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  1. Patient Safety Learning
    A sexual assault survivor chooses sterilization so that if she is ever attacked again, she won’t be forced to give birth to a rapist’s baby. An obstetrician delays inducing a miscarriage until a woman with severe pregnancy complications seems “sick enough.” A lupus patient must stop taking medication that controls her illness because it can also cause miscarriages.
    Abortion restrictions in a number of states and the Supreme Court’s decision to overturn Roe v. Wade are having profound repercussions in reproductive medicine as well as in other areas of medical care.
    “For physicians and patients alike, this is a frightening and fraught time, with new, unprecedented concerns about data privacy, access to contraception, and even when to begin lifesaving care,” said Dr. Jack Resneck, president of the American Medical Association.
    Even in medical emergencies, doctors are sometimes declining immediate treatment. In the past week, an Ohio abortion clinic received calls from two women with ectopic pregnancies — when an embryo grows outside the uterus and can’t be saved — who said their doctors wouldn’t treat them. Ectopic pregnancies often become life-threatening emergencies and abortion clinics aren’t set up to treat them.
    It’s just one example of “the horrible downstream effects of criminalizing abortion care,″ said Dr. Catherine Romanos, who works at the Dayton clinic.
    Read full story
    Source: AP News, 16 July 2022
  2. Patient Safety Learning
    Carole Davies and her partner, Malcolm, looked at each other in shocked silent horror as her surgeon spoke to them. 
    Carole, 76, from Stevenage, Hertfordshire, had endured weeks of agony after an NHS surgeon had inserted a polypropylene mesh implant to treat a slight incontinence problem. The mesh was meant to act as a scaffold to support her leaking bladder.
    Carole, then 60 and a recently retired personnel administrator, had returned to see the surgeon with her partner seven weeks after the surgery. She was in tears as she explained her debilitating pain.
    'I told the surgeon that I could feel the mesh cutting into me, which was agonising,' Carole told Good Health.
    'But he ignored this and said everything was OK. He told me: 'I just don't understand how you could be in pain. I will refer you to a psychiatrist.' Then he turned to Malcolm and said: 'I've made her nice and tight for you.' '
    It was lewd and inappropriate but, as we can reveal, is shockingly by no means an isolated example — an insult, literally, not just to Carole but for many others, among the tens of thousands of British women who have suffered agonising complications from mesh-tape operations since they were first introduced in the late 1990s to treat incontinence or prolapse.
    To add insult to injury, these women often struggled for years to have their complaints taken seriously, while surgeons dismissed the idea that there was anything wrong.
    The Mail joined forces with campaigning group Sling The Mesh to highlight the issue, the Government set up an inquiry, led by Baroness Cumberlege, in July 2018.
    This led initially to a pause in the use of surgical mesh for the treatment of urinary incontinence. The inquiry has since called for this pause to be extended until strict requirements on safety and recompense are met.
    Nevertheless, an investigation by Good Health last month found that not only is mesh still being surgically implanted in women, but also that its use could well be on the rise again.
    Sling The Mesh has received dozens of messages from women detailing similarly appalling responses, the majority in the past five years, that surgeons had made to deny, belittle and denigrate their agonising pain, emotional trauma and — in some cases — ruined sex lives.
    You can read all the messages on the hub's community thread.
    Read full story
    Source: Mail Online, 18 July 2022
    Further reading
    Doctors’ shocking comments reveal institutional misogyny towards women harmed by pelvic mesh - a Patient Safety Learning blog
  3. Patient Safety Learning
    Doctors’ leaders have reacted with incredulity to demands that all hospitals in England take “immediate steps” to find extra space for patients so that no ambulance waits longer than 30 minutes.
    A letter from NHS England sent to the heads of NHS trusts, integrated care boards, and ambulance trusts acknowledged that this will not be easy “and that it may place additional burden on staff at an already challenging time.
