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  1. Patient Safety Learning
    NASA scientists as well as other innovators are busy developing alternatives to the traditional ventilator being used worldwide to treat severe cases of COVID-19.  The movement is in response to growing evidence that in some cases ventilators can cause more harm than good in some patients with low oxygen levels. Statistics tell the story: 80% of patients with the coronavirus die on such machines.
    Its VITAL machine is tailored for COVID-19 patients and is focused on providing air delicately to stiff lungs — a hallmark symptom of the virus.
    Eight U.S. manufacturers have been selected to make the ventilator that was made in 37 days by engineers at NASA’s Jet Propulsion Laboratory.
    Read full story
    Source: CNBC, 30 May 2020
    Read f
  2. Patient Safety Learning
    A new rapid coronavirus testing device has been shown to reduce the average stay for patients on a COVID-19 holding ward at a UK hospital by almost half.
    The Samba II portable machines can diagnose the virus in less than 90 minutes and have been trialled at Addenbrooke’s Hospital in Cambridge.
    The average length of stay for patients on a coronavirus holding ward, before they were either discharged or could progress with treatment, fell from 58.5 hours to 30 hours, according to the Cambridge University study.
    Researchers said the devices “could make all the difference” in freeing up hospital capacity as the NHS faces a mounting backlog of operations due to the pandemic.
    Read full story
    Source: The Independent, 3 June 2020
  3. Patient Safety Learning
    The pharmaceutical giant Johnson and Johnson has agreed to pay an undisclosed sum to settle a legal action by hundreds of Scottish women who claimed they suffered serious injuries from the company’s pelvic mesh implants.
    The settlement came as four lead cases brought by women who suffered pain and other serious side effects from the implants, made by Johnson and Johnson subsidiary Ethicon, were about to reach court in Edinburgh.
    Read full story (paywalled)
    Source: BMJ, 2 June 2020
  4. Patient Safety Learning
    The head of NHS test and trace has refused to give MPs any data on the first six days of the new service, leading health committee chair Jeremy Hunt to warn that a lack of transparency could “destroy confidence” in its work.
    Baroness Dido Harding, who is leading the new effort, said she was working to validate performance data, which relies on people with COVID-19 symptoms isolating and being called by a team of tracers to identify others they have been in contact with.
    MPs had wanted to know how many patients had been contacted within 24 hours as well as how many were willing to share their contacts, and the compliance with self-isolation advice.
    But Baroness Harding said she would not share the information until the UK Statistics Authority was happy with the data and could ensure it can be trusted. The UKSA criticised the government earlier this week over its public use of test results data.
    Chair of the committee and former health secretary Jeremy Hunt said he was “disappointed” with her refusal and said it was hard for the committee to scrutinise services if it did not have the data, which she had been pre-warned it would ask for.
    Leaked information on Tuesday suggested only two-fifths of coronavirus patients and one-third of their contacts were identified and contacted by the tracing service.
    Read full story
    Source: The Independent, 3 June 2020
  5. Patient Safety Learning
    Large numbers of staff could have been unknowingly spreading coronavirus through care homes, according to the UK's largest charitable care home provider.
    Data from MHA shows 42% of its staff members who recently tested positive were not displaying symptoms. Nearly 45% of residents who had a positive test were also asymptomatic.
    MHA operates in England, Scotland and Wales and has fully tested staff and residents in 86 of its 90 homes so far.
    A Department for Health and Social Care spokesperson said: "Our priority is to ensure care workers and those receiving care are protected, and the latest statistics show over 60% of care homes have had no outbreak at all.
    "We've set out a comprehensive support package for residents and staff, including a £600m infection control fund, testing regardless of whether you have symptoms, and a named clinical lead to support every care home."
    In total, 7% of MHA staff and 13% of residents received a positive test result. Routine testing is not yet under way.
    MHA CEO Sam Monaghan told BBC Newsnight: "It is not difficult to imagine that a lot of people may not have ended up dying if we'd had earlier testing and we'd been therefore better able to manage infection control in our homes."
