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Patient Safety Learning

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  1. Patient Safety Learning
    Digital improvement will be added to the conditions which trusts and integrated care systems have to legally meet as part of their operating licence, the government has indicated. 
    The move is part of a raft of actions unveiled by the Department of Health and Social Care which are intended to “modernise” the NHS.
    The Plan for Digital Health and Social Care states: “At present, there are limited formal mechanisms for overseeing delivery of NHS digital priorities. Digital does not yet feature in the provider licence, system oversight framework, or Care Quality Commission assessments.”
    It adds: “We are exploring options for filling this gap in discussions between NHS England and the CQC, and through a review and consultation with system leaders and frontline staff.”
    New “regulatory levers” will be used to: “signal that digitisation is a priority, identify the non-negotiable standards of digital capability, [and] explain how we will monitor and support compliance”.
    Read full story (paywalled)
    Source: HSJ, 30 June 2022
  2. Patient Safety Learning
    The privatisation of NHS care accelerated by Tory policies a decade ago has corresponded with a decline in quality and “significantly increased” rates of death from treatable causes, the first study of its kind says.
    The hugely controversial shakeup of the health service in England in 2012 by the health secretary, Andrew Lansley, in the Tory-Lib Dem coalition government, forced local health bodies to put contracts for services out to tender.
    Billions of pounds of taxpayers’ cash has since been handed to private companies to treat NHS patients, according to the landmark review.
    It shows the growth in health contracts being tendered to private companies has been associated with a drop in care quality and higher rates of treatable mortality – patient deaths considered avoidable with timely, effective healthcare.
    The analysis by the University of Oxford has been published in the Lancet Public Health journal. “The privatisation of the NHS in England, through the outsourcing of services to for-profit companies, consistently increased [after 2012],” it says.
    “Private-sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of healthcare services.”
    Read full story
    Source: The Guardian, 29 June 2022
  3. Patient Safety Learning
    Women who underwent damaging surgery in Irish hospitals have accused health authorities of dragging them into a "nightmare" of "gaslighting, ignorance and disrespect".
    Having had vaginal mesh implants, the women told an Oireachtas committee that they were "maimed" and then led on "a fool's errand" when they sought support from the HSE.
    The Health Committee heard from members of Mesh Ireland and Mesh Survivors Ireland who represent around 750 women.
    While the HSE said that it would be "extremely difficult" to provide accurate figures, it estimates that around 10,000 women had this surgery in Ireland.
    More than one in ten have suffered complications, Dr Cliona Murphy, Clinical Lead for the National Women and Infants Health Programme, revealed.
    Mary McLaughlin, Mesh Ireland, said that at one point, "I lay in bed 16 hours a day", because of the pain she was in.
    She demanded dignity and respect for survivors in the face of this "global scandal".
    The women are calling for access to a US-based expert in complete mesh removal, to mirror schemes in Scotland and the Canadian state of Quebec.
    Read full story
    Source: RTE, 29 March 2022
  4. Patient Safety Learning
    The shortage of GPs in England is set to become worse, with more than one in four posts predicted to be vacant within a decade, an analysis suggests.
    The Health Foundation study said the current 4,200 shortfall could rise to more than 10,000 by 2030-31. The think tank believes the government will struggle to increase the number of GPs, while demand will continue to rise - creating a bigger shortfall.
    The government has promised to recruit 6,000 extra GPs by 2024, but ministers have admitted they are struggling to achieve that.
    The analysis said the numbers entering the profession are on the rise, but this will be offset by GPs retiring or moving towards part-time working, according to current trends.
    The worst-case scenarios suggested more than half of GP posts could even be vacant.
    Anita Charlesworth, director of research at the Health Foundation, said: "It's sobering that over the next decade things are set to get worse, not better."
    "It's critical that government takes action to protect general practice and avoid it getting locked in a vicious cycle of rising workload driving staff to leave, in turn creating more pressure on remaining staff and fuelling even more departures."
    Prof Martin Marshall, chairman of the Royal College of GPs, said the predictions were "bleak" and the worst-case scenario would be a "disaster".
    "Our members have told us they lack the time to deliver the care that they want to deliver for patients - and that patients need," he said.
