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Patient Safety Learning

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  1. Patient Safety Learning
    Women are underrepresented in clinical trials, and even lab mice are predominantly male – and the effects show up in almost every aspect of human health
    Women are twice as likely as men to die from heart attacks; when a nonsmoker dies of lung cancer, it’s twice as likely to be a woman as a man; and women suffer more than men from Alzheimer’s and autoimmune disease.
    Yet research into these conditions, and many more, generally fails to examine women separately. It’s even less likely to look at disparities affecting women of color – why, for instance, Black women are nearly three times more likely to die in pregnancy than white women are.
    It’s been 30 years since the US Congress ordered the National Institutes of Health to make sure women were included equally in clinical trials. Despite some progress, research on women still lags, and there’s growing evidence that women and girls are paying the price.
    “Research on women’s health has been underfunded for decades, and many conditions that mostly or only affect women, or affect women differently, have received little to no attention,” the first lady Jill Biden said in announcing a new White House initiative on women’s health research on 13 November.
    “Because of these gaps, we know far too little about how to manage and treat conditions like endometriosis, and autoimmune diseases like rheumatoid arthritis. These gaps are even greater for communities that have historically been excluded from research – including women of color and women with disabilities.”
    Not only do researchers fail to include enough women in clinical trials, they often don’t look for differences between how men and women respond to treatments.
    Read full story
    Source: The Guardian, 20 November 2023
    Further reading on the hub
    Dangerous exclusions: The risk to patient safety of sex and gender bias Gender bias: A threat to women’s health Animal testing doesn't work, we need to find new ways of testing the safety of medicines—a blog by Pandora Pound
  2. Patient Safety Learning
    Health systems are still struggling to meet their financial plans, despite hundreds of millions being raided from investment budgets to help balance the books.
    Senior leaders in most regions said the cash falls short of their existing financial gaps.
    Earlier this month, NHS England announced that £800m would be made available to integrated care systems (ICSs) to offset the additional cost of strikes. 
    HSJ understands ICSs reported a combined deficit that was £1.5bn worse than planned in the six months to October, which implies a gap of several hundred million pounds unless systems can report substantial surpluses for the second half of the year.
    HSJ spoke to senior sources in all seven regions, with more than half saying their systems would still fail to deliver breakeven, despite the funding transfers.
    A source in the South East said their system’s share of the funding “won’t touch the sides”, adding that NHSE was playing “hardball”.
    Another local source said they had identified a set of “nuclear options” to balance the books, but these would be “catastrophic for quality of care and/or nigh-on impossible to deliver”.
    Read full story (paywalled)
    Source: HSJ, 22 November 2023
  3. 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
  4. Patient Safety Learning
    Scotland's NHS is unable to meet the growing demand for health services, a spending watchdog has warned.
    A review by Audit Scotland said the increased pressure on the NHS was now having a direct impact on patient safety and experience.
    The watchdog also claimed there was no "overall vision" for the future of the health service.
    The annual report on the state of Scotland's health service highlighted that the NHS was facing soaring costs, patients were waiting longer to be seen and there were not enough staff.
    Stephen Boyle, Auditor General for Scotland, said this had "added to the financial pressures on the NHS and, without reform, its longer-term affordability".
    He added: "Without change, there is a risk Scotland's NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services.
    "To deliver effective reform the Scottish government needs to lead on the development of a clear national strategy for health and social care.
    "It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS."
    Read full story
    Source: BBC News, 22 February 2024
  5. Patient Safety Learning
    The NHS requires a ‘new central investment’ to achieve digital maturity and realise the potential of emerging technologies, according to the person who was commissioned by Jeremy Hunt to examine the issue in 2015.
    Bob Wachter was commissioned by the then health and social care secretary in 2015, and authored the 2016 report Making IT Work, which called on all NHS trusts to achieve the “realistic target” of a good level of digital maturity by 2023.
    While Professor Wachter told HSJ that there had been “reasonably good” progress, he said it was “not quite what I would have hoped for” seven years on from his report. 
    He acknowledged that factors such as the pandemic and the subsequent economic situation slowed progress, but added that he was “a little bit worried” at the state of digital maturity in some areas, including interoperability and reliability of key systems such as electronic patient records.
    Read full story (paywalled)
    Source: HSJ, 1 November 2023
  6. 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
     
  7. Patient Safety Learning
    A patient says he felt ignored and that NHS care was lacking after he spent 14 hours on a bed in a hospital corridor.
