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Patient Safety Learning

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  1. Patient Safety Learning
    The number of calls for an ambulance in England have almost doubled since 2010, with warnings of record pressures on the NHS that are seeing A&E patients stuck in corridors and many paramedics quitting the job.
    Ambulance calls have risen by 10 times more than the number of ambulance workers, according to a new analysis of NHS data carried out by the GMB union. An increase in people seeking emergency treatment, GPs unable to cope with demand and cuts to preventive care are all being blamed for the figures.
    While the figures represent all calls for an ambulance, some of which go unanswered and do not lead to a vehicle being sent, they reveal the increasing pressures that have led to claims that patient safety is being put at risk by ambulance waiting times. There has been a significant increase in the number of the most serious safety incidents logged by paramedics in England over the past year.
    Paul, a paramedic and GMB deputy branch secretary, said he had recently seen a crew waiting almost 10 hours between arriving at hospital and transferring a patient to hospital care. “They arrived at the hospital at 20.31,” he said. “They then cleared from the hospital at 05.48 in the morning. The impact of the lack of resources is affecting the ambulance service.
    “We are also seeing people become aggressive to the ambulance crew, because they’ve waited hours upon hours in an ambulance."
    Read full story
    Source: The Guardian, 12 June 2022
     
  2. Patient Safety Learning
    The NHS needs reform rather than more money, the health secretary has said, while admitting that record-high waiting lists will continue to rise before they fall.
    Sajid Javid said the health service already had the resources it needed and did not require more to care for patients effectively. “The NHS now has locked in the resources it needs. It doesn’t need any more money. What it needs to deliver for more people is not money. It needs reform,” he said.
    In an interview with the Times, he compared the NHS to the now defunct video rental chain Blockbuster, arguing that it needed to be dramatically restructured in order to continue delivering healthcare free at the point of use.
    “You want to have a system that, yes, it’s got the values of 1948 but looking at delivery towards 2048,” he said.
    The health secretary’s remarks on funding for the health service follow a damning report that showed the NHS had lost almost 25,000 beds across the UK in the last decade. The Royal College of Emergency Medicine said the drop had led to a sharp increase in waiting times for A&E, ambulances and operations, and was causing “real patient harm” and a “serious patient safety crisis”.
    Read full story
    Source: The Guardian, 11 June 2022
  3. Patient Safety Learning
    Those recovering from Covid-19 are to be given devices which can help spot dips in their blood oxygen-levels while they recover at home.
    The NHS is trialling the use of oximeters, combined with an app, which will make it easier to spot whether people need to be re-admitted to hospital.
    The new oximeter service is being tested with more than 150 patients in sites on Watford, Hertfordshire and north London.
    Clinicians in ‘virtual wards’ are able to track patients’ vital signs – including temperature, heart rate and blood oxygen saturation – in near real-time, receiving alerts if they suggest a patient is deteriorating so that further assessments and care can be arranged.
    Health and Social Care Secretary, Matt Hancock, said: “While we restore face to face NHS services too, new innovations will ensure patients can benefit from the comfort of home, with the reassurance that they can be fast tracked to support from the NHS should they need. NHS at Home will help keep people safe and out of hospital while providing the best possible care.”
    Read full story
    Source: Digital Health, 5 June 2020
  4. Patient Safety Learning
    Virtual wards, at-home antibiotic kits and using artificial intelligence in GP surgeries are among new initiatives to be trialled as part £160m funding to tackle waiting lists in the NHS.
    NHS England announced the funding to aid in the health service’s recovery after the pandemic, after figures last month revealed the number of people waiting to begin hospital treatment in England had risen to a new record.
    A total of 4.7 million people were waiting to start treatment at the end of February - the highest figure since records began in August 2007. But NHS England said indicators suggest operations and other elective activity were at four-fifths of pre-pandemic levels in April, which is "well ahead" of the 70% threshold set out in official guidance.
    It said it is working to speed up the health service's recovery by trialling new ways of working in 12 areas and five specialist children's hospitals.
