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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Covid-19 is on the retreat across the American continents but it is too early for the region to let its guard down, warned the Pan American Health Organisation, the World Health Organization’s regional office for the Americas, on 9 March. Reported cases of Covid-19 fell by 26% in the past week and deaths by nearly 19%, as the omicron wave of infections tailed off. But ongoing transmission and future variants could expose the region’s public health priorities once more, said PAHO’s director, Carissa Etienne. A total of 2.6 million people have died from Covid-19 in the Americas, the highest number of any region of the world and almost half of the global total, despite being home to only 13% of its population. “This is a tragedy of enormous proportions, and its effects will be felt for years to come,” said Etienne on the second anniversary of the pandemic. Patchy vaccination coverage has left countries vulnerable to current and future variants of SARS-CoV-2. Around 248 million people in Latin America and the Caribbean are yet to receive a single dose of a covid vaccine, with vaccination rates particularly low in hard-to-reach rural areas. In the first two months of 2022 the Americas accounted for 63% of the world’s new cases. Despite a general fall in incidence across the region, new cases rose by 2.2% in the Caribbean, while Bolivia and Puerto Rico reported an increase in deaths in the past week. Michael Touchton, head of the University of Miami’s Covid-19 policy observatory for Latin America, said, “Latin America is perhaps the most vulnerable region in the world to the emergence of a new variant. Vaccine delays have a greater impact in Latin America due to concentrated urban populations, chronic disease burden, and low capacity health systems. Taken together, Latin America is likelier to fare worse than other similarly low and middle income regions.” Read full story Source: BMJ, 14 March 2022
  2. News Article
    What do you do with bottles of expired or no-longer-needed medications? That’s a problem, according to Elizabeth Skoy, an associate professor at North Dakota State University’s School of Pharmacy in the USA. “In recent years, there’s been a spotlight on medication disposal, because of the opioid epidemic,” she said. “It’s important to get rid of any medication when you are done with it to prevent misuse or having it fall into the hands of others.” Plus, having old medications in the home increases the chances of accidental poisoning of children or pets. But while many of us might be aware that we shouldn’t toss pill bottles in the trash or flush medication down the toilet, we’re less knowledgeable about safe alternatives. And there haven’t been many options beyond the USA's Drug Enforcement Administration’s semiannual National Prescription Drug Take Back Day. In the past decade, however, pharmacies, hospitals and law enforcement agencies have been stepping up to help clean out medicine cabinets year-round. One of the most accessible solutions is medication collection bins, which are being added to convenient locations such as retail stores, health clinics, police stations and other easily accessed sites. “We decided in 2016 we wanted to be part of the solution,” said Kurt Henke, ambulatory pharmacy manager for Colorado’s Denver Health hospital system, which has collection bins in each of its eight pharmacies. Drugstore chain CVS began putting units in police departments in 2014 and adding them to its more than 9,000 retail locations in 2017; so far it has deployed more than 4,000 of the bins. States are taking the initiative, as well. In North Dakota the state’s Board of Pharmacy provides MedSafe, a take-back box, to any pharmacy that wants one; at this point, about 120 are participating. The DEA maintains a searchable database of controlled-substance collection sites. Simply type in your Zip code or city to find the nearest one. Read full story (paywalled) Source: The Washington Post, 15 March 2022
  3. News Article
    The parents of a baby boy who lived for just 27 minutes have told an inquest they were "completely dismissed" throughout labour. Archie Batten died on 1 September 2019 at the Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate, Kent. His inquest began on Monday at Maidstone Coroner's Court. The East Kent Hospitals University NHS Foundation Trust has already admitted liability and apologised for Archie's death. The coroner heard Archie's mother Rachel Higgs was frustrated at being turned away from the maternity unit in the morning, when she had gone to complain of vomiting and extreme pain. She was told she was not far enough into labour to be admitted. She returned home to Broadstairs with her partner Andrew Batten, but continued to feel unwell so phoned the hospital. She was told the unit was now closed. Instead, two community midwives were sent to their home, where they attempted to deliver the baby but could not find a heartbeat. Andrew Batten told the inquest the midwives looked "terrified," and that there was "an air of panic", with the midwives whispering in the hallway instead of telling him and Ms Higgs what was happening. Under examination from the family's barrister Richard Baker, Victoria Jackson, the midwife who had originally seen Ms Higgs, admitted the high number of patients she was having to deal with had affected her ability to spend time with her. Read full story Source: BBC News, 14 March 2022
  4. Content Article
    ECRI's annual Top 10 list helps organisations identify imminent patient safety challenges. The 2022 edition features many first-time topics, and emphasis is on potential risks that could have the biggest impact on patient health across all care settings. The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages. Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically understaffed, while 100 more facilitates anticipated facing critical staff shortages within the following week. The list includes diagnostic and vaccine-related errors that can impact patient outcomes. In addition, several topics on this year's list reflect challenges that have arisen as a result of the stresses associated with delivering care during a global pandemic.
