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Patient Safety Learning

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  1. Patient Safety Learning
    NHS England has revealed it estimates there are 5.5 million people on elective referral to treatment waiting lists, rather than the 7 million which is often reported.
    No figures have previously been given for the number of separate individuals, but many in politics, policy and the media have often indicated it is the same as the total number of entries on the RTT list – which hit 7 million in August.
    NHSE elective recovery chief Sir Jim Mackey, speaking at the King’s Fund annual conference in London yesterday, revealed an estimate for the first time of the number of individuals.
    Sir Jim said: “It’s actually 5.5 million people, but seven million entries on the waiting list. There are around a million and a half people, we think, who are on multiple times. So, it’s a lot more complicated than we all think.”
    He said it was not clear how many were patients waiting for genuinely separate issues or procedures, and how many were duplicates for the same pathway – essentially errors. Sir Jim said he hoped a new NHSE project would clarify the picture.
    He said: “Sometimes there are people on twice, where they need one thing then another thing. Other times it’s a bit more complicated… We’re just about to start a process with a handful of organisations to try and work out what that means.”
    Read full story (paywalled)
    Source: HSJ, 2 November 2022
  2. Patient Safety Learning
    Extreme disruption to NHS services has been driving a sharp spike in heart disease deaths since the start of the pandemic, a charity has warned.
    The British Heart Foundation (BHF) said ambulance delays, inaccessible care and waits for surgery are linked to 30,000 excess cardiac deaths in England.
    It has called for a new strategy to reduce "unacceptable" waiting times.
    Doctors and groups representing patients have become increasingly concerned about the high number of deaths of any cause recorded this year.
    New analysis of the mortality data by the BHF suggests heart disease is among the most common causes, responsible for 230 deaths a week above expected rates since February 2020.
    The charity said "significant and widespread" disruption to heart care services was driving the increase.
    Its analysis of NHS data showed that 346,129 people were waiting for time-sensitive cardiac care at the end of August 2022, up 49% since February 2020.
    It said 7,467 patients had been waiting more than a year for a heart procedure - 267 times higher than before the pandemic.
    At the same time, the average ambulance response time for a suspected heart attack has risen to 48 minutes in England against a target of 18 minutes, according to the latest NHS figures.
    The BHF said difficulty accessing face-to-face GP and hospital care may have also contributed to the rise.
    Read full story
    Source: BBC News, 3 November 2022
  3. Patient Safety Learning
    A baby was left "severely disabled" after a delay during his delivery by Caesarean section, a High Court judge has been told.
    Betsi Cadwaladr health board will pay £4m in compensation after a negligence claim was brought by one of the boy's relatives.
    He has required 24-hour care since his birth in 2018 at Glan Clwyd Hospital in Denbighshire.
    The hospital apologised, saying doctors are "working hard" to learn lessons.
    "We are extremely sorry," barrister Alexander Hutton KC, representing the health board, told Mr Justice Soole.
    "[Betsi Cadwaladr] is working hard to learn lessons from this case," he added.
    Read full story
    Source: BBC News, 2 November 2022
  4. Patient Safety Learning
    Some of the most senior gender identity specialists in the UK have accused their professional body of “contributing to an atmosphere of fear” around young people receiving gender-related healthcare.
    More than 40 clinical psychologists have signed an open letter to the Association of Clinical Psychologists UK in protest at the organisation’s recent position statement on the provision of services for gender-questioning children and young people. They say they believe there was a failure to properly consult experts in the field or service users, resulting in a “misleading” statement that “perpetuates damaging discourses about the work and gender-diverse identities more broadly”.
    About half of those signatories are current or former holders of senior roles – including the current director – at what was the only NHS gender identity service for children in England and Wales, the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London.
    NHS England announced in July it would be closing the GIDS and replacing it with regional hubs, after being warned by the interim report of the Cass Review into gender services for young people that having only one provider was “not a safe or viable long-term option”.
    In 2021, inspectors rated the service “inadequate” overall and highlighted overwhelming caseloads, deficient record-keeping and poor leadership, suggesting that record waiting lists meant thousands of vulnerable young people were at risk of self-harm as they waited years for their first appointment.
