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Patient Safety Learning

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  1. Patient Safety Learning
    A "virtual ward" enabling patients who want to die at home get the palliative care they need has launched.
    Hospice Outreach provides a "specialised pathway" for patients identified by existing services who would benefit from support.
    It is part of a project that supports people at the very end of their life.
    Dr Victoria Bradley, of Oxford University Hospitals NHS Foundation Trust (OUH), said it was about giving people "control and agency".
    OUH claims Hospice Outreach's virtual ward will mean more people will receive personalised care, including in their own homes if that is their choice.
    It said specialist palliative care would be "provided virtually or in person, depending on what is best for the patient".
    Amelia Foster, chief executive at Sobell House, said: "Being able to offer a virtual ward to those in a palliative crisis or at the end of their lives helping them to remain at home means more people can access our care in the way that they wish."
    Dr Bradley, who is the clinical lead for palliative medicine at OUH, said: "We can support with discharge from hospital to people's homes if that is their wish, and by reducing people's time in hospital and caring for them at home, we can offer the right support in their chosen surroundings."
    Read full story
    Source: BBC News, 14 March 2024
  2. Patient Safety Learning
    While the importance of translating evidence into policies and practices is widely acknowledged by evidence producers, intermediaries, users, and funders, there is much less agreement on suitable mechanisms for promoting effective evidence use. As a response, the World Health Organization (WHO) has initiated an extensive and inclusive research priority-setting exercise in Knowledge Translation (KT) and Evidence-informed Policy-making (EIP) through a series of technical consultations.
    This priority-setting initiative, coordinated by the Evidence to Policy and Impact Unit in WHO’s Science Division, involves national and international researchers, practitioners, and organizations across all WHO regions. Collectively, they will assess the evidence base for effective research utilization in decision-making. The overarching goal of this project is to maximize the impact of KT and EIP research to promote the translation of evidence into effective policies that enhance population health and well-being. Key objectives include:
    Efficiency and Synergy: Streamlining research efforts in KT and EIP. Strategic Funding: Directing research funding toward identified priority areas. Effective Approaches: Enhancing understanding of evidence use for policy-making. Collaboration: Promoting cross-sectoral collaboration in KT and EIP research. Awareness: Championing for evidence-informed policy-making at all levels. In the first half of the 2024, global experts – selected during an open call – are now actively participating in a series of consultations to identify gaps and opportunities in KT and EIP research. The consultations provide a pivotal opportunity for participants to discuss current research gaps, harmonize terminology and chart a course toward shared priorities.
    Read full story
    Source: WHO, 22 March 2024
  3. 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
  4. 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
  5. Patient Safety Learning
    Cancer patients in the UK wait up to seven weeks longer to begin radiotherapy or chemotherapy than people in comparable countries, research has revealed.
    The stark findings are yet more damning evidence of the extent to which the UK lags behind other nations, as experts warn that people’s chances of survival are being affected by long waits for treatment.
    In the first research of its kind, experts at University College London analysed data from more than 780,000 cancer patients diagnosed between 2012 and 2017 in four comparable countries: Australia, Canada, Norway and the UK. Eight cancer types were included: oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer.
    The two studies, published in the Lancet Oncology, were the first to examine treatment differences for eight cancer types in countries across three continents. UK patients experienced the longest waits for treatment, the research found.
    The average time to start chemotherapy was 48 days in England, 57 in Northern Ireland, 58 in Wales and 65 in Scotland. The shortest time was 39 days in Norway.
    In radiotherapy, the UK fared even worse. It took 53 days on average for treatment to begin in Northern Ireland, 63 in England, 79 in Scotland and 81 in Wales.
    Cancer Research UK, which part-funded the two studies, said delays to begin treatment were partly a result of the UK government’s lack of long-term planning on cancer in recent years. Countries with robust cancer strategies backed by funding had seen better improvements in survival rates, it said.
    Read full story
    Source: The Guardian, 27 February 2024
  6. Patient Safety Learning
    Government’s standards watchdog has launched a review into accountability in public bodies, warning that problems are too often not dealt with quickly and effectively.
    Over the next few months, the Committee on Standards in Public Life will look at “where public bodies should focus their attention to maximise the likelihood of problems being uncovered and addressed before issues escalate and lives are damaged”.
