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Patient Safety Learning

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  1. Patient Safety Learning
    The Irish health services did “relatively well” during Covid-19 but, as in other countries, the pandemic unmasked existing problems, a renowned patient safety expert has said.
    Peter Lachman of the Royal College of Physicians of Ireland (RCPI), was one of nine international experts who consulted on a new World Health Organization (WHO) report on the implications of the Covid-19 pandemic for patient safety.
    Dr Lachman said the impact is only starting to be understood.
    “Ireland did very well early on [in the pandemic], then opened up over Christmas [2020] which led to our numbers going sky-high, then we clamped down again,” he said.
    "We did well on some things and not so well on others. We have done relatively well when compared with other countries." 
    “Covid-19 was an event which around the world unmasked problems which were there already rather than creating them necessarily,” he said.
    “The findings start with safety problems — we’ve had safety problems in Ireland but things are getting better.  There is a good strategy coming on. I’ve worked with hospitals around the country on this. It’s no worse than other countries.”
    Read full story
    Source: The Irish Examiner, 12 August 2022
  2. Patient Safety Learning
    Doctors and health service providers welcomed publication of an NHS strategy for managing demand ahead of another busy winter for health and social care, but said it failed to address underlying problems with the system.
    In a letter to the heads of NHS trusts and integrated care boards, NHS England chiefs said they had begun planning for capacity and operational resilience in urgent and emergency care ahead of "significant challenges" during the coming months.
    The British Medical Association (BMA) said the strategy was a "step in the right direction", but "lacks detail", while the Royal College of Emergency Medicine (RCEM) said it amounted to little more than "a crisis mitigation plan".
    The package of measures included creating the equivalent of 7000 extra general and acute beds through a mix of new physical beds, scaling up 'virtual' beds, and "improvements in discharge and flow". The letter acknowledged that there was "a significant number of patients spending longer in hospital than they need to" and that whilst "the provision of social care falls outside of the NHS’s remit, the health service must ensure patients not requiring onwards care are discharged as soon as they are ready and can access services they may need following a hospital stay."
    Read full story
    Source: Medscape, 15 August 2022
  3. Patient Safety Learning
    Department of Health and Social Care (DHSC) officials are concerned that many more people are dying than expected in recent months – particularly older working-age people – with NHS care delays and interruptions a likely cause.
    HSJ understands there is concern and analysis under way across the chief medical officer’s team and in the Office for Health Improvement and Disparities.
    The DHSC told HSJ initial work showed the biggest causes of the “excess deaths” were cardiovascular disease (heart attacks and strokes) and diabetes.
    This supports the case they are being caused by a combination of the current very long delays for ambulances and other emergency care, and by people with heart disease and diabetes missing out on routine checks due to Covid and its knock-on effects, HSJ was told.
    Read full story (paywalled)
    Source: HSJ, 17 August 2022
  4. Patient Safety Learning
    Dozens of referrals to specialist care for women with serious mental health problems during or after pregnancy are being turned down because no bed was available, data collected by HSJ reveals.
    HSJ submitted freedom of information requests to 19 trusts running mother and baby units (MBUs) – which are inpatient services where women who experience serious mental health problems during or after pregnancy can stay with their child – asking for the “total number of referrals… which could not be admitted because no bed was available”. 
    Although all of the 19 trusts HSJ sent freedom of information requests to responded, many said they did not hold this information. However, five – Cumbria, Northumberland, Tyne and Wear Foundation Trust, Essex Partnership University FT, Greater Manchester Mental Health FT, Hertfordshire Partnership University FT, and Nottinghamshire Healthcare FT – together identified 197 referrals which were rejected. Greater Manchester identified a further three which were turned down in the calendar year 2022, although it did not specify which financial year this was.
    Several experts told HSJ the figures reflected a lack of capacity for mothers with serious mental health problems.