    The so-called "elective accelerators" will each get some of the £160m as well as extra support for new ways to increase the number of elective operations, NHS England said.
    Tens of thousands of patients in the trial areas will be part of initiatives including a high-volume cataract service, one-stop testing facilities and pop-up clinics to allow patients to be seen and discharged closer to home.
    Other trials over the next three months include virtual wards and home assessments, 3D eye scanners, at-home antibiotic kits, "pre-hab" for patients ahead of surgery, artificial intelligence in GP surgeries and so-called "Super Saturday" clinics, bringing multi-disciplinary teams together at the weekend to offer more specialist appointments.
    Read full story
    Source: The Independent, 
  5. Patient Safety Learning
    NHS London’s plan for dealing with the omicron wave needs to take a more multidisciplinary approach and be more evidence-based if it is to not build unwarranted variation into services, write Elaine Maxwell and Alison Leary in HSJ.
    A key tenet of high reliability organisations is to expect the unexpected. The start of the global COVID-19 pandemic was perhaps a little too unexpected to have good plans in place, but nearly two years on there really is no excuse and the NHS London plan for the omicron wave leaves a lot to be desired. Standing down Covid Virtual Wards across the summer with limited capacity to restart them (and no clear evaluation) was, in hindsight, a mistake - but standing up a different model without careful forethought is perhaps a bigger mistake.
    We have talked for at least a decade about unwarranted variation and we seem to be building it into services now, because we don’t spend the time considering the research evidence and consulting the whole multidisciplinary team in order to set meaningful standards. In safety science terms, this is a nightmare. We should and could do better.
    Read full story (paywalled)
    Source: HSJ, 23 December 2021
  6. Patient Safety Learning
    NHS England’s plans to rapidly expand virtual wards are being ‘hastily rolled out’ and could put patients at risk while taking up significant staffing capacity, leading clinicians have warned.
    The Society for Acute Medicine and the Royal College of Physicians are among those who have raised concerns to HSJ about the huge increase in the use of the virtual wards model, under which patients are discharged home and given oximeters that fit on their finger so they can be remotely monitored by clinical staff.
    The concerns follow NHSE ordering trusts to ensure a minimum of 15% of hospital covid patients were being treated in virtual wards, in plans to help ease pressures on hospital wards announced just before Christmas.
    At the time NHSE announced the plans there were around 7,000 covid inpatients in English NHS hospitals, meaning around 1,000 patients should be in virtual wards. But the covid inpatient figure had more than doubled to nearly 16,000 by 5 January.
    The project is hugely significant because NHSE and trust chiefs want to use virtual wards much more widely – including for non-covid patients – and believe they represent a potentially game-changing option when it comes to alleviating pressure on hospitals and speeding up discharges.
    Many of the clinicians who spoke to HSJ were supportive of the principle of virtual wards but had serious concerns about the speed and timing of the rollout. They said there was a lack of evidence the approach was safe.
    Society for Acute Medicine president Tim Cooksley said virtual wards had potential for the future but that they “simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic”.
    Read full story (paywalled)
    Source: HSJ, 7 January 2022
  7. Patient Safety Learning
    The NHS plans to treat up to 25,000 hospital patients at home in “virtual wards” to help clear the backlog caused by the pandemic, the “living with Covid” plan has revealed.
    Patients will be offered acute clinical care at home, including remote monitoring and treatment, as an alternative to hospital stays.
    Consultants or GPs will review patients daily via digital platforms and phone calls. In some cases, patients will be provided with a wearable device to continuously monitor and report their vital signs.
    The NHS has set a national target of 40 to 50 virtual beds per 100,000 population, which equates to about 25,000 beds across England, according to the “living with Covid” plan published this week.
    The document said: “The use of ‘virtual wards’ and ‘hospital at home’ models of care have ensured that patients can be safely cared for in their own homes and that additional bed capacity can be freed up in hospitals.” 
    Commenting on the initial rollout of virtual wards, Dr Tim Cooksley, the president of the Society for Acute Medicine, warned a “hasty” rollout could risk patient safety.