    In a letter to the prime minister about the review, CSPL chair Doug Chalmers said the committee had been “struck by how, when failures occur within public institutions, it repeatedly seems to be the case that indicators of emerging issues were present, but missed, with the result that the window to respond appropriately, before problems escalate, has often also been missed”.
    In its announcement of the review, CSPL said it had seen “several examples of major failures within public institutions” in recent years where “opportunities were missed to address issues before they escalated”.
    “We are asking, when things go wrong in public bodies, why does it take so long for problems to be recognised and the leadership to respond appropriately and, most importantly, what needs to change?”
    Rather than reinvestigating previous incidents, the committee will look at how to encourage more effective accountability within public bodies “so that problems are addressed before catastrophic failure”, Chalmers said.
    As part of the review, CSPL has opened a consultation today inviting members of the public to submit evidence on why public bodies might fail to act quickly when problems arise, along with suggestions on how to tackle problems better and examples of good practice. The consultation closes on 14 June.
    Read full story
    Source: Civil Service World, 25 March 2024
  7. Patient Safety Learning
    The family of a man who needlessly died after a 12-hour delay in surgery have called for changes at a troubled NHS trust as regulators expressed alarm about patient safety and waiting times.
    The Care Quality Commission (CQC) upgraded the surgery department at the Royal Sussex county hospital in Brighton from “inadequate” to “requires improvement” at a time when it is at the centre of a police investigation into dozens of patient deaths, allegations of negligence and cover-up.
    In their report, the regulator expressed concern about already long and lengthening waiting times, repeated cancelled operations and staff shortages that could compromise safety.
    The inspection report comes as the Guardian can reveal the trust apologised and settled with the family of Ralph Sims, who died aged 65 after heart surgery in April 2019 when doctors failed to act appropriately to a drop in his blood pressure.
    Sims, who was a keen runner, suffered a drop in blood pressure and developed an irregular heart rhythm eight hours after surgery to replace an aortic valve at the hospital.
    An internal investigation into Sims’ treatment acknowledged that hospital staff failed to “recognise the significance of the fall in blood pressure”.
    University Hospitals Sussex NHS foundation trust, which runs the hospital, accepted that the father of three should have returned to surgery to identify the cause of his deterioration. Instead, medics decided that he should be observed overnight.
    Due to another emergency case, an angiogram was not carried out on Sims until just before noon the following day – 12 hours after the drop in pressure. The delay caused irreversible – and avoidable – heart muscle damage, leading to his death five weeks later.
    The family said: It added: “Whilst the trust has apologised to our family it feels hollow. Ralph’s death was entirely unnecessary, and despite the issues in his care, it took the trust several years to apologise.”
    Read full story
    Source: The Guardian, 14 February 2024
  8. Patient Safety Learning
    The number of people in the UK who have avoidant restrictive food intake disorder (Arfid), in which those afflicted avoid many foods, has risen sevenfold in five years, figures show.
    The eating disorders charity Beat received 295 calls about Arfid in 2018 – comprising 2% of its 20,535 inquiries that year. However, it received 2,054 calls last year, which accounted for one in 10 of its 20,535 requests for help. Many were from children and young people or their parents.
    Andrew Radford, Beat’s chief executive, said: “It’s extremely worrying that there has been such a dramatic increase in those seeking support for Arfid, particularly as specialist care isn’t always readily available.”
    Patchy provision of NHS help meant many people were experiencing long delays before accessing support, he added.
    Eight in 10 eating disorder service providers did not state on their website whether or not they offered Arfid care, research by Beat found.
    “All too often we hear from people who have been unable to get treatment close to home or have faced waits of months or even years to get the help they need,” Radford said.
    Arfid is much less well-known than anorexia or bulimia. It is “an eating disorder that rarely gets the attention it deserves”. The sharp increase in cases should prompt NHS chiefs to end the postcode lottery in care for Arfid and ensure that every region of England had a team of staff fully trained to treat it, he added.
    “Unlike other eating disorders such as anorexia or bulimia, Arfid isn’t driven by feelings around [someone’s] weight or shape,” Radford said. “Instead, it might be due to having sensory issues around the texture or taste of certain foods, fear about eating due to distressing experiences with food, for example choking, or lack of interest in eating.”
