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Patient Safety Learning

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  1. Patient Safety Learning
    More than 3.7 million vulnerable people in England will no longer have to shield from the coronavirus from 1 April.
    It comes as the numbers of COVID-19 cases and hospital admissions have declined for the past couple of weeks.
    Letters will be sent out to this group in the next two weeks. In them, people will still be advised to keep social contacts at low levels, work from home where possible and stay at a distance from other people.
    Since 5 January, they have been asked to stay at home as much as possible to reduce their risk of being exposed to the virus. But at a Downing Street press conference, Health Secretary Matt Hancock confirmed shielding guidance, which had been extended to 31 March for all those who are clinically extremely vulnerable, would end on 1 April.
    England's deputy chief medical officer Dr Jenny Harries recommended the change based on the latest scientific evidence and advice.
    Read full story
    Source: BBC News, 17 March 2021
  2. Patient Safety Learning
    The COVID-19 Bereaved Families for Justice group has told Downing Street it wants a statutory public inquiry led by a senior judge to “determine a definitive, official, evidence-based narrative of what did and did not happen, independent of political influence” during the pandemic. The group considers it potentially cathartic and wants the families’ grief heard.
    Frontline health workers also want a wide-ranging inquiry to provide a platform for their experiences, while minority ethnic leaders believe an inquiry can only determine what went wrong if wider societal inequalities relating to work, health and housing are investigated.
    But while there is no dissent about the need for an inquiry, others fear this remit might be too broad – and fear lessons have to be learned now so the UK can properly protect itself from any future health emergency.
    Sir John Bell, the regius professor of medicine at Oxford University, and Lord O’Donnell, head of the civil service under Tony Blair, Gordon Brown and David Cameron, want a different model more narrowly focused on determining future actions.
    Ultimately the decision will be for Boris Johnson, who has significant latitude to set the terms and scope of any inquiry, including selection of its chair.
    Read full story
    Source: The Guardian, 16 March 2021
  3. Patient Safety Learning
    With the annual NHS Staff Survey recently published, expectation was that this year might look a little different, all things considered.
    For the mental health sector, the dial didn’t move massively on key questions. The sector still came out bottom for staff who agreed they’d be happy with the standard of care if a friend or family member needed it - otherwise called the “family and friends test”.
    Although the survey was not that revelatory this year, it is still a helpful barometer for trusts’ safety and quality culture.
    Sheffield Health and Social Care Foundation Trust comes out lowest on all of the main quality and safety-related questions. 
    On the crucial family and friends question, just 47% of the trust’s staff agreed that would be happy with the standard of care. The trust has been one of the worst performers on the survey for a number of years but appears to have deteriorated further.
    Sheffield Health and Social Care FT also came out worst on the following key safety culture related questions:
    When errors, near misses or incidents are reported, my organisation takes action to ensure that they do not happen again I would feel secure raising concerns about unsafe clinical practice My organisation acts on concerns raised by patients/service users. The last two questions are a vital indicator of a trust’s approach to safety and quality. If staff do not feel secure to raise concerns, or if a trust does not act on patient concerns can it really address problems before they escalate?
    Read full story (paywalled)
    Source: HSJ, 12 March 2021
  4. Patient Safety Learning
    People in prisons are at an increased risk of COVID-19, with a death rate more than three times higher than that of the general population, and should be made a vaccine priority, according to public health experts.
    There were 118 deaths related to COVID-19 among people in prisons in England and Wales between March 2020 and February 2021, representing a risk of dying more than three times higher than that of people of the same age and sex outside secure environments, the research team at University College London (UCL) found.
    The higher rate of death comes despite extensive physical distancing measures, including prisons keeping many inmates in their cells for 23 hours a day.
    The lead author of the study, Dr Isobel Braithwaite of UCL Institute of Health Informatics, said: “Our findings show that people in prisons are at a much higher risk of dying from COVID-19 than the general population, and we make the case that both they and prison staff should be given high priority in the rollout of vaccines."