    Read full story
    Source: BBC News, 3 June 2020
  6. Patient Safety Learning
    A trial has been launched in the UK to test whether ibuprofen can help with breathing difficulties in COVID-19 hospital patients.
    Scientists hope a modified form of the anti-inflammatory drug and painkiller will help to relieve respiratory problems in people who have more serious coronavirus symptoms but do not need intensive care unit treatment.
    Half the patients participating in the trial will be administered with the drug in addition to their usual care, while the other half will receive standard care to analyse the effectiveness of the treatment.
    Read full story
    Source: The Independent, 3 June 2020
  7. Patient Safety Learning
    The COVID-19 pandemic has dramatically curtailed the provision of health services for non-communicable diseases, says a survey of 155 countries by the World Health Organization conducted over three weeks in May.
    In the survey poorer countries were the most likely to report disrupted services, but some 94% of responding countries had reassigned health ministry staff from work on NCDs to dealing with the pandemic. Hypertension treatment has been partially or completely disrupted in 53% of the countries surveyed, diabetes treatment in 49%, cancer treatment in 42%, and cardiovascular emergency responses in 31% of countries, the survey found.
    In the Netherlands, new cancer diagnoses have fallen by 25% since the pandemic lockdown began. In rural India, 30% fewer cardiac emergencies reached health facilities in March 2020 than the previous year.
    Rehabilitation services, which are often key to a healthy recovery after severe COVID-19, have been disrupted in 63% of countries surveyed. Screening campaigns have been put on hold in more than half.
    WHO’s director general, Tedros Adhanom Ghebreyesus, said, “The results of this survey confirm what we’ve been hearing from countries for a number of weeks now. Many people who need treatment for diseases like cancer, cardiovascular disease, and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”
    Read full story
    Source: BMJ, 3 June 2020
  8. Patient Safety Learning
    The use of electroconvulsive therapy (ECT) to treat depression should be immediately suspended, a study says. ECT involves passing electric currents through a patient's brain to cause seizures or fits.
    Dr John Read, of the University of East London said there was "no place" for ECT in evidence-based medicine due to risks of brain damage, but the Royal College of Psychiatrists said ECT offers "life-saving treatment" and should continue in severe cases.
    The National Institute for Health and Care Excellence (NICE) currently recommends the use of ECT for some cases of moderate or severe depression as well as catatonia and mania. However, peer-reviewed research published in the journal Ethical Human Psychology and Psychiatry concludes "the high risk of permanent memory loss and the small mortality risk means that its use should be immediately suspended".
    In response to the study, the Royal College of Psychiatrists said ECT should not be suspended for "some forms of severe mental illness".
    Dr Rupert McShane, chair of the college's Committee on ECT and Related Treatments, said there was evidence showing "most people who receive ECT see an improvement in their condition".
    "For many, it can be a life-saving treatment," he said.
    "As with all treatments for serious medical conditions - from cancer to heart disease - there can be side-effects of differing severity, including memory loss."
    Read full story
    Source: BBC News, 3 June 2020
  9. Patient Safety Learning
    At least 25 people have died at a care home amid claims from an industry body that a council's actions "caused" or "increased COVID-19 deaths".
    Melbury Court in Durham is thought to be the care home with the highest number of deaths in the UK. County Durham has had the highest number of care home deaths in England and Wales.
    Durham County Council said it "strongly refuted" the claim by the County Durham Care Home Association (CDCHA).
    Some patients went from the nearby University Hospital of North Durham to Melbury Court without being tested for coronavirus or after a positive test.
    A BBC investigation has discovered that in a conference call in late March, council officials were told plans to move hospital patients into care homes without testing would be disastrous.
    The CDCHA offered to find a specific home or homes where COVID-19 positive or untested people could be cared for rather than have them spread around the network, but this was never acted on and now the CDCHA has calculated there has been an outbreak of coronavirus in 81 of the county's 149 care homes.
