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Patient Safety Learning

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  1. Patient Safety Learning
    The body which regulates health and social care services in Northern Ireland has made recommendations aimed at preventing choking deaths.
    It follows the deaths of 31 people since 2016 - 10 of whom died in the last 15 months.
    The Regulation and Quality Improvement Authority (RQIA) review found a "clear and urgent" need to improve the "quality and safety" of care.
    People at higher risk of choking include those who have had a stroke. It also includes older people and those with mental health or learning disabilities.
    The key recommendations include enhanced training for staff, shorter waiting times for assessment by speech and learning therapy and better communication between staff.
    RQIA chief executive Briege Donaghy said the vast majority of people who died from choking were known to have a swallowing issue and many had a care plan in place.
    "However, choking incidents may occur due to failures in communication of the care plan and when people are inadvertently provided with, or are able to access food and drink that is not suitable or safe for them."
    Read full story
    Source: BBC News, 19 May 2022
  2. Patient Safety Learning
    Obese adults in Britain are on course to outnumber those who are a healthy weight within five years, a stark report has revealed.
    Experts have warned there will be a “tipping point” in 2027 when one third of adults will be obese if current trends continue.
    By 2040, they predict there will 21 million people classed as obese in the UK, and 19 million deemed to be overweight.
    The analysis by Cancer Research UK shows seven in 10 (71%) people will be overweight or obese by 2040. Of this, almost four in 10 (36%) adults will be obese.
    At present, 64% of adults are overweight or obese, with figures rising every year.
    Being overweight or obese increases the risk of at least 13 different types of cancer and also causes other conditions such as high blood pressure and Type 2 diabetes.
    The new data comes after former Conservative leader William Hague attacked the government for postponing a ban on “buy one get one free” deals for foods high in fat, salt and sugar for a year because of the cost-of-living crisis.
    Read full story
    Source: The Independent, 19 May 2022
  3. Patient Safety Learning
    A woman who had her ovaries removed by mistake was one victim of the hundreds of “never events” that occurred in the NHS over the past year.
    Between April 2021 and March 2022 more than 400 patients in England’s hospitals suffered errors so serious that they should never have happened according to data released by NHS England. They include the wrong hips, legs, eyes and knees being operated on, and diabetic patients being given too much insulin.
    Foreign objects were left inside 98 patients after operations, including gauzes, swabs, drill guides, scalpel blades and needles. Vaginal swabs were left in patients 32 times and surgical swabs were left 21 times. Other objects left inside patients included part of a pair of wire cutters, part of a scalpel blade, and the bolt from surgical forceps. On three separate occasions part of a drill bit was left in a patient.
    “Wrong-site surgery” was carried out on 171 patients and six patients had injections to the wrong eye. The wrong hip implant was put in 12 times, a wrong knee implant was performed 11 times, and patients were connected to air instead of oxygen 13 times. Seven patients were given the wrong type of blood during a transfusion.
    Some patients were given doses of drugs that were far too high, including the immunosuppressant methotrexate, which is used for severe arthritis, psoriasis and leukaemia. There were 11 overdoses of insulin.
    Read full story (paywalled)
    Source: The Times, 19 May 2022
     
  4. Patient Safety Learning
    One of England’s most challenged integrated care systems (ICS) is set to miss by more than 800 patients the government’s target of eliminating two-year elective waits by July. 
    Devon ICS currently estimates 860 patients will have waited longer than two years for planned care by July 2022, when all patients waiting longer than two years should have been treated – according to the NHS’s elective recovery plan.
    It is the first reported example of an ICS forecasting to miss the high-profile target which government has agreed with NHS England.
    The ICS, which is among the health systems with the lowest rating from NHSE, is a national outlier against the target, with around 1,500 patients currently waiting two years or more for care.
    The backlog has occurred despite the ICS previously being one of 12 systems given extra money for planned care through the elective accelerator programme and retaining the use of its Nightingale Hospital.
    Read full story  (paywalled)
    Source: 6 May 2022
  5. Patient Safety Learning
    The NHS threat level in response to Covid-19 has been downgraded following drops in community cases and hospital inpatient numbers, NHS England chiefs have announced.
