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Patient Safety Learning

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  1. Patient Safety Learning
    Mandatory Covid vaccinations will be imposed on NHS staff, despite fears it could cause a workforce exodus, The Independent understands.
    Sources have confirmed the government is expected to make an announcement tomorrow on plans to make jabs a condition of employment for the 1.3 million NHS staff in England.
    Ministers are likely to delay the new requirement until next spring, after health bosses raised concerns over the impact it would have on NHS staffing levels during this winter.
    Earlier this week. NHS Providers, which represents NHS trusts in England, warned the imposition of vaccinations could drive staff out of the NHS. Around 100,000 workers are yet to have a Covid vaccination.
    Chris Hopson, chief executive of NHS Providers, warned the government needed to acknowledge the risk to patient safety if thousands of unvaccinated NHS staff opted to leave their jobs rather than have the vaccine.
    Read full story
    Source: The Independent, 3 November 2021
  2. Patient Safety Learning
    Huge waiting lists have left patients questioning whether their lives are worth living, a surgeon has warned.
    Paul Williams, an orthopaedic surgeon at Neath Port Talbot Hospital, dubbed the effect of long delays on mental and physical health "horrific".
    A health think-tank said waiting times were the biggest challenge the NHS in Wales has ever faced. The Welsh government said it wanted to "radically transform" how healthcare was delivered.
    Mr Williams said: "To be living with pain from an arthritic joint is terrible.
    "We sent out a questionnaire recently and many of the patients have actually replied that they're questioning if their life is worth living because of the pain they're in."
    The latest figures for the Welsh NHS showed another record high for those waiting for hospital treatment.
    The number of patients waiting more than 36 weeks has grown from 25,634 in February 2020 to 243,674 by August 2021. The longest waits included 56,279 people who needed orthopaedic or trauma treatment.
    Read full story
    Source: BBC News, 3 November 2021
  3. Patient Safety Learning
    The NHS vaccination programme to prevent cervical cancer has so far stopped thousands of women from developing the disease and experiencing pre-cancerous changes to cells, a study has found.
    In the first proof that the programme launched in England 13 years ago is saving lives, the Cancer Research UK-funded study found that cervical cancer rates in women offered the vaccine between the ages of 12 and 13 (now in their 20s) were 87% lower than in an unvaccinated population.
    Researchers said cases in this age group, which are rare, dropped from about 50 per year to just 5.
    There were also reductions in cervical cancer rates of 62% in women offered vaccination between the ages of 14 and 16, and 34% in women aged 16 to 18 when vaccination was introduced.
    Professor Peter Sasieni, lead study author, from King’s College London, said: “It’s been incredible to see the impact of HPV vaccination and now we can prove it prevented hundreds of women from developing cancer in England.
    Read full story
    Source: The Guardian, 4 November 2021
  4. Patient Safety Learning
    Planned operations including ”priority two” procedures were postponed at short notice at one of England’s largest hospital trusts earlier this week due to rising covid compounding other operational pressures, HSJ understands.
    Several sources said Leeds Teaching Hospitals Trust cancelled the large majority of elective operations scheduled for Tuesday 2 November due to rising occupancy in intensive care and throughout the trust, particularly linked to increasing numbers of covid patients.
    The postponed operations included ‘priority two’ cases, which must be undertaken within one month to avoid further harm and deterioration, a well placed source told HSJ.
    The trust said it did not, however, cancel ‘priority one’ urgent operations, which must be performed within 72 hours. It said most elective operations resumed on Wednesday as pressure had “eased a little” since Tuesday. Some daycase surgery was also postponed, it said, as areas had to be repurposed for emergency care.
    One concerned family member of a Leeds patient whose operation was cancelled, who contacted HSJ, said: ”My relative is on the cardiology list and might not be fit enough for the op if there are further delays — that could be fatal.”
    Read full story (paywalled)
    Source: HSJ, 4 November 2021
  5. Patient Safety Learning
    The COVID-19 crisis triggered high levels of anxiety and depression among doctors in the UK, Italy and Spain, a new study has found
    The research of 5,000 survey responses, across the three countries, found Italian doctors were most likely to have suffered during the crisis last year.
