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Patient Safety Learning

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  1. Patient Safety Learning
    Six out of 10 NHS nurses have had to use credit or their savings over the last year to help them cope with the soaring cost of living, according to new research.
    Acute financial pressures are forcing some nurses to limit their energy use while others are going without food. Many are doing extra shifts to help make ends meet.
    The findings have added to fears that money worries and inadequate pay will prompt even more nurses to quit the NHS, which is already short of almost 35,000 nurses.
    The Royal College of Nursing (RCN), which undertook the survey of almost 11,000 nurses in England, claimed that too many in the profession had been left without enough money to cover their basic needs as they paid the price for “the government’s sustained attack on nursing”.
    Read full story
    Source: The Guardian, 22 March 2024
  2. Patient Safety Learning
    The Government has failed to implement a number of recommendations from significant inquiries into major patient safety issues, years after they were agreed to, according to an independent panel.
    The report, commissioned by the Health and Social Committee in the wake of the Lucy Letby case, voiced concerns about “delays to take real action”.
    As part of its investigation, the panel selected recommendations from independent public inquiries and reviews that have been accepted by government since 2010.
    Nine or more years have passed since these recommendations were accepted by the government of the day
    These covered three broad policy areas – maternity safety and leadership, training of staff in health and social care, and culture of safety and whistleblowing – and were used to evaluate progress.
    The panel gave the Government a rating of “requires improvement” across the policy areas. One of the recommendations was rated good.
    The report said that “despite good performance in some areas” the rating “partly reflects the length of time it has taken for the Government to make progress on fully implementing four of the recommendations which were accepted nine years ago, or longer”.
    “Progress is imminent in several areas, which is reassuring, but we remain concerned about the time it has taken for real action to be taken,” it added.
    Read full story
    Source: The Independent, 22 March 2024
    Read Patient Safety Learning's response to the report:
    Response to Select Committee report: Evaluation of the Government’s progress on meeting patient safety recommendations
  3. Patient Safety Learning
    A new system requiring GPs to agree death certificates with a medical examiner is unlikely to launch at the beginning of April, it has emerged.
    The system, which will see medical examiners (MEs) providing independent scrutiny of all deaths in the community which are not taken to the coroner, had previously been due to come in from April last year.
    However, it was delayed by one year to allow time for Parliament to introduce the necessary supporting legislation and, according to the Department of Health and Social Care (DHSC), this has yet to happen.
    A spokesperson told Pulse that the Government’s intention is to still introduce secondary legislation ‘from April’ to implement death certification reform. However, it could not confirm the exact date the system will launch and said it would provide an update before the end of March.  
    Nottingham GP Dr Irfan Malik told Pulse that local GPs and practice staff ‘seem to be aware there is a delay’ but  have had ‘no official emails’ or communication confirming the delays.
    Read full story
    Source: Pulse, 20 March 2024
  4. Patient Safety Learning
    Trust chiefs have collectively called for the Care Quality Commission (CQC) to review its use of single-word inspection ratings, following MPs’ calls for an overhaul of Ofsted ratings for schools.
    In a report containing a series of recommendations for CQC reform, shared with HSJ, NHS Providers urges the regulator to re-evaluate the success of its single-word ratings, asking it to consider adding a narrative verdict as part of its new provider assessment reports.
    The recommendation is made “in the context of the Ofsted inquiry findings” following the death of headteacher Ruth Perry by suicide, which a coroner ruled was contributed to by an Ofsted inspection. It prompted MPs on the Commons’ education committee to call for a ban on single-word Ofsted ratings.
    The NHSP report said the inquiry’s concerns around inspectors’ behaviour, the complaints process, and single ratings can also be applied to CQC.
    The report adds: “While we recognise the differences between the two regulators’ approaches, we believe now is the right time to take stock… for example, CQC may need to consider the value of its single-word ratings, modelled upon Ofsted’s rating system.
    “As suggested by the Nuffield Trust and many trust leaders, a single-word rating will inevitably oversimplify what happens in a very complex organisation".
    Read full story (paywalled)
    Source: HSJ, 21 March 2024
  5. Patient Safety Learning
    Lessons have not been learned to prevent further deaths in north Wales, coroners have told the health secretary.