    Maria Vincent, who runs Crosshill Care Home in Stanhope, told the council in March that care homes were not set up to accept COVID-19 patients, and described it as "neglect pure and simple".
    Read full story
    Source: BBC News, 2 June 2020
  10. Patient Safety Learning
    The government’s top scientific advisers discussed care homes only twice between January and May, according to newly published minutes.
    Records for meetings of the Scientific Advisory Group for Emergencies, or Sage, which is the key group of experts advising ministers on how to react to the COCID-19 outbreak, reveal a lack of discussion about the risks facing care homes.
    Between January and May, Sage minutes mention care homes only twice, before the start of lockdown in the UK and weeks before the numbers of deaths made headlines across the country.
    Shadow care minister Liz Kendall said she was concerned not enough action had been taken and added: “It is clear that social care and the NHS were not treated equally, nor as two sides of the same coin.”
    James Bullion, president of the Association of Directors of Social Services said the publication of the minutes "appears to reinforce the impression that social care has been an afterthought – a secondary consideration after the NHS. This cannot continue."
    Read full story
    Source: The Independent, 1 June 2020
  11. Patient Safety Learning
    The Care Quality Commission (CQC) have looked at how the number of people who have died during the coronavirus outbreak this year compares to the number of people who died at the same time last year.
    They looked at information about services that support people with a learning disability or autism in the 5 weeks between 10 April to 15 May in 2019 and 2020. These services can support around 30,000 people. They found that in that 5 weeks this year, 386 people with a learning disability, who may also be autistic, died. Data for the same 5 weeks last year found that 165 people with a learning disability, who may also be autistic, died. This information shows that well over twice as many people in these services died this year compared to last year. This is a 134% increase in the number of death notifications this year.
    This new data should be considered when decisions are being made about the prioritisation of testing at a national and local level.
    Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission (CQC) said: "Every death in today's figures represents an individual tragedy for those who have lost a loved one."
    "While we know this data has its limitations what it does show is a significant increase in deaths of people with a learning disability as a result of COVID-19. We already know that people with a learning disability are at an increased risk of respiratory illnesses, meaning that access to testing could be key to reducing infection and saving lives."
    "These figures also show that the impact on this group of people is being felt at a younger age range than in the wider population – something that should be considered in decisions on testing of people of working age with a learning disability."
    Read full story
    Source: Care Quality Commission, 2 June 2020
  12. Patient Safety Learning
    Care homes are the focus of the COVID-19 outbreak in England and Wales. At least 40% of all coronavirus deaths have occurred in the very places dedicated to keeping people safe in their later years.
    The under-reporting of deaths, the lack of personal protective equipment (PPE) and testing available to staff, and the total focus on the NHS at the expense of the social care sector have all contributed to an estimated 22,000 deaths in care homes – places that government had originally advised were “very unlikely” to experience infection.
    But how could care homes have been failed so badly, and what checks and balances should have been in place to prevent this?
    Care homes in England are regulated by the Care Quality Commission (CQC). One of its key responsibilities is to carry out inspections and visits to ensure providers meet fundamental standards of quality and safety; however, as of 16 March, the regulator stopped all routine inspections to “focus on supporting providers to deliver safe care during the pandemic”.
    Had the CQC continued its inspections, it would have been in a position to challenge cases where PPE was being diverted away from care homes to the NHS, and to aid struggling homes in their battle to secure tests for staff and residents. Instead, care homes have effectively been left to fend for themselves.
    On top of this, the CQC joined similar bodies in Wales, Scotland and Northern Ireland in refusing to publish detailed data on care home deaths, arguing instead for a need to “avoid confusion” and to protect “the privacy and confidentiality of those who have died and their families”.
    Families and the wider public have a right to know when and where COVID-19 outbreaks are happening, and this lack of transparency is deeply troubling.
    Read full story
    Source: The Guardian, 1 June 2020
  13. Patient Safety Learning
    About 2.4 million people in the UK are waiting for cancer screening, treatment or tests, as a result of disruption to the NHS during the past 10 weeks, according to Cancer Research UK.
