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Patient Safety Learning

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  1. Patient Safety Learning
    Covid vaccines cut the global death toll by 20 million in the first year after they were available, according to the first major analysis.
    The study, which modelled the spread of the disease in 185 countries and territories between December 2020 and December 2021, found that without Covid vaccines 31.4 million people would have died, and that 19.8 million of these deaths were avoided. The study is the first attempt to quantify the number of deaths prevented directly and indirectly as a result of Covid-19 vaccinations.
    “We knew it was going to be a large number, but I did not think it would be as high as 20 million deaths during just the first year,” said Oliver Watson, of Imperial College London, who is a co-first author on the study carried out by scientists at the university.
    Many more deaths could have been prevented if access to vaccines had been more equal worldwide. Nearly 600,000 additional deaths – one in five of the Covid deaths in low-income countries – could have been prevented if the World Health Organization’s global goal of vaccinating 40% of each country’s population by the end of 2021 had been met, the research found.
    “Our findings show that millions of lives have likely been saved by making vaccines available to people everywhere, regardless of their wealth,” said Watson. “However, more could have been done.”
    Read full story
    Source: The Guardian, 24 June 2022
  2. Patient Safety Learning
    NHS England has published its new and updated national Freedom to Speak Up policy, which is applicable to primary care, secondary care and integrated care systems.
    Together with NHS England, the National Guardian’s Office has also published new and updated Freedom to Speak Up guidance and a Freedom to Speak Up reflection and planning tool.
    Each will help organisations deliver the People Promise for workers, by ensuring they have a voice that counts, and by developing a speaking up culture in which leaders and managers value the voice of their staff as a vital driver of learning and improvement.
    NHSE is asking all trust boards to be able to evidence by the end of January 2024:
    An update to their local Freedom to Speak Up policy to reflect the new national policy template. Results of their organisation’s assessment of its Freedom to Speak Up arrangements against the revised guidance. Assurance that it is on track implementing its latest Freedom to Speak Up improvement plan. Dr Jayne Chidgey-Clark said: “The publication of the updated universal Freedom to Speak Up Policy for the sector is an opportunity for organisations to refresh their Freedom to Speak Up arrangements. The new guidance we have developed in collaboration with NHS England will help leaders throughout the sector turn that policy into a healthy and supportive Speak Up, Listen Up, Follow Up culture.”
    Read more
    Source: National Guardian Freedom to Speak Up, 23 June 2022
  3. Patient Safety Learning
    The number of patients in English hospitals who have tested positive for Covid has increased 28% in a week, the steepest rise since mid-March
    The third Covid wave of 2022 has now seen Covid occupation levels rise from 3,835 on 4 June to 6,401 yesterday.
    The sharpest rise in the number of Covid positive patients came in the North West region, where the total rose by 43% in a week.
    There are now over 1,000 Covid positive hospital patients in the North West, North East and Yorkshire, Midlands and London regions for the first time since 11 May.
    Some 38% of Covid hospital patients are being treated primarily for the condition.
    Read full story (paywalled)
    Source: HSJ, 24 June 2022
  4. Patient Safety Learning
    A doctor who attempted to cover up the true circumstances of the death in 1995 of a four-year-old patient has been struck off.
    Consultant paediatric anaesthetist Dr Robert Taylor dishonestly misled police and a public inquiry about his treatment of Adam Strain, who died at the Royal Belfast Hospital for Sick Children, a medical tribunal found.
    The youngster was admitted for a kidney transplant at the hospital following renal failure but did not survive surgery in November 1995.
    Six months later an inquest ruled Adam died from cerebral oedema – brain swelling – partly due to the onset of dilutional hyponatraemia, which occurs when there is a shortage of sodium in the bloodstream.
    Two expert anaesthetists told the coroner that the administration of an excess volume of fluids containing small amounts of sodium caused the hyponatraemia.
    But Dr Taylor resisted any criticism of his fluid management and refused to accept the condition had been caused by his administration of too much of the wrong type of fluid.
    In 2004 a UTV documentary When Hospitals Kill raised concerns about the treatment of a number of children, including Adam, and led to the launch of the Hyponatraemia Inquiry.