    The study, published in PLOS ONE, measured the mental wellbeing of doctors in Catalonia (Spain), Italy and the UK during June, November and December 2020.
    It found that around one in four medical doctors in Italy had experienced symptoms of anxiety in June and December 2020, with around one in five reporting symptoms of depression over the same period.
    In Catalonia around 16% of doctors reported anxiety and around 17% experienced depression. In the UK around 12% of doctors reported anxiety and around 14% had symptoms of depression.
    The study is among the first cross-country analysis of mental wellbeing among healthcare workers during the COVID-19 pandemic and the first to focus on medical doctors.
    Across all countries, female doctors and doctors under 60 were more likely to have anxiety or depression.
    Professor Quintana-Domeque, professor of economics at the University of Exeter Business School, who carried out the study said: “The COVID-19 pandemic has been classified as a traumatic event, with healthcare workers arguably having the most direct and longest exposure to this disease."
    “The results of this study suggest that institutional support for healthcare workers, and in particular doctors, is important in protecting and promoting their mental health in the current and in future pandemics.”
    Read full story
    Source: The Independent, 3 November 2021
  6. Patient Safety Learning
    About 1,600 fewer people than expected were diagnosed with the three most common cancers during the first nine months of the Covid pandemic.
    Public Health Scotland (PHS) has attempted to work out how restrictions put in place at the start of coronavirus affected diagnosis of the disease. The statistics show that breast cancer diagnosis was down by 19%, bowel cancer by 25% and lung cancer by 9%.
    The data also showed cancer was not being diagnosed at the earliest stages. This is when treatment is most successful.
    Cancer Research UK called for urgent action to prevent progress on cancer survival going backwards.
    David Ferguson, from Cancer Research UK in Scotland, said the PHS report reinforced fears that opportunities to diagnose cancer at an early stage were missed during the pandemic.
    He said: "Urgent action is needed. Cancer survival wasn't good enough before the pandemic. Too many people are waiting far too long for diagnosis and treatment so this must be addressed."
    He called for a "road map" to tackle staff shortages and backlogs.
    "If swift action isn't taken, our fear is that cancer survival in Scotland could go backwards," he said.
    Read full story
    Source: BBC News, 3 November 2021
  7. Patient Safety Learning
    This week is the MHRA's sixth annual #MedSafetyWeek social media campaign. 
    This year’s campaign theme is reporting suspected side effects following vaccination. This forms part a global effort by national medicines regulatory authorities from over 60 countries and their stakeholders to raise awareness about the importance of reporting.
    Vaccines are life-saving medicinal products that are given to protect individuals against serious infections and sometimes the most effective way to prevent infectious diseases.
    The MHRA are calling on all healthcare professionals (HCPs), national immunisation programme staff, as well as patients, their carers and families to report suspected side effects from vaccines or medicines to the MHRA Yellow Card scheme.
  8. Patient Safety Learning
    Ambulance handover delays lasting more than 60 minutes have increased four-fold compared to this time last year, according to internal NHS data.
    NHS data seen by HSJ suggests there were around 28,900 ambulance handovers lasting longer than an hour during a four-week period in October. This was almost four times higher than the 7,772 hour-long handovers recorded in October 2020.
    It is also significantly higher than the 17,137 seen in January 2021, which was the peak of the coronavirus pandemic.
    Last week NHS England wrote to trusts and integrated care systems telling them to take urgent action to “immediately stop all delays” to ambulance handovers, and that “corridor care” is “unacceptable as a solution”.
    Read full story (paywalled)
    Source: HSJ, 3 November 2021
  9. Patient Safety Learning
    Mandating COVID-19 vaccinations for all health service staff should be delayed until spring to enable the health service to get through the busy winter period, an NHS leader has urged.
    Ministers have been considering whether or not to introduce mandatory jabs for all NHS staff in England. Health and social care secretary Sajid Javid said last week he is ‘leaning towards’ making the jabs compulsory as there are about 100,000 NHS workers not fully vaccinated.
    NHS Providers chief executive Chris Hopson said that if the government was to press ahead, it should delay until April to ensure the NHS can get through the ‘difficult winter’.