    The threat level to the health service has been dropped from a “level four” incident, which requires NHSE to “command and control” NHS resources in response to the pandemic, to a “level three” incident, which requires a response by a number of trusts within an NHS region.
    A letter from NHSE chief executive Amanda Pritchard and chief operating officer Sir David Sloman, published today, said local systems “need to ensure their resilience and capability to re-establish full incident responses” if needed. At NHSE’s board meeting she stressed that covid was still impacting the service.
    Trusts have also been reminded to relax visiting restrictions. The letter said all healthcare settings “should now begin transitioning back towards their own pre-pandemic [or better] policies on inpatient visiting and patients being accompanied in outpatient and [urgent and emergency care] services”.
    The default position for trusts should be “no patient having to be alone unless through their choice,” the letter said.
    It comes as some trusts have resisted pressure from government and NHSE to relax visiting restrictions.
    Read full story (paywalled)
    Source: HSJ, 19 May 2022
  6. Patient Safety Learning
    The trusts that have made the most and least progress on urgent recommendations set out by the Ockenden review have been revealed
    Published in December 2020, the interim Ockenden review set out 12 immediate and essential actions for all trusts with maternity provision, grouped into seven themes, and in its latest board papers NHS England has set out the progress they have made.
    The actions which trusts are struggling with most include “risk assessment throughout pregnancy” and clearly describing pathways of care in written information and posted on the trust websites.
    According to the data, Sheffield Teaching Hospitals Trust is the least compliant provider in England to date, as it is only fully compliant on one action.
    Last summer Sheffield’s maternity service plunged to “inadequate” from “outstanding” following a Care Quality Commission inspection, with concerns raised about staffing numbers, training and a lack of an open culture.
    Mid and South Essex Hospitals and York and Scarborough Teaching Hospitals were compliant on five actions each. MSE is rated “requires improvement” by the CQC for maternity care, whereas YSTH is “good”.
    Read full story (paywalled)
    Source: HSJ, 20 May 2022
     
  7. Patient Safety Learning
    Respiratory syncytial virus is killing 100,000 children under the age of five every year worldwide, new figures reveal as experts say the global easing of coronavirus restrictions is causing a surge in cases.
    RSV is the most common cause of acute lower respiratory infection in young children. It spreads easily via coughing and sneezing. There is no vaccine or specific treatment.
    RSV-attributable acute lower respiratory infections led to more than 100,000 deaths of children under five in 2019, according to figures published in the Lancet. Of those, more than 45,000 were under six months old, the first-of-its-kind study found.
    More children are likely to be affected by RSV in the future, experts believe, because masks and lockdowns have robbed children of natural immunity against a range of common viruses, including RSV.
    “RSV is the predominant cause of acute lower respiratory infection in young children and our updated estimates reveal that children six months and younger are particularly vulnerable, especially with cases surging as Covid-19 restrictions are easing around the world,” said the study’s co-author, Harish Nair of the University of Edinburgh. “The majority of the young children born in the last two years have never been exposed to RSV (and therefore have no immunity against this virus).”
    Read full story
    Source: The Guardian, 19 May 2022
  8. Patient Safety Learning
    Doctors are receiving "inadequate" training about the risk of sepsis after a mother-of-five died following an abortion, a coroner has warned.
    Sarah Dunn, 31, died of "natural causes contributed to by neglect" in hospital on 11 April 2020, an inquest found.
    Assistant coroner for Blackpool and Fylde, Louise Rae, said Ms Dunn had been treated as a Covid patient even though the "signs of sepsis were apparent".
    Her cause of death was recorded as "streptococcus sepsis following medical termination of pregnancy".
    In her record of inquest, the coroner noted Ms Dunn was admitted to Blackpool Victoria Hospital in Lancashire on 10 April 2020. She was suffering from a streptococcus infection caused by an early medical abortion on 23 March, which had produced sepsis and toxic shock by the time she was admitted to hospital.
    The coroner said "signs of sepsis were apparent" before and at the time of Ms Dunn's hospital admission but she was instead treated as a Covid-19 patient.