    Over the past year, coroners in Wales wrote 41 "prevention of future deaths reports" and more than half were issued to Betsi Cadwaladr health board.
    Health Secretary, Eluned Morgan, said 27 reports issued since January 2023 was "of significant concern".
    Betsi Cadwaladr health board said every report was taken very seriously and work was ongoing to respond to key themes.
    Ms Morgan said all but three of the deaths happened before the health board was moved back into special measures in February 2023.
    The "systemic issues" that emerge as common themes from the coroners' reports include:
    the quality of investigations and effectiveness of actions a lack of integrated electronic health records impacting care the impact of delays in the system on ambulance response times. In a written statement earlier this week, Ms Morgan said the health board had given assurances that it was taking the matter "extremely seriously".
    Read full story
    Source: BBC News, 21 March 2024
  6. Patient Safety Learning
    Many popular AI chatbots, including ChatGPT and Google’s Gemini, lack adequate safeguards to prevent the creation of health disinformation when prompted, according to a new study.
    Research by a team of experts from around the world, led by researchers from Flinders University in Adelaide, Australia, and published in the BMJ found that the large language models (LLMs) used to power publicly accessible chatbots failed to block attempts to create realistic-looking disinformation on health topics.
    As part of the study, researchers asked a range of chatbots to create a short blog post with an attention-grabbing title and containing realistic-looking journal references and patient and doctor testimonials on two health disinformation topics: that sunscreen causes skin cancer and that the alkaline diet is a cure for cancer.
    The researchers said that several high-profile, publicly available AI tools and chatbots, including OpenAI’s ChatGPT, Google’s Gemini and a chatbot powered by Meta’s Llama 2 LLM, consistently generated blog posts containing health disinformation when asked – including three months after the initial test and being reported to developers when researchers wanted to assess if safeguards had improved.
    In response to the findings, the researchers have called for “enhanced regulation, transparency, and routine auditing” of LLMs to help prevent the “mass generation of health disinformation”.
    Read full story
    Source: The Independent, 20 March 2024
  7. Patient Safety Learning
    A group representing hundreds of clinicians has applied to contribute to the Lucy Letby inquiry, to challenge NHS culture around whistleblowing.
    Their experiences of raising concerns should inform the inquiry, they say.
    Letby murdered seven babies and attempted to murder another six while working at the Countess of Chester NHS trust between June 2015 and June 2016.
    The public inquiry is examining how the nurse was able to murder and how the hospital handled concerns about her.
    "The evidence of this group relating to how whistleblowers are treated, not just at one trust but across the UK, is of huge significance," Rachel di Clemente, of Hudgell Solicitors, acting for the clinicians, said.
    The group, NHS Whistleblowers, comprising healthcare professionals across the UK, including current and former doctors, midwives and nurses, has written to Lady Justice Thirlwall's inquiry, asking for them to be formally included as core participants.
    The inquiry has stated it will consider NHS culture.
    And the group says "a culture detrimental to patient safety" is evident across the health service.
    "NHS staff who have bravely spoken up about patient-safety concerns or unethical practices deserve to have their voices heard," Dr Matt Kneale, who co-chairs Doctors' Association UK, which is part of the group, said.
    Read full story
    Source: BBC News, 21 March 2024
  8. Patient Safety Learning
    A campaigner in Norfolk says the "deaths crisis" at the county's mental health trust is getting worse.
    Bereaved relatives met the mental health minister, Maria Caulfield, to discuss failings at the Norfolk and Suffolk NHS Foundation Trust (NSFT).
    The trust says it is on a "rapid, and much-needed journey of improvement".
    Mark Harrison, from the Campaign to Save Mental Health Services in Norfolk and Suffolk, said: "We judge people by what they do, not what they say."
    Members of the campaign group met Ms Caulfield and other MPs in Westminster on 12 March and demanded an independent public inquiry into the trust.
    It came after a report last summer which found that more than 8,000 mental health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022.
    At the meeting, it was agreed Ms Caulfield would meet bosses at the NSFT. The health select committee will also be asked to conduct an inquiry into the trust as part of a broader public inquiry.
    But Mr Harrison said he had little confidence anything would change.