    He said: “Virtual wards do have the potential to be a model of the future. However, it is essential they are appropriately planned, resourced and staffed so they simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic. Incorrect implementation could risk patient safety and significantly impact clinician and patient confidence.”
    Read full story (paywalled)
    Source: The Telegraph, 22 February 2022
  8. Patient Safety Learning
    The Royal Surrey County Hospital is preparing to open its first virtual ward.
    From this summer 15 patients will receive treatment at home using apps and wearable technology, as an alternative to a stay in hospital.
    The ward will be overseen by a consultant, working with therapists, nursing staff and pharmacists.
    The hospital, in Guildford, plans to extend the ward to 52 patients by April 2024.
    Health providers across England have been asked to deliver virtual wards at a rate of 40 to 50 beds per 100,000 people by December 2023.
    It is hoped they will free up beds more quickly, speeding up admissions from A&E and for elective surgery.
    Read full story
    Source: BBC News, 7 June 2022
  9. Patient Safety Learning
    The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed.
    NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. 
    Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications.
    And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates.
    Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme.
    Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.”
    Read full story (paywalled)
    Source: HSJ, 31 March 2022
  10. Patient Safety Learning
    Women are wasting their time and money buying do-at-home menopause testing kits, doctors have warned.
    The urine tests are not predictive enough to tell whether a woman is going through the phase when her periods will stop, doctors have told the BBC.
    The tests, which give a result within minutes, accurately measure levels of follicle-stimulating hormone (FSH), which helps manage the menstrual cycle. But experts say it is not a reliable marker of the menopause or perimenopause.
    Dr Annice Mukherjee, a leading menopause and hormone doctor from the Society of Endocrinology, told the BBC the FSH urine tests were “another example of exploitation of midlife women by the commercial menopause industry, who have financial conflicts of interest”.
    “It’s not helpful for women to access [FSH] directly,” she said. “It is not a reliable marker of perimenopause and can cause more confusion among women taking the test. At worst, misinterpretation of results can cause harm.”
    The Royal College of Obstetricians and Gynaecologists (RCOG), along with other leading experts in women’s health, said the tests could be unhelpful and potentially misleading.
    Read full story
    Source: The Guardian, 10 June 2022
  11. Patient Safety Learning
    Coordination of waiting lists and elective treatment across health systems and regions should be ‘far more systematic’, and could have happened earlier, chief executives of some of the hardest hit trusts have told HSJ.
    In interviews for the HSJ Health Check podcast, the CEOs of King’s, Croydon, Chester and Sandwell and West Birmingham hospital trusts spoke about their experience in the pandemic and what could be learned from it.
    These included the need for faster decision making; resources for deprived and diverse areas, which are often hardest hit; the need for basic staff facilities such as parking and eating areas for staff; longer-term attention to the wellbeing of staff who were most affected; and to give time for trusts to recover.
    On elective care, the CEOs highlighted how the length of lists and waits, and the NHS’s ability to keep up, are now much worse in some areas than others. Some of those with the longest waits and lists at present – such as Countess of Chester and Birmingham – were also heavily hit by Covid; for others this is not the case.
    There were moves, particularly later in the pandemic, for patients who were on the elective waiting list of one trust to be treated at another, for example if they needed urgent treatment and faced harm if delayed, while other hospitals were still able to treat less urgent cases. Combining lists, often known as “shared patient tracking (or treatment) lists”, could also mean capacity being managed more efficiently across providers. 
    Read full story (paywalled)
    Source: HSJ, 10 June 2022
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  12. Patient Safety Learning
    Pharmacists and some other healthcare professionals, rather than just GPs, will soon be able to sign people off sick from work, under new rules.
    The law change will take effect in July and apply across England, Wales and Scotland. The aim is to free up family doctors' time.
    People off work for more than seven consecutive days because of illness may need to show a note from a healthcare professional to their employer.
    When the new legislation is passed, nurses, occupational therapists, pharmacists (working in hospitals and GP practices) and physiotherapists will be able to provide the notes, in addition to GPs.
