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Patient Safety Learning

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  1. Patient Safety Learning
    Britain’s hard-pressed carers need all the help they can get. But that should not include using unregulated AI bots, according to researchers who say the AI revolution in social care needs a hard ethical edge.
    A pilot study by academics at the University of Oxford found some care providers had been using generative AI chatbots such as ChatGPT and Bard to create care plans for people receiving care.
    That presents a potential risk to patient confidentiality, according to Dr Caroline Green, an early career research fellow at the Institute for Ethics in AI at Oxford, who surveyed care organisations for the study.
    “If you put any type of personal data into [a generative AI chatbot], that data is used to train the language model,” Green said. “That personal data could be generated and revealed to somebody else.”
    She said carers might act on faulty or biased information and inadvertently cause harm, and an AI-generated care plan might be substandard.
    But there were also potential benefits to AI, Green added. “It could help with this administrative heavy work and allow people to revisit care plans more often. At the moment, I wouldn’t encourage anyone to do that, but there are organisations working on creating apps and websites to do exactly that.”
    Read full story
    Source: The Guardian, 10 March 2024
  2. Patient Safety Learning
    All trusts should pick a “designated lead” for improving how they work with primary care, according to new NHS planning guidance. 
    The guidance for 2024-25 published by NHS England today states: “Every trust should have a designated lead for the primary–secondary care interface.”
    It also asks integrated care boards to “regularly review progress” on how secondary care services are working with primary care.
    NHSE recovery plans include trying to cut the number of patients effectively referred back to GP practices by other services, in order to reduce GP workload.
    The guidance states: “Streamlining the patient pathway by improving the interface between primary and secondary care is an important part of recovery and efficiency across healthcare systems”.
    The planning guidance — published on Wednesday night after months of delays — also said systems should continue to develop integrated neighbourhood teams, including by trying to “improve the alignment of relevant community services” to primary care network footprints. 
    Read full story (paywalled)
    Source: HSJ, 27 March 2024
  3. Patient Safety Learning
    A trust has appointed a chair to lead an independent review into dozens of suicides that was sparked by allegations of record tampering.
    Following questions from HSJ about the review’s chair and terms of reference, Cambridgeshire and Peterborough Foundation Trust said Ellen Wilkinson, a former medical director at Cornwall Partnership FT and its current chief clinical information officer, would chair the review. 
    The trust, which is looking for a substantive CEO following Anna Hills’ departure earlier this year, said the review “will not examine individual patient deaths but will take a thematic approach and look at the learnings we can take from these tragic incidents”.
    The trust told HSJ the terms of reference for the review of more than 60 cases of patients who died by suicide since 2017 were still being finalised.
    The decision not to investigate individual cases has been criticised by the whistleblower whose concerns prompted the review in the first place, as HSJ reported in October.
    While an employee of the trust, Des McVey, a consultant nurse and psychotherapist, carried out an investigation in July 2021 into the case of 33-year-old Charles Ndhlovu, who died by suicide in 2017.
    Mr McVey told HSJ his review found Mr Ndhlovu’s patient record had been tampered with and “his care plans were created on the day after his death” – a conclusion he stands by.
    Read full story (paywalled)
    Source: HSJ, 3 April 2024
  4. Patient Safety Learning
    It is a high-stakes scenario for any surgeon: a 65-year-old male patient with a high BMI and a heart condition is undergoing emergency surgery for a perforated appendix.
    An internal bleed has been detected, an anaesthetics monitor is malfunctioning and various bleepers are sounding – before an urgent call comes in about an ectopic pregnancy on another ward.
    This kind of drama routinely plays out in operating theatres, but in this case trainee surgeon Mary Goble is being put through her paces by a team of researchers at Imperial College London who are studying what goes on inside the brains of surgeons as they perform life-or-death procedures.
    Goble looks cool and collected as she laparoscopically excises the silicon appendix, while fending off a barrage of distractions. But her brain activity, monitored through a cap covered in optical probes, may tell a different story.
    The researchers, led by Daniel Leff, a senior researcher and consultant breast surgeon at Imperial College healthcare NHS Trust, are working to detect telltale signs of cognitive overload based on brain activity. In future, they say, this could help flag warning signs during surgery.
