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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    The National Deaf Children’s Society has written to every NHS trust in England urging them to start using transparent face masks because standard ones create a “serious communication barrier” for deaf patients. The letters, co-signed by the British Academy of Audiology, said deaf patients could “miss vital information about their health” as opaque masks make lip reading impossible and facial expressions difficult to read. It is likely that face masks will remain widespread in the NHS, as new guidance issued at the start of June states they will still be required in a number of settings, including cancer wards and critical care units, and staff may wear them in other areas depending on personal preference and local risk assessments. Susan Daniels, the chief executive of the National Deaf Children’s Society, said: “Transparent face masks are fully approved and they could transform the healthcare experience for deaf people. However they communicate, almost all deaf people rely on lip reading and facial expressions. Opaque face masks make these techniques much more difficult and this could seriously affect communication at a time when they might need it the most.” Three types of transparent masks, designed not to fog up, are now approved for use as PPE in healthcare settings, and although they are not currently available on the NHS supply chain, they can be bought direct from suppliers. The government previously delivered 250,000 clear masks to frontline NHS and social care workers in September 2020. Read full story Source: The Guardian, 15 June 2022
  2. News Article
    The number of children being treated at paediatric diabetes units (PDUs) in England and Wales has increased by more than 50% amid a “perfect storm” of rising obesity levels and the cost of living crisis, health leaders have said. Diabetes UK said alarming obesity levels among children had led to a “concerning climb” in the number diagnosed with type 2 diabetes, and predicted that the cost of living crisis could lead to further problems in the years to come. Data from NHS Digital shows that almost one in seven children start primary school obese – a rise of almost 50% in just a year. More than a quarter are obese by the time they finish primary school. The high levels of obesity combined with the squeeze on personal finances are creating a “perfect storm which risks irreversible harm to the health of young people”, Diabetes UK said. It accused the government of “letting our children down” as it called for concerted action to tackle obesity. Chris Askew, the chief executive of Diabetes UK, said: “We are very concerned that this spike in childhood obesity will translate into an even greater increase in children with type 2 diabetes in the coming years, a crisis fuelled by longstanding health inequalities and made worse still by impacts of the cost of living crisis." Read full story Source: The Guardian, 15 June 2022
  3. News Article
    People with a worrying cough, problems swallowing or blood in their urine will soon be able to be referred for scans and checks by a pharmacist, rather than having to wait to see their GP. The new pilot scheme, in England, aims to diagnose more cancers early, when there is a better chance of a cure. High Street pharmacies will be funded to refer customers for the checks. The NHS will also send out more "roaming trucks" to perform on-the-spot scans in the community. Lung-scanner vans driven to locations, including supermarket car parks and football stadiums, have already resulted in more people having checks. Now, some liver lorries will join them. Health and Social Care Secretary Sajid Javid said: "Ensuring patients can access diagnosis and treatment easily in their communities and on High Streets is a fundamental part of our 10-Year Cancer Plan." Dr Anthony Cunliffe, national clinical adviser for primary care, at Macmillan Cancer Support, said: "Doctors and nurses are working tirelessly to diagnose and treat the tens of thousands of people entering a very busy cancer care system. "This pilot will give people the opportunity to access more trained professionals in their community to get symptoms investigated." Read full story Source: BBC News, 15 June 2022
  4. News Article
    A fifth patient has been given the wrong blood at a major teaching hospital’s haematology department where patient safety concerns were raised by clinicians last year. The incident, at University Hospitals Birmingham Foundation Trust, is the fifth never event involving patients being transfused with the wrong blood at the trust since April 2020. Only 15 such never events have been recorded in England in the last two financial years, which means UHB accounted for a third of the total in 2020-21 and 2021-22. HSJ revealed last year that several clinicians had raised safety concerns at the trust’s haematology specialty after most of its services at Heartlands Hospital were moved to Queen Elizabeth Hospital as part of the trust’s pandemic response. The latest never event, which occurred in March, saw a patient being given an “unintentional transfusion of ABO-incompatible blood components” – according to papers provided to the trust’s council of governors. Read full story (paywalled) Source: HSJ, 14 June 2022
  5. Content Article
    This masterclass, facilitated by Peter Walsh, Chief Executive Action against Medical Accidents (AvMA), and Carolyn Cleveland, Founder and Owner C & C Empathy Training Ltd, will provide participants with an in-depth knowledge of what needs to be done to comply with the duty of candour; clarify ‘grey areas’ and provide guidance on dealing with difficult situations which may arise. It will provide participants with an understanding of good practice in implementing the duty and, in particular doing so in a meaningful way with empathy, to not only comply, but to work with patients and loved ones in a way that puts the emotional experience at the heart of communication. Staff with responsibility for implementing the duty of candour and responsible for quality, safety, clinical governance, safety investigations, complaints or CQC compliance, patient experience and executive teams would benefit from attending this one day masterclass. For more information see the flyer attached. The next events are on the 18 July, 17 October and 12 December.
