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Patient Safety Learning

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  1. Patient Safety Learning
    Jason Watkins, a British actor, has urged A&E units to look again at procedures surrounding infants as he has channels his anger at his young daughter’s death from sepsis into trying to “improve the system”.
    The actor said that his fury at the death of Maude aged two on New Year’s Day 2011 led him to smash up his shower.
    “It wasn’t anger at any individual, it was anger at fate. Why should we deserve this?” he told Andy Coulson’s Crisis What Crisis? podcast.
    “You feel really vulnerable and there’s a sort of rage against that. And there are all these different ways of resolving and wrestling out of this horrible dark pit that you’re in."
    He now campaigns for the UK Sepsis Trust.
    “I was never angry at any individual,” he said. “My anger was fuelled into trying to work out better ways of dealing with sepsis, or even more than that, the way that we look at infants in A&E. Because you know, it’s a funding issue, it’s an organisational issue. It’s another conversation.
    “Because I had identified that there wasn’t an individual at fault in the hospital, it has to be the system. So we’ve got to improve it. My anger is fuelled into that. There’s no bitterness. Nobody made a technical mistake, it’s just nobody really thought of the possibilities of what could be happening.
    “For me the whole of looking at infants arriving at A&E needs to be looked at again. Because if I say that Maude died twelve years ago, and that the ombudsman report about sepsis a couple of months ago said that nothing had changed about sepsis, now, that was like a body-blow, that makes me feel sick even thinking about it now, because we’ve worked so hard over that time.”
    Read full story
    Source: The Times, 1 February 2024
     
  2. Patient Safety Learning
    Legal costs in Irish medical negligence cases are among the highest in the world, according to a report that says the slow pace of legal actions here is damaging patients and doctors’ mental wellbeing.
    The average cost of a legal claim for medical negligence in Ireland is almost three times higher than in the UK, and cases take over 50 per cent longer to resolve, the industry report says.
    Patients and doctors in Ireland are dragged through what can be a brutal process, for longer than necessary, with patients having to wait longer to receive compensation, the report by the Medical Protection Society (MPS) asserts.
    In the report, the society, which provides indemnity cover for 16,000 doctors and other healthcare professionals in Ireland, compared the length and cost of legal actions here with other jurisdictions in which it operates.
    A medical negligence claim in Ireland takes 1,462 days on average (four years), 14% longer than in South Africa and 56% longer than in Hong Kong, the UK or Singapore, it found.
    Two hundred doctors in Ireland were interviewed for the report: 88% said they were worried about the length of time the litigation process was taking and 91% were worried about their mental wellbeing while it was ongoing. Some said they needed professional help, experienced suicidal thoughts, or quit medicine as a result of the claim.
    “It was horrendous. I had to leave medicine after it,” says one doctor involved in a claim who is quoted in the report. “I developed severe anxiety during the course of the claim and PTSD. I lost my career in medicine and I am devastated about that. I knew I could never go through the same again.”
    Read full story
    Source: The Irish Times, 31 January 2024
  3. Patient Safety Learning
    Maternity departments are raising thousands of safety reports every year about delayed inductions of labour, HSJ can reveal.
    Induction of labour may be used when women are overdue, because their waters have broken, or for other medical reasons to speed up the birth, such as poor growth of the baby.
    Delaying induction therefore may increase risks for both mothers and babies and the National Institute for Health and Care Excellence says trusts should raise a “red flag event” if it is delayed for more than two hours after admission.
    Information collected by HSJ from 50 trusts show 4,945 red flags related to delays in induction of labour in 2022-23. HSJ also found 3,109 reports in 2021-22 and 1,807 in 2020-21 across 47 trusts. 
    Meanwhile, there were 1,997 Datix reports mentioning induction of labour in 2022-23 across 59 trusts able to give HSJ figures, in response to Freedom of Information Act requests, compared with 1,690 in 2021-22 and 1,368 in 2020-21. 