    Read full story
    Source: The Guardian, 26 February 2024
  9. Patient Safety Learning
    Almost 70,000 children are missing out on mental health care they should be eligible to receive as the NHS falls short of key targets, The Independent has revealed.
    An internal analysis, seen by The Independent, shows in England the NHS has fallen short of a target, set in 2019, for 818,000 children to receive at least one treatment session from Child and Adolescent Mental Health Services (CAMHS) in 2023.
    The actual number of children who received treatment in the 12 months to December was 749,833, falling short of the target by around 9%.
    The figures came as the government announced this week it would expand the number of early access mental health hubs for children to cover 50% of the country by 2025. However, campaigners urged ministers to commit to covering the entire country to help “turn the tide on the crisis” in children’s mental health services.
    The NHS analysis shows, as of December, CAMHS in the South West was furthest away from its targets with 78% of children seen out of those eligible. In London, 80% of the target was achieved and in the North West 105%.
    Laura Bunt, chief executive at YoungMinds, said: “Referrals to mental health services are at a record high with more young people than ever in need of support with their mental health. We know that many young people are struggling in the aftermath of the pandemic, facing intense academic pressure to catch up on lost learning, a cost of living crisis and increasing global instability.
    “Every young person should be able to access mental health support when they need it, but too many don’t get it until things get much worse.  Services continue to be significantly underfunded and the number of young people receiving treatment falls woefully short of what is needed. To turn the tide on this crisis, the government must prioritise young people and their mental health by investing in prevention and early intervention.”
    Read full story
    Source: The Independent, 2 March 2024
  10. 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
  11. Patient Safety Learning
    Millions of people with long-term illnesses should get medical treatment at home rather than in hospital to help them carry on working, according to a report.
    The NHS is being urged to deliver more medicines directly to patients’ doors, so they can self-administer drugs at home, and “get on with life” rather than having to travel back and forth to hospitals.
    New research shows this model of care, called clinical homecare, helps those needing regular treatment for chronic conditions, including cancer and arthritis, to stay in employment and retain independence.
    Experts said providing more patients with specialist medicines at home can play a vital role in tackling the UK’s growing rates of economic inactivity, with 2.7 million long-term sick now signed off work.
    The report, commissioned by the National Clinical Homecare Association, said expanding the schemes means millions of patients “could be supported to continue working and living their lives without being defined by their health status”, adding that up to three million cancer patients could benefit.
    Read full story (paywalled)
    Source: The Times, 19 March 2024
  12. Patient Safety Learning
    Codeine linctus, an oral solution or syrup licensed to treat dry cough in adults, is to be reclassified to a prescription-only medicine due to the risk of abuse, dependency and overdose, the Medicines and Healthcare products Regulatory Agency (MHRA) has announced.
    Codeine linctus is an opioid medicine which has previously been available to buy in pharmacies under the supervision of a pharmacist but will now only be available on prescription following an assessment by a healthcare professional.
    Since 2019, there have been increasing reports in the media of codeine linctus being misused as an ingredient in a recreational drink, commonly referred to as ‘Purple Drank’.
    The decision to reclassify the medicine has been made following a consultation with independent experts, healthcare professionals and patients. 992 responses were received.
    The consultation was launched by the MHRA after Yellow Card reports indicated instances of the medicine being abused, rather than for its intended use as a cough suppressant.
    Dr Alison Cave, MHRA Chief Safety Officer, said: "Patient safety is our top priority. Codeine linctus is an effective medicine for long term dry cough, but as it is an opioid, its misuse and abuse can have major health consequences."
    Alternative non-prescription cough medicines are available for short-term coughs to sooth an irritated throat, including honey and lemon mixtures and cough suppressants.
    Patients are urged to speak to a pharmacist for advice and not to buy codeine linctus from an unregistered website as it could be dangerous.
    Read full story
    Source: MHRA, 20 February 2024
  13. Patient Safety Learning
    Minority ethnic people, women and people from deprived communities are at risk of poorer healthcare because of biases within medical tools and devices, a report has revealed.
    Among other findings, the Equity in Medical Devices: Independent Review has raised concerns over devices that use artificial intelligence (AI), as well as those that measure oxygen levels. The team behind the review said urgent action was needed.
