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Patient Safety Learning

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  1. 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
  2. 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
  3. 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
  4. 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
  5. Patient Safety Learning
    Patients are dying needlessly every year due to vulnerable Britons with heart problems not being given antibiotics when they visit the dentist, doctors have said.
    Almost 400,000 people in the UK are at high risk of developing life-threatening infective endocarditis any time they have dental treatment, the medics say. The condition kills 30% of sufferers within a year.
    A refusal to approve antibiotic prophylaxis (AP) in such cases means that up to 261 people a year are getting the disease and up to 78 dying from it, they add. That policy may have caused up to 2,010 deaths over the last 16 years, it is claimed.
    That danger has arisen because the National Institute for Health and Care Excellence (NICE) does not follow international good medical practice and tell dentists to give at-risk patients antibiotics before they have a tooth extracted, root canal treatment or even have scale removed, the experts claim.
    The doctors – who include a professor of dentistry, two leading cardiologists and a professor of infectious diseases – have outlined their concerns in The Lancet medical journal. In it, they urge NICE to rethink its approach in order to save lives, citing pivotal evidence that has emerged since the regulator last examined the issue in 2015, which shows that antibiotics are “safe, cost-effective and efficacious”.
    Read full story
    Source: The Guardian, 2 April 2024
  6. Patient Safety Learning
    Experts and patient groups have warned that the high cost of private Covid vaccinations could exacerbate health inequalities and leave those more at risk from the virus without a vital line of defence.
    Both high street chain Boots and pharmacies that partner with the company Pharmadoctor are now offering Covid jabs to those not eligible for a free vaccination through the NHS, with the former charging almost £100 for the Pfizer/BioNTech jab.
    While Pharmadoctor says each pharmacy sets its own prices, it suggests the Pfizer/BioNTech jab will set customers back £75-£85, while the latest Novavax jab will cost about £45-£55.
    However experts have raised concerns that the high cost of the private jabs will widen inequalities, with the vaccinations unaffordable for many.
    “The most disadvantaged in society are most likely to be exposed to respiratory viruses due to things like poverty, intergenerational households and crowded workplaces. While they might be most in need of a seasonal vaccine, they will also be the least likely to afford £100 in the midst of a cost of living crisis,” said Dr Marija Pantelic, of the University of Sussex.
    Read full story
    Source: The Guardian, 28 March 2024
  7. Patient Safety Learning
    Britain’s health cover market has grown by £385m in a year as the NHS crisis prompted more people to seek out private medical treatment and demand for dental insurance increased, according to a report.
    The total health cover market, including medical and dental insurance and cash plans, grew 6.1% to £6.7bn in 2022, the latest year for which figures are available, according to the health data provider LaingBuisson.
    About 4.2 million people were subscribed to medical cover schemes. Including dependants on the policies, 7.3 million people were covered – the highest number since 2008.
    The NHS waiting list in England continued to lengthen, to a peak of nearly 7.8m last September. In February, it was still 7.5m and half of the patients had been waiting for 18 weeks or longer.
    Private medical insurance, the largest part of the health cover market, grew by 6% year on year in 2022 to £5.3bn, more than triple the average annual growth rate of 1.8% between 2008 and 2019. After a decade of decline until 2018, more people signed up, particularly in the aftermath of the Covid-19 pandemic which led to a backlog of major procedures such as hip and knee replacements.
    Tim Read, author of the report, said: “Demand began to increase in 2018, as the NHS waiting list began to rise out of control. A new Labour government is likely to aim to tackle it but will have limited fiscal headroom to make substantial progress.
    “With people still struggling to access NHS services and the waiting list remaining stubbornly high, there is little likelihood that demand for health insurance is going to fall any time soon.”
    Read full story
    Source: The Guardian, 18 April 2024
  8. 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
  9. Patient Safety Learning
    MPs are calling for a new review into the dangers of the drug Primodos, claiming that families who suffered avoidable harm from it have been "sidelined and stonewalled".
    MPs said the suggestion there is no proven link between the hormone pregnancy test and babies being born with malformations is "factually and morally wrong".
