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Patient Safety Learning

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  1. Patient Safety Learning
    HRT used to be a dirty word. Now it’s a battle cry. Women will begathering in Parliament Square in London later this month to support the menopause bill to demand free prescriptions for hormone replacement therapy in England. The bill could help thousands more women to access this life-changing treatment and will put the menopause under the microscope.
    For years, a combination of medical sexism, hysterical reporting and outdated science has held women back from asking for the health care they need. HRT replenishes the oestrogen, progesterone (and sometimes testosterone) that women lose when having the menopause. As a result of previous misleading reports linking the treatment to a risk of breast cancer and dementia, HRT has long been considered controversial.
    Last week, however, a BMJ paper studying more than 100,000 HRT users over two decades in the UK found that there was no overall association between hormone replacement and an increased risk of developing dementia. Meanwhile, the science lumping the many different types of HRT together in one “causes-breast-cancer” basket is being questioned by menopause experts.
    A sexist, ageist culture has kept the menopause – and the stigma associated with it – hidden for decades. In a TUC survey of 4,000 women, 85% said the menopause affected their working life. Many women have lost their health, jobs, relationships and even their lives at the time of their menopause, when rates of suicide peak.
    But now, Labour MP Carolyn Harris is pushing the second reading of her menopause bill through parliament later this month. Aside from making HRT free in England (it’s already free in Scotland and Wales), the bill will also cover broader issues around menopause rights and education, particularly in the workplace.
    Read full story
    Source: The Guardian, 6 October 2021
  2. Patient Safety Learning
    MP Carolyn Harris is part of a movement determined to smash the remnants of the menopause taboo, pushing a private member’s bill to turn up the volume on a debate about the menopause that is growing louder by the day.
    As an increasing number of countries, businesses and individuals mark World Menopause Day today, Harris says she is ready to shame whoever stands in the way of progress.
    Harris will lead a small army of supporters to Parliament Square in London before her bill, which is due to be heard on the 29 October, to demand free prescriptions for hormone replacement therapy in England – already available in Scotland and Wales. The government is said to be “interested” in the bill, with Harris adding that she has cross-party support from dozens of MP.
    “In the last two years the narrative has completely changed,” says Harris, who adds that since the private members bill was announced she’s had calls from countries from Canada and the US, to Australia and Japan.
    “People are waking up to the fact that we have to find a better way of supporting women through the menopause,” she says. “Women are enhanced coming through this process, but only if they get the support they need.”
    The evidence suggests they all too often don’t. There are more than 13 million currently experiencing menopause or perimenopause in the UK. Menopause campaigners argue that medical sexism and a lack of training means many women are left to suffer the symptoms of menopause – which can include depression, anxiety, insomnia and brain fog as well as hot flushes.
    Harris’s own experience with the menopause was brutal. Twenty years after losing her eight-year-old son in a road traffic accident she blamed herself for not processing her grief when she was hit by a deep depression. “It took me six years, having conversations with women, for me to realise I was going through the menopause,” she says.
    Read full story
    Source: The Guardian, 18 October 2021
  3. Patient Safety Learning
    The widow of a top Scottish government official, who died after contracting Covid, believes the full details of his illness were concealed to protect the reputation of a troubled hospital.
    Andrew Slorance, Scottish government's head of response and communication unit, in charge of its handling of the Covid pandemic, went into Glasgow's Queen Elizabeth University Hospital for cancer treatment a year ago.
    His wife Louise believes he caught Covid there as well as another life-threatening infection. 
    Andrew went in to the £850m flagship Queen Elizabeth University Hospital (QUEH) at the end of October 2020 for a stem cell transplant and chemotherapy as part of treatment for Mantle Cell Lymphoma (MCL). 
    He died nearly six weeks into his stay, with the cause of his death listed as Covid pneumonia. But after requesting a copy of his medical notes, Mrs Slorance discovered her husband had also been treated for an infection caused by a fungus called aspergillus, which had not been discussed with either of them during his hospital stay.
    The infection is common in the environment but can be extremely dangerous for people with weak immune systems.
    Mrs Slorance questions whether it may have played a part in her husband's death, and if so, why she was not told?
    She told the BBC: "I think somebody and probably a number of people have made an active decision not to inform his family of that infection, either during his admission or post-death."
