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Patient Safety Learning

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  1. Patient Safety Learning
    An external review into the Healthcare Safety Investigations Branch (HSIB), the national safety watchdog, has revealed ‘damaging’ cultural problems, including bullying, sexism and racism which go ‘right to the top of the organisation’.
    The King’s Fund was commissioned by NHS England to undertake a review of the HSIB’s leadership and culture, as it prepares to be an independent organisation.
    The review, seen by HSJ, concluded: “Bullying, sexism, racism and other forms of discrimination and unprofessional behaviours appear to be prevalent and tolerated – this goes right to the top of the organisation.”
    The result of this was found to be “very damaging to the health and wellbeing of staff, diminished the culture and undermines the potential of the organisation”
    The review also described a “perceived command-and-control approach to leadership, lack of openness to challenge, hierarchical approaches to management and behaviour that is out of step with the organisation’s values”.
    The reviewers also identified a “strong voice from staff”, which felt that senior maternity investigation team leaders were “not being held accountable for behaviours that had a very negative impact on staff”.
    Read full story (paywalled)
    Source: HSJ, 21 January 2022
  2. Patient Safety Learning
    The NHS could be forced to dismiss almost 2,000 midwives by the government’s mandatory vaccination policy, amid warnings from a former chief nurse of England that mothers and babies will be put at risk.
    Well-placed senior sources have told HSJ around 1,700 midwives remain unvaccinated nationally, according to the latest data from trusts.
    Based on official headcount data that would amount to between 6.5-8% of the workforce, depending on whether it counts full time equivalent or total staff numbers.
    However, they are mostly in London, with the latest estimate in the city said to be about 680 (representing between 12 and 14% of the workforce), several well placed sources told HSJ, meaning its maternity services could be seriously destabilised.
    A former chief nurse of England, Sarah Mullally, who now sits in the House of Lords as the Bishop of London, said she believed about 12.5% of London’s midwives were unvaccinated, and called on the government to delay the mandatory health worker vaccination policy.
    Speaking in Parliament yesterday, she warned mothers and babies would be put at risk, “in order to implement a policy that has been superseded by the evolution of the virus”.
    She added: “I would strongly encourage everyone, including NHS staff and health care workers, to get fully vaccinated. However, having heard from midwives myself this week, I can see the anxiety that the requirement for mandatory vaccination is causing, as well as the potential risks to the heath service and its patients.
    Read full story (paywalled)
    Source: HSJ, 21 January 2022
  3. Patient Safety Learning
    The public are being urged not to put off seeking help for worrying cancer symptoms because of NHS pressures.
    NHS England chiefs said record numbers were being seen for check-ups before Omicron hit - and despite the current situation cancer was being prioritised.
    There have been nearly 50,000 fewer cancer diagnoses across the UK since the start of the pandemic, Macmillan Cancer Support say.
    This risks an increase in late-stage diagnoses, reducing survival chances.
    Past surveys have suggested people are reluctant to come forward during surges in Covid cases because they did not want to be a burden to the health service.
    NHS England said record numbers had had urgent cancer check-ups in November when 246,000 saw a consultant after a referral by a GP - although just over three quarters of these were seen in the target time of two weeks.
    NHS England cancer director Dame Cally Palmer added it was vital people did not delay now even though hospitals were under huge strain.
    "NHS staff are working hard to ensure that those who are coming forward for checks can be seen quickly so that cancer can be caught at an earlier stage."
    She said common symptoms to look out for included diarrhoea that lasts for three weeks or more, new lumps or bumps and unexplained weight loss or fatigue.
    Read full story
    Source: BBC News, 2o January 2022
  4. Patient Safety Learning
    Ministers have been issued with a stark warning over mandatory Covid vaccines for NHS workers in England, with a leaked document saying growing evidence on the Omicron variant casts doubts over the new law’s “rationality” and “proportionality”.
    Two jabs will become compulsory for frontline NHS staff from 1 April after MPs voted on the legislation last month.
    But the document, drawn up by Department of Health and Social Care (DHSC) officials and seen by the Guardian, said the evidence base on which MPs voted “has changed”, creating a higher chance of objections and judicial review.
    The effectiveness of only two vaccine doses against Omicron, and the lower likelihood of hospitalisations from the milder variant, are cited.