    A report by the All-Party Parliamentary Group (APPG) on hormone pregnancy tests claims evidence was "covered up" and it is possible to "piece together a case that could reveal one of the biggest medical frauds of the 20th century".
    Around 1.5 million women in Britain were given hormone pregnancy tests between the 1950s and 1970s.
    They were instructed to take the drug by their GPs as a way of finding out if they were pregnant.
    But Primodos was withdrawn from the market in the UK in the late 1970s after regulators warned "an association was confirmed" between the drug and birth defects.
    However, in 2017 an expert working group found there was insufficient evidence of a causal association.
    But MPs now claim this report is flawed. It's hugely significant because the study was relied upon by the government and manufacturers last year to strike out a claim for compensation by the alleged victims.
    Read full story
    Source: Sky News, 1 March 2024
  10. 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
  11. Patient Safety Learning
    Thousands of pests including rats, cockroaches and bedbugs have been found at NHS hospitals in England as the health service buckles under a record high repair bill.
    Hospital bosses are having to spend millions of pounds on pest control after discovering lice, flies and rodents in children’s wards, breast clinics, maternity units, A&E departments and kitchens, in the most graphic illustration yet of the dismal and dangerous state of the NHS estate.
    NHS bosses have repeatedly warned ministers of the urgent need to plough cash into fixing rundown buildings in order to protect the safety and dignity of patients and staff. The maintenance backlog now stands at £11.6bn in England.
    Figures obtained under freedom of information laws and reviewed by the Guardian suggest the NHS is struggling to cope with an army of pests plaguing decrepit hospitals.
    There were more than 18,000 pest incidents in the last three years, the NHS data reveals. There were 6,666 last year, equivalent to 18 a day. The figures also show NHS bosses are having to spend millions of pounds calling out pest control and dealing with infestations, with £3.7m spent in the last three years.
    Read full story
    Source: The Guardian, 9 April 2024
  12. Patient Safety Learning
    The UK’s data protection regulator has published new guidance for health and social care organisations it says will help them be more transparent about how personal information is being used.
    The Information Commissioner’s Office (ICO) said the new guidance would provide regulatory certainty to organisations on how they should keep people properly informed as technology is increasingly used to deliver care and carry out research.
    The regulator said focus on the issue was needed as the health and social care sector routinely handles sensitive information about the most intimate aspects of peoples’ health, and that under data protection law, people have a right to know what is happening to their personal information.
    Being transparent is essential to building public trust in health and social care services
    Anne Russell, head of regulatory policy projects at the ICO, said the ever-increasing use of technology meant personal data was more important than ever, and so therefore was more transparency.
    “Being transparent is essential to building public trust in health and social care services,” she said.
    “If people clearly understand how and why their personal information is being used, they are likely to feel empowered to share their health information to both access care and support initiatives such as medical research.
    “As new technologies are developed and deployed in the health sector, our personal information is becoming more important than ever to boost the efficiency and public benefit of these systems.
    “With this bespoke guidance, we want to support health and social care organisations by improving their understanding of effective transparency, ensuring that they are clear, open and honest with everyone whose personal information is being used.”
    Read full story
    Source: The Independent, 15 April 2024
  13. Patient Safety Learning
    Hospitals which rely heavily on locum doctors are 'undoubtedly' risking patient safety, a study of NHS practice found.
    While temporary staff are a 'vital resource' to plug workforce gaps, issues such as unfamiliarity with protocols and procedures mean they 'pose significant patient safety challenges' for the NHS, experts say.
    The report warned many were left feeling isolated and stigmatised by resident staff, creating a 'hostile environment'.
    This has led to a 'defensive' culture over mistakes, hindering improvements to care, according to researchers.
    Calling for greater monitoring by inspectors, NHS leaders must rethink how these professionals are supported and used, the authors said.
    Writing in a linked editorial, Professor Richard Lilford, of the Institute of Applied Health Research at the University of Birmingham, said the findings suggested 'the life of the locum is a difficult and lonely one, opening up many pathways to unsafe practice.'
    Likening it to airline pilots, he suggested staff would benefit from standardised practices – such as how the medicine cabinet is stocked – to minimise mistakes.