    Mrs Slorance believes that officials wanted to protect the hospital, which is already the subject of a public inquiry, and its reputation, "no matter what the cost".
    Mrs Slorance says a full investigation should take place into incidences of aspergillus at the hospital campus.
    In response, NHS Greater Glasgow and Clyde said: "We are sorry that the family are unhappy with aspects of Mr Slorance's treatment, details of which were discussed with the family at the time.
    "While we cannot comment on individual patients, we do not recognise the claims being made. We are confident that the appropriate care was provided. There has been a clinical review of this case and we would like to reassure the family that we have been open and honest and there has been no attempt to conceal any information from them."
    Read full story
    Source: BBC News, 18 November 2021
  4. Patient Safety Learning
    The NHS has been given the green light to offer people living with HIV the first "long-acting injectable" to keep the virus at bay.
    Charities have hailed the "incredible news" which offers an alternative to adults living with HIV who have to take daily antiretroviral drugs.
    Many people living with HIV can keep the virus at very low levels by taking antiretroviral tablets each day. These drugs keep the number of virus particles in the blood - also known as the viral load - so low that it cannot be detected or transmitted between people.
    But now an estimated 13,000 people will be eligible for the injectable treatment in England which means they no longer need daily treatment but will have two injections every two months. This means they can reduce the days they receive treatment from 365 to 6 per year.
    Meindert Boysen, deputy chief executive NICE, said: "Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment. However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle."
    "We're pleased therefore to be able to recommend cabotegravir with rilpivirine as a valuable treatment option for people who already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing."
    Read full story
    Source: 18 November 2021
  5. Patient Safety Learning
    Thousands of patients a year are dying because of overcrowding in A&E units in Britain, and more fatalities will follow this winter, emergency care doctors claim.
    An estimated 4,519 people in England died in 2020-21 as a direct result of people receiving less than ideal care while delayed in A&E waiting to start treatment in the hospital.
    “To say this figure is shocking is an understatement. Quite simply, crowding kills,” said Dr Adrian Boyle, a vice-president of the Royal College of Emergency Medicine (RCEM).
    There have also been 709 deaths in Wales and 303 in Scotland so far this year for the same reason, according to a report by the college. Another 566 excess deaths caused by overcrowding occurred in Northern Ireland in 2020-21. The 4,519 in England “may be an underestimate”, it adds.
    The four figures taken together mean the college has identified at least 6,097 deaths across the four home nations that it believes occurred because overcrowding hampered the person’s treatment.
    “There’s a lot of human misery behind these figures. It’s uncomfortable and unbearable that people are being put through this. It’s impossible not to feel upset and angry about this,” Boyle said.
    Read full story
    Source: The Guardian, 18 November 2021
  6. Patient Safety Learning
    An inspection at a failing hospital trust has identified "some progress" but its services are still inadequate.
    The Care Quality Commission (CQC) inspected the Shrewsbury and Telford Hospital NHS Trust (SaTH) in August. The Trust has been in special measures since 2018 and its maternity services are subject of a review following a high rate of baby and maternal deaths.
    The CQC said SaTH still had "significant work to do" to improve its patient care and safety standards.
    Inspectors highlighted particular concerns around risk management at the Trust which it said was "inconsistent" and and urgent and emergency care where patients "did not always receive timely assessment".
    The CQC also reported a shortage of staff working in end-of-life care and midwifery, however maternity staff were said to have "an exceptionally dedicated and caring approach".
    "I recognise the enormous pressure NHS services are under across the country and that usual expectations cannot always be maintained, but it is important they do all they can to mitigate risks to patient safety while facing these pressures," chief inspector of hospitals, Ted Baker, said.
    "While the trust continues to have significant work to do to provide care that meets standards people have a right to expect, it is providing more effective care overall.
    "However, its risk management remains inconsistent and we are not assured it is doing all it can to ensure people's safety."
    Read full story
    Source: BBC News, 18 November 2021
     
  7. Patient Safety Learning
    Suicidal thoughts are three times as common in those living with a spinal cord injury in the UK, according to new research
    And yet, it’s estimated that only one third of people living with a spinal cord injury (SCI) are getting access to mental health support, and of those, 68% do not feel that support services available are able to meet their needs.
    These alarming statistics are taken from a new report, ‘It’s not just physical’ which was presented to parliament yesterday (17 November).  The report shines a light on the mental health problems faced by people with spinal cord injuries in the UK today.
