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Patient Safety Learning

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  1. Patient Safety Learning
    The NHS may be missing more than 9 million referrals, while patients face a “postcode lottery” for cancer treatment and routine operations, a parliament watchdog has warned.
    Millions of patients have either avoided or been unable to obtain healthcare during the pandemic leaving the NHS with a potential unknown backlog of operations, which could push the national waiting list to 12 million by 2025.
    A report from the government’s National Audit Office today also warned patients across England are facing a postcode lottery in terms of waits with some hospital waiting lists far larger than others following the pandemic.
    Eve Byrne, head of campaigns and public affairs, at Macmillan Cancer Support, said: “This report confirms what we hear day in, day out from people living with cancer. Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that is only set to worsen without urgent action.
    She said the government’s plan to tackle operations backlog must be backed up by steps to ensure enough nurses staff.
    “Without these critical pieces of the puzzle, we risk increasing numbers of people facing later diagnoses, poorer care and potentially worse chances of survival. This has to change,” she added.
    Read full story
    Source: The Independent, 1 December 2021
  2. Patient Safety Learning
    Children with poorly controlled asthma are up to six times more likely to be admitted to hospital with Covid than those without the condition, research has suggested.
    Scientists involved in the study said 5 to 17-year-olds in this category should be considered a priority for Covid vaccination. About 9,000 children in Scotland would benefit from the jab, researchers said.
    Vaccines are offered to the over-12s in Scotland, but not to younger children.
    In the study, poorly controlled asthma was defined as a prior hospital admission for the condition, or being prescribed at least two courses of oral steroids in the last two years.
    Prof Aziz Sheikh, director of the University of Edinburgh's Usher Institute and Eave II study lead, said: "Our national analysis has found that children with poorly controlled asthma are at much higher risk of Covid-19 hospitalisation.
    "Children with poorly controlled asthma should therefore be considered a priority for COVID-19 vaccination alongside other high-risk children."
    Prof Sheikh said it was important to consider both the "risks and benefits" from vaccinations.
    He added: "Emerging evidence from children aged five and older suggests that COVID-19 vaccines are overall well-tolerated by the vast majority of children."
    Read full story
    Source: BBC News, 1 December 2021
  3. Patient Safety Learning
    A lack of support for general practice is indirectly putting patient lives at risk, amid escalating abuse in GP practices, the England LMCs conference has heard.
    A debate around abuse saw 99% of conference delegates agree that ‘the abuse of primary care staff directly affects patient care and puts patient safety at risk’.
    And 98% agreed that ‘when Government and [NHS England] choose not to support NHS staff, they directly affect patient safety and knowingly put lives at risk’.
    The conference also voted to ‘demand that healthcare policy is decided based on high-quality evidence on population health, and not the whims of a handful of vitriolic media’, with the vote unanimous on the topic.
    Speaking in the debate, which focussed on GP abuse and wellbeing, Dr Abel Adegoke of Wirral LMC told delegates that the NHS "runs on the blood of GPs"
    He said: "About four weeks ago, my younger sister was being buried and I had to watch via Zoom because that was taking place in Nigeria – yet I was still seeing patients. That was the day I felt so sad about being a GP because despite that sacrifice, I was still abused by a patient who wanted to be seen urgently for an absolutely non-urgent condition."
    "We are being taken for granted."
    Read full story
    Source: Pulse, 30 November 2021
  4. Patient Safety Learning
    People needing acute mental health treatment are being left in prison for extended periods, HSJ can reveal.
    Figures HSJ obtained under the Freedom of Information Act show that 3,111 patients were transferred from prisons to mental health facilities between 2018-19 and 2020-21. A total of 481 (15%) of the transfer took more than 14 days from the date the mental health casework section received an application for transfer to the date the transfer took place.
    Across these three years, 167 transfers (5%) took more than 28 days. The longest wait for transfer was 161 days, which happened in 2018-19. However, the average number of days taken to transfer a patient has remained consistent at between 10 and 11 days.
    Until the summer, NHS England’s guidance recommended a 14-day time limit for transfers of patients from prisons to mental health facilities.