    Ivan Philpotts, 77, from Norwich, was transferred between wards at the Norfolk & Norwich University Hospital (NNUH), having contracted pneumonia.
    He said he was left in a bed in a corridor with no access to water, was unable to eat and that his wife was unable to visit.
    The hospital said it had experienced a high number of patients last week.
    "I felt very vulnerable," Mr Philpotts said. 
    "Nobody seemed to be taking any notice of you and you were sitting there, people walking by you.
    "I was there from 8.30 in the morning until 9.10 at night before I actually got into a bay. We got no communication whatsoever."
    The hospital trust is one of just two in England that has been carrying out a trial of a "corridor care" scheme.
    The Royal College of Nursing's eastern regional director Teresa Budrey said: "We're starting to normalise it and that's not OK.
    "There are patients who are suffering for hours, without proper privacy or equipment and you've also got nurses dealing with an expanded number of patients.
    "We need government minsters and employers to come together for some bigger solutions across the system."
    Read full story
    Source: BBC News, 6 March 2024
    Further reading on the hub:
    A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift  
  8. Patient Safety Learning
    More than 7,000 Covid-related hospital admissions could have been prevented in the UK in the summer of 2022 if the population had received the full number of jabs recommended, according to research in The Lancet.
    Some 44% of the UK population was under-vaccinated, with younger people among the most likely to skip doses.
    In a first, health records for everyone over five in the UK were analysed. The same approach could now be used to understand other diseases.
    The entire population of the UK is 67 million, and all those over the age of five had their anonymised electronic health data analysed for The Lancet study.
    With about 40,000 severe hospital admissions related to Covid during that summer, the research estimates that more than 7,000 - 17% - would have been avoided if everyone had taken up the offer of the vaccine and booster doses for which they were eligible.
    Read full story
    Source: BBC News, 16 January 2024
  9. Patient Safety Learning
    Senior doctors are urging MPs to reject government plans to regulate “physician associates”, whose growing use in the NHS has divided the medical profession.
    The British Medical Association has said that allowing the General Medical Council (GMC) to regulate physician associates (PAs) would “blur the lines” between doctors and non-doctors.
    Many medics are opposed to the increased use of PAs, who they fear patients will wrongly see as doctors, even though they do not have a medical degree. They have expressed concern that letting the GMC – which regulates doctors – regulate PAs from April, as ministers plan, is “potentially dangerous” because it could confuse the public, diminish the status of doctors, and leave patients at risk of being treated by someone without the appropriate skills.
    The BMA is running advertisements in the Guardian and on social media asking MPs on a Commons committee examining the plan to vote against it when they consider it on Thursday. “PAs are not the same as doctors, and blurring the lines can have tragic consequences for patients who think they have seen a doctor when they have not,” the adverts say.
    Read full story
    Source: The Guardian, 18 January 2024
  10. Patient Safety Learning
    A suicidal man died hours after being discharged from a scandal-hit hospital which is at the centre of a probe into the care of Nottingham triple killer Valdo Calocane.
    Daniel Tucker was released from a mental health ward at Highbury Hospital in Nottingham last year and died shortly afterwards, having taken a toxic substance he had purchased online.
    An inquest into his death last week found there were multiple failings by Nottinghamshire Healthcare Foundation Trust in the lead-up to Tucker’s death, with no appropriate care plan or risk assessment in place for him before or after his discharge.
    The 10-day hearing heard he had been discharged from the hospital on 22 April, despite having shared suicidal intentions with staff just days before. The jury concluded that failures by staff to ensure an appropriate plan for him contributed to his death.
    It comes after health secretary Victoria Atkins ordered the Care Quality Commission to carry out an inquiry into Nottinghamshire Healthcare. The probe will look at the handling of Calocane, who had been discharged from Highbury Hospital and was a patient under the trust’s community crisis services when he stabbed three people to death in a brutal knife rampage.
    Read full story
    Source: The Independent, 18 February 2024
  11. Patient Safety Learning
    A campaigner in Norfolk says the "deaths crisis" at the county's mental health trust is getting worse.
    Bereaved relatives met the mental health minister, Maria Caulfield, to discuss failings at the Norfolk and Suffolk NHS Foundation Trust (NSFT).
    The trust says it is on a "rapid, and much-needed journey of improvement".
    Mark Harrison, from the Campaign to Save Mental Health Services in Norfolk and Suffolk, said: "We judge people by what they do, not what they say."
