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Patient Safety Learning

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  1. Patient Safety Learning
    Naga Munchetty has said she spent decades being failed, gaslit and “never taken seriously” by doctors, despite suffering debilitatingly heavy periods, repeated vomiting and pain so severe that she would lose consciousness.
    The BBC presenter, newsreader and journalist told the Commons women and equalities committee on Wednesday that she was “deemed normal” and told to “suck it up” by NHS GPs and doctors during the 35 years she sought help for her symptoms.
    Munchetty was finally diagnosed with adenomyosis, a condition where the lining of the womb starts growing into the muscle in its walls, in November last year.
    She said she was consistently told by doctors that “everyone goes through this”.
    “I was especially told this by male doctors who have never experienced a period but also by female doctors who hadn’t experienced period pain,” said Munchetty.
    Munchetty’s diagnosis came after she had bled heavily for two weeks and experienced pain so severe she asked her husband to call an ambulance. Only then was she taken seriously, seeing a GP who specialised in women’s reproductive health. That GP advised her to use private healthcare to avoid lengthy NHS waiting lists.
    Munchetty and Vicky Pattison, a television and media personality, were giving evidence as part of the committee’s inquiry into the challenges that women face being diagnosed and treated for gynaecological and reproductive conditions.
    The committee is also considering any disparities that exist in diagnosis and treatment, and the impact of women’s experiences on their health and lives.
    Read full story
    Source: The Guardian, 19 October 2023
  2. Patient Safety Learning
    A woman has spoken of her "complete shock" at being misdiagnosed with cancer and undergoing surgery when she never had the condition at all.
    Megan Royle, 33, from East Yorkshire, was diagnosed with skin cancer in 2019.
    As part of her treatment, she underwent immunotherapy and her eggs were frozen due to the risk to her fertility.
    But after she was given the all-clear in 2021, a review showed she never had cancer and she has now won compensation from the two NHS trusts involved.
    Ms Royle, from Beverley, said: "You just can't really believe something like this can happen, and still to this day I've not had an explanation as to how and why it happened.
    "I spent two years believing I had cancer, went through all the treatment, and then was told there had been no cancer at all."
    "You'd think the immediate emotion would be relief and, in some sense, it was - but I'd say the greater emotions were frustration and anger."
    Read full story
    Source: BBC News, 18 October 2023
  3. Patient Safety Learning
    A hospital trust has dismissed three members of staff following complaints of sexual harassment.
    The sackings by University Hospitals Birmingham (UHB) NHS Trust were revealed at the launch of its sexual safety charter on Monday.
    Sexual safety was one of the areas highlighted in a review of the trust's culture.
    UHB said sexism, misogyny and sexual harassment would not be tolerated in the workplace.
    The trust has been subject to three enquiries following a BBC investigation into its culture.
    The second of these investigations, by Prof Mike Bewick, identified a new line of inquiry into allegations of misogynistic behaviour and sexual harassment.
    Prof Bewick said the trust had begun formal investigations and there was a widening of the scope of the enquiry to accommodate the sensitive nature of these concerns.
    Read full story
    Source: BBC News, 19 October 2023
  4. Patient Safety Learning
    Almost two-thirds of maternity units provide dangerously substandard care that puts women and babies at risk, the NHS watchdog has said in a damning report.
    The Care Quality Commission (CQC) has rated 65% of maternity services in England as either “inadequate” or “requires improvement” for the safety of care – up from 54% last year.
    Services are beset by a host of problems, including serious staff shortages and internal tensions, which mean that too many mothers and their babies receive care that is not good enough, it said.
    Women too often face delays in accessing care, do not receive the one-to-one care from a midwife to which they are entitled or experience communication problems with staff looking after them, including being shouted at by midwives.
    The CQC judged overall quality of care to be inadequate or require improvement at 85 maternity units, almost as many at which it rated it to be either good or outstanding – 87. The number of units offering substandard care has soared by 30 in the last year, from 55 to 85.
    It said that, having inspected 73% of all maternity units, “the overarching picture is one of a service and staff under huge pressure. People have described staff going above and beyond for women and other people using maternity services and their families in the face of this pressure.
    “However, many are still not receiving the safe, high-quality care that they deserve.”
    Read full story
    Source: The Guardian, 20 October 2023
  5. Patient Safety Learning
    The boss of Britain’s biggest medicines courier has been told to urgently improve its complaints system by the NHS ombudsman amid concerns patients let down by missing deliveries are repeatedly ignored.