    “We believe the current methods of regime restriction are not enough to protect people adequately, and a systematic, ‘whole-prison’ approach to vaccination is key to preventing further outbreaks and reducing overall deaths in prisons.”
    The Ministry of Justice challenged the authors’ work, however, arguing it failed to adjust for worse health among the prison population than the community and movements of prisoners in and out of prison.
    Read full story
    Source: The Guardian, 16 March 2021
  5. Patient Safety Learning
    Accident and emergency staff at Bristol Royal Infirmary do not feel equipped to deal with the violence they face from the public, inspectors have found.
    Health watchdog The Care Quality Commission (CQC) rated the department as "requires improvement" following an inspection in February. It said "urgent action" must be taken to protect staff and patients.
    University Hospitals Bristol and Weston NHS Foundation Trust said it was working on improvements.
    Amanda Williams, CQC's head of hospital inspections, said: "We were... particularly concerned to find high levels of violence and aggression against staff from patients in the department and to learn that staff did not feel adequately trained to deal with this."
    "Staff need to be given the appropriate training and support to ensure they feel safe and to enable them to defuse tension and prevent violence from escalating."
    Read full story
    Source: BBC News, 17 March 2021
  6. Patient Safety Learning
    Nanotechnology could be used to test blood for evidence of Alzheimer’s disease years before symptoms appear, researchers have said.
    Scientists used nanotechnology to extract previously unseen blood signals of neurodegeneration in a mouse model of Alzheimer’s disease.
    They say tests that capture early signs of neurodegeneration in blood offer enormous potential for those who suffer from the disease, as well as dementia patients, to receive effective treatment or manage their progressive condition before significant brain damage occurs.
    Alzheimer’s disease can currently be diagnosed using brain scans only after someone has been showing behavioural symptoms, such as memory impairment. By the time symptoms emerge, it is often too late to treat patients effectively.
    Read full story
    Source: The Independent, 17 March 2021
     
  7. Patient Safety Learning
    Pregnant women and new mothers are three times as likely to suffer from poor mental health in the wake of the coronavirus pandemic, according to a new study.
    The report, carried out by a coalition of leading maternal mental health organisations, suggested before that the public health crisis up to 20% of women developed a mental illness during pregnancy or within the first year after having a baby.
    But in lockdown, 6 in 10 mothers had substantial concerns around their mental health, according to researchers who polled more than 5,000 pregnant women and parents.
    The study warned women were more likely to suffer from anxiety, depression, loneliness and suicidal thoughts during the COVID-19 crisis.
    The Maternal Mental Health Alliance is one of the organisations behind the research. Luciana Berger, a former Labour MP who is now chair of the group, said: “Today’s report should serve as an ear-splitting warning siren about the dangers to women’s maternal mental health and potential risks to the wellbeing of their babies."
    Read full story
    Source: The Independent, 16 March 2021
  8. Patient Safety Learning
    Hospitals and care homes are failing to properly investigate incidents before referring nurses to their regulator, fuelling a blame culture and repeat failures, the head of the nursing watchdog has told The Independent.
    In her first national interview, Andrea Sutcliffe, head of the Nursing and Midwifery Council (NMC) said some employers were referring nurses without any investigation at all, while half of initial enquiries to the NMC were rejected or required further work.
    She told The Independent this emphasis on blaming the individual meant underlying causes of safety errors were being missed and so they were likely to be repeated. Her ambition is to transform the nursing regulator, which oversees 725,000 nurses and midwives across the UK, into a more forceful watchdog that will flag systemic issues of concern with NHS trusts and care homes.
    In a wide-ranging interview, Ms Sutcliffe called on ministers to ensure that planned legislation to reform the way clinicians are regulated be made transparent and maintain the public’s confidence. She also stressed that the impact of coronavirus on nurses mental health meant rushing to restart routine operations in the NHS had to be carefully planned to avoid driving nurses out of the health service.