    "Sepsis was not recognised or treated by the GP surgery, emergency department or acute medical unit and upon Sarah's arrival at hospital, the sepsis pathway was not followed," she added.
    Read full story
    Source: BBC News, 19 May 2022
  9. Patient Safety Learning
    A private hospital facing a police investigation following a patient’s death has been given an urgent warning by the care regulator due to concerns over patient safety.
    The Huntercombe Hospital in Maidenhead, which treats children with mental health needs, was told it must urgently address safety issues found by the Care Quality Commission (CQC) following an inspection in March.
    The CQC handed the hospital a formal warning due to concerns over failures in the way staff were carrying out observations of vulnerable patients.
    The move comes as The Independent revealed police are investigating the hospital in relation to the death of a young girl earlier this year.
    In a report published last week, the care watchdog said it had received “mainly negative” feedback from young people at the hospital’s Thames ward, a psychiatric intensive care unit which treats acutely unwell children.
    Commenting on the hospital overall, the report said: “Young people told us that staff did not follow the care plans in relation to their level of observations. They told us that if there was an incident the staff stopped doing intermittent observations. Staff in charge of shifts on wards asked new staff members to do observations before they understood how to do it. Staff had to ask the young person how to carry out their observations as they did not always understand what was expected of them in carrying out different levels of observations.”
    Read full story
    Source: The Independent, 19 May 2022
  10. Patient Safety Learning
    Injured women are experiencing sex discrimination in the administration of a life-saving drug that cuts the risk of bleeding to death by 30%, researchers have warned.
    They found that female trauma victims were half as likely to receive tranexamic acid (TXA) as injured men – even though the treatment is equally effective regardless of sex.
    “These results are very concerning. TXA is the only proven life-saving treatment for traumatic bleeding. Women were treated less frequently than men regardless of their risk of death from bleeding or the severity of their injuries,” said Prof Ian Roberts of the London School of Hygiene and Tropical Medicine (LSHTM), who was involved in the study.
    “This looks like sex discrimination, and there is an urgent need to reduce this disparity, so all patients who need the drug have the chance to receive it.”
    “Whatever of the mechanism of injury, and whatever the bleeding risk we looked at, women were statistically less likely to receive tranexamic acid than men, apart from road traffic collisions with a very high risk of bleeding,” said Tim Nutbeam, whose research was published in the British Journal of Anaesthesia. “However, when we looked at mechanisms of injury which we tend to associate less with major trauma, such as falls from standing, women and particularly older women were much less likely to receive it.”
    As striking as these results are, they are not necessarily surprising, he added: “It is already known that women with chest pain are less likely to receive aspirin, less likely to be resuscitated for out of hospital cardiac arrest, and less likely to be taken to hospital by an ambulance using lights and sirens.”
    Read full story
    Source: The Guardian, 18 May 2022
  11. Patient Safety Learning
    More than 27,000 nurses and midwives quit the NHS last year, with many blaming job pressures, the Covid pandemic and poor patient care for their decision.
    The rise in staff leaving their posts across the UK – the first in four years – has prompted concern that frontline workers are under too much strain, especially with the NHS-wide shortage of nurses.
    New figures show the NHS is also becoming more reliant on nurses and midwives trained overseas as domestic recruitment remains stubbornly low.
    In a report on Wednesday, the Nursing and Midwifery Council (NMC) discloses that the numbers in both professions across the UK has risen to its highest level – 758,303.
    However, while 48,436 nurses and midwives joined its register, 27,133 stopped working last year – 25,219 nurses, 1,474 midwives and 304 who performed both roles. That was higher than the 23,934 who did so during 2020 after Covid struck, and 25,488 who left in 2019.
    Andrea Sutcliffe, the NMC’s chief executive, said that while the record number of nurses and midwives was good news, “a closer look at our data reveals some worrying signs”. She cited the large number of leavers and the fact that “those who left shared troubling stories about the pressure they’ve had to bear during the pandemic”.
    Read full story
    Source: The Guardian, 18 May 2022
  12. Patient Safety Learning
    Around 60,000 NHS staff members have post-traumatic stress after working through the Covid-19 pandemic, new research suggests.