    Members of the campaign group met Ms Caulfield and other MPs in Westminster on 12 March and demanded an independent public inquiry into the trust.
    It came after a report last summer which found that more than 8,000 mental health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022.
    At the meeting, it was agreed Ms Caulfield would meet bosses at the NSFT. The health select committee will also be asked to conduct an inquiry into the trust as part of a broader public inquiry.
    But Mr Harrison said he had little confidence anything would change.
    "The deaths crisis is just out of control and it's accelerating," he said.
    "We have been doing this for 10 years. Every time somebody promises to do something, it doesn't come to anything."
    Read full story
    Source: BBC News, 20 March 2024
  12. Patient Safety Learning
    More than 100 families looking after severely disabled adults and children outside hospital, have told the BBC that the NHS is failing to provide enough vital support.
    The NHS says help is based on individual needs and guidelines ensure consistency across England and Wales. However, some families describe the system as adversarial.
    Only those living outside hospital with life-limiting conditions, or at risk of severe harm if they don't have significant support, get this help from the NHS.
    It is provided through a scheme called Continuing Healthcare (CHC) for adults, and its equivalent for under-18s, Children and Young People's Continuing Care.
    Cases in England are decided by NHS Integrated Care Boards (ICBs) - panels responsible for planning local health and care services. In Wales, they are overseen by local health boards.
    The BBC has heard from 105 families who described serious concerns with how the two schemes are working - with most calling for reform.
    One young man with 24-hour needs hasn't received any CHC help despite being eligible since February 2023 - his parents, who first applied for support on his behalf nearly two years ago, currently provide round-the-clock care
    Another family were told overnight care for their teenage child - who is non-verbal, has severe mobility issues and requires 24/7 support - would be reduced from seven down to three nights a week, without a reason being given.
    Read full story
    Source: BBC News, 14 February 2024
  13. Patient Safety Learning
    Shortly before Joseph Ladapo was sworn in as Florida’s surgeon general in 2022, the New Yorker ran a short column welcoming the vaccine-skeptic doctor to his new role, and highlighting his advocacy for the use of leeches in public health.
    It was satire of course, a teasing of the Harvard-educated physician for his unorthodox medical views, which include a steadfast belief that life-saving Covid shots are the work of the devil, and that opening a window is the preferred treatment for the inhalation of toxic fumes from gas stoves.
    But now, with an entirely preventable outbreak of measles spreading across Florida, medical experts are questioning if quackery really has become official health policy in the nation’s third most-populous state.
    As the highly contagious disease raged in a Broward county elementary school, Ladapo, a politically appointed acolyte of Florida’s far-right governor Ron DeSantis, wrote to parents telling them it was perfectly fine for parents to continue to send in their unvaccinated children.
    “The surgeon general is Ron DeSantis’s lapdog, and says whatever DeSantis wants him to say,” said Dr Robert Speth, a professor of pharmaceutical sciences at south Florida’s Nova Southeastern University with more than four decades of research experience.
    “His statements are more political than medical and that’s a horrible disservice to the citizens of Florida. He’s somebody whose job is to protect public health, and he’s doing the exact opposite.”
    Read full story (paywalled)
    Source: Guardian, 3 March 2024
  14. Patient Safety Learning
    A blood test for detecting Alzheimer’s disease could be just as accurate as painful and invasive lumbar punctures and could revolutionise diagnosis of the condition, research suggests.
    Measuring levels of a protein called p-tau217 in the blood could be just as good as lumbar punctures at detecting the signs of Alzheimer’s, and better than a range of other tests under development, experts say.
    The protein is a marker for biological changes that happen in the brain with Alzheimer’s disease.
    Dr Richard Oakley, an associate director of research and innovation at the Alzheimer’s Society, said: “This study is a hugely welcome step in the right direction as it shows that blood tests can be just as accurate as more invasive and expensive tests at predicting if someone has features of Alzheimer’s disease in their brain.
    “Furthermore, it suggests results from these tests could be clear enough to not require further follow-up investigations for some people living with Alzheimer’s disease, which could speed up the diagnosis pathway significantly in future. However, we still need to see more research across different communities to understand how effective these blood tests are across everyone who lives with Alzheimer’s disease.”
    Read full story
    Source: The Guardian, 23 January 2024
     
  15. Patient Safety Learning
    Poorer people find it much harder to access NHS care than the well-off and have a worse experience when they do get it, research by the health service’s consumer watchdog has found.