  6. News Article
    More than 380,000 patients waited more than 12 hours in A&E last year, new figures show, amid claims ‘misleading’ public data masks the true scale of the problem. A Royal College of Emergency Medicine report shows 381,991 people across 74 NHS trusts waited half a day or longer from the time they arrived at hospital in 2021. The figures are 14 times higher than the official numbers published by the NHS – which say 25,553 people waited more than 12 hours during the same period at the same trusts – due to the different ways waiting times are measured. While NHS England publishes data every month, it only shows how long patients have waited after a decision by doctors to admit them. Experts claim this is misleading and have called for the NHS to publish the figures from point of arrival instead. It comes after The Independent revealed leaked data in May, showing that more than 3,000 patients a day were regularly facing 12-hour waits in the first four months of 2022. Dr Adrian Boyle, RCEM vice president, said the new figures were “staggering” and “make clear that measuring 12-hour waits from decision to admit masks the reality facing patients and staff. Read full story Source: The Independent, 14 June 2022
  7. Event
    until
    This free webinar will explore near misses in three different sectors and how controls can, or cannot, be developed to prevent future events. It will start with an introduction to the concept of near misses in healthcare and the challenges faced in learning from these near misses to improve safety. You will then hear how near misses are approached in rail and nuclear and how controls are developed in their processes. At this event, you’ll: Gain valuable insights from all three sectors: healthcare, rail and nuclear. Hear discussion about defining near misses with respect to controls. Learn how to build barriers in systems. Who will this be of interest to? This webinar will be of interest to anyone involved in the management of safety events in their industry/ organisation, and especially human factors practitioners, safety investigators, policy leads and regulators. Register
  8. Content Article
    Emergency Department (ED) patient waiting times provide an important barometer for the wider pressures experienced in the NHS. There are currently alarming levels of crowding in our EDs, indicating that the health service is unable to meet the needs of patients with the current level of resource and capacity. In March 2022, for the first time in the history of the metric, the numbers of patients waiting 12-hours or more from decision to admit (DTA) exceeded 20,000. However the Royal College of Emergency Medicine (RCEM) argue that this number represents the tip of iceberg, as far greater numbers of patients experience extreme waits of 12 hours or more from their time of arrival. To investigate this issue further, RCEM carried out a Freedom of Information (FOI) request examining the extent of very long stays in EDs, with a particular focus on the numbers of patients waiting 12 hours or more from their time of arrival. They found that the current 12-hour data is a gross underrepresentation of the reality of patient waits, as it fails to capture the vast majority of patients who have no choice but to spend extended lengths of time in EDs. It additionally conceals the patients who are discharged home after very long stays. 
