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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    GPs in England are finding it "increasingly hard to guarantee safe care" as the number of doctors falls and demand surges, a senior medic said. Prof Martin Marshall, chair of the Royal College of GPs, told the Guardian GP numbers had fallen by 4.5% despite an ageing population with an increased need for care. GPs feared making serious mistakes due to excessive workloads, he said. Prof Marshall also defended the continued use of remote consultations. Prof Marshall said the demand for services from GPs, including more complex consultations and the vaccination programme, on top of this decline in numbers was putting family doctors under strain. "The fact that general practice is under such enormous pressure means it can't deliver the patient-centred services that it wants to. Many GPs are even finding it challenging to maintain a safe service," he said. He said family doctors were more likely to make a mistake if they were working 11- or 12-hour days, seeing 50 or 60 patients. "GPs are finding it increasingly hard to guarantee safe care to their patients," he said. "The chances of making a mistake in a diagnosis or a mistake in a referral decision or a mistake in prescribing are all greater when you're under stress." Read full story Source: BBC News, 11 September 2021
  2. News Article
    A third of all children’s acute hospital beds in parts of England are being occupied by vulnerable children who do not need acute medical care but have nowhere else to go, safeguarding experts have warned. Doctors say they feel like very expensive “babysitters” for vulnerable children, many of whom are in care but whose placements have broken down because of their violent and self-harming behaviour. Others have severe neurodevelopmental or eating disorders and need specialist treatment not available on ordinary children’s wards, where they get “stuck”, sometimes for months at a time. Paediatricians told the Guardian they have had to deal with vulnerable children who were not physically ill but displayed such challenging behaviour that they could not be looked after in children’s homes. “It is estimated that roughly a third of acute hospital beds at the moment are full of these vulnerable young people, many who are subject to child protection plans, or they are already children in care, living in a residential placement that’s falling apart,” said Dr Emilia Wawrzkowicz, a paediatric consultant who is the assistant officer for child protection at the Royal College of Paediatrics and Child Health (RCPCH). Though many of these children are in extreme distress, they often have no diagnosable mental illness and do not qualify for a psychiatric “tier four” bed. “Some children have such extreme emotional and behavioural issues or are at risk of exploitation that they can’t get back to their residential placements or their foster parents. They can’t obviously go back to their homes, and we’ve got to keep them safe. So they sit in the hospital because there’s nowhere else to go. There are children sitting on our wards for months,” said Wawrzkowicz. Charlotte Ramsden, president of the Association of Director of Children’s Services, warned that a failure to increase the suitable provision for traumatised children would lead to more child suicides and more children ending up in custody after harming others. Read full story Source: The Guardian, 13 September 2021
  3. Content Article
    The Safer Dx Checklist is an organisational self-assessment tool with 10 recommended practices to achieve diagnostic excellence.
  4. Content Article
    COVID-19 continues to have a severe effect on planned surgery in the UK, and dealing with the resulting backlog is a critical concern for the NHS.  In this BMJ Editorial, Andrew Carr and colleagues look at why the waiting times have increased so much and what can be done.
  5. Content Article
    Despite the effectiveness of total knee arthroplasty (TKA; knee replacement surgery), patients often have lingering pain and dysfunction. Recent studies have raised concerns that preoperative mental health may negatively affect outcomes after TKA. The primary aim of this study from Melnic et al. investigates the relationship between patient-reported mental health and postoperative physical function following TKA. The study found that poor mental health should not be a contraindication for performing TKA. For patients with the lowest mental health scores, physicians should account for the possibility that physical function scores may deteriorate a year after surgery. Tighter follow-up guidelines, more frequent physical therapy visits, or treatment for mental health issues may be considered to counter such deterioration.
  6. Event
    A Patient Safety Learning event. Amy, John Jim and Cliff will be presenting and inviting questions. We will add further details shortly.