    In a position statement published last month, the ACP-UK wrote that “the new, regional services will have to offer a radical alternative [after the closure of GIDS] to meet the needs of all young people with gender dysphoria.”
    The letter suggests: “An alternative interpretation is that it is possible to provide support for distress related to gender identity where mental health needs and neurodiversity are also present, and remain cognisant of all factors within formulation-based practice”.
    Read full story
    Source: The Guardian, 2 November 2022
  5. Patient Safety Learning
    NHS England has ordered the collection of identifiable patient data from hospitals by US data firm Palantir, for a pilot scheme aimed at accelerating recovery of elective waiting lists.
    The regulator has instructed NHS Digital, with which it will merge in January, to use Palantir’s Foundry platform to collect data about patients’ admission, inpatient, discharge and outpatient activity at acute hospitals.
    Identifiable data such as patients’ NHS numbers, date of birth, and postcode will be collected through Palantir’s software. Patients cannot opt out of having their data collected.
    But NHS Digital’s Caldicott Guardian – who is meant to safeguard use of data – has identified “risks” in the pilot and said it needs additional work before it can meet confidentiality requirements.
    The data collected will be “anonymised in accordance with the ICO’s (Information Commissioner’s) Anonymisation Code of Practice”. However, privacy campaigners Medconfidential claimed this code is not fit for purpose and warned that NHS chiefs were making the same mistakes as previous failed efforts to use patient data appropriately.
    Read full story (paywalled)
    Source: HSJ, 1 November 2022
  6. Patient Safety Learning
    A consultant oncologist who ignored a hospital instruction and attended patients’ cancer surgery on two days when he knew he was still testing positive for Covid-19 has been suspended from the UK medical register for three months.
    Andrew Gaya admitted knowingly breaking the rules but told the medical practitioners tribunal he had feared that the patients’ treatments would be postponed if he could not attend the private London Gamma Knife Centre, part of HCA Healthcare UK. The two incidents occurred in the early weeks of the pandemic, at a time of high covid death rates.
    “I did not take the decision to attend the centre on 3 April 2020 lightly and was aware it was not in accordance with the instructions I had been given,” Gaya told the tribunal. “At the time I thought that I wasn’t going to do any harm and that I was acting in the best interests of the patient as the case was urgent.
    “I know I should have telephoned [the relevant manager] and asked if she would allow me to undertake the treatment, but I was afraid her answer would be ‘no’ and that the patient’s treatment would be cancelled,” he told the tribunal in a witness statement.
    Both patients have since died, but after the tribunal concluded Gaya told the Daily Telegraph, “One lived for 6 months with good quality of life.”
    Gaya, who was present as part of a multidisciplinary team, wore protective gear and observed social distancing. There is no evidence that he had infected anyone.
    Read full story
    Source: BMJ, 1 November 2022
  7. Patient Safety Learning
    Mandatory training for treating people with autism and learning disabilities is being rolled out for NHS health and care staff after a patient died.
    It comes after Oliver McGowan, 18, from Bristol, died following an epileptic seizure.
    At the time, in November 2016, he had mild autism and was given a drug he was allergic to despite repeated warnings from his parents.
    His mother Paula lobbied for mandatory training to potentially "save lives".
    A spokesman for the NHS said the training had been developed with expertise from people with a learning disability and autistic people as well as their families and carers.
    The first part of the Oliver McGowan Mandatory Training is being rolled out following a two-year trial involving more than 8,300 health and care staff across England.
    Mark Radford, chief nurse at Health Education England said: "Following the tragedy of Oliver's death, Paula McGowan has tirelessly campaigned to ensure that Oliver's legacy is that all health and care staff receive this critical training.
    "Paula and many others have helped with the development of the training from the beginning.
    "Making Oliver's training mandatory will ensure that the skills and expertise needed to provide the best care for people with a learning disability and autistic people is available right across health and care."
    Read full story
    Source: BBC News, 2 November 2022
  8. Patient Safety Learning
    Many people who are medically ready to leave hospital are not able to go home because of pressures in social care.
    Health and social care teams across Scotland are working to create more room in hospitals as we go into winter when it traditionally gets busier.