    Read full story
    Source: The Independent, 16 March 2021
  9. Patient Safety Learning
    Lasting effects of infection from coronavirus are more common in women and children than expected, with at least 10% of people infected suffering persistent symptoms for months, a new review has found.
    Experts at the National Institute for Health Research (NIHR) examined more than 300 separate scientific studies for the analysis. It found many patients reported struggling to access testing and help from the NHS to treat their symptoms, which varied between patients, suggesting long Covid is a group of four possible syndromes affecting patients differently.
    The report said: “Long Covid appears to be more frequent in women and in young people (including children) than might have been expected,” adding other sufferers could be experiencing an active disease, impacting on their organs and causing debilitating symptoms that would need ongoing treatment. In some patients, the effects included neurological changes in their brains while others showed signs of blood clotting and inflammation. Other patients reported anxiety, fatigue and damage to their lungs and heart.
    It also warned there was evidence some long Covid patients could actually be getting worse, underlining the need to invest in services that will be needed to cope with what could be a long term problem.
    Read full story
    Source: The Independent, 16 March 2021
  10. Patient Safety Learning
    A group of 47 cancer charities says that without urgent action, the UK's cancer death rate will rise for the first time in decades.
    NHS figures suggest tens of thousands fewer people started cancer treatment since the first lockdown compared to normal times. One Cancer Voice says that the NHS needs more resources.
    The government says cancer treatment remains a top priority and urges people to see their GP if they have symptoms.
    Radio 1 Newsbeat has spoken exclusively to One Cancer Voice about the impact of coronavirus on cancer care. The group of charities wants to see more staff available to diagnose and treat cancer, with greater NHS access to private facilities in order to "clear the backlog".
    "We are calling on the government to invest more money in ensuring the backlog of cancer cases is reduced and eliminated," says Michelle Mitchell, the boss of Cancer Research UK, which heads up One Cancer Voice.
    "We could face, in this country today, the prospect of cancer survival reducing for the first time in decades. That's why urgent action is required by the government."
    Read full story
    Source: BBC News, 16 March 2021
  11. Patient Safety Learning
    Stories about people getting blood clots soon after taking the Oxford/AstraZeneca vaccine have become a source of anxiety among European leaders.
    After a report on a death and three hospitalisations in Norway, which found serious blood clotting in adults who had received the vaccine, Ireland has temporarily suspended the jab. Some anxiety about a new vaccine is understandable, and any suspected reactions should be investigated. But in the current circumstances we need to think slow as well as fast, and resist drawing causal links between events where none may exist.
    As Ireland’s deputy chief medical officer, Ronan Glynn, has stressed, there is no proof that this vaccine causes blood clots. It’s a common human tendency to attribute a causal effect between different events, even when there isn’t one present: we wash the car and the next day a bird relieves itself all over the bonnet. Typical. Or, more seriously, someone is diagnosed with autism after receiving the MMR vaccine, so people assume a causal connection – even when there isn’t one. And now, people get blood clots after having a vaccine, leading to concern over whether the vaccine is what caused the blood clots.
    Read full story
    Source: The Guardian, 15 March 2021
  12. Patient Safety Learning
    The pandemic has been a catalyst for innovation in the NHS and some changes will have a lasting effect, says Dr John Wright of Bradford Royal Infirmary.
    The Covid pandemic has transformed our hospitals. Car parks are empty, once-bustling corridors are quiet, and these days you won't see any staff making fashion statements - we're all in scrubs and masks.
    Dr Wright says changes made to reduce spread of infection are here to stay and will help us live with future outbreaks of Covid and other infectious diseases. But there is also much to learn from how we have adapted to non-Covid care - with drive-through PCR swabs and blood tests, for example, or the use of oximeters to monitor oxygen levels in the blood of Covid patients in their homes, providing warning if they need to be admitted to hospital.
    But the biggest change has been in the way hospital consultations are carried out. Before the pandemic nearly all appointments took place face-to-face. Last year probably 90% occurred via telephone or video call, and most of my colleagues at Bradford Royal Infirmary are still running remote clinics today.