    The Care Quality Commission has also raised concerns in inspections that incidents which should have been treated as “red flags” have not always been reported as such. The watchdog has also raised concerns about a lack of board-level oversight of maternity safety incidents and a need for clearer guidance for staff on reporting processes. 
    Read full story (paywalled)
    Source: HSJ, 2 April 2024
  4. Patient Safety Learning
    Children are being forgotten by the government as they face “disgraceful” waiting times for NHS treatment, Britain’s top paediatric doctor has warned.
    Dr Camilla Kingdon said children are being failed because their care is not being treated as a priority, despite considerable progress having been made in reducing waiting times for adults.
    In her final interview as president of the Royal College of Paediatrics and Child Health, she also issued a stark warning over the impact of poverty on young people’s health, lamenting the rise in the number of children being treated for severe lung disease due to damp and poor ventilation in inadequate housing.
    Many parents cannot afford to be at their dying or sick child’s bedside because of financial pressures – an issue that has grown significantly worse in the past five years, she said.
    She told The Independent: “Children simply need to be made a priority. We cannot afford to be ignoring this problem.”
    The latest NHS figures show that the backlog for children’s hospital care has risen again, increasing from 387,000 in August to 412,000 in January, despite the adult waiting list having fallen since October.
    Read full story
    Source: The Independent, 31 March 2024
  5. Patient Safety Learning
    The NHS is failing some parents whose children die unexpectedly, a leading paediatrician has told BBC Panorama.
    About 50 children's deaths in the UK every year are termed as "sudden unexplained death in childhood" (SUDC). Little is known about what causes them.
    Gavin and Jodie's two-year-old son Addy died unexpectedly in November 2022.
    BBC Panorama followed the parents over nine months as they searched for answers to why their son died - and whether it could have been prevented.
    Even after a forensic post-mortem examination, no-one could work out why the little boy went to sleep and never woke up, so his death was categorised as SUDC.
    When a child dies unexpectedly, a review is held to gather information about what happened. The NHS is required to assign a key worker to help bereaved parents to navigate this process, and provide emotional support. The role of key worker can be taken by a range of practitioners and is often a specialist nurse.
    However, even though it is a mandatory requirement, a survey carried out by the Association of Child Death Review Professionals (ACDP) found that more than half of NHS areas in England do not have a specialist nurse to visit parents after an unexpected death.
    "It makes me really angry," says paediatrician Dr Joanna Garstang, the chair of the ACDP, who runs one of the few teams in England that support parents.
    "Bereaved families after the sudden death of a child are the most vulnerable people. And if we don't put in early support… we're setting these parents up for a lifetime of misery."
    Read full story
    Source: BBC News, 5 February 2024
  6. Patient Safety Learning
    Concerns have been raised that patients may not be receiving “vital” safety information after HSJ discovered a high-risk medication was frequently not being dispensed as originally packaged. 
    In 2018, the Medicines and Healthcare Products Regulatory Agency asked pharmacies to dispense valproate-containing medications in their original pack where possible, to ensure packages include safety warnings. 
    It also asked manufacturers to produce smaller pack sizes and add pictorial warnings, while pharmacists were additionally asked to add stickered warnings to the outer box of any valproate-containing medication not dispensed in its original packaging.
    Yet, data obtained via freedom of information requests to the NHS Business Services Authority revealed that while the proportion and number of valproate-containing items dispensed as split packs – as opposed to whole packs – had decreased over the last five years, split packs still accounted for more than half of items dispensed in 2022-23. 
    Emma Murphy, of campaign group In-Fact, said the figures on split pack dispensing were “quite horrifying” and showed “the system is not working”.
    She added: “Attitudes have got to change – prescribers, GPs etc need to be proactive and warn women of the risks because this isn’t just a side effect, this is harming real babies. As a mum of five affected children, the consequences of valproate in pregnancy on that baby is devastating.”