    The tribunal found Dr Taylor acted dishonestly on four occasions in his dealings with the the public inquiry, including failing to disclose to the inquiry a number of clinical errors he made and falsely claiming to detectives he spoke to Adam’s mother before surgery.
    Read full story
    Source: The Independent, 22 June 2022
  5. Patient Safety Learning
    The NHS is urgently tracking down the parents of 35,000 five-year-old children in London who are not fully vaccinated against polio.
    Health officials are hoping to contain the spread of the virus after detecting the first outbreak since 1984.
    They are trying to trace it back to a “single household or street” after identifying polio in a sewage plant serving four million people in northeast London.
    Experts are concerned polio, which had been eradicated in Britain in the 1980s, could take off again due to relatively low vaccination uptake in London.
    Latest NHS data shows 101,000 five-year-olds in England — 15% of the total — have not had their booster polio dose, offered when they reach the age of three.
    One third of these, 34,104 in total, live in London. Jane Clegg, the chief NHS nurse for London said they are “reaching out to parents of children aged under five in London who are not up-to-date with their polio vaccinations to invite them to get protected.”
    Read full story
    Source: The Times, 23 June 2022
  6. Patient Safety Learning
    The cost of living crisis is adding to pressures on GPs, the British Medical Association (BMA) in Northern Ireland has warned.
    The BMA said that is because the number of people asking for prescriptions for medicines that can be bought over the counter is increasing.
    That includes medicines like painkillers and allergy medication, Dr Alan Stout of the BMA said.
    Prescriptions are free for everyone in Northern Ireland.
    The rise in prescription request increases "the cost to the health service as a whole and the pressure on GPs", Dr Stout told Ulster's Good Morning Ulster programme.
    "We have talked before about the difficulties people have accessing GPs and this is just more demand and difficulties," he said.
    Dr Stout added: "I absolutely don't hold that against anyone, it is not our position as GPs to deny people medication or deny people prescriptions if they need this medication."
    Read full story
    Source: BBC News, 23 June 2022
  7. Patient Safety Learning
    A hospital and one of its managers are facing a criminal investigation into the death of a vulnerable man who absconded by climbing a fence.
    An inquest concluded failings amounting to neglect contributed to the death of Matthew Caseby in 2020, after he fled from Birmingham's Priory Hospital Woodbourne and was hit by a train.
    The investigation will be carried out by the Care Quality Commission (CQC). Priory said it would co-operate fully "if enquiries are raised by the CQC".
    Mr Caseby, 23, climbed over a 2.3m-high (7ft 6in) courtyard fence on 7 September 2020. He was found dead the following day after being hit by a train near Birmingham's University station.
    The inquest in April heard other patients had previously climbed the fence and, despite concerns by members of staff, no action was taken to improve security in and around the courtyard until another patient absconded two months after Mr Caseby's death.
    Following the inquest, coroner Louise Hunt said she was concerned the fence and courtyard area may still not be safe and urged health chiefs to consider imposing minimum standards for perimeter fences at mental health units.
    She also criticised record-keeping and how risk assessments were carried out.
    Read full story
    Source: BBC News, 23 June 2022
  8. Patient Safety Learning
    Polling by the Royal College of General Practice (RCGP) as part of a campaign to make NHS GP services sustainable for the future found that 42% of 1,262 GPs and trainees who took part said they were likely to quit the profession in the next five years.
    A workforce exodus on this scale would strip the health service of nearly 19,000 of the roughly 45,000 headcount GPs and GP trainees currently working in general practice.
    RCGP chair Professor Martin Marshall warned that general practice was a profession in crisis - with the intensity and complexity of GP workload rising as the workforce continued to shrink.
    He warned that 'alarming' findings from the RCGP poll must serve as a stark warning to politicians and NHS leaders over the urgent need for solutions to begin to tackle the crisis facing general practice.
    Four in five respondents told the RCGP they expect working in general practice to get worse over the next few years - while only 6% expected things to improve.
    Nearly two in five respondents said GP practice premises are not fit for purpose, and one in three said IT for booking systems is not good enough.