  7. Content Article
    The Good Things Foundation has published a new paper on digital exclusion and its impact on people’s health, social life and economic potential. To support the Health Foundation’s COVID-19 impact inquiry, the Good Things Foundation, the Health Foundation and the King’s Fund came together earlier this year, to focus on tackling digital exclusion and health inequalities. The resulting report from the workshop and meeting provides an overview of digital exclusion and who is affected by it, as well as the impact of the pandemic on this, and some of the policy responses so far.
  8. Content Article
    Humans have a tendency to think in particular ways that can lead to systematic deviations from making rational judgements. Here's all 188 cognitive biases in existence, grouped by how they impact our thoughts and actions. Produced by DesignHacks.co.
  9. Content Article
    The relationship between exercise and stroke recurrence is controversial. This study from Hou et al. was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. It found that stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate; however, irregular exercise increases the risk of stroke recurrence.
  10. Content Article
    This joint letter calls on Nadine Dorries MP, Minister for Patient Safety, Suicide Prevention and Mental Health, to urgently fund a confidential enquiry into the deaths of Asian and Asian British babies. It is signed by the Chief Executives of Sands, The Royal College of Midwives, NCT and the President of the Royal College of Obstetricians and Gynaecologists.
  11. Content Article
    The Healthcare Safety Investigation Branch (HSIB) has analysed its first 22 HSIB national investigations to identify the recurring patient safety themes and to explore the impact so far of the 85 recommendations they have made to address them.
  12. Event
    WHO Patient Safety Flagship invites you to participate in World Patient Safety Day 2021 Virtual Global Conference “Together for safe and respectful maternal and newborn care” The conference will be opened by WHO leadership and will feature: Keynote addresses by global patient safety leaders and advocates. Global landscape and stories from the ground on maternal and newborn health and safety. Panel discussions on prioritizing safety in maternal and newborn care in the journey towards universal health coverage and the role of partners. Introduction of World Patient Safety Day Goals 2021. World Patient Safety Day 2021 is dedicated to “Safe maternal and newborn care” recognising the significant burden of avoidable harm women and newborns are exposed to due to unsafe care, particularly around the time of childbirth. Registration
  13. Event
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    This online event is an important update for prescribers, and for those who take prescribed medicines, on the RPS Prescribing Competency Framework. This framework was originally produced in by the National Prescribing Centre as a competency framework for all prescribers, and updated by the Royal Pharmaceutical Society (RPS) in 2016. Join this event to: Hear about the changes to the RPS competency framework for all prescribers. Hear how others in pharmacy and other healthcare professions are using the framework. Ask questions to colleagues who were involved in updating the framework. Register
  14. News Article
    A trust facing serious questions about its working culture has had a dramatic rise in the number of concerns raised about issues such as harassment and bullying. In the first quarter of 2021-22, staff raised 84 incidents to East of England Ambulance Service Trust’s Freedom to Speak Up guardian, compared with only eight in the first quarter of 2020-21. Half of the cases raised to the guardian this year involved issues of harassment, bullying or concerns about behaviours or relationships, according to a report to the trust board. However, the biggest single area of concern — with 35 cases — was “the inconsistent applications of processes in policies” and only one out of 84 cases involved patient safety or quality. The report said: “Staff across the organisation are exhausted and express concern at continuing under this pressure… staff continue to report that the slow pace of change leaves them with little confidence of lasting change.” Read full story (paywalled) Source: HSJ, 8 September 2021
  15. News Article