    Read full story
    Source: BBC News, 30 June 2022
  5. Patient Safety Learning
    A coroner has said Britain is failing young people and more will die because of under-resourced mental health services, as she ruled that neglect led to the death of a 14-year-old girl.
    Penelope Schofield, the senior coroner for West Sussex, said she would write to the health secretary, Sajid Javid, to raise concerns after the case of Robyn Skilton, who killed herself after being let down by “gross failures” in NHS mental health services.
    Robyn, from Horsham in West Sussex, disappeared from her family home and took her own life in a park on 7 May last year, her inquest in Chichester heard.
    Despite serious concerns about her mental health, Robyn did not get face-to-face consultations, was not seen by a child psychiatrist or assessed for mental health issues, and was discharged from an NHS service a month before her suicide though she was on its high-risk “red list”.
    Her father, Alan Skilton, told the inquest he pleaded for help, and he described the lack of care his daughter received as “astonishing”. He said he believed that if Robyn had been seen earlier, her mental health would have improved and she would not have killed herself.
    The coroner said: “As a society we are failing young people.” She said she was shocked to hear that the number of young people seeking mental health help had increased by 95%. “Trying to manage it without more resources means we are not providing the help that young people need. Robyn’s case is a testament to that. It’s a clear risk that more lives will be lost if we don’t address it.”
    Read full story
    Source: The Guardian, 29 June 2022
  6. Patient Safety Learning
    A review of the medical records of a small number of deceased patients of former neurologist Dr Michael Watt has been completed, the BBC has learned.
    The findings from the review, conducted by the Royal College of Physicians (RCP), are being shared with the families of the 44 deceased patients.
    In May 2018, the Department of Health commissioned the review. It asked regulator the RQIA to review the records of Dr Michael Watt's patients who died in the previous ten years.
    The Royal College of Physicians, which has been examining 44 deceased patients' records as part of phase 2 of the review, has provided the RQIA ( Regulation and Quality Improvement Authority) with its reports.
    Families who wish to receive details of the review of their loved ones' medical records are being offered an opportunity to discuss the findings.
    The RQIA has estimated there may be more than 3,000 deceased patients who were at some point under the care of Dr Watt in the 10-year period prior to May 2018.
    The 44 cases selected for review included deceased patients whose family members had approached the RQIA with concerns about their care.
    Read full story
    Source: BBC News, 29 June 2022
  7. Patient Safety Learning
    Press release: 29 June 2022
    Today, Dean Russell MP, a member of the Health and Social Care Select Committee, with the charity Patient Safety Learning and the Safety for All campaign, are hosting a Parliamentary reception with MPs, Peers and representatives of the wider patient safety and healthcare community.
    Each year in the UK thousands of people are killed and harmed as a result of unsafe care, costing the NHS billions of pounds for additional treatment, support, and compensation costs relating to litigation by those harmed. Following the unprecedented impact that the Covid-19 pandemic has placed on health and social care, both the public and the healthcare sector believe politicians must prioritise the improvement of both patient and healthcare worker safety.
    At this reception politicians and members of the wider healthcare community will discuss how we can harness the knowledge, enthusiasm and commitment of healthcare organisations, professionals and patients for system-wide change, to improve care and reduce avoidable harm to patients and healthcare workers.
    This event also marks the launch by the Safety for All campaign of a new guide for Staff directly involved in a serious safety incident. This step-by-step good practice guide sets out how to ensure we support staff involved in serious safety incidents better, so that these can be more effectively investigated and result in learning and improvement. It is also an opportunity to discuss the recently published report, Mind the implementation gap: The persistence of avoidable harm in the NHS, which highlights a patient safety implementation gap in the UK that results in the continuation of avoidable harm.
    Dean Russell MP said:
    “I am delighted to host this event to reinvigorate parliamentary action in improving patient and healthcare worker safety. The NHS estimates that there are 11,000 avoidable deaths in the UK each year due to patient safety incidents. We must look at the issue of patient safety holistically. If we can change blame culture and allow workers to be open and learn from mistakes, then we can reduce the number of serious safety incidents. Also, if we ensure, in the transition back normality following the pandemic, that the safety of healthcare workers is a priority this will also impact positively on patient safety.”