    It estimates 2.1 million have missed out on screening, while 290,000 people with suspected symptoms have not been referred for hospital tests. More than 23,000 cancers could have gone undiagnosed during lockdown.
    Chief executive Michelle Mitchell said COVID-19 has placed an "enormous strain on cancer services". "The NHS has had to make very hard decisions to balance risk," she said.
    "...there have been some difficult discussions with patients about their safety and ability to continue treatment during this time. Prompt diagnosis and treatment remain crucial to give people with cancer the greatest chances of survival and prevent the pandemic taking even more lives."
    To ensure no-one is put at risk from the virus now that cancer care is returning, Cancer Research UK said "frequent testing of NHS staff and patients, including those without symptoms" was vital.
    Read full story
    Source: BBC News, 1 June 2020
     
     
  14. Patient Safety Learning
    World leaders in infection control and disease prevention convened online at the inaugural iClean 2020 conference on 28 May to discuss innovative infection control reform in hospitals and aged-care facilities in the wake of the COVID-19 crisis.
    Keynote speaker Professor Didier Pittet* said there has never been a more pertinent time to address infection control in our healthcare systems.
    “During this devastating COVID-19 pandemic, up to one in five people who contracted the virus globally are healthcare workers, and we saw similar numbers in the SARs and MERS outbreaks."
    “Furthermore, aged-care residents accounted for 29% of COVID-19-related deaths in Australia, and this rate is even higher in Europe, the United States and the United Kingdom, who have been hardest hit by the pandemic,” Professor Pittet said.
    “We are therefore calling for urgent reform in our approach to cleaning and disinfection in hospitals and aged-care homes.”
    Professor Pittet explained that Clean Hospitals — an initiative aiming to create better procedures, training, auditing and management processes — would allow cleaning and infection control managers around the world to improve quality and outcomes.

    Read more
    Source: Hospital Healthcare, 1 June 2020
  15. Patient Safety Learning
    DigitalHealth.London is helping health and care professionals turn the idea of digital innovation into tangible improvements in experience and outcomes for patients. Our work is instrumental in giving health and care stakeholders across London insight into the best digital health interventions and tools on the market.
    DigitalHealth.London is a collaborative programme delivered by MedCity, and London’s three Academic Health Science Networks – UCLPartners, Imperial College Health Partners, and the Health Innovation Network.
    Closing date: Midnight, Sunday 5 July 2020
    Read more
     
  16. Patient Safety Learning
    NHS pathology labs were given just two days to roll out thousands of antibody tests, amid a push to reach a COVID-19 testing target set out by Boris Johnson.
    Earlier this month the Prime Minister set a target of having a testing capacity of 200,000 per day by the end of May. Capacity currently stands at 161,000, Matt Hancock has said.
    Until now there has been very limited use of antibody tests, with most capacity used to deliver PCR tests that indicate whether someone currently has the virus. Antibody tests are intended to identify whether someone has previously had the virus.
    On 27 May, NHS England and Improvement wrote to local leaders giving them two days’ notice to put in place testing capacity for, and deliver, thousands of antibody tests of staff and patients. 
    In one letter to leaders in the south east, seen by HSJ, the regulator said labs were expected to establish capacity and deliver 6,000 tests daily by 29 May. A senior source from London confirmed to HSJ the region had also been given a target of 6,000. There are seven local regions in the NHS, which would indicate around 42,000 tests per day, which if PCR testing continued at the current levels, could enable the government to meet the 200,000 target.
    One head of pathology at a trust said: “There is one obvious answer as to why there is suddenly such an urgency to roll this out. While it will be interesting to have the results, there is nothing meaningful we can do with this test data at the moment.”
    Another trust director involved in the scheme described the antibody tests as having “no clinical value”.
    Read full story
    Source: HSJ, 29 May 2020
  17. Patient Safety Learning
    The coronavirus pandemic is a “magnifier of inequality” that threatens the wellbeing of women, children, and adolescents worldwide, a roundtable of influential female leaders has heard.
