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Patient Safety Learning

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  1. 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
  2. Patient Safety Learning
    Almost half of healthcare workers at some hospitals were infected with COVID-19 during the height of the first wave, the director of a biomedical research centre has told MPs.
    Sir Paul Nurse, director of the Francis Crick Institute, told MPs today that COVID-19 had infected up to 45% of healthcare workers during ”the height of the pandemic” at some hospitals, according to the centre’s research.
    Chief medical officer Chris Whitty also told the Health and Social Care Committee that there was more evidence that COVID-19 was transmitted between staff, rather than from patients to staff, and there was “just as much risk as people being in their break rooms than on wards”.
    Sir Paul told MPs the Francis Crick Institute contacted Downing Street in March and wrote to health secretary Matt Hancock in April to emphasise the importance of regular systematic testing for all healthcare workers as it was “quite clear” that those without symptoms were likely to be transmitting the disease.
    He said hospital staff “were infecting their colleagues, they were infecting their patients, yet they were not being tested systematically.”
    Read full story
    Source: HSJ, 21 July 2020
  3. Patient Safety Learning
    NHS England is trying to force a prestigious cancer trust to publicly apologise to a group of whistleblowers, after being ‘shocked’ by the way it responded to a review into their concerns.
    As HSJ reported in January, an external review into The Christie Foundation Trust supported multiple concerns which had been raised by staff about a major research project with pharma giant Roche.
    The review had also noted how 20 current and former employees, some of whom were “long-standing, loyal, senior staff”, had described bullying behaviours and felt they had suffered detriment because they spoke out.
    In response to the review, trust chair Christine Outram and chief executive Roger Spencer issued a bullish report listing numerous “inaccuracies” and characterised the concerns as being limited to a “small number of staff who are dissatisfied or aggrieved”.
    It did not thank the staff for raising the issues, nor apologise for the experiences they had. However, HSJ has now learned that NHSE is trying to ensure the trust issues a public apology.
    At a meeting with some of the whistleblowers on 11 February, David Levy, medical director for NHSE North West, said he was “shocked” and “frankly a bit angry” at the trust’s response, saying it reflected badly on the organisation, HSJ understands.
    Read full story (paywalled)
    Source: HSJ, 9 March 2022
  4. Patient Safety Learning
    A&E waits are now “apocalyptic” and “worse than ever imagined” leaked NHS data shows, and could be driving 1,000 patient deaths a month, The Independent can reveal.
    Almost 700,000 people have waited more than 12 hours in A&E in the first seven months of 2022, according to leaked NHS data.
    The “hidden” monthly trolley waits, not published in national data, have more than doubled this year in comparison to 2019.
    Dr Katherine Henderson, President of the Royal College of Emergency Medicine, warned data shows trolley waits are “worse than ever imagined” and said it is “scandalous” the real figures are not published despite promises.
    Dr Henderson warned the deterioration in A&E waiting times is the result of “decades of underfunding” and “unheeded warnings” over staffing and social care.
    In one message to staff in Nottinghamshire, seen by The Independent, hospital leaders said last week patients were waiting more than 40 hours for beds in A&E, while some areas of the hospital were running on a 1:14 staffing ratios and patients were waiting at home with no care.
    Read full story
    Source: The Independent, 1 August 2022
  5. Patient Safety Learning
    The NHS’ mental health director has branded abuse exposed at a city inpatient unit as “heartbreaking and shameful” and ordered a national review of safety across all providers.
    In a letter to all leaders of mental health, learning disability and autism providers, shared with HSJ, Claire Murdoch responded to BBC Panorama’s exposure of patient abuse at the Edenfield Centre run by Greater Manchester Mental Health FT by warning trusts they should leave “no stone unturned” in seeking to eradicate and prevent poor care.
    An investigation by the programme found a “toxic culture of humiliation, verbal abuse and bullying” at the medium-secure inpatient unit in Prestwich near Manchester.
    In response, Ms Murdoch said the mindset that “it could happen here” must be at the front and centre of national and local approaches, adding that trusts which already adopt this outlook are most likely to identify and prevent toxic and closed cultures.
    She also urged all boards to urgently review safeguarding of care in their organisations and identify any immediate issues requiring action now, such as freedom to speak up arrangements, complaints, and care and treatment reviews. A separate national probe into the quality of inpatient care is due to launch imminently.
    Read full story (paywalled)
    Source: HSJ, 30 September 2022
  6. Patient Safety Learning
    Most GP practices in England are still using ‘archaic’ Lloyd George paper records despite a commitment to digitise them, HSJ has found.