    Professor Marshall said: 'What our members are telling us about working on the frontline of general practice is alarming. General practice is significantly understaffed, underfunded, and overworked and this is impacting on the care and services we’re able to deliver to patients.
    Read full story
    Source: GP, 22 June 2022
  9. Patient Safety Learning
    A serious revelation may derail the Cerner Millenium rollout. A draft report by the Department of Veterans Affairs (VA) Office of Inspector General (OIG) states that a flaw in Cerner’s software caused the system to lose 11,000 orders for specialty care, lab work, and other services – without alerting healthcare providers the orders (also known as referrals) had been lost. This created ‘cases of harm’ to at least 150 veterans in care. 
    The VA patient safety team classified dozens of cases of “moderate harm” and one case of “major harm.” The major harm cited affected a homeless veteran, aged in his 60s, who was identified as at risk for suicide and had seen a psychiatrist at Mann-Grandstaff in December 2020, after the implementation. After prescribing medication to treat depression, the psychiatrist ordered a follow-up appointment one month later. That order disappeared in the electronic health record and was not scheduled. The consequences were that the veteran, weeks after the unscheduled appointment date, called the Veterans Crisis Line. He was going to kill himself with a razor. Fortunately, he was found in time by local first responders, taken to a non-VA mental health unit, and hospitalized.
    The draft report implies that the ‘unknown queue’ problem has not been fixed and continues to put veterans at risk in the VA system.
    There may be as many as 60 other safety problems. Other incidents cited in the draft report include one of “catastrophic harm” and another case the VA told the OIG may be reclassified as catastrophic. Catastrophic harm is defined by the VA as “death or permanent loss of function.”
    Read full story
    Source: Telehealth and Telecare Aware, 21 June 2022
  10. Patient Safety Learning
    The NHS is warning about widespread scam text messages telling recipients they have been in close contact with a Covid case.
    "We've seen reports of fake NHS text messages about ordering Omicron Covid-19 test kits," it tweeted.
    Close contacts of people who have tested positive are no longer advised to test.
    The aim of the messages appears to be harvesting financial and personal information.
    In its alert, the NHS says it will "never ask for bank details, so please be aware of suspicious messages".
    Most people are no longer advised to test for Covid and are ineligible for free tests - but some some pharmacies and shops sell them.
    Read full story
    Source: BBC News, 22 June 2022
  11. Patient Safety Learning
    Vulnerable patients cared for in secure mental health units across England could miss out on vital medications due to a shortage of learning disability nurses, the Healthcare Safety Investigation Branch (HSIB) has  warned.
    The report into medication omissions in learning disability secure units across the country highlights problems with retaining learning disability nurses, with the number recruited each year matching those leaving.
    Figures quoted in the report suggest the number of learning disability nurses in the NHS nearly halved from 5,500 in 2016 to 3,000 in 2020.
    The HSIB launched a national investigation after being alerted to the case of Luke, who spent time in NHS secure learning disability units but was not administered prescribed medication for diabetes and high cholesterol on several occasions. 
    At Luke’s facility, which included low and medium secure wards, HSIB investigators considered that the quality and style of care provided to patients had been directly impacted by a lack of nurses with required skill sets.
    Findings from HSIB’s wider national investigation link a shortfall of learning disability nurses to instances of patients missing their medication, with the report’s authors describing a “system in which medicines omissions were too common and prevention, identification and escalation processes were not robust”. 
    Read full story (paywalled)
    Source: HSJ, 23 June 2022
  12. Patient Safety Learning
    A trust was supplied with ventilators that were not ‘fit for NHS purposes’ by two suppliers at the height of the first Covid wave, HSJ  has revealed.
    Guy’s and St Thomas’ Foundation Trust has now received a refund for both contracts, which were signed in March 2020 just as the pandemic began to hit the NHS.
    The service rushed to secure the equipment in response to fears that existing ventilator capacity would be inadequate to deal with the rising number of seriously ill Covid patients. At the time, the use of ventilators was the only effective therapy for the sickest Covid patients. 