    Plans for mandatory jabs for staff who work or volunteer in care homes in England were announced in June, with an 11 November deadline for staff to have had both doses of vaccine, unless medically exempt.
    However, Loss of vaccine-hesitant staff may compromise patient safety. Mr Hopson cited cases in Cornwall where NHS staff have been drafted in to help the social care sector.
    "If we lose large numbers of unvaccinated staff, particularly over the winter period, then that also constitutes a risk to patient safety and quality of care," he told BBC Breakfast.
    "We know that we’ve got a very, very difficult winter coming up and we know the NHS is going to be absolutely at full stretch. ‘So it makes sense to set the deadline once that winter period has passed. We know that January, February and often early March is very busy, so that’s why we’re saying that an April 2022 deadline is a sensible time.’
    Read full story
    Source: Nursing Standard, 1 November 2021
  10. Patient Safety Learning
    Trusts are still spending at least £1m a year on settlement agreements with staff containing ‘gagging clauses’ despite a crackdown on these conditions in recent years, HSJ research reveals.
    Freedom of information responses reveal 214 settlement agreements with confidentiality conditions worth £4.6m across three years
    NDAs — which are also known as “confidentiality clauses” or “gagging clauses” and prevent parties to a settlement agreement from disclosing its details — also seem to be becoming less popular. HSJ’s FOIs revealed 119 settlement agreements with an NDA with a total value of £2.16m, in 2018-19. In 2019-20, this fell to 87 such agreements with a total value of £1.5m. In 2020-21, there were 41 settlement agreements with such a clause, with a total value of £1.04m.
    A source with knowledge of confidentiality agreements in the NHS said: “Following some high-profile whistleblowing cases a few years ago… NHS organisations have been far more cautious in imposing confidentiality obligations in settlement agreements.”
    Numerous health secretaries have issued warnings about NDAs potentially being used to silence staff. In 2019, former health and social care secretary Matt Hancock said: “Settlement agreements that infringe on an individual’s right to speak out for the benefit of patients are completely inappropriate.”
    In 2013, then health secretary Jeremy Hunt said he would ban clauses in compromise agreements — as settlement agreements were then known — preventing NHS staff from raising patient safety concerns. After the Mid Staffordshire report was published, he wrote to all trust chairs, asking them to review the confidentiality clauses they were using.
    Read full story (paywalled)
    Source: HSJ, 1 November 2021
  11. Patient Safety Learning
    "What has happened to us is home-grown, institutionalised female genital mutilation," says Mary Lodato, 63, a mother of three and a university researcher, from Kettering in Northamptonshire.
    "It has been a systemic failure in health and care and it was totally avoidable."
    What Mary is referring to are complications due to implanted surgical mesh, designed to treat post-childbirth pelvic damage in women, which has left thousands effectively crippled as the material disintegrated inside their bodies, and sheared into the tissue, causing a range of devastating symptoms including pain, difficulty walking and sexual dysfunction.
    An eight-year Good Health campaign to get official recognition of the problem led to the establishment of a government inquiry under the leadership of former Conservative health minister Baroness Julia Cumberlege.
    Although the inquiry report was published in July 2020, some of its key recommendations have still not been implemented, leaving thousands of women suffering and not getting the help they need.
    Seven specialist NHS mesh removal clinics were meant to open in April this year in London, Cambridge, Manchester, Newcastle, Nottingham, Sheffield and Leicester. But the affected women claim a shortage of specialists has meant that only two are functioning — at University College London Hospital and Southmead Hospital in Bristol (which was not on the original list).
    They also say that it's extremely difficult to get a referral to one of these new centres and even if they do, waiting times can stretch into years.
    "To the doctors who originally treated us, these operations weren't anything major — but to us it was a catastrophically painful loss of work, family life and intimacy," says Mary. 
    Mary's story is one familiar to almost 10,000 women who have joined an anti-mesh group called Sling the Mesh, and a number of other support organisations.