  9. News Article
    A whistleblower nurse who was sacked after warning that the workload on NHS staff had led to a patient’s death has been awarded hundreds of thousands of pounds. Linda Fairhall, who had an “unblemished” career as a nurse for almost 40 years, was suspended and then sacked in 2016 after raising concerns about patient safety. The 62-year-old nurse, from Billingham, has now been awarded a payout in excess of £462,000, her lawyers have said. It is thought to be a record for lost salary and remedies. Ms Fairhall had been a nurse at North Tees and Hartlepool NHS Trust. She started working with the NHS in 1979 and had been overseeing a team of about 50 district nurses in Hartlepool when she was suspended. In 2020, Ms Fairhall successfully challenged her employer's decision to dismiss her. Though the trust tried to appeal the decision last year, the appeal court found in her favour again – saying the tribunal had reached “an unimpeachable decision” that she was dismissed for whistleblowing. The trust says it is continuing to learn lessons and implement positive change. She said: "If it changes things for others then it will be worthwhile. I'm relieved it's over. Read full story Source: The Northern Echo, 14 June 2022
  10. News Article
    Health boards are avoiding publicising their Long Covid services to avoid a rush of patients, an expert has claimed. Edward Duncan, a professor of applied health research, has been evaluating rehabilitation services in Scotland for the past eight months. The latest ONS figures showed 155,000 Scots had long lasting Covid symptoms. Prof Duncan said the current situation was contributing to a "trickle" of patients accessing treatment in some regions. He is working with Robert Gordon University, the University of Dundee and Long Covid sufferers to work out the best way to maximise recovery and quality of life for patients. It comes after patient groups accused the health service and government ministers of pretending the illness has disappeared. Prof Duncan said: "Staff in some health boards have said to us that they are purposely not publicising the pathway, because they fear that if they do, they will have so many referrals that they will not be able to meet demand." "There is a lack of proactive publicity, despite the fact that in late 2020 every health board said that these services were there for patients who need them." "We know from other research that patients are going to primary care and being told by their GP that they don't know where to send them." Read full story Source: BBC News, 14 June 2022
  11. News Article
    NHS patients are being put in danger and waiting lists are getting even longer due to a £9bn maintenance backlog and a major lack of capital funding that has left some parts of hospitals “extremely dilapidated” and unfit for patients, health leaders have warned. Boris Johnson promised in 2019 to “build and fund 40 new hospitals”. But the Infrastructure and Projects Authority (IPA), the government watchdog, later gave the project an “amber/red” ranking, meaning its delivery “is in doubt with major risks or issues apparent in a number of key areas”. At the same time, the NHS in England is facing a £9bn maintenance backlog. Half of that sum, which is up from £6.5bn just three years ago, is required to tackle failings classed as posing either a “high” or “significant” risk to patients and staff. Now health leaders are warning that without an urgent injection of capital funding, patient safety is at risk and the waiting list for care – worsened by the pandemic – “will grow even larger”. Speaking to the Guardian, Matthew Taylor, the chief executive of the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland, said the crisis had become extremely serious. Patient safety as well as the ability of the NHS to tackle record waiting lists is being “severely hampered”, Taylor warned, because the UK has been “plagued” by one of the worst records for capital investment in healthcare across all OECD countries over the past decade. One NHS trust chair in London told a survey, carried out this month, that “cramped” space means the trust is not “building up our capacity to deal with waiting lists”, and conditions for patients in some wards were “not fit for purpose”. Read full story Source: The Guardian, 14 June 2022
  12. News Article
    Victims of breast surgeon Ian Paterson said independent inquiry improvements are not being implemented fast enough. Paterson was jailed in 2017 after he was found to have carried out needless operations on patients across Birmingham and Solihull. The 2020 report's recommendations include the recall of his 11,000 patients to assess their treatment. The Department of Health and Social Care (DHSC) said it is working to stop future patients facing similar harm. On Sunday, ITV screened a documentary 'Bodies of Evidence: The Butcher Surgeon' which featured victim and campaigner Debbie Douglas, who was instrumental in getting the inquiry established. She said the government needs "to put pace behind" the work to implement the 15 recommendations it made. "It is important those recommendations are embedded in legislation, it is important there is governance over those recommendations to stop another Paterson, it is important that there is a proper consent procedure," she said. The recommendations called for consultants to write directly to patients to explain proposed surgical treatment as standard practice, a public register to detail which types of operations surgeons are able to perform and for patients to be given time to reflect on their diagnosis and treatment options before they are asked to consent to surgery. Read full story Source: BBC News, 14 June 2022
  13. News Article