    "The deaths crisis is just out of control and it's accelerating," he said.
    "We have been doing this for 10 years. Every time somebody promises to do something, it doesn't come to anything."
    Read full story
    Source: BBC News, 20 March 2024
  9. Patient Safety Learning
    The chair of an inquiry into the deaths of mental health patients in Essex has said she is “disappointed” at a delay in having its scope confirmed by the health secretary.
    Baroness Kate Lampard said she has been unable to begin substantive work on the probe while still waiting for sign-off from government. 
    An inquiry was launched in 2021 to review the deaths of at least 2,000 people in contact with Essex mental health services across a 20-year period.
    Baroness Lampard took over as chair last year after it gained new powers to compel people to give evidence, following concerns not enough staff were coming forward.
    She has proposed expanding its scope by a further two years until 2022 due to ongoing concerns and to cover NHS patients treated in the private sector.
    The final terms of reference will be set by the health secretary Victoria Atkins. Baroness Lampard said she has not heard back from the Department of Health and Social Care on her proposals since submitting them three months ago.
    Read full story (paywalled)
    Source: HSJ, 19 March 2024
  10. Patient Safety Learning
    William Wragg, the Tory chair of the Public Administration and Constitutional Affairs Committee (PACAC), has belatedly intervened in the growing crisis over the failure of the Prime Minister to appoint a new Parliamentary Ombudsman to replace Rob Behrens who quits the Parliamentary and Health Service Ombudsman on 31 March 2024.
    In a letter published on the committee’s website, Mr Wragg asks Sir Alex Allan, the senior non executive director on the Parliamentary and Heath Services Ombudsman board, what measures will be taken to keep the office going and what is going to happen to people who, via their MP, want to lodge a complaint to the Ombudsman. He also raises whether reports can be published and complaints investigated. 
    The letter discloses that recruitment for a new Ombudsman began last October and a panel chose the winning candidate at the beginning of January. Since then the Cabinet Office and Rishi Sunak, who has to approve the appointment, have not responded. The silence from Whitehall and Downing Street means no motion can be put to Parliament appointing a new Ombudsman, who then appears before the PACAC for a pre appointment hearing. PACAC has only a couple of weeks to set up the hearing.
    Read full story
    Source: Westminster Confidential, 12 March 2024
  11. Patient Safety Learning
    Millions of people with long-term illnesses should get medical treatment at home rather than in hospital to help them carry on working, according to a report.
    The NHS is being urged to deliver more medicines directly to patients’ doors, so they can self-administer drugs at home, and “get on with life” rather than having to travel back and forth to hospitals.
    New research shows this model of care, called clinical homecare, helps those needing regular treatment for chronic conditions, including cancer and arthritis, to stay in employment and retain independence.
    Experts said providing more patients with specialist medicines at home can play a vital role in tackling the UK’s growing rates of economic inactivity, with 2.7 million long-term sick now signed off work.
    The report, commissioned by the National Clinical Homecare Association, said expanding the schemes means millions of patients “could be supported to continue working and living their lives without being defined by their health status”, adding that up to three million cancer patients could benefit.
    Read full story (paywalled)
    Source: The Times, 19 March 2024
  12. Patient Safety Learning
    The BMA has called for an independent inquiry into the use of physician associates (PAs) on medical rotas in place of doctors.
    The union said that health secretary Victoria Atkins must launch the investigation ‘to get to the bottom of the scale’ of the issue across the NHS, as doctors have been reporting instances where gaps in medical rotas are being filled by PAs.  
    This is happening on top of NHS England ‘investing heavily’ in the use of PAs in primary care, ‘instead of qualified experienced doctors’, the BMA added.
    On Friday The Telegraph reported  on leaked rotas from more than 30 hospitals showing physician associates taking on doctors’ shifts.
    This coincided with new NHS England guidance to ‘emphasise that PAs are not substitutes for doctors’, as they are ‘supplementary members’ of the team and they ‘should not be used as replacements for doctors on a rota’.
    BMA chair of council Professor Philip Banfield said: ‘We know from our members’ experiences that hospitals are putting physician assistants on medical rotas, in place of medically qualified doctors.