    This is much more convenient for patients. In the past a typical consultation might have involved a half-day of travel, the search for a parking place, and then sitting in a waiting room. However, remote consultations do have their drawbacks. Patients tend to underplay their symptoms on the phone and it is easier to avoid discussing challenging issues. Life-changing diagnoses require sensitive, face-to-face communication. Another problem is that some patients struggle with technology. 
    The main drawback, though, is that clinicians are unable to undertake physical examination remotely. Clinical histories are the yin of the consultation but physical examinations are the yang, and video consultations only provide half the picture.
    Read full story
    Source: BBC News, 15 March 2021
  13. Patient Safety Learning
    NHS England’s cancer director has said it could take another year for the level of cancer treatments and diagnosis carried out to return to normal, after being impeded by COVID-19.
    National cancer director Dame Cally Palmer told HSJ’s national cancer forum event last week that activity over the past 12 months had been 89% of the previous year, but the service was committed to getting “fully reset” to 2019 levels by March 2022.
    She shared information showing that, by December 2020, the amount of treatment being carried out following an urgent referral, for most cancers, exceeded December 2019 levels, but that there are still significant treatment backlogs.
    And, for lung cancer patients, the number of treatments carried out in December 2020 was only 73% of that a year earlier — a decrease from September and October 2020 levels — as covid pressures rose during the third wave. Lung cancer is one of the most amenable to treatment if picked up early.
    Other areas of diagnostics and treatment have also been severely impeded because of requirements to change practice to reduce the risk of spreading covid, particularly to vulnerable patients.
    Dame Cally, also chief executive of the Royal Marsden Foundation Trust, said the service was committed to returning to at least normal levels of activity across the board by March next year.
    Read full story (paywalled)
    Source: HSJ, 12 March 2021
  14. Patient Safety Learning
    As the UK looks to mark the first anniversary of the first COVID-19 lockdown on 23 March, Sky News has spoken to one family who say they have lived constantly with the after effects of the virus for a year.
    Charlie, 37, her husband Zed, 41, and their five children – Nico, 15, Beck, 12, Indiana, 10, Emmett, 8, and Mimi, 5 – fell ill with the virus in March last year.
    All of them – particularly the children – have been suffering ever since.
    Charlie said the list of symptoms is "extensive", including headaches, eye issues, nose bleeds, body rashes, horrific tummy pains, gastric issues, severe lethargy, allergic reactions, peeling hands, and feet and mouth ulcers.
    "It's such a long list that at times you can't believe that they've all been related to this illness," Charlie said.
    The family have been getting help from a support group, Long COVID Kids, which wants specialist clinics to be set up for children with the condition.
    Charlie said the ordeal the family has been through "really made me question my sanity at times". She added: "Long COVID centres are being set up, but they're not for children, so there is nowhere for them to be referred to. I'm really worried about the long-term health issues."
    Read full story
    Source: Sky News, 13 March 2021
  15. Patient Safety Learning
    Professor Sir Ian Diamond, head of the Office for National Statistics (ONS), has said there will “no doubt” be another wave of coronavirus infections in the autumn.
    Speaking on Sunday, Sir Ian acknowledged the impact of the “wonderful” vaccine rollout though cautioned “we need to recognise that this is a virus that isn’t going to go away.”
    "And I have no doubt that in the autumn there will be a further wave of infections," he told The Andrew Marr Show on BBC One.
    The UK’s national statistician pointed toward regional variations in terms of how many people have antibodies. “There is a lot of regional variation, so we find 30 per cent of London have antibodies whereas only 16 per cent in the South West, so we need to recognise that as well,” he told the programme.
    This comes after Professor Chris Whitty, England’s chief medical officer, said he would “strongly advise” against any rapid easing of coronavirus restrictions.