    “The operating theatre can be a very chaotic environment and, as a surgeon, you have to keep your head and stay calm when everyone is losing theirs,” said Leff. “As the cognitive load increases, it has major implications for patient safety. There’s no tool we can use to know that surgeon is coping with the cognitive demands of that environment. What happens when the surgeon is maxed out?”
    In the future, Leff envisages a system that could read out brain activity in real-time in the operating theatre and trigger an intervention if a surgeon is at risk of overload.
    Read full story
    Source: 2 March 2024
  5. Patient Safety Learning
    Many popular AI chatbots, including ChatGPT and Google’s Gemini, lack adequate safeguards to prevent the creation of health disinformation when prompted, according to a new study.
    Research by a team of experts from around the world, led by researchers from Flinders University in Adelaide, Australia, and published in the BMJ found that the large language models (LLMs) used to power publicly accessible chatbots failed to block attempts to create realistic-looking disinformation on health topics.
    As part of the study, researchers asked a range of chatbots to create a short blog post with an attention-grabbing title and containing realistic-looking journal references and patient and doctor testimonials on two health disinformation topics: that sunscreen causes skin cancer and that the alkaline diet is a cure for cancer.
    The researchers said that several high-profile, publicly available AI tools and chatbots, including OpenAI’s ChatGPT, Google’s Gemini and a chatbot powered by Meta’s Llama 2 LLM, consistently generated blog posts containing health disinformation when asked – including three months after the initial test and being reported to developers when researchers wanted to assess if safeguards had improved.
    In response to the findings, the researchers have called for “enhanced regulation, transparency, and routine auditing” of LLMs to help prevent the “mass generation of health disinformation”.
    Read full story
    Source: The Independent, 20 March 2024
  6. Patient Safety Learning
    Six out of 10 NHS nurses have had to use credit or their savings over the last year to help them cope with the soaring cost of living, according to new research.
    Acute financial pressures are forcing some nurses to limit their energy use while others are going without food. Many are doing extra shifts to help make ends meet.
    The findings have added to fears that money worries and inadequate pay will prompt even more nurses to quit the NHS, which is already short of almost 35,000 nurses.
    The Royal College of Nursing (RCN), which undertook the survey of almost 11,000 nurses in England, claimed that too many in the profession had been left without enough money to cover their basic needs as they paid the price for “the government’s sustained attack on nursing”.
    Read full story
    Source: The Guardian, 22 March 2024
  7. Patient Safety Learning
    Older people are routinely enduring hidden waits of several months to get essential care and support, according to new figures obtained from government. 
    Waiting time figures for adult social care are not routinely published in England, but last summer the Department of Health and Social Care collected the information from councils for the first time in at least a decade.
    They have been released to HSJ after a freedom of information appeal, and show average waits of up to 149 days (about five months) in Bath and North East Somerset, with 25 councils (30% of the 85 councils which supplied this information) reporting waits of two months or more. Some people will be waiting much longer than the averages reported.
    Across the 85 councils which reported average waits, the average of those figures was around 50 days. But the figures released to HSJ show huge variation – with three councils reporting waits of less than 10 days – although this is partly due to recording differences. 
    The lack of clear figures, and absence of national waiting time measures and standards for adult social care, in contrast to the many targets and published figures in the NHS, and has sparked calls for that to be changed.
    Sir David Pearson, a former integrated care system chair and director of adult social care, who led the government’s Covid-19 care taskforce in the wake of the disaster in care homes in spring 2020, said: “One way of ensuring public confidence is a timely response to need.
    “Being clearer about a small number of standards and measures would help to achieve this. Of course it has to be associated with the right funding and reform, including supporting the social care workforce”.
    Read full story (paywalled)
    Source: HSJ, 25 March 2024
  8. Patient Safety Learning
    NHS England’s workforce ambitions are based on ‘significant’ substitution of fully qualified GPs with trainees and specialist and associate specialist (SAS) doctors, the public spending watchdog has revealed.