    Ministers, including the health and social care secretary, are bashing managers and exploiting the culture wars to try to ‘explain away’ the crisis in the NHS instead of facing up to the problems that 12 years of Conservative-led government have created, NHS Confederation chief executive Matthew Taylor has told HSJ. During a wide-ranging and exclusive interview with HSJ, MatthewTaylor also raised concerns about the Messenger review and called on local system leaders to speak out if they thought NHS England was setting unrealistic financial targets The Confed CEO told HSJ: “When you’ve been in government 12 years, to acknowledge the scale of the problems which now exist, problems which clearly reflect decisions made across those 12 years, is a hard thing to do politically. “If you can’t recognise that the fundamental reasons [underpinning why] we face this yawning capacity gap are to do with, particularly, the decade of austerity, but [also] other failings to address capacity issues like workforce and capital, then you have to look for other culprits and you end up manager bashing and talking about wokery, because it becomes a way to explain away the reality that the patients and the public see.” Read full story (paywalled) Source: HSJ, 14 June 2022
  14. News Article
    Patients who enter general practices in England no longer have to wear a face mask unless they have respiratory symptoms, NHS England and NHS Improvement says. But the updated guidance also underlines the importance of local risk assessments and says that increased measures can be used when deemed necessary. A letter sent to clinical commissioning groups and trusts set out the changes to infection prevention and control measures following updates from the UK Health Security Agency.1 It said that health and care staff should continue to wear face masks as part of personal protective equipment when working with patients with suspected or confirmed covid-19, including untriaged patients in primary care and emergency departments. It said that universal masking should be applied when there is a known or suspected cluster of SARS-CoV-2, for example during an outbreak or if new variants of concern emerge. Health and care staff working in non-clinical areas such as offices and social settings do not need to wear masks unless it is their personal preference or if there are specific problems raised by a risk assessment. Patients with respiratory symptoms who are required to attend for emergency treatment should wear a face mask, if tolerated, or be offered one on arrival. All other patients are “not required” to wear a face mask but can if they prefer. In settings where patients are at high risk of infection owing to immunosuppression, such as oncology or haematology, patients might be encouraged to wear a face mask after a local risk assessment. Read full story Source: BMJ, 13 June 2022
  15. Content Article
    This letter from NHS England and NHS Improvement sent to clinical commissioning groups and trusts set out the changes to infection prevention and control measures following updates from the UK Health Security Agency.
  16. News Article
    Doctors who worked on the frontline during the pandemic and have been left with long Covid say they have been denied financial support by the UK government, with some left with little option but to sell their house. Months or even years after an initial Covid infection some people continue to have symptoms, from fatigue to brain fog. According to the Office for National Statistics, as of 1 May an estimated 2 million people in the UK reported having long Covid, as the condition is known. Now healthcare staff in the UK have told the Guardian that despite being left with serious impairments as a result of long Covid, they have been turned down for personal independence payment (Pip), a non means-tested benefit helping people with the extra living costs of their chronic illness or disability. One respiratory consultant revealed they had been refused Pip despite reporting to the Department for Work and Pensions (DWP) that they had urinary incontinence, were unable to be on their feet for more than five to 10 minutes without a rest, and had difficulties preparing food, eating, washing, dressing or engaging with people face to face, among other problems. Speaking anonymously, as their application is under mandatory reconsideration, the consultant said they contracted Covid while working on a coronavirus ward in November 2020 and first applied for Pip in June 2021 after developing long Covid, which has left them unable to work. “I thought that I had illustrated quite clearly what my disability was,” they said. “When I got the report back, I thought ‘is this about me?’” Read full story Source: The Guardian, 13 June 2022
  17. News Article
    Record numbers of chronically ill patients living with disabilities are being denied funding for their care, The Mail on Sunday has reveal. An analysis of official figures shows only a fifth of those with disabling conditions such as Parkinson's disease, dementia and spinal injury asking for Government-funded help are being granted it this year. This is the lowest figure on record, with the exception of the pandemic years when assessments stopped altogether. Every year about 160,000 people apply for NHS funding called 'continuing healthcare', money available to those with significant medical needs. Unlike social care funding, arranged for some who need looking after, continuing healthcare is only offered to those in ill health who need regular attention from medical professionals. A decade ago, 34% of these applications were successful. Today that figure is 22%. Meanwhile, separate data seen by this newspaper reveals a sharp rise in the number of assessments that are deemed to have wrongly decided against funding at a subsequent appeal. Lisa Morgan, partner at Hugh James solicitors, which specialises in helping families fight for NHS care funding, says: 'In many cases, if [the clinical commissioning group] had made the right decision in the first place, it could have saved itself thousands of pounds.' The revelations come weeks after The Mail on Sunday told of the heartbreaking stories of desperately unwell people left utterly reliant on relatives, having been refused NHS-funded care. Some have then embarked on the lengthy and costly process of appealing the decision with legal help, to be told months or years later that they should have been granted funding all along. Read full story Source: Mail Online, 11 June 2022
