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Patient Safety Learning

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  1. Patient Safety Learning
    Twenty UK women are taking legal action after developing a rare form of cancer linked to their breast implants. More than 50 women have been diagnosed with the same condition in the UK, and hundreds more worldwide. A top surgeon said there were gaps in implant information and people were almost being "used as guinea pigs".
    One manufacturer has issued a worldwide recall of some textured implants, which have been linked to most cases of breast implant-associated lymphoma. The Medicines and Healthcare products Regulatory Agency (MHRA), which regulates medical devices in the UK, is currently collecting data on women affected by breast implant associated-anaplastic large cell lymphoma (BIA-ALCL).
    Tens of thousands of breast implant surgeries are thought to take place each year in the UK, mostly in private clinics.
    Read full story
    Source: BBC News, 16 August 2019
  2. Patient Safety Learning
    Women who underwent damaging surgery in Irish hospitals have accused health authorities of dragging them into a "nightmare" of "gaslighting, ignorance and disrespect".
    Having had vaginal mesh implants, the women told an Oireachtas committee that they were "maimed" and then led on "a fool's errand" when they sought support from the HSE.
    The Health Committee heard from members of Mesh Ireland and Mesh Survivors Ireland who represent around 750 women.
    While the HSE said that it would be "extremely difficult" to provide accurate figures, it estimates that around 10,000 women had this surgery in Ireland.
    More than one in ten have suffered complications, Dr Cliona Murphy, Clinical Lead for the National Women and Infants Health Programme, revealed.
    Mary McLaughlin, Mesh Ireland, said that at one point, "I lay in bed 16 hours a day", because of the pain she was in.
    She demanded dignity and respect for survivors in the face of this "global scandal".
    The women are calling for access to a US-based expert in complete mesh removal, to mirror schemes in Scotland and the Canadian state of Quebec.
    Read full story
    Source: RTE, 29 March 2022
  3. Patient Safety Learning
    A troubled acute trust has been sent a further warning notice after inspectors found severe shortages of midwives were causing dangerous delays to labour inductions.
    During one day in June, the Care Quality Commission found eight high-risk women at Blackpool Victoria Hospital had waited prolonged time periods for their labour to be induced.
    They said one woman had waited five days, while another who was forced to wait more than two days despite her waters having broken on the ward. Delays to labour induction can lead to serious safety risks for mothers and babies.
    The hospital’s maternity services, previously rated “good” for safety, have now been rated “inadequate” in this domain. The overall rating for maternity has dropped to “requires improvement”.
    The problems were caused by severe shortages of midwives at the hospital, which had struggled to bring in agency staff due to a lack of availability in the area. However, inspectors also said there was a lack of any discussion or attention to the issues within the trust, despite the Healthcare Safety Investigation Branch previously highlighting concerns.
    Read full story (paywalled)
    Source: HSJ, 1 September 2022
  4. Patient Safety Learning
    New guidance from health officials on the treatment of chronic pain could be devastating for women already struggling to get doctors to take their pain seriously, write Sarah Graham, 
    The guidelines, published last week by the National Institute for Health and Care Excellence (NICE), say that patients suffering from chronic pain that has no known underlying cause (known as chronic primary pain) should not be prescribed painkillers. Instead, it suggests, these patients should be offered exercise, antidepressants, talking therapies and acupuncture.
    This has huge implications for the future treatment of anyone living with unexplained chronic pain – the majority of whom are women – and runs the risk of patients being viewed as hysterical until proven otherwise.
    Read full story
    Source: iNews, 7 April 2021
  5. Patient Safety Learning
    Women in the UK with type 2 diabetes have a 60% increased risk of an early death and will live five years less than the average woman in the general population, early research suggests.
    Scientists have also found that men with the disease have a 44% increased risk of dying prematurely and live 4.5 years less.
    Results also suggest that smoking shortens the life expectancy of people with type 2 diabetes by 10 years, while diagnosis at a younger age cuts life expectancy by over eight years.
    The findings, presented at the European Association for the Study of Diabetes in Stockholm, Sweden, are based on a cohort of nearly 12,000 patients at the Salford Royal Hospital in Salford.