    Maternal Mental Health Alliance campaign manager Karen Middleton said MBUs offered “the best outcomes” for new mothers who needed inpatient treatment".
    Ms Middleton continued: “When a much-needed MBU bed isn’t available, women instead face admission to general adult psychiatric wards, separating them from their newborn babies at a crucially important time for relationship development. These wards lack appropriate facilities and expertise to support postnatal mothers with their specific physical and emotional needs.”
    Read full story (paywalled)
    Source: HSJ, 16 August 2022
  5. Patient Safety Learning
    Senior doctors have raised concerns about the numbers of patients now dying in their A&E department due to extreme operational pressures.
    HSJ has seen an internal memo sent to staff at Royal Albert Edward Infirmary in Wigan, which warns it is becoming “increasingly common” for patients to die in the accident and emergency department.
    The memo suggests the department has reported five deaths in the latest weekly audit, when it would normally report one or two fatalities.
    The memo said: “Of the 72 patients in A&E as I write this, 16 have been there over 24 hours and 34 over 12 hours. The longest stay is almost 48 hours…
    “It’s becoming increasingly common to die in A&E. We have included A&E deaths [in weekly audits] for the last 4 years. They used to be 1 or 2. This week there were 5. They used to die at or just after arrival, but that’s changing too…
    “There is every reason to think winter will be worse.”
    The memo echoes warnings made by numerous NHS leaders in recent months around the intense service pressures and an increased risk of incidents and mistakes. 
    Read full story (paywalled)
    Source: HSJ, 17 August 2022
  6. Patient Safety Learning
    The number of midwives has fallen in every English region in the past year, figures show.
    Numbers dropped by around 600 on top of a longstanding shortage of more than 2000 midwives, according to analysis of NHS Digital data by the Royal College of Midwives (RCM).
    The RCM said more investment is needed in maternity services to ensure the safety and quality of care, as "even the smallest falls are putting increasing pressures on services already struggling with shortages, worsened by the pandemic".
    Dr Suzanne Tyler of the RCM said midwife numbers had "fallen significantly over the past year on top of already serious shortages" in England.
    Dr Tyler said: "The falls across the regions are compounding the difficulties employers are facing to recruit and keep their midwives.
    "We are raising these issues because we want women to get the best possible care and midwives to not only stay in the profession, but to encourage others to become one.
    "These figures must shock this moribund Government into action for the sake of women, babies, their families and staff."
    Read full story
    Source: Medscape, 16 August 2022
  7. Patient Safety Learning
    Survivors of the contaminated blood scandal have been awarded interim government payments after a 40-year battle, but thousands of parents and children of the victims have still received nothing.
    Ministers have accepted the urgency of the need to make the £100,000 payments to about 3,000 surviving victims, after being warned that those mistakenly infected with HIV and hepatitis C were dying at the rate of one every four days.
    But parents and children of the victims accused the government of perpetuating the scandal by failing to recognise their own trauma and loss in today’s announcement.
    Contaminated blood products administered in the 1970s and 1980s to up to 6,000 people have already led to the deaths of more than 2,400 people in the biggest treatment scandal in NHS history.
    The government said it intends to make payments to those who have been infected and bereaved partners in England by the end of October. The same payments will be made in Scotland, Wales and Northern Ireland.
    Announcing the plan, the prime minister, Boris Johnson, said: “While nothing can make up for the pain and suffering endured by those affected by this tragic injustice, we are taking action to do right by victims and those who have tragically lost their partners by making sure they receive these interim payments as quickly as possible.
    “We will continue to stand by all those impacted by this horrific tragedy, and I want to personally pay tribute to all those who have so determinedly fought for justice.”
    Read full story
    Source: The Guardian, 17 August 2022
  8. Patient Safety Learning
    A 60-year-old woman in England’s poorest areas typically has the same level of illness as a woman 16 years older in the richest areas, a study into health inequalities has found.