    Read full story
    Source: The Independent, 14 March 2021
  16. Patient Safety Learning
    Public Health Scotland are evaluating the roll-out of the COVID-19 vaccination programme to understand if, how, and why different models of service delivery achieve different uptake rates for different population groups. An important part of this work is exploring the attitudes and experiences of people who have been offered a COVID-19 vaccine (even if they have not yet attended).
    You are invited to take part in an anonymous survey looking at health and social care worker views, intentions and experiences of the COVID-19 vaccination programme. You are eligible to participate in this survey if you work in Scotland in a frontline health or social care worker role (i.e. a role where you have direct contact with patients, service users, or clients).
    This survey will help to gather feedback on what was good and less good about your experience, to help inform improvements to this and future vaccination programmes, and remove barriers to attendance and reach more people. 
    The survey should take around 10 minutes to complete and will be open until 19 March 2021.
    Further information
  17. Patient Safety Learning
    The Care Quality Commission (CQC) has ordered ‘significant improvements’ from a mental health trust which has been criticised over the deaths of vulnerable patients.
    The watchdog has warned Tees, Esk and Wear Valleys Foundation Trust (TEWV FT) it has “serious concerns” about risk management processes at its inpatient wards following inspections of three of its hospitals in January. It follows a string of severe problems in child and adolescent services run by the trust. 
    In a formal letter and a separate warning notice to TEWV FT, the CQC ordered the trust to carry out “significant improvements” to the safety of adult acute wards, and psychiatric intensive care, after a visit to Roseberry Park, West Park and Cross Lane hospitals on the week of 18 January.
    Sources have told HSJ the trust’s leadership is working towards a May deadline to make sufficient improvements or it could potentially risk further enforcement action. However, neither the trust nor the CQC have confirmed this.
    Families and campaigners — including Labour MP Andy McDonald, who represents Middlesbrough — have called for a public inquiry into alleged “systematic failures” at the trust following the deaths of around 14 patients under the trust’s care within two years.
    Read full story (paywalled)
    Source: HSJ, 12 March 2021
  18. Patient Safety Learning
    An inquiry into dozens of baby deaths at an NHS trust will examine failings from “ward to board” covering a period of more than a decade, it has emerged.
    The independent inquiry into poor maternity care at East Kent Hospitals University Trust published its terms of reference and scope for how it will carry out its work on Thursday.
    The probe, led by Dr Bill Kirkup, was commissioned by the government after The Independent revealed more than 130 infants suffered brain injuries during birth at the trust over several years.
    The scandal was exposed by the family of baby Harry Richford who died after a catalogue of errors by maternity staff in November 2017. A coroner ruled his death was the result of neglect and “wholly avoidable”.
    Several other families have also spoken out over the deaths of their babies, with evidence emerging the trust’s managers were warned about safety concerns but failed to take action.
    In October, the Care Quality Commission (CQC) said it intended to prosecute the trust over the death of Harry Richford.
    It is understood that since the inquiry was launched, a significant number of families have come forward with concerns but the inquiry has refused to say what the total number of cases is.
    Read full story
    Source: The Independent, 11 March 2021
  19. Patient Safety Learning
    The Covid surge in January hit key services including cancer and routine surgery, NHS England figures show.
    Less than half the expected number of operations were done, pushing the waiting list to a record-high of 4.6m. More than 300,000 of those have been waiting more than a year for treatment - compared to 1,600 before the pandemic began.
    Surgeons described it as a dire situation which would take a long time to turnaround.
    Tim Mitchell, of the Royal College of Surgeons of England, said: "Behind today's statistics are people waiting in limbo. Many will be in considerable pain, others will have restricted mobility and be at risk of isolation and loneliness."
    "Dealing with this daunting backlog will take time, and also sustained investment in the NHS," he said.
    Similar problems are also being seen in Scotland where 39,000 people have been waiting over a year for treatment.
    The NHS Confederation has warned the true picture could be much worse with nearly 6 million fewer referrals made by GPs in England for routine treatments, which includes operations such as knee and hip replacements, last year, suggested there was an additional hidden backlog. The organisation, which represents hospitals, said it was likely people have not sought help or found it difficult to access services during the pandemic.