    Jonathan Hazan, Chair of Patient Safety Learning, said:
    “Patient Safety Learning is working to make patient safety the core purpose of health and social care, not just one of many priorities to be traded with others. We engage with politicians, healthcare organisations, professionals and patients to campaign for system change and we work together on projects to reduce harm to patients. Dean Russell MP and his colleagues in Parliament can play a major role in improving safety and we look forward to working with them.”
    Dr. Paul Grime, Chairman of Safer Healthcare Biosafety Network (SHBN), said:
    “Today’s reception is a chance for the patient safety and wider healthcare community to meet and discuss how we can harness the knowledge, enthusiasm and commitment of healthcare organisations, professionals and patients for system-wide change, to improve care and reduce avoidable harm to patients and healthcare workers. The Safety for All campaign will be pressing MPs and Peers here today and those in leadership roles within the NHS and social care to address these recommendations and lend their support to the campaign and the practical actions we are taking to deliver safety for all.”
    Ian Duncalf, Chair of Patient Safety Group at ABHI, said:
    “The Patient Safety group at the Association of British HealthTech Industries has been supporting and helping to deliver the patient and staff safety agenda for many years. The ABHI are very pleased to be supporting the work of the Safety for All campaign, which with Patient Safety Learning, is now implementing the practical plan, activities and deliverables of the campaign over the next year and beyond. I am delighted that I am joined today by members of the Safer Healthcare and Biosafety Network and the Safety for All campaign Industry Group who are committed to delivering improved patient and staff safety outcomes.”
    Notes to editors
    1. 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.
    2. The Safer Healthcare and Biosafety Network is an independent forum focused on improving healthcare worker and patient safety and has been in existence more than 20 years. It is made up of clinicians, professional associations, trades unions and employers, manufacturers and government agencies with the shared objective to improve occupational health and safety and patient safety in healthcare. COVID-19 pandemic has provided a stark reminder of the vital role healthcare professionals play in providing care to those in our society who need it most and this was recognized in the WHO Patient Safety Day in September 2020: only when healthcare workers are safe can patients be safe. In 2020, the Network launched a campaign called ‘Safety for All’ to improve practice in, and between, patient and healthcare worker safety to prevent safety incidents and deliver better outcomes for all.
    The Safety for All white paper is calling for improvements in, and between, patient and healthcare worker safety to prevent safety incidents and deliver better outcomes for all by:
    Improved understanding and advocacy of the mutual benefits to be accrued for patient safety by improving healthcare worker safety, and vice versa, and of the common risks, factors and interventions across patient and healthcare worker safety
    The application of shared learning and best practice between workplace and patient safety and, where appropriate, aligned or integrated synergistic solutions in safety systems, standards, governance and preventive measures
    Resources, leadership and staff committed to a stronger, reciprocal patient and workplace safety culture, with safety as a core purpose for both, underpinned by better education and training
    Greater support for staff, and for them to speak up, following patient safety incidents, including a safety care pathway for both patients and staff, and to ingrain a just culture
    Improved risk management and reporting of safety incidents, learning and communication across patient and healthcare worker safety
    3. ABHI is the UK’s leading industry association for health technology (HealthTech). ABHI supports the HealthTech community to save and enhance lives. Members, including both multinationals and small and medium sized enterprises (SMEs), supply products from syringes and wound dressings to surgical robots and digitally enhanced technologies. We represent the industry to stakeholders, such as the government, NHS and regulators. HealthTech plays a key role in supporting delivery of healthcare and is a significant contributor to the UK’s economic growth. HealthTech is now the largest employer in the broader Life Sciences sector, employing 131,800 people in 4,060 companies, with a combined turnover of £25.6bn. The industry has enjoyed growth of around 5% in recent years. ABHI’s 320 members account for approximately 80% of the sector by value.
  8. Patient Safety Learning
    The NHS App will soon be updated with features to help offer people in England more personalised care.
    It is part of the government's plan for a digital revolution to speed up care and improve access while saving the health service time and money.
    By March 2023, more users will receive messages from their GP and be able to see their medical records and manage hospital elective-care appointments.
    By March 2024, the app should offer face-to-face video consultations.
    The government's ambition is for at least 75% of adults to be using it by March 2024. Currently, less than half - about 28 million - have it on their phone or tablet.