    The letter was sent on 15 July, in response to the increased pressure on ambulance services over the past year and in light of the current heatwave. It said, “All systems that are currently unable to offload ambulances within 30 minutes should now take further steps to create capacity within acute hospitals to ensure the rapid release of vehicles. This will require risk based decisions to be made about both the use of estate and deployment of clinical workforce.”
    Vishal Sharma, chair of the consultants committee at the BMA, said, “The government should be ashamed that it has come to this. If hospitals had the space or the staff to allow them to care for these patients, they wouldn’t be waiting in ambulances at the hospital door in the first place. The sad fact is that after decades of underinvestment, our hospitals are under-resourced, under-bedded, and understaffed.”
     
    Read full story
    Source: BMJ, 18 July 2022
  4. Patient Safety Learning
    NHS England will ask GP practices to make ‘reasonable adjustments’ for patients with a learning disability or autism such as giving them ‘priority appointments’.
    They could also be asked to provide ‘easy-read appointment letters’ to the group, the Department of Health and Social Care (DHSC) said yesterday in a new strategy on strengthening support for autistic people and those with a learning disability.
    It said the measures aim to support Government plans to reduce reliance on mental health inpatient care, with a target to reduce the number of those with a learning disability or autism in specialist inpatient care by 50% by March 2024 compared with March 2015.
    The policy paper said: ‘We know that people experience challenges accessing reasonably adjusted support which may prevent them from having their needs met.’
    It added: ‘To make it easier for people with a learning disability and autistic people to use health services, there is work underway in NHS England to make sure that staff in health settings know if they need to make reasonable adjustments for people."
    NHS England is also developing a ‘reasonable adjustments digital flag’ that will signal that a patient may need reasonable adjustments on their health record, it said.
    It plans to make this flag, which is currently being tested, available across all NHS services, it added.
    Read full story
    Source: Pulse 15 July 2022
  5. Patient Safety Learning
    Mental health patients who arrive at emergency departments (ED) in crisis are increasingly facing ‘outrageous’ long waits for an inpatient bed, with some being forced to wait several days.
    HSJ research suggests ED waits of more than 12 hours have ballooned in 2022, and are now around two-and-a-half times as high as pre-Covid levels.
    Early intervention for patients in mental health crisis is deemed to be crucial in their care and recovery.
    The Royal College of Emergency Medicine said the findings are a “massive concern”, while the Royal College of Psychiatrists described them as “unacceptable”.
    RCEM president Katherine Henderson said the experience of mental health patients in accident and emergency departments “is not what it should be from a caring healthcare system”.
    She said: “We have massive concern for this patient group. We feel they are getting a really poor deal at the moment.
    “The bottom line is there are not enough mental health beds. There are not enough community mental health services to support patients and perhaps therefore prevent a crisis and the need for beds in the first place.
    “Mental health crisis first responder teams work – a mental health practitioner working with the ambulance service can prevent the need for an ED visit.”
    Read full story (paywalled)
    Source: HSJ, 19 July 2022
  6. Patient Safety Learning
    Press release: London, UK, 18 July 2022
    In a letter shared with Patient Safety Learning, Keith Conradi, outgoing Chief Investigator at the Healthcare Safety Investigation Branch (HSIB), has raised serious concerns with the Secretary of State about the lack of interest shown in the patient safety activities of HSIB at the highest levels of the Department of Health and Social Care and NHS England.
    Keith Conradi states that successive leaders of NHS England have shown “little interest” in the work of HSIB. He also highlights concerns about NHS England’s engagement in several HSIB investigations delayed by the pandemic, stating that a lack of participation has “reduced the safety impact of their output”.
    The letter calls for the Department of Health and Social Care to take a safety management system approach to safety, like other safety critical industries such as aviation. Keith Conradi notes that currently where patient safety is done well in the NHS, this is “because of the drive and enthusiasm of individuals rather than through a state organised structured approach”.
    Commenting on this letter, Patient Safety Learning’s Chief Executive Helen Hughes said:
    “We believe that HSIB can play an important role in improving patient safety in the NHS, but not without system-wide commitment and support for their work. It is disappointing to hear of this apparent lack of interest in their activities by NHS England.
