with the National Health Service suggests a small number of patients with complex cases will have waited longer than two years for NHS treatment by the end of July 2022”. Streeting said the admission was a further example of the government not backing up rhetoric on the NHS with concrete action. “It is unacceptable for anyone to be left waiting more than one year for healthcare, let alone two,” he said. “Once again the Conservatives have overpromised, [and] undelivered, and patients are paying the price.” Read full story Source: The Guardian, 3 August 2022
  25. Content Article
    Tommy Greene and David Hencke report on a number of worrying NHS dismissal cases in this Byline Times article.
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