    Nine out of 10 health workers say it will take them years to recover from the ordeal and one in four had lost a colleague to coronavirus, according to NHS Charities Together
    The charity, NHS staff and mental health experts are now calling for more support from the health service and UK government to support those struggling in the aftermath of the pandemic.
    “I think it’s quite clear there hasn’t been enough support to help NHS workers recover from their experiences during the pandemic. As a result, a lot of people are feeling incredibly jaded,” said Dr Ed Patrick, an NHS anaesthetist who worked in a Covid-19 intensive care unit from the beginning of the pandemic.
    On his experiences of working on the front lines of the health service, Dr Patrick said: “Like everyone else in the world, we lost our outlets for release. Everything was shut down and for NHS workers, our lives just became the hospital."
    He described the long and gruelling hours and the emotional burden of working at the height of the pandemic: “We all had an overwhelming feeling of powerlessness. There was also a deep sadness because everything you would normally do to help patients just wasn’t working.
    Read full story
    Source: The Independent, 17 May 2022
  13. Patient Safety Learning
    Difficulties seeing GPs during the pandemic have hampered efforts to tackle dementia, with thousands missing out on a diagnosis, Sajid Javid has said.
    Announcing a ten-year strategy aimed at preventing four in ten cases of the disease, the health secretary said that delays had “stemmed the tide of progress”. GPs must play a “crucial role” in referring patients, he said.
    NHS leaders went further, saying a drop in face-to-face GP appointments had meant “opportunities have been lost” to spot signs of dementia. Only 62% of consultations in March were face to face, compared with 80% before the pandemic.
    Javid said: “By 2025, one million people in the UK are expected to have dementia, and this is expected to rise to 1.6 million by 2040. I know the Alzheimer’s Society has estimated over 30,000 people didn’t receive a diagnosis because of the pandemic. Tens of thousands are still missing out on a dementia diagnosis each year because they confuse key symptoms with getting old.”
    About 325,000 in England have dementia but are undiagnosed, meaning they cannot get treatment or social care support.
    Speaking at the Alzheimer’s Society conference, Javid said the government would publish a strategy this year, which would be “as bold as we’ve been with our ten-year plan for cancer”, focusing on prevention and research.
    Read full story (paywalled)
    Source: The Times, 18 May 2022
    This week is Dementia Action Week - see our Top picks: 5 key resources about patient safety for people with dementia
  14. Patient Safety Learning
    The parents of a teenage girl who died from an allergic reaction to a Pret a Manger baguette have set up a clinical trial to make "food allergies history".
    Nadim and Tanya Ednan-Laperouse's daughter Natasha, 15, died in 2016 after eating a baguette containing sesame, to which she was allergic.
    The trial will investigate if everyday food products can be used as treatment.
    It is a unique opportunity to establish immunotherapy as a practical treatment, according to an expert.
    The trial, set up by the family from Fulham in west London, will see whether commonly available food products, such as milk and peanuts, can be used under medical supervision to treat those with food allergies.
    After a 12-month desensitisation period, those involved will be tracked for two further years.
    Mr and Mrs Ednan-Laperouse's daughter died in 2016 after she ate an artichoke, olive and tapenade baguette containing sesame seeds, bought from a Pret a Manger at Heathrow Airport.
    The wrapper did not have any allergy information, and, as it was made on the premises, this was not required by law at the time.
    In October, "Natasha's Law" was brought in, making allergy information a requirement for food made on site.
    Read full story
    Source: BBC News, 18 May 2022
    Related articles on the hub
    Why allergies are the Cinderella service of the NHS – a blog by Tim McLachlan
  15. Patient Safety Learning
    A hospital trust has pleaded guilty to failures in care that contributed to the deaths of two patients.
    One of the charges related to the death of patient Mohammed Ismael Zaman in 2019 at the Royal Shrewsbury Hospital.
    The 31-year-old died of severe blood loss while undergoing dialysis, Telford Magistrates' Court heard.
    Max Dingle, in his 80s, died after his head became trapped between a mattress and bed rail while he was being treated at the Royal Shrewsbury Hospital.