    In June 2021, NHSE published new guidance which recommended a 28-day time limit between a person first being referred for inpatient assessment and being admitted to a mental health facility. The timeline, which consists of two sequential 14-day periods, says medical reports should be “completed to be sent to the [MHCS]” between days 15 and 25, while the MCHS should approve and issue a warrant and admission should take place before day 28.
    Sophie Corlett, of mental health charity Mind, said: “Nobody who has been assessed as needing specialist inpatient care should be left for extended periods of time in prison, as it’s a completely inappropriate setting for anyone in crisis… When people are a risk to themselves, it’s crucial there are enough staff and beds available to make sure they are cared for in a safe and therapeutic environment.”
    Bethan Roberts, British Medical Association forensic and secure environments committee interim chair, said: “A prisoner who is mentally unwell and cannot be adequately cared for in a prison should… be transferred to a forensic mental health unit as soon as possible."
    Read full story (paywalled)
    Source: HSJ, 1 December 2021
  5. Patient Safety Learning
    The British Red Cross have found that that 367,000 people, which equates to around one percent of the population in England attend A&E up to 346 times a year.
    These figures accounted for nearly one in three ambulance call outs and over one in six A&E visits.
    The research analysis found that a fifth of those repeatedly attending A&E lived alone and also often lived in deprived areas of the country.
    Frequent users also accounted for 29% of all ambulance call outs and 16% of non-minor-injury A&E visits.
    The data also revealed that people in their twenties were more likely to repeatedly visit A&E than any other age category.
    Mike Adamson, chief executive of the British Red Cross, said: 'High intensity use of A&E is closely associated with deprivation and inequalities - if you overlay a map of frequent A&E use and a map of deprivation, they're essentially the same.'
    Read full story
    Source: National Health Executive, 29 November 2021
  6. Patient Safety Learning
    A watchdog is "very concerned" about the safety of people using the services of Greater Manchester Mental Health NHS Trust.
    The damning report says inspectors found there was not always enough nursing staff and that permanent staff did not feel safe if bank or agency workers were used as they didn't have the relevant training.
    It follows an unannounced inspection in September by the Care Quality Commission "due to on-going concerns about the safety of services".
    Three young patients died in nine months at Prestwich Hospital, one of the Trust's units.
    A campaign group and the families are campaigning for a full investigation into those cases by NHS England.
    The CQC's two-day inspection of eight wards across five of the the Trust's seven sites found:
    The service did not always have enough nursing staff, who knew the patients or received basic and essential training to keep patients safe from avoidable harm. The environment on Poplar ward (Park House) was not clean on the first day of inspection and space on the ward was limited for patients. It was not clear that immediate concerns or learning from incidents was shared across the locations, although local learning and reviews were taking place. The wards did not all have up to date and recently reviewed ligature risk assessments. Staff on two wards could not locate the ligature risk assessments at the time of the inspection. Read full story
    Source: Greater Manchester News, 26 November 2021
     
  7. Patient Safety Learning
    Public services are dismissing sickle cell patients because the illness disproportionately affects Black people, campaigners have warned.
    The blood disorder is prevalent among African and Caribbean communities and advocacy groups say this means it remains poorly understood within state institutions, often leading to the needless suffering and even death of those diagnosed.
    The issue has gained wider attention following the high-profile cases of two Black men, Richard Okorogheye and Evan Nathan Smith, who lived with the disease and died amid claims their vulnerabilities were overlooked by the NHS and police.
    Chris Abdullahi, co-founder of charitable initiative Sound of Sickle, told The Independent it is common for sickle cell patients’ painful symptoms to be ignored by healthcare practitioners.
    He said he has heard similar accounts “well over 100 times” from across the UK.
    “Just last week someone else mentioned that they were in hospital and had to battle their nurses for pain medication from opioids to something as simple as ibuprofen,” the 27-year-old, who also lives with sickle cell, said.
    These experiences serve to further entrench the “massive sense of distrust” in the healthcare system which is evidenced through lower vaccine uptake in Black communities, Mr Abdullahi explained.
    A lack of awareness about the disease has led sickle cell patients to often form informal support networks, through which information can be exchanged about the best hospitals at which to maximise the chances of their condition being taken seriously.
