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Patient Safety Learning

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  1. Patient Safety Learning
    The NHS needs its best leaders to be prepared to take on “the biggest challenges” despite the risk of criticism, the Care Quality Commission’s chief inspector has said.
    At its monthly meeting, the CQC board was discussing how three previously ‘inadequate’-rated trusts – United Hospitals Lincolnshire Trust, Isle of Wight Trust and The Queen Elizabeth’s Hospital Kings Lynn FT – have all recently moved out of ‘special measures’, following improved reports from inspectors.
    In response, Professor Ted Baker said that at each of the trusts a “new approach to leadership had changed the culture”, and despite still being under “particular pressure” they were able to drive forward “major improvements”.
    He was “grateful” for the three leaders at the trusts for taking on the leadership challenge. 
    Professor Baker said: “One of my concerns is leaders are not attracted to these posts, as they feel they are posts where they can be easily criticised. The best NHS leaders need to take on the biggest challenges.”
    Read full story (paywalled)
    Source: HSJ, 23 February 2022
  2. Patient Safety Learning
    The death of a "vulnerable" transgender teenager who struggled to get help was preventable, a coroner has said.
    Daniel France, 17, was known to Cambridgeshire County Council and Cambridgeshire and Peterborough Foundation Trust (CPFT) when he took his own life on 3 April 2020.
    The coroner said his death showed a "dangerous gap" between services.
    When he died, Mr France was in the process of being transferred from children and adolescent mental health services (CAMHS) in Suffolk to adult services in Cambridgeshire.
    The First Response Service, which provides help for people experiencing a mental health crisis, also assessed Mr France but he had been considered not in need of urgent intervention, the coroner's report said.
    Cambridgeshire County Council had received two safeguarding referrals for Daniel, in October 2019 and January 2020, but had closed both.
    "It was accepted that the decision to close both referrals was incorrect", Mr Barlow said in his report.
    Mr Barlow wrote in his report, sent to both the council and CPFT: "My concern in this case is that a vulnerable young person can be known to the county council and [the] mental health trust and yet not receive the support they need pending substantive treatment."
    He highlighted Daniel was "repeatedly assessed as not meeting the criteria for urgent intervention" but that waiting lists for phycological therapy could mean more than a year between asking for help and being given it.
    "That gap between urgent and non-urgent services is potentially dangerous for a vulnerable young person, where there is a chronic risk of an impulsive act," Mr Barlow said.
    Read full story
    Source: BBC News, 25 February 2022
     
     
  3. Patient Safety Learning
    The symptoms of polycystic ovary syndrome (PCOS) became so difficult for one woman, she did not want to live.
    Angharad Medi Lewis from Carmarthenshire said "embarrassing" heavy periods and excess facial hair made her not want to leave home.
    "I was having very heavy periods, I was in serious pain for a whole week every month, growing hair on my face, I was anxious, so worried about going out because of the heavy periods that it was actually embarrassing," she said.
    According to Neuroendocrinology expert Prof Aled Rees, the condition and its link with mental health side effects "isn't appreciated enough".
    "Patients often come to us at the clinic, and it's obvious from the symptoms they describe, that it's going to have an impact on their mental health."
    He said there was a "gap" in the general conversation with PCOS patients.
    "There needs to be greater emphasis for patients and doctors that any consultation they have includes a discussion about mental health because there is an effective treatment available".
    The charity Fair Treatment for Women in Wales has called on the Welsh government to put women's physical and mental health at the top of the agenda.
    Julie Richards, a consultant with the charity, said the mental health impacts of conditions like PCOS and endometriosis, are often forgotten.
    "We need specialist clinics in Wales, and when it comes to women's health generally, we're lagging behind in all areas," she said.
    The Welsh government said women's wellbeing was a priority and it would publish plans on how to support women.
    Read full story
    Source: BBC News, 25 February 2022
  4. Patient Safety Learning
    The rising rate at which Australian children are being admitted to hospital for serious food allergies has flattened since infant feeding guidelines were changed, new research shows.
    The rate of hospitalisation for food anaphylaxis has increased in Australia in recent decades – but data suggests that changes to allergy prevention and infant feeding guidelines in 2008 and 2016 have helped to stem the rise in young children and teenagers.
    In 2008, the Australasian Society of Clinical Immunology and Allergy guidelines were changed to recommend that allergenic solid foods should no longer be delayed, and in 2016 they were again updated to suggest such foods should be introduced in the first year of life.
    Study co-author Prof Mimi Tang, an immunologist at the Murdoch Children’s Research Institute, said the greatest benefit of the updated guidelines was in children aged one to four.