    The government also wants 90% of NHS trusts to have electronic patient records in place or be processing them by December 2023 and for all social-care providers to adopt a digital social-care record.
    And patients across the country should be able to complete their hospital pre-assessment checks from home by September 2024.
    Read full story
    Source: BBC News, 29 June 2022
  9. Patient Safety Learning
    When you think of cancer, a glamorous mum in her mid-30s is not the first image that springs to mind.
    But You, Me and the Big C podcaster Dame Deborah James was just 35 when she found out she had bowel cancer. Blood and stool tests had come back normal and her GP had laughed "not once, but three times over the course of six months" at the idea she could possibly have a tumour in her bowels. The diagnosis came only when she paid to have her colon examined privately.
    Her experience has raised questions about how good we are at spotting and treating cancer in the under-40s. Simply - are we failing young people with cancer?
    Overall, around 4.3% of cancers diagnosed in the UK are in the under-40s, while those over 75 make up more than a third of all cancer cases, which poses a challenge for us and the doctors who treat us.
    When we are young, we're less likely to attribute any ill health to cancer. Changes to our bowel movements could just be stress, blood in the toilet after we poo could be inflammatory bowel disease or haemorrhoids. Because, for most people, cancer is something that happens to our parents or grandparents.
    Your doctor should be alert to major warning signs of cancer, but there is a medical saying: "When you hear hooves, think horses, not zebras". It's a call to look for the most common or likely explanation, and the younger you are, the less likely cancer is to be behind your symptoms. This helps channel the health service's limited resources to those most likely to need them.
    But that means some younger people aren't being seen quickly enough, although the problem can affect older people too. Bowel Cancer UK's Never Too Young report in 2020 found that four in 10 people surveyed had to visit their GP three or more times before being referred for further tests to see if they had cancer.
    "I don't think GPs are a problem," says Genevieve Edwards, chief executive of Bowel Cancer UK. "It [bowel cancer] is rare in younger people... It will usually be something else."
    The question is - what if you are the zebra, that relatively rare case who does have cancer at a young age?"
    Read full story
    Source: BBC News, 14 May 2022
  10. Patient Safety Learning
    Hospitals are bringing back requirements for masks on wards just weeks after rules were relaxed as Covid rates spike, The Independent can reveal.
    Experts have warned of a surge in cases, believed to be the fifth wave, with one in 40 people in the UK testing positive for the virus.
    Meanwhile, latest NHS data shows more than 8,000 Covid-positive patients on wards following a warning of a “deleterious” impact on hospital waiting times.
    In response, three major hospital trusts have told staff they must wear masks, with warnings more must follow if the NHS is to handle another wave of Covid.
    Dr Tim Cooksley, president of the Society for Acute Medicine told The Independent: “Over the past 2 years Covid has highlighted and exacerbated what was an already growing crisis.
    “High staff absence levels, burn-out and low morale have dominated staff landscapes during this time and continue to do so. Future waves and potentially large numbers of upcoming flu cases will only serve to deepen these problems making the hopes of patients, clinicians and politicians alike of elective recovery seem somewhat fanciful."
    Read full story
    Source: The Independent, 29 June 2022
  11. Patient Safety Learning
    Rapidly falling continuity of care levels pose an “existential threat” to patient safety, Britain’s top family doctor will warn today as research reveals only half of Britons regularly see the same GP.
    Prof Martin Marshall, chair of the Royal College of GPs (RCGP), will say trusted relationships between family doctors and patients are the most “powerful intervention” for delivering effective, high-quality care as they boost patient satisfaction and health outcomes, and reduce use of hospital services.
    But in a keynote speech to the college’s annual conference, Marshall will warn that continuity of care is becoming almost impossible to deliver on the NHS amid soaring demand and shrinking numbers of GPs, in what he will describe as the “most worrying crisis in decades”.
    There are mounting concerns over the ability of the NHS to tackle record waiting lists, with 6.5m patients awaiting care in England alone. Earlier this month Sajid Javid, the health secretary, admitted the current model of GP care “is not working” but insisted there would be no more money for the health service.
    At the RCGP conference in London, Marshall will tell delegates that because of rising workloads and fewer staff, GPs no longer have the time to properly assess patients, with 65% warning safety is being compromised due to appointments being too short, according to a recent survey commissioned by the college.