    Minutes published by the trust at its most recent board meeting revealed the issue. GSTT then told HSJ in a statement: “Two contracts for ventilators were in dispute. In one case, the trust has already received a refund. In the other, which involved equipment we do not assess as fit for NHS purposes, the trust was reimbursed by central funding.”
    The trust would not confirm the number of ventilators involved, the cost or the issue that meant they were not “fit for NHS purposes”.
    Read full story (paywalled)
    Source: HSJ, 23 June 2022
  13. Patient Safety Learning
    A group of 95 people who developed health problems or lost relatives as a result of rare side-effects of the Oxford-AstraZeneca Covid-19 vaccine say they have been let down by the "out-of-date" government payment scheme.
    One woman whose fiancé died after the jab was awarded £120,000 this week.
    BBC News has since learned two more people have been told they will receive payments. But many more are still waiting for their cases to be assessed, despite some having final death certificates meaning senior doctors and lawyers have concluded the vaccine caused their loved one's death.
    As of May, more than 1,300 claims had been made to the Vaccine Damage Payment Scheme (VDPS) but only 20 referred for medical assessment.
    Meanwhile, some fear their genuine but rare cases are being drowned out by a flurry of people making unproven claims about vaccine damage online.
    Claire Hibbs was unable to work for a year after developing vaccine-induced immune thrombotic thrombocytopenia (VITT) and struggles with chronic fatigue, migraines and brain fog and fears her job could be at risk - but believes she will not be considered 60% disabled.
    Like others in the group, she has been upset by suggestions she might be opposed to vaccines - "it's a pro-vaccination campaign," Ms Moore says.
    But Ms Hibbs acknowledges false claims about damage from Covid vaccines have been widely circulated online - and research suggests such claims can increase vaccine hesitancy and put people's lives at risk.
    Members of the group, Vaccine, Injured, Bereaved UK (VIB UK) have all received official confirmation of a link to the vaccine. But underneath many of its factual posts, other accounts share reams of false and misleading claims about the vaccine
    Read full story
    Source: BBC News, 23 June 2022
  14. Patient Safety Learning
    A leading NHS hospital failed to publicly disclose that four very ill premature babies in its care were infected with a deadly bacterium, one of whom died soon after, the Guardian has revealed.
    St Thomas’ hospital did not admit publicly that it had suffered an outbreak of Bacillus cereus in the neonatal intensive care unit (NICU) of its Evelina children’s hospital in late 2013 and early 2014.
    It occurred six months before a well publicised similar incident in June 2014 in which 19 premature babies at nine hospitals in England became infected with it after receiving contaminated baby feed directly into their bloodstream. Three of them died, including two at St Thomas’.
    Leaked documents show that both the first outbreak and newborn baby’s death were investigated but never publicly acknowledged by the NHS trust that runs the hospital.
    GSTT insists that it did not acknowledge the baby’s death publicly in any reports because it believed the child had died of other medical conditions, not the bacteria. However, it declined to say if it had told the baby’s parents that it had become infected with Bacillus cereus.
    Read full story
    Source: The Guardian, 23 June 2022
  15. Patient Safety Learning
    Public health officials have declared a national incident after routine surveillance of wastewater in north and east London found evidence of community transmission of poliovirus for the first time.
    The UK Health Security Agency (UKHSA) said waste from the Beckton sewage treatment works in Newham tested positive for vaccine-derived poliovirus in February and that further positive samples had been detected since.
    No cases of the disease or related paralysis have been reported, and the risk to the general public is considered low, but public health officials urged people to make sure that they and their families were up to date with polio vaccinations to reduce the risk of harm.
    “Vaccine-derived poliovirus has the potential to spread, particularly in communities where vaccine uptake is lower,” said Dr Vanessa Saliba, consultant epidemiologist at the UKHSA. “On rare occasions it can cause paralysis in people who are not fully vaccinated, so if you or your child are not up to date with your polio vaccinations it’s important you contact your GP to catch up or if unsure check your red book.”
    “Most of the UK population will be protected from vaccination in childhood, but in some communities with low vaccine coverage, individuals may remain at risk,” she added.