    In Lothian, they are using care homes as an interim measure to help rehabilitate people before they can go back home.
    Nineteen rooms at the Elsie Inglis Nursing Home in Edinburgh are being used in an effort to help people get out of hospital.
    Archie McQuater, who spent seven months in The Royal Infirmary of Edinburgh after one of his big toes was removed because of an infection, has finally got out of hospital and is now staying at the Elsie Inglis.
    The 94-year-old has been in the care home for two months and is trying to improve his mobility so that he can return home.
    Archie is among 200 people in Edinburgh who have been moved from a hospital to a care home between November 2021 and September 2022.
    NHS Lothian estimates it has saved about 13,000 bed days in hospitals during that time.
    Read full story
    Source: BBC News, 2 November 2022
  9. Patient Safety Learning
    NHS England “forgot the people” when it published controversial guidelines last month which said patients faced being removed from the waiting list if they declined two appointment dates, a senior director has admitted.
    NHSE elective recovery chief Sir Jim Mackey said the guidance was drafted to address legitimate concerns from trusts, but that the process had been “rushed”.
    Following Sir Jim’s comments, NHSE told HSJ the guidance, which had sparked widespead criticism including from patient groups, would not be changing. But Sir Jim said NHSE would “spend time” better understanding patients after “reflecting” on the process which had created the controversial guidelines.
    Speaking at the King’s Fund annual conference, Sir Jim said: “[The guidance] was largely a response to trusts saying to us: ‘We keep offering these patients options and they won’t take them, so what do we do?’
    “We rushed through a policy to try and deal with that, and in the process, I think forgot the people…We’ve reflected on that.”
    Read full story (paywalled)
    Source: HSJ, 1 November 2022
  10. Patient Safety Learning
    Further funding cuts to the NHS will unavoidably endanger patient safety, an NHS leader warned last week after the chancellor’s promise of spending cuts of “eye-watering difficulty”.
    Matthew Taylor, the chief executive of the NHS Confederation, said his members were issuing the “starkest warning” about “the huge and growing gulf between what the NHS is being asked to deliver and the funding and capacity it has available”.
    The warning came as figures showed that paramedics in England had been unavailable to attend almost one in six incidents in September due to being stuck outside hospitals with patients. Service leaders say wait times for A&E and other care are being exacerbated by an acute lack of nurses, with a record 46,828 nursing roles – more than one in 10 – unfilled across the NHS.
    "Patients are presenting more unwell," says a GP from South Wales,
    "Wait times in A&E have become unmanageable, so we’re seeing patients who have waited so long to be seen they’re bouncing back to us. Things we can’t deal with, like injuries and chest pain. We tell them they have to go back to A&E.
    "Abuse of surgery reception and admin staff began last year and it’s just scaled up from there. We’ve had staff members who have been verbally and physically threatened and we’re struggling to recruit and retain staff – people are hired and quit in a couple days. A lot of people are going off sick with stress."
    Five healthcare workers describe the pressures they are facing, including ambulance stacking, rising A&E wait times and difficulties discharging patients.
    Read full story
    Source: The Guardian, 1 November 2022
  11. Patient Safety Learning
    One in 10 patients undergoing fertility treatment experience suicidal thoughts “all the time”, a survey suggests.
    Fertility Network UK, which carried out the poll, said the findings reveal the “far-reaching trauma” of experiencing infertility and undergoing IVF in the UK.
    Four in 10 respondents - 98% of whom were women - said they had experienced suicidal feelings.
    Gwenda Burns, chief executive of Fertility Network UK, said: “Fertility patients encounter a perfect storm: not being able to have the child you long for is emotionally devastating.
    "But then many fertility patients face a series of other hurdles, including potentially paying financially crippling amounts of money for their necessary medical treatment, having their career damaged, not getting information from their GP, experiencing their relationships deteriorate, and being unable to access the mental support they need."
    “This is unacceptable. Infertility is a disease and is as deserving of medical help and support as any other clinical condition.”
    Three in four patients said their GP did not provide sufficient information about fertility problems and treatment.