    Read full story
    Source: The Independent, 18 April 2021
  8. Patient Safety Learning
    From the end of 2021, a question on sexual activity of partners in areas where HIV is widespread will be removed from the donor safety check form, in an effort to increase inclusivity among donors.
    The changes will particularly improve the ease to donate blood for Black African donors.
    Currently, prospective donors are asked if they have recently had sex with a partner who may ever have been sexually active in an area where HIV is endemic, which includes most of sub-Saharan Africa. If they have, the donor will then be deferred for three months after the last sexual contact with that partner. This can often mean Black African and other potential donors in long-term relationships have been unable to donate blood.
    Now, the UK Government has outlined plans to remove the question from those asked in the donor safety check, opening the door to a greater number of donations.
    Increasing blood donor inclusivity for those who are Black African, Black Caribbean, and of Black mixed ethnicity is particularly important because they are more likely to have the rare blood sub-group, such as Ro, that many Black sickle cell patients need.
    The change, making it easier for people from these groups to donate, will create greater opportunities to meet the ongoing need for rarer blood types and help improve and save lives in the UK.
    Read full story
    Source: National Health Executive, 11 October 2021
  9. Patient Safety Learning
    It was 4am on a Sunday in San Antonio, US, when Dana Jones heard an ominous sound, barely audible over the whirring of box fans, like someone struggling to breathe. She ran down the hall and found her daughter Kyra, age 12, lying on her back, gasping for air. Terrified, she called 911.
    A police officer, the first to arrive, dashed into Kyra’s bedroom, threw the slender girl over his shoulder and laid her on a leather sofa in the living room. He asked her mother, an oral surgery technician, to give her CPR.
    Kyra’s lips were ice-cold. An ambulance whisked the girl to Methodist Children’s Hospital, where staff members swarmed her and put her into a medically induced coma.
    Kyra, who has sickle cell, had suffered a devastating stroke — her second — a common complication of this inherited disease, which afflicts 100,000 Americans, most of them Black. She most likely would never have had the strokes if she had been given an annual screening test and treatment proven more than two decades earlier to prevent 9 out of 10 strokes in children with the disease and recommended by the National Institutes of Health. But like countless other children with sickle cell, she was never screened.
    Read full story
    Source: New York Times, 23 May 2021
  10. Patient Safety Learning
    A groundbreaking inquiry into sickle cell disease has found “serious care failings” in acute services and evidence of attitudes underpinned by racism.
    The report by the all-party parliamentary group (APPG) on Sickle Cell and Thalassaemia, led by Pat McFadden MP, found evidence of sub-standard care for sickle cell patients admitted to general wards or attending A&E departments.
    The inquiry also found widespread lack of adherence to national care standards, low awareness of sickle cell among healthcare professionals and clear examples of inadequate training and insufficient investment in sickle cell care.
    The report notes frequent disclosures of negative attitudes towards sickle cell patients, who are more likely to be people with an African or Caribbean background, and evidence to suggest that such attitudes are often underpinned by racism.
    The inquiry also found that these concerns have led to a fear and avoidance of hospitals for many people living with sickle cell.
    Care failings have led to patient deaths and “near misses” are not uncommon, leading to a cross-party call for urgent changes into care for sickle cell patients.
    Read full story
    Source: The Independent, 15 November 2021
  11. Patient Safety Learning
    A total of 44 batches of irbesartan medicines are being recalled as a precaution from pharmacies and wholesalers due to presence of a chemical substance (AZBT) formed in the manufacturing process that is over the limit permitted for this product.
    Irbesartan medicines treat high blood pressure to help prevent heart attacks and stroke. They are also used in patients with heart failure or those who had a recent heart attack.
    Patients being prescribed these medicines should continue to take their medication since the risk from stopping is greater than the risk associated with short-term exposure to ABZT above its acceptable level from packs that they already have. Not treating a patient’s high blood pressure or heart problems may lead to harms, so patients should not stop their treatment unless clinically advised.