    Tang said there had been important changes to allergy prevention advice in the last 15 years. “Prior to 2008, all of the food allergy … prevention guidelines around the world were advising to delay the introduction of allergenic foods such as egg, milk and peanut until the ages of somewhere between two and four, depending on the food,” she said.
    “The reason these recommendations were in place was based on theoretical concerns that the gut barrier was perhaps not as strong in young babies.”
    But a growing body of evidence showed that delaying allergenic foods was associated with an increased risk of developing food allergies.
    In the new study, published in the Journal of Allergy and Clinical Immunology, Tang and her colleagues noted an ongoing increase in anaphylaxis hospitalisation rates in teenagers aged 15 and older at the time the research was completed. People in this age group were born before the 2008 changes to the Australian guidelines.
    Read full story
    Source: The Guardian, 24 February 2022
  5. Patient Safety Learning
    The NHS has been accused by a major charity of failing to address the emerging gap in Covid booster vaccine coverage for racialised communities.
    Blood Cancer UK has told The Independent it has “serious concerns” over what it claims is a “shocking” lack of urgency from the NHS in addressing the gap in booster vaccine doses for immunocompromised people from black and minority ethnic communities.
    The charity has said NHS England has failed to set out any “concrete” plans since it revealed 84% of immunocompromised people from a white British background had three vaccine doses by mid-December, compared to just 43% of immunocompromised people from a Pakistani background.
    The news comes after the government announced people over 75 and immunocompromised children would be eligible to receive a fourth Covid vaccine by Spring.
    According to an analysis published by Open Safely, a team of data scientists at Oxford University, of those who are part of the shielding population, as of the 22 February just 72% of Black people have had their booster does, and 73% of south Asian people. This compares to 89% of white people.
    NHS England has highlighted a number of actions it is taking to address the situation such as using pop-up sites within communities and providing free transport.
    Speaking with The Independent chief executive of Blood Cancer UK Gemma Peters, said: “We have serious concerns about how the poor roll-out of third doses for the immunocompromised has left people from some communities much less well-protected than people from a white British background. But while it is deeply troubling that a racial disparity in access to third vaccine doses has been allowed to develop, just as shocking has been NHS England’s apparent lack of urgency in addressing it."
    Read full story
    Source: The Independent, 25 February 2022
  6. Patient Safety Learning
    Breast cancer screening uptake fell to its lowest point ever during the pandemic, as the numbers of women seen dropped by more than one third.
    Just 1.19 million women aged 45 and over were screened for breast cancer in 2020-21, while the numbers of women who actually took up their invitation for screening dropped to 61%.
    Analysis by Breast Cancer Now, of the new NHS figures published on Thursday, found that uptake during the first year of the pandemic was the lowest it had been since records began.
    The number of women who had cancer detected through screening decreased by almost 40 per cent, although rates when calculated per 1,000 women were up by 8.4%.
    The news comes after NHS figures revealed that half of patients in October waited more than two weeks following an urgent breast cancer referral.
    According to analysis from the Labour Party in January, breast cancer patients faced the longest waits when compared to all other cancer referrals.
    Breast Cancer Now chief executive Baroness Delyth Morgan said: “Screening uptake has hit its lowest point in history, with less than 62% of women invited being screened, despite NHS staff working tirelessly, in the toughest of circumstances, to restart and continue breast screening services after they needed to be paused in March 2020.
    “The human cost behind these figures is stark, with an estimated 8,870 women in the UK living with undetected breast cancer as a result of the pandemic – a significant number of which would have been detected at routine screening. Tragically, research suggests that up to an additional 680 women could die from breast cancer in the next decade due to impacts of the pandemic on screening.”
    Read full story
    Source: The Independent, 24 February 2022
  7. Patient Safety Learning
    A Covid report by the Local Government and Social Care Ombudsman has highlighted some ‘tragic individual cases’ over the past months.
    The report analyses cases over the first 18 months of the pandemic which for the majority reveal that councils and care providers weathered the unprecedented pressures they were under fire.
    However, the report also reveals the ‘serious impact on people’s lives’ when things go wrong.
    Cases include a woman who died from COVID-19 at a care home with poor infection control procedures which was then compounded by staff trying to cover up the facts.
    The Ombudsman’s report focuses on the lessons that can be learned from the complaints it has received about the pandemic and welcomes that, in many cases, councils and care providers are already using their experiences from the pandemic to consider how they can make improvements to services.