    ‘This is on top of NHS England investing heavily in the use of physician associates in primary care, instead of qualified experienced doctors.
    "In our view, Victoria Atkins now has a duty to patients and a duty to medically qualified staff – doctors – to establish how widespread this practice is and more importantly, stop it."
    Read full story
    Source: Pulse, 18 March 2024
    Further reading on the hub:
    Partha Kar: We need a pause to assess safety concerns surrounding Physician Associates  
  13. Patient Safety Learning
    A secret report has warned that the NHS is failing to protect trainee paramedics from widespread sexual harassment and racism at work, The Independent has revealed.
    A confidential NHS England report uncovered by The Independent has found that “extremely alarming” conduct and undermining behaviour are rife in ambulance trusts across the country, with trainees subjected to derogatory comments about their age, ethnicity and appearance in front of patients.
    There is a “worrying acceptance” that this is “part of the job”, with students hesitant to raise complaints about sexual behaviour by male colleagues in case it gives them a reputation as “annoying snowflakes”, the report says.
    The revelations come after a recent NHS staff survey revealed that thousands of ambulance staff had reported unwanted sexual behaviour from colleagues and patients last year.
    One healthcare leader described the findings as “harrowing”, warning that much more needs to be done to protect junior staff.
    The national report, which is understood to have gone through several edited versions and is marked commercially sensitive, was not due to be released until The Independent obtained the document through a freedom of information request.
    It found an “undercurrent” of bullying in some areas, with examples of students leaving their jobs as a result of inappropriate behaviour.
    Trainees reported feeling undervalued and unwanted while on the job, with one apparently told: “Your concerns don’t matter – we have to meet patient demands.”
    Ambulance handover delays have also led to student paramedics having less experience and training on the job, prompting fears that newly qualified paramedics do not have sufficient levels of experience in life-critical situations.
    Read full story
    Source: The Independent, 19 March 2024
  14. Patient Safety Learning
    A controversial unproven medical condition which is rooted in pseudoscience and disputed by doctors is routinely being used in Britain to explain deaths after police restraint, the Observer has found.
    “Acute behavioural disturbance” (ABD) and “excited delirium” are used to describe people who are agitated or acting bizarrely, usually due to mental illness, drug use or both. Symptoms are said to include insensitivity to pain, aggression, “superhuman” strength and elevated heart rate.
    Police and other emergency services say the labels, often used interchangeably, are a helpful shorthand used to identify when a person who might need medical help and restraint may be dangerous. But the terms are not recognised by the World Health Organization and have been condemned as “spurious” by campaigners who say they are used to “explain away” the police role in deaths.
    The American Medical Association rejected “excited delirium” after it was used by police lawyers in the case of George Floyd. California lawmakers banned it as a diagnosis or cause of death in October, saying it had been “used for decades to explain away mysterious deaths of mostly black and brown people in police custody”.
    The Royal College of Psychiatrists has also warned that the current definition of ABD, as it is now more commonly known in the UK, could be leading to people “being subjected to avoidable and potentially harmful interventions”. In 2017, a Home Office-commissioned review into deaths in police custody said the terms were “strongly disputed amongst medical professionals”.
    The Royal College of Psychiatrists has also warned that the current definition of ABD, as it is now more commonly known in the UK, could be leading to people “being subjected to avoidable and potentially harmful interventions”. In 2017, a Home Office-commissioned review into deaths in police custody said the terms were “strongly disputed amongst medical professionals”.
    Read full story
    Source: The Guardian, 17 March 2024
  15. Patient Safety Learning
    Hospitals are cynically burying evidence about poor care in a “cover-up culture” that leads to avoidable deaths, and families being denied the truth about their loved ones, the NHS ombudsman has warned.
    Ministers, NHS leaders and hospital boards are doing too little to end the health service’s deeply ingrained “cover-up culture” and victimisation of staff who turn whistleblower, he added.
    In an interview with the Guardian as he prepares to step down after seven years in the post, Rob Behrens claimed many parts of the NHS still put “reputation management” ahead of being open with relatives who have lost a loved one due to medical negligence.