    It's calling on the NHS, government and other health policy makers to provide better mental health support services for people with spinal cord injuries – and their unpaid carers – as a matter of urgency.  Nik Hartley, Spinal Injuries Association CEO said:
    “We are at risk of failing thousands of people in the UK living with a spinal cord injury. Our new report highlights that psychological damage caused by a SCI is, at best, considered as an afterthought, and at worst, completely ignored by the medical profession. We need urgent action and for services to be sufficiently specialised to support the thousands of people living with this type of injury before it is too late.”
    Read full story
    Source: Spinal Injuries Association, 17 November 2021
  8. Patient Safety Learning
    The mother of a man who took his own life said bereaved families would be left "in limbo" by a mental health trust's serious incident report delays.
    Local health officials have raised concerns over the "timeliness" of Cambridgeshire and Peterborough NHS Foundation Trust's (CPFT) reports.
    Maria Nowshadi, whose son James died in 2020, said they should be done quickly "so there's answers for families".
    Ms Nowshadi said: "These investigations should happen in a timely, quick manner so there's answers for families, but also in case there's any learning to be had... to make sure there's no further deaths that happen in the same way, because of any errors within the system."
    She said when the original date the report was due to be completed passed, she "reached the stage where I was looking at the mailbox every day". She said she told a patient liaison officer: "This is actually starting to affect my mental health.
    The chief nurse at Cambridgeshire and Peterborough's Clinical Commissioning Group (CCG), Carol Anderson, said there were "concerns... [around] serious incident processes and reporting" at CPFT.
    A CCG spokeswoman added they had agreed an extension with CPFT "for the completion of serious incident reports due to additional pressures due to the pandemic and staff redeployment".
    "Our overall concern is the timeliness of serious incident reporting, so that we can ensure that learning is put in place as soon as possible," she added.
    Read full story
    Source: BBC News, 17 November 2021
  9. Patient Safety Learning
    A ‘culture of distrust’ between consultants and the use of incident reporting as a tool of ‘reprisal’ impacted patient care at a trust’s cardiology department, a review has concluded.
    An external review undertaken for Hull University Teaching Hospitals Trust has made a series of recommendations after looking into allegations of bullying and several examples of poor care within its cardiology services.
    In a report published in the trust’s board papers, the Royal College of Physicians reported a “perceived tendency to downplay clinical incidents, and, to undermine those who wanted to raise patient safety issues”.
    It added: “We met a group of individual consultants who did not work well as a team. There is a culture of distrust, a lack of departmental cohesion and allegations of bullying in the department. All of which reinforce a clear divide between the interventional and non-interventional consultant cardiologists."
    “There have been a number of allegations of belittling, intimidation and undermining…The review team heard accounts of a culture where datix has been used as a tool for possible personal reprisal along with ignoring/downplaying incidents that have been raised.”
    The review concludes: “This behaviour is impacting on patient care and therefore, all medical staff should be reminded of good medical practice as the [General Medical Council] code of conduct of how doctors must work collaboratively with colleagues.”
    Read full story (paywalled)
    Source: HSJ, 16 November 2021
  10. Patient Safety Learning
    UK health officials are warning of a "hidden pandemic" of antibiotic-resistant infections if people fail to act responsibly after Covid.
    Cold symptoms will be more common this winter, with social mixing - but taking antibiotics is not the answer. This could encourage harmful bacteria to evade treatment and put everyone's health at risk, the UK Health Security Agency says.
    One in five people with an infection in 2020 had an antibiotic-resistant one. And if the bacteria causing their infection no longer responds to treatment with these common medicines, this can cause serious complications and lead to hospital admission.
    Antibiotics should be taken or prescribed only when really needed, for example to treat bacterial infections such as sepsis, meningitis or pneumonia. They can also help protect against infection during chemotherapy, Caesarean sections and other common surgeries.
    However they are sometimes prescribed to treat coughs, earache and sore throats, on which they have little or no effect.
    UKHSA chief medical adviser Dr Susan Hopkins said antimicrobial resistance was a "hidden pandemic" and it was important "we do not come out of Covid-19 and enter into another crisis".
    Serious antibiotic-resistant infections "will rise once again if we don't act responsibly", she added.