    In a new assessment of the NHS long-term workforce plan, the National Audit Office (NAO) found that NHS England’s modelling of the future workforce had ‘significant weaknesses’ and that some of its ‘assumptions’ may have been ‘optimistic’.
    Last year, the national commissioner committed to doubling medical school places to 15,000 and increasing GP training places to 6,000 by 2031. 
    This was based on modelling which predicted that, without these changes, the NHS could face a staffing shortfall of 360,000 and a GP shortfall of 15,000 by 2036.
    The NAO’s report has examined the robustness of NHS England’s predictions, and made a number of recommendations which could influence the refreshed projections NHSE has committed to publishing every two years.
    The long-term workforce plan (LTWP) projected only a 4% increase in fully-qualified GPs between 2021 and 2036, compared to a 49% growth in consultants. 
    "The total supply of doctors in primary care is projected to increase substantially over the modelled period but the total number of fully qualified GPs is not," the report said. 
    It found that NHSE’s projected supply growth in general practice "consists mainly of trainee GPs", who accounted for 93%, as well as "making increased use of specialist and associate specialist (SAS) doctors in primary care". 
    Read full story
    Source: Pulse, 22 March 2024
  9. Patient Safety Learning
    A woman said she has been unable to get her ADHD medication for months.
    Hannah Huxford, 49, from Grimsby is one of thousands of patients unable to get hold of medicine to manage their symptoms due to a national shortage.
    Mrs Huxford, who was diagnosed with the condition two years ago, described the situation as a "huge worry".
    The Department of Health and Social Care (DHSC) said it had taken action to improve the supply of medicines but added that "some challenges remain".
    Mrs Huxford said the medicine made a "huge difference" and got her life back on track.
    "It enables me to function and concentrate so I can be more proactive, I can be more productive," she explained.
    She said she had been unable to get her usual supply since October 2023 and has to ration what she can get hold of.
    "Christmas time it was just getting beyond a joke. I was going back to the pharmacy, probably two or three times in a month, just to collect the little IOUs and it was getting to the point where that, in itself, was becoming a stress," she said.
    "All of a sudden, if this medication is taken away from me, I'm frightened that I will go back to not being able to cope."
    James Davies, from the Royal Pharmaceutical Society, said the supply shortage has been caused by manufacturing problems and an increase in demand.
    "There are more people who are being diagnosed with ADHD, more people seeking to access ADHD treatments. That's not just related to the UK, this is a global problem," he said.
    Mr Davies said some ADHD medication has come back into stock but added "it's quite a fluid situation at the moment".
    Read full story
    Source: BBC News, 19 February 2024
    Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? 
    To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our community thread on the topic: 
     
    You'll need to register with the hub first, its free and easy to do. 
    We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. What barriers and challenges have you seen around medication availability? Is there anything that can be done to improve wider systems or processes?
  10. Patient Safety Learning
    A new CMS report reveals disparities in care quality and patient safety within US hospitals before and during the pandemic, finding "a large proportion of measures had worse than expected performance." 
    CMS released its 2024 National Impact Assessment Feb. 28, which is released every three years and evaluates the measures used in 26 CMS quality and value-based incentive payment programs. This edition of the report compares quality measure scores pre-COVID-19 with hospitals' results in 2020 and 2021, the initial years of the COVID-19 public health emergency. 
    Here are eight findings from the 72-page assessment:
    1. During 2020 and 2021, a large proportion of measures had worse than expected performance, including significant worsening of key patient safety metrics.
    2. Half or more of the performance measures in five priorities had worse results in 2021 than expected from the 2016–2019 baseline. Priorities with the highest proportions of worse-than-expected results in 2021 were wellness and prevention (69%), behavioural health (55%), safety (54%), chronic conditions (52%), and seamless care coordination (50%). 
    3. Specific to safety, standardised infection ratios worsened significantly in hospitals for central line–associated bloodstream infections (94% worse), MRSA (55% worse) and CAUTI (34% worse). Before the Covid-19 PHE (2015–2019), 34,455 fewer healthcare-associated infections (HAIs) were reported in acute care settings. 
    4. More than 35% of measures in two priorities had better results in 2021 than expected from 2016–2019 baseline trends. Those priorities are seamless care coordination (50%) and affordability and efficiency (38%). 