    In a highly unusual development, Darryn Gibson, the chief executive of Sciensus, has received a written warning from Rob Behrens, the parliamentary and health service ombudsman (PHSO). It says patients “should not be ignored” and must be “listened to and taken seriously” or he will consider taking further action.
    The PHSO investigates complaints that have not been resolved by the NHS or by private providers of NHS care. Sciensus is the single largest provider of homecare medicines services to the NHS and has contracts worth millions of pounds.
    In an email seen by the Guardian, Behrens told Gibson he had been unable to investigate most reports received about Sciensus because patients had not been able to complete the company’s complaints process. “That is not acceptable or fair to complainants,” Behrens wrote.
    In a statement, Sciensus said it worked “very hard” to ensure NHS patients received their medicines on time. Its services had “a 95% satisfaction rating”, it added.
    The move follows a Guardian investigation that exposed how Sciensus put NHS patients at risk of harm with delayed, missed or botched deliveries of medicines for conditions including cancer, heart disease, diabetes, dementia and HIV.
    It also uncovered how patients’ alarm at vital drugs and medical devices not arriving at their home was often compounded by a struggle to reach Sciensus to complain and fix the problems.
    Read full story
    Source: The Guardian, 19 October 2023
  6. Patient Safety Learning
    Children are waiting years for autism and cerebral palsy treatments as NHS leaders accuse the government of ignoring warnings of a crisis in community care.
    The number of patients waiting for NHS community services hit more than one million in August and a new analysis has revealed one in five of those patients are children. 
    The waits are so bad in some areas of England that a 12-year-old needing treatment might not get it until they are 16, the NHS Community Services Network warned.
    The analysis, by NHS Confederation and NHS Providers, also found 34,000 children have been waiting more than 18 weeks for diagnosis and care, which is the maximum time anyone should be waiting, with the backlogs growing quickly in spinal and eye care.
    Matthew Taylor, chief executive for NHS Confederation, which represents hospitals, community service providers and primary care, told The Independent that long waits can impact children more severely than adults because delays in treatment can have a knock-on effect on communication skills, social development and educational as well as mental wellbeing.
    “We have a real and growing problem with long waits in community services, but despite repeated warnings that neglect of these vital services is having a detrimental impact on patients, these warnings seem to be met with a shoulder shrug from the government. Leaders are working incredibly hard to deliver these important services for patients but are fighting a rising tide and need help,” he said.
    Read full story
    Source: The Independent, 20 October 2023
  7. Patient Safety Learning
    Lessons still have not been learned at a Kent hospital trust which was criticised in a damning report, a mother has said.
    Dr Bill Kirkup's review found at least 45 babies might have survived with better care at East Kent NHS hospitals.
    Victoria, whose six-year-old daughter needs 24-hour support, said: "I've had no contact from anyone from the trust."
    Her case was one of 202 that were examined by Dr Kirkup in his report, which was published exactly a year ago.
    Victoria, whose daughter is living with the consequences of failings in her care during her birth, said: "Our children have become unwell because of what has happened to them.
    "I don't feel lessons have been learned whatsoever.
    "Treatment hadn't been made available as easily as it should have done for children that are still living this experience every day."
    Read full story
    Source: BBC News, 19 October 2023
  8. Patient Safety Learning
    An employment and equality lawyer will lead investigations into claims of racism, sexism and toxic culture at the Nursing and Midwifery Council (NMC).
    The nursing regulator has appointed Ijeoma Omambala KC to review claims that fitness to practise cases have been mishandled, especially those involving racism, discrimination, sexual misconduct and child protection. She will lead a concurrent investigation into how complaints about allegations were handled.
    "I’m sorry anyone has concerns about our culture, and the regulatory decisions we take. We’re committed to a rigorous, transparent and independent response".
    Read full story (paywalled)
    Source: Nursing Standard, 17 October 2023
  9. Patient Safety Learning
    Eighteen more hospitals in England contain potentially crumbling concrete, bring the total affected to 42, the Department of Health and Social Care has confirmed.
    The reinforced autoclaved aerated concrete (Raac) has also been found in 214 schools and colleges in England as well as thousands of other buildings.
    NHS Providers, which represents hospitals, said the concrete "puts patients and staff at risk".
    Full structural surveys are taking place at all newly confirmed sites.
    The government said it was committed to eradicating Raac from NHS buildings completely by 2035.
    Seven of the worst-affected hospitals will be replaced by 2030 as part of the programme to build 40 new hospitals in England, it added.
    Read full story
    Source: BBC News, 21 October 2023
  10. Patient Safety Learning
    You might not have heard of a ‘physician associate’ - and that’s not your fault. They probably won’t tell you. A physician associate walks and talks like a doctor, but they are no replacement for one.