    Read full story (paywalled)
    Source: The Telegraph, 31 October 2022
  12. Patient Safety Learning
    The Covid public inquiry has asked to see Boris Johnson's WhatsApp messages during his time as prime minister as part of its probe into decision-making.
    Counsel for the inquiry, Hugo Keith KC, said the messages had been requested alongside thousands of other documents.
    He said a major focus of this part of the inquiry was understanding how the "momentous" decisions to impose lockdowns and restrictions were taken.
    The revelations came as he set out the details of how this module will work. The inquiry is being broken down into different sections - or modules as they are being called.
    The preliminary hearing for module one, looking at how well prepared the UK was, took place last month.
    Monday marked the start of the preliminary hearing for module two, which is looking at the political decision-making.
    Mr Keith said this allowed the inquiry to take a "targeted approach". He said it would look at whether lives could have been saved by introducing an earlier lockdown at the start of 2020.
    Read full story
    Source: BBC News, 31 October 2022
  13. Patient Safety Learning
    The largest expansion of medical training posts has been announced the day after Scotland’s health secretary warned that the NHS was facing up to its most challenging winter.
    Humza Yousaf yesterday confirmed that 152 more places for trainee doctors would be created next year.
    He hailed it as the “most significant increase in medical training places to date” and an increase on the 139 places created last year. The announcement comes after ministers were urged to fund the creation of additional training places in key specialities including general practice, core psychiatry, oncology, emergency medicine, intensive care medicine and anaesthetics.
    “These additional training places highlight the Scottish government’s continued commitment to ensure that our health service is resilient and can continue delivering high quality care to those who need it,” Yousaf said. “This record expansion will support a wide range of medical specialties, many of which are under increased pressure as a result of growing demand.
    “We will continue to monitor the number of available training places in collaboration with NHS Education for Scotland to help make sure the NHS is equipped to meet the country’s current and future needs.”
    Read full story (paywalled)
    Source: The Times, 1 November 2022
  14. Patient Safety Learning
    Insulin rights activists and those who live with diabetes are calling for meaningful action to address the high costs of insulin in the United States as a new study shows the widespread habit of rationing the life-saving medicine.
    A study published on 18 October in the Annals of Internal Medicine by researchers at Harvard Medical School, the City University of New York’s Hunter College and Public Citizen, found that 1.3 million Americans rationed insulin due to the high costs of insulin in 2021. The staggering number represents an estimated 16.5% of the US population with diabetes.
    The study found insulin rationing was most commonly reported by those without health insurance coverage and individuals under the age of 65 not eligible for Medicare. Black insulin users were more likely to report rationing insulin, at 23.2%.
    The impact of the practice can be terrible.
    Janelle Lutgen of Dubuque county, Iowa, lost her 32-year-old son Jesse, a type 1 diabetic, after he started rationing his insulin because he lost his job and with it his health insurance and died in early 2018 from diabetic ketoacidosis.
    Without health insurance, Lutgen said over-the-counter insulin costs more than $1,000 (£865) a month, and that her son couldn’t afford the high cost of healthcare coverage in the marketplace without a job and wasn’t eligible for Medicaid coverage because his income from when he was working was too high.
    “It would probably be impossible to really know exactly all the harm that’s been done with high insulin prices,” said Lutgen, who explained that individuals who ration insulin because of the cost, if they do survive, can still experience other health impacts such as neuropathy, or losing toes or feet. “It seems like we can’t get it through legislators’ heads that we have to make sure everyone who needs insulin can get it, not just people who have insurance or people on Medicare – everybody. The only way to do that is to go to the root of the problem, big pharma.”
    Read full story
    Source: The Guardian, 1 November 2022
  15. Patient Safety Learning
    The number of people under 40 in the UK being diagnosed with type 2 diabetes is rising at a faster pace than the over-40s, according to “shocking” and “incredibly troubling” data that experts say exposes the impact of soaring obesity levels.
    The UK ranks among the worst in Europe with the most overweight and obese adults, according to the World Health Organization. On obesity rates alone, the UK is third after Turkey and Malta.
    The growing numbers of overweight and obese children and young adults across the UK is now translating into an “alarming acceleration” in type 2 diabetes cases among those aged 18 to 39, analysis by Diabetes UK suggests.