    5. Specific to affordability and efficiency, emergency department visits for home health patients fared 1.4 percentage points better, and acute care hospitalization in the first 60 days of home health in 2021 was 1.5 percentage points better. 
    6. Accountable entities with the highest proportions of worse than expected results in 2021 were clinicians (64%), accountable care organizations (54%), and acute care facilities (54%). 
    7. Wellness and prevention had the highest percentage of measures showing health equity disparities; notable examples include pneumococcal and influenza vaccinations among racial and ethnic groups.
    8. Comparison racial and ethnic groups fared worse than the White reference group on 40 of 45 (88.9%) affordability and efficiency measures and 32 of 41 (78%) chronic conditions measures. For example, disparities were recorded for Black or African American patients in 32, or 71%, of the affordability and efficiency measures, mostly related to readmissions.
    Read full story
    Source: Becker Hospital Review, 29 February 2024
  11. Patient Safety Learning
    Alice and Lewis Jones were forced to watch their 18-month-old baby die in front of them after a failure by a scandal-hit NHS trust left him with a “catastrophic brain injury” following his birth.
    Their son Ronnie was one of hundreds of babies who have died following errors by Shrewsbury and Telford Hospital, where the largest NHS maternity scandal to date was previously uncovered by The Independent.
    Two years later, Mr and Mrs Jones are calling for the Supreme Court to overturn a controversial decision in February which ruled bereaved relatives could not claim compensation over the psychological impact of seeing a loved one die, even if it was caused by medical negligence.
    It comes after the trust admitted to failings in a letter to the parents’ lawyers.
    Ronnie’s birth in 2020 fell outside of the Ockenden review and his parents have warned it showed failures were still occurring despite warnings made during the inquiry.
    Within the Ockenden inquiry, multiple cases of staff failing to recognise and act upon CTG training were found, and the final report recommended all hospitals have systems to ensure staff are trained and up to date in CTG and emergency skills.
    The report also said the NHS should make CTG training mandatory and that clinicians must not work in labour wards or provide childbirth care without it.
    A CTG measures a baby’s heart and monitors conditions in the uterus and is an important measure before birth and during labour to observe the baby for any signs of distress.
    Ms Jones said: “We knew about the Ockenden review, but everything at Telford was new and so I think we just assumed that lessons had been learned, the same thing wouldn’t happen to us.”
    Ronnie’s parents are campaigning to reverse the Supreme Court which ruled that “secondary victims” – including parents who are not directly harmed by the birth – are not eligible to bring claims for psychiatric injury following medical negligence.
    Read full story
    Source: The Independent, 14 March 2024
  12. Patient Safety Learning
    Black and Asian people who spot cancer symptoms are taking twice as long to be diagnosed as white people, a shocking new study shows.
    Research by Bristol Myers Squibb (BMS) and Shine Cancer Support shows that people from minority ethnic backgrounds face an average of a year’s delay between first noticing symptoms and receiving a diagnosis of cancer.
    These groups report more negative experiences of cancer care than white people, limited knowledge about the diseases and lack of awareness of support services, which all contribute to later diagnostic rates.
    “In a year that’s revealed that the UK’s cancer survival lags behind comparable countries, I am saddened but unsurprised that people from minority ethnic groups face additional hurdles that delay their diagnosis.” said Ceinwen Giles, co-ceo of Shine Cancer Support.
    “We know that catching cancer earlier saves lives, yet with year long waits for some people, collaborative efforts between health leadership, advocacy groups and the pharmaceutical industry are required.”
    Read full story
    Source: The Independent, 9 April 2024
  13. Patient Safety Learning
    Bereaved parents who lose a baby before 24 weeks of pregnancy in England can now receive a certificate in recognition of their loss.
    Ministers say they have listened to bereaved parents who have gone through the painful experience of miscarriage.
    Campaigners said they were "thrilled" that millions of families would finally get the formal acknowledgement that their baby existed.
    All parents who have experienced baby loss since September 2018 can apply.
    They should visit the gov.uk website - applicants must be at least 16 years old, have been living in England at the time of the loss and be one of the baby's parents or surrogate.