    "As we head into winter, with increasing amounts of respiratory infections in circulation, it is important to remember that antibiotics are not needed for many cold-like symptoms.
    "Stay at home if you feel unwell," she said.
    "Taking antibiotics when you do not need them only puts you and your loved ones at more risk in the future, so please listen to your GP, nurse, dentist or pharmacist's advice."
    Read full story
    Source: BBC News, 17 November 2021
  11. Patient Safety Learning
    Researchers are to use artificial intelligence (AI) in the hope of reducing risk to pregnant black women.
    Loughborough University experts are to work with the Healthcare Safety Investigation Branch (HSIB) to identify patterns in its recent investigations.
    Research has suggested black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK.
    The researchers plan to look at more than 600 of HSIB's recent investigations into adverse outcomes during pregnancy and birth.
    The research team will develop a machine learning system capable of identifying factors, based on a set of codes, that contribute to harm during pregnancy and birth experienced by black families. These include biological factors, such as obesity or birth history; social and economic factors such as language barriers and unemployment; and the quality of care and communication with the mother.
    It will look at how these elements interact with and influence each other, and help researchers design ways to improve the care of black mothers and babies.
    Dr Patrick Waterson, from the university, who is helping to lead the project, said: "Ultimately, we believe the outcomes from our research have the potential to transform the NHS's ability to reduce maternal harm amongst mothers from black ethnic groups."
    He added that in the longer term, the research could improve patient safety for all mothers.
    Read full story
    Source: BBC News, 17 November 2021
  12. Patient Safety Learning
    A young woman was left with a retained foreign object, after surgery in an India hospital. A checklist could have avoided her death. The response from the health officials was: “We have issued a show-cause notice to the staff seeking an explanation. We will initiate departmental action based on their replies and finding of our inquiry.”
    In the fields of healthcare quality and patient safety, such punitive measures of “naming and shaming” have not worked.
    T.S. Ravikumar, President, AIIMS Mangalagiri, Andhra Pradesh, moved back to India eight years ago with the key motive to improve accountability and safety in healthcare delivery. He believes that we have a long way to go in reducing “preventable harm” in hospitals and the health system in general.  "We need to move away from fixing blame, to creating a 'blame-free culture' in healthcare, yet, with accountability. This requires both systems design for safe care and human factors engineering for slips and violations".
    "Providing safe care without harm is a 'team sport', and we need to work as teams and not in silos, with mutual respect and ability to speak up where we observe any deviation or non-compliance with rules, says Ravikumar. Basic quality tools and root-cause analysis for adverse events must become routine. Weekly mortality/morbidity conferences are routine in many countries, but not a routine learning tool in India.
    He proposes acceleration of the recent initiative of the DGHS of the Government of India to implement a National Patient Safety Framework, and set up an analytical “never events” or sentinel events reporting structure.
    Read full story
    Source: The Hindu, 12 January 2020
  13. Patient Safety Learning
    Politicians and doctors in Germany have called for urgent action to control the spread of COVID-19 after a record number of cases were reported on 11 November.
    Germany had 50 196 new confirmed Covid cases on 11 November, up from 39 676 cases on 10 November and 9658 on 1 November, showed figures from the Robert Koch Institute. A total of 235 Covid related deaths were reported on 11 November, up from 23 on 1 November.
    Speaking in the Bundestag, Germany’s lower house of parliament, the federal vice chancellor, Olaf Scholz, said that immediate steps must be taken to “winterproof” Germany against what is being described as the nation’s fourth wave of Covid-19. Scholz will meet next week with the prime ministers of Germany’s 16 states to discuss new measures to fight the pandemic.
    “The virus is still with us and threatens the health of citizens,” Scholz said, adding that efforts must be intensified to convince unvaccinated Germans to become fully vaccinated and encourage those already vaccinated to have the booster shot."
    Everything must be done, he said, to ensure “that millions of citizens get a booster—that is the task of the next weeks and months.”
    Read full story
    Source: BMJ, 12 November 2021
  14. Patient Safety Learning
    A patient suffering a mental health crisis was made to sleep overnight on the floor of an NHS hospital because it had no spare beds, The Independent has learned.
    On Sunday, Mr Ben Ashcroft was given a mattress on the floor at Barnsley Hospital where he had been admitted after waiting for 36 hours at a different mental health hospital.