    We were also deeply alarmed by concerns about a lack of engagement by NHS England in HSIB safety investigations reducing their impact. This is simply not acceptable and flies in the face of the NHS Patient Safety Strategy’s vision of seeking to continuously improve patient safety.
    We hope that NHS England will seriously rethink its approach to how it works with the national patient safety investigator, and that the new Secretary of State and incoming new Prime Minister seek to reset and re-invigorate our national approach to improving patient safety.”
    Notes to editors
    Patient Safety Learning is a charity and independent voice for improving patient safety. We harness the knowledge, enthusiasm and commitment of healthcare organisations, professionals and patients for system-wide change and the reduction of harm. We support safety improvement through policy, influencing and campaigning and the development of ‘how to’ resources such as the hub, our free award-winning platform to share learning for patient safety. HSIB is the independent national investigator for patient safety in England. It seeks to improve patient safety through professional safety investigations that do not apportion blame or liability.
  7. Patient Safety Learning
    A paediatrician has been struck off for falsely diagnosing children with cancer to scare their parents into paying for expensive private treatment.
    Dr Mina Chowdhury, 45, caused "undue alarm" to the parents of three young patients - one aged 15 months - by making the "unjustified" diagnoses so his company could cash in by arranging tests and scans, a medical tribunal found.
    Chowdhury, who worked as a full-time consultant in paediatrics and neonatology at NHS Forth Valley, provided private treatment at his Meras Healthcare clinic in Glasgow. But the clinic made losses, despite "significant" potential income from third-party investigations and referrals for treatment – with patients charged a mark up fee of up to three times the actual cost. In all three cases, Chowdhury gave a false cancer diagnosis, without proper investigation, before recommending “unnecessary and expensive” private tests and treatment in London.
    Parents previously told the tribunal of their shock and upset at receiving Chowdhury’s diagnoses during consultations between March and August 2017. He told the parents of a 15-month-old girl - known as Patient C - that a lump attached to the bone in her leg was a "soft tissue sarcoma" and a second lump had developed. Chowdhury urged them to see a doctor in London who could arrange an ultrasound scan, a MRI scan and biopsy in a couple of days, saying: "If things are happening it is best to get on top of them early." He also warned that it would be "confusing" to return to the NHS for treatment. But the parents spoke to an A&E doctor and an ultrasound scan revealed that the lumps were likely fat necrosis.
    Patient C later was discharged after her bloods tests came back as normal. The child’s mother told the tribunal that she and her husband had been "very upset" at Chowdhury’s diagnosis. She was also left "angry" after she later read Dr Chowdhury’s consultation notes and realised they were a "total falsification" of what was discussed.
    Read full story
    Source: Medscape, 18 July 2022
  8. Patient Safety Learning
    Patients are at risk of a missed cancer diagnosis due to a reliance on paper records, an NHS trust has admitted after a man died due to his tumour being overlooked.
    Michael Lane, 50, from Shrewsbury, was “failed” by Shrewsbury and Telford Hospital Trust, his family has said after his cancer scan result was misplaced leaving him with a growing kidney tumour for 10 years.
    The trust is yet to fully launch an electronic record system a year after an investigation into Mr Lane’s death warned other patients were at risk due to the gap in paper records.
    Mr Lane went into Shrewsbury and Telford Hospital for a scan following a referral for suspected cancer in 2011. The radiographer flagged a small tumour but the scan was overlooked, placed within his paper records and never reported as being a concern.
    In an investigation report carried out by the trust in May 2021, seen by The Independent, the hospital admitted that had his tumour been seen and operated on earlier he may have survived.
    The report also admitted there were ongoing risks within the trust due to gaps in its electronic records system.
    It said: “The implementation of an IT solution will not prevent sad cases such as that of Mr Lane where the scan report that was missed took place before the widespread availability of such systems, however, it is clear that until we have an electronic requesting and sign-off system we remain at risk of new cases of missed results and harm occurring as a result of the ongoing reliance of paper-based results.”