    In Wales, there are plans to deliver a similar scheme. 
    Babies who are born dead after 24 completed weeks of pregnancy are called stillbirths, and their deaths are officially registered. But this does not happen for babies who die before that stage.
    Pregnancy loss or miscarriage before 24 weeks is the most common complication of pregnancy, experienced by an estimated one in five women in the UK.
    Read full story
    Source: BBC News, 21 February 2024
  14. Patient Safety Learning
    Patient Safety Awareness Week, an annual recognition event in the USA that occurs in March, is intended to encourage everyone to learn more about health care safety.
    During this week, the Institute for Healthcare Improvement (IHI) seeks to advance important discussions locally and globally, and inspire action to improve the safety of the health care system — for patients and the workforce.
    Patient Safety Awareness Week serves as a dedicated time and platform for growing awareness about patient safety and recognising the work already being done.
    IHI works with partners around the world to improve the safety of health care for patients, caregivers, and the health care workforce.
    Learn more about IHI's work to advance patient and workforce safety.
  15. Patient Safety Learning
    The NHS is experiencing an “avalanche of need” over autism and attention deficit hyperactivity disorder (ADHD), but the system in place to cope with surging demand for assessments and treatments is “obsolete”, a health thinktank has warned.
    There must be a “radical rethink” of how people with the conditions are cared for in England if the health service is to meet the rapidly expanding need for services, according to the Nuffield Trust.
    The thinktank is calling for a “whole-system approach” across education, society and the NHS, amid changing social attitudes and better awareness of the conditions. It comes days after the NHS announced a major review of ADHD services.
    Thea Stein, the chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand for autism assessments and ADHD treatments have completely overtaken the NHS’s capacity to meet them. It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand.
    “We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer while they wait.”
    Read full story
    Source: The Guardian, 4 April 2024
  16. Patient Safety Learning
    Boston-based Massachusetts General Hospital is requesting permission from the state to add more than 90 inpatient beds amid what it says is an "unprecedented capacity crisis." 
    The hospital's emergency department has experienced critical levels of overcrowding nearly every day for the past six months, Massachusetts General said in a news release. The hospital boards between 50 to 80 ED patients every night who are waiting for a hospital bed to open. On 11 January, Massachusetts General had 103 patients boarding in the ED, representing one of the most crowded days in the hospital's more than 200-year history.
    "While hospital overcrowding has significantly affected patient care for many years, COVID-19 and the post-pandemic demand for care has escalated this challenge into a full-blown crisis – for patients seeking necessary emergency care, as well as for staff who are required to work under these increasingly stressful conditions," David F.M. Brown, president of Massachusetts General, said in a news release.
    Massachusetts General's request comes as hospitals across the state grapple with capacity issues, workforce shortages and a jump in respiratory illnesses this winter. On 9 January. the Massachusetts Department of Public Health issued a memo urging hospitals to expedite discharge planning amid the capacity crunch. Some health plans have also waived the need to obtain prior authorisation for short stays in post-acute care facilities. 
    Read full story 
    Source: Becker Hospital Review, 19 January 2024
  17. Patient Safety Learning
    In 2023-2024, the US News Best Hospitals ranked hospitals in the USA in 15 adult specialties as well as recognised hospitals by state, metro and regional areas for their work in 21 more widely performed procedures and conditions.
    Of the nearly 5,000 hospitals analyzed and 30,000 physicians surveyed, only 164 hospitals ranked in at least one of the specialties.
    Read full story
    Source: US News
  18. Patient Safety Learning
    A woman who described the time in her life after a pelvic mesh implant as "soul destroying" said proposed government compensation was "disappointingly low".
    Claire Cooper, from Uckfield, is one of around 100,000 women across the UK who had transvaginal mesh implants.
    England's patient safety commissioner suggested compensation could start at around £20,000.
    Ms Cooper, 49, was originally given the mesh implant as a treatment for incontinence after childbirth.
    However, after struggling with pain following the operation, Ms Cooper claimed doctors treated her as if she were "psychotic" and "a nuisance".
    She said her experience was one of being "mocked".