    Laboratory testing has found that long-term exposure to this chemical substance (AZBT) above acceptable limits may potentially increase the risk of cancer, but there is no UK or international evidence that this substance has caused any harm to patients. 
    Dr Alison Cave, MHRA Chief Safety Officer, said:
    “Patient safety is at the heart of everything we do. This recall is a precautionary measure to prevent further exposure to AZBT above the acceptable safety limit. There is no evidence that this substance has caused any harm to patients. “It’s vitally important that you continue to take your medicine but do contact your doctor or pharmacist if you have any questions.
    “It’s important that healthcare professionals check their stock to quarantine and return these batches to their supplier using their supplier’s approved process.
    “The MHRA has asked companies to implement control measures to ensure that the levels of the substance are at or below the required level. We are also working with our international counterparts, given this is a global issue, to ensure the safety of patients.”
    Read MHRA press release
  12. Patient Safety Learning
    How much of a threat does the emergence of Omicron pose to the NHS? Among hospital bosses there is a curious combination of apprehension that the new variant could lead to a surge in infections but also a battle-weary belief, born of negotiating the previous waves of Covid-19, that they can handle a potentially major rise in people seriously ill with the disease.
    “Trusts are already making contingency plans for what would happen if there were to be a significant spread of this variant and it turned out that the symptoms and disease produced as a result is as serious as with the Delta variant,” said Chris Hopson, the chief executive of NHS Providers, which represents health service trusts in England.
    He added: “If it turns out that this variant does evade vaccines then clearly the NHS will see a significantly higher caseload than it has at the moment.” Hopson pointed out that when the second wave was at its worst in January, hospitals in England were treating 34,000 people with Covid. On Monday, it was far, far fewer – just 6,094.
    He said: “The chief executive of a district general hospital told me today that they were going through plans for how they would expand critical care capacity, and their general respiratory support capacity, because that’s exactly what they needed to do last January when we had over 34,000 cases.
    A return to that number of hospital beds taken up with Covid patients would again force hospitals to cancel planned operations, he said. “If we get anywhere near the 34,000 cases we saw in January, then something would have to give. Elective surgery could be cancelled. As we saw last January, we would need to prioritise [care] on the basis of clinical need.”
    Read full story
    Source: The Guardian, 29 November 2021
  13. Patient Safety Learning
    The inquiry into the government’s handling of the Covid pandemic should look at the “mishandling” of the NHS 111 service, families bereaved during the crisis have said.
    In a scathing report, the COVID-19 Bereaved Families for Justice group said the service was inappropriately used to “alleviate the burden on the NHS” with “horrific” consequences.
    The report, based on a survey of families, said many believed that the service “failed to recognise how seriously ill their relatives were and direct them to appropriate care”.
    They argue that the service was also quickly “swamped” during the first wave despite the addition of 700 new call handlers, many of who were making life or death decisions with just 10 weeks training.
    The phone line is one of a number of areas the groups want the government’s inquiry to cover. Other areas include No 10’s level of pandemic preparedness, particularly PPE shortages, as well as an investigation into the disproportionate impact on ethnic minority groups and those with disabilities.
    Read full story
    Source: The Independent, 30 November 2021
  14. Patient Safety Learning
    Two specialist Covid vaccination clinics for people with learning disabilities are to be held in Leicestershire.
    Local health bosses said the sessions would provide a calm environment, longer appointment times and extra support.
    They will take place at Loughborough Hospital later and at Leicester's Peepul Centre on 15 December.
    Pre-booked visitors can receive their first, second or booster jabs.
    Sam Screaton, learning disability vaccination clinical lead at the Leicestershire Partnership NHS Trust, said: "It is extremely important to us to ensure the Covid-19 vaccines and boosters are accessible to everyone.
    "All staff working at these clinics will go the extra mile to ensure patients feel comfortable, calm and able to have the vaccine."
    Read full story
    Source: BBC News, 30 November 2021
  15. Patient Safety Learning
    Social care services across England are “rapidly deteriorating”, with waiting lists soaring and councils struggling with care home closures, social services chiefs have warned.
    Long-term waiting lists have almost quadrupled and 1.5m hours of necessary home care were not delivered in the three months to November, amid a deepening staffing crisis going into winter.