    Those on the lowest incomes have much more difficulty getting a GP appointment, dental care or help with mental health problems, according to a survey by Healthwatch England.
    They are also more likely to feel they are not listened to by a health professional and not involved in key decisions about their care compared with those who are financially comfortable.
    The links between poverty and ill-health are well known, but the Healthwatch findings show that the worse-off also face the disadvantage what the watchdog called barriers to obtaining healthcare when they need it.
    The findings have prompted fears that the NHS is too often a “two-tier service” with access closely related to wealth, and calls for it to do more to make services more accessible to everyone.
    Healthwatch’s survey of 2,018 people aged 16 and over in England, which was a representative sample of the population, found that:
    42% of those who described their financial situation as “really struggling” said they had trouble getting to see a GP, double the 21% of those who were “very comfortable”. 38% of the worst-off found it hard to get NHS dental care, compared with 20% of the better-off. 28% of the very poor had difficulty accessing mental health treatment, whereas only 9% of the very comfortable did so. Read full story
    Source: The Guardian, 4 March 2024
  16. Patient Safety Learning
    Almost 9,000 foreign nurses a year are leaving the UK to work abroad, amid a sudden surge in nurses quitting the already understaffed NHS for better-paid jobs elsewhere.
    The rise in nurses originally from outside the EU moving to take up new posts abroad has prompted concerns that Britain is increasingly becoming “a staging post” in their careers.
    The number of UK-registered nurses moving to other countries doubled in just one year between 2021-22 and 2022-23 to a record 12,400 and has soared fourfold since before the coronavirus pandemic.
    Seven out of 10 of those leaving last year – 8,680 – qualified as a nurse somewhere other than the UK or EU, often in India or the Philippines. Many had worked in Britain for up to three years, according to research from the Health Foundation.
    The vast majority of those quitting are heading to the US, New Zealand or Australia, where nurses are paid much more than in the UK – sometimes up to almost double.
    Experts have voiced their alarm about the findings and said the NHS across the UK, already struggling with about 40,000 vacancies for nurses and hugely reliant on those coming from abroad, is increasingly losing out in the global recruitment race.
    “It feels like the NHS is falling down the league table as a destination of choice for overseas nurses,” said Dame Anne Marie Rafferty, a professor of nursing studies at King’s College London.
    “Worryingly, it feels as if the UK is perceived not as a high- but middle-income country in pay terms and as a staging post where nurses from overseas can acclimatise to western-type health systems in the search for better pay and conditions.”
    Read full story
    Source: The Guardian, 25 March 2024
  17. Patient Safety Learning
    Patients who feel fortunate to get a doctor's appointment then find they are in and out of the GP surgery in less than five minutes.
    A fifth of the consultations in England last year were done within that time.
    Dennis Reed, of the Silver Voices campaign group for over-60s, said: "It is hard enough to get a face-to-face appointment with a GP these days, without being shown the door before you have had a chance to take your coat off.
    "The public wants the family doctor back, who knows your family history and has the time to chat about your general health and wellbeing.
    "A revolving door policy, with the patient exiting after a couple of minutes clutching a prescription, is not the way to run a primary care service."
    Research from the House of Commons Library, commissioned by the Lib Dems, found 22% of GP appointments between January to October 2023 lasted five minutes or less.
    Lib Dem MP Wera Hobhouse said: "Seeing a GP is the most vital contact for people to address their health concerns, seek help and start treatment.
    "Not having quick and easy access to a GP and not having sufficient time for patients during an appointment leads to huge problems later on, let alone the anxiety and additional pain people suffer because of delays."
    Read full story
    Source: The Express, 31 December 2023
  18. Patient Safety Learning
    Paramedics are "watching their patients die in the back of ambulances because they can't get them into A&E", according to the health union, Unison.
    It was commenting on data showing 2,750 hours were lost by ambulance crews waiting to hand over patients at Hull Royal Infirmary in October 2023.
    One crew was stuck outside A&E for 10 hours and 27 minutes.
    Hull University Teaching Hospitals said it was "confident" a new urgent treatment centre on the hospital site would "improve overall waiting times" and lost ambulance hours had "reduced notably" this month.
    The figures, obtained by the BBC through a freedom of information request, showed on 9 October 2023 ambulance crews lost 144 hours and 18 minutes, the equivalent to one crew being out of action for six full days and nights.