    “A woman with type 2 diabetes, for example, might live five years less than the average woman in the general population, while someone diagnosed at a younger age might lose eight years of life expectancy.
    “It is vital that the groups at the highest risk are made aware of not just the increased risk that they face but also the size of the risk."
    “Doing so may make the health advice they are given seem more relevant and so help them make changes that can improve their quality – and length – of life.”
    Read full story
    Source: The Independent, 21 September 2022
  6. Patient Safety Learning
    Doctors are warning that embarrassment about naming parts of the female anatomy is putting women's health in jeopardy.
    Dr Aziza Sesay said the hyper-sexualisation of women's bodies and anatomy "perpetuates the taboo, stigma and embarrassment".
    She said it could lead to women not getting the medical help they need.
    She said a lot of women's health conditions are often considered benign - meaning they're not life-threatening - but that she disliked the term as it minimised "how much it will affect someone's life".
    Dr Sesay is one of a number of women's health specialists who are due to appear at Cardiff's Everywoman Festival on 24 June, where topics will range from periods to menopause.
    The festival is the brainchild of colorectal surgeon, Julie Cornish, who works for Cardiff and Vale health board.
    She said "embarrassing" symptoms are all too often never discussed.
    "It's not uncommon to see patients who waited 10, 15 years with symptoms," she said. "It's got to the point where they've had to stop working, or their relationship has broken down.
    "People retire early, they stop working or stop socialising. And that delay often means it's more severe. They might need surgery rather than simple physiotherapy, dietary tricks or modifications that could've worked so easily early on."
    Read full story
    Source: BBC News, 3 April 2023
  7. Patient Safety Learning
    Too many women feel fobbed off or not listened to when they raise concerns about their health, according to a women's health campaign group.
    The Women's Health Wales coalition says women are often misdiagnosed or have to push for a diagnosis.
    The theme has emerged repeatedly during BBC Wales interviews with women.
    The Welsh government said it had set out what's expected of the NHS on women's health, and a full plan is due to be published this autumn.
    "From the moment I went to my GP about my symptoms in my late teens, I have always felt dismissed," said Jessica Ricketts, 35, who was diagnosed with endometriosis.
    But the feeling of being fobbed off has cropped up in countless conversations with women whether it be in relation to a heart attack, UTI, stroke, autism or even brain tumour.
    Patients have told us that clinicians thought they were having a panic attack rather than a heart attack," said Gemma Roberts, policy and public affairs manager at British Heart Foundation Cymru, and co-chair of the Women's Health Wales coalition.
    "We hear from patients and from clinicians that women have to see their GPs multiple times before they get a diagnosis. Women often aren't listened to.
    "They are told that pain is a normal part of the female experience but actually that isn't the case. I think we need to be listening to women more about what's going on with their own bodies."
    The coalition wants:
    Greater focus on women's health from the very beginning of medical training. Health data to be broken down by protected characteristics because "the stories of women with those backgrounds goes untold". Equitable access to healthcare, including specialist care, regardless of where women live in Wales. Read full story
    Source: BBC News, 28 September 2022
    Related blogs on the hub
    ‘Women are being dismissed, disbelieved and shut out’ The normalisation of women’s pain Gender bias: A threat to women’s health
  8. Patient Safety Learning
    Women’s healthcare in the UK is worse than that of China and Saudi Arabia, according to a global tracker. 
    Poor efforts at prevention, diagnosis and treatment of health problems left the UK ranked lower than several countries with a troubling record on women’s rights.
    The research, which compared a wealth of data, found Britain fared worse than most comparable Western countries, including the United States, Australia, New Zealand, France and Germany.
    The UK was placed 30th out of 122 countries, in the 2021 Hologic Global Women’s Health Index published on Tuesday.
    The score – three points lower than when a similar exercise was carried out last year – places it on a par with Kazakhstan, Slovenia, Kosovo and Poland for women’s healthcare provision.
    Read full story
    Source: The Telegraph, 24 January 2023
  9. Patient Safety Learning
    Work pressures are driving thousands of nurses and midwives a year away from the profession, the Nursing and Midwifery Council  (NMC) says.
    The NMC said retention was becoming a major concern despite an overall growth in the register.
