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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    The shift towards a digital-first healthcare system has accelerated during the COVID-19 pandemic, demonstrating that, given the opportunity for better access, people will engage in new ways with their health and wellbeing services. However, while many individuals have developed a greater awareness of their health and taken meaningful steps to improve it, the pandemic has exposed, and potentially increased inequalities in health outcomes due, in part, to inequalities in access to the technologies, connectivity, and digital and/or health literacy needed to improve outcomes equitably. The move to Integrated Care Systems (ICS) provides an opportunity to give greater priority to patient engagement and to integrate services around a 360 degree view of patient’s needs, focusing on how people experience their lives and health conditions, rather than on specific treatment/disease areas or pathways. This blog from Catherine Skilton, Deloitte, discusses what ICSs can do to realise the long-held vision of a person-centric health and care system.
  2. News Article
    The parents of a young disabled woman who died after she went into hospital for a routine eye operation have told a coroner that doctors ignored their daughter’s attempts to communicate. Laura Booth, 21, stopped eating after she was admitted to the Royal Hallamshire hospital in Sheffield, her mother told an inquest hearing in the city on Monday. Patricia Booth, from Sheffield, said her daughter was ignored by clinicians after she went into the hospital in October 2016 despite her being able to communicate to some extent, including using Makaton signing. She said this was in contrast to her treatment at the Children’s hospital in the city. Sitting next to her husband, Ken, on a remote link, Booth told the inquest: “They never discussed anything with Laura. They just ignored her. She couldn’t speak but she could understand everything.” Booth explained how her daughter could make herself understood to her family and would hold her hands out to the doctors, but did not get a response. “They never gave her a chance,” she said. “They never spoke to her. “It’s really heartbreaking. Laura was trying to communicate with them but they just wouldn’t listen … It just upset Laura that the doctors ignored her.” Read full story Source: The Guardian, 12 April 2021
  3. News Article
    Feeling manipulated into having medical procedures, dismissed by professionals and labelled with racial stereotypes are among the complaints of parents who responded to a national inquiry into racial injustice in UK maternity care. A panel established by the charity Birthrights is investigating discrimination ranging from explicit racism to racial bias and microaggressions that amount to poorer care. It comes as parliament is due on 19 April to debate the large racial disparity in maternal mortality in British hospitals, after a petition from the campaign group Five X More gathered 187,519 signatures. Black women are four times more likely than white women to die during pregnancy or childbirth in the UK. Testimonies include that of a British Bangladeshi woman who said her labour concerns were dismissed. “I felt unsafe and like maternity professionals are not used to being challenged by brown women,” she said. “There is a stereotype of Asian women that we are tame, quiet and compliant people who have no voice and will be obedient. “I was treated like a vessel, not like a human. The experience left me feeling humiliated, disempowered and ashamed.” Read full story Source: The Guardian, 13 April 2021
  4. News Article
    A ‘flurry’ of whistleblowers have raised concerns about the culture within an NHS trust which is grappling with finance and governance problems, its directors were told today. Staff at Cornwall Partnership Foundation Trust have reported a “command and control” culture at the trust, which last week apologised to its employees for overtime payments made to board members for extra hours worked during the first peak of the pandemic. It comes as the trust’s new chair and interim chief executive both pledged to communicate “openly and honestly” with staff. Read full story (paywalled) Source HSJ, 12 April 2021
  5. News Article
    A cheap drug, commonly used to treat asthma, can help people at home recover more quickly from COVID-19, a UK trial has found. Two puffs of budesonide twice a day could benefit many over-50s with early symptoms around the world, said the University of Oxford research team. There are also early signs the drug could reduce hospital admissions. The NHS says it can now be prescribed by GPs to treat Covid on a case-by-case basis from today. At present, there are few options for treating people with Covid who are not in hospital, apart from paracetamol. This widely-available asthma drug works in the lungs, where coronavirus can do serious damage, and could improve the recovery of at-risk patients who are unwell with Covid at home. Prof Stephen Powis, national medical director of NHS England, said he was "delighted" by the trial results so far and he said GPs could prescribe it after "a shared decision conversation" with patients. Read full story Source: BBC News, 12 April 2021