    Megan Ollerhead, Unison's ambulance lead in Yorkshire, said paramedics were "literally watching their patients die in the back of these ambulances because they can't get into A and E."
    "I talk to a lot of the people who receive the 999 calls in the control rooms and they're just listening to people begging for ambulances and they know there are none to send."
    Read full story
    Source: BBC News, 26 January 2024
  19. Patient Safety Learning
    Seeing the same GP improves patients’ health, reduces doctors’ workloads and could free up millions of appointments, according to the largest study of its kind.
    Research has previously suggested there may be benefits to seeing the same family doctor. But studies have mostly been small or covered a short period of time. Now University of Cambridge and Insead business school researchers have analysed data from 10m consultations over more than a decade in the most authoritative study on the issue yet.
    They found that if all GP practices moved to a model where patients saw the same doctor at each visit, it would significantly reduce doctors’ workloads while improving patient health. Multiple benefits emerged when patients had a long-term relationship with their doctor, researchers found.
    Seeing the same GP – known as continuity of care – meant people waited on average 18% longer between visits, compared with patients who saw different doctors.
    People did not take up more GP time in each consultation and the findings were particularly strong for older patients, those with multiple chronic illnesses, and people with mental health conditions.
    Although it will not always be possible for people to see their regular GP, researchers said the findings would translate to an estimated 5% reduction in consultations if all practices provided the level of continuity of care of the best 10% of practices. That suggests millions of appointments could be freed up.
    The researchers added: “Importantly, if patients receiving care from their regular doctors have longer intervals between consultations without requiring longer consultations, then continuity of care can potentially allow physicians to expand their patient list without increasing their time commitment.”
    Read full story
    Source: The Guardian, 23 February 2024
  20. Patient Safety Learning
    Patients at the hospital that treated killer Valdo Calocane were discharged too soon and released in a worse state into the community, the NHS safety watchdog has found.
    Serious failings by Nottinghamshire Hospital Foundation Trust in keeping patients and the public safe have been identified in a review from the Care Quality Commission (CQC).
    More than 1,200 patients are waiting to be seen by community services, the report found. Meanwhile, several hundred who are receiving treatment did not have a clinician overseeing their care,the CQC found.
    The review was launched by the government following the conviction of killer Valdo Calocane, who was under the care of the NHS trust’s community services.
    The CQC review said patients reported that crisis services are either “useless” or detrimental to their health.
    The three broad areas of concern, highlighted in the CQC’s report, were:
    High demand for services was leading to long waiting times for care and a lack of oversight of those waiting. The trust does not have enough staff to keep patients safe in the community and within some hospital services. Senior leaders at the trust do not have clear oversight of the risks and issues within the service. Read full story
    Source: The Independent, 27 March 2024
  21. Patient Safety Learning
    According to analysis from the NHS Confederation, capital budgets within the NHS must double to ensure that the delivery of faster and more productive patient care can be supported.
    Published yesterday, the Investing to Save: The Capital Requirement for a More Sustainable NHS in England report has outlined that a further £6.4 billion of capital funding must be committed through all three years of the next Spending Review so that the NHS’ maintenance backlog can be addressed. This will also help with the refurbishment of dilapidated buildings, the upgrading of equipment, and the increasing of staff productivity.
    Chief Executive of the NHS Confederation, Matthew Taylor, said:
    “Some of our members have parts of their estate that are barely fit for the 19th century, let alone the 21st, so any future Secretary of State for Health and Social Care must make the physical and digital condition of the NHS a priority if the health service is to reduce backlogs and get productivity levels to where the government want them to be.
    “Lack of capital across different care settings, covering digital and physical infrastructure and mental and physical health, is clearly not just leading to missed opportunities to improve productivity, but actively undermining it and causing patient safety issues. Health leaders across England have endless ideas about how capital funding could drive large productivity increases.
    “Equipping staff with the right tools, and allowing them to operate in safe, modern, optimised environments will improve efficiency, meaning that an increase to the capital budget will help limit the need for growth in revenue spend, relieve pressure on wider NHS finances and services, and put the NHS on the path to longer-term financial sustainability.
    “This will require a significant increase to the NHS capital budget to make up for years of under-resourcing and repeated raids on capital that has left much of the estate broken. Based on the assessment of health leaders, this will need to be an increase of £6.4 billion to take the capital budget to £14.1 billion for each year of the next spending review in order to fully address the repairs backlog and realise some of the innovative transformation projects which have previously fallen by the wayside. The next government must grasp the nettle.”