  5. News Article
    GPs have received updated guidance on providing healthcare to people coming from Ukraine. In a bulletin to general practices on 10 March notifying them of the update from the Office for Health Improvement and Disparities, NHS England said that the health service was starting to see refugees and citizens returning from Ukraine and reminded practices that proof of identity is not required for registration at a practice. The guidance advises practices to explain to people coming from Ukraine how the NHS works and their entitlements to healthcare, to ensure that they are up to date with the UK immunisation schedule, and to ask about any travel plans they may have to visit friends and relatives in their country of origin. GPs are also advised to: Screen all new entrants, including children, for tuberculosis Ascertain any risk factors for hepatitis B infection that may indicate the need for screening (owing to its low prevalence in the UK) Consider screening for hepatitis C, because of a considerably higher prevalence in Ukraine than in the UK Ensure that travellers are offered typhoid immunisation and advice on preventing enteric fever Consider nutritional and metabolic concerns (anaemia, vitamin D, vitamin A, iodine) Work with a professional interpreter where language barriers are present Consider the effects of culture, religion, and gender on health Assess for mental health conditions, and Refer pregnant women to antenatal care. Read full story Source: BMJ, 14 March 2022
  6. Content Article
    Advice and guidance on the health needs of migrant patients from Ukraine for healthcare practitioners.
  7. News Article
    A privately run mental health hospital put in special measures last year has been rated “inadequate” again following a fresh Care Quality Commission inspection. Inspectors raised serious concerns about unsafe ward environments and staff not managing patient risks at the Priory Hospital Arnold, which has beds commissioned by Nottinghamshire Healthcare Foundation Trust. Inspectors said that while the leadership team was experienced, the registered manager had been in post since April last year and the improvements they had made “had not been fully embedded”. The registered manager had changed after the service was placed in special measures. Ligature risks were found in patients’ bathrooms despite the provider making “some progress” and undertaking “substantial work” to remove them, the CQC said. And in one instance, a patient had tried to harm themselves with a plastic bag which was a restricted item on the ward. CQC head of hospital inspection for mental health and community services Craig Howarth said staff “had not followed the patient’s risk assessment” and had not searched the patient on their return from a visit off the ward. He added: “It was also concerning that despite rotas showing enough staff were available across the hospital, staff gave examples of when a lack of staffing had impacted on patient care and safety. “Despite the measures in place, the risks to patients were not reduced and there was evidence of incidents of harm to patients.” Read full story (paywalled) Source: HSJ, 15 March 2022
  8. News Article
    The highest ever number of medical students have been told there are no places for them this year, despite the health service’s crippling shortage of medics. The risk that young would-be doctors may not be allocated to start their training at a hospital in the UK has sparked concern among the medical students affected, as well as medical organisations. Pressure is growing for action to close the gap between the number of training places available across the NHS and the number of graduates seeking one, so medical talent is not wasted and hospitals hire as many fresh recruits as they can to help tackle the widespread lack of medics. Doctors are worried that the mismatch between demand for and supply of training places will lead to the NHS missing out on medics it sorely needs and that some of those denied a place will either go to work abroad instead or give up medicine altogether. The most recent official figures showed that the NHS in England is short of almost 8,200 doctors. Dr Dustyn Saint, a GP in Norfolk, tweeted the health secretary, Sajid Javid, about the situation, saying: “Sajid Javid sort this out! You know how much general practice needs these people in a few years, standing by and doing nothing is inexcusable.” Another doctor said: “It’s bonkers that 800 would-be doctors could be denied training places at a time when the NHS in England is short of 8,200 doctors.” The British Medical Association has voiced concern about the large number of unallocated medics. “Now we have a situation where a record number are left with unnecessary uncertainty about where they are headed this August,” said Khadija Meghrawi, the co-chair of its medical students committee. “In a time where student mental health is declining, this additional source of uncertainty and stress is particularly unfair.” Read full story Source: The Guardian, 15 March 2022
  9. News Article