    Agencies providing staff should be given routine feedback by employers and locum staff, to enhance patient safety, he said.
    Read full story
    Source: MailOnline, 16 April 2024
  14. Patient Safety Learning
    More than half of England’s army veterans have experienced mental or physical health issues since returning to civilian life, and some are reluctant to share their experiences, a survey has revealed.
    The survey of 4,910 veterans, commissioned jointly by the Royal College of GPs (RCGP) and the Office for Veterans’ Affairs (OVA), found that 55% have experienced a health issue potentially related to their service since leaving the armed forces. Over 80% of respondents said their condition had got worse since returning to civilian life.
    One in seven of those surveyed said they had not sought help from a healthcare professional. A preference for managing issues alone and the belief that their experience would not be understood by a civilian health professional were the most common reasons given.
    This fear of being misunderstood is demonstrated by the finding that 63% of veterans said they would be more likely to seek help if they knew their GP practice was signed up to the Veteran Friendly Accreditation scheme.
    More than 3,000 of England’s 6,313 GP practices are accredited, but the survey’s findings have prompted the RCGP – with NHS England and the OVA – to launch an initiative to get more GP practices on to the scheme.
    Practices that sign up will be provided with a “simple process” for identifying, understanding and supporting veterans and, where appropriate, referring them to dedicated veterans’ physical and mental health and wellbeing services.
    Read full story
    Source: The Guardian, 25 March 2024
  15. Patient Safety Learning
    Trusts and NHS England are failing to prioritise training for senior leaders on listening to whistleblowers — despite repeated findings of serious concerns going unheard — the National Guardian’s Office has said.
    The Guardian’s Office — set up by the government to ensure whistleblowers and other staff raising concerns are properly listened to — made the claim in its written evidence to an inquiry into NHS leadership, performance, and patient safety.
    The Commons health and social care committee is considering regulation of NHS leaders and managers, among other issues, including progress made on the 2022 report for ministers by General Sir Gordon Messenger. 
    The NGO’s evidence, published on Wednesday, said: “In our opinion, there has been little progress on recommendations from the Messenger Review to date…
    “The NGO has developed, in collaboration with [NHSE], three e-learning modules (Speak Up, Listen Up, Follow Up) which are freely available for anyone who works in healthcare. We have recommended to the sector that these modules should be a minimum standard for all staff and be made mandatory.
    “Although accessible to all, many organisations have not adopted them, and NHS England has not prioritised these across the system.”
    Read full story
    Source: HSJ, 18 April 2024
  16. Patient Safety Learning
    The Priory healthcare group has been fined more than £650,000 over the death of a 23-year-old patient who was hit by a train after absconding from a mental health hospital.
    Matthew Caseby, a personal trainer, was able to leave Birmingham’s Priory hospital Woodbourne by scaling a wall after being “inappropriately unattended” for several minutes in September 2020, an inquest jury ruled in 2022.
    The healthcare company pleaded guilty to a criminal safety failing linked to the death of a patient, breaching the 2008 Health and Social Care Act, at Birmingham magistrates court on Friday.
    The London-based provider was charged after an investigation into the death of Caseby conducted by the Care Quality Commission.
    Caseby’s father, Richard Caseby, who had been campaigning for a prosecution of the healthcare organisation, told the court the company attempted to “evade accountability for its gross failures”.
    In a victim impact statement which he presented as part of the prosecution on Friday, he said: “I found it unbelievable that a private company commissioned by the NHS to care for its most vulnerable psychiatric patients in the greatest crisis of their lives could be so cruel and resort to such desperate tactics to hide the truth.”
    Read full story
    Source: The Guardian, 8 March 2024
  17. Patient Safety Learning
    The BMA has called for an independent inquiry into the use of physician associates (PAs) on medical rotas in place of doctors.
    The union said that health secretary Victoria Atkins must launch the investigation ‘to get to the bottom of the scale’ of the issue across the NHS, as doctors have been reporting instances where gaps in medical rotas are being filled by PAs.  
    This is happening on top of NHS England ‘investing heavily’ in the use of PAs in primary care, ‘instead of qualified experienced doctors’, the BMA added.