    The United Nations has predicted that 47 million women could lose access to contraception resulting in 7 million additional unintended pregnancies over the next six months1 because of “deadly and disabling” COVID-19, the virtual event was told.
    There could also be 31 million additional cases of gender based violence in low and middle income countries. Policy makers have a clear duty to protect the most vulnerable and disadvantaged and to tackle the root causes of inequality with targeted policies and resources, the participants concluded.
    Henrietta Fore, executive director of Unicef, said that, in countries with already weak health systems, COVID-19 was disrupting medical supply chains and straining financial and human resources. Visits to healthcare centres are declining owing to lockdowns, curfews, and transport disruptions, and as communities remain fearful of infection. 
    She cited recent research that indicated there could be an increase in child deaths amounting to an additional 6000 a day over the next six months, and 56 700 more maternal deaths. “This is a statistic we want to avoid. We are concerned about access to services,” she said.
    Read full story
    Source: BMJ, 29 May 2020
  18. Patient Safety Learning
    New data has shown the number of coronavirus patients being admitted to hospital and intensive care units across the country has risen as lockdown rules are set to be eased further on Monday.
    The Public Health England (PHE) data, published on Friday, covers 134 NHS trusts across the country and shows the daily rate of new patients admitted to hospital and critical care with COVID-19 has risen compared to recent weeks, with London experiencing a sharp spike in new admissions in the past week. The south east region also saw an increase.
    The surveillance data on the spread of COVID-19 throughout England has also revealed an increase in the number of people testing positive at their GP.
    Read full story
    Source: Independent, 31 May 2020
  19. Patient Safety Learning
    Pharmacy leaders in the black, Asian and minority ethnic (BAME) communities have expressed concern that assessments of BAME staff’s susceptibility to COVID-19 are not widespread enough in community pharmacy.
    NHS England wrote to community pharmacies on 29 April 2020 advising employers to “risk assess staff at potentially greater risk” of COVID-19 after “emerging UK and international data” suggested people from BAME backgrounds are “being disproportionately affected”.
    The Faculty of Occupational Medicine later published a risk reduction framework — backed by NHS England — to assist with the risk assessments on 14 May 2020. This was updated on 28 May 2020 to include guidance from the Health and Safety Executive to “help organisations identify who is at risk of harm”.
    But speaking to The Pharmaceutical Journal, Elsy Gomez Campos, president of the UK Black Pharmacists’ Association (UKBPA), said she had been told by a small number of community pharmacists that “nothing has been done” in terms of risk assessing BAME staff.
    “I know of a few people who have been assessed and that is mainly in hospital,” she said. “In terms of community pharmacists — who I’ve had contact with so far — they haven’t even been asked to have the risk assessment done.”
    However, she stressed that not many from the community pharmacy sector have come forward, but “the people who have come forward have said no, it has not been done”.
    “People are quite scared to ask as well because it can have repercussions on their employment or their relationships [at work],” she added.
    Read full story
    Source: The Pharmaceutical Journal, 29 May 2020
  20. Patient Safety Learning
    Some extremely vulnerable people have been told they have been removed from shielding lists via text message, without the knowledge of their GP.
    This has caused confusion, with charities demanding clearer guidance for this group as lockdown eases. GPs say they should be notified when their patients are added or removed from the lists.
    Shielding has now been extended until the end of June and is under constant review, the government says.
    Around 2.2 million people in the UK are staying at home to protect themselves from the virus because they were told they were at high risk of being seriously ill with COVID-19.
    But 40 healthcare charities say the lack of a clear plan for their future is causing anxiety and potentially putting their health at risk.
    Read full story
    Source: BBC News, 30 May 2020
  21. Patient Safety Learning
    We’re living in an unprecedented time and facing new challenges. We’re asking questions we’ve never had to ask before – questions that differ according to our unique circumstances, concerns and needs.
    With an increasingly complex health and social care system, Patient Safety Learning wants to continue working towards a future that is safe for both patients and staff.