    The chief executive of three NHS trusts says ringfencing elective care within an acute hospital site is potentially more ‘productive’ than sending it to a separate ‘cold’ site. Glen Burley, who leads a “provider group” in the West Midlands, says his trusts have been grappling with the challenge of how to maximise elective activity without it being disrupted by emergency pressures. The conventional view – as outlined in the NHS long-term plan – is that performing more elective care on a separate site from emergency can help ensure theatre lists are not disrupted. But George Eliot Trust, which has been led by Mr Burley since 2018 and only has a single district general hospital, has created a “ringfenced” elective hub within the site. In an interview with HSJ, Mr Burley said: “So I actually think the most productive model in the NHS is if you can pull that off. “If you can actually protect your elective capacity and offer it on the same site [as] urgent care, so the clinicians are not having to move between sites, you’ve got optimal productivity. “The challenge right across the NHS has been avoiding that spillage, of emergency care into your elective capacity. “As you get busier and you escalate… the order in which you encroach into areas that you should not encroach into, is really key in that. We are saying we are going to protect our elective beds in a way that we haven’t done before." Read full story (paywalled) Source: HSJ, 14 March 2022
  10. News Article
    The number of referrals for specialist NHS mental health care reached a record high in England by the end of 2021, an analysis suggests. The Royal College of Psychiatrists says the pandemic has led to unprecedented demand and backlogs and services are struggling to keep up. There were 4.3 million referrals, for conditions such as anxiety and depression, in 2021, NHS Digital says. Just under a quarter - 1.025 million - were for children or adolescents. The college said the NHS had delivered 1.8 million mental health consultations in December 2021, but an estimated 1.4 million people were still waiting for treatment. And hundreds of adults were being sent far from home for treatment because of a lack of beds in their area. President Dr Adrian James said: "As the pressure on services continues to ratchet up, the silence from government continues to be of grave concern for the college, the wider mental health workforce and, most importantly, our patients. "The warning of the long tail of mental ill health caused by the pandemic has not been heeded. "Many thousands of people will be left waiting far too long for the treatment they need unless the government wakes up to the crisis that is engulfing the country. "Staff are working flat out to give their patients the support they need but the lack of resources and lack of staff mean it's becoming an impossible situation to manage... "...We need a fully funded plan for mental-health services, backed by a long-term workforce plan, as the country comes to terms with the biggest hit to its mental health in generations." Read full story Source: BBC News, 15 March 2022
  11. News Article
    A newly-discovered Covid variant that combines mutations from both Omicron and Delta is “the real thing,” scientists have said. Earlier in the year, concern was raised after a lab in Cyprus claimed to have found evidence of a Delta-Omicron recombination event – when the two variants co-infect a patient and exchange genetic material to produce a new viral offspring – but experts said the findings were false. Now, however, virologists from L’Institut Pasteur in Paris have sequenced the genome of a genuine “Deltacron” variant, which has been detected in several regions of France and appears to have been circulating since early January. “This one is legit,” said Aris Katzourakis, a professor of evolution and genomics at the University of Oxford. “[It is] one to keep an eye on.” “The French cluster appears to be a validated occurrence where a recombination event has given rise to a virus fit enough to circulate,” said Dr Stephen Griffin, a virologist at the University of Leeds. In deriving its spike from Omicron, the Deltacron variant could similarly target the upper respiratory pathway, rather than the lungs, Dr Griffin said. “At the same time, there are some parts of Omicron thought to lessen severity that are missing from the recombinant,” he said. Dr Griffin said: "This is another clear demonstration that we remain in a dynamic situation with respect to Sars-2, and that the maintenance of genetic surveillance and testing is both relevant and prudent." Read full story Source: The Independent, 11 March 2022
  12. News Article
