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Patient Safety Learning

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  1. Patient Safety Learning
    Proposals for primary care networks to evolve into more collaborative “integrated neighbourhood teams” to improve access to care have been broadly welcomed.
    A “stocktake” report commissioned by NHS England, published on 26 May, called for urgent same day appointments to be dealt with by “single, urgent care teams” for every neighbourhood with greater use of a range of health and social care professionals. 
    The report, written by Claire Fuller, a general practitioner and chief executive of Surrey Heartlands Integrated Care System, undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looks at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
    Doctors’ leaders welcomed many of the report’s recommendations but emphasised that they could only work if the government resourced primary care practices better and tackled workforce shortages.
    Read full story (paywalled)
    Source: BMJ, 27 May 2022
  2. Patient Safety Learning
    Emergency doctors in Scotland are “dreading” the Queen’s Jubilee weekend as fears grow that the public holiday will add to long patient queues.
    One accident and emergency consultant has pleaded with patients to be considerate to NHS staff as they deal with long backlogs at a time when other workers will be on holiday.
    Calvin Lightbody, at Hairmyres Hospital in Lanarkshire, said that the GP out-of-hours service in his region had been so short-staffed they had to send patients to A&E instead of treating the people themselves, adding to the delays in hospitals.
    He said a four-day bank holiday weekend, when doctors’ surgeries will be shut, threatened to add to the pressure on “creaking” services.
    “If you go to A&E you are going to have a very long wait to be seen, several hours probably,” he said. “Please be kind. Our staff are working extremely hard, they are flat out, they are exhausted, they are doing their best.” He appealed to patients not to delay seeking medical attention if they were seriously unwell including those suffering chest pain, heavy bleeding and stroke symptoms even though services were “overwhelmed”.
    Read full story
    Source: The Times, 1 June 2022
  3. Patient Safety Learning
    The death of a retired police officer who got his head trapped in a hospital bed was an avoidable accident, an inquest has concluded.
    Max Dingle, 83, of Newtown, Powys, died after he became stuck between the rails and mattress at the Royal Shrewsbury Hospital on 3 May 2020.
    The initial post-mortem test gave the cause of death as heart disease.
    But a second examination, commissioned by Mr Dingle's son, found entrapment and asphyxiation to be the cause.
    After comparing and discussing their findings, both pathologists then agreed "entrapment did play a significant part in the cause of death", the senior coroner for Shropshire John Ellery said.
    The inquest was told Mr Dingle's son Phil had asked for the second post-mortem test because "did not accept" the initial findings and had sought the opinion of a pathologist in Australia, where he lives.
    Max Dingle, who had been admitted to the hospital with shortness of breath, died 15 minutes after he was found to be trapped, the hearing was told.
    Concluding the inquest, Mr Ellery said: "Based on all the evidence, the conclusions of this inquest are Mr Dingle's death was an avoidable accident."
    Read full story
    Source: BBC News, 1 June 2022
  4. Patient Safety Learning
    Women could be screened for cervical cancer every five years instead of every three and as many cancers could still be prevented, a new study suggests.
    Researchers at King’s College London said that screening women aged 24 to 49 who test negative for human papillomavirus (HPV) at five-year intervals prevented as many cancers as screening every three years.
    The study of 1.3 million women in England, published in the BMJ, found that women in this age group were less likely to develop clinically relevant cervical lesions, abnormal changes of the cells that line the cervix known as CIN3+, and cervical cancer three years after a negative HPV screen compared to a negative smear test.
    Lead author Dr Matejka Rebolj, senior epidemiologist at King’s College London, said the results were “very reassuring”.
    She added: “They build on previous research that shows that following the introduction of HPV testing for cervical screening, a five-year interval is at least as safe as the previous three-year interval.
    “Changing to five-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.”
    Read full story
    Source: The Independent, 31 May 2022
  5. Patient Safety Learning
    The number of people suspected to be living with Long Covid has risen to a record high of two million, new figures show.