    Its annual report found 27,000 professionals had left the register in the UK in the year to the end of March.
    While retirement appeared to be the most common reason for leaving, health and exhaustion were cited as the next.
    NMC Chief Executive Andrea Sutcliffe said: "There are clear warnings workforce pressures are driving people away.
    "Many are leaving earlier than planned, because of burnout and exhaustion, lack of support from colleagues, concerns about quality of care and workload and staffing levels."
    Read full story
    Source: BBC News, 24 May 2023
  10. Patient Safety Learning
    President Biden has endorsed “harm reduction,” which aims to cut down on overdoses by encouraging safer drug use. But the organizations carrying out that strategy are severely underfunded.
    In his State of the Union address on Tuesday, Mr Biden, the first president to endorse the strategy, highlighted the federal government’s attention to some of the core features of harm reduction work, including a provision in a recently enacted spending package that makes it easier for doctors to prescribe buprenorphine, an effective addiction medication that Ms Krauss works to get to drug users. During his speech, Mr Biden recognised the father of a 20-year-old from New Hampshire who died from a fentanyl overdose, citing the more than 70,000 Americans dying each year from the potent synthetic opioid.
    But two years after Mr Biden took office, with the nation’s drug supply increasingly complex and deadly, the practice of harm reduction remains underfunded and partially outlawed in many states.
    Read full story (paywalled)
    Source: New York Times, 10 February 2023
  11. Patient Safety Learning
    Women going through menopause should be given greater rights and protection in the workplace, MPs say.
    The Women and Equalities Committee said a lack of support in the UK was pushing women out of work.
    The cross-party group wants menopause to become a protected characteristic like pregnancy, to give working women more rights.
    Caroline Nokes, who chairs the committee said: "Stigma, shame and dismissive cultures can, and must, be dismantled."
    The government, speaking on the issue for England as health issues is devolved to the national governments in Scotland, Wales and Northern Ireland, said the issue was a priority, highlighting it had recently appointed a women's health ambassador and set up a menopause taskforce to look into workplace support.
    Read full story
    Source: BBC News, 28 July 2022
  12. Patient Safety Learning
    Conduct guidelines for UK doctors are being updated to spell out what constitutes workplace sexual harassment, amid concerns abuse is going unchallenged.
    The General Medical Council, which regulates doctors to ensure they are safe and fit to care for patients, says it is adopting a zero-tolerance policy.
    The new advice explains it is not just physical acts that can be a breach. Verbal and written comments or sharing images with a colleague count too.
    The new guidance will not come into effect until the end of January, after a five-month familiarisation period for staff. And some say there is still a long way to go.
    Dr Chelcie Jewitt, an emergency-medicine doctor who is part of the Surviving in Scrubs campaign group, which aims to raise awareness of sexism, harassment and sexual assault in the healthcare workforce, said: "We have spoken with the GMC about the guidelines and we do think that they are a step in the right direction - but there is still a long way to go on this journey to eradicating the culture of sexual misconduct within healthcare.
    "The GMC has the potential to make a real difference and we need to see them supporting victims when they report perpetrators.
    "We need their reporting processes to be transparent and clearly explained to victims.
    "We need cases to be thoroughly investigated rather than dismissed.
    "And we need appropriate, proportionate sanctioning of perpetrators."
    Read full story
    Source: BBC News, 22 August 2023
    Read a blog Dr Chelcie Jewitt wrote for the hub: Calling out the sexist and misogynist culture within healthcare
     
  13. Patient Safety Learning
    The world is “on the cusp of a first generation of treatments for Alzheimer’s disease”, experts have said, as a new drug was found to slow cognitive and functional decline.
    The drug donanemab, made by Eli Lilly and Company, slowed decline by 35% to 36% in a late-stage phase 3 clinical trial, the company said.
    Donanemab appeared to slow the decline associated with Alzheimer’s compared to placebo in 1,182 people with early-stage disease based on those with intermediate levels of a protein known as tau.
    The drug also resulted in 40% less decline in the ability to perform activities of daily living, according to the firm.
    Dr Susan Kolhaas, executive director of research and partnerships at Alzheimer’s Research UK, said: “This is incredibly encouraging, and another hugely significant moment for dementia research".