    The ombudsman for England said that although the NHS was staffed by “brilliant people” working under intense pressures, too often his investigations into patients’ complaints had revealed cover-ups, “including the altering of care plans and the disappearance of crucial documents after patients have died and robust denial in the face of documentary evidence”.
    Read full story
    Source: The Guardian, 17 March 2024
  16. Patient Safety Learning
    Local NHS organisations are facing intense “pressure” from NHS England’s national and regional teams to cut staffing numbers to improve the service’s financial outlook for 2024-25. 
    Multiple sources have told HSJ that first draft financial returns submitted by the 42 integrated care systems indicate a combined deficit of around £6bn for the service.
    The £6bn figure is likely to fall substantially as NHS England meets individually with integrated care systems with the worst numbers.
    The need to reduce the number is prompting “horrible” conversations about service cuts, according to HSJ sources. One local leader in the South East region said the need to reduce staffing numbers constituted a “very significant part of the pushback on first-cut numbers”.
    A senior source in the Midlands added: “We’ve got virtually no workforce growth in our plan now… and we’ve still got a deficit. To get to breakeven we’d have to be looking at quite a significant workforce reduction.”
    Another leader in the South of the country said there was “big pressure” to get down to pre-pandemic staff numbers, “despite [the] increases in acuity, demand and backlogs as a consequence of covid”.
    Read full story (paywalled)
    Source: HSJ, 18 March 2024
  17. Patient Safety Learning
    The wait to be diagnosed with endometriosis has increased to almost ten years, a "devastating" milestone say women with the condition.
    It now takes almost a year more than before 2020 to be diagnosed, according to research published by Endometriosis UK, which is setting up new volunteer-led support groups in Wales.
    The wait in Wales is also the longest in the UK, the research found.
    The Welsh government said it knew there was "room for improvement".
    "Nobody listened to me, and to feel like women are still going through that 20 years after my diagnosis is horrific," said Michelle Bates. The 48-year old from Cardiff was diagnosed aged 25 after suffering with "harrowing" pain from age 13 onwards - a 12-year wait.
    "I went back and forth to the GP with my mum, who was the only one who believed in my pain," she said.
    The study by Endometriosis UK, which is based on a survey of 4,371 people who received a diagnosis of endometriosis, showed almost half of all respondents (47%) had visited their GP 10 or more times with symptoms prior to receiving a diagnosis, and 70% had visited five times or more.
    It also found 78% of people who later went on to receive a diagnosis of endometriosis - up from 69% in 2020 - were told by doctors they were making a "fuss about nothing", or comments to that effect.
    Read full story
    Source: BBC News, 18 March 2024
  18. Patient Safety Learning
    A nurse has warned that she has been “crushed and silenced” over a battle with the NHS and the nursing regulator to investigate claims that she was sexually harassed by a colleague at work.
    Michelle Russell told Nursing Times of the “eight-year nightmare” she has endured since coming forward about her experiences and that she said had recently led her nursing career to come to an end.
    “Knowing what’s happened to me is not going to make it easier for anybody else to speak out"
    She has argued that “speaking up is not encouraged” in the NHS and that her case would discourage other nurses from coming forward about sexual harassment.
    Ms Russell said: “Anybody who has been around me would be able to see the emotional impact of all of this on me.
    “I’ve lost my job for highlighting a public safety concern.”
    The national guardian for the NHS told Nursing Times sexual harassment was a “patient safety issue” and warned that staff continued to face difficulties when speaking out.
    It comes as the latest NHS Staff Survey this month revealed that almost 4% of nurses and midwives had been the target of unwanted sexual behaviour in the workplace by another member of staff in the last 12 months.
    Read full story
    Source: Nursing Times, 15 March 2024
  19. Patient Safety Learning
    Gripping a bag of morphine handed to him by hospital staff, Antonio sheltered at a bus stop, cold and shivering, as he tried to work out what to do.
    It was three days after undergoing gruelling surgery to remove his testicular cancer and the 36-year-old had been discharged from NHS care with nowhere to go.
    He was clutching a referral letter for the council’s housing team, given to him by hospital staff. When he arrived at the council office, he explained he had been homeless for the past few months – but was told they could not house him.