    Estimates from the Office for National Statistics (ONS) suggest that, as of 1 May, around 3.1% of the population were suffering from persistent symptoms after becoming infected with coronavirus.
    This includes 826,000 who have had Long Covid for at least one year – up from 791,000 in April. Some 376,000 people have meanwhile lived with the condition for at least two years, the figures show.
    The prevalence of Long Covid in the UK has jumped sharply since the end of the Omicron wave, which infected millions of people over winter. Since the beginning of the year, 700,000 people have developed the condition – more than one-third of the overall total.
    Lingering symptoms adversely affected the day-to-day activities of 1.4 million people, the ONS said, with 398,000 reporting that their ability undertake day-to-day activities had been “limited a lot”.
    Long Covid was found to be most prevalent in people aged 35 to 69 years, women, people living in more deprived areas, those working in healthcare, social care, or teaching and education, and those with another activity-limiting health condition or disability, the ONS said.
    Read full story
    Source: The Independent, 1 June 2022
  6. Patient Safety Learning
    Criminal acts of violence at GP surgeries across the UK have almost doubled in five years, new figures reveal, as doctors’ leaders warn of a perfect storm of soaring demand and staff shortages.
    Police are now recording an average of three violent incidents at general practices every day. Staff are facing unprecedented assaults, abuse and aggression by patients, with surgeries struggling to cope with “unmanageable levels of demand” after years of failure to recruit or retain sufficient numbers of family doctors.
    Security measures such as CCTV, panic buttons and screens at reception are now increasingly being rolled out across GP surgeries, the Guardian has learned, with senior medics claiming ministers perpetuate a myth that services are “closed”.
    Last night, Britain’s two most senior doctors condemned the wave of violence and called for urgent action to finally resolve the workforce crisis.
    “It is unacceptable that GPs and their staff are afraid and at risk of being verbally or physically abused, when they are working amid exceptional pressures and striving to do their best for patients,” said Dr Chaand Nagpaul, chair of the British Medical Association. “GP practices are facing unmanageable levels of demand with 2,000 fewer GPs than in 2015.”
    He added it was “no surprise” that patients were struggling to get appointments because of the national “lack of capacity” and “lack of historic investment in general practice”.
    Read full story
    Source: The Guardian, 31 May 2022
  7. Patient Safety Learning
    A Bristol woman says her life has 'never been the same' since receiving unnecessary operations on her bowel more than ten years ago.
    Following a recent review, Mandy Giltrow is one of more than 200 patients who received a mesh bowel procedure - which she says may not have been needed.
    The operations were all conducted by surgeon Tony Dixon who has been sacked by the North Bristol NHS Trust.
    Mandy Giltrow underwent a mesh bowel procedure which was performed by Mr Dixon at Frenchay Hospital in April 2011.
    Following the surgery her symptoms continued. Following follow up appointments Mandy, a mum-of-four, underwent a further procedure in April 2013.
    Mr Dixon carried out a further operation in October 2014 at Spire Bristol to replace mesh.
    However Mandy, who is 49 and lives in Staple Hill, continues to suffer issues including stomach and bowel pain as well as recurrent water infections. She also has a hernia near her surgery scars.
    North Bristol NHS Trust has since admitted liability.
    Mandy told ITV West Country: "I got anxiety for all the different operations I had and then I physically could not do anything. I was stuck for three months in a bubble."
    "I couldn't go out, I couldn't do anything with my children not even take them to school."
    Mandy says her mental health was badly affected by the operations leading to a nervous breakdown and agoraphobia, meaning she could not lead the house.
    "You have an operation. It doesn't resolve the original problem and now you have another problem which is twice as bad."
    Read full story
    Source: ITV, 30 May 2022
  8. Patient Safety Learning
    The NHS has lost almost 25,000 beds across the UK in the last decade, according to a damning report  says the fall has led to a sharp rise in waiting times for A&E, ambulances and operations.