    Michael King, Local Government and Social Care Ombudsman, said: “We have investigated some tragic individual cases over the past months. Each represents poor personal experiences where councils and care providers did not get things right.
    “Our investigations have shown that, while the system did not collapse under the extreme pressures placed on it, Covid-19 has magnified stresses and weaknesses present before the pandemic affecting some councils and providers.
    “We have always advocated how crucial good complaint handling is in any setting, so I am particularly saddened that, in some authorities, dealing with public concerns and complaints itself became a casualty of the crisis. At a time when listening to public problems was more important than ever, we saw some overstretched and under-resourced complaints teams struggle to cope.
    “If evidence was needed, this report proves that managing complaints should be considered a frontline service.”
    Read full story
    Source: Care Home Professional, 24 February 2022
  8. Patient Safety Learning
    Electronic patient record (EPR) systems must be implemented in at least 90% of NHS trusts by the end of next year, the health secretary has announced at HSJ’s Digital Transformation Summit.
    Speaking at the event with digital healthcare leaders in Birmingham, Mr Javid said an estimated one in five trusts are currently without EPR systems implemented. He said: “We have seen some brilliant progress {on digital transformation] but it’s not always been consistent across the board.”
    He said: “We must see these disparities as just as unjust as disparities in access to education and employment.”
    And added: “Electronic patient records are the essential prerequisite for a modern, digital NHS."
    Mr Javid said 40% of social care providers were grappling with entirely paper based records, and he also wanted them to all adopt electronic records. 
    He also outlined the intended future of the NHS App, and the government’s ambition for this to be used by 75 per cent of adults in England by March 2024. Currently it is just over half of all adults.
    Mr Javid said he wanted the app to be the “future front door for interaction with the NHS”, and will be used by patients to directly communicate with their healthcare providers, to receive personalised health advice and to access test results.
    Read full story (paywalled)
    Source: HSJ, 24 February 2022
  9. Patient Safety Learning
    A London mum says she has been left in "agony" and only able to walk 10 minutes at a time after a transvaginal mesh implant perforated her organs. Anna Collyer, 53, had a transvaginal mesh fitted in 2015 at St. Helier hospital in Sutton.
    The mesh is a net-like implant and aims to give permanent support to the weakened organs and to repair damaged tissue. The mesh implants are designed to be permanent, but last April, Anna started to experience severe pain when the mesh cut into her organs leaving her "unable to live any sort of life anymore," she said.
    Even when doctors partially removed the mesh last June - her symptoms persisted. Anna, who lives in Morden, told MyLondon: "I could feel something sharp inside me. The pain relief tablets were not touching it. I was in agony.
    "It's got to the stage now where 10 minutes is all I can walk, because the pain is excruciating. I have pain in pelvis, groin, hips, back and shooting pains in legs. The level is horrendous. I have to lie down all the time.
    The vaginal mesh procedure was once common place in the UK, with more than 92,000 women receiving one between April 2007 and March 2015 in England alone. But the treatment was “paused” and The Independent Medicines and Medical Devices Safety Review was ordered by the then health secretary, Jeremy Hunt, in 2018 amid mounting safety concerns.
    Women told the review team of “excruciating chronic pain feeling like razors inside their body" and felt dismissed when reporting complications including “unacceptable labelling of so many symptoms as ‘normal’ and attributable to ‘women’s problems’”, the report says.
    The new review accuses medial professionals of displaying “an institutional and professional resistance” to changing practice. The report concluded that “those harmed are due not only an apology, but better care and support through specialist centres”.
    Read full story
    Source: MyLondon. 22 February 2022
  10. Patient Safety Learning
    The NHS is facing a “time bomb” and will be forced to cancel or delay around 8 million operations each year by 2040, due to a lack of consultant anaesthetists across the services.
    The Royal College of Anaesthetists (RCOA) said the current shortage of at least 1,400 staff across the UK means millions operations will not be able to take place.
    The college has warned its speciality is facing a “perfect storm” of limited training places, poor retention and an ageing workforce with 39 per cent nearing retirement age.
    The analysis found as demand for surgeries continue the need for anaesthetists is due to increase by 3.85 per year, meaning the NHS will need around 25,000 doctors in these posts by 2040.
    Dr Fiona Donald, president of the RCOA said: “The NHS is facing an anaesthetic workforce time bomb. We already have profound workforce shortages that are preventing huge numbers of operations from taking place – and unless urgent action is taken, the problem is going to worsen.