    Read full story
    Source: Mail Online, 1 November 2021
    Blogs from Kath Sansom, Sling the Mesh
    Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies
    Ineffective medical device recalls are a patient safety scandal
  12. Patient Safety Learning
    A major trust’s Freedom To Speak Up Guardian has warned that a failure to address staff concerns about alleged bullying and long-standing ‘dysfunctional behaviours’ is damaging confidence and resulting in the loss of high-quality staff.
    Professor Julian Bion, presenting a half-yearly report to University Hospitals Birmingham Foundation Trust’s board, revealed that the majority of the 41 reports to the FTSU service between April and October this year had expressed a “fear of detriment” when raising concerns.
    Just under half (44%) of 34 concerns raised by the contacts related to “problematic attitudes and behaviours”, ranging from reports of micro-aggressions to overt bullying.
    Professor Bion, UHB’s FTSU guardian since 2019, told HSJ such concerns are always “complex and sensitive issues” and recognised that the trust is handling them during “difficult circumstances” for the NHS. UHB has seen very large numbers of covid patients throughout much of the pandemic.
    But he warned the board that several “common themes” were emerging in UHB’s complaints process – including a fear of detriment, “problematic” delays to cases being resolved, and a lack of response from divisional departments.
    Suggesting there is a “disinclination” within the trust to address concerns, he said: “Very often, these dysfunctional behaviours are known about for a long time but they haven’t been addressed.”
    Read full story (paywalled)
    Source: HSJ, 2 November 2021
  13. Patient Safety Learning
    Misdiagnosed Type 1 diabetes patients could be freed from the need to take insulin after a new test is rolled out.
    Scotland will become the first country to offer the C-peptide blood test to all patients who have had a Type 1 diagnosis for at least three years. The test shows how much insulin a patient's body is producing itself.
    A pilot by NHS Lothian allowed some people who had been taking insulin to stop or reduce the treatment. The test will be available from 1 November.
    C-peptide testing, which has been used as part of diagnosis for some patients for many years, can help distinguish whether a patient has Type 1 or Type 2 diabetes. C-peptide is made in the body at the same time as insulin. By testing levels of C-peptide, doctors can work out how much insulin a diabetes patient is making themselves.
    If C-peptide is present in significant amounts, it might indicate that the person does not have Type 1 diabetes at all, and consequently may not need daily insulin injections.
    The tests will be offered at hospital diabetes centres.
    Public Health Minister Maree Todd said that tackling diabetes was a priority for the Scottish government and that she wanted everyone living with diabetes to access safe, effective healthcare, treatment and support.
    She said: "Type 1 diabetes is a significant health challenge right across the world."
    Read full story
    Source: BBC News, 31 October 2021
  14. Patient Safety Learning
    It is coming up to a year since the first mRNA vaccines were approved for use against COVID-19, and almost seven months since they were approved for expectant mothers. The initial government advice was was that they should hold off getting a jab, but since more data has become available, medical experts have been encouraging women to get vaccinated. But there has been no big government awareness campaign, despite pregnant women being identified as a vulnerable group. The proportion of fully vaccinated pregnant women in the UK is as low as 15% (in the US, it is more than twice that, at 33.8%).
    That such a small porportion of pregnant women are fully vaccinated in the UK, seven months after vaccines were approved for them, is nothing short of a scandal. And more women and their babies are at risk of dying because of it. Recent figures for England show that one in six critically ill patients are unvaccinated pregnant women with Covid. Of the 20 pregnant women requiring the highest level of life-saving care, 19 were unvaccinated and one had received one dose.
    These are frightening statistics, but on their own they do not seem to be enough to persuade pregnant women to get vaccinated. In order to do that, it’s important to understand why we are seeing such high levels of hesitancy...
    Read full story
    Source: The Guardian, 29 October 2021
  15. Patient Safety Learning
    A new information standard has been developed for sharing digital information on medication and allergies across different parts of health and social care services.
    The standard, which aims to reduce medicines errors comes into effect this month. NHS and social care organisations will have to show compliance by March 2023.
    GP practices, hospitals, mental health trusts, pharmacists, community teams and residential care homes will all have to meet the standard when transferring medication and prescription information between teams.
    The standard will be particularly helpful in reducing medication errors when patients transfer between care locations NHS Digital said.