    The Royal College of Emergency Medicine said the huge loss of beds since 2010-11 was causing “real patient harm” and a “serious patient safety crisis”. At least 13,000 more beds are urgently needed, it added, in order to tackle “unsafe” bed occupancy levels and “grim” waiting times for emergency care and handover delays outside hospitals.
    Patients are increasingly “distressed” by long waiting times, the college said, as are NHS staff who face mounting levels of burnout, exhaustion and moral injury. The UK has the second lowest number of beds per 1,000 people in Europe at 2.42 and has lost the third largest number of beds per 1,000 population between 2000 and 2021 (40.7%), the report said.
    There are currently 162,000 beds in the NHS across the UK, according to the college.
    “The situation is dire and demands meaningful action,” said Dr Adrian Boyle, the college’s vice-president. “Since 2010-11 the NHS has lost 25,000 beds across the UK, as a result bed occupancy has risen, ambulance response times have risen, A&E waiting times have increased, cancelled elective care operations have increased.
    “These numbers are grim,” Boyle added. “They should shock all health and political leaders. These numbers translate to real patient harm and a serious patient safety crisis. The health service is not functioning as it should and the UK government must take the steps to prevent further deterioration in performance and drive meaningful improvement, especially ahead of next winter.”
    Read full story
    Source: The Guardian, 31 May 2022
  9. Patient Safety Learning
    It may take seven years to get NHS Wales waiting lists of 700,000 back to 2020 levels, Wales' auditor general has said.
    The number of patients waiting for non-urgent treatment has doubled since February 2020, just prior to the Covid pandemic.
    They include Patient Michael Assender, 74, who has spent two years on a waiting list with severe back pain. After struggling with his back, Mr Assender, from Cwmbran, Torfaen, paid £1,500 for a private scan, which revealed he had two slipped discs.
    "At the moment I'm coping pretty well, taking pills for the pain and trying to stay active," he said. "But something that took me half hour before now takes an hour."
    Mr Assender said he knew others waiting for surgery who had become depressed and considered taking their lives, adding: "A lot of people out there are in a constant pain and I do pity them."
    "It's a dire situation really."
    The Welsh government said it had a plan to deal with backlogs.
    But Wales' Auditor General Adrian Crompton said: "Just as the NHS rose to the challenge of the pandemic, it will need to rise to the challenge of tackling a waiting list which has grown to huge proportions."
    "Concerted action is going to be needed on many different fronts, and some long-standing challenges will need to be overcome."
    Read full story
    Source: BBC News, 31 May 2022
     
  10. Patient Safety Learning
    A lack of diabetes checks following the first Covid lockdown may have killed more than 3,000 people, a major NHS study suggests.
    Those with the condition are supposed to undergo regular checks to detect cardiac problems, infections and other changes that could prove deadly.
    But researchers said a move to remote forms of healthcare delivery and a reduction in routine care meant some of the most crucial physical examinations did not take place during the 12 months following the first lockdown.
    Experts said the findings showed patients had suffered “absolutely devastating” consequences and were being “pushed to the back of the queue”.
    The study, led by Prof Jonathan Valabhji, the national clinical director for diabetes and obesity, links the rise in deaths to a fall in care the previous year.
    It showed that, during 2020/21, just 26.5% of diabetes patients received their full set of checks, compared with 48.1% the year before.
    Those who got all their checks in 2019-20 but did not receive them the following year had mortality rates 66% higher than those who did not miss out, the study, published in Lancet Diabetes and Endocrinology, found.
    The study shows that foot checks, which rely on physical appointments, saw the sharpest drop, falling by more than 37%.
    “The care process with the greatest reduction was the one that requires the most in-person contact – foot surveillance – possibly reflecting issues around social distancing, lockdown measures, and the move to remote forms of healthcare delivery,” the study found. Those in the poorest areas were most likely to miss out.