    Alison Fuller, of Epilepsy Action, said the high proportion of split packs being dispensed made it “clear why the change in guidance introduced in October 2023 was necessary”, adding: “The manufacturer’s original full pack always contains all the relevant information, which is why it’s the best option for patient awareness.”
    Read full story (paywalled)
    Source: HSJ, 
  7. Patient Safety Learning
    Deeply ingrained medical misogyny and racial biases are routinely putting people in need of treatment at risk, the government’s patient safety commissioner in England has warned.
    Dr Henrietta Hughes was appointed in 2022 in response to a series of scandals in women’s health. She outlined a “huge landscape” of biases in need of levelling, citing examples ranging from neonatal assessment tools and pulse oximeters that work less well for darker skin tones to heart valves, mesh implants and replacement hip joints that were not designed with female patients in mind.
    Hughes said: “I don’t see this as blaming individual healthcare professionals – doctors and nurses – for getting it wrong. It’s pervasive in the systems we have – the training, the experience, the resources.
    “Anatomy books are very narrow in their focus. Even the resuscitation models are of pale males – we don’t have female resuscitation models, we don’t have them in darker skin tones. This is deeply ingrained in the way that we assess and listen to patients.”
    She described the realisation that pulse oximeters, used to measure blood oxygen levels, work less well for darker skin tones as a “real shock to the system” when the problem was highlighted during the pandemic. More recently, the NHS Race and Health Observatory highlighted concerns about neonatal assessments.
    Bilirubinometers, widely used to assess jaundice in newborn babies, are less reliable for darker skin tones and some guidelines for the assessment of cyanosis (caused by a shortage of blood oxygen) refer to “pink”, “blue” or “pale” skin, without reference to skin changes in minority ethnic babies. The Apgar score, a quick test given to newborns that was rolled out in the 1950s, traditionally includes checking whether a baby is “pink all over”.
    “Even the names of those conditions – jaundice and cyanosis – suggest a colour. The Apgar score includes P for pink all over,” said Hughes. “There are systemic biases in that if you have a darker skin tone those conditions may not be so apparent.”
    Read full story
    Source: The Guardian, 4 February 2024
  8. Patient Safety Learning
    “What if I told you one of the strongest choices you could make was the choice to ask for help?” says a young, twentysomething woman in a red sweater, before recommending that viewers seek out counselling. This advert, promoted on Instagram and other social media platforms, is just one of many campaigns created by the California-based company BetterHelp, which offers to connect users with online therapists.
    The need for sophisticated digital alternatives to conventional face-to-face therapy has been well established in recent years. If we go by the latest data for NHS talking therapy services, 1.76 million people were referred for treatment in 2022-23, while 1.22 million actually started working with a therapist in person.
    While companies like BetterHelp are hoping to address some of the barriers that prevent people from seeking therapy, such as a dearth of trained practitioners in their area, or finding a therapist they can relate to, there is a concerning side to many of these platforms. Namely, what happens to the considerable amounts of deeply sensitive data they gather in the process? Moves are now under way in the UK to look at regulating these apps, and awareness of potential harm is growing.
    Last year, the UK’s regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (Nice), began a three-year project, funded by the charity Wellcome, to explore how best to regulate digital mental health tools in the UK, as well as working with international partners to help drive consensus in digital mental health regulations globally.
    Holly Coole, senior manager for digital mental health at the MHRA, explains that while data privacy is important, the main focus of the project is to achieve a consensus on the minimum standards for safety for these tools. “We are more focused on the efficacy and safety of these products because that’s our role as a regulator, to make sure that patient safety is at the forefront of any device that is classed as a medical device,” she says.
    Read full story
    Source: The Guardian, 4 February 2024
  9. Patient Safety Learning
    Worsening health among the under fives in the UK needs to be urgently addressed, experts say.
    The Academy of Medical Sciences highlights what it says are "major health issues" like infant deaths, obesity and tooth decay.
    It says society is betraying children and the problems are limiting their future and damaging economic prosperity.