    Health and Social Care Secretary Sajid Javid said: "I know how important it is for people to be able to see their GP speedily and in the way they want.
    "That's why we are slashing bureaucracy to reduce GPs workloads, so they can focus on seeing patients and giving people the care they urgently need.
    Read full story
    Source: BBC News, 9 June 2022
  13. Patient Safety Learning
    Rises in the cost of living are already having a negative impact of people's health, health professionals warn.
    BBC News has been told of people skipping meals or cutting back on medication, because of money worries.
    The Royal College of Nursing says people are having to make heart-wrenching choices that compromise their health and wellbeing. Along with GPs and hospital doctors, they warn health inequalities between rich and poor risk becoming worse.
    Laura Brant, 28, has already had to make some tough choices about a treatment keeping her alive.
    Having lived with kidney disease since the age of seven, she has already had two kidney transplants - and now needs another.
    Laura is dependent on a dialysis machine to carry out the filtering process usually performed by the kidneys. Without it, she could be dead in a week.
    Laura was having dialysis at home - but the machine used so much electricity and water the bills started to mount rapidly.
    "I'd say that it's the straw that broke the camel's back, really, with the cost of running the dialysis machine, the water it uses, the electric," she says.
    "And it was adding to my anxiety, like, 'How am I going to pay to do this treatment every month?'"
    Royal College of Physicians president Dr Andrew Goddard says some of his respiratory-medicine colleagues are hearing of patients choosing to turn off oxygen supplies to save money.
    "Respiratory disease disproportionately affects those least able to afford to improve their social circumstances," he says.
    "It seems likely the cost of living crisis will widen this disparity further."
    Read full story
    Source: BBC News, 9 June 2022
  14. Patient Safety Learning
    Women, low earners and ethnic minorities are faring worse on NHS waiting lists, according to research.
    Healthwatch, a patient watchdog, warned there was a risk that those with “more demands on their lives” such as long hours or caring responsibilities could end up at the back of the queue.
    It urged hospitals to be proactive in managing waiting lists and communicate with patients who might otherwise be left in limbo.
    The Healthwatch survey found 54% of women had waited more than four months for treatment, compared with 42% of men.
    They were also more likely to have had treatment delayed or cancelled, and to feel that a delay to treatment had made an impact on their ability to work.
    Some 54% of people on lower incomes had been waiting more than four months for hospital care, compared with 34% of higher wealth individuals. They reported a greater impact on their mental health and their ability to work.
    And 57% of respondents from ethnic minorities had faced a delay to or cancellation of hospital treatment, compared with 42 per cent of white British people.
    Louise Ansari, Healthwatch England’s national director, said the factors could have a “layering effect” that meant people had a much poorer experience, calling for “an additional specific focus on those groups” so that they do not end up “in worse and worse health”.
    Read full story (paywalled)
    Source: The Times, 8 June 2022
  15. Patient Safety Learning
    Sajid Javid’s claim that the number of NHS roles dedicated to promoting equality and diversity should be cut is incorrect and not what the government-commissioned review into NHS management recommended, according to its author.
    The review by General Sir Gordon Messenger and Leeds Teaching Hospital chair Dame Linda Pollard was published Wednesday.
    Speaking to the Daily Telegraph on Tuesday evening, the health secretary said: “In my view, there are already too many working in roles focused solely on diversity and inclusion, and at a time when our constituents are facing real pressures around cost of living, we must spend every penny on patients’ priorities.
    “As this report sets out, it should be the responsibility of everyone to encourage fairness and equality of opportunity which is why we must reduce the number of these roles.”
    Speaking later to HSJ, Mr Javid was asked if there was any area of NHS management cuts should be made.
    He said: “I would like to see fewer managers in terms of diversity managers and things, because I think it should actually be done by all management and all leadership, and not contracted out as some kind of tick-box exercise.”
    However, when HSJ spoke to General Messenger he said: “The report does not recommend the reduction of EDI (equality, diversity and inclusion) professionals.