    “The treatment effect is modest, as is the case for many first-generation drugs, and there are risks of serious side effects that need to be fully scrutinised before donanemab can be marketed and used.
    “However, this news underlines the urgency of preparing the NHS to make these treatments available should regulators deem them safe and effective".
    Read full story
    Source: The Independent, 3 May 2023
  14. Patient Safety Learning
    The World Health Organization's (WHO) World Antibiotic Awareness Week (WAAW) aims to increase awareness of antibiotic resistance as a global problem, and to promote best practices among the general public, health workers and policy-makers to avoid the further emergence and spread of antibiotic resistance.
    Since their discovery, antibiotics have served as the cornerstone of modern medicine. However, the persistent overuse and misuse of antibiotics in human and animal health have encouraged the emergence and spread of antibiotic resistance, which occurs when microbes, such as bacteria, become resistant to the drugs used to treat them.
    As part of preparations for the 2019 Awareness Week this November, a group of senior leaders from across the health system, including NHS England and Improvement, have co-signed a letter, coordinated by Public Health England, that reminds commissioners and providers alike of their responsibility to contribute to this important agenda. The letter also reminds colleagues that this year’s WAAW campaign is the first of a new five-year UK National Action Plan for antimicrobial resistance, which contains stretching ambitions for reducing inappropriate prescriptions; as well as controlling and preventing infections.
  15. Patient Safety Learning
    A spike in the number of measles cases around the world has sparked concerns over the potential for serious outbreaks this year.
    Almost 17,338 measles cases were reported worldwide in January and February 2022, compared to 9,665 during the first two months of last year – which represents a rise of 79%.
    Unicef and the World Health Organisation (WHO) warned that there is a “perfect storm” for serious outbreaks of the vaccine-preventable illnesses such as measles.
    As of this month, the agencies report 21 large and disruptive measles outbreaks around the world in the last 12 months.
    The five countries with the largest measles outbreaks since the past year include Somalia, Yemen, Nigeria, Afghanistan, and Ethiopia.
    The coronavirus pandemic has seen much of health funding and resources diverted to deal with the spread of the virus since 2020.
    In 2020, the first year of the pandemic, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.
    These pandemic-related disruptions – as well as increasing inequalities in access to vaccines – has left many children without protection against contagious diseases while Covid restrictions are eased in most countries, the two organisations said.
    Read full story
    Source: The Independent, 28 April 2022
  16. Patient Safety Learning
    Medical students are using hologram patients to hone their skills with life-like training scenarios. The project at Addenbrooke’s Hospital in Cambridge is the first in the world to use the mixed reality technology in this way.
    Students wear Microsoft HoloLens headsets that let them interact with the patient while still being able to see each other. Lecturers are able to alter the patient’s response, make observations and add complications to the scenario. It enables realistic and immersive safe-to-fail training which can be delivered remotely as well as in person.
    The first module, covering respiratory conditions and emergencies, has already been launched and more are planned around cardiology and neurology.
    The HoloScenarios system is being developed by Cambridge University Hospitals NHS Foundation Trust, in partnership with the University of Cambridge and US-based tech firm GigXR.
    Consultant anaesthetist Dr Arun Gupta, who is leading the project in Cambridge, said: “Mixed reality is increasingly recognised as a useful method of simulator training. As institutions scale procurement, the demand for platforms that offer utility and ease of mixed reality learning management is rapidly expanding"
    Read full story
    Source: CIEHF, 21 July 2022
  17. Patient Safety Learning
    MP Carolyn Harris is part of a movement determined to smash the remnants of the menopause taboo, pushing a private member’s bill to turn up the volume on a debate about the menopause that is growing louder by the day.
    As an increasing number of countries, businesses and individuals mark World Menopause Day today, Harris says she is ready to shame whoever stands in the way of progress.
    Harris will lead a small army of supporters to Parliament Square in London before her bill, which is due to be heard on the 29 October, to demand free prescriptions for hormone replacement therapy in England – already available in Scotland and Wales. The government is said to be “interested” in the bill, with Harris adding that she has cross-party support from dozens of MP.