    The Health Foundation found a similarly stark, though less wide, gap in men’s health. At 60 a man living in the most deprived 10% of the country typically has the burden of ill-health experienced by a counterpart in the wealthiest 10% at the age of 70.
    The thinktank’s analysis of NHS data also shows that women in England’s poorest places are diagnosed with a long-term illness at the age of 40 on average, whereas that does not happen to those in the most prosperous places until 48.
    The findings underline Britain’s wide and entrenched socio-economic inequalities in health, which the Covid-19 pandemic highlighted. Ministers have promised to make tackling them a priority as part of the commitment to levelling up, but a promised white paper on that has been delayed.
    Researchers led by Toby Watt said their findings were likely to be the most accurate published so far because they were based on data detailing patients’ interactions with primary care and hospital services, and unlike previous studies did not rely on people’s self-reported health.
    “In human terms, these stark disparities show that at the age of 40, the average woman living in the poorest areas in England is already being treated for her first long-term illness. This condition means discomfort, a worse quality of life and additional visits to the GP, medication or hospital, depending on what it is. At the other end of the spectrum, the average 40-year-old woman will live a further eight years – about 10% of her life – without diminished quality of life through illness,” Watt said.
    Read full story
    Source: The Guardian, 17 August 2022
  9. Patient Safety Learning
    Only a quarter of patients on valproate, who do not have appropriate contraception, are being referred by their pharmacist to their GP or a specialist about the issue, an audit carried out by NHS England has found.
    A report on the 2019/2020 Pharmacy Quality Scheme Valproate Audit — which was carried out in community pharmacies across England — published on 11 August 2022, has indicated that the Medicines and Healthcare products Regulatory Agency’s (MHRA’s) safety requirements for use of valproate in women and girls of childbearing age, and trans men who are biologically able to be pregnant, are “still not being fully met”.
    Since 2018, the MHRA has advised that valproate, a treatment for epilepsy and bipolar disorder, must not be used in anyone of childbearing potential, unless a Pregnancy Prevention Plan (PPP) is in place.
    As part of a PPP, pharmacists are required to remind patients of the risks of taking sodium valproate in pregnancy and the need for highly effective contraception; ensure patients have been given the patient guide; and remind patients of the need for an annual specialist review.
    However, the audit, which was conducted by 10,293 community pharmacies in England, including responses from 12,068 patients and patient representatives, found that pharmacists were not referring or signposting “a sizeable minority”, who appeared to be without appropriate contraception, back to the prescriber.
    The report said that community pharmacists should refer “all people aged 12–55 who are biologically able to be pregnant and have not had their valproate medication reviewed within the last 12 months to their GP or specialist, as well as to local contraception services as appropriate”.
    For patients not referred to their GP or specialist, the report said that the pharmacist should be able to confirm that the patient is fully informed, understands the risks of not using highly effective contraception and knows who to contact if their circumstances change.
    Read full story
    Source: The Pharmaceutical Journal, 12 August 2022
  10. Patient Safety Learning
    Major reforms have been set out on how NHS organisations should respond to patient safety incidents, which are aimed at ensuring better engagement with patients and families.
    The Patient Safety Incident Response Framework (PSIRF), published today, replaces the serious incident framework and provides guidance to trusts on how and when they should conduct investigations.
    According to NHSE, a key aim is to allow trusts to focus resources on where investigations will have the greatest impact, rather than investigating all incidents as they did under the old framework.
    NHSE said the more flexible approach should make it easier to address concerns specific to health inequalities, as incidents can be learnt from that would not have met the serious incident definition.
    However, it does not affect the need for a patient safety incident investigation following a never event’ or maternity incident; this is still required.
    Helen Hughes, chief executive of charity Patient Safety Learning, said the new framework “places an emphasis on individual organisations assessing their patient safety risks”, and provided a “welcome acknowledgement of the importance of engaging patients and families as part of the investigation process”.