    Prof Frank Kee, the director of the centre for public health at Queen’s University Belfast and a co-author of the review, said: “We’d like an equity lens on the entire lifecycle of medical devices, from the initial testing, to recruitment of patients either in hospital or in the community, into the early phase studies and the implementation in the field after they are licensed,.”
    The government-commissioned review was set up by Sajid Javid in 2022 when he was health secretary after concerns were raised over the accuracy of pulse oximeter readings in Black and minority ethnic people.
    The widely used devices were thrown into the spotlight due to their importance in healthcare during the Covid pandemic, where low oxygen levels were an important sign of serious illness.
    The report has confirmed concerns pulse oximeters overestimate the amount of oxygen in the blood of people with dark skin, noting that while there was no evidence of this affecting care in the NHS, harm has been found in the US with such biases leading to delayed diagnosis and treatment, as well as worse organ function and death, in Black patients.
    The team members stress they are not calling for the devices to be avoided. Instead the review puts forward a number of measures to improve the use of pulse oximeters in people of different skin tones, including the need to look at changes in readings rather than single readings, while it also provides advice on how to develop and test new devices to ensure they work well for patients of all ethnicities.
    Read full story
    Source: The Guardian, 11 March 2024
  14. Patient Safety Learning
    Women who freeze their eggs are being misled by some UK clinics about their chances of having a baby, a fertility charity says.
    The Fertility Network was reacting to BBC analysis that found 41% of clinics offering the service privately could be breaching advertising guidance.
    The watchdog which sets guidance says clinics "must not give false or misleading information".
    It comes as a record number of people are freezing their eggs.
    The UK fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), also said it was concerned about the information given to those considering egg freezing.
    A successful pregnancy is not guaranteed by the procedure.
    Egg freezing for non-medical reasons, also known as social egg freezing, is an increasingly popular method for women to preserve their fertility in order to have children at a later date.
    Read full story
    Source: BBC News, 13 March 2024
  15. Patient Safety Learning
    Sickle cell patients are being put at risk because of a chronic shortage of specialist nurses to treat them, a damning new report has found.
    'The Difference Between Life and Death', a new study by the Sickle Cell Society, found that there are not enough sickle cell workers to deliver a good standard of care.
    One patient called Abi Adeturinmo told researchers that previous traumatic experiences caused by delays in receiving pain relief medication and poor care meant she “tries not to go to the hospital when in sickle cell crisis unless it is life-threatening”.
    Another patient, Araba Mensah, whose daughter has sickle cell disorder, said there was a lack of “hands-on” nursing, and said patients who have difficulties feeding themselves or with personal hygiene were “left to suffer unattended”.
    John James, CEO of the Sickle Cell Society, said: “While there are undoubtedly workforce challenges across all parts of the health system, the evidence in this report suggests that sickle cell is disproportionately impacted as a result of the legacy of neglect of sickle cell care.
    “On behalf of everyone affected by sickle cell, we are urging NHS England to take action now to ensure all sickle cell patients have access to the specialist care they are entitled to.”
    Read full story
    Source: The Independent, 24 November 2023
  16. 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
  17. Patient Safety Learning
    A dedicated mental health and addiction support service for secondary care staff is shutting to new patients, as NHS England is set to cut its funding.
    The NHS Practitioner Health programme, which was rolled out nationally in October 2019, is halting new registrations for secondary care staff from 15 April.
    NHS England has informed the provider its funding will be cut for secondary care staff, subject to a review it is carrying out of wider services. The Practitioner Health programme for GPs and dentists is expected to continue for another year, although its future beyond that is also unclear, HSJ was told.
    An announcement published on X, formerly known as Twitter, said: “New secondary care patients will be signposted to alternative sources of support, including your GP, occupational health departments and organisational employee assistance programmes.”
    Its axing comes amid severe pressure on NHS budgets nationally and locally, with overall funding barely keeping up with anticipated inflation in 2024-25, and many integrated care systems forecasting large deficits.
    Medical unions and senior doctors have criticised the axing of the service.
    Read full story (paywalled)
    Source: HSJ, 12 April 2024
  18. Patient Safety Learning
    Researchers at the National Institutes of Health applied artificial intelligence (AI) to a technique that produces high-resolution images of cells in the eye. They report that with AI, imaging is 100 times faster and improves image contrast 3.5-fold. The advance, they say, will provide researchers with a better tool to evaluate age-related macular degeneration (AMD) and other retinal diseases.