    “In the last two years the narrative has completely changed,” says Harris, who adds that since the private members bill was announced she’s had calls from countries from Canada and the US, to Australia and Japan.
    “People are waking up to the fact that we have to find a better way of supporting women through the menopause,” she says. “Women are enhanced coming through this process, but only if they get the support they need.”
    The evidence suggests they all too often don’t. There are more than 13 million currently experiencing menopause or perimenopause in the UK. Menopause campaigners argue that medical sexism and a lack of training means many women are left to suffer the symptoms of menopause – which can include depression, anxiety, insomnia and brain fog as well as hot flushes.
    Harris’s own experience with the menopause was brutal. Twenty years after losing her eight-year-old son in a road traffic accident she blamed herself for not processing her grief when she was hit by a deep depression. “It took me six years, having conversations with women, for me to realise I was going through the menopause,” she says.
    Read full story
    Source: The Guardian, 18 October 2021
  18. Patient Safety Learning
    Today is World Mental Health Day. An opportunity for all of us to raise awareness of mental health issues and advocate against social stigma. This year's theme, set by the World Federation for Mental Health, is suicide prevention. 
    Every year close to 800,000 people globally take their own life and there are many more people who attempt suicide. Every suicide is a tragedy that affects families, communities and has long-lasting effects on the people left behind. It's the leading cause of death among young people aged 20-34 years in the UK and is the second leading cause of death among 15-29 year-olds globally.
    Read more
    Source: Mental Health Foundation, 10 October 2019
  19. Patient Safety Learning
    The head of the World Health Organisation warned on Tuesday that governments need to prepare for a disease even deadlier than Covid-19.
    Dr Tedros Adhanom Ghebreyesus, director general of WHO, told its annual health assembly in Geneva that it was time to advance negotiations on preventing the next pandemic.
    He warned that nation states cannot “kick this can down the road” and that the next global disease was bound to “come knocking”.
    Dr Tedros said: “If we do not make the changes that must be made, then who will? And if we do not make them now, then when?”
    He added: “The threat of another variant emerging that causes new surges of disease and death remains. And the threat of another pathogen emerging with even deadlier potential remains.”
    Read full story
    Source: The Independent, 24 May 2023
  20. Patient Safety Learning
    Today millions of pharmacists worldwide will celebrate World Pharmacists Day, this year themed “safe and effective medicines for all.”

    The annual day is used to highlight the value of the pharmacy profession to stakeholders and to celebrate pharmacy globally. It was originally adopted in 2009 at the World Congress of Pharmacy and Pharmaceutical Sciences.
    The theme for 2019 aims to promote pharmacists’ crucial role in safeguarding patient safety through improving medicines use and reducing medication errors.
    “Pharmacists use their broad knowledge and unique expertise to ensure that people get the best from their medicines. We ensure access to medicines and their appropriate use, improve adherence, coordinate care transitions and so much more. Today, more than ever, pharmacists are charged with the responsibility to ensure that when a patient uses a medicine, it will not cause harm”, says International Pharmaceutical Federation (FIP) President Dominique Jordan.
    Watch Dominique Jordan's video
    Source: FIP, 25 September 2019
  21. Patient Safety Learning
    At least 12,000 people were treated for sepsis in hospitals in Ireland last year, with one in five of those dying from the life-threatening condition.
    However, the HSE said the total number of cases is likely to be much higher.
    Marking World Sepsis Day, it said the condition kills more people each year than heart attacks, stroke or almost any cancer.
    The illness usually starts as a simple infection which leads to an “abnormal immune response” that can “overwhelm the patient and impair or destroy the function of any of the organs in the body”.
    Dr Michael O’Dwyer, the HSE’s sepsis clinical lead, said: “The most effective way to reduce deaths from sepsis is by prevention.
    “A healthy lifestyle with moderate exercise, good personal hygiene, good sanitation, breastfeeding when possible, avoiding unnecessary antibiotics and being vaccinated for preventable infections all play a role in preventing sepsis.
    “Early recognition and then seeking prompt treatment is key to survival. Recognising sepsis is notoriously difficult and the condition can progress rapidly over hours or sometimes evolve slowly over days.”