    Read full story
    Source: The Independent, 17 July 2022
  9. Patient Safety Learning
    Medical experts in cases involving doctors should have a mandatory duty to consider systems issues such as inadequate staffing levels to avoid them being scapegoated for wider failures, the Medical Protection Society (MPS) has said.
    The MPS, which supports the the professional interests of more than 300,000 healthcare professionals around the world, says medical expert reports focus on scrutinising the actions of the individual doctor even when failings are a result of the setting in which they work.
    Its report on the issue, shared with the Guardian before publication, points out that for doctors “adverse opinion can lead to loss of career or liberty”.
    It references the case of Dr Hadiza Bawa-Garba who was convicted of gross negligence manslaughter in 2015 and handed a 24-month suspended sentence for her part in the death of six-year-old Jack Adcock from sepsis. She was later struck off by the General Medical Council before the court of appeal overturned the GMC’s decision.
    Dr Rob Hendry, the MPS medical director, said: “In giving an opinion on whether or not the care provided by a doctor has fallen short of a reasonable standard, it would seem fair to the doctor that the medical expert considers all relevant circumstances. Any individual performance concerns must of course be addressed, but doctors should not be scapegoats for the failings of the settings in which they work. Sadly, we see this all too often in cases against doctors …
    “Many expert reports focus solely on the actions of the individual without considering the wider context. In reality, patient harm arising from medical error is rarely attributable to the actions of a single individual. Inadequate staffing levels, lack of resources, or faulty IT systems are just some issues which can contribute to adverse incidents. Doctors confront these issues every day and have little influence over them.”
    Read full story
    Source: The Guardian, 18 July 2022
  10. Patient Safety Learning
    Catherine O’Connor, who was born with spina bifida and used a wheelchair all her life, was looking forward to the surgery to fix her twisted spine.
    Tragically, after a catastrophic loss of blood, she died on the operating table at Salford Royal Hospital in Manchester.
    She died in February 2007 but only now has an NHS-commissioned report concluded the “unacceptable and unjustifiable” actions of her surgeon, John Bradley Williamson, “directly contributed” to her death. Williamson pressed on with the surgery despite being explicitly told he needed a second consultant surgeon.
    Her case is one of more than a hundred of Williamson’s being reviewed by Salford Royal Hospital amid allegations by whistleblowers of a cover-up by managers and a “toxic culture” within his surgery team.
    An internal list produced by concerned clinicians as long ago as 2014 describes some of Williamson’s patients being left paralysed or in severe pain as a result of misplaced spinal screws and others being rushed back to theatre for life-saving surgery.
    Separately, leaked minutes of a meeting between staff and the hospital’s new chief executive in December 2021 described a “snapshot” of five of Williamson’s patients which “clearly identified significant areas of clinical care, avoidable harm and avoidable death”. They added: “Concerns around Mr Williamson continue to be raised and remain unaddressed.”
    Read full story (paywalled)
    Source: The Times, 17 July 2022
  11. Patient Safety Learning
    A senior hospital nurse said she could not discharge 180 patients due to a lack of "care and support" at home.
    Norfolk and Norwich University Hospital said among the people that did not need to be in hospital was a patient who had been there for 145 days.
    Claire Fare, senior discharge matron, said delays "impact on the whole of the flow" of patients.
    Norfolk County Council's social care department blamed the "national care crisis" for the problems.
    In June, the hospital, which has about 1,200 beds, pleaded for family and friends to help look after fit patients to ease demand.
    Melanie Syson, the hospital's discharge coordinator, said there was a person in the hospital ready for discharge that had been there for more than four months.
    "She is medically fit to be discharged but we are waiting for support to be ready at home," she said.
    Ms Syson added: "The length of stay of the patients seems to be getting longer."
    To help cope with the delays, the hospital opened a "home-first unit" in January for patients who did not need acute care but it was unable to discharge. The unit focuses on rehabilitation to try to prevent the patients coming back into hospital or requiring more care at home.