    More than 70,000 NHS staff – 4.9% – could remain unvaccinated by 1 April, the document says. NHS trusts in England are preparing to start sending dismissal letters from 3 February to any member of staff who has not had their first dose by then.
    Amid significant pressures on the NHS, last week groups including the Royal College of Nursing urged Sajid Javid, the health secretary, to delay the legislation, known as “vaccination as a condition of deployment” (VCOD2).
    On Tuesday the Royal College of Nursing said the leaked memo should prompt ministers to call a halt to the imposition of compulsory jabs, which it called “reckless”.
    “The government should now instigate a major rethink”, said Patricia Marquis, the RCN’s England director. “Mandation is not the answer and sacking valued nursing staff during a workforce crisis is reckless.”
    Read full story
    Source: The Guardian, 18 January 2022
  5. Patient Safety Learning
    A GP’s ethnicity has an impact on the level of leadership support it gets from regulators and external bodies, a new Care Quality Commission (CQC) report has suggested.
    In 2021, the CQC conducted research looking at concerns raised by some doctors that ethnic minority-led GP practices were “more likely to have a poorer experience or outcomes” from regulation.
    In a final report, the CQC has admitted ethnic minority-led practices are “not operating on a level playing field”, due to several factors including the fact they are more likely to care for populations with higher levels of socio-economic deprivation and poorer health.
    This can affect their ability to achieve some national targets used in assessments of quality, and increase challenges around recruitment and funding.
    The evidence gathered by the CQC also suggested that practices led by ethnic minority doctors “often lacked leadership support from other bodies and suffered from low morale”.
    Read full story (paywalled)
    Source: HSJ, 19 January 2022
  6. Patient Safety Learning
    NHS leaders have raised concerns over the “new mini Nightingales” as hospitals draw up plans for use with “minimal” nursing levels, The Independent has learned.
    In December the NHS announced it would be launching eight “surge” hubs dubbed “mini Nightingales” to help hospitals manage increased admissions amid the Omicron wave.
    These facilities would be able to admit about 100 patients and have been set up as temporary sites across eight NHS hospitals.
    Details around the safety requirements and required staffing levels have yet to be published, however several NHS sources have said some hubs are planning to use a “low” ratio of 1:15 nurses to patients within the units.
    One trust chief has called the staffing models a “disgrace” and says the hospitals should never be used.
    Senior sources have questioned the safety of using a 1:15 ratio, although they said the risk would depend on how ill the patients being sent to the units are and whether there would be sufficient health care assistant support. However, sources have said the staffing models have yet to be finalised and so could change.
    Read full story
    Source: The Independent, 20 January 2022
  7. Patient Safety Learning
    NHS dentistry is "hanging by a thread" with some patients facing two-year waits for check-ups, the British Dental Association has said.
    Department of Health data analysed by the BBC shows almost 1,000 dentists working in 2,500 roles across England and Wales left the NHS last year.
    One woman told how she had been in pain for more than a year while waiting to have root canal surgery.
    NHS England said patients who most needed care should be prioritised.
    Pamela Carr, 58, from Carlisle, has been looking for an NHS dentist to fix her root canal since November 2020.
    "I've become used to the pain," she said. "I can't afford the private care, and I've tried every practice within 30 miles. I phoned NHS England too."
    "They said there's nothing they can do because there are no NHS dentists. That was the end of the conversation."
    Clinical Commissioning Group North Cumbria, which covers the area, lost 4% of its dentists in the last year. The worst-affected area was NHS Portsmouth CCG, which lost 26% of its NHS dentists over 12 months. At least 10% of NHS dentists were lost in 28 other English CCGs.
    Read full story
    Source: BBC News, 19 January 2022
  8. Patient Safety Learning
    Hundreds of care homes in England are providing substandard care to dementia patients, analysis by the Guardian has found.
    One in five homes specialising in dementia are rated “inadequate” or “requires improvement” by the Care Quality Commission (CQC), inspection reports show. Some pose such a serious risk to people with dementia – including filthy conditions, poor infection control and untrained staff – that inspectors have ordered them to be placed into special measures.
    Altogether, 1,636 care homes are failing patients in findings described by charities and campaigners as “appalling”. They said urgent action was needed to tackle the “unacceptable” state of dementia care across the country.
    Zoe Campbell, the director of operations at the Alzheimer’s Society, said: “It’s appalling to hear that one in five care homes specialising in dementia are delivering substandard care. Every person with dementia deserves to live in a safe, secure place and to be treated with compassion and respect.”