    “We would welcome government funding for additional anaesthetic training posts. One hundred additional posts per year would start to plug the gap and help get the UK back on a sound footing to be able to address the waiting list backlog. Without this investment, we foresee impacts to patient care and a further impact on the mental health of our current workforce – they need to be able to prioritise their own health and that of their families alongside the focus they already place on the health of patients and the public.”
    Read full story
    Source: The Independent, 22 February 2022
  11. Patient Safety Learning
    Next month, a report will be published into one of the biggest scandals in the history of the NHS, the failures of maternity care at the Shrewsbury and Telford Hospital NHS Trust. The BBC's Michael Buchanan who helped uncover the problems examines why so many failures were allowed to happen for so long.
    Kayleigh Griffiths' baby, Pippa, died at 31 hours old. The cause of death, the couple were later told, was an infection - Group B Strep. The Shrewsbury and Telford Hospital NHS Trust told the family they would carry out an investigation. But after several weeks of silence, Kayleigh contacted the trust to be told it was an internal investigation and the couple's input wouldn't be required. Kayleigh, an NHS auditor at a different trust, feared the truth was being hidden from her. That's when she decided to send the email to Rhiannon Davies, whose baby, Kate, also died at the Shrewsbury and Telford Hospital NHS Trust
    As the bond between the mothers deepened, their conversations morphed into something else. Armed with little more than a gnawing suspicion, they started to scour the internet, coroner's records and death notices to see if any other families had received poor maternity care at the Shropshire trust.
    They collated 23 cases dating back to 2000 - including stillbirths, neonatal deaths, maternal deaths and babies born with brain injuries. Appalled by what they had found, they wrote to the then health secretary Jeremy Hunt in December 2016, asking him to order an investigation. He agreed and in May 2017, senior midwife Donna Ockenden was appointed to lead the review.
    One of the themes the inquiry has already noted, in an interim report published in December 2020, is that in many cases the trust failed to investigate after something went wrong, or simply carried out its own inquiry. Panorama has discovered the trust even developed its own investigation system, what they called a High Risk Case Review.
    It was outside any national framework that has been used to help learn lessons from incidents and doesn't appear to be a system that's used in any other NHS organisation. Another consequence of the unorthodox system was that fewer incidents were reported to NHS regulators, limiting the opportunity to learn lessons.
    One of the earliest cases on the original list of 23 compiled by the two couples was the death of Kathryn Leigh in 2000. Panorama has investigated the case and discovered that a theme identified almost two decades ago was to come up repeatedly in subsequent incidents.
    The publication of the final report by Donna Ockenden next month will be a watershed moment in the history of the NHS - the revelation of multiple instances of maternity failures in a rural corner of England. Pippa Griffiths and Kate Stanton-Davies lived fewer than 40 hours between them, but their legacy, in terms of improved maternity care, could last decades.
    Read full story
    Source: BBC News, 23 February 2022
    Source: 
  12. Patient Safety Learning
    Five months after being infected with the coronavirus, Nicole Murphy’s pulse rate is going berserk. Normally in the 70s, which is ideal, it has been jumping to 160, 170 and sometimes 210 beats per minute even when she is at rest — putting her at risk of a heart attack, heart failure or stroke.
    No one seems to be able to pinpoint why. She’s only 44, never had heart issues, and when a cardiologist near her hometown of Wellsville, Ohio, USA, ran all of the standard tests, “he literally threw up his hands when he saw the results,” she recalled. Her blood pressure was perfect, there were no signs of clogged arteries, and her heart was expanding and contracting well.
    Murphy’s boomeranging heart rate is one of a number of mysterious conditions afflicting Americans weeks or months after coronavirus infections that suggest the potential of a looming cardiac crisis.
    A pivotal study that looked at health records of more than 153,000 U.S. veterans published this month in Nature Medicine found that their risk of cardiovascular disease of all types increased substantially in the year following infection, even when they had mild cases. The population studied was mostly White and male, but the patterns held even when the researchers analyzed women and people of color separately. When experts factor in the heart damage probably suffered by people who put off medical care, more sedentary lifestyles and eating changes, not to mention the stress of the pandemic, they estimate there may be millions of new onset cardiac cases related to the virus, plus a worsening of disease for many already affected.
    “We are expecting a tidal wave of cardiovascular events in the coming years from direct and indirect causes of covid,” said Donald M. Lloyd-Jones, president of the American Heart Association.
    Read full story (paywalled)
    Source: Washington Post, 21 February 2022
  13. Patient Safety Learning
    The NHS should not be given greater control of social care because it is ‘hierarchical, centralised and not person-centred’, according to a government-commissioned review which is repeatedly scathing about the health service.