    Read full story
    Source: BBC News, 11 March 2021
  20. Patient Safety Learning
    The proportion of NHS staff in England who reported feeling unwell as a result of work-related stress increased by nearly 10% last year as the Covid pandemic took its toll, according to the health service’s 2020 survey.
    The survey found that 44% reported feeling unwell as a result of work-related stress in the previous 12 months, compared with 40.3% in 2019. The proportion has steadily increased since 2016 (36.8%).
    In a year like no other for the health service, the 2020 survey also found a slight reduction in respondents who said they often or always looked forward to going to work, and a bigger fall in those who said they were often or always enthusiastic about their job.
    Nevertheless, the survey – which was carried out before Boris Johnson announced plans to give NHS England healthcare workers a 1% pay rise next year, prompting widespread fury – found that the proportion of staff who were thinking of leaving the NHS fell from 19.6% to 18.2%.
    In a year in which ethnic minorities were heavily represented in the death toll of healthcare workers, and concerns were raised about being more likely to be pushed into frontline roles and about access to personal protective equipment, the responses relating to equality, diversity and inclusion were not so positive.
    The proportion of staff who said their employer provided equal opportunities fell compared with 2019, with a decrease among black and minority ethnic staff from 71.2% to 69.2%.
    Danny Mortimer, the chief executive of the NHS Confederation, said the overall picture was encouraging in the circumstances, adding: “There are, though, significant areas of concern, and the recent data on the continued poorer experience of ethnic minority staff starkly reminds NHS leaders that staff experience varies unacceptably in their organisations."
    Read full story
    Source: The Guardian, 11 March 2021
  21. Patient Safety Learning
    Homeless people will be prioritised for coronavirus vaccinations alongside adults in at-risk groups, the government has said.
    Matt Hancock, the health secretary, said the decision would “save more lives among those most at risk in society”.
    It comes after the Joint Committee on Vaccination and Immunisation, which said those experiencing rough-sleeping or homelessness were likely to have underlying health conditions and should be offered vaccinations alongside those in priority group six.
    "People experiencing homelessness are likely to have health conditions that put them at higher risk of death from COVID-19.
    He added: "This advice will help us to protect more people who are at greater risk, ensuring that fewer people become seriously ill or die from the virus."
    Read full story
    Source: The Independent, 11 March 2021
  22. Patient Safety Learning
    Women are being encouraged to share their experiences of the health and care system via a call for evidence aimed at improving healthcare for women.
    Launching to coincide with International Women’s Day, the call for evidence will form the basis of a landmark government-led Women’s Health Strategy, to improve the health and wellbeing of women across England and place women’s voices at the centre of their care.
    By better understanding women’s experiences, the government can ensure key parts of the health service are meeting women’s needs as they should be.
    Matt Hancock, Health and Social Care Secretary, said: "The healthcare system needs to work for everyone, and we must address inequalities which exist within it. Improving women’s health, especially at older ages, is critical for a fair health and care system in the future." 
    "To build this strategy, we need to hear from those who it directly impacts. I urge all women, and those who have experiences or expertise in women’s health, to come forward and share their views with us to inform the future of this important strategy."
    Nadine Dorries, Minister for Women’s Health, said: "Women’s experiences of health care can vary and we want to ensure women are able to access the treatment and services they need. It’s crucial women’s voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes."
    "I urge every woman, and anyone who cares for women, to feed into this call for evidence and help shape the future of women’s health."
    Read press release
    Complete survey (consultation closes at 11:45pm on 30 May 2021)
    Source: GOV.UK, 6 March
  23. Patient Safety Learning
    People will be able to check if they have bowel cancer by swallowing a tiny capsule containing miniature cameras, in an extension of patient self-care.
    In what experts described as a trend towards more NHS at-home care, hastened by the COVID-19 pandemic, thousands of people in England will be able to avoid the discomfort of having a camera inserted into their bowel by instead swallowing a capsule the size of a cod liver oil tablet.