    Read full story (paywalled)
    Source: The Telegraph, 30 May 2022
  11. Patient Safety Learning
    "It's isolating, debilitating and you feel dirty."
    Too many women have to cope with bowel incontinence from injuries during childbirth, according to one charity.
    Anna Clements, from Masic, said stigma and a lack of information meant women were unaware of the medical support available.
    The Welsh government said a plan would be published in the summer on how health boards should provide "high-quality women's health services".
    A coalition of charities said this was one of a number of ways women experience poor health outcomes.
    Women need to be listened to and not just dismissed and told 'this happens with birth - just get on with it'," added Ms Clements.
    Masic supports women who have experienced anal sphincter injuries - an issue which carries so much stigma that few will speak to anyone about their symptoms.
    Julie Cornish, a colorectal surgeon, was instrumental in setting up a hub which helps patients with pelvic organ prolapse, incontinence and bowel dysfunction.
    "These are really common conditions - they mainly affect women, but can affect men as well," she said.
    Clinics for things such as bowel, bladder or gynaecological issues are held simultaneously in the hub, based at Barry Hospital, Vale of Glamorgan. This means patients can get immediate advice from different specialists without joining separate waiting lists which cuts waiting times significantly.
    Ms Cornish acknowledged the numbers currently seeking help were "the tip of the iceberg" because of the stigma.
    Read full story
    Source: BBC News, 28 May 2022
  12. Patient Safety Learning
    Close contacts of people infected with monkeypox have criticised health officials for a lack of communication and support while they have to isolate.
    Public health experts and scientists have said the government needs to offer financial support to people forced to self-isolate for 21 days, as it emerged that one local council has already stepped in to provide sick pay for an infected man who could not work from home and was told he would not be paid.
    With cases of monkeypox on the rise in the UK – 106 were infections detected as of Friday – it’s thought hundreds of people have been told to self-isolate since the beginning of May.
    The UK Health Security Agency (UKHSA) said it was providing daily calls for infected individuals and close contacts to offer support.
    However, one man from Leicester, whose housemate contracted monkeypox after visiting Gran Canaria pride festival, described UKHSA’s handling of his case as a “farce”, saying he has waited days for instruction from officials.
    “They couldn’t provide any meaningful or helpful information and nothing about housemates or close contacts,” the housemate told The Independent.
    The World Health Organisation (WHO) has meanwhile said countries should take quick steps to contain the spread of monkeypox and share data about their vaccine stockpiles.
    Read full story
    Source: The Independent, 29 May 2022
  13. Patient Safety Learning
    "I shouldn't have to work out my escape route when I walk into a property."
    Paramedic Joanna Paskell was a victim of one of the near-3,000 attacks on emergency workers in Wales last year.
    The patient who punched her got a 12-month community order, but it left the 45-year-old suffering with anxiety and meant she was off work for four months.
    "It took four security guards to calm her down so she could be treated," said Mrs Paskell, who has worked with the ambulance service for more than 25 years.
    She said at first she tried to laugh it off, but it was only when getting ready for her next shift, five days later, that she felt the emotional toll.
    "All I want to do is make a difference - that's why I joined this job. We can't do that if we're working in fear of our own safety."
    Last year there were 2,838 assaults against police officers, firefighters, ambulance staff, NHS workers and prison staff - a 4.9% rise.
    Read full story
    Source: BBC News, 30 May 2022
  14. Patient Safety Learning
    A London hospital has launched an investigation after a woman whose baby died in the womb had to deliver her son at home due to lack of beds and keep his remains in her fridge when A&E staff said they could not store them safely.
    Laura Brody and her partner, Lawrence, said they were “tipped into hell” after being sent home by university hospital Lewisham to await a bed when told their baby no longer had a heartbeat but no beds were immediately available to give birth, the BBC reported.