    The review was ordered by then health and social care secretary Matt Hancock in June 2020. Cross-bench peer, writer and former Number 10 adviser Baroness Camilla Cavendish was asked “to make recommendations for social care reform and integration with health in the wake of the Covid-19 pandemic, which could fit alongside the funding reforms planned by the department in the context of the NHS long-term plan.”
    In her final report, Baroness Cavendish wrote that “one answer” to the problems facing the sector “would be to let the NHS take over social care. On paper, this would join up the care continuum.”
    However, she rejected the idea because of the NHS’ “hierarchical” and “centralised” nature. Baroness Cavendish also suggested the NHS’ role should be limited because it is “still struggling to join up primary and secondary care”.
    In contrast to the NHS, she claimed: “Social care is more innovative, more responsive and human.”
    She added: “The culture of the NHS is still largely one of ‘doing to’ patients, and the NHS has much to learn from social care about how to be responsive and human facing.”
    Referencing “recent attempts to import the successful [Buurtzorg] model of self-managing teams into the NHS”, the cross-bench peer said these “have foundered, because the NHS culture cannot seem to cope with giving staff the autonomy required”.
    Read full story (paywalled)
    Source: HSJ, 23 February 2022
  14. Patient Safety Learning
    Despite a backlog of routine operations, NHS hospitals are being advised to delay elective surgical procedures by at least seven weeks if a patient has just had Omicron.
    UK experts say it is a precaution since the first couple of months following infection is a riskier period, linked to poorer post-operative recovery.
    In some circumstances the surgery may be urgent enough to go ahead, however. Patients should ideally have had all of their Covid vaccines too.
    The advice has been issued by surgery and anaesthesia experts, including two Royal Colleges representing those professions.
    The experts who drew up the recommendations say the desire to tackle waiting lists and backlogs must be balanced with delivering the safest care possible.
    The latest expert guidance on routine operations recommends:
    Elective surgery should not take place within 10 days of a confirmed Covid infection, mainly because the patient may be infectious which is a risk to staff and other patients. Operations that happen in the six-week period after an infection - even an asymptomatic one - carry a higher risk of serious complications for the patient, experience suggests. Dr Mike Nathanson, president of the Association of Anaesthetists, said: "The frustration felt by patients is immense and we - the healthcare professionals - want to do our jobs and provide these services when it is safe to do so and with the risks clear to all involved."
    Read full story
    Source: BBC News, 23 February 2022
  15. Patient Safety Learning
    A former consultant gynaecologist has told how he raised concerns over bullying, unsafe practices and a "dysfunctional culture" ahead of a report into a maternity scandal.
    Bernie Bentick, who worked at Shrewsbury and Telford Hospitals Trust (Sath) for almost 30 years, has spoken publicly about maternity care at the trust for the first time.
    Sath is at the centre of the largest inquiry in the history of the NHS into maternity care, which is expected to report next month. An official investigation is examining the care that 1,862 families received.
    Mr Bentick says he told senior management several times about a deteriorating culture at Sath.
    “I was increasingly concerned about the level of bullying, of dysfunctional culture, of the imposition of changes in clinical practice that many clinicians felt was unsafe," Mr Bentick told BBC's Panorama.
    "If the resources had been made available to employ adequate numbers, to provide safe levels of care in accordance with national guidelines, then the situation may have been profoundly different.”
    Mr Bentick went on to say that though some “cursory” investigations were launched into his complaints, he believed the trust responded in a way that tried to “preserve the reputation of the organisation.”
    Read full story
    Source: Shropshire Star, 23 February 2022
  16. Patient Safety Learning
    The Care Quality Commission (CQC) should not ‘sit in an ivory tower and dream up what it thinks good looks like’ when it starts rating integrated care systems, the proposed new chair for the regulator has told MPs.
    Ian Dilks, the government’s preferred candidate to become the CQC’s new chair, was questioned by the health and social care committee on Tuesday. During the session the committee chair’s Jeremy Hunt asked how Mr Dilks would make the rating of systems “a success”.
    Mr Hunt said: “We became the first healthcare system in the world to ‘Ofsted rate’ our hospitals. Under your leadership, assuming you take up this role, we will become the first healthcare system in the world to do the same for entire geographical regions of health systems.”
    Mr Dilks responded: “I don’t think it is up to the CQC to sit in an ivory tower and dream up what it thinks good looks like.”
    “It will not be in anybody’s interest if the CQC comes up with a whole bunch of ratings and ICSs say, ‘well I don’t know how you got there’.” He added: “I think involving all parties in the development process so that what emerges has a high degree of acceptance.”