    The report says:
    The UK is 30th out of 49 rich countries for infant mortality. One in five children falls short of the expected level of development aged two. One in five is overweight or obese by five. Vaccination targets are being missed for diseases such as measles. One in four is affected by tooth decay by five. One in five women struggles with their mental health during or just after pregnancy. Air pollution is linked to worsening asthma. Rising demand for child mental health services. The report calls for a cross-government vision to be developed to tackle the problems and investment in the child health workforce, including health visitors.
    Read full story
    Source: BBC News, 5 February 2024
  10. Patient Safety Learning
    Rishi Sunak has admitted the government has failed on a pledge to cut NHS waiting lists in England.
    The prime minister said the government had "not made enough progress" but that industrial action in the health service "has had an impact".
    Mr Sunak made the comments in an interview with TalkTV.
    Cutting NHS waiting lists is one of five priorities Mr Sunak set out in January 2023, along with measures on the economy and illegal immigration.
    At the time he said "NHS waiting lists will fall and people will get the care they need more quickly" but did not set a timeframe for achieving that.
    Asked if his government has failed to achieve that pledge, Mr Sunak said: "Yes, we have."
    The prime minister continued: "What I would say to people is that we've invested record amounts in the NHS - more doctors, more nurses, more scanners.
    "All these things mean the NHS is doing more than it ever has but industrial action has had an impact."
    Read full story
    Source: BBC News, 5 February 2024
  11. Patient Safety Learning
    Hospitals are being pressured to shift their resources to treating patients with less serious conditions to meet a “politically motivated” target, according to multiple senior sources.
    The pressure appears to be coming through NHS England’s regional teams, with local sources saying they are being told to focus energies on patients in their emergency departments who do not need to be admitted to a ward.
    These cases are typically faster to deal with, and therefore shifting resources to this cohort could significantly improve performance against the four-hour target.
    However, experts in emergency care repeatedly warn that admitted patients are the most likely to suffer long waits and harm.
    The NHS has been tasked with lifting performance against the four-hour target to 76% in 2023-24, but has failed to meet that in any month this year. Performance in December was 69%.
    Some trust leaders told HSJ they would ignore the instructions, saying they would continue to focus resources on reducing the longest waits.
    One chief executive in the north of England said: “It’s a complete nonsense and just politically motivated. We’re getting a very clear message to hit 76 per cent which is hugely problematic because it will drive non patient focussed behaviour. We have said ‘no, we are focussing on long waiters and ambulance delays’… in other words doing the right thing for patients.”
    Read full story (paywalled)
    Source: HSJ, 5 February 2024
  12. Patient Safety Learning
    Ministers must begin paying compensation to the families of children disabled by the epilepsy drug sodium valproate by next year, a report will say this week.
    The report’s author, Dr Henrietta Hughes, England’s patient safety commissioner, says valproate is “a bigger scandal than thalidomide, in terms of the numbers of people affected”.
    She will back calls for financial redress for the thousands of children left physically and mentally disabled. Every month, three babies are still being born who have been exposed to the drug.
    Speaking before the report’s launch, Hughes, 54, a GP, said the state had failed pregnant women by not telling them about key information regarding the drug’s risks. “These families have already been betrayed, because they weren’t given the right information to be able to make decisions to keep themselves and their family safe,” she said.
    “There are senior politicians of every stripe who have expressed their sincere sympathy and support for patients who have been harmed. I take the view that people who seek high office need to also accept the responsibility that comes with that high office.
    “The time for redress is now. The government is responsible. I’ve been asked to give them options for redress and I’ve done that. They have the recommendations, they have the advice, they have everything they need. Get on with it.”
    Read full story (paywalled)
    Source: The Times, February 2024
  13. Patient Safety Learning
    Next week’s launch of the ‘Wayfinder’ waiting time information service on the NHS App will give patients “disingenuous” and “misleading” information about how long they can expect to wait for care, senior figures close to the project have warned.