    Read full story
    Source: National Health Executive, 29 November 2023
  22. Patient Safety Learning
    A record 420,000 patients had to wait more than 12 hours in A&E last year, analysis has shown.
    The latest NHS England figures revealed a 20% increase on 2022 in people facing lengthy delays after a decision to admit them to hospital from the emergency department.
    In 2023, 419,560 people – or one in 15 A&E patients – faced “trolley waits” of 12 hours or more, according to the Liberal Democrats, who compiled the analysis. It marks by far the highest number since records began in 2011, and amounts to an average of 1,150 patients a day.
    Ed Davey, the party leader, criticised the “appalling delays” and accused Rishi Sunak’s government of “ignoring the suffering of patients and driving our health service into the ground”.
    Significant waits in A&E have been linked to excess deaths and increased harm to patients, as their condition could deteriorate before they are admitted or given a bed on a ward.
    Davey said: “Every year A&E delays are getting worse and worse under this Conservative government as hospitals are starved of the resources and staff they need. These appalling delays are leaving often vulnerable and elderly patients waiting for hours on end in overcrowded A&Es."
    Read full story
    Source: The Guardian, 14 January 2024
  23. Patient Safety Learning
    People who are severely ill with suspected sepsis should promptly be given life-saving access to antibiotics to prevent unnecessary deaths, according to updated guidance from the National Institute for Health and Care Excellence (NICE.) The guidelines state that the national early warning score should be used to assess people with suspected sepsis aged 16 and over, who are not and have not recently been pregnant, and are in an acute hospital setting or ambulance.
    The updated guidance also recommends that doctors are more considerate as to who is given antibiotics, in order to reduce the risk of antibiotic resistance in people being prescribed them for less severe cases of sepsis.
    With the update, NICE says that more people will be categorised at a lower risk level where a sepsis diagnosis should be confirmed before being given antibiotics.
    Prof Jonathan Benger, Nice’s chief medical officer, said: “This useful and usable guidance will help ensure antibiotics are targeted to those at the greatest risk of severe sepsis, so they get rapid and effective treatment. It also supports clinicians to make informed, balanced decisions when prescribing antibiotics.
    “We know that sepsis can be difficult to diagnose so it is vital there is clear guidance on the updated [national early warning score] so it can be used to identify illness, ensure people receive the right treatment in the right clinical setting and save lives."
    Read full story
    Source: The Guardian, 31 January 2024
  24. Patient Safety Learning
    Italy will carry out an inquiry into its handling of the coronavirus pandemic in a move hailed as “a great victory” by the relatives of people killed by the virus but criticised by those who were in power at the time.
    Italy was the first western country to report an outbreak and has the second highest Covid-related death toll to date in Europe, at more than 196,000. Only the UK’s death toll is higher.
    The creation of a commission to examine “the government’s actions and the measures adopted by it to prevent and address the Covid-19 epidemiological emergency” was approved by the lower house of parliament after passing in the senate.
    Consuelo Locati, a lawyer representing hundreds of families who brought legal proceedings against former leaders, said: “The families were the first to ask for a commission and so for us this is a great victory. The commission is important because it has the task, at least on paper, to analyse what went wrong and the errors committed so as not to repeat the massacre we all suffered.”
    Read full story
    Source: The Guardian, 15 February 2024
  25. Patient Safety Learning
    A mental health trust linked to thousands of unexpected patient deaths repeatedly failed to act on coroners' safety warnings, campaigners say.
    BBC News has been given exclusive access to new evidence from coroners' reports gathered by a campaign group.
    It wants a criminal investigation into why so many patients died at Norfolk and Suffolk NHS Foundation Trust - and has sent police the evidence.
    Campaigners, including patients and bereaved families, claim it is failing to make vital safety improvements despite promising to do so.
    Last summer, a report found more than 8,000 mental-health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022. This is defined as the death of a patient who has not been identified as critically ill or whose death is not expected by the clinical team.
    The new evidence, based on 38 coroners' prevention of future death (PFD) reports since 2013, suggests there were repeated warnings more patients could die unless safety issues were addressed, including:
    dangerously poor record-keeping and communication family concerns being ignored unsafe levels of staffing at the trust. And campaigners say the trust's failure to improve safety has led to more deaths.
    Read full story
    Source: BBC News, 12 March 2024
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