    However, she said there would need to be a “significant training programme for staff in a range of human factors informed approaches”, to ensure reviews lead to safety improvements.
    She added: “What is being proposed is a complex innovation in the NHS’s approach to incident investigation. Its success to a large part will depend on having the right organisational leadership and resources to support this transition. [NHSE has] now provided a set of tools and a timetable for this. However, ultimately this initiative should be judged on its implementation and effectiveness in reducing avoidable harm.”
    Read full story (paywalled)
    Source: HSJ, 16 August 202
  11. Patient Safety Learning
    As the risk of cyberattacks on medical devices continues to mount, the Food and Drug Administration isn’t doing enough to ensure device makers include adequate security in their products, experts say. 
    They charge that part of the problem is that the agency lacks the funds and the trained personnel to evaluate the cyber risk the devices carry and enforce the rules it does have on the books for approving devices.
    “I’ve spoken to device manufacturers, specifically product security people at device manufacturers, saying that they’ve been telling their organizations for the last year or two that they need to include cybersecurity as part of their submissions or else they’re going to get rejected,” said Mike Kijewski, CEO of medical device cybersecurity firm MedCrypt. “Yet for some of their recent submissions, they didn’t have a lot of cybersecurity documentation and they still got accepted by the FDA.”
    Cyberattacks remain a significant risk for healthcare companies. US patient safety group ECRI reported 173 medical device cybersecurity alerts in the past five years. The organisation warned that cybersecurity incidents don’t just disrupt business operations, but can “pose a real threat of physical harm.” For instance, ransomware attacks on hospitals can cause device outages that disrupt patient care, and at worst, put lives at risk. 
    Read full story
    Source: MedTech Dive, 11 August 2022
  12. Patient Safety Learning
    Redeployment of community staff to other services – meaning visits for babies and parents were missed – was the “wrong decision” and would “never be repeated”, a provider has stated.
    Nikki Lawrence, the head of public health nursing at Sirona Care and Health, which provides community services for Bristol and the surrounding area, appeared to blame the government for about 70% of its health visiting staff being redeployed to adult services, leaving around 30% to care for new families at the height of the pandemic.
    Health visitors take over from midwives to monitor the health of children and parents for a period after the baby is born, including to guard against safeguarding threats.
    Ms Lawrence said: “The national learning about redeployment – we have reflected on it, the government has reflected on it and they have agreed it was the wrong decision to make.
    “We basically abandoned families at a time of need, and that decision will never, ever be taken again, from what I’ve been told. In hindsight it was the wrong decision to make, and… it did have a detrimental impact on families and we really regret that, but it was out of our hands.”
    Read full story (paywalled)
    Source: HSJ, 16 August 2022
  13. Patient Safety Learning
    Lamborghinis and ski trips to the Swiss Alps were among the incentives a pharmaceutical giant developed to market a surgical device that has ruined the lives of hundreds of Australian women.
    Documents obtained by the ABC show the extent to which Johnson and Johnson oversold its surgical mesh products, which are used to treat incontinence and prolapse after childbirth.
    They paint a picture of a company that tried to sell surgeons a jet-setting lifestyle where they could insert four devices "before lunch" and notch up $10,000 in surgeries in a single morning.
    The mesh devices have left at least 3,000 Australian women with serious side effects including chronic pain, infections and inability to have sex, and are the subject of both a Senate inquiry and a class action.
    New court documents released in the class action against Johnson and Johnson show that as early as 2009, concerns were raised inside the company that it was making "a huge mistake" by commercialising its latest brand of mesh, was "rushing to market", and opening up the use of the product to "unqualified surgeons".
    Lawyers from Shine, who are representing the women in the class action, claim the pharmaceutical giant did not investigate proper clinical trials on the possible complications of the mesh.
    Read full story
    Source: ABC News, 13 August 2022
  14. Patient Safety Learning
    Thirty-four hospital buildings in England have roofs made of concrete that is so unstable they could fall down at any time, ministers have admitted.