    Briefing documents seen by HSJ show the figure displayed to patients will be a mean average of wait times taken from the Waiting List Minimum Data Set and the My Planned Care site.
    However, it was originally intended that the metric displayed would be the time waited by 92% of relevant patients. This is more commonly known as the “9 out of 10” measure.
    Mean waits are likely to be about “half the typical waiting time” measured under the 9 out of 10 metric, according to the waiting list experts consulted by HSJ.
    Ahead of The Wayfinder service’s launch on Tuesday, NHS trusts and integrated care boards have been sent comprehensive information on how to publicise it, including a “lines to take” briefing in case of media inquiries. This mentions the use of an “average” time but does not provider any justification for this approach.
    HSJ’s source said the mean average metric was “the worst one to choose” as it would be providing patients with “disingenuous” information that will leave them disappointed. They added that the 92nd percentile metric would be a “far more realistic” measure “for a greater number of people”.
    They concluded that “using an average” would create false expectations “because in reality nobody will be seen in the amount of time it is saying on the app.”
    Read full story (paywalled)
    Source: HSJ, 26 January 2024
  14. Patient Safety Learning
    Working with physician and anaesthesia associates actually increases a doctor’s workload rather than freeing up time to focus on care of patients, a BMA survey finds.1
    The association surveyed more than 18 000 UK doctors to inform its position on physician and anaesthesia associates. Some 55% (7397 of 13 344 who responded to this question) reported that their workload had risen since the employment of medical associate professionals, with only 21% (2799 of 13 344) reporting a decreased workload.
    The House of Lords will shortly consider legislation to regulate physician associates under the General Medical Council rather than the Health and Care Professions Council.
    Read full story (paywalled)
    Source: BMJ, 2 February 2024
  15. Patient Safety Learning
    A nurse whistleblower has described her eight years of hell as she fights the NHS over its failure to properly investigate claims she was sexually harassed by a colleague.
    Michelle Russell, who has 30 years of experience, first raised allegations of sexual harassment by a male nurse to managers at the mental health unit where she worked in London in 2015.
    Years of battling her case saw the trust’s initial investigation condemned as “catastrophically flawed” while the nursing watchdog, the Nursing Midwifery Council, has apologised for taking so long to review her complaint and has referred itself to its own regulator over the matter.
    With the case still unresolved, Ms Russell will see her career in the NHS end this week after she was not offered any further contract work.
    Speaking to The Independent she said: “If I’m going to lose my job, I want other nurses to know that this is what happens when you raise a concern. I want the public to know this is what happens to us in the NHS when we are trying to protect the public.
    “I have an unblemished career. They’re crying out for nurses. I’ve dedicated my life to the NHS. I haven’t done anything wrong.”
    Read full story
    Source: The Independent, 6 February 2024
  16. Patient Safety Learning
    A test that can detect oesophageal cancer at an earlier stage than current methods should be made more widely available to prevent deaths, charities have said.
    The capsule sponge test, previously known as Cytosponge, involves a patient swallowing a dissolvable pill on a string. The pill then releases a sponge which collects cells from the oesophagus as it is retrieved.
    The test can detect abnormalities that form as part of a condition known as Barrett’s oesophagus, which makes a person more likely to develop oesophageal cancer.
    In the UK 9,300 people are diagnosed with oesophageal cancer a year, according to Cancer Research. The disease is difficult to detect because the symptoms for the cancer are not easily recognisable – and can be mistaken for indigestion – until a it is at an advanced stage.
    The capsule sponge test can detect the cancer at an earlier stage than the current methods, such as an endoscopy, used to diagnose oesophageal cancer. However, it is only currently available to higher-risk patients as an alternative to endoscopy as part of NHS pilot schemes.
    Cancer Research UK is working with the National Institute for Health and Care Research (NIHR) on a trial that will recruit 120,000 people to see if the capsule sponge test can reduce deaths from oesophageal cancer. If successful, the test could be rolled out more widely.