    Stephanie Ward, the ward sister, said it aimed to "give patients the time they need to do things themselves as much as they can".
    Read full story
    Source: BBC News, 15 July 2022
     
  12. Patient Safety Learning
    Serious incidents causing patient harm have increased steeply compared to previous years at an ambulance service whose nursing director still expects will “fail” next month under mounting service pressures.
    There were 98 patient harm incidents at West Midlands Ambulance Service in June, official data obtained by HSJ suggests, up from 49 in the same month last year.
    The figures show that from April-June this year, 262 harm incidents have been logged – a 240% on 77 in the same period in 2019 and a 71% on 153 last year.
    Nursing director Mark Docherty, who previously warned the service was facing a “Titanic moment” and would “all fail” around a specific date of 17 August, said much of the increase can be attributed to worsening hospital handover delays. 
    More than 700 people at one time waited for ambulances “that were not going to turn up” on Monday, according to Mr Docherty, who described the situation as a “really dangerous place to be”.
    Mr Docherty explained how the harm incidents, including deaths, resulted from growing delays: ”You can’t underplay the risk. If you’ve got 750 patients like we did on Monday waiting, none of those patients have been assessed.
    “Sadly, amongst them there will have been patients with stroke who won’t be treated because they’ve waited too long."
    Read full story (paywalled)
    Source: HSJ, 15 July 2022
  13. Patient Safety Learning
    Patients are increasingly avoiding seeing their GP because they find it too difficult to book an appointment, the latest data show.
    Results from the 2022 GP Patient Survey also show that satisfaction with family doctors in England has dwindled since the previous year. The findings come as the Government and the NHS struggle to retain GPs and boost recruitment to meet rising patient demand and an ageing population.
    The survey found that overall satisfaction ratings have declined over the past 2 years, although most patients who responded to a questionnaire reported a good overall experience with their GP practice, had confidence and trust in the healthcare professional who saw them, and considered they received good care and treatment.
    The results also revealed an increase in the barriers patients faced in getting an appointment in the first place, with 55.4% who needed one in the last 12 months saying they had avoided making one – an increase of 13.1% since the last survey. The most common reason given was that they found it too difficult, cited by 26.5% of respondents, and a huge increase on last year's figure of 11.1%.
    Commenting on the results, Beccy Baird, senior fellow at The King's Fund said: "For many of us, general practice is the front door to the NHS – these results show that patients are finding that door increasingly hard to push open.
    "GPs are working harder than ever before, yet these findings show a dramatic fall in patients' experience of getting an appointment."
    She said recruitment of GPs, nurses, and other professionals to meet rising levels of need was proving tough "because in many cases those staff simply don’t exist".
    Read full story
    Source: Medscape, 14 July 2022
  14. Patient Safety Learning
    Ambulance services are under intense pressure, with record numbers of callouts and the most urgent, category-one, calls last month.
    BBC Two's Newsnight programme spent from 08:00 to 20:00 on Monday at six hospitals with the longest delays handing patients over from paramedics to accident and emergency staff.
    This should take 15 minutes or less - but crews often wait many hours and sometimes whole 12-hour shifts, with ambulances queuing outside unable to respond to other emergency calls.
    At Royal Cornwall, 25 ambulances were queuing by the afternoon, three for at least 10-and-a-half hours, at Derriford, in Plymouth, 20 were queuing up to 11 hours in an overflow car park and the longest wait at Heartlands was more than five hours.
    "We're right on the fringe of collapse right now," a paramedic who has worked in emergency care for more than a decade said.
    "People are phoning and being told that they're not going to get an ambulance for six or nine hours. And that's happening routinely - that is happening pretty much every shift."
    "It would be wrong to say that there are times when I haven't shed a tear... for the people we haven't been able to help because it's been too late," the paramedic said. 
    "They may have died anyway but there are definitely cases that I've been to where we should have been to them sooner and less harm would have come to them."