    Having specific requirements in place for how medicine and allergy information is transferred will also provide clinicians with a more detailed and consistent source of medicines related information across all care settings and allow them to obtain medicines information more quickly and efficiently, they added in a document outlining the changes. 
    The standard defines how the send and receive messages involving medicines information are constructed, and how the data within is structured so that it is machine-readable when sent between different IT systems.
    Dr Simon Eccles, deputy CEO of NHSX and national chief clinical information officer said:
    ‘This new standard will make medicine prescribing safer for patients and easier for clinicians, reducing errors in prescription and improving the monitoring of medications that can cause harm.
    ‘This is the result of a true collaborative effort between NHSX, NHS Digital, industry and the frontline that will make a real difference to the care and support local clinicians can provide to their patients."
    Read full story
    Source: Pulse, 28 October 2021
  16. Patient Safety Learning
    A decade after scientists identified a link between certain implants and cancer, the US Food and Drug Administration has ordered “black box” warnings and a new checklist of risks for patients to review.
    Federal regulators have placed so-called black box warnings on breast implant packaging and told manufacturers to sell the devices only to health providers who review the potential risks with patients before surgery.
    Both the warnings and a new checklist that advises patients of the risks and side effects state that breast implants have been linked to a cancer of the immune system and to a host of other chronic medical conditions, including autoimmune diseases, joint pain, mental confusion, muscle aches and chronic fatigue.
    Startlingly, the checklist identifies particular types of patients who are at higher risk for illness after breast implant surgery. The group includes breast cancer patients who have had, or plan to have, chemotherapy or radiation treatments.
    That represents a large percentage of women who until now were encouraged to have breast reconstruction with implants following their treatment.
    Reactions to the new requirements were mixed. While some doctors welcomed the new warning system, others worried that the potential risks and side effects would not be conveyed adequately by plastic surgeons who were eager to reassure patients the procedure is safe and that the new checklist would be handled in a dismissive manner.
    But Dr. Mark Clemens, a professor at M.D. Anderson Cancer Center in Houston who serves a liaison to the F.D.A. for the American Society of Plastic Surgeons Society, said the black box warning and checklist represented “a huge step forward for patient safety and implants.”
    Read full story
    Source: The New York Times, 27 October 2021
  17. Patient Safety Learning
    Covid booster jabs are now being given at walk-in clinics in England as the NHS aims to increase vaccine uptake before what is expected to be a challenging winter.
    From Monday, anyone in an eligible group who had their second dose of a coronavirus vaccine at least six months ago can turn up at one of hundreds of sites to get their top-up without making an appointment. The walk-in centres are also offering vaccinations to 12- to 15-year-olds.
    The move follows criticism of the booster campaign, with only about half of the 12 million people in England eligible so far for a third vaccine dose having received one. The vaccine rollout to teenagers has lagged behind that of countries including France, Italy and Spain.
    People entitled to a booster jab are: those aged 50 and over, people who live and work in care homes; frontline health and social care workers; people aged 16 and over with a health condition that puts them at high risk of getting seriously ill from Covid-19; those aged 16 and over who are a main carer for someone at high risk from the virus, and; people aged 16 and over who live with someone who is more likely to get infections.
    Nikki Kanani, a GP and the deputy lead for the NHS Covid-19 vaccination programme, said: “NHS staff are making it as easy as possible for people to get their top-up vaccination, and from today people can now go online, find their nearest site and go and get their booster without delay.
    “The booster is not just nice to have. It is really important protection ahead of what we know will be a challenging winter.”
    Read full story
    Source: The Guardian, 1 November 2021
  18. Patient Safety Learning
    Patients are being put at "catastrophic risk" of harm due to ambulance handover delays, health bosses say.
    West Midlands Ambulance Service (WMAS) has raised its risk rating for such delays to its highest level for the first time in its history. The risk rating shows the trust believes patient harm is "almost certain" due to the handover hold-ups.
    Mark Docherty, director of nursing and clinical commissioning, said it was a "completely unacceptable situation".
    It comes as a patient died after waiting more than five hours in the back of an ambulance in Worcestershire.
    At a meeting on Wednesday, the ambulance service's board of directors heard the amount of time being lost to delays had reached previously unseen levels, the Local Democracy Reporting Service said.