    The revelation has prompted renewed fears that ceilings at the hospitals affected might suddenly collapse, injuring staff and patients, and calls for urgent action to tackle the problem.
    Maria Caulfield, a health minister, made the disclosure in a written answer to a parliamentary question asked by the Liberal Democrats’ health spokesperson, Daisy Cooper.
    Caulfield said surveys carried out by the NHS found that 34 buildings at 16 different health trusts contained reinforced autoclaved aerated concrete (RAAC), which one hospital boss has likened to a “chocolate Aero bar”. RAAC was widely used in building hospitals and schools in the 1960s, 70s and 80s but has a 30-year lifespan and is now causing serious problems.
    In 2020 Simon Corben, NHS England’s director of estates, declared that RAAC planks posed a “significant safety risk” because their age meant they could fall down without warning.
    Read full story
    Source: The Guardian, 14 August 2022
  15. Patient Safety Learning
    NHS England has said integrated care systems (ICSs) will be responsible for ‘initial problem solving and intervention’ if trusts fail to deliver against key targets to prepare for winter.
    NHSE’s letter on winter planning and response, published on Friday, said system working “means a new approach to accountability” and that ICBs – the NHS executive of ICSs – would be accountable for ensuring that providers and others “deliver their agreed role in their local plans and work together effectively”.
    The document, signed by NHSE’s leadership, says: “ICBs are responsible for initial problem solving and intervention should providers fail, or be unable, to deliver their agreed role.
    “Intervention support can be provided from NHS England regional teams as required, drawing on the expertise of our national level urgent and emergency care team as needed.”
    Read full story (paywalled)
    Source: HSJ, 15 August 2022
  16. Patient Safety Learning
    The UK has become the first country to approve a dual vaccine which tackles both the original Covid virus and the newer Omicron variant.
    Ministers say the vaccine will now form part of the autumn booster campaign.
    Moderna thinks 13 million doses of its new vaccine will be available this year, but 26 million people are eligible for some form of booster.
    Health officials say people should take whichever booster they are offered as all jabs provide protection.
    Moderna's latest vaccine - called Spikevax - targets both the original strain and the first Omicron variant (BA.1), which emerged last winter. It is known as a bivalent vaccine as it takes aim at two forms of Covid.
    The UK's Medicines and Healthcare Products Regulatory Agency has considered the evidence and given the vaccine approval for use in adults.
    Dr June Raine, the regulator's chief executive, said: "What this bivalent vaccine gives us is a sharpened tool in our armoury to help protect us against this disease as the virus continues to evolve."
    Read full story
    Source: BBC News, 16 August 2022
  17. Patient Safety Learning
    A care home nurse has been struck off after he gave a brain tumour patient sugar and water instead of pain relief.
    Vijayan Rajoo said he felt the patient was "just being lazy" and did not need pain relief.
    Rajoo, 64, also failed to check supplies in the controlled drug cupboards at the start and end of his shifts, according to a misconduct panel.
    He was struck off for 18 months after a deputy manager at the home, St Fillans in Colchester, Essex, discovered 20ml of liquid morphine Oramorph was unaccounted for in June 2019.
    Rajoo later confessed to not giving the brain tumour patient a dose of Oramorph as a form of pain relief as he felt the patient "did not need it".
    It was reported the patient could immediately tell the sugar and water mix "didn't taste right".
    The misconduct panel found all charges against Rajoo proven. In their conclusions, the panel said Rajoo showed a "serious lack of compassion".
    Read full story
    Source: ITV News, 13 August 2022
  18. Patient Safety Learning
    Almost 200 maternity units in England will be inspected by the Care Quality Commission amid fears for mothers and babies’ safety and concerns that improvements are not happening fast enough.
    The commission is taking the unusual step as NHS England faces accusations of pressuring hospitals to reorganise the way midwives work when they lack the staff to do it safely.