    Read full story
    Source: BBC News, 15 July 2022
  15. Patient Safety Learning
    More men are dying from melanoma skin cancer than women in the UK, Cancer Research UK is warning as the country's heatwave continues.
    Rates of the cancer, which can develop in sun-damaged skin, have been rising in both men and women in recent years.
    Late diagnosis may be part of the reason why men are faring worse.
    Melanoma is treatable if it is diagnosed early - the charity is urging people to take care in the sun and get any unusual skin changes checked.
    Melanoma death rates have improved for women in the last 10 years, but not for men.
    Michelle Mitchell, chief executive of Cancer Research, says the figures "drive home the importance of sun safety".
    "We all need to take steps to protect ourselves from the sun's harmful UV rays. Getting sunburnt just once every two years can triple your risk of skin cancer," she adds.
    Read full story
    Source: BBC News, 15 July 2022
  16. Patient Safety Learning
    Being in a productive and supportive work environment is linked to better mental health. However, those experiencing mental health problems are often either excluded from the workplace or not supported appropriately when in work, according to new guidance from the Royal College of Psychiatrists.
    As many as one in six people of working age are diagnosed with a mental health condition. Mental health problems are a leading cause of absence from work, but ‘good’ work can improve overall wellbeing. This is achieved by improving self-esteem, feeling useful, building a routine, and importantly, avoiding poverty, which adversely impacts health in many ways.
    ‘Good’ work should offer standard benefits such as job security, an appropriate wage, positive work/life balance, and opportunities for career progression as well as supportive mental health and wellbeing policies. These practices should support employees with existing mental health disorders while minimising the risk of developing issues with mental health and well-being.
    This includes flexible working policies, use of appropriate reasonable adjustments to help people maintain employment and access to counselling and support services as needed.
    The Royal College of Psychiatrists is calling for better support for people with mental health problems to find, return to, and remain in good work, and for employers and Government to recognise the valuable contribution these people make to the workforce.
    Dr Adrian James, President of the Royal College of Psychiatrists, said:
    “We all need to do more if the workplace is to consistently play a positive role in a person’s mental health and wellbeing. We know that issues such as insecure work and unemployment can have a disproportionate impact on the wellbeing of people with mental health conditions.
    “Psychiatrists and occupational therapists can play a key role between employers and patients, ensuring staying in good work is seen as an important outcome of treatment. We must put in place better support for people with mental health problems to find, return to, and remain in good work and for employers and Government to recognise the valuable contribution these people make to the workforce.”
    Read press release
    Source: Royal College of Psychiatrists, 14 July 2022
  17. Patient Safety Learning
    Women working in healthcare earn on average 24% less than their male peers and face a larger gender pay gap than in other economic sectors, a joint report by the International Labour Organization and the World Health Organization has found.
    The analysis, which looked at data from 54 countries across all geographic and income regions, found a raw gender pay gap of around 20%, which jumped to 24% when factors such as age, education, and working time were considered. Gender pay gaps also tended to be wider in higher pay categories, where men were over-represented, while women were over-represented in the lower pay categories.
    The authors said the findings highlighted that women, who accounted for 67% of the global health and care workforce in 2020, were underpaid and undervalued.
    Read full story (paywalled)
    Source: BMJ, 13 July 2022
  18. Patient Safety Learning
    A health minister incorrectly told the Commons yesterday “we have procured a contract” for surge support for ambulance services, despite the contract not having been awarded yet, HSJ has learned.
    There are also doubts about two other points made by health minister Maria Caulfield in Parliament yesterday in a debate about the current high pressure on ambulance services.
    She said: “We have procured a contract with a total value of £30m for an auxiliary ambulance service, which will provide national surge capacity if needed to support the ambulance response during periods of increased pressure. That capacity is there, should we need it.”
    However, NHS England, which advertised the contract in May, confirmed to HSJ today that it “is yet to be awarded”.
    Ms Caulfield was responding to an urgent question from Labour shadow health and social care secretary Wes Streeting about pressure on ambulance services and the heatwave. HSJ reported on Tuesday that all 10 major ambulance services in England were on the highest level of alert.