    Two days later, after waking up in severe pain, Brody, who was four months into her pregnancy, gave birth in agony on the toilet in their bathroom. “And it was then,” she told the broadcaster, “I saw it was a boy”.
    The couple, who wanted investigative tests to be carried out at a later time, dialled 999 but were told it was not an emergency. They wrapped their baby’s remains in a wet cloth, placed him in a Tupperware box, and went to A&E where they were told to wait in the general waiting room, they said.
    She was eventually taken into a bay and told she would require surgery to remove the placenta. But, with the waiting room hot and stuffy and staff refusing to store the remains or even look inside the Tupperware box, they decided as it got to midnight they had no option but for her partner to take their baby’s remains home.
    Brody said the whole experience “felt so grotesque”.
    “When things go wrong with pregnancy there are not the systems in place to help you, even with all the staff and their experts – and they are working really hard – the process is so flawed that it just felt like we had been tipped into hell,” she told Radio 4’s Today programme.
    The case is said to have raised wider concerns among campaigners who argue that miscarriage care needs to be properly prioritised within hospitals including A&E.
    Read full story
    Source: The Guardian, 30 May 2022
  15. Patient Safety Learning
    A study conducted by NHS Education for Scotland and Health Improvement Scotland found patients felt safer by having someone listen to their experiences after adverse events.
    The findings were published in the BMJ and have been positively received by NHS boards across the country.
    Healthcare Improvement Scotland’s Donna Maclean said: “The compassionate communications training has seen an unprecedented uptake across NHS boards in Scotland, with the first two cohorts currently under way and evaluation taking place also.”
    Clear communication and a person-centred approach was seen as being central to helping those who have suffered from traumatic events.
    Researchers found many said their faith was restored in the healthcare system if staff showed compassion and active engagement.
    This approach is likely to enhance learning and lead to improvements in healthcare.
    Health boards were advised that long timelines can have a negative impact on the mental health of patients and their families.
    Rosanna from Glasgow, who was affected by an adverse event, said: “I believe this study and its findings are crucial to truly understanding patients and families going through adverse events.
    “Not only does the study capture exactly what needs to change, but it also highlights the elements that are most important to us: an apology and assurance that lessons will be learnt is all we really want.
    Read full story
    Source: The National, 30 May 2022
  16. Patient Safety Learning
    An ambulance trust has been accused of acting like a “criminal gang” and lying to dead patients’ families by an employee who repeatedly warned about paramedics’ mistakes being covered up.
    Paul Calvert, a coroner’s officer whose job was to produce reports on deaths, tried to raise concerns about managers at the North East Ambulance Service (NEAS) for three years before walking out last year on the verge of a breakdown.
    “My life was being made a misery,” said Calvert, who was previously a detective with Northumbria police. “They were basically like a criminal gang. I had tried everything I could to warn the proper authorities about how the service was destroying and concealing evidence meant for the coroner. I spoke to my managers, to human resources, to external auditors. I even made disclosures to the Care Quality Commission and Northumbria police. Nothing was done about it.”
    Despite their denials of a large-scale cover-up of mistakes, the NEAS this year offered Calvert £41,000 as part of a non-disclosure agreement it asked him to sign. One of the clauses meant destroying all the evidence he had collected. Another tried to stop him making any further disclosures to police.
    Reports and witness statements from ambulance staff were not being disclosed to the coroner “on a daily basis”, according to Calvert, amounting to key pieces of evidence relating to deaths being hidden from the public.
    Read full story (paywalled)
    Source: The Times, 29 May 2022
  17. Patient Safety Learning
    ECRI, the nation's largest patient safety organization, announces its unity with the United States' top safety experts in calling for a total systems approach to safety, a theme that was the central focus at the May 2022 Institute for Healthcare Improvement (IHI) Patient Safety Congress.
    During its annual convening of national safety leaders, IHI leadership announced its Declaration to Advance Patient Safety, an initiative focused on addressing safety from a total systems approach, as presented in the 2020 National Action Plan to Advance Patient Safety.