    The new model of care, which is designed to provide mothers with a dedicated midwife throughout pregnancy, has been introduced only partially across the NHS, leading to a two-tier service in which hospital wards are left short of staff and women face potentially dangerous delays.
    Under “continuity of carer”, midwives work in teams and are on call for specific mothers when they go into labour. But this can leave hospital wards understaffed and women not included in the programme waiting for a midwife.
    NHS England is pushing hospitals to make this the default model of care by March 2024 despite a warning by Donna Ockenden, who led the inquiry into baby deaths at the Shrewsbury and Telford Hospital Trust, and who said in her final report that introduction of the new model should be suspended if services lack enough staff.
    Read full story
    Source: The Times, 14 August 2022
    Further reading - Midwifery continuity of carer resources on the hub.
  19. Patient Safety Learning
    Legal costs in some lower-value medical negligence claims can be double or even triple the amount of compensation paid to patients. 
    Figures in the Medical Defence Union’s (MDU’s) annual report for 2021 reveal the average sum paid in claimants’ legal costs on medical claims settled for up to £10,000 was in excess of £18,500. 
    For claims settled between £10,000 and £25,000, the average was nearly £35,000. 
    The not-for-profit indemnifier called on the Government to proceed quickly with the reforms needed to the clinical negligence system to make disproportionate legal costs a thing of the past. 
    Its chief executive Dr Matthew Lee said: "Disproportionate legal costs are one of several defects in the current litigation system and particularly affect lower value claims. 
    "It cannot be right for legal costs paid to claimants’ lawyers to regularly exceed the damages paid to claimants by double or triple the amount."
    Read full story
    Source: Independent Practitioner Today, 9 August 2022
  20. Patient Safety Learning
    A woman with fast-growing stage-four breast cancer says the NHS has let her down, with delays at every stage of her treatment.
    Caroline Boulton, 56, had several appointments for a mammogram, which checks for early signs of cancer, cancelled because of Covid, in March and November 2020.
    In late 2021, she found a small lump, went to her GP and was referred urgently to a specialist - but then the delays began.
    "They haven't moved quickly enough," Ms Boulton says, who lives in Greater Manchester. "It's been really, really slow."
    "Between each appointment, each scan, there's been four-, five-, six-, seven-, eight-week waiting times and delays every time."
    The referral letter came through "very quickly" but then she waited three weeks, instead of the recommended two, to see a consultant.
    "When I first found the lump, it was only pea-sized," Ms Boulton says. "By the time I got to see the consultant, it was the size of a tangerine."
    Her cancer was growing quickly, she was told, but it would be eight weeks before a mastectomy could be scheduled to remove her breast.
    "Considering it was fast-growing, that's a huge concern - you're living with that, waiting, knowing it's growing," Ms Boulton says.
    When she finally saw an oncologist seven months after finding the lump, had another scan and received the results, the cancer had spread to her liver - and there was no longer any treatment they could offer.
    "I've now got stage-four cancer that I shouldn't have - and two years to live."
    Read full story
    Source: BBC News, 10 August 2022
  21. Patient Safety Learning
    England’s mental health inpatient system is “running very hot” and operating well above recommended occupancy levels, HSJ has been told, as new funding to address the problem is revealed.
    The move was announced by NHS England mental health director Claire Murdoch in an exclusive interview with HSJ. 
    It comes amid a steep rise in mental health patients waiting more than 12 hours in accident and emergency. Last month, an HSJ investigation revealed 12-hour waits for people in crisis had ballooned by 150% in 2022 compared to pre-pandemic levels. Problems finding specialist beds have been cited by experts as one of the root causes of A&E breaches.
    Ms Murdoch told HSJ the funds would not come from ”within the mental health service budget” and that they would be used to “help address any pressures where we think the answer is more of either beds or other urgent and emergency care which has a capital need.”