    Mimi McCord, the founder of Heartburn Cancer UK, who lost her husband, Mike, to oesophageal cancer in 2002, said: “Cancer of the oesophagus is a killer that can hide in plain sight. People don’t always realise it, but not all heartburn is harmless. While they keep on treating the symptoms, the underlying cause might be killing them.”
    Read full story
    Source: The Guardian, 5 February 2024
  17. Patient Safety Learning
    The NHS Race and Health Observatory, in partnership with the Institute for Healthcare Improvement and supported by the Health Foundation, has established an innovative 15-month, peer-to-peer Learning and Action Network to address the gaps seen in severe maternal morbidity, perinatal mortality and neonatal morbidity between women of different ethnic groups.
    Across England, nine NHS Trusts and Integrated Care Systems will participate in this action oriented, fast-paced Learning and Action Network to improve outcomes in maternal and neonatal health. Through the Network, the nine sites will aim to address the gaps seen in severe maternal morbidity, perinatal mortality and neonatal morbidity between women of different ethnic groups. Haemorrhage, preterm birth, post-partum depression and gestational diabetes have been identified as some of the priority areas for the programme.
    The sites will generate tailored action plans with the aim of identifying interventions and approaches that reduce health inequalities and enhance anti-racism practices and learning from the programme. These will be evaluated and shared across and between healthcare systems.
    The Network, the first of its kind for the NHS, will combine Quality Improvement methods with explicit anti-racism principles to drive clinical transformation, and aims to enable system-wide change.  Over a series of action, learning and coaching sessions, participants will review policies, processes and workforce metrics; share insights and case studies; and engage with mothers, parents, pregnant women and people.
    The programme will run until June 2025, supported by an advisory group from the NHS Race and Health Observatory, Institute for Healthcare Improvement, and experts in midwifery, maternal and neonatal medicine.
    Read full story
    Source: NHS Race and Health Observatory, 24 January 2024
  18. Patient Safety Learning
    Bosses at hospitals where police are investigating dozens of deaths have been criticised for “bullying” and fostering a “culture of fear” among staff in a damning review by the Royal College of Surgeons in England.
    The review focused on concerns about patient safety and dysfunctional working practices in the general surgery departments at the Royal Sussex County hospital in Brighton and the Princess Royal hospital in nearby Haywards Heath.
    But the reviewers were so alarmed by reports of harassment, intimidation and mistreatment of whistleblowers that they suggested executives at the University Hospitals Sussex trust may have to be replaced.
    They concluded: “Consideration should be given to the suitability, professionalism and effectiveness of the current executive leadership team, given the concerning reports of bullying.”
    The report comes as Sussex police continue to investigate allegations of medical negligence and cover-up in the general surgery department and neurosurgery department, involving more than 100 patients, including at least 40 deaths, from 2015 to 2021.
    The investigation was prompted by concerns from a general surgeon, Krishna Singh, and a neurosurgeon, Mansoor Foroughi, who lost their jobs at the trust after blowing the whistle over patient safety.
    Read full story
    Source: The Guardian, 6 February 2024
  19. Patient Safety Learning
    Families of children left disabled by an epilepsy drug and women injured by pelvic mesh implants should be given urgent financial help, England's patient safety commissioner has said.
    Dr Henrietta Hughes has called on the government to act quickly to help victims of the two health scandals.
    It follows a review which found lives had been ruined because concerns about some treatments were not listened to.
    It is estimated that, since the early 1970s, about 20,000 babies have been born with disabilities after foetal exposure to sodium valproate, which can harm unborn babies if taken in pregnancy.
    Scientific papers from as early as the 1980s suggested valproate medicines were dangerous to developing babies, yet warnings about the potential effects were not added to some packaging until 2016.
    Some families affected have been campaigning for decades to raise awareness of the potential effects of the drug, with some calling for compensation and a public inquiry.
    Dr Hughes was asked by the government to look into a potential compensation scheme for those affected by that scandal, as well as the one involving some 10,000 women who were injured by their pelvic mesh implants - a treatment for pelvic organ prolapse (POP) and incontinence.