    The NHS has publicly recognised that chronic urinary tract infections (UTIs) exist and has updated its advice for patients following pressure from campaign groups. For many patients who develop a UTI, their experience is extremely painful but short-lived. But for thousands of others, a one-off acute attack turns into a chronic infection that dominates their lives and lasts for months or even years. NHS Digital updated its website to last week to provide information around chronic bladder infections where previously there was none. Campaigners say this is a “huge step forward” but there is still a long way to go in improving testing and treatments for the condition. Chronic UTI sufferer Leah Herridge has been pushing for the change alongside Chronic Urinary Tract Infection Campaign (CUTIC) and Bladder Health UK. The NHS website’s Cystitis page has been updated to include mentions of chronic UTI and to acknowledge that current tests may not pick up these infections. Previously, the NHS made no mention of chronic UTIs, meaning GPs and even consultants would often default to misdiagnosing patients with interstitial cystitis. Specialists say the infections, which often begin as an acute bout of cystitis, can occur when bacteria become embedded within the bladder wall and become difficult to treat with short courses of antibiotics. “People tend to think chronic means really bad. What it means is everlasting,” said Carolyn Andrew, from CUTIC. In August 2021, Ms Herridge sent a letter to NHS Digital demanding the web page be updated. The campaign was backed by CUTIC and Bladder Health UK as well as 100 other chronic UTI sufferers who also wrote letters. “NHS Digital has actually been really, really fantastic at working with us and I do feel like they have really co-produced, certainly the interstitial cystitis page with the leading professionals in the area, the charities and myself,” said Ms Herridge. Read full story Source: iNews, 14 March 2022
  13. Content Article
    Get information on waiting times for treatment at NHS Trusts in England. This data is sourced from NHS England, and is published two months in arrears. Please note that some data may not be available. This could be because a) the Trust does not provide treatment for the selected condition, b) data has not been submitted, or c) some services (e.g. mental health) are not covered in the source data.
  14. News Article
    More than 200 women were affected by failures in Ireland’s CervicalCheck screening system. It emerged in 2018 that 221 women and families were not told about misreported smear tests. The Minister for Health said that non-disclosure issues which arose in the cervical check screening controversy will be legislated for to prevent it from happening again. Stephen Donnelly said new legislation will address the negligence issues and ensure that the failure to inform the women of the clinical audit of their screening will “never happen again”. Mr Donnelly was discussing a number of amendments at the committee stage of Ireland's Patient Safety Bill. The new legislation will require the mandatory open disclosure of serious patient safety incidents, and sets out a list of incidents which must be reported to the health watchdog, Health Information and Quality Authority (HIQA). Mr Donnelly said that he will introduce an amendment at the report stage of the Bill that will provide for non-disclosure and will deal with issues around delayed diagnosis and delayed screening. Mr Donnelly said: “I’ve had lengthy discussions with the department on this and it doesn’t fit neatly with this Bill because the serious patient safety issues which result in death or serious harm, they are very clear and binary. “Legislating around delayed diagnosis and delayed screening, it is really complex and doesn’t fit neatly in this Bill, however my view is that the non-disclosure that happened in cervical check, even though it doesn’t neatly fit here, should still be legislated for." Read full story Source: The Independent, 11 March 2022
  15. News Article
    Serious safety concerns have been raised about a children’s mental health hospital where staff lacked respect for patients, as the provider faces a police investigation into another one of its units. The Huntercombe Hospital in Stafford has been rated as “inadequate” by watchdog the Care Quality Commission (CQC) after inspectors found the safety of children within the hospital was at risk. The concerns about this hospital come as The Independent revealed police have launched an investigation into another mental health unit run by the provider in Maidenhead. Following an inspection in October inspectors sent an urgent warning notice to the provider, after it found there were not enough staff to keep patients safe. The hospital was described as relaying on agency workers who did not have knowledge of the patients. The CQC inspectors found children’s wards were dirty with poor hygiene measures in the hospital and patients at risk of infection. According to the report staff were found “sitting with their eyes closed for prolonged periods of time”, and that staff observations of at risk patients were “undermined by a blind spot where people could self-harm unseen.” Craig Howarth, CQC head of inspection for mental health and community health services, said: “Further to these issues, we saw that staff sometimes showed a lack of respect to patients and one ward was poorly furnished and maintained and there wasn’t always enough emphasis on some people’s individual requirements.” Read full story Source: The Independent, 11 March 2022
  16. News Article