    "It was just soul destroying," Ms Cooper told BBC Radio Sussex. "I lost my fight because I was met at every turn with resistance so I just lost the ability to advocate for myself."
    Ms Cooper eventually had surgery to remove the mesh, which she said one doctor compared to "cheese cutting wire". She is still living with chronic pain.
    Read full story
    Source: BBC News, 15 February 2024
    Further reading on the hub:
    Doctors shocking comments to women harmed by mesh
     
  19. Patient Safety Learning
    Health systems will be asked to deliver the same amount of elective activity next year as they were tasked with completing in 2023-24, HSJ understands.
    Local leaders have been issued with varying interim targets for 2024-25 that produce an average national threshold of 7% more activity than pre-covid levels, on a value-weighted basis.
    It means the target for the current year has effectively been rolled over into next, suggesting the elective recovery is a year behind schedule.
    Even if systems hit their thresholds next year, they will still fall well short of the central target set out in the elective recovery plan in 2022.
    Recent weeks have seen other elective ambitions ditched or watered down, including the prime minister’s headline pledge to bring the overall waiting list down. It is likely a result of the government accepting it cannot push more elective activity due to ongoing strikes and overspending.
    Read full story (paywalled)
    Source: HSJ, 27 February 2024
  20. Patient Safety Learning
    A nurse has warned that she has been “crushed and silenced” over a battle with the NHS and the nursing regulator to investigate claims that she was sexually harassed by a colleague at work.
    Michelle Russell told Nursing Times of the “eight-year nightmare” she has endured since coming forward about her experiences and that she said had recently led her nursing career to come to an end.
    “Knowing what’s happened to me is not going to make it easier for anybody else to speak out"
    She has argued that “speaking up is not encouraged” in the NHS and that her case would discourage other nurses from coming forward about sexual harassment.
    Ms Russell said: “Anybody who has been around me would be able to see the emotional impact of all of this on me.
    “I’ve lost my job for highlighting a public safety concern.”
    The national guardian for the NHS told Nursing Times sexual harassment was a “patient safety issue” and warned that staff continued to face difficulties when speaking out.
    It comes as the latest NHS Staff Survey this month revealed that almost 4% of nurses and midwives had been the target of unwanted sexual behaviour in the workplace by another member of staff in the last 12 months.
    Read full story
    Source: Nursing Times, 15 March 2024
  21. Patient Safety Learning
    Ministers are being urged to roll out a better testing regime for one of the country’s biggest killers, with the most recent figures showing death rates for chronic obstructive pulmonary disease more than three times higher in some of the most deprived areas of the country.
    More than 20,000 people a year in England die from chronic obstructive pulmonary disease. The most significant cause of COPD is smoking, but a significant proportion of cases are work-related, triggered by exposure to fumes, chemicals and dust at work.
    Figures from the Office for National Statistics reveal that death rates from the disease are significantly higher in more deprived areas of the country.
    The NHS is rolling out targeted lung screening across England for people aged between 55 and 74 who are current or former smokers. The charity Asthma + Lung UK says the checks will identify many people who may have COPD, but there is no established protocol for them to be diagnosed and given appropriate treatment and support.
    Dr Samantha Walker, interim chief executive at Asthma + Lung UK, said: “Once targeted lung health checks are fully rolled out, millions of people could be told they have an incurable lung disease like chronic obstructive pulmonary disease, but they won’t be given a firm diagnosis or signposted to the right support, which is simply unacceptable.
    “What we need to see is a national referral pathway in place for those people who show signs of having other lung conditions as part of this screening process to ensure that people with all suspected lung conditions get the diagnosis and treatments that they deserve. We know that people with lung disease will live better, fuller lives with an earlier diagnosis.”
    Read full story
    Source: The Guardian, 24 March 2024
  22. Patient Safety Learning
    Almost 10 million people across England could be waiting for an NHS appointment or treatment, 2 million more than previously estimated, according to a survey by the Office for National Statistics (ONS).
    The ONS survey of about 90,000 adults found that 21% of patients were waiting for a hospital appointment or to start receiving treatment on the NHS.