    "As a member of the National Steering Committee for Patient Safety that created the National Action Plan to Advance Patient Safety, ECRI fully supports this renewed call to action as outlined in the recent Declaration," states Chief Medical Officer Dheerendra Kommala, MD.  "ECRI, the most trusted voice in healthcare, is in a unique position to deliver a comprehensive, robust solution that reduces preventable harm."
    ECRI's total system approach to advancing safety includes the design and implementation of a proactive, coordinated strategy to establish healthcare safety processes that impact patients, families, visitors, and healthcare workers across the continuum of care.
    Read full story
    Source: CISION, 26 May 2022
  18. Patient Safety Learning
    Three trusts have lost out on more than £1m in rebate from the maternity clinical negligence scheme (CNST) after they ‘mis-declared’ that they were compliant with safety requirements.
    University Hospitals Sussex Foundation Trust, University Hospitals Morecambe Bay FT and Doncaster and Bassetlaw FT have all received a small amount of funding to implement their action plans but a much larger rebate on the NHS Resolution maternity section of the clinical negligence scheme for trusts has been withheld.
    This amounted to a loss of close to half a million pounds for Doncaster and Bassetlaw and is likely to be more for the other two trusts, which had made bigger contributions to the maternity section of the CNST.
    Western Sussex had mis-declared its compliance on five safety actions, BSUH on seven, Doncaster and Bassetlaw on five and UHMB on seven.
    Read full story (paywalled)
    Source: HSJ, 26 May 2022
  19. Patient Safety Learning
    Dozens of patients died or suffered ‘severe harm’ after long waits for ambulances during a three-month period in a health system facing ‘extreme pressure’ on its emergency services.
    The 29 serious incidents in Cornwall included patients waiting many hours for assistance despite being in “extreme pain”, patients having suspected sepsis, patients in cardiac arrest, and patients experiencing a stroke.
    The incidents were reported to the Care Quality Commission by staff at South Western Ambulance Service Foundation Trust during an inspection of the Cornwall integrated care system’s urgent and emergency care services.
    According to the CQC, the pressures on the ambulance service were “unrelenting”, while “significant work” was needed to “alleviate extreme pressure”.
    This meant there was a “high level of risk to people’s health when trying to access urgent and emergency care in the county”, the report said.
    Read full story (paywalled)
    Source: HSJ, 27 May 2022
  20. Patient Safety Learning
    Donna Ockenden, the midwife who investigated the Shopshire maternity scandal, has been appointed to lead a review into failings in Nottingham following a dogged campaign by families.
    The current review will be wound up by 10 June after concerns from NHS England and families that it is not fit for purpose.
    It was commissioned after revelations from The Independent and Channel Four News that dozens of babies had died or been brain-damaged following care at Nottingham University Hospitals Foundation Trust.
    In a letter to families on Thursday, NHS England chief operating officer David Sloman said: “I want to begin by apologising for the distress caused by the delay in our announcing a new chair and to take this opportunity to update you on how the work to replace the existing Review has been developing as we have taken on board various views that you have shared with us.”
    “After careful consideration and in light of the concerns from some families, our own concerns, and those of stakeholders including in the wider NHS that the current Review is not fit for purpose, we have taken the decision to ask the current Review team to conclude all of their work by Friday 10 June.”
    “We will be asking the new national Review team to begin afresh, drawing a line under the work undertaken to date by the current local Review team, and we are using this opportunity to communicate that to you clearly.”
    Ms Ockenden said: “Having a baby is one of the most important times for a family and when women and their babies come into contact with NHS maternity services they should receive the very best and safest care."
    “I am delighted to have been asked by Sir David Sloman to take up the role of Chair of this Review and will be engaging with families shortly as my first priority. I look forward to working with and listening to families and staff, and working with NHS England and NHS Improvement to deliver a Review and recommendations that lead to real change and safer care for women, babies and families in Nottingham as soon as possible.”