    The General Medical Council (GMC) has achieved marginal improvements against its targets to reduce racial inequalities, it said in an annual update on the programme. However, BAME doctor representatives as well as the GMC itself said the progress was not sufficient against the targets which the regulator had set itself last year. These included stopping disproportionate complaints from employers about ethnic minority doctors by 2026, and getting rid of disadvantage and discrimination in medical education and training by 2031. According to the update, the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared to white doctors, has marginally reduced. The report also acknowledged the judgment by an employment tribunal in June last year, which found that the GMC had discriminated against a doctor based on his race. Reading Employment Tribunal upheld a complaint that Dr Omer Karim, who previously worked as a consultant urologist in Slough, had been discriminated against during an investigation by the GMC, after the body dismissed charges against a white doctor accused of the same conduct. The GMC has appealed the verdict but is still waiting for the appeal to be heard. Read full story Source: Pulse, 10 March 2022
  17. News Article
    Less than half of women are being seen following an urgent breast cancer referral, as NHS performance drops to a new low. ‘Alarming’ new NHS figures have shown just 47% of women in England referred “urgently” for breast cancer symptoms were seen by a specialist within two weeks. For women without symptoms but referred urgently to see a specialist, just 49% were seen within two weeks. In both cases this is the first time since records began that less than 50% cent of women were seen. Within some trusts less than 10% of women referred with symptoms were seen within two weeks, with less than two per cent of women referred to United Lincolnshire Hospitals Trust being seen within this time frame in January. Wes Streeting, Labour shadow health secretary said: “I know from experience the importance of an early cancer diagnosis and quick treatment. It is appalling that most suspected breast cancer patients are left waiting so long before being seen, with the insecurity of not knowing." Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “It’s alarming that in January, for the first time, less than half of women 47.5 per cent in England who were urgently referred with potential breast cancer symptoms, were seen by a specialist within two weeks." “...the government must consider what immediate steps it can take to reverse this rapid decline. Agonising delays must be replaced with prompt diagnoses for all women – and the sooner breast cancer is diagnosed the greater the chance of treatment being successful.” Read full story Source: The Independent, 11 March 2022
  18. News Article
    It has been nine years living “like a prisoner” in “excruciating” pain and Kate is still facing a wait for surgery to tackle the horrifying mistakes in her postnatal care. Despite a difficult birth at Leeds General Hospital, Kate described the atmosphere at the trust’s labour ward as “lovely”. However, her experience quickly deteriorated into “hell” after she was told she had third-degree tears and was admitted to a postnatal ward, describing the care she received as “awful”. A few days following her discharge, which occurred before she’d had a bowel movement, Kate said she was left “screaming in pain” at home, “bleeding a lot from the back passage” and “incontinent”. Despite reporting these symptoms to the maternity department, Kate was told it was a “normal” experience. “I felt like nobody was listening to me,” Kate said. After six months, living in “intense pain”, with “flooding diarrhoea” and not able to leave the house, she was told by the NHS her symptoms were down to postnatal depression. She was referred to a colorectal surgeon, who found her anal sphincter was “fully open almost as if it wasn’t ever stitched”. Following an operation in 2015 to fix the issue, Kate developed sepsis, nearly losing her life and meaning it took 18 weeks for her wound to heal. However, her ordeal did not stop there. She had developed nerve damage, chronic pelvic pain, incontinence, coxalgia and a prolapse as a result of her problems being neglected for so long. By 2022, nine years later, she is now waiting for a colostomy bag operation – the only option to address her pain. Kate told The Independent: “Everywhere I go I have to plan the full day. I need to know where the toilets are. I don’t go out of the house. I’ve felt like a prisoner in my own home for nine years. “It makes me so emotional thinking about everything they have put me through. It hasn’t just affected my life, it’s also affected my partner and family. I have lost so much time that I’ll never get back. I couldn’t enjoy life and do the things that all mothers do with their babies. “There was no care, no sympathy, nothing. Nobody cared for me apart from my surgeon at Sheffield. I’ve forgotten what it feels like to feel normal. I can’t remember life without pain." Read full story Source: The Independent, 13 March 2022
  19. News Article