    "Artificial intelligence helps overcome a key limitation of imaging cells in the retina, which is time," said Johnny Tam, Ph.D., who leads the Clinical and Translational Imaging Section at NIH's National Eye Institute.
    Tam is developing a technology called adaptive optics (AO) to improve imaging devices based on optical coherence tomography (OCT). Like ultrasound, OCT is noninvasive, quick, painless, and standard equipment in most eye clinics.
    "Our results suggest that AI can fundamentally change how images are captured," said Tam. "Our P-GAN artificial intelligence will make AO imaging more accessible for routine clinical applications and for studies aimed at understanding the structure, function, and pathophysiology of blinding retinal diseases. Thinking about AI as a part of the overall imaging system, as opposed to a tool that is only applied after images have been captured, is a paradigm shift for the field of AI."
    Read full story
    Source: Digital Health News, 11 April 2024
  19. Patient Safety Learning
    The government has been accused of “deprioritising women’s health” as analysis shows that almost 600,000 women in England are waiting for gynaecological treatment, an increase of a third over two years.
    There are 33,000 women waiting more than a year for such treatment, an increase of 43%, according to Labour analysis of data from the House of Commons library.
    It found that there is no region in England that meets the government’s target for cervical cancer screening of 80% coverage, with just over two-thirds of women (68.7%) having been screened in the past five and a half years.
    Also, one in four women (26%) with suspected breast cancer waited more than a fortnight to see a specialist in the year to September 2023.
    Under two-thirds (66.4%) of eligible women have been screened for breast cancer in the last three years, with just two English regions meeting the 70% coverage target.
    The NHS target in England is that 92% of patients have a referral-to-treatment time of less than 18 weeks.
    The figures come after the government pledged to end decades of gender-based health inequalities through a new women’s health strategy for England.
    Read full story
    Source: The Guardian, 22 April 2024
  20. Patient Safety Learning
    Health service dentistry in Northern Ireland could be caught in a "death spiral" without radical action, more than 700 dentists have warned.
    They say a combination of factors could make the service unsustainable.
    These include a potential ban on dental amalgam metals used in fillings, budget pressures and a "financially unviable contractual framework".
    The dentists have called on the Department of Health (DoH) "to show leadership and take action now".
    A DoH spokesperson said the department "valued the important role" of dentists and was "aware of the ongoing pressures on dental practices".
    In an open letter to Peter May, the top civil servant at the DoH, dentists from the British Dental Association (BDA) Northern Ireland warned that services were under "intolerable pressure".
    The letter said: "Despite clear evidence and repeated warnings issued by the BDA about the death spiral health service dentistry in Northern Ireland appears to be in, we have seen inaction from the authorities."
    The dentists added that a move away from health service dentistry was "well and truly underway" and dentists would "be increasingly driven out of health service dentistry to keep their practices afloat".
    Read full story
    Source: BBC News, 30 January 2024
  21. Patient Safety Learning
    NHS leaders have welcomed the £6bn budget boost Jeremy Hunt handed the beleaguered service to help it meet rising demand, tackle the care backlog and overhaul its antiquated IT system.
    The chancellor gave the NHS in England an extra £2.5bn to cover its day-to-day running costs in 2024/25, after the Institute for Fiscal Studies had warned that it was set to receive less funding next year than this.
    Julian Hartley, the chief executive of hospital body NHS Providers, said the money would offer “much needed – but temporary – respite” and “some breathing space” from the service’s acute financial difficulties, which have been exacerbated by inflation and the costs incurred by long-running strikes by NHS staff.
    However, there was little to stabilise England’s creaking adult social care system, and Hunt’s budget delivered an ongoing squeeze on resources, said the Association of Directors of Adult Social Services (ADASS).
    “Millions of adults and carers will be disappointed,” said Anna Hemmings, joint chief executive of ADASS. “Directors can’t invest enough in early support for people close to home, which prevents them needing hospital or residential care at a greater cost.”
    Read full story
    Source: The Guardian, 6 March 2024
  22. Patient Safety Learning
    Local NHS organisations are facing intense “pressure” from NHS England’s national and regional teams to cut staffing numbers to improve the service’s financial outlook for 2024-25. 