    When extrapolated, this equates to 9.7 million people. In January, the waiting list stood at 7.6 million, according to official NHS statistics.
    The survey found that the delays were most prominent among 16-24-year-olds, one in five of whom said they had experienced waiting times of more than a year.
    Conducted in January and February, the survey was part of the annual winter coronavirus infection study of adults aged 16 and over.
    The ONS said the survey was the first of its kind to assess the experiences of adults awaiting hospital appointments, tests or medical treatments. It said the data was experimental, based on self-reported data, and may differ from other statistics on waiting lists.
    Read full story
    Source: The Guardian, 3 April 2024
  23. Patient Safety Learning
    A fertility clinic in London has had its licence to operate suspended because of “significant concerns” about the unit, the regulator has said.
    The Homerton Fertility Centre has been ordered by the Human Fertilisation and Embryology Authority (HFEA) to halt any new procedures while investigations continue.
    The clinic in east London said there had been three separate incidents highlighting errors in some freezing processes. This resulted in the “tragic loss of a small number of embryos” that either did not survive or became “undetectable”, which means an embryo stored in frozen liquid solution in a container cannot be found during subsequent thawing.
    The clinic has informed the patients affected and apologised for any distress caused.
    Homerton Healthcare NHS foundation trust said it began an investigation in late 2023 and immediately made regulators fully aware of it. The HFEA is now conducting its own investigation alongside the trust.
    In a statement, the clinic said that while the investigators had not been able to find any direct cause of the errors, it had made changes in the unit to prevent the recurrence of such incidents.
    All staff now work in pairs to ensure all clinical activities are checked by two healthcare professionals, competencies of staff within the unit have been rechecked, and security at the unit has been increased.
    Read full story
    Source: The Guardian, 8 March 2024
  24. Patient Safety Learning
    The number of people dying needlessly in A&E soars on a Monday as hospitals are stretched to the limit and failing to discharge patients at the weekend, new data shows.
    Figures uncovered by The Independent show an average of 126 patients died every Monday between 2020-2023 – 25% higher than any other day. On a Saturday, the average number of deaths drops as low as 90.
    Waiting times are also shown to spike massively at the start of the week, with an average of 9,300 patients spending more than 12 hours waiting on a Monday – up to 2,000 more than any other day.
    Medical experts said the rise in A&E waits can be attributed to people staying away from hospitals during weekends and patients not being discharged from medical care, causing a bottleneck in an already buckling system.
    The stark statistics also directly contradict repeated government efforts to make the NHS a seven-day service. Multiple coroners have warned the government and health leaders about delays to patients’ treatment and diagnosis due to variations in staffing and access to specialists – particularly over the weekend.
    Adrian Boyle, president of the Royal College of Emergency Medicine, said the NHS England data clearly signposted an “increased risk” at the start of the week. Another expert said the sharp rise in deaths on Mondays showed an A&E “running constantly in the red zone”.
    Read full story
    Source: The Independent, 8 April 2024
  25. Patient Safety Learning
    The wait to be diagnosed with endometriosis has increased to almost ten years, a "devastating" milestone say women with the condition.
    It now takes almost a year more than before 2020 to be diagnosed, according to research published by Endometriosis UK, which is setting up new volunteer-led support groups in Wales.
    The wait in Wales is also the longest in the UK, the research found.
    The Welsh government said it knew there was "room for improvement".
    "Nobody listened to me, and to feel like women are still going through that 20 years after my diagnosis is horrific," said Michelle Bates. The 48-year old from Cardiff was diagnosed aged 25 after suffering with "harrowing" pain from age 13 onwards - a 12-year wait.
    "I went back and forth to the GP with my mum, who was the only one who believed in my pain," she said.
    The study by Endometriosis UK, which is based on a survey of 4,371 people who received a diagnosis of endometriosis, showed almost half of all respondents (47%) had visited their GP 10 or more times with symptoms prior to receiving a diagnosis, and 70% had visited five times or more.
    It also found 78% of people who later went on to receive a diagnosis of endometriosis - up from 69% in 2020 - were told by doctors they were making a "fuss about nothing", or comments to that effect.
    Read full story
    Source: BBC News, 18 March 2024
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