    Read full story
    Source: The Guardian, 22 June 2022
  16. Patient Safety Learning
    Last year, Diana Berrent—the founder of Survivor Corps, a US Long COVID support group—asked the group’s members if they’d ever had thoughts of suicide since developing Long Covid. About 18% of people who responded said they had, a number much higher than the 4% of the general US adult population that has experienced recent suicidal thoughts.
    A few weeks ago, Berrent posed the same question to current members of her group. This time, of the nearly 200 people who responded, 45% said they’d contemplated suicide.
    While her poll was small and informal, the results point to a serious problem. “People are suffering in a way that I don’t think the general public understands,” Berrent says. “Not only are people mourning the life that they thought they were going to have, they are in excruciating pain with no answers.”
    Long Covid, a chronic condition that affects millions of Americans who’ve had COVID-19, often looks nothing like acute COVID-19. Sufferers report more than 200 symptoms affecting nearly every part of the body, including the neurologic, cardiovascular, respiratory, and gastrointestinal systems. The condition ranges in severity, but many so-called “long-haulers” are unable to work, go to school, or leave their homes with any sort of consistency.
    Long COVID can also be incredibly painful, and research has linked chronic physical pain to an increased risk of suicide. Nick Güthe has been trying to spread that message since his wife, Heidi Ferrer, died by suicide in 2021 after living with Long Covid symptoms for about a year. Among her most disruptive symptoms, Güthe says, were foot pain that prevented her from walking comfortably, tremors, and vibrating sensations in her chest that kept her from sleeping.
    “My wife didn’t kill herself because she was depressed,” Güthe says. “She killed herself because she was in excruciating physical pain.”
    Read full story
    Source: Time. 13 June 2022
  17. Patient Safety Learning
    Student paramedics are missing out on learning how to save lives because they are wasting hours in ambulances outside A&E instead of attending calls, it has been revealed.
    The College of Paramedics and ambulance directors say the hold-ups mean trainees are missing vital on-the-job experience, leading to fears over the safety of patients.
    Will Boughton, of the College of Paramedics Trustee for Professional Standards, said handover delays had become a problem for trainees’ development and exposure to real-life experience, meaning training had become “unpredictable”.
    If steps weren’t taken to increase training opportunities and address wider quality concerns in education, “it is very possible that patient safety may be at risk due to missed experience during practice education”, he warned.
    “A student could complete a regular shift and see lots of patients, getting lots of things in their portfolio signed off, or they could be the unlucky ambulance that joins the back of a queue and is then at hospital X for however many hours waiting to release that patient, so and it varies from county to county and service to service,” he said.
    Read full story
    Source: The Independent, 22 June 2022
  18. Patient Safety Learning
    Women including refugees, asylum seekers, and undocumented migrants are being charged as much as £14,000 to give birth on the NHS in England, a report by Doctors of the World (DOTW) has found.
    The report, which examined inequalities in maternity care among migrant pregnant women and babies, gathered the experiences of 257 pregnant women accessing DOTW’s services from 2017 to 2021. It found that over a third (38%) who accessed its services had been charged for healthcare, often inappropriately. The women were charged £296 to £14 000, and half of them were billed over £7000.
    The report said that inequalities in access to antenatal care experienced by migrant women were likely to lead to poorer outcomes for their pregnancy and the health of their children.
    The evidence highlights the need for urgent action to address the inequalities experienced by migrant pregnant women and their babies. There is a pressing need for immigration status to be considered as part of the ethnic and racial health inequalities agenda and for independent action to be taken to review the impact of NHS charging policy.
    Read full story (paywalled)
    Source: BMJ, 20 June 2022
  19. Patient Safety Learning
    Health trackers worn on the wrist could be used to spot Covid-19 days before any symptoms appear, according to researchers.
    Growing numbers of people worldwide use the devices to monitor changes in skin temperature, heart and breathing rates. Now a new study shows that this data could be combined with artificial intelligence (AI) to diagnose Covid-19 even before the first tell-tale signs of the disease appear.
    “Wearable sensor technology can enable Covid-19 detection during the presymptomatic period,” the researchers concluded. The findings were published in the journal BMJ Open.