    Campbell said the revelations meant staff recruitment and dementia training must be prioritised in the government’s social care proposals.
    Read full story
    Source: The Guardian, 18 January 2022
  9. Patient Safety Learning
    GPs should regularly review self-harm patients and offer a specific CBT intervention, according to a consultation on the first new guidance for self-harm to be drawn up in 11 years.
    The new draft guidance emphasises the importance of referring patients to specialist mental health services, but stresses that, for patients who are treated in primary care, continuity is crucial.
    If someone who has self-harmed is being treated in primary care, GPs must ensure regular follow-up appointments and reviews of self-harm behaviour, as well as a medicines review, the draft guideline say.
    They must also provide care for coexisting mental health issues, including referral to mental health services where appropriate, as well as information, social care, voluntary and non-NHS sector support and self-help resources.
    The guidance says that referring people to mental health services would ‘ensure people are in the most appropriate setting’.
    However, the committee agreed that ‘if people are being cared for in primary care following an episode of self-harm, there should be continuity of care and regular reviews of factors relating to their self-harm to ensure that the person who has self-harmed feels supported and engaged with services’.
    The draft guidance, out for consultation until 1 March, also says ambulance staff should suggest self-harming patients see their GP to maximise the chance of engagement with services.
    It says: ‘When attending a person who has self-harmed but who does not need urgent physical care, ambulance staff and paramedics should discuss with the person (and any relevant services) if it is possible for the person to be assessed or treated by an appropriate alternative service, such as a specialist mental health service or their GP.’
    It notes that ‘ambulance staff often felt that the emergency department was not the preferred place that the person who had self-harmed wanted to be taken. They agreed that referral to alternative services could facilitate the person’s engagement with services’.
    Read full story
    Source: Pulse, 18 January 2022
  10. Patient Safety Learning
    A troubled integrated care system has been told it must provide more help to a severely under-pressure acute trust where patients were treated on the floor and in a storeroom.
    The Care Quality Commission said Devon ICS must give more “input” to University Hospitals Plymouth Trust, where inspectors warned staff could “not ensure the safety of all patients” arriving at the emergency department.
    During a visit to the trust’s Derriford Hospital in September, inspectors saw staff treating six patients who “lay on the floor” of the ambulatory assessment unit, while another patient who had been in the department overnight was being “treated/assessed in the ‘storeroom’” – according to the CQC’s report.
    Inspectors reported: “The department was overcrowded, there was no seating available… Social distancing was not possible.”
    While the CQC praised senior leaders in the ED and executive chiefs for being “open to challenge” and “understanding the problems” faced by the urgent and emergency care service, inspectors said there was only so much the trust could do alone.
    Catherine Campbell, head of hospital inspection at CQC, said: “The impact of a high number of patients attending to receive care, combined with reduced staffing levels in the ED, created issues that the trust couldn’t solve alone and further support was needed from the local health and social care system."
    Read full story (paywalled)
    Source: HSJ, 19 January 2022
  11. Patient Safety Learning
    Changes in cervical cancer screenings will help save lives, not put them at risk, according to a top gynaecologist.
    Prof Alison Fiander said people should not be worried screenings have dropped from every three to every five years in Wales as tests are "more effective".
    Public Health Wales (PHW) said the new rules were for people aged 25 to 49.
    More than 1.2 million people backed calls for a rethink in a UK petition and politicians in Wales will debate it after 30,000 signed a Senedd petition.
    Women and people with a cervix - as it could also affect trans men too - who had not tested positive for human papillomavirus (HPV) will now wait two more years between tests.
    Health chiefs in Wales said they changed the interval between screenings to the same time as those in Scotland because tests are now more accurate. Cervical screening gaps in England and Northern Ireland remain at three years.
    But Wales' public health body did publicly apologise for causing "concern", and admitted health chiefs "hadn't done enough to explain the changes".
    Prof Fiander, a clinical lead at the Royal College of Obstetricians and Gynaecologists, said PHW had "missed an opportunity" to help educate people but reassured the public the change was safe and not a cost-cutting exercise.
    Read full story
    Source: BBC News, 18 January 2022
  12. Patient Safety Learning
    Hospitals are not able to cope with current pressures, senior doctors have warned, as a new study links long A&E waits to an increased risk of death.