    To become a physician associate you need to complete a two-year postgraduate course or three-year apprenticeship. But despite much less learning than the five years a junior doctor must undergo to be qualified, they are often paid more than them.
    Which is why the government’s plan to flood the NHS with 10,000 more of them over the next 15 years doesn’t make any sense. There’s certainly no money-saving aspect. This is simply another corner-cutting exercise to quickly plug gaps in a struggling NHS that will put patients at risk.
    Far from saving doctors work (their original purpose), they often create more. Physician associates are unregulated so cannot be held accountable for their mistakes, meaning doctors must recheck any critical decisions they make. Critical decisions are made quite frequently in hospitals.
    But they’re not just overstretching doctors and creating more work; they’re harming patients. A recent Daily Mail investigation has found brain bleeds misdiagnosed as inconsequential headaches and lung disease mistaken for a chest infection.
    Doctors say they are “increasingly concerned” by this.
    Read full story
    Source: LBC, 16 October 2023
  11. Patient Safety Learning
    The Health and Social Care Select Committee have commissioned an Expert Panel to consider the Government’s progress against accepted recommendations from public inquiries and reviews on patient safety.
    The Panel will consider a range of recommendations made by public inquiries and reviews on both patient safety and whistleblowing and subsequently select a number of these for evaluation. The Panel will in its final report provide a rating of the Government’s progress against each of these recommendations.
    Panel members are:
    Professor Dame Jane Dacre (Chair). Sir Robert Francis KC Anita Charlesworth Professor Stephen Peckham Sir David Pearson Professor Emma Cave Read full story
    Source: House of Commons Health and Social Care Select Committee, 24 October 2023
  12. Patient Safety Learning
    Sepsis is still killing too many patients due to the same hospital failings that occurred a decade ago, a damning report by the NHS ombudsman has warned.
    Avoidable mistakes include delays in spotting and treating the condition, poor communication between health staff, sub-standard record keeping and missed opportunities for follow-up care, according to Rob Behrens, the parliamentary and health service ombudsman (PHSO).
    Despite some progress since a previous report on sepsis by the ombudsman in 2013, lessons are not being learned and repeated mistakes are putting people at risk, Behrens said. Major improvements are urgently needed to avoid more fatalities, he added.
    “I’ve heard some harrowing stories about sepsis through our investigations, and it frustrates and saddens me that the same mistakes we highlighted 10 years ago are still occurring,” said Behrens. “It is clear that lessons are not being learned. Losing a life through sepsis should not be an inevitability.”
    Melissa Mead, whose one-year-old son, William, died from sepsis in 2014 after concerns were dismissed by doctors, said: “I think this report, nine years on from William’s death, really lays bare the incidences of sepsis cases.”
    Mead, who peer-reviewed the study, added: “Too many lives are being lost in preventable circumstances.”
    Read full story
    Source: The Guardian, 25 October 2023
    Further reading on the hub:
    Top picks: Six resources about sepsis
  13. Patient Safety Learning
    The medical regulator has told NHS England to ‘directly tackle’ a perception there is a plan to replace doctors with physician associates amid an ‘intense’ debate about their future.
    General Medical Council chief executive Charlie Massey wants NHS England and health systems in the devolved nations to address several issues surrounding the expansion of medical associate roles.
    This follows intense debate over recent weeks, including multiple media reports of safety incidents where the involvement of physicians and anaesthesia associates has been questioned. The debate has been partially prompted by ambitions in the long-term workforce plan to increase their numbers, and the impact this would have on post-graduate medical training.
    Last week almost 90% cent of Royal College of Anaesthetists members voted to pause the rollout of anaesthesia associates, after an extraordinary general meeting. This prompted NHSE leaders to stress to trusts that associates should be working within established guidelines and have appropriate supervision.
    In response, Mr Massey has written to NHSE, calling for it to: “Directly tackle the perception that there is a plan for the health services to ‘replace’ doctors with PAs or AAs by convening and leading a system-wide discussion on an agreed vision for these roles.”
    Read full story (paywalled)
    Source: HSJ, 25 October 2023
  14. Patient Safety Learning
    A coroner has found neglect contributed to a baby's death at the hospital where he was born.
    Jasper Brooks died at the Darent Valley Hospital in Kent on 15 April 2021. The coroner found gross failures by midwives and consultants at the hospital and says Jasper's death was "wholly avoidable".