    “They asked me: ‘If you are in so much pain and trouble, why did they send you here?’ and I didn’t know what to say,” Antonio, whose name has been changed, tells The Independent. He was given a piece of paper with a phone number on it and told to call the next day.
    It was now late in the afternoon and the Salvation Army’s homeless day centre, where he would usually go for help, was closed. He had no option but to turn around and ready himself for a night on the streets.
    Antonio’s story is, tragically, not unique. He is one of thousands of people across England who have been discharged from NHS hospitals into homelessness in recent years, many while still battling serious health conditions.
    Data obtained by The Independent, in collaboration with the Salvation Army, shows at least 4,200 people were discharged from wards to “no fixed abode” in 2022/23.
    Read full story
    Source: The Independent, 17 March 2024
  20. Patient Safety Learning
    The government is facing calls for a public inquiry into the scandal of sexual abuse in mental health hospitals, following an investigation by The Independent.
    Rape Crisis England and Wales has warned that the “alarming” scale of abuse within the UK’s psychiatric system requires “major intervention” from ministers.
    It comes after an expose by the Independent and Sky News revealed that almost 20,000 reports of sexual incidents – involving both patients and staff – had been made in more than half of NHS mental health trusts in the past five years.
    As well as a public inquiry, which would give survivors the chance to give evidence, Rape Crisis England and Wales wants the government to appoint a named minister with responsibility for addressing the problem.
    Chief executive Ciara Bergman said: “That anyone in the already vulnerable position of needing or being detained for in-patient care because of their mental health needs should experience sexual violence and abuse whilst in the care of the state, is deeply concerning.
    “We are concerned that without major intervention and leadership at the highest levels, this could lead to more incidents of sexual violence and abuse happening, and this behaviour being accepted as inevitable, when it is not, and is indeed absolutely preventable.”
    Read full story
    Source: The Independent, 15 March 2024
  21. Patient Safety Learning
    Some 6.8% of American adults are currently experiencing long Covid symptoms, according to a new survey from the US Centers for Disease Control and Prevention (CDC), revealing an “alarming” increase in recent months even as the health agency relaxes Covid isolation recommendations, experts say.
    That means an estimated 17.6 million Americans could now be living with long Covid.
    “This should be setting off alarms for many people,” said David Putrino, the Nash Family Director of the Cohen Center for Recovery From Complex Chronic Illness at Mount Sinai. “We’re really starting to see issues emerging faster than I expected.”
    When the same survey was conducted in October, 5.3% of respondents were experiencing long Covid symptoms at the time.
    The 1.5 percentage-point increase comes after the second-biggest surge of infections across the US this winter, as measured by available wastewater data.
    More than three-quarters of the people with long Covid right now say the illness limits their day-to-day activity, and about one in five say it significantly affects their activities – an estimated 3.8 million Americans who are now experiencing debilitating illness after Covid infection.
    Read full story
    Source: The Guardian, 15 March 2024
  22. Patient Safety Learning
    A doctor working at a women’s health clinic in Melbourne has been suspended as a regulator revealed it was aware of concerns about other practitioners there. The facility’s boss claims it is a “witch hunt”.
    It follows the death of 30-year-old mother Harjit Kaur, who died in January at the Hampton Park Women’s Clinic after what was described as a “minor procedure”.
    It was later identified as a pregnancy termination.
    The Australian Health Practitioner Regulation Agency (Ahpra) has confirmed Dr Rudolph Lopes’ registration had been suspended but did not reveal the reason behind the decision.
    His registration details show he was reprimanded in 2021 for failing to respond to the regulator’s inquiries.
    “[The regulator] has received a range of concerns about a number of practitioners associated with the Hampton Park Women’s Clinic,” Ahpra said in a statement.
    “[The regulator] has established a specialist team to lead a co-ordinated examination of these issues which involve multiple practitioners across a number of professions and across a number of practice locations.”
    Ahpra chief executive, Martin Fletcher, said he was “gravely concerned by the picture that is emerging.”
    “We have taken strong action to protect the public while our investigations continue,” Fletcher said.
    “National boards stand ready to take any further regulatory action needed to keep patients safe.
    “While the coroner continues to examine the tragic death of a patient, our inquiries are focusing on a wider range of issues that our investigations bring to light.”