    Patients waiting more than five hours within an emergency department are at an increased risk of dying, according to a study published in the Emergency Medicine Journal (EMJ).
    The study’s findings come as emergency care performance across England continues to deteriorate, and as pressures across hospitals mean that more patients are waiting for more than four hours in A&E departments than ever before.
    According to the research, death rates for patients waiting between six and eight hours before admission to hospital were 8% higher, and they were 10% higher for those waiting eight to 12 hours. The study was based on data collected prior to the pandemic, and national A&E waiting times have since deteriorated further.
    In November last year, the Royal College of Emergency Medicine (RCEM) warned that long delays and overcrowding in A&Es may have caused thousands of deaths during the pandemic.
    Researchers said that although cause and effect could not be established between longer waits and deaths after 30 days of hospital admission, they recognised a statistically significant trend.
    The paper said: “Long stays in the emergency department are associated with exit block and crowding, which can delay access to vital treatments. And they are associated with an increase in subsequent hospital length of stay, especially for older patients.
    Read full story
    Source: The Independent, 19 January 2022
  13. Patient Safety Learning
    Academy-style hospitals will be set up to improve patchy NHS leadership under a shake-up planned by Sajid Javid to deal with post-pandemic waiting lists.
    The health secretary is formulating the reorganisation to give well-run hospitals more freedom as well as forcing failing trusts to improve. A new class of “reform trust” will be established as Javid signals an appetite for wide-ranging changes to deal with a “huge” variation in performance across the health service.
    Modelling reforms on the Blairite academies programme could lead to failing hospitals being forcibly turned into reform trusts, as happens with schools that are rated inadequate. It is possible that chains of hospitals will be run by leading NHS managers, or even outside sponsors, although this is yet to be decided.
    Boris Johnson is said to want to focus on cutting NHS waiting times as part of an “operation red meat” designed to shift the focus from rows over Downing Street parties. Allies of Javid say, however, that his desire for reform long predates the prime minister’s present problems and that as the Omicron wave recedes he believes he has a “six-month window” to introduce changes before planning for next winter takes over.
    His proposals raise the prospect of ministers embarking on another NHS reorganisation, even before the government’s Health and Care Bill — itself designed to reverse previous Tory reforms – becomes law.
    The plans are still at an early stage but are due to feature in a white paper that will set out Javid’s plans for dealing with weak leadership and slow adoption of best practice in parts of the NHS. A Whitehall source said: “Sajid’s reform agenda is all about driving up performance across the NHS. To achieve that we are going to apply some lessons from the academies programme.”
    Read full story (paywalled)
    Source: The Times, 18 January 2022
  14. Patient Safety Learning
    Barts Health NHS Trust has been told to take action to prevent future deaths after an elderly woman was unlawfully killed at one of its hospitals.
    East London acting senior coroner Graeme Irvine sent a report to the trust in which he raised concerns over the death of 78-year-old Surekha Shivalkar in 2018.
    The report follows an inquest into Mrs Shivalkar's death, which reached a narrative conclusion incorporating a finding of unlawful killing.
    A Barts spokesperson said the trust had made a number of changes after carrying out an investigation.
    Mrs Shivalkar underwent hip replacement revision surgery at Newham Hospital on September 28, 2018 in a procedure estimated to last between four and five hours, the coroner wrote. 
    She had a number of serious conditions, including ischaemic heart disease, osteoporosis and chronic obstructive pulmonary disorder. But Mr Irvine said an inaccurate risk of death of less than 5% was given, as no formal risk assessment tool was used. 
    The surgery took longer than seven and a half hours, during which time Mr Irvine said Mrs Shivalkar sustained a "prolonged and dangerous" period of hypotension, or low blood pressure.
    He said the anaesthetist failed to communicate this to the surgical team and agreed to prolong surgery at the six hour point.
    Mr Irvine said: "Poor communication between the orthopaedic surgical team and the anaesthetist during surgery led to a collective failure to identify a critically ill patient."
    Read full story
    Source: Newham Recorder, 17 January 2022
  15. Patient Safety Learning
    An ambulance trust has apologised after a man having a heart attack said he was advised to get a lift to hospital or face a long wait.
    Graham Reagan said he was on the verge of collapsing when he finally got to York hospital after a lift from his son.
    Mr Reagan said he was concerned about the impact on patients with potentially life-threatening conditions.