    Mr Docherty warned the situation was set to get worse over the coming months as a result of winter pressures.
    "Despite everything we are doing by way of mitigation, we know that patients are coming to harm as a result of delays," he said.
    "We know that there are patients that are having significant harm and indeed, through our review of learning from deaths, we know that sadly some patients are dying before we get to them."
    Read full story
    Source: BBC News, 28 October 2021
  19. Patient Safety Learning
    Former health secretary Jeremy Hunt has warned extra funding for the NHS “will unravel quickly” without the extra doctors and nurses needed.
    The health committee chair said today that the lack of any mention of workforce training budgets in the Chancellor’s speech on Wednesday was “the big gap” in news for the NHS.
    Before the budget, Mr Hunt, who served as health secretary for six years and who has accepted he did not do enough to increase staffing levels in the NHS, said a workforce plan for the NHS was needed.
    In the budget documents, released after the Chancellor Rishi Sunak had finished speaking, the Treasury confirmed only that it would continue to fund workforce training and repeated existing promises around 50,000 extra nurses.
    But many experts including the Health Foundation and think tanks as well as NHS leaders have said what is needed is a properly costed long term workforce plan so that the NHS can train enough staff to meet future patient demand.
    Read full story
    Source: The Independent, 28 October 2021
  20. Patient Safety Learning
    Deborah Birx, who was the White House coronavirus response coordinator under President Donald Trump, has told a congressional inquiry that at least 129 000 lives could have been saved if his administration had provided adequate testing and properly communicated the gravity of the situation to the public.
    But the election year “just took people’s time away and distracted them from the pandemic,” she told the House Select Subcommittee on the Coronavirus Crisis. “I felt like the White House had gotten somewhat complacent through the campaign season.”
    Asked if Trump did everything he should have to counter the pandemic, she said, “No. And I’ve said that to the White House. I believe I was very clear to the president in specifics of what I needed him to do.”
    “If we had fully implemented the mask mandates, the reduction in indoor dining, the getting friends and family to understand the risk of gathering in private homes, and we had increased testing, then we probably could have decreased fatalities by 30-40%.” That would amount to at least 129 000 preventable covid deaths over the course of the Trump presidency, which saw roughly 429 000 reported deaths attributed to the coronavirus."
    Read full story
    Source: BMJ, 28 October 2021
  21. Patient Safety Learning
    A senior doctor has warned that paediatric intensive care units (PICUs) are ‘as pressured as I can ever recall’ – despite the absence of cold weather, which typically leads to higher demand levels.
    James Fraser, president of the Paediatric Critical Care Society, said national bed occupancy in PICUs has “often been greater than 95 per cent” over recent weeks, while several units have reported 100 per cent occupancy. He said some children have had to be transferred between regions in order to admit them to a bed.
    PICUs are often under more pressure during winter, due to seasonal RSV and other viral infections.
    But high demand levels have started earlier this year, which has meant severely ill children have occasionally waited longer in local hospitals before being admitted to PICUs, and have sometimes had to be transferred to another site.
    Mr Fraser told HSJ: “[PICUs] are really busy, as pressured as I can ever recall them.
    “Every winter PICUs are under huge pressure due to seasonal RSV bronchiolitis. This usually happens between November and February. This year we always anticipated it would be a much longer season. It’s putting a lot of pressure on our national bed base.
    “What is different is we have been under this pressure earlier in the year with RSV and other viral chest infections. We have been under this pressure for a month. The pressure is both the number of patients and there are a lot of staff off having to self-isolate."
    Read full story (paywalled)
    Source: HSJ, 29 October 2021
  22. Patient Safety Learning
    The NHS and private hospitals need to improve how they work together after the death of an NHS patient treated privately during the pandemic, a watchdog has warned.
    An investigation by the Healthcare Safety Investigation Branch (HSIB) found some private hospitals took on more complex patients than they were used to, while problems with communication and confusion over responsibilities created safety risks.
    It has called on the Care Quality Commission to do more to inspect how the two sectors work together and how patients are transferred between hospitals safely.