    Patients being assessed remotely in general practice, rather than face-to-face, has been raised as a risk in reports on five deaths by a single coroner since the pandemic hit. Senior coroner for Greater Manchester Alison Mutch has written five prevention of future deaths reports highlighting concerns that doctors were missing details in telephone appointments which may have been spotted, had the patient been seen in person. The reports cover a variety of conditions, including covid, a broken femur, and anxiety and depression. In March 2020, NHS England guidance instructed GPs to adopt a “total triage” approach, where face-to-face appointments should generally only follow a phone, video or digital consultation. But, in May, NHSE wrote to GPs to ask them to “ensure they are offering face to face appointments”, adding remote appointments “should be done alongside a clear offer of appointments in person”. There have been growing calls in the media for increased face-to-face appointments, while, in March 2021, a report by Healthwatch concluded: “While telephone appointments are convenient for some, others are worried that their health issues will not be accurately diagnosed.” Maureen Baker, former chair of the Royal College of GPs and Patient Safety Learning trustee told HSJ she was “not aware pre-pandemic of any major concerns with remote consulting”, adding: “It’s not that things don’t go wrong. They do, but things can and do go wrong in face-to-face consultations as well.” “Many practices have been using remote consulting very successfully for many years [but for GPs introducing remote consultations during the pandemic] the concern is that practices will have had to change and implement it very quickly.” Read full story (paywalled) Source: HSJ, 9 September 2021 You may also be interested in a recent blog from Trish Greenhalgh: 'Why remote consultation with a doctor is difficult – and how it can be improved'
  16. News Article
    Health and care sector workers in England who decline to be fully vaccinated could be moved to back-office roles, a UK government minister has suggested, as a consultation on plans to mandate COVID-19 and flu vaccinations was launched. The six-week consultation process will take views on whether vaccine requirements should apply for health and wider social care workers – those in contact with patients and people receiving care. It would mean only those who are fully vaccinated, unless medically exempt, could be deployed to deliver health and care services. Speaking on Times Radio, Helen Whately, the minister for care, said the government was working with care homes and other settings to see if workers who refused the vaccine could be redeployed. She said: “You can look at whether there are alternative ways somebody could be deployed, for instance, in a role that doesn’t involve frontline work, or doesn’t involve being physically in the same setting as the patient – whether it’s, for instance, working on 111, something like that." But she suggested that people who refused to get vaccinated against coronavirus should not work in social care. Speaking on Sky News, Whately said care homes had been hit particularly hard by Covid, and added: “The reality is that one of the best ways we can protect people living in care homes is through making sure that staff are vaccinated.” Read full story Source: The Guardian, 9 September 2021
  17. News Article
    A care home owner has said she was "forced" to ask two staff with Covid-19 to work because of a staff shortage. The Caledonia home in Holyhead, Anglesey, said 11 of its 12 residents had Covid and the two staff only cared for residents who were also positive. Ann Bedford said Anglesey council and an agency had both been unable to provide emergency cover for staff who were sick or isolating. After speaking to social services, it was agreed the staff could work. "I have never known a situation as bad as we faced over the last weekend. As a matter of course we have contingency plans in place to cope in emergencies but even these buckled under the strain," she said. "My heart sinks when I think about the weeks and months ahead. We felt abandoned and alone. I called on social services for help but they were facing their own emergencies." "The shortage of carers on Anglesey is at dangerous levels and is being intensified by the pandemic." Read full story Source: BBC News, 8 September 2021
  18. News Article
    Following a government announcement, a new body set to tackle health disparities in the UK will launch on Friday 1 October. The Office for Health Improvement and Disparities (OHID) aims to tackle health inequalities across the country and will be co-led by newly appointed Deputy Chief Medical Officer (DCMO), Dr Jeanelle de Gruchy. The OHID will play a vital role in the Department of Health and Social Care, driving the prevention agenda throughout the government to minimise health disparities, many of which have been exacerbated by the pandemic, and improve the public’s health. Unfortunately, health disparities around the UK are austere. For example, a woman living in Blackpool will on average live 16 fewer years in good health than a woman born in Brent, London. The government is also aware that ethnicity can impact health and health outcomes. Health disparities can consequently undermine a person’s ability to work and live a long, healthy and independent life, whilst putting pressure on the NHS, social care and other public services. Read full story Source: National Health Executive, 7 September 2021
  19. Content Article
    Derek Richford talks to Rob Behrens about the loss of his newborn grandson, Harry, at East Kent Hospitals University Trust. He explains how his sheer persistence uncovered the truth of what went wrong and eventually led to a criminal investigation at the Trust. He also tells us what organisations involved in the complaint process can learn from his family's tragic experience.