  18. News Article
    Adult mental health patients in England have spent more than 200,000 days being treated in “inappropriate” out-of-area placements – at a cost to the NHS of £102m – in the year since the government pledged to end the practice. The Royal College of Psychiatrists, which carried out the analysis, says such placements, in which mental health patients can be sent hundreds of miles from home, are a shameful and dangerous practice that must stop. The government said it would end such placements by April last year but, in the 12 months since, 205,990 days were spent inappropriately out of area, at a cost equivalent to the annual salaries of more than 900 consultant psychiatrists, the college found. Dr Adrian James, the college’s president, said: “The failure to eliminate inappropriate out-of-area placements is a scandal. It is inhumane and is costing the NHS millions of pounds each year that could be spent helping patients get better. “No one with a mental illness should have to travel hundreds of miles away from home to get the treatment they desperately need.” He said investment was needed in local, properly staffed beds, alternatives to admission, and follow-up care in the community as well as government backing “to address the workforce crisis that continues to plague mental health services”. Read full story Source: The Guardian, 13 June 2022
  19. News Article
    The UK's biggest chain of GP practices lets less qualified staff see patients without adequate supervision, an undercover BBC Panorama investigation has found. Operose Health is putting patients at risk by prioritising profit, says a senior GP. The company, with almost 600,000 NHS patients, is owned by US healthcare giant Centene Corporation. BBC Panorama sent undercover reporter Jacqui Wakefield to work as a receptionist at one of the UK company's 51 London surgeries. A GP working at the practice said they were short of eight doctors. The practice manager said they hired less qualified medical staff called physician associates (PAs), because they were "cheaper" than GPs. Physician associates were first introduced by the NHS in 2003, so that doctors could deal with more complex patient needs. PAs are healthcare professionals who have completed two years of post-graduate studies on top of a science degree, as opposed to 10 years education and training for GPs. They support GPs in the diagnosis and management of patients, but should have oversight from a doctor. Panorama gathered evidence that PAs were not being properly supervised at the Operose practice. The PAs told the undercover reporter they saw all sorts of patients, sometimes without any clinical supervision. They said the practice treated them as equivalent to GPs. Prof Sir Sam Everington, a senior practising GP at an unconnected partner-run practice, reviewed BBC Panorama's undercover footage and said he was concerned for patient safety. During the undercover investigation at the London practice, administrative workers also revealed a backlog of thousands of medical test results and hospital letters on Operose computer systems. One worker said they were tasked with getting through 200 documents a day, deciding which were important enough to be seen by a GP or pharmacist and which would be filed to the patient's records. One member of staff, worried about making mistakes said they sometimes used Google to help them work out what to do with the documents. Read full story Source: BBC News, 11 June 2022
  20. Content Article
    The dangerous practice of sending people with a mental illness hundreds of miles away from home for weeks at a time continues in England, according to new analysis published by the Royal College of Psychiatrists.  Despite Government pledges to end the shameful practice, known as inappropriate out of area placements, by March 2021, almost 206,000 days have been spent by patients out of area in the 12 months since the deadline passed.  Being far away from home, with friends and family not being able to visit, can leave patients feeling extremely isolated and emotionally distressed with devastating, long-lasting consequences for their mental health.   Not only that, but it comes at a huge cost to the NHS. The health service spent £102 million on inappropriate out of area placements last year – the equivalent to the cost of the annual salary of over 900 consultant psychiatrists.   The Royal College of Psychiatrists is calling on the NHS to adopt a ‘zero tolerance’ approach to inappropriate out of area placements and to take urgent action to ensure all patients get the care they need from properly staffed, specialist services in their local area.  
  21. Content Article
    In this letter to the Guardian newspaper, a specialist nurse writes on an NHS service that puts women in control of pain relief, Sara Davies on the torturous pain she endured to have an intrauterine device fitted, and Lee Bennett on why it pays to speak up persistently. Have you experienced pain during a medical procedure? Share your experience along with hundreds of women to one of our community forums: Do women experience poorer medical attention when it comes to pain? Pain during IUD fitting Painful hysteroscopy
  22. News Article
    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
  23. News Article
    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
  24. Content Article
    Pharmacy teams may want to develop or implement new services in their organisations to realise quality, safety and operational benefits and financial efficiencies, or to improve the patient experience. The Pharmaceutical Journal highlights eight steps pharmacists should follow to ensure that a business case is as robust as possible.
  25. Content Article
    Call 4 Concern is a patient safety initiative enabling patients and families to call for immediate help and advice when they feel concerned that they are not receiving adequate clinical attention. Here is the University Hospitals Sussex Trust's leaflet.
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