    “What it does say though, is that if one successfully inculcates equality, diversity and inclusion to every leadership’s responsibilities then that becomes an accepted, instinctive, understood part of being a leader and a manager at every level then the requirement for dedicated EDI professionals should reduce over time."
    Read full story (paywalled)
    Source: HSJ, 8 June 2022
  16. Patient Safety Learning
    A troubled NHS trust failed for months to give vital medication to a prison inmate who had a long-standing diagnosis of HIV, an inquest has found.
    A jury at Essex Coroner’s Court concluded that a series of failures and neglect by Essex Partnership University Trust (EPUT) contributed to the death of Thokozani Shiri in April 2019.
    The 21-year-old spent two spells as a prisoner at HMP Chelmsford, where EPUT provided some services at the time.
    He was considered vulnerable due to a long-standing diagnosis of HIV for which he was receiving treatment before he went to prison, and the trust was aware he had HIV throughout both stays, the inquest heard.
    The inquest jury identified that five separate failings had “probably caused” Mr Shiri’s death. These included: a failure to provide antiretroviral medication to Mr Shiri during both periods of imprisonment; a failure to refer him to an HIV clinic; the absence of an appropriate care plan and engagement with a multidisciplinary team; and inadequate management of records.
    Each failing on behalf of the trust was considered by the jury to have amounted to neglect.
    Read full story (paywalled)
    Source: HSJ, 9 June 2022
  17. Patient Safety Learning
    A number of hospitals are insisting that patients keep wearing masks despite instructions from NHS chiefs to drop the rules.
    National coronavirus guidance which insisted on face coverings has now been scrapped, with health officials leaving it to local organisations to draft their own policies.
    However, several hospitals have called on patients and staff to continue to wear masks and face coverings on their sites.
    Sajid Javid, the Health Secretary, has repeatedly called on NHS trusts to drop restrictions in hospitals which are limiting operational capacity. Last month, he threatened to name and shame hospitals that do not lift social distancing measures and restrictions on visitors.
    A letter from health chiefs said that patients visiting accident and emergency (A&E) departments, hospital outpatient appointments and GP surgeries no longer needed to wear masks “unless this is a personal preference”.
    Hospitals have now begun issuing guidance for their local communities, with a number saying they intend to keep insisting on people wearing masks.
    The Sheffield Teaching Hospitals NHS trust issued a notice to patients and staff saying: “We are still asking patients, visitors, staff and anyone working at one of our hospital or community sites to continue to wear a mask, gel hands and social distance while in our buildings despite the lifting of national restrictions."
    “This is to keep vulnerable people as safe as possible.”
    Read full story (paywalled)
    Source: The Telegraph, 8 June 2022
  18. Patient Safety Learning
    East Kent Hospitals University NHS Foundation Trust has adopted artificial intelligence (AI) to test the health of patient’s eyes. In collaboration with doctors at the trust, the University of Kent has developed AI computer software able to detect signs of eye disease.
    Patients will benefit from a machine-based method that compares new images of the eye with previous patient images to monitor clinical signs and notify the doctor if their condition has worsened.
    Nishal Patel, an Ophthalmology Consultant at the Trust and teacher at the University said: “We are seeing more and more people with retinal disease and machines can help with some of the capacity issues faced by our department and others across the country."
    “We are not taking the job of a doctor away, but we are making it more efficient and at the same time helping determine how artificial intelligence will shape the future medicine. By automating some of the decisions, so that stable patients can be monitored and unstable patients treated earlier, we can offer better outcomes for our patients.” 
    Read full story
    Source: National Health Executive, 22 November 2019
  19. Patient Safety Learning
    Concerned healthcare workers in Illinois and Indiana are calling on The Joint Commission to add a safe staffing standard to its accreditation process.
    Yolanda Stewart, a patient care technician at Northwestern Memorial Hospital, once injured her back so badly on the job that she couldn’t work for six months. But when she talks about that time, she doesn’t mention her own pain. Instead, she talks about the patient she’d been trying to help, recalling his extreme discomfort.