    Only 39% of respondents said they were able to deliver the continuity of care their patients need – down from 60% two years ago.
    Read full story
    Source: The Guardian, 29 June 2022
  12. Patient Safety Learning
    The outgoing chief investigator of the national safety watchdog has described his frustration with the organisation’s ‘ambivalent’ relationship with NHS England.
    Keith Conradi, who is due to retire from the Health Safety Investigation Branch in July, said he did not think he had “ever really spoken to any of the hierarchy in NHS England”. He added “their priorities are elsewhere”.
    In an interview with health commentator Roy Lilley for the Institute for Health and Social Care Management, Mr Conradi also described HSIB’s relationship with NHSE as “ambivalent”.
    “It wobbled along that sort of line and got worse as time has gone on,” he said. “At the very start I had a chat with the permanent secretary of the Department of Health and said we would be better off in the department than NHS England. He disagreed and felt that we’d be too close to [then health secretary] Jeremy Hunt, and particularly at that time that would have a negative effect.”
    Mr Conradi was also critical of the decision to ask HSIB to take on investigations into maternity care early in its life. He said he was “shocked” that it happened so quickly “when we hadn’t really got going”.
    He continued: “We hadn’t developed a method of doing normal national investigations and suddenly we were being asked to do maternity ones. There was a huge amount of pressure to do this.”
    Read full story (paywalled)
    Source: HSJ, 28 June 2022
  13. Patient Safety Learning
    A drive to ‘transform’ access to urgent, emergency and planned care will be added to the goals of the NHS long-term plan, a document leaked to HSJ has revealed
    The  long-term plan for the NHS was originally published in January 2019. Last September, NHS England said it was reviewing the commitments made within the plan, with senior officials warning that many of them could not be met after the damage of the pandemic.
    HSJ has seen a document prepared for the most recent meeting of the NHS Assembly which sets out NHSE’s approach to the refresh.
    Strategic developments expected include better joined-up community based and preventive care, transform access to urgent, emergency and planned care, improve care quality and operations, and tackle health inequalities, improve population health and develop a sustainable health service through greater collaboration.
    Read full story (paywalled)
    Source: HSJ, 24 June 2022
  14. Patient Safety Learning
    Reproductive health doctors are reacting to the Supreme Court's decision to overturn Roe vs Wade, the 1973 case that allowed people to seek abortions with limited government intervention.
    On Friday, Justice Samuel Alito delivered his opinion on the case Dobbs vs Jackson Women's Health, saying he favoured the state of Mississippi in the case. Now, Roe vs Wade, which allowed abortion until about 24 weeks of pregnancy, is overruled, and individual states have the power to decide their residents' abortion rights.
    OBGYNs who provide abortion care and family-planning services told Insider they worry for their patients' health and safety, and the future of all reproductive healthcare including miscarriages, fertility treatments, and birth control.
    "This decision made by the SCOTUS is one that completely obliterates freedom from reproductive justice and women's health directly," Dr. Jessica Shepherd, a Texas-based gynecologist and Chief Medical Officer at Verywell Health, told Insider.
    Dr. Stephanie Ros, a Florida-based OBGYN, says she fears most for working-class abortion seekers.
    "I'm not worried about my wealthy patients – they will have the means to go 'visit an aunt' in Europe or elsewhere, and access abortion care if they so desire. I'm terrified for my middle class and poor patients, who don't have the means to pick up and travel on a moment's notice, and who often don't have access to medical care to even discover they're pregnant until later than their wealthy counterparts." 
    Read full story
    Source: Insider, 24 June 2022
  15. Patient Safety Learning
    The UK response to the removal of the constitutional right to abortion in the US has been one of anger, sadness, and disbelief.
    The US Supreme Court has voted to overturn the 1973 case of Roe vs Wade, so in effect revoking the constitutional right to abortion that American women have had since the landmark decision. It means the 50 individual US states will be able to set their own abortion laws. Half are expected to ban abortions, some already have, and already clinics across the US have been closing down.
    The ruling has been widely condemned by the UK’s healthcare organisations, including the British Medical Association and the Royal College of Obstetricians and Gynaecologists.