  6. News Article
    New guidance from health officials on the treatment of chronic pain could be devastating for women already struggling to get doctors to take their pain seriously, write Sarah Graham, The guidelines, published last week by the National Institute for Health and Care Excellence (NICE), say that patients suffering from chronic pain that has no known underlying cause (known as chronic primary pain) should not be prescribed painkillers. Instead, it suggests, these patients should be offered exercise, antidepressants, talking therapies and acupuncture. This has huge implications for the future treatment of anyone living with unexplained chronic pain – the majority of whom are women – and runs the risk of patients being viewed as hysterical until proven otherwise. Read full story Source: iNews, 7 April 2021
  7. News Article
    Lyth Hishmeh kept feeling ill months after contracting coronavirus a year ago in March. He had chest pain and couldn't concentrate. At 26 years old, the former regular runner was fatigued and breathless, struggling to function properly. Yet medical professionals kept telling him he simply could not still be ill. "They were telling me it's all in my head," he said. For Hishmeh who lives in London and many sufferers of long Covid, proving they are sick has become a big part of trying to get better. Another Londoner, Monique Jackson, has lost count of the number of times her pain was described as 'just anxiety.' The 32-year old illustrator was repeatedly told by medical professionals to go to the accidents and emergency, only to be discharged soon after. "I felt like I was wasting people's time, that people either didn't believe me ... or the ones who were sympathetic and supportive said 'we don't know, it's a new disease and we just don't know,'" she said. Clinics are springing up around the country for what some call a potential second pandemic: Long Covid. Learning that they were not alone, that other people were experiencing the same issues, was a huge revelation for both Hishmeh and Jackson. This was not just in their heads. They were not imagining the pain. They really were sick. Read full story Source: CNN Health, 11 April 2021
  8. News Article
    Doctors in pain management have raised concerns about the National Institute of Health and Care Excellence’s guidance on treating chronic primary pain, which they said do not reflect clinical practice or current evidence. Patients could be left in “despair,” said the British Pain Society, because of the recommendation that the only drugs that doctors should prescribe are certain antidepressants. Commonly prescribed drugs, including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines, and opioids, should not be used to treat chronic primary pain, said NICE. Instead patients should be offered exercise programmes, therapy, and acupuncture. Read full story (paywalled) Source: BMJ, 9 April 2021
  9. News Article
    Emergency clinicians have raised concerns and called for central guidance for dealing with a rush of unnecessary A&E attendances triggered by health anxiety over the Oxford covid vaccine’s safety. HSJ has heard from numerous emergency clinicians who reported an increasing number of attendances from people with very mild symptoms, such as headaches, but who were concerned they might be having a potentially serious reaction to the Oxford-AstraZeneca jab. The reports have come from London, the Midlands, the South, the North West and the East of England. Some expressed concerns about the impact of increased attendances on already busy accident and emergency departments. Senior staff said patients were self-presenting at A&E and at their GPs. HSJ has also been told some emergency departments have been alarmed by the number of patients presenting with mild symptoms who said they were told to go to A&E by their GPs. The concerns follow the announcement by government and regulators earlier this week that under-30s should be offered different covid vaccines where they are available, because of uncertain evidence of a very small risk of serious blood clotting linked to the Oxford/Az jab. Read full story (paywalled) Source: HSJ, 9 April 2021
  10. News Article
    Britain is facing a “terrifying” mental health crisis with tens of thousands more children needing specialist help since the start of the coronavirus pandemic. Experts from the Royal College of Psychiatrists have warned the problem facing the country will get worse before it gets better with new analysis revealing almost 400,000 children and 2.2 million adults sought help for mental health problems during the crisis. While the effect of lockdown and coronavirus has affected people of all ages, children appear to be particularly susceptible. Some 80,226 more children and young people were referred to specialist mental health services between April and December last year, up by 28% on the same months in 2019 to 372,438. Dr Bernadka Dubicka, chairwoman of the child and adolescent faculty at the Royal College of Psychiatrists, said: "Our children and young people are bearing the brunt of the mental health crisis caused by the pandemic and are at risk of lifelong mental illness." "As a frontline psychiatrist I've seen the devastating effect that school closures, disrupted friendships and the uncertainty caused by the pandemic have had on the mental health of our children and young people." Read full story Source: 9 April, 2021