    “Red lights are flashing right across our dashboard,” said Stephen Chandler, president of the Association of Directors of Adult Social Services (Adass), which ran a survey of 85 councils. “Older and disabled people are suffering.”
    A survey of care workers by the trade union Unison also found that staff shortages meant people were “dying without dignity” and in some cases there were not enough staff to sit with people in their final hours. A third of those surveyed said staffing levels were “dangerously low”.
    Read full story
    Source: The Guardian, 29 November 2021
  16. Patient Safety Learning
    The government has been warned that changes to covid-related infection prevention and control guidance will not enable a ‘rapid’ increase in the NHS’ capacity to tackle the elective care backlog and could pose significant ‘risks’.
    Trust leaders have been told they no longer have to segregate patients into separate pathways according to “high”, “medium”, or “low” risk of covid-19 in updated IPC guidance issued by the Department of Health and Social Care, NHS England and UK Health Security Agency.
    Following this guidance means the treatment of every patient without symptoms of a respiratory illness will be subject to the same precautions – such as one, rather than two, metre physical distancing. This, in theory, could create more capacity to treat larger numbers of patients.
    A subsequent letter from NHS England highlighting the changes said: ”This guidance supports efficient delivery of NHS services to meet wider patient needs, via the return to pre-COVID-19 social distancing and standard IPC measures for patients who do not have infectious respiratory diseases.”
    However, NHS Providers chief executive Chris Hopson told HSJ that many trusts are currently losing between 10 and 20% of their capacity due to “essential” IPC measures, and would not be able to abandon this approach quickly. 
    He said: “There is a conception in some people in central government’s minds that by having got this guidance changed, we are now going to see a rapid recovery of activity levels and we’ll be able to more successfully manage the infection risk. That’s what people need to be realistic about – there is a risk here."
    Read full story
    Source: HSJ, 29 November 2021
  17. Patient Safety Learning
    Women requiring the surgical removal of mesh implants have said "very little" has happened since a landmark Scottish government announcement in the summer.
    The pledge means patients can now receive free treatment from specialists in America and England. But campaigners said initial assessments in Glasgow were taking up to two years.
    The Scottish government said it was working with NHS Specialist Services to improve waiting times.
    Implant use was stopped in Scotland after hundreds of women were left with painful, life-changing side effects. In July, the Scottish government announced surgery and travel costs to Spire Health Care in Bristol and the Mercy Hospital in Missouri in the United States would be covered. The cost of each procedure is estimated to be £16,000 to £23,000.
    Marian Kenny, who is waiting on surgery to remove a mesh implant. joined the protest outside the New Victoria Hospital and admitted she felt "deflated" by the lack of progress in recent months.
    She told BBC Scotland: "For so much of this fight, we have been fighting to get it stopped and this is the only time we have been fighting for ourselves. We don't want to be guinea pigs any more."
    Health Secretary Humza Yousaf acknowledged the pain, suffering and distress mesh survivors have been through.
    He said he hoped to finalise contracts with the clinics in Bristol and Missouri "as quickly as we possibly can".
    Mr Yousaf added: "I would hope to have an update relatively soon.
    "I know they have been waiting too long and I promise them I don't want them to be waiting any longer than they have to."
    Read full story
    Source: BBC News, 24 November 2021
  18. Patient Safety Learning
    A severe shortage of midwives has led to home birth services being closed or reduced by a number of hospital trusts across the UK, with pregnant women frequently left in limbo as to where they will be able to give birth.
    The Observer has found more than 20 trusts that have had disrupted home birth services in the past three months. Eight confirmed their services remain suspended due to staff shortages. They include East Kent Hospitals, Swansea Bay University Health Board and NHS Dumfries and Galloway – all of which report that the situation is under constant review.
    Home birth services at some trusts, such as Walsall Healthcare NHS Trust and University Hospitals of Derby and Burton, have been closed since August. Others have reopened after short suspensions or have written to expectant parents to say they cannot guarantee sending a midwife when there is high demand or staff shortages.
    The findings come a week after midwives across Britain staged protests to call on the government to address the “crisis” in maternity care, with staff suffering from chronic burnout and stress.