    He described the situation as being “treated like a prisoner”, adding: “An animal is treated better than this. I’m poorly and you think this acceptable to put me in room like this. This all I have in room. Rather be in prison.”
    Mr Ashcroft was detained, earlier in the week, under the Mental Health Act at Calderdale Royal Hospital, in West Yorkshire.
    But this hospital had no beds available and transferred him to another site in Barnsley where he was taken to a room with just a mattress.
    In a statement to The Independent, the trust said demand for beds over the weekend was “exceptionally high” adding “with this level of demand we took short-term measures to ensure all our service users were kept safe”.
    Read full story
    Source: 15 November 2021
  15. Patient Safety Learning
    NHS chiefs are advising all hospitals to review their security arrangements in the wake of Sunday’s terrorist incident at Liverpool Women’s hospital, the Guardian can reveal.
    NHS England is finalising new guidance to send to all 213 health trusts in England, which between them provide services at more than 500 hospital sites.
    It will tell them to check that their security measures are adequate and also to ensure that their staff know what to do and how to stay safe if their hospital is targeted by terrorists.
    It is being finalised and will be sent imminently to hospital bosses, who are still taking in the implications of the taxi explosion outside Europe’s largest maternity hospital.
    Many hospitals have beefed up their security over the last year in response to numerous incursions by Covid deniers and anti-lockdown activists and the growing abuse of frontline staff.
    But Sunday’s incident has prompted NHS England to write to all trusts urging them to take any steps needed to ensure they are protected.
    Read full story
    Source: The Guardian, 16 November 2021
  16. Patient Safety Learning
    NHS England is set to launch 15 new specialist clinics for children living with severe obesity after the Covid pandemic shone a ‘harsh light’ on the crisis among vulnerable young people.
    Obesity currently affects one in five children in the UK. Each year, around one thousand children between the age of two to 18-years-old, and their family members, will benefit from the pilot scheme.
    The scheme will also offer access to dietitians, psychologists, specialist nurses, social workers, youth workers and a children’s doctor.
    Amanda Pritchard, chief executive of the NHS in England, described the coronavirus pandemic said: “The pandemic has shone a harsh light on obesity - with many vulnerable young people struggling with weight gain during the pandemic.
    “Left unchecked, obesity can have other very serious consequences, ranging from diabetes to cancer.
    “This early intervention scheme aims to prevent children and young people enduring a lifetime of ill-health.
    “The NHS Long Term Plan committed to take more action to help children and young people with their physical and mental health and these new services are a landmark moment in efforts to help them lead longer, healthier and happier lives.”
    Read full story
    Source: The Independent, 15 November 2021
  17. Patient Safety Learning
    Ambulance handover delays could harm 160,000 patients a year, 12,000 of them severely, according to a structured clinical review of cases by service bosses earlier this year.
    The Association of Ambulance Chief Executives examined a sample of 470 cases where handover to A&E was delayed for an hour or more on 4 January this year. The review, whose findings were shared with HSJ, involved every mainland ambulance service in England.
    It found that 85% of those who waited more than an hour suffered potential harm, with nine per cent potentially severely harmed. 
    Extrapolated across an entire year, using levels of delays up to September 2021, this suggests 160,000 patients are potentially harmed annually. Patients who waited the longest for handover were at greatest risk of some level of harm, and the risk of severe harm more than tripled for those waiting more than four hours compared with those waiting for 60 to 90 minutes.
    Read full story
    Source: HSJ, 14 November 2021
     
  18. Patient Safety Learning
    Nursing shortages are allowing “profiteering” staffing agencies to triple their rates, care leaders have warned, raising the risk of vulnerable patients being forced to move care homes and increasing the burden on the NHS.
    The crisis is forcing some nursing homes to become standard residential care homes without support for people with chronic diseases.
    The shortage also makes it harder for NHS hospitals to discharge patients. Some hospitals have redeployed their own staff into nursing homes to free beds in hospitals. In other places, NHS trusts are competing for staff with care providers.
    Geoff Butcher, director of Blackadder Corporation, which runs six homes in the West Midlands, said that he paid nurses about £19.50 an hour, slightly higher than the NHS rate of £16.52. “Two of our nurses resigned recently and they’ve gone to an agency for £35 an hour,” he said. “And that agency then came to us and said we can have these staff back at £52 an hour. They want £95 an hour for those nurses on a bank holiday nightshift. It’s utterly unaffordable.