    Read full story
    Source: Independent Ireland, 13 September 2022
    hub resources on sepsis
    RCNi: Sepsis resource collection NSW Clinical Excellence Commission - Sepsis toolkit Dr Ron Daniels video: Recognising sepsis Introducing the Suspicion of Sepsis Insights Dashboard
  22. Patient Safety Learning
    The world is likely to face a global crisis in poor mental health after the coronavirus pandemic has passed, experts have warned.
    Two dozen mental health scientists including neuroscientists, psychiatrists, psychologists, and public health experts have warned of the long-term impact of the virus on people’s mental health and demanded governments prioritise research to come up with evidence-based treatments.
    They also called for real-time monitoring of mental health in the UK and across the world in order to gauge the severity of the expected increase in poor mental wellbeing.
    Their warning, in the journal Lancet Psychiatry, comes as a new Ipsos Mori survey carried out at the end of March revealed people’s mental health was already being affected by the UK lockdown and self-isolation policy.
    Read full story
    Source: The Independent, 16 April 2020
  23. Patient Safety Learning
    A world-renowned cancer centre hit by whistleblowing concerns over alleged bullying has been downgraded by the health watchdog.
    The Care Quality Commission (CQC) told The Christie NHS Foundation Trust in Manchester it "requires improvement" in safety and leadership.
    A former trust nurse told the BBC leaders had intimidated staff to stop them voicing concerns to inspectors.
    Rebecca Wight worked at The Christie - Europe's largest cancer centre - from 2014 but quit her role as an advanced nurse practitioner in December, claiming her whistleblowing attempts had been ignored.
    She told BBC Newsnight the trust had attempted to manipulate the inspection by intimidating those who wished to paint an honest picture.
    Roger Kline, an NHS workforce and culture expert from Middlesex University Business School, told BBC Newsnight there was a culture at The Christie which was "unwelcoming of people raising concerns".
    He said: "The trust response is more likely... to see the person raising the concerns as the problem rather than the issues they have raised," adding this was "not good for patient care".
    Read full story
    Source: BBC News, 12 May 2023
  24. Patient Safety Learning
    These are challenging times for hospitals. Covid-19 put unprecedented stress on health systems, as have inflation and global financial uncertainty. In the USA and around the world, leading hospitals are dealing with rising costs, aging populations and a medical workforce exhausted from battling a global pandemic.
    Among the hallmarks of great hospitals, however, are not just first-class care, first-class research and first-class innovation. The very best institutions also share another quality: consistency. The world's best hospitals consistently attract the best people and provide the best outcomes for patients as well as the most important new therapies and research. Of all the hospitals in the world, relatively few can do all those things year in and year out. 
    To recognise them, Newsweek and global data firm Statista have put together their fifth annual listing of the World's Best Hospitals 2023. This year, they have ranked over 2,300 hospitals in 28 countries, including one that is new to the list, Taiwan. For the first time, they have ranked all top 250 global hospitals. They have listed the best hospitals by country; each country list also includes a listing of top specialty hospitals.
    Read full story
    Source: News Week
  25. Patient Safety Learning
    Poorer people find it much harder to access NHS care than the well-off and have a worse experience when they do get it, research by the health service’s consumer watchdog has found.
    Those on the lowest incomes have much more difficulty getting a GP appointment, dental care or help with mental health problems, according to a survey by Healthwatch England.
    They are also more likely to feel they are not listened to by a health professional and not involved in key decisions about their care compared with those who are financially comfortable.
    The links between poverty and ill-health are well known, but the Healthwatch findings show that the worse-off also face the disadvantage what the watchdog called barriers to obtaining healthcare when they need it.
    The findings have prompted fears that the NHS is too often a “two-tier service” with access closely related to wealth, and calls for it to do more to make services more accessible to everyone.
    Healthwatch’s survey of 2,018 people aged 16 and over in England, which was a representative sample of the population, found that:
    42% of those who described their financial situation as “really struggling” said they had trouble getting to see a GP, double the 21% of those who were “very comfortable”. 38% of the worst-off found it hard to get NHS dental care, compared with 20% of the better-off. 28% of the very poor had difficulty accessing mental health treatment, whereas only 9% of the very comfortable did so. Read full story
    Source: The Guardian, 4 March 2024
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