    Read full story
    Source: BBC News, 7 February 2024
  20. Patient Safety Learning
    Campaigners have accused the UK government of betraying them after a review of redress for victims of health scandals excluded families who may have been affected by the hormone pregnancy test Primodos.
    A report published on Wednesday by the patient safety commissioner, Dr Henrietta Hughes, found a “clear case for redress” for thousands of women and children who suffered “avoidable harm” from the epilepsy treatment sodium valproate and from vaginal mesh implants.
    But despite the commissioner wanting to include families affected by hormone pregnancy tests in her review, the Department of Health and Social Care (DHSC) told her they would not be included.
    Primodos was an oral hormonal drug used between the 1950s and 70s for regulating menstrual cycles, and as a pregnancy test. Hormone pregnancy tests stopped being sold in the late 1970s and manufacturers have faced claims that such tests led to birth defects and miscarriages. Last year, the high court dismissed a case brought by more than 100 families to seek legal compensation owing to insufficient new evidence.
    The Hughes report states: “Our terms of reference did not include the issue of hormone pregnancy tests. This was a decision taken by DHSC and should not be interpreted as representing the views of the commissioner on the avoidable harm suffered in relation to hormone pregnancy tests or the action required to address this.
    “The patient safety commissioner wanted them included in the scope but, nevertheless, agreed to take on the work as defined by DHSC ministers.”
    Marie Lyon, the chair of the Association for Children Damaged by Hormone Pregnancy Tests, said the families of those who took the tests felt “left out in the cold” and betrayed that they were not included in the commissioner’s review.
    “I feel betrayed by the patient safety commissioner, by the IMMDS [Independent Medicines and Medical Devices Safety] review and by the secretary of state for health – all three have betrayed our families because, basically, they have just forgotten us. It’s a case of ‘it’s too difficult so we will just focus on valproate and mesh’,” Lyon said.
    Prof Carl Heneghan, a professor of evidence-based medicine at the University of Oxford, who led a systematic review of Primodos in 2018, said: “It’s unclear to me how the commissioner can keep patients safe if they are blocked and don’t have the power to go to areas where patient safety matters.”
    Read full story
    Source: The Guardian, 7 February 2024
  21. Patient Safety Learning
    Harold Chugg spent much of early 2023 in a hospital bed because of worsening heart failure. During his most recent admission in June, the 75-year-old received several blood transfusions, which led to fluid accumulating in his lungs and tissues.
    Ordinarily, he would have remained in hospital for further days or weeks while the medical team got his fluid retention under control. But Harold was offered an alternative: admission to a virtual ward where he would be closely monitored in the comfort of his own home.
    Armed with a computer tablet, a Bluetooth-enabled blood pressure cuff and weighing scales, Harold returned to his farm near Chulmleigh in north Devon and logged his own symptoms and measurements daily, which were reviewed by a specialist nurse in another part of the county.
    Virtual wards provide hospital-level care in people’s homes through the use of apps, wearables and daily “virtual ward rounds” by medical staff, who review patient data and follow up with telephone calls or home visits where necessary.
    More than 10,000 such beds are already available across England and at least a further 15,000 are planned. Scotland, Wales and Northern Ireland are also funding their expansion.
    But while proponents claim patients in virtual wards recover at the same rate or faster than those treated in hospital, and that the wards’ provision can help cut waiting lists and costs, some worry that their rapid expansion could place additional strain on patients and caregivers while distracting from the need to invest in emergency care.
    “Virtual wards, if they deliver hospital-level processes of care, are just one part of the solution, not a panacea,” said Dr Tim Cooksley, a recent ex-president of the Society for Acute Medicine.
    Read full story
    Source: The Guardian, 7 February 2024
  22. Patient Safety Learning
    Doctors have warned of the risks of “freebirthing” – where a woman gives birth without the help of a medic or midwife.