    “Because the NHS can’t recruit they are having to use these agencies as well. So the NHS is bidding against us, therefore they’re pushing the rates up, and the whole thing has gone into a completely crazy spiral. The agencies are just grossly profiteering out of it."
    Read full story
    Source: The Guardian, 14 November 2021
  19. Patient Safety Learning
    A loophole in the law is leaving vulnerable patients at risk of abuse and sexual assault by unregulated private ambulance staff, The Independent has revealed.
    While many private ambulance providers are regulated, a small number, such as those providing services at events, those providing first aid, and those who are subcontracted, fall outside the reach of the Care Quality Commission (CQC).
    This is due to a loophole in the legislation, which means that organisations providing healthcare at events are not required to be CQC registered.
    The Independent has learned that around 10,000 patients a day are seen by ambulance workers who are unregulated and not part of any registered professional body.
    Alan Howson, chief executive of the Independent Ambulance Association, said he was concerned about healthcare providers that “operate outside of the scope” of the care watchdog and in “plain sight and unchecked”, leaving patients at risk from staff who might “seek to misuse their power”.
    His concerns were in response to an internal report by the CQC, completed last year, which identified specific risks around sexual harm in relation to private providers, as well as “inconsistency” in providers’ recording of incidents.
    Read full story
    Source: The Independent, 14 November 2021
  20. Patient Safety Learning
    A management coach and adviser to the Care Quality Commission has been appointed as the new ‘national guardian’ for the ’freedom to speak up’ programme.
    Jayne Chidgey-Clark will take up her new role on 1 December. The national guardian’s office leads, trains and supports the network of over 700 freedom to speak up guardians in England, as well as providing “challenge and learning to the healthcare system”.
    Ms Chidgey-Clark, a registered nurse, has served as a specialist adviser to the CQC since 2017. She has run her own coaching, consultancy and interim management business since 2009. She was a clincial adviser to NHS England’s new care models programme for three years until 2018 and the director of the end of life care modernisation project at Guy’s and St Thomas’ Foundation Trust between 2008 and 2011.
    Her appointment comes after Henrietta Hughes announced in June she was stepping down from the role after five years.
    Ms Chidgey-Clark, who is the third appointee to the position, said: “I feel excited and privileged to have been appointed as the new National Guardian for the NHS. I am passionate about, and committed to, making a real difference in people’s lives through the planning and delivery of the highest quality, effective care with excellent outcomes for people who use our health services, and their families.”
    Read full story (paywalled)
    Source: HSJ, 11 November 2021
  21. Patient Safety Learning
    People are dying in the back of ambulances and up to 160,000 more a year are coming to harm because they are stuck outside hospitals unable to be offloaded to A&E, a bombshell report has revealed.
    Patients are also dying soon after finally getting admitted to hospital after spending long periods in the back of an ambulance, while others still in their own homes are not being saved because paramedics are trapped at A&E and unable to answer 999 calls, said the report by NHS ambulance service bosses in England.
    In addition, about 12,000 of the 160,000 are suffering “severe harm” such as a permanent setback to their health. These include people with life-threatening health emergencies such as chest pains, sepsis, heart problems, epilepsy and COVID-19 because growing numbers of paramedics are having to wait increasingly long times to hand over a patient to A&E staff.
    Labour and the Liberal Democrats said the “staggering” extent of damage to patients’ health underlined the risks posed by the deepening crisis facing NHS ambulance services.
    The report, seen by the Guardian, has been drawn up by the Association of Ambulance Chief Executives (AACE) and is based on official NHS figures, which until now were secret. AACE represents the chief executives of England’s 10 regional ambulance services, all of which have had to declare an alert in recent months after being faced with unprecedented demands for help.
    It concludes that: “When very sick patients arrive at hospital and then have to wait an excessive time for handover to emergency department clinicians to receive assessment and definitive care, it is entirely predictable and almost inevitable that some level of harm will arise.
    “This may take the form of a deteriorating medical or physical condition, or distress and anxiety, potentially affecting the outcome for patients and definitely creating a poor patient experience.”
    Read full story
    Source: The Guardian, 14 November 2021
  22. Patient Safety Learning
    Nursing leaders have highlighted 10 pressures on health and social care services which they say have created “unsustainable, untenable” conditions.