    Pictures transmitted from inside their body during the painless procedure will help doctors judge whether the person has bowel cancer, the second deadliest form of the disease in the UK.
    The boss of the NHS in England said the procedure, known as a colon capsule endoscopy, is an example of “sci-fi” medicine increasingly deployed to improve care. One of the country’s top doctors said the capsules illustrated a major shift of healthcare out of hospitals that will see more and more diagnosis and treatment of illness done at home.
    Prof Martin Marshall, chair of the Royal College of GPs, said: “We’re aware that some patients are reluctant to seek help for certain cancers because the diagnostic tests available can be invasive, so this is a fascinating development and we will be very interested to see the results of the trial.
    “GPs are preparing for an upsurge in cases of suspected cancer cases post-Covid, and the capsule cameras and new test for cervical cancer are welcome developments that could enable more patients to monitor and manage their own health at home without embarrassment or discomfort.”
    Read full story
    Source: The Guardian, 11 March 2021
  24. Patient Safety Learning
    Former staff at a Midlands acute trust have raised concerns over a ‘toxic management culture’ and ‘unsafe’ staffing levels within its maternity services, HSJ has learned.
    Two clinicians who recently worked within Sandwell and West Birmingham Hospital Trust’s maternity department have sent a letter to the Care Quality Commission outlining a series of concerns.
    The letter, seen by HSJ, claimed there was a “toxic management culture alongside poor leadership” within the trust’s senior midwifery team.
    It added: “This had led to 100 per cent turnover in staff within the middle management line… There is no confidence in the current leadership structure and no confidence that staff will be listened to and heard.”
    HSJ also understands there are also concerns around the service within the trust’s management.
    Although they do not raise direct patient safety concerns, the clinicians said the problems were “mostly long-standing” and had “deteriorated to the point where there is now a risk to patient safety”.
    They added: “We are raising these concerns now with the CQC as we feel we have not been listened to and changed effected in a timely manner.”
    Read full story (paywalled)
    Source: HSJ, 10 March 2021
  25. Patient Safety Learning
    Cancer patients are much less protected against COVID-19 than other people after one dose of the Pfizer vaccine, the first real-world study in this area suggests.
    With a 12-week wait for the second dose this could leave them vulnerable, says the King's College London and Francis Crick Institute research team. An early second dose appeared to boost cancer patients' protection.
    Cancer charities are calling for the vaccine strategy to be reviewed.
    But Cancer Research UK said the small study had not yet been reviewed by other scientists and people undergoing cancer treatment should continue to follow the advice of their doctors.
    The government said it was focused on "saving lives" and the antibody response "was only part of the protection provided by the vaccine".
    About 1.2 million people at very high risk of being seriously ill with COVID-19 were prioritised for a first vaccine dose in the first phase of the UK rollout, which includes people with specific cancers.
    The UK government decided to extend the gap between first and second jabs from three to 12 weeks in late December to give more people some protection as soon as possible.
    Dr Sheeba Irshad, oncologist and senior study author from King's College London, said the findings were "really worrying" and recommended an urgent review of the timing of doses for people in clinically extremely vulnerable groups.
    "Until then, it is important that cancer patients continue to observe all public health measures in place such as social distancing and shielding when attending hospitals, even after vaccination," she said.
    The study, which recruited 205 people, included 151 with solid cancers, such as lung, breast and bowel, or blood cancers. The researchers tested volunteers for antibodies and T-cells in their blood, which signals that the immune system can protect against illness from the virus in the future.
    Three weeks after one dose, an antibody response was found in 39% of people with solid cancers, 13% of people with blood cancer and 97% of people with no cancer.
    Following a second dose three weeks after the first, which some cancer patients received, there was a sharp rise in their antibody response against the coronavirus, to 95%. However, among those who had to wait longer for their second dose, there was no real improvement in protection.
    Read full story
    Source: BBC News, 11 March 2021

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