    On Friday The Telegraph reported  on leaked rotas from more than 30 hospitals showing physician associates taking on doctors’ shifts.
    This coincided with new NHS England guidance to ‘emphasise that PAs are not substitutes for doctors’, as they are ‘supplementary members’ of the team and they ‘should not be used as replacements for doctors on a rota’.
    BMA chair of council Professor Philip Banfield said: ‘We know from our members’ experiences that hospitals are putting physician assistants on medical rotas, in place of medically qualified doctors.
    ‘This is on top of NHS England investing heavily in the use of physician associates in primary care, instead of qualified experienced doctors.
    "In our view, Victoria Atkins now has a duty to patients and a duty to medically qualified staff – doctors – to establish how widespread this practice is and more importantly, stop it."
    Read full story
    Source: Pulse, 18 March 2024
    Further reading on the hub:
    Partha Kar: We need a pause to assess safety concerns surrounding Physician Associates  
  18. 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
  19. 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
  20. Patient Safety Learning
    NHS leaders have warned that Royal Mail’s plans to cut second-class deliveries to two days a week could risk patient safety.
    The changes are part of wider measures announced by Royal Mail’s parent company, International Distributions Services (IDS), including cuts of up to 9,000 routes, which could take more than two years to implement, saving £300m a year. IDS has assured the Royal Mail workforce that there will be no compulsory redundancies and they will request only 100 voluntary redundancies.
    In a letter sent to the Telegraph, executives from the NHS, Healthwatch England, the Patients Association and National Voices said the Royal Mail proposals would increase the cost of missed appointments, which already exceeds £1bn.
    The letter said: “Provisional Healthwatch data suggest that more than 2 million people may have missed medical appointments in 2022-23 due to late delivery of letters, and this will only deteriorate under the proposed new plans.”
    Sir Julian Hartley, the chief executive of NHS Providers, said the proposed delays were “extremely unhelpful”.
    “It’s really important that patients be updated at the earliest opportunity on developments in their care and treatment,” he said.
    “An efficient, punctual postal service remains a key part of that process. At a time when far too many patients already face long delays – the last thing any trust leader wants – anything that adds to that uncertainty, and possibly the worsening of conditions, would be extremely unhelpful.”
    Jacob Lant, the chief executive of health charity National Voices, said: “The proposals being consulted on risk further delaying vital communications and worsening digital exclusion, therefore unfairly widening health inequalities. NHS mail must remain a priority service.”
    Read full story
    Source: The Guardian, 6 April 2024
  21. Patient Safety Learning
    The Met Police has launched an investigation over concerns about stem-cell injections being offered to children as a cure for autism.
    The Royal Borough of Greenwich told BBC London it was aware of concerns surrounding "experimental procedures" on autistic children.
    The Met said it was investigating "a reported fraud relating to the provision of medical services".
    The National Autistic Society said there was no "cure" for autism.
    Greenwich Council said it issued a warning to schools and nurseries in the borough after it became aware of concerns.
    A spokesperson said the authority had recently been made aware of concerns that "an individual claiming to be a doctor plans to visit the UK to offer dangerous, experimental procedures on children with autism".
    "We understand that this person is proposing the transfer of bone marrow and spinal fluid to the brain by injection," the spokesperson said.
    "This unlicensed procedure poses a significant threat to life and there is no evidence of any benefits.
    "The safety and welfare of our children and young people is of the utmost importance."
    Read full story
    Source: BBC News, 17 April 2024
  22. Patient Safety Learning
    Opill, the first birth control pill approved for over-the-counter distribution, is now being shipped to retailers and pharmacies, the company behind the pill, Perrigo, announced on Monday. It will be available in stores and online later this month.
    The Food and Drug Administration approved Opill last year, paving the way for the United States to join the dozens of countries that have already made over-the-counter birth control pills available. Opill, which works by using the hormone progestin to prevent pregnancy, is meant to be taken every day around the same time and, when used as directed, is 98% effective.
    The pill’s arrival on shelves comes at a deeply fraught time for US reproductive rights: not only has the US supreme court demolished the national right to abortion, but the nation’s highest court is set to hear arguments over two abortion-related cases over the next few months.