    There is a close association between obesity and type 2 diabetes. There is a seven times greater risk of type 2 diabetes in obese people compared with those of healthy weight, and a threefold increase in risk for those just overweight.
    “This analysis confirms an incredibly troubling growing trend, underlining how serious health conditions related to obesity are becoming more and more prevalent in a younger demographic,” Chris Askew, the chief executive of Diabetes UK, said.
    He added: “While it’s important to remember that type 2 diabetes is a complex condition with multiple other risk factors, such as genetics, family history and ethnicity, these statistics should serve as a serious warning to policymakers and our NHS.
    “They mark a shift from what we’ve seen historically with type 2 diabetes and underline why we’ve been calling on the government to press ahead with evidence-based policies aimed at improving the health of our nation and addressing the stark health inequalities that exist in parts of the UK.”
    Read full story
    Source: The Guardian, 1 November 2022
  16. Patient Safety Learning
    Parents are being told to urgently bring their children forward for flu vaccinations as new data reveals the rate of hospitalisation and ICU admission for people with the virus is rising fastest among those under five years old.
    New figures published in the UK Health Security Agency’s (UKHSA) National flu and Covid-19 surveillance report show that cases of flu have climbed quickly in the past week, indicating that the season has begun earlier than normal.
    According to the UKHSA, vaccination for flu is currently behind last season for pre-schoolers (12.1% from 17.4% in all two-year-olds and 12.8% from 18.6% in all three-year-olds).
    It has also fallen behind in pregnant women (12.4% from 15.7%) and under 65s in a clinical risk group (18.2% from 20.7%).
    Dr Mary Ramsay, director of public health programmes at the UK Health Security Agency, said: “Our latest data shows early signs of the anticipated threat we expected to face from flu this season.
    “We’re urging parents in particular not to be caught out as rates of hospitalisations and ICU admissions are currently rising fastest in children under 5.
    “This will be a concern for many parents and carers of young children, and we urge them to take up the offer of vaccination for eligible children as soon as possible.”
    Read full story
    Source: The Independent, 20 October 2022
  17. Patient Safety Learning
    Jeremy Hunt has been told that any cuts to the health budget will in effect “kill” dental services across the UK and deny millions of patients access to a dentist on the NHS.
    The chancellor has told members of the cabinet that “everything is on the table” as he seeks to find tens of billions of pounds in savings after ditching the economic plan of Liz Truss, who said on Thursday she was standing down as prime minister. Health is one key area expected to be hit.
    But in an email to Hunt seen by the Guardian, the head of the British Dental Association (BDA) said in plain terms that because NHS dentistry had already “faced cuts with no parallel anywhere in the health service” over the last decade, any further reduction in funding could trigger its collapse.
    “In blunt terms, NHS dentistry is approaching the end of the road,” Martin Woodrow, the BDA chief executive, wrote in the memo. “There is simply no more fat to trim, short of denying access to an even greater proportion of the population.”
    In the memo to Hunt, Woodrow wrote: “Recent NHS England board papers confirm officials are euphemistically ‘taking steps to maximise access from existing resources’. We know what that means. Yes, we recognise the unparalleled pressures on public spending. Equally, we cannot escape the hard fact that a service millions depend on materially lacks the resources to underpin any rebuild.
    “You have also spoken of the need for all departments to seek ‘efficiency savings’. Since the financial crash, NHS dentistry has faced cuts with no parallel anywhere in the health service, going into the pandemic with lower government contributions – in cash terms – than it saw a decade ago.
    Read full story
    Source: The Guardian, 21 October 2022
  18. Patient Safety Learning
    Tracey Fletcher, chief executive of East Kent Hospitals, said: "I want to say sorry and apologise unreservedly for the harm and suffering that has been experienced by the women and babies who were within our care, together with their families, as described in today’s report.
    "These families came to us expecting that we would care for them safely, and we failed them.
    "We must now learn from and act on this report; for those who have taken part in the investigation, for those who we will care for in the future, and for our local communities. I know that everyone at the Trust is committed to doing that.
    "In the last few years we have worked hard to improve our services and have invested to increase the numbers of midwives and doctors, in staff training, and in listening to and acting on feedback from the people who receive our care.