    Unassisted births, or “freebirths”, are thought to have been on the increase since the start of the Covid pandemic, when people may have been worried about attending hospitals and home births were suspended in many areas.
    The practice is not illegal and women have the right to decline any care during their pregnancy and delivery. Some women hire a doula to support them during birth.
    The Royal College of Obstetricians and Gynaecologists (RCOG) said women should be supported to have the birth they choose, but “safety is paramount” and families need to be aware of the risks of going it alone.
    The Nursing and Midwifery Council (NMC) said it is in the early stages of collaboration with the Chief Midwifery Officer’s teams, the Royal College of Midwives (RCM) and the Department of Health to better understand professional concerns about freebirthing and what organisations may need to do.
    Its statement on unassisted births supports women’s choice, but notes that “midwives are understandably concerned about women giving birth at home without assistance, as it brings with it increased risks to both the mother and baby”.
    It also states that women need to be informed that a midwife may not be available to be sent out to their home during labour if they change their mind and wish to have help.
    Read full story
    Source: The Independent, 8 February 2024
  23. Patient Safety Learning
    A senior surgeon has raised concerns about the way whistleblowers are dealt with, claiming he was sacked after speaking out.
    Serryth Colbert told the BBC that following attempts to "stop wrongdoing", he was investigated by the trust at Bath's Royal United Hospital.
    As a result, he said he was dismissed for gross misconduct in October 2023.
    The RUH said it has "never dismissed anybody for raising concerns and never will".
    It added that Mr Colbert's dismissal related to "significant concerns about bullying" and its investigation into his conduct was "thorough" and "robust".
    Mr Colbert said he raised safety concerns without regard for the impact it might have on his career.
    "It was never a question in my mind. This is wrong. I'm stopping the wrongdoing. I stand for justice. I stand to protect patients," he said.
    The BBC has seen no evidence his most serious concern was ever investigated and Mr Colbert is now taking the RUH to an employment tribunal.
    Read full story
    Source: BBC News, 9 February 2024
  24. Patient Safety Learning
    Cancer waiting times for 2023 in England were the worst on record, a BBC News analysis has revealed.
    Only 64.1% of patients started treatment within 62 days of cancer being suspected, meaning nearly 100,000 waited longer than they should for life-saving care. The waits have worsened every year for the past 11.
    Macmillan Cancer Support chief executive Gemma Peters called the figures "shocking".
    "This marks a new low and highlights the desperate situation for people living with cancer," she said.
    "Behind the figures are real lives being turned upside down, with thousands of people waiting far too long to find out if they have cancer and to begin their treatment, causing additional anxiety at what is already a very difficult time.
    "With over three million people in the UK living with cancer and an ageing population, this is only set to rise."
    The records go back to 2010, shortly after the cancer target was introduced.
    However, improvements have been made over the course of 2023 in how quickly patients are diagnosed with 72% told whether they have cancer or not within 28 days of an urgent referral.
    Read full story
    Source: BBC News, 8 February 2024
  25. Patient Safety Learning
    The number of patients waiting more than 12 hours in A&E hit a record in January of almost 180,000 people.
    Worsening pressures on A&E come as prime minister Rishi Sunak has officially missed his pledge, made in January last year, to cut the NHS waiting list.
    NHS England began publishing previously-hidden data on patients waiting 12 hours or more last year, after reports by The Independent.
    The latest figures for January show 178,000 people were waiting this long to be seen, treated or discharged after arriving from A&E – a record since February 2023 when the data was first published. In that month, 128,580 people waited more than 12 hours, and in December there were 156,000.
    The number waiting at least four hours from the decision to admit to actual admission has also risen, from 148,282 in December to 158,721 last month – the second-highest figure on record.
    Dr Tim Cooksley, past president of the Society for Acute Medicine, warned: “Degrading corridor care and prolonged waits causing significant harm is tragically and increasingly the expected state in urgent and emergency care.”
    Read full story
    Source: The Independent, 8 February 2024
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