    It’s for this reason that we’ve launched Oscar, the friendly health chatbot. Available on the hub, Oscar answers the public’s question about their safety – or that of their family members and friends – during the coronavirus pandemic.
    Oscar is not a diagnostic tool. We at Patient Safety Learning are not medical experts ourselves, but we want to connect patients to the best guidance currently in the public domain. This is what Oscar seeks to do, in pointing visitors to helpful and trustworthy answers, relevant to their specific situations.
    Whether you’re a well adult seeking general information about how to stay safe from coronavirus, a concerned woman about to give birth and wanting to know your options, or a carer looking for advice, Oscar is here to help you find the answers you need. In time, as we see how the public uses Oscar – and especially as we hear your feedback – we plan to build on the range of information Oscar currently offers. 
    Like everything else on the hub, Oscar is free to use.
    Please do send us any feedback, including information you’d like Oscar to provide, by emailing [email protected]
  22. Patient Safety Learning
    NHS staff at a hospital that has stopped taking new patients amid a COVID-19 spike have lodged a series of concerns, including that they are not routinely being informed of when colleagues test positive for the virus.
    The concerns were laid out in a letter from union representatives to management at Weston general hospital in Somerset, which is now testing all staff while carrying out a deep clean.
    Another concern raised by Unison was that priority for testing was not being given to BAME staff. 
    University Hospitals Bristol and Weston NHS foundation trust said on Wednesday that as many as 40% of staff from a cohort tested after contact with infected patients were found to be positive.
    The trust’s chief executive, Robert Woolley, told the BBC the figure was from a sample testing last week and authorities were now attempting to understand the scale of the infection. More than 60 patients were found to be infected last weekend.
    Read full story
    Source: The Guardian, 28 May 2020
  23. Patient Safety Learning
    Dental practices in England have been told they can reopen from Monday 8 June, if they put in place appropriate safety measures. All routine dental care in England has been suspended since 25 March.
    The British Dental Association (BDA) has welcomed the announcement but says key questions remain.
    Currently, any patient with an emergency dental problem is supposed to be referred to an Urgent Dental Care (UDC) hub for treatment.
    In a letter to all practices, NHS England's chief dental officer, Sara Hurley, said: "Today, we are asking that all dental practices commence opening from Monday, 8 June for all face-to-face care, where practices assess that they have the necessary IPC and PPE requirements in place."
    The BDA said that while dentists would be relieved by the announcement, the ability of practices to reopen would depend on the availability of personal protective equipment (PPE).
    "It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as is safely possible, but we will need everyone to be patient as practices get up and running," said BDA chairman Mick Armstrong.
    Read full story
    Source: BBC News, 28 May 2020
  24. Patient Safety Learning
    A hospital trust under the spotlight over avoidable baby deaths provided inadequate antenatal care, with inexperienced junior midwives working alone and doctors not always available to assess high risk women, the Care Quality Commission (CQC) has found.
    The latest CQC report on maternity services at East Kent Hospitals University Foundation Trust follows a report last month by the NHS Healthcare Services Investigation Branch on 24 maternity care investigations at the trust.
    Read full story (paywalled)
    Source: BMJ, 28 May 2020
  25. Patient Safety Learning
    The first hospital dedicated to helping coronavirus patients recover from the long-term effects of the illness has received its first patients.
    Surrey's NHS Seacole Centre opened this month at Headley Court, a former rehab centre for injured soldiers.
    COVID-19 patients can be left with tracheostomy wounds from having a tube inserted in the windpipe or need heart, lung or muscle therapy, the NHS said.
    Others who have survived the virus may need psychological or social care.
    NHS chief executive Sir Simon Stevens said: "While our country is now emerging from the initial peak of coronavirus, we're now seeing a substantial new need for rehab and aftercare."
    He said while patients had survived life-threatening complications, many would see a longer-lasting impact on their health.
    Read full story
    Source: BBC News, 29 May 2020

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