    Shrewsbury and Telford Hospital NHS Trust (SaTH) admitted three counts of failing to provide treatment and care in a safe way, resulting in harm or loss, between October 2019 and May 2020.
    Representing the CQC, Ryan Donoghue said the failures in Mr Zaman's care "were the legal cause of his death, for which the trust is responsible".
    He said Mr Dingle, who had been admitted with chronic lung disease, died from a cardiac arrest after he was freed.
    "The basis [of the guilty plea] is that the failures exposed him to a significant risk of avoidable harm," Mr Donoghue said.
    As well as the two deaths, the CQC accused the trust of exposing other patients to significant risk of avoidable harm.
    Read full story
    Source: BBC News, 18 May 2022
  16. Patient Safety Learning
    The NHS will miss its target to return cancer treatment waits to pre-covid levels by next March, a national cancer leader has said.
    When asked at the HSJ Cancer Forum whether the service would be back to “business as usual” performance by next spring, Liz Bishop, who sits on NHS England’s national cancer board, said: “I think it depends on what you mean by ‘business as usual’.
    “If you mean hitting the 62-day numbers, and the 104-day numbers, by next March, then no. If I am honest, I don’t think we will.
    “Do I know when that date will be? No, I don’t know. But what I do know is that everyone is working really hard to do it and get there.”
    NHSE initially said the number of patients waiting longer than 62 days for treatment following an urgent referral would return to pre-pandemic levels by March this year, but has since pushed this back to March 2023.
    Read full story (paywalled)
    Source: HSJ, 18 March 2022
  17. Patient Safety Learning
    Fourteen patients with autism or learning disabilities have died since 2015 while detained in psychiatric facilities in Scotland, figures reveal. 
    The statistics were released for the first time by Public Health Scotland (PHS) following a parliamentary question by Scottish Conservative MSP Alexander Burnett, who has campaigned to end the “national scandal” of otherwise healthy people being locked up for months or years due to a lack of community-based support. 
    The PHS report does not detail the causes of death, but does show that seven of the deaths occurred in patients who had been resident at an inpatient psychiatric facility for between 91 and 365 days, with six (43%) in patients whose stay had exceeded at least one year. 
    Rob Holland, acting director of the National Autistic Society Scotland, said the data was a “step forward in understanding the experience of autistic people and people with a learning disability within inpatient psychiatric facilities”.
    He added: “While it does not shine a light on the reasons for the deaths it does highlight how almost all of those that died had been within institutional care for more than 30 days with 6 people having been there for more than a year.
    “Hospitals are not homes and it adds further impetus to the Scottish Government’s ‘Coming Home’ strategy to reduce delayed discharge and support people to live in homes of their own choosing.”
    Read full story
    Source: The Herald, 18 May 2022
  18. Patient Safety Learning
    Hundreds of overseas-born trainee GPs are at risk of deportation because of “nonsensical” immigration rules, the profession’s leader has warned Priti Patel.
    The NHS risks losing much-needed family doctors unless visa regulations are overhauled to allow young medics to stay in Britain at the end of their GP training, Prof Martin Marshall said.
    Marshall, the chair of the Royal College of GPs, has written to Patel, the home secretary, demanding that she scrap “bureaucratic” hurdles affecting would-be GPs from abroad.
    He told the Guardian: “At a time when general practice is experiencing the most severe workload pressures it has ever known, it is nonsensical that the NHS is going to the expense of training hundreds of GPs each year who then face potential deportation by the Home Office because of an entirely avoidable visa issue.
    “We cannot afford to lose this expertise and willingness to work in the NHS, delivering care to patients, due to red tape.”
    The threat to foreign-born GP trainees has arisen because current immigration rules state that “international medical graduates” (IMGs) can be given indefinite leave to remain only after they have been in the country for five years, but GP training lasts for only three years.
    Read full story
    Source: The Guardian, 17 May 2022
  19. Patient Safety Learning
    RaDonda Vaught was sentenced to three years of supervised probation on the 13 May for a fatal medication error she made in 2017 while working as a nurse at the Vanderbilt University Medical Center in the USA.