    Because the unit was short-staffed, Stewart lifted and turned the patient on her own. The move helped the patient but cost Stewart. Many healthcare workers have similar stories, she says, adding, “Working short-staffed is a safety issue for workers and patients.”
    In fact, reports show that lack of staff in hospitals leads to higher patient infection and death rates. 
    Covid-19 has greatly worsened the healthcare staffing shortage, with 1 in 5 hospital employees — from environmental services workers to nurses — leaving the field. Hospitals have grappled with staffing issues since before the pandemic, but Covid-19 highlighted the challenges — and exacerbated them.
    Now, concerned healthcare workers throughout Illinois and Indiana are sounding the alarm. They’re calling on The Joint Commission — the third-party agency that accredits 22,000 US healthcare organisations — to add a safe staffing standard to its accreditation process, similar to student-to-teacher ratio requirements that many states have.
    “We have all kinds of rules to make sure that hospitals are safe: We make sure that healthcare workers wash their hands before procedures, that they wear gloves and protective equipment, that bed sheets are changed between patients. Yet there are no statewide regulations about hospital staffing levels,” said Service Employees International Union (SEIU) Healthcare Illinois President Greg Kelley at a demonstration in early June. 
    Read full story
    Source: Chicago Health, 8 June 2022
  20. Patient Safety Learning
    Nursing leaders are to write to Northern Ireland's Secretary of State Brandon Lewis over the failure to establish an Executive and the risk this poses to patients.
    The Royal College of Nursing (RCN) congress has passed a motion calling for all political parties and the UK Government to commit to the immediate formation of a fully functioning Executive and Assembly.
    Fiona Devlin, chair of the RCN Northern Ireland board, brought the matter to the congress and said the move represents the deep level of concern in the profession.
    “There is a responsibility to speak up when patients are coming to harm,” she said.
    “The health service is about to completely tip over the edge. We felt we did everything we could to communicate our concerns before the elections, and since then, nothing has changed.
    “The system is crumbling minute by minute, we have the worst waiting lists in the UK, our emergency departments are completely overstretched, primary care and the independent sector are in crisis.
    “Patients can’t be decanted out of ambulances into emergency departments because there’s no room in the hospitals and they’re dying in the back of ambulances.
    Read full story
    Source: Belfast Times, 8 June 2022
  21. Patient Safety Learning
    Admissions of people to hospital with Covid in England have begun to grow again, new data from the NHS shows, as fears were raised over a new wave.
    Analysis by John Roberts of the Covid Actuaries group, set up in response to the pandemic, showed hospital admissions had stopped falling after a period of decline.
    Figures on Tuesday showed weekly admissions increased by 4% across England as of 5 June and were up by 33% in the North East and Yorkshire.
    When asked if the UK was heading into another wave, Mr Roberts told The Independent: “Yes we could be but...how big that wave and how serious it will be in terms of admissions and deaths is very, very difficult to judge at this stage.”
    His comments come after experts in Europe warned there will be a new wave driven by the growth of the BA.5 and BA.4 Covid variants.
    The figures, which cover hospitals in England only, show the weekly average of admissions for patients in hospital with Covid stood at 531 as of 5 June.
    Read full story
    Source: The Independent, 9 June 2022
  22. Patient Safety Learning
    Leading doctors say they have concerns about the NHS reducing mentions of the word "women" in ovarian cancer guidance.
    They say "it may cause confusion" and create barriers to care.
    But NHS Digital, which writes the online advice, said they wanted to make it relevant for everyone who needs it.
    The updated guidance now says that people with ovaries, such as trans men, can also be affected.
    Until February, the NHS guidance began by explaining ovarian cancer was "one of the most common types of cancer for women". Now, the only specific mention of women comes on the third page with the explanation that ovarian cancer can affect "women, trans men, non-binary people and intersex people with ovaries".
    NHS Digital said the changes were introduced to make the advice more relevant and inclusive. 
    The Royal College of Obstetricians and Gynaecologists, which represents thousands of women's health specialists and pregnancy doctors, said the language used "does need to be appropriate, inclusive and sensitive to the needs of individuals whose gender identity does not align with the sex they were assigned at birth".