    He was also asked at the session about what he had learnt about improving patient safety while working at NHS Resolution.
    Mr Dilks said: “I do not think the system is good at learning… it needs some help and encouragement to firstly really understand what’s gone wrong when you have an outcome that isn’t the correct one, and secondly how do you encourage and support the system to do better the next time around.”
    Read full story (paywalled)
    Source: HSJ, 23 February 2022
  17. Patient Safety Learning
    A taskforce has been set up to tackle disparities in maternity care experienced by women belonging to ethnic minorities and those living in deprived areas.
    Black women are 40% more likely to miscarry than white, studies suggest. Maternal death rates are also higher among black and Asian women.
    Royal College of Obstetricians and Gynaecologists head Dr Edward Morris told BBC News implicit racial bias was affecting some women's care.
    Patient Safety and Primary Care Minister Maria Caulfield said: "For too long disparities have persisted which mean women living in deprived areas or from ethnic minority backgrounds are less likely to get the care they need and, worse, lose their child.
    "We must do better to understand and address the causes of this.
    "The Maternity Disparities Taskforce will help level-up maternity care across the country, bringing together a wide range of experts to deliver real and ambitious change so we can improve care for all women - and I will be monitoring progress closely."
    Chief midwifery officer Prof Jacqueline Dunkley-Bent, who will co-chair the taskforce, said: "The NHS's ambition is to be the safest place in the world to be pregnant, give birth and transition into parenthood - all women who use our maternity services should receive the best care possible."
    The taskforce will meet every two months and focus on:
    improving personalised care and support plans addressing how wider societal issues affect maternal health improving education and awareness of health when trying to conceive, such as taking supplements and maintaining a healthy weight increasing access to maternity care for all women and developing targeted support for those from the most vulnerable groups empowering women to make evidence-based decisions about their care. Read full story
    Source: BBC News, 23 February 2022
    Source: BBC News, 
  18. Patient Safety Learning
    Patient care may suffer as a result of cuts to the NHS budget to fund the continuing costs of Covid, NHS leaders and Labour have said, after Sajid Javid refused to say where the axe would fall.
    The Department of Health and Social Care (DHSC)  is trying to make savings from its budget to fund free lateral flow tests for elderly people, Covid surveillance studies and genomic sequencing, after the Treasury refused its request for £5bn in extra funding.
    Although the government announced an end to most free mass testing and contract tracing on Monday, remaining Covid measures are expected to cost more than £1bn.
    The Treasury and the DHSC refused to say exactly how much cash would be needed or which services would have to be cut back, prompting fears that the NHS could have to find savings at a time of a huge waiting list backlog.
    It is understood that DHSC officials are working on identifying savings in the department’s £178.5bn budget for 2022-23, to fund the measures agreed on Monday, including maintaining a “baseline” testing capability that can be scaled up if necessary.
    They have ruled out hitting Javid’s plan for tackling waiting lists, but a government source would not rule out any other areas being affected, saying a “significant amount of money” would have to be found by “reprioritising”.
    Saffron Cordery, the deputy chief executive of NHS Providers, warned the government against abandoning its commitment to give the NHS “whatever it needs” to tackle Covid and called for transparency about “where the impact of these extra costs will fall”.
    “Trust leaders are understandably anxious over reports that the ongoing and significant costs of living with Covid will be met by ‘reprioritising’ the NHS’s existing budget,” she said. “There is a very real risk of trade-offs affecting the quality of patient care – something no one wants to see.”
    Read full story
    Source: The Guardian, 23 February 2022
  19. Patient Safety Learning
    The government of Mexico City handed out nearly 200 000 “ivermectin based kits” last year to people who had tested positive for Covid-19, without telling them they were subjects in an experiment on the drug’s effectiveness.
    The results of that experiment were then written up by public officials in an article placed on popular US preprint server SocArXiv. It became one of site’s most viewed articles, claiming that ivermectin had reduced hospital admissions by 52-76%.
    But those officials have been under fire at home since SocArXiv withdrew the paper earlier this month, calling it “either very poor quality or else deliberately false and misleading.”
    Opposition deputies in Mexico City’s Congress demanded hearings and said they would bring legal action against the paper’s lead author, José Merino, head of the city’s Digital Agency for Public Innovation.
    Explaining the decision to withdraw the article—the first to be taken down by SocArXiv—the site’s steering committee wrote that it had responded “to a community groundswell beseeching us to act” in order “to prevent the paper from causing additional harm.”