    Midwives are being driven out of the NHS by understaffing and fears they cannot deliver safe care, according to a recent survey published by the Royal College of Midwives (RCM).
    Maria Booker, programmes director at the charity Birthrights, said: “Staffing pressures in maternity services are very real right now. But for many women the option to give birth at home is not a luxury but the only option that feels safe to them."
    “Some know they will labour better at home while some do not want to visit hospital during a pandemic. Others have a had a previous traumatic hospital birth. We cannot just accept that home birth and other choices go out the window every time a maternity service is squeezed.”
    Read full story
    Source: The Guardian, 28 November 2021
  19. Patient Safety Learning
    Soaring numbers of women are being diagnosed with advanced breast cancer, undermining their chances of survival, because of Covid’s disruption of NHS care, a charity has warned.
    The number of women being diagnosed with the disease at stage 4 is as much as 48% higher in some months than expected, with the pandemic to blame, says Macmillan Cancer Support.
    At the same time, fewer women are being confirmed as having breast cancer at stage 1, when their chances of responding well to treatment and living longer are much higher.
    Macmillan estimates that there is now a backlog of 47,300 people across the UK who have not yet been diagnosed with some form of cancer, as a direct result of Covid. They include people who could not access care in the usual way because many NHS services were scaled back, and also those who were too scared to seek help or did not want to add to the pressure the health service was already under. None have had a confirmed diagnosis of cancer, though some may be undergoing tests or screening.
    Steven McIntosh, Executive Director of Advocacy and Communications at Macmillan Cancer Support, says:
    “Nearly two years into the pandemic, there is still a mountain of almost 50,000 people who are missing a cancer diagnosis. Thousands more are already facing delays and disruption as they go through treatment. While hard-working healthcare professionals continue to do all they can to diagnose and treat patients on time, they are fighting an uphill battle. Cancer patients are stuck, waiting in a system that doesn’t have the capacity to treat them fast enough, let alone deal with the backlog of thousands who have yet to come forward.”
    “The Government has promised an NHS Elective Recovery Plan. This must show how it will tackle spiralling pressures on cancer services. It has never been more crucial to boost NHS capacity to treat and support everybody with cancer, so people receive the critical care they need now and in the years to come.”
    Read full story
    Source: The Guardian, 26 November 2021
  20. Patient Safety Learning
    The UK's Health Security Agency says its analysis of English data shows Covid vaccines are safe in pregnancy, reinforcing international evidence.
    The agency found similar rates of stillbirths and preterm births for vaccinated and unvaccinated mothers.
    Researchers say women should feel confident the jabs will help protect them and urge more to take them.
    Their report shows just 22% of women who gave birth in August had had at least one jab.
    Since mid-April, mothers-to-be have been offered the Pfizer-BioNTech or Moderna jab, with the second dose recommended eight weeks after the first. But women first eligible for vaccination were more likely to be older or have an underlying medical condition - putting them at higher risk of premature births, researchers say.
    Meanwhile, studies suggest about one in five women admitted to hospital with the virus have their babies delivered early and some of these babies need special intensive care. And evidence suggests the risks of stillbirths are higher if a woman has Covid in pregnancy.
    UKHSA immunisation head said the new information on safety was reassuring.
    "Every pregnant woman who has not yet been vaccinated should feel confident to go and get the jab and that this will help to prevent the serious consequences of catching Covid in pregnancy," she said.
    Read full story
    Source: BBC News, 26 November 2021
  21. Patient Safety Learning
    An independent body set up by the NHS to tackle health inequalities has formally committed to never use blanket acronyms such as “BAME” after feedback that they are not representative.
    The NHS Race and Health Observatory launched a four-week consultation with the public in July on how best to collectively refer to people from black, Asian and minority ethnic groups.
    The Observatory said it has become the norm in public policy to use initialisms to refer to a “hugely diverse” group of people, but that renewed scrutiny has been spurred on by the Black Lives Matter movement.
    It said terminology that “crudely conflates” different groups “does not just erase identities; it can also lead to broad brush policy decisions that fail to appreciate the nuance of ethnic inequality in the UK”.