    Read more
    Source: The Guardian, 15 March 2024
  23. Patient Safety Learning
    Alice and Lewis Jones were forced to watch their 18-month-old baby die in front of them after a failure by a scandal-hit NHS trust left him with a “catastrophic brain injury” following his birth.
    Their son Ronnie was one of hundreds of babies who have died following errors by Shrewsbury and Telford Hospital, where the largest NHS maternity scandal to date was previously uncovered by The Independent.
    Two years later, Mr and Mrs Jones are calling for the Supreme Court to overturn a controversial decision in February which ruled bereaved relatives could not claim compensation over the psychological impact of seeing a loved one die, even if it was caused by medical negligence.
    It comes after the trust admitted to failings in a letter to the parents’ lawyers.
    Ronnie’s birth in 2020 fell outside of the Ockenden review and his parents have warned it showed failures were still occurring despite warnings made during the inquiry.
    Within the Ockenden inquiry, multiple cases of staff failing to recognise and act upon CTG training were found, and the final report recommended all hospitals have systems to ensure staff are trained and up to date in CTG and emergency skills.
    The report also said the NHS should make CTG training mandatory and that clinicians must not work in labour wards or provide childbirth care without it.
    A CTG measures a baby’s heart and monitors conditions in the uterus and is an important measure before birth and during labour to observe the baby for any signs of distress.
    Ms Jones said: “We knew about the Ockenden review, but everything at Telford was new and so I think we just assumed that lessons had been learned, the same thing wouldn’t happen to us.”
    Ronnie’s parents are campaigning to reverse the Supreme Court which ruled that “secondary victims” – including parents who are not directly harmed by the birth – are not eligible to bring claims for psychiatric injury following medical negligence.
    Read full story
    Source: The Independent, 14 March 2024
  24. Patient Safety Learning
    A trust which last year was ordered to pay a whistleblowing nurse nearly £500,000 must now give a surgeon £430,000 to compensate him for the racial discrimination and harassment he faced after raising patient safety concerns.
    Tribunal judges previously upheld complaints made by Manuf Kassem against North Tees and Hartlepool Foundation Trust and have published a remedy judgment this week setting out the levels of damages the NHS organisation must pay.
    The judgment comes just over a year after a former senior nurse at the trust was awarded £472,600 for unfair dismissal after she warned high workloads had led to a patient’s death.
    Mr Kassem raised 25 concerns regarding patients’ care during a grievance meeting in August 2017. He alleged patients had “suffered complications, negligence, delayed treatment and avoidable deaths”.
    A trust review concluded appropriate processes were followed in the 25 cases. However, the tribunal ruled Mr Kassem was subjected to detriment after making the protected disclosure.
    According to the judgment, Mr Kassem was subsequently removed from the on-call emergency rota and his identity as a whistleblower was revealed by clinical director Anil Agarwal.
    In September 2018, he was the subject of a disciplinary investigation following several allegations against him made by colleagues and others, which concerned “unsafe working practices,” “excessive working hours,” and “potential fraudulent activity.”
    The investigation lasted 17 months and none of the allegations against Mr Kassem were upheld or progressed to a disciplinary hearing. 
    Read full story (paywalled)
    Source: HSJ, 15 March 2024
  25. Patient Safety Learning
    NHS England has told integrated care board (ICBs) leaders they must intervene over failures in abortion services in their patches amid “unprecedented demand” for such provision, HSJ has learned.
    NICE guidance states people should be assessed within a week of requesting an abortion, while procedures should take place within a week of assessment.
    However, NHSE said in a letter to ICBs today that “significant service pressures” have driven up waiting times for surgical abortions – approximately 13% of procedures – to three weeks or longer.
    NHSE has told ICBs to work with providers to, by July 2024:
    Respond to cases of “acute service disruption” and instances where rising waiting times risk limiting access to services; Establish referral pathways and procedures to ensure smooth transfers of care between independent and NHS providers when required; Ensure contracts for 2024-25 are sustainable and follow guidance in the NHS payment scheme; and Commission services in a more managed and collaborative way, including coordination of provision locally to bring waiting times in line with NICE standards. Read full story (paywalled)
    Source: HSJ, 12 March 2024
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