  11. News Article
    With the latest UK government figures showing that there have been nearly 150,000 deaths where COVID-19 was mentioned on the death certificate, it’s understandable why some people compare the pandemic with a war. Indeed, daily life in the NHS is now peppered with military language: the frontline, gold command calls, redeployment, buddy systems and 'moral injury' Moral injury can be defined as the distress that arises in response to actions or inactions that violate our moral code, our set of individual beliefs about what is right or wrong. In the medical literature, moral injury has historically been associated with the mental health needs of military personnel, arising from their traumatic experiences during active service. Moral injury is generally thought to arise in high-stakes situations so it’s no surprise that the term has gained traction in healthcare settings over the course of the pandemic, given that healthcare staff have been faced with extreme and sustained pressure at work. In many ways, working in the NHS over the past year has felt like being some sort of circus acrobat, contorting ourselves to balance various competing realities: the desire to provide high-quality care for all our patients in the context of limited resources, looking after our own health needs alongside those of our patients, trying to make peace with the responsibility we feel towards our loved ones while still upholding our duty of care to patients. If we fail to deliver, particularly in high-stakes situations where we think things should have been done differently, it can shake us to our core. Our moral code transcends the relatively superficial responsibilities of our professional role: it gets to the heart of who we are as human beings. If we feel like our core values have been attacked, it can leave us feeling devastated and disillusioned. Read full story Source: The Guardian, 12 April 2021
  12. Content Article
    This government report, the fifth of its kind, explores suicide prevention, setting out the data and evidence, together with the personal stories and experiences that guide us. It sets out progress against existing commitments, and sets new commitments and priorities
  13. Content Article
    The ISMP Targeted Medication Safety Best Practices for Hospitals (TMSBP) were developed to identify, inspire, and mobilise widespread, national adoption in the US of consensus-based best practices for specific medication safety issues that continue to cause fatal and harmful errors in patients, despite repeated warnings in ISMP publications. The best practice recommendations presented in this guidance document are based on error reports received through the ISMP National Medication Errors Reporting Program (ISMP MERP) and have been reviewed by an external expert advisory panel and approved by the ISMP Board of Trustees. This initiative was first launched in 2014 and is updated with additional best practices, as needed, every two years. While targeted for the hospital-based setting, some best practices are applicable to other healthcare settings. Facilities can focus their medication safety efforts on these Best Practices, which are realistic and have been successfully adopted by numerous organisations. 
  14. Content Article
    Our Impact Films presents a feature short film on Autism in the London Borough of Sutton. Film maker Mohammed captures a very powerful message through this film that was represented from the perspective of young autistic participants. He highlights the importance of communication of young autistic people from diverse backgrounds. Through this film, the hope is to give the audience the chance to understand what life can be like being autistic and really celebrate the fact that differences don’t separate people but in-fact makes the diversity of society all the more valuable.
  15. Content Article
    Ali Raza uses the Swiss Cheese Model by James Reason to look at discrimination in the workplace.
  16. Content Article
    The Medicines and Healthcare products Regulatory Agency (MHRA) and the Joint Committee on Vaccinations and Immunisation (JCVI) has issued new advice suggesting people under the age of 30 with no underlying health conditions should receive an alternative to the AstraZeneca vaccine, where available.  Both the MHRA and JCVI have stressed that vaccination is highly effective and substantially reduces the risk of infection and severe COVID-19 disease.
  17. Content Article
    Space From Covid programme is made up of six modules, each addressing issues you may be experiencing due to the COVID-19 Pandemic. Each module provides clinically-backed support for trouble sleeping, coping with stress, developing mindfulness, financial worries and experiencing grief and loss. SilverCloud is offering this service completely free of charge and for anyone to use. The average module takes 30 minutes to complete and is accessible 24/7 from a smartphone, tablet or computer.