    The committee wrote, “The paper is spreading misinformation, promoting an unproved medical treatment in the midst of a global pandemic. The paper is part of, and justification for, a government programme that unethically dispenses (or did dispense) unproven medication apparently without proper consent or appropriate ethical protections.”
    Read full story
    Source: BMJ, 22 February 2022
  20. Patient Safety Learning
    Medically vulnerable people say the decision to end Covid restrictions means their freedoms being eroded.
    Prime Minister Boris Johnson announced that legal requirements, including the need to self-isolate if you test positive, will end on Thursday.
    Two clinically vulnerable women in the West say not knowing who is infected means it is now more dangerous for them to leave their homes.
    "It doesn't feel safe," said Chloe Ball-Hopkins, from Gloucestershire.
    "My friends and family will continue to try and keep me safe, my partner will keep me safe, they'll continue to test before they meet me," said the 25-year-old from Wotton-under-Edge.
    Miss Ball-Hopkins has already had her fourth vaccine dose as she is considered extremely clinically vulnerable.
    She has a rare form of muscular dystrophy called nemaline myopathy which affects her respiratory system, and contracted sepsis in 2019 which undermined her immune system further.
    Miss Ball-Hopkins said that while the easing of restrictions would feel like freedom to much of the population, it meant the opposite for her.
    "I'm supposed to go out and live my life normally yet now I won't know if someone next to me in a supermarket is literally breathing Covid down on me, as I'm in a wheelchair.
    "I was actually probably safer in January when everyone was wearing masks than I will be in a week's time. That makes no sense," she said.
    Read full story
    Source: BBC News, 22 February 2022
  21. Patient Safety Learning
    GPs and women are still ignoring key symptoms of ovarian cancer despite better awareness of the disease, a charity has warned, prompting fears that yet more patients will be diagnosed late and “die needlessly”.
    Symptoms include frequently having a swollen tummy or feeling bloated; pain or tenderness in the tummy or the pelvis; having no appetite or feeling full quickly after eating, and an urgent need to pee or needing to pee more often, according to the NHS.
    However, Target Ovarian Cancer is concerned that despite successful campaigns to boost awareness of the disease, many are still failing to act on the vital signs. “Key symptoms are being ignored – both by those experiencing them and their GPs,” a spokesperson said.
    A poll of 1,000 women for the charity found 79% did not know that bloating was a symptom, while 68% were unaware abdominal pain was a sign, and 97% did not know feeling full was another. Most women (99%) did not know that needing to pee more urgently was also a sign, while evidence suggests women can often be told by their GP that their symptoms are more a symptom of irritable bowel syndrome (IBS), Target Ovarian Cancer said.
    Ovarian cancer kills about a third of women with the disease in the first year after diagnosis, and is often diagnosed in the late stages. There are about 7,500 new ovarian cancer cases in the UK every year.
    “These figures are incredibly disappointing,” said Annwen Jones, the chief executive of Target Ovarian Cancer. “We know we’ve shifted the dial in the past 10 years through the dedication of thousands of Target Ovarian Cancer’s campaigners, but it is not enough. Knowing the symptoms is crucial for everyone.
    “We need to make sustained and large-scale government-backed symptoms campaigns a reality. Progress is possible. If we do this, fewer people will be diagnosed late, fewer will need invasive treatment, and, ultimately, fewer will die needlessly from ovarian cancer.”
    Read full story
    Source: The Guardian, 22 February 2022
  22. Patient Safety Learning
    Patients face limits on visitors in every hospital trust in England, The Telegraph has revealed, with restrictions set to continue even once the country moves to "living with Covid".
    It comes as Boris Johnson announces that all Covid regulations including self-isolation will be abolished at the end of February. 
    The health service supports keeping some visiting restrictions in place while Covid remains in circulation among the general population, it is understood.
    A spokesman said: "The NHS regularly reminds hospitals that visits for patients should continue to go ahead as much as possible and extra measures should already be in place so that this can be done safely."
    NHS England encourages trusts to facilitate visits "wherever possible, and to do so in a risk-managed way", but it is up to individual trusts to set their own policies based on UK Health Security Agency guidelines.
    Analysis by The Telegraph found that at least 34 hospital trusts across England still have routine visits suspended, with exceptions such as those for patients receiving end-of-life care and people with dementia. All 125 trusts have some form of visiting restriction in place. The most common policy is to have one named visitor per patient for the entirety of a patient's stay, who can only visit for one hour once a day.
    Helen Wildbore, the director of the Relatives and Residents Association, said limiting patients to one nominated visitor put pressure on families, leaving the carer "exhausted".