    Read full story (paywalled)
    Source: 14 July 2022
  19. Patient Safety Learning
    A jury ordered Becton, Dickinson and Co to pay $255,000 to a man who sued the company, alleging he had been injured by its hernia repair surgical mesh, according to a court filing.
    The verdict in Columbus, Ohio federal court comes in the second bellwether trial in a multidistrict litigation over the company's hernia mesh products, which were sold by C.R. Bard Inc before its 2017 acquisition by Becton Dickinson. The first bellwether trial last year ended with a verdict in favour of the company.
    More than 16,000 cases have been consolidated before Chief U.S. District Judge Edmund Sargus in Columbus, in the third-largest pending MDL nationwide. Plaintiffs claim that the mesh products caused infections, pain, inflammation and other problems.
    The verdict came in a case brought by Antonio Milanesi, who had Bard's Ventralex mesh implanted during a hernia repair in 2007, and his wife, Alicia Morz De Milanesi. They claimed that Milanesi developed an infection and bowel abscess because of the mesh, requiring a second surgery in 2017.
    Like other plaintiffs in the MDL, the Milanesis say the mesh products are defectively designed because their polypropylene material degrades when in implanted in human tissue.
    Read full story
    Source: Reuters, 16 April 2022
  20. Patient Safety Learning
    A cross-party group of MPs and peers have written to the health secretary requesting an “urgent” meeting to discuss “unregulated” and “untested” treatments that are being offered to Long Covid patients in the UK.
    It comes after The Independent uncovered a wide range of unproven and “dangerous” therapies being touted to patients, few of which have been approved for use in the NHS – or rigorously tested – for alleviating persistent coronavirus symptoms.
    Patients with Long Covid are also travelling abroad to clinics in Europe to receive treatments such as “blood washing”, often at a cost of tens of thousands of pounds, according to an ITV and BMJ investigation.
    In a letter to health secretary Steve Barclay, the All-Party Parliamentary Group on Coronavirus expressed concern that patients “desperately” awaiting treatment through the NHS are being exploited by private clinics, and urged the government to launch an investigation into the provision of unproven care.
    The group wrote: “It has come to the attention of the APPG that a number of unregulated long Covid clinics are operating in the UK, offering untested and unscientific treatments to people living with long Covid.
    “The evidence our parliamentary group has heard makes it clear that in some parts of the country the current NHS long Covid care pathways are unfit for purpose, with access to NHS long Covid clinics being described as a ‘postcode lottery’.”
    Read full story 
    Source: The Independent, 14 July 2022
  21. Patient Safety Learning
    More than a quarter of nursing staff in hospitals across the UK say patient care is being compromised due to treatment taking place in the wrong setting.
    Investment in the nursing workforce is needed now, the Royal College of Nursing insists, as survey findings show clinical care is taking place in settings such as hospital corridors and waiting rooms rather than on wards. 
    The poll of more than 20,000 nursing and midwifery staff found the situation is worst in emergency care settings where nearly two-thirds of respondents reported the problem. 
    Elsewhere, more than a quarter of nursing staff who responded say patients are being treated in the wrong setting, meaning their care is being compromised and even made unsafe. 
    Staff shortages are a key factor, and across health and social care settings this is causing delays to patients being discharged into the community. This leaves hospitals full, with emergency care staff having to provide care in inappropriate settings.  
    One specific issue identified by respondents was extra beds being added to wards, making carrying out care more difficult, and leading to a lack of privacy for patients and their families.  
    A nurse who works on an NHS adult acute ward in Scotland said patients and their relatives had complained about an extra bed being squeezed into a four-bedded bay, meaning they had no buzzer, no curtains and were not two-metre distanced. 
    She added: “I feel incredibly frustrated and embarrassed. It is totally inappropriate for ward rounds, nursing procedures, COVID precautions and an extra stress on staff.” 