    It launched an inquiry after the death of a patient, known as Rodney, aged 58, who was due to have keyhole surgery to remove part of his bowel due to cancer.
    His NHS operation was cancelled and rebooked at a nearby private hospital after cancer services were transferred to the independent hospital due to COVID-19.
    Rodney was asked to sign a consent form for open bowel surgery, rather than the less invasive keyhole procedure, due to guidance at the time around a "potentially increased risk of COVID-19 transmission with laparoscopic surgery", the HSIB said.
    The cancerous part of his bowel was removed but eight days later his condition he deteriorated rapidly and was transferred to the local hospital so he could receive intensive care - which was not available at the private hospital.
    When he arrived at the NHS hospital, a scan and more surgery showed a leak in his bowel which led to sepsis and organ failure. He died later that day.
    As a result of the case, the HSIB launched a wider investigation into NHS surgical services being carried out in independent hospitals.
    Read full story
    Source: The Independent, 28 October 2021
  23. Patient Safety Learning
    GPs are set to be balloted on industrial action over controversial reforms proposed by health secretary Sajid Javid.
    The “outraged” doctors in England have voted unanimously to reject the government’s plans at a British Medical Association (BMA) meeting.
    The government wants to see GP surgeries ranked in league tables to “name and shame” those that do not carry out enough face-to-face appointments with their patients.
    From early November, GPs will have to have their names and wages published if they earn an NHS salary of more than £150,000.
    The BMA says that forcing GPs to publish their earnings “provides no benefit to patients or their care, yet will potentially increase acts of aggression towards GPs, will damage morale amongst the profession, and only worsen practices’ ability to recruit and retain GPs”.
    GP surgeries will not be eligible for new funding if they fail to provide an “appropriate” number of in-person consultations. Patients will also be asked to rate their GPs via text message.
    Mr Javid has insisted that his plans would improve patients’ access to primary care – but the union representing the GPs says it has been “left with no alternative” but to ballot over whether to take industrial action.
    Read full story
    Source: The Independent, 22 October 2021
  24. Patient Safety Learning
    A major hospital has declared a “critical incident” after a surge in demand saw more than 100 patients awaiting treatment in A&E and 25 ambulances queueing outside.
    The Royal Cornwall Hospital Treliske, in Truro said “unprecedented” pressure this week is worse “than at any point during the pandemic.”
    It urged “families, friends and neighbours” to collect any patients who are able to “to leave hospital sooner.”
    Managers at Cornwall’s main hospital raised the operating level from OPEL4 — known as a ‘black alert’ — to an ‘internal critical incident’ to allow for greater cooperation to ease the crisis.
    It comes as the government is under intense pressure to reimpose some COVID-19 measures amid a surge in cases, with many other NHS clinics and hospitals across the country facing similar pressure.
    Allister Grant, medical director of the RCHT, said: “There is unprecedented demand on health and care services in Cornwall, more so this week than at any point during the pandemic.
    “As a result, we have escalated our operational level from OPEL4 to an internal critical incident.
    “Pressure will always be most visible at the Emergency Department where ambulances are waiting, and our priority here is to move people into wards as soon as we can.”
    Read full story
    Source: The Independent, 21 October 2021
  25. Patient Safety Learning
    Tens of thousands of defibrillators across the UK risk being unusable because 999 call handlers do not know about them.
    When someone has a cardiac arrest, ambulance staff can only direct bystanders to the nearest defibrillator if it is on a central register.
    "That could be the difference between life and death," said Adam Fletcher, head of British Heart Foundation Cymru.
    A campaign to register defibrillators on The Circuit has now been launched.
    Survival rates are low in the more than 30,000 out-of-hospital cardiac arrests each year in the UK, according to the British Heart Foundation (BHF) - with fewer than one in 10 people surviving.
    BHF said early CPR and defibrillation could double the chances of surviving and it was often down to 999 call handlers being aware that a defibrillator was nearby.
    "If we don't know a defibrillator is there, we can't send somebody to get it, to potentially save somebody's life," said Carl Powell, the clinical support lead for cardiac care with the Welsh Ambulance Service.
    Read full story
    Source: BBC News, 22 October 2021

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