    Read full story
    Source: BBC News, 26 May 2022
  21. Patient Safety Learning
    More than 200 women were harmed when a rogue surgeon carried out operations on them unnecessarily, an NHS inquiry has found.
    Some of the women were left with life-changing physical problems or unable to work, while many also suffered trauma and serious psychological harm as a result.
    Overall, 203 women on whom Anthony Dixon performed procedures between 2007 and 2017 came to harm, according to a review by the North Bristol NHS trust (NBT). Dixon, who for years was Britain’s most influential pelvic surgeon, worked for both the trust and the private Spire hospital in the city.
    In 2017, NBT launched a review of Dixon’s performance and suspended him after dozens of women he had performed procedures on complained that they had experienced appalling consequences, including unmanageable pain and incontinence. The Guardian revealed in late 2017 that 100 women were suing him for medical negligence. Some cases have since been settled, but dozens are ongoing.
    NBT sacked Dixon in 2019 and he is currently banned from practising in the UK.
    During the review, 378 women were recalled and asked to set out their dealings with Dixon. All had undergone a procedure called laparoscopic ventral mesh rectopexy (LVMR), in which plastic mesh is inserted to repair weakened tissue in the pelvic floor.
    In papers presented to NBT’s board on Thursday, board members were told that the inquiry had concluded. “The trust has notified 203 NHS patients that, although their LVMR operation was carried out satisfactorily, they should have been offered alternative treatments before proceeding to surgery. We have defined these patients as suffering ‘harm’ as a result,” it said.
    Read full story
    Source: The Guardian, 26 May 2022
  22. Patient Safety Learning
    The UK government failed in its duty of care to protect doctors and other healthcare staff from avoidable harm and suffering in its management of the covid-19 pandemic, a major review by the BMA has concluded.
    Two reports published on 19 May document the experiences of thousands of UK doctors throughout the pandemic, drawing on real time surveys carried out over the past two years, formal testimonies, data, and evidence sessions. The reports will form part of a wider review by the BMA into the government’s handling of the pandemic, with three further instalments to come.
    The evidence lays bare the devastating impact of the pandemic on doctors and the NHS, with repeated mistakes, errors of judgment, and failures of government policy amounting to a failure of a duty of care to the workforce, the BMA said.
    Chaand Nagpaul, BMA chair of council, said, “A moral duty of government is to protect its own healthcare workers from harm in the course of duty, as they serve and protect the nation’s health. Yet, in reality, doctors were desperately let down by the UK government’s failure to adequately prepare for the pandemic, and their subsequent flawed decision making, with tragic consequences.
    “The evidence presented in our reports demonstrates, unequivocally, that the UK government failed in its duty of care to the medical profession.”
    Read full story
    Source: BMJ, 19 May 2022
  23. Patient Safety Learning
    The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a national patient safety alert for the NovoRapid PumpCart prefilled insulin cartridge and the Roche Accu-Chek Insight Insulin pump system following concerns raised about cracked cartridges and insulin leaks.
    Patients are being asked to check the pre-filled glass insulin cartridge for cracks prior to use. The cartridge should not be used if it has been dropped even if no cracks are visible. Closely follow the updated handling instructions in the pump user manual when changing pre-filled glass insulin cartridges.
    The device, which releases the insulin your body needs through the day and night, comprises a pump, tube, battery and a pre-filled glass insulin cartridge. In some of the reported leakage incidents, the cartridges were found to be cracked and provided an inadequate supply of insulin to patients. However, leakages also occurred in cases where no cracks in the cartridge were visible. In some patients there were consequences of not receiving enough insulin from their pump system, including reports of severely high blood sugar and diabetic ketoacidosis (a serious complication of diabetes when the body produces high levels of blood acids called ketones).
    Health care professionals are being advised to contact patients over the next six months using said device to discuss their individual needs and source an alternative pump where appropriate.