    Generic collective terms such as “BAME”, “BME” and “ethnic minority” are “not representative or universally popular”, the Observatory said after receiving responses from 5,104 people.
    It found no single, collective umbrella term to describe ethnic groups was agreed by the majority of respondents.
    The body had previously said it was committed to avoiding the use of acronyms and initialisms, but has now formalised this as one of five key principles it is adopting in its communications.
    Where possible it will be specific about the ethnic groups it is referring to, but where collective terminology is necessary it will “always be guided by context and not adopt a blanket term”.
    Read full story
    Source: The Independent, 26 November 2021
  22. Patient Safety Learning
    Referrals to mental health crisis services in England have increased by almost 75% ‘post-pandemic’, senior NHS leaders have revealed.
    Documents submitted to NHS England and Improvement’s November board meeting capture the scale of demand facing the sector, which national director Claire Murdoch described to fellow leaders as “huge”.
    Bed occupancy rates in adult acute services have remained above the recommended ‘safe’ level of 85% since June 2020, performance reports suggest.
    Above that threshold, experts warn that patient safety, out of area placements, and surge demand risks are likely to increase.
    Ms Murdoch wrote in her report to the board that between 180,000 and 200,000 calls per month were being fielded by covid-19 response crisis lines in the first quarter of 2021-22 — more than 6,000 each day.
    She added that there had been a 74% increase in referrals to crisis services ‘post-pandemic’: ”We’re now seeing huge demand and we’re back to pre-covid levels.” She said some people had not sought help during pandemic peak periods and this was leading to more severe demand."
    Read full story (paywalled)
    Source: HSJ, 25 November 2021
  23. Patient Safety Learning
    There has been a 27% rise in people dying while in treatment for drug and alcohol addiction during the pandemic, an official report shows.
    Changes to support and reduced access to healthcare during lockdowns are likely to have been factors, it says.
    Between April 2020 and March 2021, 3,726 people died while in contact with drug and alcohol services - up from 2,929 the year before.
    The figures, published by the Office for Health Improvement and Disparities, for England, show a small 2% rise in the overall numbers of adults receiving help for drug and alcohol problems from 2020 to 2021.
    Out of more than a quarter of a million people affected, more than half were in treatment for problems with opiates - medicines to treat pain - and a quarter with alcohol problems.
    The proportion of deaths in treatment for alcohol addiction rose by 44% to 1,064 and for opiate addiction by 20% to 2,418.
    UKAT, a group providing residential detox treatment, said a "concerning" number of services closed their doors to addicts during the pandemic.
    "But drug and alcohol treatment is critical care intervention and cannot be simply put on pause," said Nuno Albuquerque, head of treatment for the group.
    "It cannot be a coincidence that more people have subsequently lost their lives when they were in fact trying to save it."
    Read full story
    Source: BBC News, 25 November 2021
  24. Patient Safety Learning
    When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid.
    Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment.
    When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. 
    But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth.
    Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant.
    But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue.
    The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.”
    Read full story
    Source: The Guardian, 23 November 2021
  25. Patient Safety Learning
    A doctor has accused England's health and care regulator of "moral corruption".
    Consultant orthopaedic surgeon Shyam Kumar says the Care Quality Commission misled the public over patient safety.
    Mr Kumar alleges he was unfairly dismissed from his role as a special adviser to the CQC because he acted as a whistleblower.
    His claims were made during an employment tribunal hearing in Manchester.
    Seconded by his employer, University Hospitals of Morecambe Bay NHS Foundation Trust, Mr Kumar had been giving the CQC expert advice on surgical departments during hospital inspections.
    But he was dismissed from this role, in early 2019.
    The CQC said a letter he had written to a colleague he had been in dispute with at his trust was incompatible with the standards expected of its special advisers.
    But Mr Kumar claims he was dismissed because, in 2018, he raised concerns with senior CQC figures that he was expected to simply rubber-stamp the final report following an under-resourced inspection.
    And he accused the regulator of sweeping his concerns under the carpet and providing false assurances on patient safety.
    Read full story
    Source: BBC News, 25 November 2021

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