    Speaking to BBC Yorkshire and Lincolnshire's Politics North programme, Mr Reagan described his experience as "scary".
    "I'd had indigestion, or so I thought, for a couple of days, and then on 17 December I went to bed early feeling rough," he said.
    In the early hours, Mr Reagan said the pains in his chest grew worse and he asked his wife to call for an ambulance. "I couldn't take it any more," he said.
    Mr Reagan, from Malton in North Yorkshire, said his wife was asked "can you get to hospital" as the nearest ambulance was about 20 to 30 miles away.
    "My wife doesn't drive, but fortunately my son was with us and he drove me to York hospital."
    On arrival Mr Reagan said they found the entrance to A&E had also been re-routed.
    "So, we then had to walk out of the hospital grounds and back in - by which time I'm collapsing," he added.
    He said staff at the hospital were "absolutely brilliant" and arranged for him to be transferred to Hull for treatment after a heart attack was confirmed. However, he said he was faced with a further 35-minute delay while he waited for an ambulance to take him.
    Mr Reagan said he wanted to share his experience to raise awareness.
    Read full story
    Source: BBC News, 16 January 2022
  16. Patient Safety Learning
    A woman has spoken of her "devastation" after losing a baby delivered while she was in an induced coma with Covid.
    Rachel, from Wolverhampton was admitted to hospital over the summer in the 19th week of pregnancy. She said uncertainty about whether pregnant women should have the Covid vaccine had put her off getting it.
    Her condition deteriorated and she said she was so ill she did not realise at first son Jaxon was stillborn.
    "I was heavily sedated a lot of the time and from what I'm told by my family, my chances weren't looking very good," the 38-year-old said. "They were trying to get the baby to survive to 28 weeks but unfortunately, at 24 weeks, my son was born stillborn."
    Rachel, who said she had planned to have the vaccine after giving birth, is now urging others to get the jab, particularly women from minority backgrounds, for whom uptake is lower.
    Read full story
    Source: BBC News, 15 January 2022
  17. Patient Safety Learning
    There is no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services, research has concluded.
    Researchers at the London School of Economics studied the performance of all 129 non-specialist acute trusts between 2012-13 and 2018-19.
    They measured hospital performance on five indicators covering financial position, elective and emergency waiting times, level of admissions and mortality. This was then compared to the number of managers each trust employed and the amount spent on management staff.
    The researchers also attempted to measure the quality of management based on answers given to relevant questions in the annual NHS staff survey.
    Reviewing the evidence they analysed, the LSE team state: “We find no evidence of an association between our measures of quantity of managerial input and quality of management… Furthermore, we find no associations between our measures of quantity of management input and five measures of hospital performance.”
    They add: “This holds, irrespective of how we define managerial input, whether by number of managers or expenditure on management. These results are generally robust to how we account for variation between hospitals and within hospitals over time.”
    This leads the researchers to conclude: “Hospitals hiring more managers do not see an improvement in the quality of management leading to better performance, and increasing the numbers of managers does not appear to improve hospital performance through any other direct or indirect mechanism.”
    Read full story (paywalled)
    Source: HSJ, 17 January 2022
  18. Patient Safety Learning
    “Unacceptable” failures by a mental health hospital to manage the physical healthcare of a woman detained under the mental health act contributed to her starving to death, The Independent has learned.
    A second inquest into the death of a 45-year-old woman, Jennifer Lewis, has found that the mental health hospital to which she was admitted “failed to manage her declining physical health” as she suffered from the effects of malnutrition.
    Ms Lewis had a long-term diagnosis of schizophrenia. Her family described how she had lived a full life, completed a degree, and given lectures about living with mental illness. However, after undergoing bariatric surgery, against the wishes of her family, her mental state declined and she was admitted to the Bracton Centre, run by Oxleas, in 2014.
    In an interview with The independent, her sister, Angela, described how, in the year before her death, Ms Lewis lost her hair, suffered from diarrhoea, and developed sores on her legs as she effectively “starved to death” from malnutrition.
    Ms Lewis’s sister told The Independent that in the year leading up to her death, when the family warned doctors she was “starving to death”, their concerns were dismissed and they were told that the hospital “will not let it come to that”.
    Mental health charity Rethink has called for improvements to physical healthcare for patients with severe mental illness, whose physical needs they say are “all too often ignored”, while experts at think tank the Centre for Mental Health have warned that patients with mental illness are dying too young as the system “still separates mental and physical health”.