    The discovery could lead to health trackers being adapted with AI to detect Covid-19 early, simply by spotting basic physiological changes. This could help provide an early warning system to users that they may be infected, which may in turn help to prevent the spread of the disease more widely.
    Read full story
    Source: The Guardian, 21 June 2022
  20. Patient Safety Learning
    An ambulance trust has been placed in special measures after the Care Quality Commission (CQC) rated its leadership ‘inadequate’ and said staff felt unable to raise concerns without fear of reprisal
    The CQC inspected South East Coast Ambulance Service Foundation Trust after being contacted by staff with concerns about bullying and harassment, inappropriate sexualised behaviour and a leadership team which failed to address concerns.
    Many of the concerns echo those raised in 2017 in an independent review into a “culture of fear” at the trust, shortly after it was first placed in regulatory special measures. It was taken out in 2019 but has now been placed back in the equivalent “recovery support programme” on the CQC’s recommendation.
    CQC director of integrated care Amanda Williams praised staff who had contacted the regulator. She said: “While staff were doing their very best to provide safe care to patients, leaders often appeared out of touch with what was happening on the front line and weren’t always aware of the challenges staff faced. Staff described feeling unable to raise concerns without fear of reprisal – and when concerns were raised, these were not acted on.
    “This meant that some negative aspects of the organisational culture, including bullying and harassment and inappropriate sexualised behaviour, were not addressed and became normalised behaviours."
    Read full story (paywalled)
    Source: HSJ, 22 June 2022
  21. Patient Safety Learning
    Some pharmacies run by the High Street chain Boots have been criticised for telling some patients on multiple drugs that they can no longer have blister pack boxes, known as dosette boxes or multi-compartment compliance aids (MCCAs).
    Weekly pill organisers can help users keep track of their daily medication and stay safe. Pharmacists put the tablets into individual boxes in the trays, each one indicating when they should be taken.
    The NHS says boxes are not always available for free on the NHS and they're not suitable for every type of medicine.
    Tracey Hobbs' mother, Pat Garner, lives at home with care visits. For several years, she has had her MCCAs provided by her local Boots pharmacy. She takes more than 15 pills each day.
    Tracey says she was phoned by Boots and told that from one month later her mother would receive all the drugs in the original packaging, rather than organised into morning and night doses for each day of the week.
    Tracey told the BBC: "I pointed out that the blister packs were the only way we could know she had taken her medication at the right time. Handing seven individual boxes with different instructions on each one was totally unworkable and - quite frankly - dangerous".
    A Boots spokesperson said: "The latest Royal Pharmaceutical Society guidance indicates that the use of multi-compartment compliance aids is not always the most appropriate option for patients that need support to take their medicines at the right dose and time."
    "Pharmacists are speaking with patients who we provide with MCCAs to discuss whether it is the right way to support them, depending on their individual circumstances and clinical needs."
    Prof Gill Livingston, an expert in elderly medicine at University College London, said she was concerned to hear that some patients and their families were being told the boxes were being scrapped.
    She said: "Blister packs enable people with mild dementia or some memory problems to take their own medication and remain independent. They can check that they have taken it and they know they have taken the right thing, as it is already sorted out.
    "Later on in dementia or with other disabilities, it enables paid carers and families to help them take their medication and remain in the community and remain as well as possible."
    Read full story
    Source: BBC News, 21 June 2022
  22. Patient Safety Learning
    Systems and processes in place around patient safety failed in terms of the work of a Belfast-based neurologist, an inquiry has found.
    Dr Michael Watt was at the centre of Northern Ireland’s largest ever recall of patients, which began in 2018, after concerns were raised about his clinical work.
    More than 4,000 of his former patients attended recall appointments.
    Almost a fifth of patients who attended recall appointments were found to have received an “insecure diagnosis”.
    The final report following the Independent Neurology Inquiry found that problems with Dr Watt’s practice were missed for years and opportunities to intervene were lost.
    It makes 76 recommendations to the Department of Health, healthcare organisations, General Medical Council and the independent sector.