    Read full story
    Source: Royal College of Nursing, 14 July 2022
  22. Patient Safety Learning
    NHS England’s director of community health has said a new strategy for rehabilitation care is needed, because present coverage is sometimes ‘bizarre’, with other services ‘masquerading’ as rehab.
    Matthew Winn, who is also Cambridgeshire Community Services Trust CEO and senior responsible officer of the “ageing well” programme in the NHS long-term plan, made the comments in a webinar for local senior clinicians and managers in the sector.
    He said there was an intention to roll out a national “intermediate care strategy”, describing it as “the essence” of providing rehabilitation and helping hospital patients to “optimise, to recover, to rehab through a skilled multiprofessional team”. They would leave hospital in a “timely pathway” and not need as much social care support afterwards.
    It comes amid huge pressure to speed up hospital discharge, which often relies on rehab services.
    Read full story (paywalled)
    Source: HSJ, 14 July 2022
  23. Patient Safety Learning
    The NHS must be more welcoming to patients who often feel they should not bother doctors, the new patient safety commissioner for England has urged.
    Dr Henrietta Hughes, who takes up the role this week, said it was vital that patients had time to ask questions, despite pressures on the health service.
    Clinicians and managers need to put themselves in the shoes of their patients, she said, highlighting “highly inappropriate” interactions between doctors and patients that showed “a total lack of care and respect”.
    Hughes said it was not a surprise that all the groups affected in the Cumberlege report were women. “That’s something which is a societal problem, and it’s really important that the voices of all patients, including those of women, are listened to and taken really seriously,” she said. “Because otherwise untold harm happens and it can not only extend to the individual patient themselves, but to their families, to their children, to their livelihoods. This role is a real opportunity for championing patients’ voices, and also making sure those who are in charge who are able to make the changes, listen and respond appropriately."
    Read full story (paywalled)
    Source: The Times, 14 July 2022
  24. Patient Safety Learning
    Hundreds of children suffering from mental health issues are attending A&E each day, with some waiting up to five days in emergency departments, The Independent can reveal.
    Internal NHS data leaked to The Independent, shows the number of young patients waiting more than 12 hours from arrival has also more than doubled in the last year.
    A national survey of senior A&E doctors by the Royal College of Emergency Medicine (RCEM) found in some areas children’s mental health services have worsened in the last three years, while the majority of respondents warned there were no children’s crisis services open after 5pm.
    One NHS trust chief executive has warned his hospital’s A&Es have seen a “real surge” in both attendances of people with severe mental health issues and a sharp increase in long waits in recent months.
    One parent, Lee Pickwell, told The Independent his daughter was admitted to paediatric wards several times and stayed days in an emergency “section 136” unit while she waited more than two months for a mental health bed.
    Dr Mark Buchanan, RCEM’s lead for children’s mental health, told The Independent that despite improvements, children’s mental health services still fall short of what is needed.
    Dr Buchanan said: “I’ve seen children who have been not seen by Child and Adolescent Mental Health Services (CAMHS), who been refused the referrals, despite the fact that the mum and dad were taking it in turns to sleep outside their bedroom door because they were scared that they’d run away and do some harm.”
    Read full story
    Source: The Independent, 13 July 2022
  25. Patient Safety Learning
    A spike in Covid absences and the extended heatwave have left NHS hospitals and ambulance services struggling to cope.
    The hot weather is also driving more patients to A&E departments, and callers are being urged not to use 999 except in serious emergencies.
    All 10 ambulance trusts in England are on black alert, the highest level, while health leaders warn that “ill-equipped” hospital buildings are struggling to store medicines correctly amid the abnormally high temperatures.
    Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said: “The NHS ambulance sector is under intense pressure, with all ambulance services operating at the highest level of four within their local resource escalation action plans, normally only ever reserved for major incidents or short-term periods of unusual demand.
    “Severe delays in ambulance crews being able to hand over their patients at many hospital emergency departments are having a very significant impact on the ambulance sector’s ability to respond to patients as quickly as we would like to, because our crews and vehicles are stuck outside those hospitals.”
    Read full story
    Source: The Independent, 12 July 2022

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