    Key patient recommendations are:
    Check the pump and cartridge regularly for damages, for example cracks or leakage. If you smell insulin (a strong antiseptic chemical smell) this could also indicate a leakage. Do not use the cartridge if cracks or leakage are seen or if the cartridge was dropped. Follow the instructions of your Accu-Chek Insight user manual for replacing a cartridge and for cleaning the cartridge compartment in the insulin pump. During the day and before going to sleep please carefully check that your insulin pump is delivering insulin and there are no leakages. Never change treatment delivery methods without first consulting a relevant healthcare professional. Failure of insulin delivery due to leakage may not result in an alert notification from the insulin pump and cracks and leakages may not always be visible. You should check blood glucose levels multiple times throughout your day whilst using pumps. Tell your healthcare professional immediately if you suspect a problem with your insulin delivery. Read full story
    Source: Gov.UK, 26 May 2022
  24. Patient Safety Learning
    Waiting times for outpatient appointments, hospital procedures, emergency care, GPs and community health services have all hit record levels in Northern Ireland, with health care staff and patients declaring it the "worst ever" crisis to hit health services in the region.
    The impact of the COVID-19 pandemic, ever-growing patient demand, staff shortages, and the failure to put together a new Executive government following the recent Northern Ireland elections are being cited as the key drivers of the crisis, with health care staff now at breaking point.
    Speaking to Medscape UK, British Medical Association Northern Ireland (BMA NI) council chair Dr Tom Black said the current crisis in Northern Ireland's health services essentially boils down to "workload and workforce" issues.
    Waiting lists to access hospital appointments in Northern Ireland were already long before COVID-19, but the pandemic has significantly exacerbated the situation, he noted. Northern Ireland has the worst waiting lists in the UK, with more than 350,000 people currently waiting for a consultant-led appointment – more than half of them waiting over a year, with many waiting two, three, and even more years for an appointment.
    "We're now heading towards nearly 400,000 on hospital waiting lists, which is a huge number when you consider that is one-in-five of the total population," Dr Black commented.
    This week a judicial review is due to get underway at the High Court in Belfast after two patients initiated a legal case against the health services over excessive waiting times for access to care. One of the women has been waiting over five years to see a neurologist after being referred by her GP for suspected multiple sclerosis. The case is seeking a judicial declaration that the length of the waiting lists are unlawful and breached their human rights.
    Read full story
    Source: Medscape UK, 24 May 2022
  25. Patient Safety Learning
    The former health secretary Jeremy Hunt has claimed the government snubbed bereaved families’ requests for Donna Ockenden to chair a review into maternity services in Nottingham as she is “too independent”.
    Hundreds of families involved in the Nottingham maternity scandal review have called for Ms Ockenden, chair of the Shrewsbury maternity scandal inquiry, to take over the investigation.
    NHS England had attempted to appoint a former healthcare leader, Julie Dent to chair the review. However, following pressure from families not to accept, Ms Dent announced shortly after she would be declining the role.
    Following the families’ calls for Ms Ockenden, Mr Hunt, chair of the government’s health committee, said on Wednesday: “I can’t see any other barriers to appointing her but sounds like she still won’t be. For some reason the Department of Health appears to think she is too independent – which is of course precisely why Nottingham families do have confidence in her. It feels like another own goal.”
    Families involved in the Nottingham maternity review, which will now cover almost 600 cases, have said they’ve been left in limbo by NHS England after if informed them of an interim report which has been completed by the review team.
    This follows several letters from families to health secretary Sajid Javid raising concerns over the review and calls for it to be overhauled.
    Speaking with The Independent, a couple whose son died under the care of Nottingham University Hospitals Foundation Trist said: “The key to successful long term change is developing a relationship with harmed families, built on trust, sensitivity and understanding. The current review does not command this. The relationship is untenable.”
    Read full story
    Source: The Independent, 26 May 2022

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