  20. Content Article
    "The biggest struggle I had to overcome was the lack of confidence caused by microaggressions over time", says Samantha Tross, the first Black female orthopaedic surgeon in Britain. In the latest episode of the Royal College of Surgeons of England Health inequalities podcast series, Samantha considers how diverse leadership can be better developed and supported within surgery, with a focus on widening opportunities and creating a more positive training environment.
  21. Event
    Leadership in the NHS is the responsibility of all staff. Understanding human factors will allow healthcare to enhance performance, culture and organisation. It can be used to assess why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This virtual masterclass, facilitated by Mr Perbinder Grewal, General Vascular Surgeon, will guide you in how to use Human Factors in your workplace. For full programme content, speaker line-up and to book visit www.healthcareconferencesuk.co.uk/conferences-masterclasses/human-factors-workplace hub members receive a 20% discount. Please email info@pslhub.org for discount code
  22. Event
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    Julie Tyrer, Tissue Viability Nurse Consultant at Liverpool Heart and Chest, NHS Foundation Trust, presents her new ‘Minimise Moisture’ initiative for raising awareness of moisture-associated skin damage (MASD) during the next Harm Free Care Network online meeting. Register
  23. News Article
    The UK's vaccine advisory body has decided not to recommend vaccines for healthy 12-15-year-olds, but it will offer vaccines to thousands more children with underlying health problems. Ministers will now seek more advice on extending the rollout based on factors such as school disruption. There is general agreement that this was a really tricky call to make. Bur The Joint Committee on Vaccination and Immunisation (JCVI) has focused squarely on the health benefits of vaccination to children themselves - not on the impact to their schooling or other people. Children's risk from Covid isn't zero but the chances of them becoming seriously ill from Covid are incredibly small. Deaths among healthy children are extremely rare - most have life-limiting health conditions. That means there needs to be a clear and obvious advantage to giving them a jab. However, a very rare side-effect of the Pfizer and Moderna vaccines has made that calculation a lot more complicated. Paul Hunter, professor of medicine at University of East Anglia, says there's been intense pressure on the JCVI and he can understand why they are being cautious. "I don't know what the answer is - I'm very close to the fence on this. There's not enough data to be absolutely certain." Read full story Source: BBC News, 4 September 2021
  24. News Article
    Community doctors in Scotland have told the BBC they cannot imagine returning to normal face-to-face service with current levels of demand. Allowing more patients to see their GP in person is a top priority for the government's NHS Recovery Plan. But as the country tries to emerge from the pandemic, surgeries are seeing unprecedented pressure to catch up with patients. The health secretary has confirmed that new guidance should allow practices to see more people in person. But greater use of telephone and video appointments, brought in when the pandemic hit, is going to continue. Dr Begg has been a GP for 25 years. He says they won't go back to business as usual, the way they worked before. "In person consultations are really important, to examine people, to give injections, to remove lesions, all of these. I think a flexible approach is what we need. It's what we were planning to do before the pandemic anyway; a flexible mix of phone call, video and in-person consulting where it is appropriate." Dr Begg says the new ways of working are essential to deal with the huge number of requests they get. "There is a demand, capacity gap and indeed there was before the pandemic. We are seeing at last more students come through medical school and more people finally coming to join general practice training, but this is going to take at least ten years to turn things around." Read full story Source: BBC News, 7 September 2021
  25. News Article
    More than 600,000 cancer patients in the UK are facing treatment delays or missing out on vital support because of a shortage of specialist nurses, a new report from Macmillan Cancer Support reveals. One in five of all those living with cancer (21%) are lacking dedicated support. The NHS is suffering from a “shocking” shortfall of 3,000 specialist nurses in England alone, according to the analysis by Macmillan Cancer Support. As a result, cancer patients are struggling with medication, having hospital appointments cancelled because there are not enough staff or experiencing devastating delays to chemotherapy. In some cases, patients are ending up in A&E. Patricia Marquis, England director of the Royal College of Nursing, warned the workforce crisis was having a “devastating impact” on people living with cancer. “Expertise built up over many years is lost very quickly and it is patients who pay the price, as this report shows,” she added. Read full story Source: The Guardian, 8 September 2021
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