    "While we have made progress, we know there is more for us to do and we absolutely accept that. Now that we have received the report, we will read it in full and the Board will use its recommendations to continue to make improvements so that we are providing the safe, high-quality care our patients expect and deserve.
    "I want every family – whether they contributed to the investigation or not – to know I am here to listen to them, to learn and to lead our Trust in acting on this report. 
    "I would like to thank Dr Bill Kirkup and the investigation team for their work. Today, our thoughts remain with those who have shared their experiences. We are grateful to them.”
    Source: NHS East Kent Hospitals, 19 October 2021
  19. Patient Safety Learning
    Russell-Cooke personal injury and clinical negligence partner Grant Incles recently represented Mrs Karen Preater in a clinical negligence case over vaginal mesh surgery performed on her at a hospital in north Wales in 2014. 
    Wrexham County Court found in favour of Mrs Preater, and roundly dismissed allegations made by the defendant in this case, the Betsi Cadwaladr University Health Board, that the claimant had lied in the presentation of her case, as part of a Fundamental Dishonesty defence. 
    Mrs Preater underwent vaginal mesh surgery in January 2014 - to which she had not been properly consented. The surgery itself was performed negligently and as a result she suffered a life-changing chronic pain condition. In late 2020, the defendant carried out intrusive video surveillance of Mrs Preater and trawled through her life on social media, proceeding to launch a defence of Fundamental Dishonesty pursuant to S.57 of the Criminal Justice and Courts Act 2015.
    The defendant alleged that the claimant was seeking to lie to the Court about her ability to work and need for care and assistance which, if found to be correct by the Court, would have meant that Mrs Preater would have lost all of her claimed compensation, and which may well have led to an application by the defendant to have her committed to prison for her alleged dishonesty.
    The case was fought to trial over seven days in July 2022. HHJ Howells found that Mrs Preater had not sought to deceive any party at any time and should be fully compensated for her grave suffering since being injured over eight years ago. 
    Read full story
    Source: Russell-Cooke, 4 August 2022
    Court judgement:
    22081101.Preater v BCUHB approved judgment dated 4 August 2022.pdf
  20. Patient Safety Learning
    The “social prescribing” of gardening, singing and art classes is a waste of NHS money, a study suggests.
    Experts found that sending patients to community activity groups had “little to no impact” on improving health or reducing demand on GP services.
    The research calls into question a major drive from the NHS and Department of Health to increase social prescribing as a solution to the shortage of doctors and medical staff.
    In 2019 the NHS set a target of referring 900,000 patients for such activities via their GP surgeries within five years.
    Projects receiving government funding include football to support mental health, art for dementia, community gardening and singing classes to help patients to recover from Covid.
    However, the study, published in the journal BMJ Open, said there was “scant evidence” to support the mass rollout of so-called “social prescribing link workers”.
    Read full story (paywalled)
    Source: The Times, 18 October 2022
  21. Patient Safety Learning
    A quarter of services the Care Quality Commission has recently inspected required enforcement action from the regulator, its chief executive has revealed. 
    Speaking at the launch of the regulator’s annual State of Care report, Ian Trenholm called for a “long-term, sustainable funding solution” from the government to aid a service that was ”genuinely struggling to cope”.
    Mr Trenholm said “about a quarter of the services” the CQC has inspected in 2022 had resulted in it having to take “enforcement action”.
    Examples of action taken against NHS trusts in the last year included enforcement measures placed on Nottingham University Hospitals, University Hospitals Sussex, and Princess Alexandra Hospital.
    In response to a question from HSJ about the robustness of the CQC’s inspection regime following further care quality and safety scandals, Mr Trenholm said observers should not focus solely on the ratings given to trusts by the CQC as there was a lot ”work going on in the background, whether that’s enforcement or otherwise”.
    He added the CQC had significantly increased the amount of information it was gathering in relation to concerns about services.
    Read full story
    Source: HSJ, 21 October 2022
     
  22. Patient Safety Learning
    Indonesia has temporarily banned all syrup-based and liquid cough medicines after the death of nearly 100 children from acute kidney failure since the start of this year.