    The BMA called it "deeply worrying for the future of women’s reproductive health". Dr Zoe Greaves, chair of the BMA’s medical ethics committee said: "Banning or severely restricting abortion prevents only the safe termination of pregnancy, it doesn’t prevent abortions. If women are denied necessary and appropriate care, they will be forced to travel out of their home state to access services, something which is also being suggested will be made illegal. It could also drive abortion services underground and lead to an increase in self-administered abortions, placing the most vulnerable of women at greatest risk of harm. Restricting abortion will harm ‘rural, minority and poor patients’ the most, according to leading health organisations in the US."
    Dr Helen Munro, vice-chair of the Faculty of Sexual and Reproductive Healthcare (FSRH) said: "Criminalising abortion and hampering access to care only serves to increase the number of unsafe abortions, putting women’s lives at risk.
    "All women should be able to receive prompt access to abortion services, which should include good pregnancy decision-making support and access to post-abortion contraception by trained healthcare professionals if they choose."
    Read full story
    Source: Medscape, 27 June 2022
  16. Patient Safety Learning
    Suffering is “the new norm” in the NHS and people can expect to spend their last few years in pain, the outgoing chairman of the British Medical Association said.
    Chaand Nagpaul, who steps down this week, said the NHS was in a “perilous state”. He also wants people to have sympathy for the “plight” of junior doctors, who have said they will prepare for a ballot on strikes over pay.
    There are 6.5 million people on NHS waiting lists, many of whom have been waiting a year or more. Nagpaul, who has been a GP for 33 years, said: “I have not come across this scale of suffering, of unmet need. And what we’re going to be seeing is people spending the last years of their lives, literally in pain, unable . . . to have a hip operation. That will be the final years of their lives.”
    He said there was a “whole, larger population of patients just literally not featuring in the statistics” waiting for outpatient treatment, mental health care and diabetes checks.
    Read full story (paywalled)
    Source: The Times, 27 June 2022
  17. Patient Safety Learning
    Doctors have thrown down the gauntlet to the government by calling for a pay rise of up to 30% over the next five years, in a move that increases the chances of strike action.
    Delegates at the British Medical Association’s (BMA) annual conference voted to press ministers to agree to the increase to make up for real-terms cuts to their salaries over the last 14 years.
    Frontline doctors said years of pay freezes and annual salary uplifts of 1% had caused the real value of their take-home pay to fall by almost a third since 2008. They now want “full pay restoration” to return the value of their pay to 2008 levels, and have instructed the BMA to pursue that goal with a government that has made clear it will not hand public sector workers sizeable salary increases in case it fuels already rampant inflation.
    The motion noted “with horror that all doctors’ pay has fallen against RPI [the retail prices index] since 2008 to the tune of up to 30%”. It said the BMA’s leadership should “achieve pay restoration to 2008 for its members within the next five years” and report back annually on progress.
    Proposing the motion, Dr Emma Runswick, a member of the BMA’s ruling council, said: “We should not wait for things to get worse. All of us deserve comfort and pleasure in our lives. Pay restoration is the right, just and moral thing to do. But it is a significant demand and it won’t be easy to win. Every part of the BMA needs to plan for how to achieve this.”
    Read full story
    Source: The Guardian, 27 June 2022
  18. Patient Safety Learning
    Former prime minister Sir John Major has described the contaminated blood scandal as "incredibly bad luck", drawing gasps from families watching him give evidence under oath to the public inquiry into the disaster.
    Up to 30,000 people contracted HIV and hepatitis C in the 1970s and 80s after being given blood treatments or transfusions on the NHS. Thousands have since died.
    Sir John later apologised for his choice of language.
    He said: "I obviously caused offence inadvertently this morning when I referred to the fact that it was awful that people had been fed infected blood and I referred to it as sheer bad luck.
    "I can only say to people it wasn't intended to be offensive. I was seeking to express the fact that I was concerned about what happened.
    "It was intended simply to say that it was a random matter and I perhaps expressed it injudiciously."
    The UK-wide inquiry was launched after years of campaigning by victims, who claim the risks were never explained and that the scandal was covered up.
    Campaigners say those infected decades ago are now dying at the rate of one every four days as a result.
    Read full story
    Source: BBC News, 27 June 2022
  19. Patient Safety Learning
    A possible link between blood clots and ongoing symptoms of Covid is under scrutiny by researchers in the UK.