    She added: "If you’re going into hospital and you're not able to have your family with you, you're going to come out worse." In some cases, patients who needed hospital care had chosen not to go because they were worried about being isolated from family, she said.
    Caroline Abrahams, the Charity Director at Age UK, said it was "imperative that hospitals open their doors to visitors again as wide as they possibly can" as the pandemic eases.
    Read full story (paywalled)
    Source: The Telegraph, 18 February 2022
    You may also be interested in reading: 
    Visiting restrictions and the impact on patients and their families: a relative's perspective
  23. Patient Safety Learning
    A diabetic pensioner died on the roof of a hospital after staff physically ejected him despite being in a “confused” state.
    Stephen McManus, a long-term Type 1 diabetes patient, had earlier been rushed to Charing Cross Hospital in west London while suffering a hypoglycaemic episode.
    Despite colleagues having expressed concerns about his slurred speech and erratic behaviour, a junior doctor decided the 60-year-old had the mental capacity to go home.
    He was wheeled out of the building by security guards, despite having no phone, money and being in his slippers. His family had not been contacted to inform them he was being discharged.
    Some time later Mr McManus re-entered the building and managed to gain access to a construction area, somehow finding his way onto the roof.
    He was found dead the next morning following a police search after his family reported him missing.
    An inquest has begun trying to establish why Stephen was allowed to leave the hospital in the first place and how he was able to access a potentially dangerous zone.
    Mr McManus’s family say the case raises profound questions about the treatment of diabetic patients in the NHS.
    “My father was an extremely vulnerable patient and the nature of his removal from the hospital is inexplicable, Jonathan McManus, his son, told The Telegraph.
    “Had he been kept in hospital he would no doubt be alive today.”
    Read full story
    Source: Yahoo News, 19 February 2022
  24. Patient Safety Learning
    Having Covid-19 puts people at a significantly increased chance of developing new mental health conditions, potentially adding to existing crises of suicide and overdoses, according to new research looking at millions of health records in the US over the course of a year.
    The long-term effects of having Covid are still being discovered, and among them is an increased chance of being diagnosed with mental health disorders. They include depression, anxiety, stress and an increased risk of substance use disorders, cognitive decline, and sleep problems – a marked difference from others who also endured the stress of the pandemic but weren’t diagnosed with the virus.
    “This is basically telling us that millions and millions of people in the US infected with Covid are developing mental health problems,” said Ziyad Al-Aly, chief of research and development at the VA St Louis Healthcare System and senior author of the paper. “That makes us a nation in distress.”
    The higher risk of mental health disorders, including suicidal ideation and opioid use, is particularly concerning, he said.
    “This is really almost a perfect storm that is brewing in front of our eyes – for another opioid epidemic two or three years down the road, for another suicide crisis two or three years down the road,” Al-Aly added.
    These unfolding crises are “quite a big concern”, said James Jackson, director of behavioural health at Vanderbilt University’s ICU Recovery Center, who was not involved with this study. He is also seeing patients whose previous conditions, including anxiety, depression and opioid use disorder, worsened during the pandemic.
    Read full story
    Source: The Guardian, 18 February 2022
  25. Patient Safety Learning
    At least five people in the Netherlands who developed Long Covid through their jobs are planning to sue their employers for financial and emotional damage, according to RTL Nieuws. But lawyers, unions, company doctors and academics expect many more cases will arise and say they could take years to reach a conclusion, RTL said.
    One case involves a residential care nurse who was told to take care of a patient without protective clothing. It later transpired that the unit manager knew the patient may have had coronavirus. The nurse has been at home for almost two years with Long Covid, and her salary has been reduced in line with sick pay regulations.

    Ambulance worker Lenny Wagemans is also holding her former employer responsible for her illness. She picked up coronavirus in March 2020 after a patient coughed all over during a trip to hospital. She too did not have a face mask or other protection. 
    Dealing with work related illnesses is often complex and with Covid it is difficult to establish exactly where an infection took place, said Utrecht University researcher Marlou Overheul. ‘You might have picked up coronavirus somewhere else and that can have an impact on a damages claim,’ she said.

    The Federation of Dutch Trade Unions said last month over 500 healthcare workers face losing their jobs because they are suffering from Long Covid and have been on sick pay for the regulation two years.

    MPs have voted in favour of a motion which calls on the government to formally recognise Long Covid as an illness and which will ensure all nursing staff are entitled to invalidity benefits. The government has asked the national health council to make recommendations about how to deal with Long Covid which will be published in the first quarter of this year.

    Read full story
    Source: Dutch News, 20 February 2022

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