  18. News Article
    The number of people suffering with long Covid should be published routinely, as happens with those infected with or hospitalised with coronavirus, MPs and peers are urging Boris Johnson. The cross-party group of parliamentarians want the prime minister to ensure that the “untold human suffering” that the condition involves helps shape future government policy towards the pandemic. Thirty-two MPs and 33 peers have signed a letter urging Johnson to give greater priority to the potential harm posed by long Covid following the Office for National Statistics’ finding last week that an estimated 1.1m people are suffering its effects – far more than previously thought. The signatories come from eight parties and include the Tory MP Dr Dan Poulter, a former health minister; Lord Darzi, the surgeon and ex-health minister; and the SNP MP Dr Philippa Whitford, who is an NHS breast surgeon. In the letter, coordinated by the all-party parliamentary group on coronavirus, they say: “Cases, hospitalisations and deaths are not the only measure of this pandemic. We urge the government to also count the number of people left with long Covid, many of them whose lives have been devastated by this pandemic. Read full story Source: The Guardian, 9 April 2021
  19. News Article
    SilverCloud, a digital mental health platform, has launched a new COVID-19 support programme – ‘Space from COVID-19’ – which it has made free and available to everyone in the UK over the age of 18 years, indefinitely. The company hopes to improve access to digital mental health services during the pandemic and beyond, to help shoulder some of the demand that now faces health services in the UK and across the globe. SilverCloud’s new programme brings together a suite of digital resources and support that will assist users in managing and improving their mental health and wellbeing, specifically in regard to the impact of COVID-19. Crucially, it removes potential barriers by being open to all, with or without a clinical referral, and is fee-free for everyone. Dr Lloyd Humphreys, Clinical Psychologist and Head of Europe for SilverCloud, told HTN: “For us, what is really important is to support people during this difficult time. Everyone is talking about the mental health impact of COVID-19, everyone is talking about the problem, but no-one is really offering a solution." Read full story Source: Health Tech Newspaper, 8 April 2021
  20. News Article
    Some hospitals are using an out of date triaging tool for emergency patients suffering from sepsis that could leave them at risk of harm. A warning has been issued to NHS trusts to make sure their triage tools are up to date with the latest advice after several reported incidents in accident and emergency departments. The Royal College of Emergency Medicine flagged the risk to NHS England in a letter seen by The Independent warning patients could come to harm if action wasn’t taken. NHS England and NHS Digital has issued an alert to hospital chief executives warning of a potential safety risk. It told members: “The latest version of the system has updated treatment priorities especially in relation to the treatment of adult and paediatric sepsis. It is therefore crucial that if your organisation uses the Manchester Triage System clinical risk management triage tool, please ensure that the most recent version is being used and where this is not the case, specific local mitigation for the risks is in place.” It added that hospitals should ensure the latest versions of any clinical systems were being used to safeguard patient care. Read full story Source: The Independent, 8 April 2021
  21. News Article
    Increasingly strong evidence shows that the UK's vaccination programme is breaking the link between COVID-19 cases and deaths, scientists tracking the epidemic have said. A study found infections had fallen by roughly two-thirds since February, before beginning to level off. This is probably because people are beginning to mix more - but deaths have not followed the same pattern. This was not the case before January, when the vaccine rollout began. The research, commissioned by the government and run by Imperial College London, is based on swabs taken from 140,000 people selected to represent England's population. Of that group, who were tested for the virus between 11 and 30 March, 227 had a positive result, giving a rate of 0.2%, or one in 500 people. But in people over the age of 65, the infection rate was half that with one in 1,000 people testing positive for Covid. Read full story Source: BBC News, 8 April 2021
  22. News Article
    Women need more information about contraceptive options, experts said, after concerns over rare blood clots linked to the AstraZeneca Covid jab prompted a debate over side-effects caused by certain forms of the pill. On Wednesday the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) said that evidence that the jab could be causing a rare blood clotting syndrome was growing stronger. As a result the UK’s Joint Committee on Vaccination and Immunisation (JCVI) recommended that healthy people under the age of 30 who were at low risk of Covid should be offered a different vaccine if possible. But the announcement prompted numerous posts on social media questioning why there had been little comment on combined hormonal contraceptives. These methods, which include certain pills, vaginal rings and patches, contain forms of oestrogen and progesterone hormones and have been associated with increased risk of clots, including deep vein thrombosis, pulmonary embolism and cerebral venous sinus thrombosis (CVST) – a very rare clot on the brain. Speaking on ITV’s Good Morning Britain Adam Finn, a professor who is part of the JCVI, confirmed the difference in risk. “The risks of thrombosis that come with taking the pill are very much higher than the risks that we were just seeing on those slides [relating to the rare blood clots from the AstraZeneca vaccine],” he said. Read full story Source: The Guardian, 9 April 2021
  23. Content Article
    The prolonged illness experienced by many patients following acute COVID-19 has been termed ‘Long Covid’ by the self-organised patient groups formed on platforms like Facebook. Some of these patients have now been symptomatic for over a year. Long Covid impacts on ability to work, which has implications for employers, occupational health (OH) services and the wider economy. Clare Rayner and Richard Campbell discuss this in an article in Occupational Medicine.
  24. Content Article
    Helen McKenna sits down with Suzie Bailey, Director of Leadership and Organisational Development at The King’s Fund, and Professor Michael West to explore the results of the 2020 NHS Staff Survey and discuss how the NHS can create an inclusive, compassionate, and supportive working environment for staff.
  25. Event
    As multiple SARS-CoV-2 variants appear around the world, information on detection, transmission, current vaccine efficacy, and health security is rapidly developing. Join this session to learn about emerging variant strains and what is known about the mutation of the virus. Register
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