    But it added: "Limiting the term 'woman' to one mention may cause confusion and create further barriers for some women and people trying to make an informed choice about their care.
    "We would therefore support the use of the word 'woman' alongside inclusive language."
    Read full story
    Source: BBC News, 8 June 2022
  23. Patient Safety Learning
    The Care Quality Commission (CQC) has issued a trust with a warning notice following an inspection that found wards did not have enough staff to care for patients.
    Staff at York hospital told inspectors they were not able to interact with individual patients and cater to their needs, with one saying: “We have to choose, do we turn, check, and make sure all patients are not soiled, or do we fully wash ten? Some of these patients haven’t been washed for two to three days.” 
    York and Scarborough Teaching Hospitals CEO Simon Morritt said: “Many of the issues raised by the CQC were known to us, and reflect the extreme pressures facing the trust, the demands of covid and associated staff absence, and the well-documented recruitment challenges. The report demonstrates that, when faced with these pressures, it is not always possible to give the standard of care we would want for all of our patients all of the time.”
    The CQC said there were “significant safety concerns about fundamental standards of patient care” at the hospital. 
    “The service didn’t have enough nursing staff with the right skills, training and experience to keep patients safe and to provide the right care and treatment,” said Sarah Dronsfield, the CQC’s head of hospital inspection. “It was disappointing that managers didn’t regularly review the situation and change the staffing arrangements to accommodate this.”
    Read full story (paywalled)
    Source: HSJ, 9 June 2022
  24. Patient Safety Learning
    All the NHS’s 1.5m staff in England should tackle discrimination against disadvantaged groups, not just bosses and specialist diversity teams, a major review has concluded.
    NHS trusts will need fewer equality, diversity and inclusion (EDI) teams if action against discrimination does become “the responsibility of all”, according to the report.
    The review of NHS leadership said the health service should adopt a different approach to equality issues in order to overcome the widely recognised disadvantages faced by certain groups of its own staff, which include lower pay and chances of promotion among Black and ethnic minority doctors compared with white medics and low BAME representation in senior managerial ranks.
    The inquiry, undertaken by Genl Sir Gordon Messenger and Dame Linda Pollard, was commissioned last year by Sajid Javid, the health secretary.
    The report concluded that: “Most critically, we advocate a step-change in the way the principles of equality, diversity and inclusion are embedded as the personal responsibility of every leader and every member of staff.
    “Although good practice is by no means rare, there is widespread evidence of considerable inequity in experience and opportunity for those with protected characteristics, of which we would call out race and disability as the most starkly disadvantaged.
    “The only way to tackle this effectively is to mainstream it as the responsibility of all, to demand from everyone awareness of its realities and to sanction those that don’t meet expectations.”
    Read full story
    Source: The Guardian, 8 June 2022
  25. Patient Safety Learning
    When Jenny* had a mastectomy after being diagnosed with breast cancer, she believed the major surgery to remove her breast, although traumatic, had saved her life.
    She described feeling “rage” when at a follow-up appointment three years later, she said to her surgeon, “I would probably be dead by now” if she had not received the surgery, to which he replied: “Probably not.”
    It was only then, after she had already undergone invasive and life-changing treatment, that Jenny learned about “overdiagnosis”.
    While breast cancer screening programs are essential and save lives, sometimes they also detect lumps that may never go on to cause harm in a woman’s lifetime, leading to overtreatment, and psychological and financial suffering.
    Jenny is 1 of 12 women from the UK, US, Canada and Australia whose stories were published in the medical journal BMJ Open. It is the first study to interview breast cancer patients who believe they may have received unnecessary and harmful treatment, highlighting the effect this has had on their lives.
    “The usual story of breast cancer screening is ‘screening saves lives’,” an author of the study and a professor of public health at the University of Sydney in Australia, Alexandra Barratt, said.
    “This study reports the other side of the story – how breast cancer screening can cause harm through overdiagnosis and overtreatment.”
    Read full story
    Source: The Guardian, 8 June 2022

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