    In remarks made during the sentencing hearing, Ms. Vaught expressed concerns over what her case means for clinicians and patient safety reporting. 
    "This sentencing is bound to have an effect on how [nurses] proceed both in reporting medical errors, medication errors, raising concerns if they see something they feel needs to be brought to someone's attention," she said. "I worry this is going to have a deep impact on patient safety." 
    Numerous medical organisations expressed similar concerns in statements circulated after Ms. Vaught's sentencing. 
    "To achieve our goal of zero patient harm and death from preventable medical errors, we need to foster a culture where leadership of hospitals and healthcare organizations support healthcare workers and encourage them to share near misses," the Patient Safety Movement Foundation said in a statement. "Healthcare workers are human and healthcare systems need to ensure there are appropriate processes in place to provide their staff with a safe and reliable working environment so they can provide their patients with the best care. Only by identifying potential problems and learning from them can change occur."
    Read full story
    Source: Becker's Hospital Review, 16 May 2022
  20. Patient Safety Learning
    National NHS officials have proposed a major shift in the funding model for inpatient mental health beds for children and young people, information seen by HSJ reveals.
    A report on child and adolescent mental health services by Getting it Right First Time (GIRFT), an NHS England national programme, recommends a move away from the current ‘payment per bed day’ model to a system which funds particular outcomes or “therapeutic models”.
    It appears the proposal in the GIRFT recommendations seen by HSJ would apply to both NHS and independent provision, although some NHS providers are already less likely to receive funding on a ”per bed day” basis.
    Ananta Dave, consultant CAMHS psychiatrist at Lincolnshire Partnership Foundation Trust, told HSJ that having agreed therapy and outcome measures as recommended by the report would not only boost patient experience but also lead to better results.
    “One inpatient bed can actually be the equivalent of 100 young people being looked after in the community. So these are precious resources we are talking about, hence the quality of inpatient units is really important.
    “It should not just be a tick-box exercise that a bed exists. Instead, it is about the quality of that service. If you simply go by the number of bed days, you’re unlikely to meet your target or meet your ambition of reducing the spend on inpatient services.”
    Read full story (paywalled)
    Source: HSJ, 16 May 2022
  21. Patient Safety Learning
    The NHS has become 'dangerously over-reliant' on China for vital medicines and supplies, a report has warned.
    One in six medical items used in UK hospitals — including needles, bandages and oxygen — are shipped from the communist state.
    Thinktank Civitas found that overall NHS dependency on Chinese supply chains has trebled since 2019, with the UK now sending £6.2billion a year to Beijing for medical gear.
    Security experts are now calling for an 'NHS Security Act' to wean Britain off Chinese medical items and start manufacturing more domestically.
    Civitas looked at 228 medical items on the Government's disaster relief list — which include drugs, tests, medical devices and personal protective equipment (PPE). The team found that 17% came from China in 2020, up from 6% before the pandemic. 
    The report found up to a third of tests and diagnostic equipment and 30% of PPE used in the health service now come from China.
    Almost all paper masks used by medics in hospitals come from China (90%), more than half of all gloves (54%) and almost 80% of bandages. And 42% of emergency trolleys and wheelchairs are Chinese-made.
    Robert Clark, head of defence and security at Civitas, said: 'Things like gloves, monitors, wheelchairs and bandages all largely come from China rather than the UK. We are dangerously over-reliant on China."
    "Let's not be naïve about China. This is an urgent issue for health bosses with the risk that future geo-political spats could lead to the Chinese switching off critical medical supplies destined for the NHS."
    Read full story
    Source: Mail Online,17 May 2022
  22. Patient Safety Learning
    A hospital trust is investigating after a patient was incorrectly diagnosed and treated for Alzheimer's disease for seven years.
    Alex Preston, from Anstey, Leicestershire, was 54 at the time and said the diagnosis completely destroyed his life and made him feel suicidal.
    Mr Preston said he was having problems concentrating at work in 2014. "The doctor thought I had low mood and anxiety," he said.
    Mr Preston, now 62, was sent to the Bradgate Mental Health Unit where he underwent a series of tests and was diagnosed with Alzheimer's disease.