    Jasper was a second child for Jim and Phoebe Brooks. Due to a complication during pregnancy of her first child, Phoebe was booked in to have an elective Caesarean section to deliver Jasper. But in April 2021 those plans changed overnight.
    A check-up found Phoebe had raised blood pressure. She was told to remain in hospital and that the C-section would happen the following morning - nine days earlier than planned - when there were more staff on duty.
    Jasper's parents say the midwives caring for Phoebe repeatedly failed to listen to her and Jim's concerns - that she was shaking violently, feeling sick, and thought she was bleeding internally.
    "We felt like an inconvenience - no-one wanted to deal with me that night," Phoebe says. "The doctor didn't want to do my C-section, the midwife that's meant to be looking after me, she just doesn't really care.
    "I remember saying clearly to her, 'my whole body is shaking - something's happening, and no-one's taking the time to listen to what I'm saying or listen in on my baby'."
    At the inquest hearing, midwife Jennifer Davis was accused by the family's barrister, Richard Baker KC, of "failing to act on signs of blood loss, failing to determine if Phoebe was in active labour, and failing to call a senior doctor when necessary".
    Jasper was born without a heartbeat, so a resuscitation team was called. But during the inquest, the family learned that further errors were made because the correct people failed to attend the resuscitation.
    There was no consultant neonatologist on site - a doctor with expertise in looking after newborn infants or those born prematurely. Intubation, the process of placing a breathing tube into the windpipe - which should only take a few minutes - did not occur for 18 minutes. There was also a delay in administering adrenaline to try to stimulate Jasper's heart.
    Read full story
    Source BBC News, 24 October 2023
     
  15. Patient Safety Learning
    More than a quarter of ‘critical incidents’ have been declared by just four trusts since the start of the crisis in urgent and emergency care.
    Data obtained by HSJ shows 241 critical incidents have been declared by organisations due to “operational” or “system pressures” between April 2021, when long waits for urgent care began to surge upwards, and last month. Four trusts account for 68 of these (28%).
    Critical incidents are declared when the level of disruption “results in an organisation temporarily or permanently losing its ability to deliver critical services, or where patients and staff may be at risk of harm”. These incidents may require “special measures and support from other agencies, to restore normal operating functions,” according to the NHS England definition. 
    Most critical incidents were only in place for a few days before being stood down by the trust or system, but some were in place for much longer – sometimes for several months at a time, the data suggests.
    Read full story (paywalled)
    Source: HSJ, 25 October 2023
  16. Patient Safety Learning
    The NHS has launched an investigation after it sent “priority” letters to people who died years ago, in some cases decades, urging them to book flu and Covid-19 jabs to reduce their risk of serious illness.
    The health service is asking eligible patients to arrange appointments for both vaccines to avoid a potential “twindemic” of flu and coronavirus this winter, which would pile further pressure on hospitals and GP surgeries.
    “You are a priority for seasonal flu and Covid-19 vaccinations,” the two-page letter tells recipients. “This is because you are aged 65 or over (by 31 March 2024).
    However, some of the letters, which contain personal information such as NHS numbers, have been sent to people who died years ago. Others have been sent to people who are not eligible for the vaccines, with no connection to the addressee.
    In a statement, NHS England told the Guardian it was investigating. It declined to answer questions about when the error was first discovered, what had caused it and how many people had been affected.
    “We have been made aware of some letters sent in error and appreciate this may have been upsetting for those who received it – we are working as quickly as possible to investigate this,” a spokesperson for NHS England said.
    Read full story
    Source: The Guardian, 24 October 2023
  17. Patient Safety Learning
    Several people have been admitted to hospital in Austria after using suspected fake versions of Novo Nordisk’s diabetes drug Ozempic, the country’s health safety body has said, the first report of harm to users as a European hunt for counterfeiters widened.
    The patients were reported to have suffered hypoglycaemia and seizures, serious side-effects that indicate that the product contained insulin instead of Ozempic’s active ingredient semaglutide, the health safety regulator Bundesamt für Sicherheit im Gesundheitswesen (BASG) said on Monday.
    The European Medicines Agency (EMA) warned last week that pens falsely labelled as Ozempic were in circulation, and Austria’s criminal investigation service said on Monday that the fake injection pens could still be in circulation.
    The Danish maker of the drug, Novo Nordisk, has warned of a rise in the online offers of counterfeit Ozempic as well as its weight-loss drug Wegovy, both based on semaglutide.
    “It appears that this shortage is being exploited by criminal organisations to bring counterfeits of Ozempic to market,” said BASG.
    Read full story
    Source: The Guardian, 24 October 2023
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