    Multiple sources have told HSJ that first draft financial returns submitted by the 42 integrated care systems indicate a combined deficit of around £6bn for the service.
    The £6bn figure is likely to fall substantially as NHS England meets individually with integrated care systems with the worst numbers.
    The need to reduce the number is prompting “horrible” conversations about service cuts, according to HSJ sources. One local leader in the South East region said the need to reduce staffing numbers constituted a “very significant part of the pushback on first-cut numbers”.
    A senior source in the Midlands added: “We’ve got virtually no workforce growth in our plan now… and we’ve still got a deficit. To get to breakeven we’d have to be looking at quite a significant workforce reduction.”
    Another leader in the South of the country said there was “big pressure” to get down to pre-pandemic staff numbers, “despite [the] increases in acuity, demand and backlogs as a consequence of covid”.
    Read full story (paywalled)
    Source: HSJ, 18 March 2024
  23. Patient Safety Learning
    Nearly a dozen junior doctors have been relocated from a London hospital’s general surgery department by NHS England, after concerns about a culture of fear, poor support, and reports of bullying. 
    NHSE has withdrawn 11 surgical foundation year trainees from Barnet Hospital, in north London, after a review uncovered concerns regarding staff behaviour and safety.
    The General Medical Council has opened a case into the hospital’s department, which is run by the Royal Free London Foundation Trust, and the trainees have been placed elsewhere in the trust.
    Colin Melville, the GMC’s medical director and director of education and standards, told HSJ: “Doctors in training in the department reported a culture of fear, worry, and feeling unsupported and unable to raise concerns in the appropriate manner.
    “There are also concerns over their supervision, bullying, and undermining behaviours in the department, as well as doctors’ physical and mental wellbeing.
    “Because of the [trust’s] failure to meet the high standards we require, we stand firmly with NHSE workforce, training, and education London’s decision to relocate the 11 trainees, [to] where they can work and learn in a supportive environment.
    “This action is necessary not only to ensure their safety, but to protect the public as well.”
    Read full story (paywalled)
    Source: HSJ, 18 April 2024
  24. Patient Safety Learning
    Thousands of vulnerable children questioning their gender identity have been let down by the NHS providing unproven treatments and by the “toxicity” of the trans debate, a landmark report has found.
    The UK’s only NHS gender identity development service used puberty blockers and cross-sex hormones, which masculinise or feminise people’s appearances, despite “remarkably weak evidence” that they improve the wellbeing of young people and concern they may harm health, Dr Hilary Cass said.
    Cass, a leading consultant paediatrician, stressed that her findings were not intended to undermine the validity of trans identities or challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress.
    But she said this care was made even more difficult to provide by the polarised public debate, and the way in which opposing sides had “pointed to research to justify a position, regardless of the quality of the studies”.
    “There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.”
    Read full story
    Source: The Guardian, 10 April 2024
  25. Patient Safety Learning
    Almost £35 million will be invested to improve maternity safety across England with the recruitment of additional midwives and the expansion of specialist training to thousands of extra healthcare workers.
    The investment, which was announced as part of the Spring Budget 2024, will be provided over the next 3 years to ensure maternity services listen to and act on women’s experiences to improve care.  
    The funding includes:
    £9 million for the rollout of the reducing brain injury programme across maternity units in England, to provide healthcare workers with the tools and training to reduce avoidable brain injuries in childbirth investment in training to ensure the NHS workforce has the skills needed to provide ever safer maternity care. An additional 6,000 clinical staff will be trained in neonatal resuscitation and we will almost double the number of clinical staff receiving specialist training in obstetric medicine in England increasing the number of midwives by funding 160 new posts over 3 years to support the growth of the maternity and neonatal workforce  funding to support the rollout of maternity and neonatal voice partnerships to improve how women’s experiences and views are listened to and acted on to improve care. Health and Social Care Secretary Victoria Atkins said:
    "I want every mother to feel safe when giving birth to their baby.
    Improving maternity care is a key cornerstone of our Women’s Health Strategy and with this investment we are delivering on that priority - more midwives, specialist training in obstetric medicine and pushing to improve how women are listened to in our healthcare system.
    £35 million is going directly to improving the safety and care in our maternity wards and will move us closer to our goal of making healthcare faster, simpler and fairer for all."
    Read full story
    Source: Gov.UK, 10 March 2024
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