    "That's when my life was completely destroyed. "As soon as we were told that diagnosis, everything me and Susan had planned just went," he said.
    He was then re-examined in the pandemic and told that diagnosis was a mistake.
    Leicestershire Partnership NHS Trust (LPT) said it was undertaking an independent review of the case.
    Read full story
    Source: BBC News, 16 May 2022
  23. Patient Safety Learning
    NHS prescription charges in England are to be frozen for the first time in 12 years, the government has confirmed.
    Single prescription charges, which the Department of Health said would normally rise "in line with inflation", will remain at £9.35 until next year.
    Health Secretary Sajid Javid said freezing the costs would "put money back in people's pockets".
    Faith Angwet, a single mother of two, said she had to choose between paying for prescriptions to treat for her high blood pressure, or using that money to feed her children.
    She said the price freeze "won't go far" because "it's not necessarily the outgoings affecting me, everything is going up in price and I'm not able to afford everything I use to be, including my prescription".
    Claire Anderson, of the Royal Pharmaceutical Society, said people who do not qualify for free prescriptions because of their income, age, or medication type, often had to make decisions about which medicines they need.
    "Those medicines are prescribed for a reason because that patient needs that treatment," she told the BBC.
    And Laura Cockram, chairwoman of the Prescription Charges Coalition, who welcomed the freeze, said the government should review the list of those who qualified for free prescriptions.
    She said the prescription exemption charge list was put together more than 50 years ago, when conditions like HIV "didn't even exist" and at a time there "weren't life saving treatments for things like asthma, Parkinson's and MS".
    Read full story
    Source: BBC News, 16 May 2022
  24. Patient Safety Learning
    Nearly 600 patients waited 10 hours or more in the back of an ambulance to be transferred into emergency departments last month – with one taking 24 hours, HSJ can reveal.
    The 24-hour wait was the longest handover delay recorded in the past year, and probably ever, according to information released by ambulance trust chief executives.
    In May last year the longest recorded rate was seven hours. This has risen steadily during the year to hit 24 hours in April. In March a patient in the West Midlands had to wait 23 hours.
    The figures also show 11,000 patients waited more than three hours for handover last month, with 7,000 of them taking more than four hours and 4,000 over five hours. Some 599 waited more than 10 hours.
    The Association of Ambulance Chief Executives estimates 35,000 patients were potentially at risk of harm from delayed handovers last month, with just under 4,000 of those risking severe harm. This is based on work it did looking at patients waiting more than 60 minutes in 2021 and was a slight fall on March. They are based only on handover delays and do not include harm from patients left waiting for an ambulance response.
    Hours lost to ambulance handover delays restrict ambulance trusts’ ability to reach other patients waiting for an ambulance in the community.
    Read full story (paywalled)
    Source: HSJ, 16 May 2022
  25. Patient Safety Learning
    The National Institute for Health and Care Excellence has issued an unprecedented implementation statement1 setting out the practical steps needed for its updated guideline on the diagnosis and management of myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS)2 to be implemented by the NHS.
    Such statements are only issued when a guideline is expected to have a “substantial” impact on NHS resources, and this is thought to be the first. It outlines the additional infrastructure and training that will be needed in both secondary and primary care to ensure that the updated ME/CFS guideline, published in October 2021, can be implemented.
    The statement is necessary because the 2021 guideline completely reversed the original 2007 guideline recommendations that people with mild or moderate ME/CFS be treated with cognitive behavioural therapy (CBT) and graded exercise therapy (GET). Instead the guideline recommends that any physical activity or exercise programmes should only be considered for people with ME/CFS in specific circumstances and should begin by establishing the person’s physical activity capability at a level that does not worsen their symptoms. It also says a physical activity or exercise programme should only be offered on the basis that it is delivered or overseen by a physiotherapist in an ME/CFS specialist team and is regularly reviewed.
    Although cognitive behavioural therapy (CBT) has sometimes been assumed to be a cure for ME/CFS, the guideline recommends it should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness.
    Read full story
    Source: BMJ, 16 May 2022

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