    A national robotic-assisted surgery programme allowing surgeons to perform complex procedures with more precision and control is being introduced in Wales, the Health Minister has announced. The All-Wales Robotic Assisted Surgery Network, developed by health boards, the Life Sciences Hub Wales and the Moondance Cancer Initiative, will provide less invasive surgery for thousands of cancer patients across the country. The surgery involves the use of highly advanced robotic surgical instruments under the control of a surgeon. It will initially be used in Wales for some Colorectal, Upper Gastrointestinal, Urological and Gynaecological cancers. The Welsh Government will support the network with funding of £4.2m over five years, alongside £13.35m provided by health boards over 10 years. Health and Social Services Minister Eluned Morgan said: "The All-Wales Robotic Assisted Surgery Network is an ambitious and important programme helping to improve outcomes for patients and the NHS in Wales. It will put Wales at the forefront of international research for the use of robotic surgical techniques. This pioneering service will also encourage specialist staff to come to Wales to train and practice". It will initially be provided in the Betsi Cadwaladr University Health Board area, with the first patient expected to receive treatment in June. Once fully established, patients in north Wales will no longer need to travel to England to receive robotic-assisted surgery. Read full story Source: Welsh Government, 14 March 2022
  20. Content Article
    When a patient dies because of preventable avoidable harm it is crucial that we learn from the event and implement changes to ensure it does not reoccur. Implementing the findings and recommendations of Coroner’s Prevention of Future Deaths (PFD) reports can play a key role in this. This blog reflects on a recent discussion at a Patient Safety Management Network (PSMN) meeting about PFD reports and how their insights can be used for learning and improvement. The PSMN is an informal voluntary network for patient safety managers in England. Created by and for patient safety managers it provides a weekly drop-in session with guests to talk through issues of importance to patient safety managers, providing information, peer support and safe space for discussion. You can find out about the network here.
  21. Content Article
    The Pre-Hospital Care Podcast is designed to have engaging and inspirational conversations with some of the World’s leading experts relating to pre-hospital care. This session interviews flight paramedic Paul Swinton, to talk about how to optimise the rapid sequence intubation (RSI) in the pre-hospital environment. It unpacks some of the nuances, challenges, and approaches that Paul has found from being both a pre-hospital practitioner and in innovating the layout and design for an RSI in creating the SCRAM bag. SCRAM™ (Structured CRitical Airway Management) is an innovative solution for enhancing the performance of emergency airway management. It involves the systemisation, standardisation, cognitive offloading, human factors and good governance are core principles to the design and philosophy of SCRAM.
  22. Content Article
    Renal replacement therapy is treatment that are given to patients whose kidneys stop working properly, including chronic kidney disease and acute kidney injury. The therapy includes haemodialysis (HD), peritoneal dialysis (PD) and continuous renal replacement therapy (CRRT), sometimes referred to as haemofiltration. This guidance has been produced in collaboration with the UK Kidney Patient Safety Committee, to summarise known safety issues with dialysis and CRRT and describe what to do to minimise or prevent serious injury. This guidance is aimed mainly at healthcare professionals and patients who carry out their own dialysis. This guidance replaces the previous Dialysis Lessons Learn guidance published by the MHRA.
  23. Content Article
    Catherine Villanueva Gardner, Professor of Women’s and Gender Studies and Philosophy at the University of Massachusetts Dartmouth, looks at the material effects on women with Long Covid.
  24. Content Article
    Healthcare professionals need clearer guidance on responding to racism in paediatric settings, argue Zeshan Qureshi and colleagues.
  25. Content Article
    A report from the Institute of Health and Social Care Management Power-House series discusses virtual wards, an innovation due to be implemented at scale in the NHS as a method of addressing patient waiting lists. With the help of remote treatment options and supported by technology, patients are monitored and cared for in their own homes. The report lists the advantages and disadvantages of this approach. In addition to the report, you can watch the 'How to virtual wards Power Hour' video where an expert panel discusses the details around virtual wards. Roy Lilley was joined by Professor Alison Leary, Elaine Strachan-Hall, Steph Lawrence, Alexandra Evans and Dr Elaine Maxwell for an unmissable hour of insight, expertise and guidance.
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