    “While one process or system failure may not be critical, the synergistic effect of numerous failures ensured that a problem with an individual doctor’s practice was missed for many years and, as this inquiry finds, opportunities to intervene, particularly in 2006/2007, 2012/2013, and earlier in 2016 were lost,” the inquiry found.
    Read full story
    Source: The Independent, 21 June 2022
  23. Patient Safety Learning
    Ground breaking new data on community services appears to show enormous variation between areas in the number of referrals for a “two-hour urgent response” being recorded. 
    NHS England has published new provisional data on the performance of urgent community response services against a key NHS long-term plan target of reaching at least 70% of patients referred to them within two hours by December 2022.
    It is the first time performance data has been published for community health services.
    It also includes the number of referrals made which are reported as “in scope” of the target, and the total number of service contacts. There is huge variation in both referrals and contacts, not accounted for by the size of areas or population need. 
    The publication of the first national performance data for community services was described as “an important moment for community providers” by Siobhan Melia, chair of the Community Network, which is part of NHS Providers and the NHS Confederation. She added it would “raise the profile of community services, and shine a light on the important work taking place in the sector”.
    Read full story (paywalled)
    Source: HSJ, 21 June 2022
  24. Patient Safety Learning
    A proposed new training pathway for treating complications of pelvic mesh implants needs more input from patients and more consistent supervision of surgical procedures being carried out, campaigners have urged.
    The pathway proposed by the Royal College of Obstetricians and Gynaecologists (RCOG) aims to outline the skills required of doctors working in specialist mesh removal centres, which were set up after a recommendation in the Cumberlege review into avoidable harm among patients injured by implanted pelvic mesh.
    But a joint blog published on 17 February by Patient Safety Learning and Sling the Mesh raised several concerns about the proposed pathway, including that the consultation for implementing it was too short and not well publicised, offering limited opportunities for patients and groups to comment.
    The groups wrote, “While the development of the training pathway did involve a focus group of six women with mesh related issues, we believe that RCOG have missed an opportunity to engage much more widely."
    “Patient engagement is key to improving patient safety, even more so when there has been a significant loss of trust for patients in healthcare professionals, such as in the case of surgical mesh. We believe it is vital that RCOG, further to its focus group, should be engaging directly with patient groups to hear their concerns and experiences and to genuinely co-produce this type of guidance.”
    Jo Mountfield, vice president of the RCOG, said that the concerns raised by the groups would be considered as part of the review process. She acknowledged that the consultation period could have been longer.
    She said, “There will be further opportunity to involve patient groups as part of our application to the General Medical Council for approval of the training pathway, and we will take the comments raised in this blog on board."
    Read full story (paywalled)
    Source: BMJ, 17 February 2022
    Related reading
    First Do No Harm APPG public meeting on redress: Speech from Kath Sansom (26 January 2022). Kath Sansom, ‘Mesh removal surgery is a postcode lottery’ – patients harmed by surgical mesh need accessible, consistent treatment (2 December 2021). McFadden et al, The long-term impact of vaginal surgical mesh devices in UK primary care: a cohort study in the CPRD (20 August 2021). Sharon Hartles, Mesh: Denial, half-truths and the harms (23 March 2021). Patient Safety Learning, A year on from the Cumberlege Review: Initial reflections on the Government’s response (23 July 2021).
  25. Patient Safety Learning
    People with disabilities must be helped more by health providers to access information, a report has found.
    Over 300 people in North Yorkshire were asked about communication from GPs, hospitals, and healthcare providers in a survey by watchdog Healthwatch.
    The report said there is "some good practice" but many patients are not being contacted in their preferred format. This leads to missed appointments which "costs time and money".
    Since 2016, the Accessible Information Standard means health and care organisations must legally provide a "consistent approach to identifying, recording, flagging, sharing, and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment, or sensory loss," Healthwatch said.
    But the report said some people receive printed letters which they are unable to read meaning they have to ask for private and confidential information to be relayed.
    Scarborough respondent Ian said it was "amazing" that in the 21st Century many are still facing such issues.
    "The [GP booking] system doesn't anticipate that not everyone can use the phone," he said.
    "The problem is a lot of organisations haven't moved with the times".
    Read full storyp
    Source: BBC News, 21 June 2022

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