    Read full story
    Source: The Independent, January 2022
  19. Patient Safety Learning
    More than £100 million has been paid out in damages by one hospital trust over 10 years after its maternity units were accused of being responsible for dozens of deaths and stillbirths, Channel 4 News has revealed.
    From April 2010 to March 2021, £103,097,198 was paid out by the Mid & South Essex NHS Foundation Trust involving 176 obstetrics claims, according to NHS Resolution figures obtained by a freedom of information request.
    Of those claims made against the trust, 36 related to mothers and children dying, 27 referred to stillbirths and 55 concerned babies born with brain damage or cerebral palsy.
    Gabriela Pintilie died in Basildon University Hospital, which is run by the trust, in 2019 after losing six litres of blood giving birth, and a coroner said there were “serious failings” in her care.
    Basildon University Hospital’s maternity unit was twice rated inadequate in 2020, following two separate inspections, with a report saying the service “did not always have enough staff to keep women safe”.
    The report also criticised “longstanding poor staff culture” which had “created an ineffective team”.
    In August 2020, the Care Quality Commission (CQC) issued a warning notice to the hospital as inspectors found six serious incidents occurred between March and April that year in which babies were born in a poor condition starved of oxygen and at risk of brain damage.
    Read full story
    Source: Channel 4 News, 14 January 2022
  20. Patient Safety Learning
    A six-year-old girl thought to have died from sepsis was in fact suffering from a blood condition triggered by E coli infection, an inquest has found.
    Coco Rose Bradford was taken to the Royal Cornwall hospital in the summer of 2017 suffering from stomach problems and later transferred to the Bristol Royal hospital for children, where she died.
    The following year an independent review flagged up failings in her care in Cornwall and the Royal Cornwall hospitals trust apologised for how it had treated her.
    Her family were left with the belief she had died of sepsis and could have been saved if she had been given antibiotics. But on Friday, coroner Andrew Cox, sitting in Truro, found that Coco died from multiple organ failure caused by haemolytic uraemic syndrome (HUS). The inquest heard there is no proven treatment for HUS.
    Cox said Coco’s family had been misled over the sepsis diagnosis, which he said was deeply regrettable, adding: “As a matter of fact, I find Coco had overwhelming HUS, not overwhelming sepsis.”
    During the inquest, the court heard Coco’s family felt staff at the Cornish hospital were “dismissive, rude and arrogant” and did not take her condition seriously.
    Cox found that although staff had recognised the risk of HUS from the moment Coco was admitted, this was not clearly set out in a robust management plan. The coroner also said a lack of communication had made Coco “something of a hostage to fortune”.
    Read full story
    Source: The Guardian, 14 January 2022
  21. Patient Safety Learning
    Over a third of doctors say they feel sleep deprived on at least a weekly basis and over a quarter have been in a position where tiredness has impacted their ability to treat patients, a new survey by the Medical Defence Union (MDU) has found.
    The UK's leading medical defence organisation carried out the survey among its doctor members. Of 532 respondents one in four doctors (26%) said tiredness had affected their ability to safely care for patients, including almost 40 near misses and seven cases in which a patient actually sustained harm. In addition, six in ten respondents said their sleep patterns had worsened slightly or significantly during the pandemic.
    Dr Matthew Lee, MDU chief executive, said:
    "Doctors and their healthcare colleagues are running on empty. Our members have come through a period of immense pressure caused by the pandemic and it is affecting all aspects of their life, including sleep patterns. Previous studies have shown that fatigue can increase the risk of medical error and affect doctors' health and wellbeing. In our survey, side effects doctors reported due to sleep deprivation included poor concentration (64%), decision making difficulties (40%), mood swings, (37%) and mental health problems (30%).
    "Taking regular breaks is vital in the interests of doctors and their patients yet in our survey, three in ten doctors got no breaks at all during the working day despite many working long shifts. In addition, 21% didn't have anywhere to go such as a staff room, or quiet area, to take a break.
    "Pressures on frontline healthcare workers are likely to get worse for doctors in the coming weeks. At a time of considerable staff absence in the NHS it is more important than ever that those staff who are fit to work are properly supported so they can care for patients safely."
    Read full story
    Source: MDU, 17 January 2022
  22. Patient Safety Learning
    The debilitating disease multiple sclerosis could be caused by the common virus behind "kissing disease", scientists claim.