    While Covid can cause a period of acute illness, it can also lead to longer-term problems. Research has suggested fewer than a third of patients who have ongoing Covid symptoms after being hospitalised with the disease feel fully recovered a year later.
    Now researchers are due to begin a number of trials to explore whether blood thinners may help those who have had the disease.
    Prof Ami Banerjee, of University College London, who is leading a study called Stimulate-ICP, said it was known that a Covid infection increases the risk of blood clots, and that people who have had the disease have a greater risk of related conditions including stroke, heart attacks and deep vein thrombosis.
    In addition, Banerjee said research from scientists in South Africa had suggested that people with long Covid have microclots in their blood, while studies in the UK suggested almost a third of long Covid patients have clotting abnormalities.
    But he said it was not clear if the findings were generalisable, and while there had been calls on social media for anticoagulants to be made available on the basis of such findings, further research was needed, not least as blood thinners can lead to an increased risk of bleeds.
    Read full story
    Source: The Guardian, 27 June 2022
  20. Patient Safety Learning
    The effects of the Supreme Court's proposed overrule of Roe vs Wade will touch health systems nationwide — leading some clinicians to urge industry leaders to start preparing for potential fallout prior to the decision. 
    "Health systems that view abortion exclusively as a political or partisan issue, perhaps one they'd like to avoid, will soon bear witness to the reality that abortion care, or lack thereof, is a healthcare and health equity issue," Lisa Harris, MD, PhD, wrote in a 11 May for The New England Journal of Medicine. "Avoiding the issue will not be possible, short of abandoning care and equity missions altogether. Thoughtful preparation is needed now."
    Four leaders at three systems share there insights.
    Read full story
    Source: Becker's Hospital Review, 23 June 2022
  21. Patient Safety Learning
    NHS patients in England who have been waiting more than two years for surgery are being offered hospital treatment in alternative parts of the country.
    More than 6,000 long-term waiting-list patients are being offered travel and accommodation costs where appropriate to help the NHS through the backlog.
    Health officials want to ensure nobody is waiting more than two years by the end of July.
    Three patients waiting for surgery in Derby have already received treatment in the Northumbria health region, with another two patients booked in, NHS England said.
    And in south-west London, 17 orthopaedic patients from the South West of England are being treated, with another 11 patients set to follow in the coming weeks.
    Health and Social Care Secretary Sajid Javid said the number of two-year waits had already reduced by two-thirds since January.
    "Innovations like this are helping to tackle waiting lists and speed up access to treatment, backed by record investment," he said.
    But British Medical Association leader Dr Chaand Nagpaul is warning that attempts to address what he called a "once in a generation backlog of unimaginable proportions" would be undermined by a lack of staff and beds.
    Read full story
    Source: BBC News, 27 June 2022
  22. Patient Safety Learning
    New plans to strengthen the regulation of medical devices to improve patient safety and encourage innovation have been published.
    Following the UK’s exit from the European Union (EU), the Medicines and Healthcare products Regulatory Agency (MHRA) has a unique opportunity to improve how medical devices and in vitro diagnostic medical devices (IVDs) are regulated in the UK.
    The package of reforms will apply to medical devices such as hearing aids, x-ray machines and insulin pumps; new technologies such as smartphone apps and Artificial Intelligence (AI); as well as certain cosmetic products like dermal fillers.
    The new measures include:
    Strengthening the MHRA’s powers to act to keep patients safe. Giving the public and patients greater assurance on both the performance and safety of the highest-risk medical devices, such as those which need to be implanted. Increasing the scope and extent of regulation to respond to public need. Enhancing systems that are already in place to better protect users of medical devices and certain cosmetic products, and providing greater assurance of their performance and safety. Addressing health disparities and mitigating identified inequities throughout medical devices development and use. Mitigating against inequities in medical devices, ensuring they function as intended for diverse populations. The government has launched a review into the potential equity issues in the design and use of medical devices to tackle health inequalities and will update in due course. Making the UK a focus for innovation, and the best place to develop and introduce innovative medical devices. Ensuring the new regulatory framework encourages responsible innovation so that patients in the UK are better able to access the most advanced medical devices to meet their needs. Setting world-leading standards and building the new UKCA mark. Transforming a new stamp of certification, replacing the CE mark, into a trusted brand that signifies global safety, health and environment protection standards have been met for medical device products. This will in turn boost the MHRA’s global reputation and growing partnerships with other regulators. Health and Social Care Secretary Sajid Javid said: "Now we have left the EU, these new changes will allow innovation to thrive and ensure UK patients are among the first to benefit from technological breakthroughs."