    Most of those affected are said to be below the age of six.
    Muhammad Syahril Mansyur, the country’s health ministry spokesman, said: “Until today, we have received 206 reported cases from 20 provinces with 99 deaths.”
    He added: “As a precaution, the ministry has asked all health workers in health facilities not to prescribe liquid medicine or syrup temporarily … we also asked drug stores to temporarily stop non-prescription liquid medicine or syrup sales until the investigation is completed.”
    The ban, announced by the health ministry on Wednesday, applies to prescription and over-the-counter medicines. It comes after nearly 70 children died of acute kidney failure this year in the Gambia, linked to four brands of paracetamol cough syrup manufactured by India’s Maiden Pharmaceuticals.
    Read full story (paywalled)
    Source: The Times, 20 October 2022
  23. Patient Safety Learning
    A medical expert has told the trial of nurse Lucy Letby how he noticed a "quite disturbing and quite unusual" pattern in the deaths of babies she is accused of murdering.
    Ms Letby is charged with killing seven babies and attempting to murder 10 others at the Countess of Chester Hospital in 2015 and 2016.
    Expert Dr Dewi Evans was approached by the National Crime Agency to review the case in 2017.
    Giving evidence at Manchester Crown Court, Dr Evans said: "The concern was that there had been a number of deaths in the Countess of Chester that had been unusual.
    "There were far more deaths than they would expect. There was collapses in babies that were otherwise quite stable, but in many of the cases resuscitation was not successful."
    It is alleged Ms Letby injected air into the bloodstream of a baby referred to in court as Child A, shortly after she came on shift in June 2015, just over 24 hours after his premature birth.
    The prosecution alleges she used the same method to attack his sister, Child B, on the following night shift.
    Dr Evans told the court that a review of Child A's records showed that the baby boy was in a "stable condition" before his collapse.
    He said: "He was as well as could be expected, all the markers of wellbeing were very satisfactory.
    Read full story
    Source: BBC News, 25 October 2022
     
  24. Patient Safety Learning
    A Harley Street doctor suspended for working while testing positive for Covid at the height of the pandemic has said that his patient’s cancer treatment took priority.
    Dr Andrew Gaya was found to have “blatantly disregarded” the rules by going to work at a centre for patients with brain tumours after he tested positive for the disease.
    The “highly regarded” consultant oncologist “dishonestly” misled colleagues that he was safe to work by keeping his positive test secret, a tribunal found.
    Dr Gaya, whose work is at the forefront of tumour care and has been described as “world class”, said he defied Covid-19 rules because he believed “the risk of harm to his patient” in delaying treatment was “greater than the risk he posed”.
    Now, the doctor of 27 years has been suspended for three months at a Medical Practitioners’ Tribunal.
    Read full story (paywalled)
    Source: The Times, 20 Ocotober 2022
  25. Patient Safety Learning
    Two out of five maternity units in England are providing substandard care to mothers and babies, the NHS watchdog has warned.
    “The quality of maternity care is not good enough,” the Care Quality Commission (CQC) said in its annual assessment of how health and social care services are performing.
    It published new figures showing it rated 39% of maternity units it inspected in the year to 31 July to “require improvement” or be “inadequate” – the highest proportion on record.
    Ian Trenholm, the CQC’s chief executive, said maternity services were deteriorating, substandard care was unacceptably common and failings were “systemic” across the NHS.
    Its latest state of care report said: “Our ratings as of 31 July 2022 show that the quality of maternity services is getting worse, with 6% of NHS services (nine out of 139) now rated as inadequate and 32% (45 services) rated as require improvement.
    “This means that the care in almost two out of every five maternity units is not good enough.”
    The report said: “The findings of recent reviews and reports … show the same concerns emerging again and again. The quality of staff training, poor working relationships between obstetric and midwifery teams and a lack of robust risk assessment all continue to affect the safety of maternity services. These issues pose a barrier to good care.”
    Staff not listening to women during pregnancy and childbirth is a recurring problem, Trenholm said. Their concerns “are not being heard” by midwives and obstetricians “in the way that they should”.
    Read full story
    Source: The Guardian, 21 October 2022
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