    A report from the Royal College of Nursing (RCN) said members working across health and social care in England dispute statements that the current situation in health and care is sustainable.
    NHS hospital waiting times is listed as one of the 10 indicators with the report referring to this issue as “clearly a symptom of an unsustainable system”.
    The report, 10 Unsustainable Pressures on the Health and Care System in England, refers to “corridor care” – time spent on trolleys in hospital corridors before being admitted to a hospital bed.
    “We are clear that delivery of care within inadequate environments such as that frequently referred to as ‘corridor care’ or ‘corridor nursing’ is fundamentally unsafe and must not be normalised,” the report says.
    The 10 pressures also include high COVID-19 infection rates, NHS nursing workforce vacancy rate, social care workforce vacancies and NHS elective/community waiting times.
    The report says: “Action needs to be taken to retain as many nursing staff as possible in light of serious staffing vacancies, as well as high levels of exhaustion and burnout.
    Read full story
    Source: The Guardian, 15 November 2021
  23. Patient Safety Learning
    Blood pressure drugs could prevent millions of people worldwide from developing type 2 diabetes, a large study suggests.
    Lowering high blood pressure is an effective way to slash the risk of the disease in the future, according to the research published in the Lancet.
    Doctors already prescribe cheap blood pressure drugs to reduce the chances of a life-threatening heart attack or stroke. However, until now, the question of whether these drugs could also help fend off the threat of type 2 diabetes had been unanswered.
    Now researchers have found the protective effects of the drugs are much wider than previously thought. The study shows they may directly reduce someone’s risk of type 2 diabetes, a condition that an estimated 13.6 million people in the UK are at high risk of developing.
    Currently, health experts say being a healthy weight and adopting a healthy lifestyle is the best way to reduce the risk of type 2 diabetes. Researchers say existing drugs – particularly ACE inhibitors and ARBs – should now be considered for some patients who are at higher risk of the disease.
    Prof Kazem Rahimi, lead researcher of the study at the University of Oxford and a consultant cardiologist, said: “Our research provides clear evidence that giving ACE inhibitors or ARBs, which are widely available and affordable worldwide, to patients at high risk could curb the growing burden of type 2 diabetes.”
    Read full story
    Source: The Guardian, 11 November 2021
  24. Patient Safety Learning
    A boy who suffered "catastrophic brain injuries" when doctors failed to see he had a virus and sent him home after he had a seizure has been awarded £27m.
    The boy, who cannot be identified but is now 13, suffered seizures as a toddler more than a decade ago.
    Details of the settlement between the boy's father and Liverpool's Alder Hey Children's NHS Foundation Trust were published in a written ruling.
    High Court judge Mr Justice Fordham said it was a "sensible settlement".
    Trust bosses admitted "breach of duty" and "causation of loss and damage", the judge said.
    The judgment, from the hearing in Manchester, said the boy had suffered a seizure at 17 months old on 19 September 2009 and was taken to Alder Hey Children's Hospital.
    He suffered a second seizure in the accident and emergency department which was seen by medical staff. The boy was sent home and, despite going back to hospital, was not diagnosed with a virus until 24 September.
    Read full story
    Source: BBC News, 12 November 2021
  25. Patient Safety Learning
    Family doctors have reopened their bitter dispute with the government by accusing Sajid Javid of misleading MPs and the public by blaming overloaded A&Es on a lack of GP appointments.
    The Royal College of GPs has told the health secretary in a strongly worded letter that there is no basis for the claim, which he made to MPs last week and which was widely covered by the media.
    In it Prof Martin Marshall, the college’s chair, said that its 54,000 members “are dismayed and disappointed at the media coverage of your evidence session, which suggested that the lack of face-to-face GP appointments was placing additional strain on accident and emergency departments”.
    He disputed Javid’s claim that there is evidence which links the issues.
    He wrote: “You told the [health and social care select] committee you had seen data which showed that more patients were presenting at A&E departments because they were unable to access primary care. I am not aware of any evidence to suggest that this is happening and would welcome sight of any data you have.”
    Tensions are simmering between GPs and the government since Javid’s edict last month that GPs in England must see any patient who wants an in-person appointment.
    Read full story
    Source: The Guardian, 12 November 2021

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