    NHSE is now working with the 42 integrated care systems to determine where the money can best be used. Ms Murdoch said the money would be spent ”where there is a particular need” and that there was “no blanket approach” to its allocation. 
    Read full story (paywalled)
    Source: HSJ, 10 August 2022
  22. Patient Safety Learning
    A cyber attack that has caused a major outage of NHS IT systems is expected to last for more than three weeks, leaving doctors unable to see patients’ notes, The Independent has learned.
    Mental health trusts across the country will be left unable to access patient notes for weeks, and possibly months.
    Oxford Health Foundation Trust has declared a critical incident over the outage, which is believed to affect dozens of trusts, and has told staff it is putting emergency plans in place.
    One NHS trust chief said the situation could possibly last for “months” with several mental health trusts, and there was concern among leaders that the problem is not being prioritised.
    In an email to staff, Oxford Health Foundation Trust chief executive Nick Broughton, said: “The cyber attack targeted systems used to refer patients for care, including ambulances being dispatched, out-of-hours appointment bookings, triage, out-of-hours care, emergency prescriptions and safety alerts. It also targeted the finance system used by the Trust."
    The NHS director said: “The whole thing is down. It’s really alarming…we’re carrying a lot of risk as a result of it because you can’t get records and details of assessments, prescribing, key observations, medical mental health act observations. You can’t see any of it…Staff are going to have to write everything down and input it later.”
    They added: “There is increased risk to patients. We’re finding hard to discharge people, for example to housing providers, because we can’t access records.”
    Read full story
    Source: The Independent, 11 August 2022
  23. Patient Safety Learning
    All children aged one to nine and living in Greater London will be offered a polio vaccine after the virus was detected in sewage.
    The virus, which can cause paralysis, has been found 116 times in London's wastewater since February.
    The urgent immunisation campaign will see nearly a million children offered the vaccine - including those already up to date with their jabs.
    Parents and carers will be contacted by their GP within the next month.
    Polio is seen as a disease of the past in the UK after the whole of Europe was declared polio-free in 2003.
    Dr Vanessa Saliba, a consultant epidemiologist at UKHSA, said: "All children aged one to nine years in London need to have a dose of polio vaccine now - whether it's an extra booster dose or just to catch up with their routine vaccinations."
    She said the risk for the majority of the population who are vaccinated remains "low" but said it was "vital" parents ensure their children are fully vaccinated.
    Read full story
    Source: BBC News, 10 August 2022
  24. Patient Safety Learning
    The Senate passed a sweeping budget package Sunday intended to bring financial relief to Americans, but not before Republican senators voted to strip a proposal that would have capped the price of insulin at $35 per month for many patients.
    A proposal that limits the monthly cost of insulin to $35 for Medicare patients was left untouched. But using a parliamentary rule, GOP lawmakers were able to jettison the part of the proposal that would apply to privately insured patients.
    Lowering the price of drugs such as insulin, which is used by diabetics to manage their blood sugar levels, is broadly popular with voters, polling shows. Senate Democrats denounced Republicans for voting against relief for Americans struggling to pay for the lifesaving drug.
    More than 30 million Americans have diabetes, and about 7 million require insulin daily to manage their blood sugar levels.
    The insulin price cap, part of a larger package of proposals to cut prescription drug and other health-care costs, was intended to limit out-of-pocket monthly insulin costs to $35 for most Americans who use insulin.
    More than 1 in 5 insulin users on private medical insurance pay more than $35 per month for the medicine, according to a recent analysis from the Kaiser Family Foundation. The same analysis found that the median monthly savings for those people would range from $19 to $27, depending on their type of insurance market.
    A Yale University study found insulin is an “extreme financial burden” for more than 14% of Americans who use it. These people are spending more than 40% of their income after food and housing costs on the medicine.
    Read full story (paywalled)
    Source: The Washington Post, 8 August 2022
  25. Patient Safety Learning
    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

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