    “Week after week, we hear stories of people being denied the reproductive health care they so desperately need because of politicians and judges overstepping into the lives of patients and providers. Today, we get to celebrate different news,” Dr Tracey Wilkinson, a pediatrician in Indiana and a board member with Physicians for Reproductive Health, said in a statement.
    “As Opill makes its way to pharmacies across the country, I am relieved to know that birth control access will become less challenging for so many people, but especially young people.”
    Read full story
    Source: The Guardian, 4 March 2024
  23. Patient Safety Learning
    Trust chiefs have collectively called for the Care Quality Commission (CQC) to review its use of single-word inspection ratings, following MPs’ calls for an overhaul of Ofsted ratings for schools.
    In a report containing a series of recommendations for CQC reform, shared with HSJ, NHS Providers urges the regulator to re-evaluate the success of its single-word ratings, asking it to consider adding a narrative verdict as part of its new provider assessment reports.
    The recommendation is made “in the context of the Ofsted inquiry findings” following the death of headteacher Ruth Perry by suicide, which a coroner ruled was contributed to by an Ofsted inspection. It prompted MPs on the Commons’ education committee to call for a ban on single-word Ofsted ratings.
    The NHSP report said the inquiry’s concerns around inspectors’ behaviour, the complaints process, and single ratings can also be applied to CQC.
    The report adds: “While we recognise the differences between the two regulators’ approaches, we believe now is the right time to take stock… for example, CQC may need to consider the value of its single-word ratings, modelled upon Ofsted’s rating system.
    “As suggested by the Nuffield Trust and many trust leaders, a single-word rating will inevitably oversimplify what happens in a very complex organisation".
    Read full story (paywalled)
    Source: HSJ, 21 March 2024
  24. Patient Safety Learning
    Senior bosses have shared concerns about the closure of the NHS gender identity clinic for young people, leaked emails seen by BBC News reveal.
    Hospital executives voiced worry about the cancellation of appointments, patients lacking information and poor communication with the new services.
    In one email, the service's director, Dr Polly Carmichael, said cancellations could potentially put patients at risk.
    The controversial Gender Identity Development Service (Gids), which is run by the Tavistock and Portman NHS Foundation Trust, is due to close later this week.
    Its closure was announced in July 2022, after an independent review said a "fundamentally different" model of care for young people with gender-related distress was needed.
    It will initially be replaced by two new regional hubs; a London-based southern hub and a north of England hub. Additional hubs are expected to open in the coming years.
    However, BBC News has spoken to staff at the existing service who say, just days before the 31 March closure, they have been unable to answer basic questions from patients about the future of their care.
    They say they still do not have enough details about how the new services will operate or when some provisions will be fully operational in the new clinics.
    Read full story
    Source: BBC News, 27 March 2024
  25. Patient Safety Learning
    The NHS is set to roll out artificial intelligence (AI) to reduce the number of missed appointments and free up staff time to help bring down the waiting list for elective care.
    The expansion to ten more NHS Trusts follows a successful pilot in Mid and South Essex NHS Foundation Trust, which has seen the number of did not attends (DNAs) slashed by almost a third in six months.
    Created by Deep Medical and co-designed by a frontline worker and NHS clinical fellow, the software predicts likely missed appointments through algorithms and anonymised data, breaking down the reasons why someone may not attend an appointment using a range of external insights including the weather, traffic, and jobs, and offers back-up bookings.
    The appointments are then arranged for the most convenient time for patients – for example, it will give evening and weekend slots to those less able to take time off during the day.
    The system also implements intelligent back-up bookings to ensure no clinical time is lost while maximising efficiency.
    It has been piloted for six months at Mid and South Essex NHS Foundation Trust, leading to a 30% fall in non-attendances. A total of 377 DNAs were prevented during the pilot period and an additional 1,910 patients were seen. It is estimated the trust, which supports a population of 1.2 million people, could save £27.5 million a year by continuing with the programme.
    The AI software is now being rolled out to ten more trusts across England in the coming months.
    Read full story
    Source: NHS England, 14 March 2024
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