    "We are now able to introduce some of the most robust safety measures in the world for medical devices to ensure patients are protected."
    Read press release
    Source: Gov.UK, 26 June 2022
     
  23. Patient Safety Learning
    Surgery waiting lists will triple by 2030, triggering a “population health crisis”, unless there is a huge increase in NHS capacity, according to new research.
    Experts from Birmingham University have said efforts to reduce hospital backlogs are not enough and that it is “impossible” for the existing frontline workers to tackle increasing waiting lists.
    The most in-depth analysis of the challenge facing hospital waiting lists in England has revealed 4.3 million people need invasive surgery or procedures such as endoscopy, the largest number since 2007.
    Of these, an estimated 3.3 million are on a “hidden waiting list”, likely to need treatment but yet to be identified by the NHS due to the impact of the pandemic.
    More than 2.3 million people, 53% of the waiting list, are of working age, meaning their delayed diagnoses and treatments could have an impact on the economy.
    Without a substantial increase in NHS capacity, the team behind the work say the total figure for those waiting for surgery in England could rise to 14.6 million by 2030.
    Read full story (paywalled)
    Source: The Times, 26 June 2022
  24. Patient Safety Learning
    Patients will not be able to directly contact Scotland’s new Patient Safety Commissioner under the role’s proposed remit, according to the Sunday Post.
    Officials drawing up the job description for the position are proposing patients with concerns and complaints should go through their local health boards instead of dealing directly with the commissioner.
    Last week, Henrietta Hughes was named as the government’s preferred candidate for the role of Patient Safety Commissioner in England. In that role, Hughes will be able to be directly contacted by the public.
    Despite being the first UK country to announce the intention to appoint a commissioner two years ago the role in Scotland is not yet filled.
    The decision not to allow patients to directly contact the commissioner in Scotland has been criticised by Baroness Julia Cumberlege, author of the report, First Do No Harm.
    She said: “Of course, patients must be able to communicate directly with the commissioner and their office. In our review we said the healthcare system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns. Listening to patients is pivotal to that.
    “This is why one of our principal recommendations was the appointment of an independent Patient Safety Commissioner, a person of standing who sits outside the healthcare system, accountable to parliament through the Health and Social Care Select Committee."
    Read full story
    Source: The Sunday Post, 26 June 2022
  25. Patient Safety Learning
    Senior doctors have drawn up a major dossier refuting Sajid Javid’s claim that the pressures on the NHS were created by the Covid pandemic, amid continued warnings over patient safety, scarce beds and staff morale.
    The health secretary has repeatedly suggested that the problems around record waiting lists and ambulance waiting times have been prompted by the pandemic. Last week in parliament, he accused shadow health secretary Wes Streeting of having his “head under a rock for two years” for not seeing that the pressures stemmed from Covid.
    However, in a major review of evidence shared with the Observer, doctors pointed to issues around funding, bed capacity, staffing and recruitment that pre-dated the arrival of Covid. The dossier, drawn up by the British Medical Association as it gathers for its annual conference this week, finds that the UK’s health services were ill-prepared for the pandemic as a result of “historical underfunding and under-resourcing in the decade preceding the virus”.
    Denise Langhor, an emergency medicine consultant in the north-west of England, said that the pandemic had “laid bare” the health service’s problems, but did not create them. “Those problems and those holes already existed,” she said. “It is entirely disingenuous of this government to claim the waiting lists and the difficulties people are experiencing with NHS care at the moment are due to Covid. They have been building for a decade.
    “Every day, I have patients that I wish I could have treated sooner. It’s an awful thing as a doctor to be trying to look after patients on a corridor, and knowing they are not getting the standard of care that you want to give them.
    “Frequently it feels like we’re operating by choosing the least worst option rather than the best option.”
    Read full story
    Source: The Guardian, 26 June 2022

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