    A new study from Harvard University suggests the chronic disease could be from an infection of Epstein-Barr, a herpes virus that causes infectious mononucleosis.
    Mono or glandular fever, as it’s otherwise known, is colloquially known as "the kissing disease" for being highly contagious through saliva.
    While causing fatigue, fever, rash, and swollen glands, researchers propose that the Epstein-Barr virus could also establish a latent, lifelong infection that may be a leading cause of multiple sclerosis.
    Affecting 2.8 million people, there is no known cure for the chronic inflammatory disease of the central nervous system.
    “The hypothesis that EBV causes MS has been investigated by our group and others for several years, but this is the first study providing compelling evidence of causality,” the study’s senior author Alberto Ascherio, a professor of epidemiology and nutrition at Harvard Chan School, said in a press release.
    “This is a big step because it suggests that most MS cases could be prevented by stopping EBV infection, and that targeting EBV could lead to the discovery of a cure for MS.”
    Read full story
    Source: The Independent, 13 January 2022
  23. Patient Safety Learning
    NHS England is urging health systems to ramp up physical health checks for people with severe mental illnesses to address a widening life expectancy gap caused by covid, according to a letter seen by HSJ.
    In a letter circulated to integrated care system leads, chairs, mental health and community trust executives on Wednesday, national commissioners warn the impact of the pandemic may widen current gaps in life expectancy for people with SMI and learning disabilities even further, without “decisive and proactive action”.
    The letter, circulated by national mental health director Claire Murdoch, learning disability and autism director Tom Cahill and inequalities director Bola Owolabi, quotes NHS data suggesting people with SMI are five-and-a-half times more likely to die prematurely and those with learning disabilities three times more likely to die from an avoidable cause of death.
    It says: ”The health inequalities faced by people living with SMI and people with a learning disability are stark… The impacts of the pandemic will widen this gap further unless we take decisive and proactive action to address inequalities… These checks are a key lever to address the reduced life expectancy for both groups.”
    It calls on primary care teams, already delivering thousands of covid vaccinations as part of the booster programme, to prioritise annual physical health checks alongside the rollout, “even as we continue with a level 4 national incident” caused by the omicron variant.
    Read full story (paywalled)
    Source: HSJ, 14 January 2022
  24. Patient Safety Learning
    Just under 6 million people in England are now waiting for hospital treatment – a record high – as latest performance figures show how the NHS was struggling even before the Omicron Covid variant emerged.
    A total of 5,995,156 patients were on the waiting list for an operation in November, of whom more than 2 million had already waited longer than the maximum standard of 18 weeks for routine treatment.
    Figures published by the NHS underlined its growing inability to provide timely care. They also showed that more than 300,000 people have been waiting more than a year for surgery and that performance against the crucial four-hour A&E target is the worst ever.
    The figures led to warnings from the Health Foundation thinktank that the NHS was “being stretched to its limits” and from the Liberal Democrat health spokesperson Daisy Cooper that “patients are being catastrophically let down by this government’s woeful neglect of the NHS”.
    “With the NHS now in the thick of one of the most uniquely challenging periods in its history, unacceptably long waits for hospital care are becoming increasingly commonplace,” said Siva Anandaciva, the chief analyst at the King’s Fund.
    Read full story
    Source: The Guardian, 13 January 2022
  25. Patient Safety Learning
    A new study has linked COVID-19 to complications during pregnancy.
    Scottish researchers found that women who catch the virus near the end of pregnancy were more vulnerable to birth-related complications. They are more likely to suffer them than women who catch Covid in early pregnancy or not at all.
    The researchers say getting vaccinated is crucial to protect pregnant women and their babies from life-threatening complications.
    The latest findings come from the Covid in Pregnancy Study (Cops), which carried out research across Scotland to learn about the incidence and outcomes of Covid-19 infection and vaccination in pregnancy. It is one of the first national studies of pregnancy and Covid.
    They found that preterm births, stillbirths and newborn deaths were more common among women who had the virus 28 days, or less, before their delivery date. The majority of complications occurred in unvaccinated women.
    The results, which have been published in Nature Medicine, come after recent data showed 98% of pregnant women admitted to UK intensive care units with coronavirus symptoms were unvaccinated.
    Researchers are now calling for measures to increase vaccine uptake in pregnant women.
    Read full story
    Source: BBC News, 13 January 2022
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