    NHS England’s 2019 GP contract included a commitment to do away with the so-called “Lloyd George envelopes” – named after the early 20th century prime minister who introduced a pre-NHS health insurance scheme – and digitise them by 2022-23. The NHS stopped issuing new envelopes for first-time registrations in January 2021.
    But Freedom of Information requests submitted by HSJ have revealed that the famous brown paper records, some of them many decades old, are still widely used in England.
    Where they are still used, staff typically use electronic records for new information, but have to find and consult the paper records occasionally, when they need older information. This is less efficient than if the records had been digitised, and storing the paper records takes up several rooms in many practices.
    Read full story (paywalled)
    Source: HSJ, 5 June 2023
  7. Patient Safety Learning
    NHS England and the Care Quality Commission are becoming less understanding of the pressures on trusts, their leaders report, with one CEO complaining “the arrogance and bullying continues to get worse”. 
    This is the finding of a new survey of trust chiefs, chairs and directors by NHS Providers, shared with HSJ and published in a new report on regulation today.
    It found two-thirds of trust leaders felt NHSE had a good understanding of “the pressures that NHS providers are facing” — down from 74% cent in a similar NHSP regulation survey in 2019, and 75% in 2018.
    NHSP found: “Leaders from the acute sector were much more likely to say regulators understood the pressure they were under than those from the mental health or community sectors.”
    One combined acute/community CEO said: “Not only have the number of requests increased but now they are coming from multiple levels, [integrated care system], regional and national.”
    Meanwhile, most respondents welcomed regulators’ proposed changes to their approach – for example, by the CQC to a “risk based” approach, and NHSE towards collaboration – but many indicated they did not feel these were being put into practice.
    Read full story (paywalled)
    Source: HSJ, 26 July 2022
  8. Patient Safety Learning
    Paramedics are being told to take a police escort to more than 1,200 addresses for fear of attack, The Times has revealed.
    The College of Paramedics said the figure was outrageous and called on courts to implement tougher sentences for assaults on paramedics.
    Ambulance services have marked hundreds of addresses after violence towards crew. Notes on addresses include “patient keeps axe under pillow — serrated knife hidden round the house and is known to be a risk”, “shoots/throws acid”, and “patient is anti-ambulance”.
    Read full story (paywalled)
    Source: The Times, 4 June 2023
  9. Patient Safety Learning
    The government has been told it is ‘not sustainable’ to continue to delay its response to a major review on patient safety as ‘babies are still being damaged’.
    The Independent Medicines and Medical Devices Safety Review spoke to more than 700 people, mostly women who suffered avoidable harm from surgical mesh implants, pregnancy tests and an anti-epileptic drug, and criticised “a culture of dismissive and arrogant attitudes” including the “unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”.
    The review’s author Baroness Julia Cumberlege told HSJ that “time is marching on” for the Department of Health and Social Care to implement the recommendations of her July report, which include setting up a new independent patient safety commissioner.
    The Conservative peer said pressure was building on government to adopt the findings of the review, since it had been endorsed by Royal Colleges and has already been adopted by the Scottish government. She said the government had given “evasive” answers in parliament on the issue.
    In an exclusive interview with HSJ, Baroness Cumberlege said:
    There is a crowded field of regulators but “there’s a void” for a service that listens and responds to patients’ safety concerns. She feels “diminished” that women’s concerns are still being dismissed by clinicians, but said young doctors are a cause for hope. She is “very optimistic” report will be implemented – but the NHS has to have the will to make changes. Read full story (paywalled) 
    Source: HSJ, 13 October 2020
  10. Patient Safety Learning
    An ambulance trust at the centre of an inquiry into alleged cover-ups has shown signs of improvement, according to the Care Quality Commission (CQC).
    North East Ambulance Service Foundation Trust has been accused of withholding information from coroners. An ongoing inquiry chaired by former acute trust chief executive Dame Marianne Griffiths is looking at how it deals with serious incidents, whistleblowers’ concerns and whether the trust complies with the “duty of candour” as well as its processes around inquests. 
    The CQC report suggests it has made progress on many of these areas since inspections last year – which triggered a warning notice – and has raised the rating for its emergency and urgent care division from “inadequate” to “requires improvement”. 
    The inspectors said it was a “mixed picture” but they had seen “the beginnings of a safety culture emerging within the trust”.
    Read full story
    Source: HSJ, 7 July 2023
  11. Patient Safety Learning
    Many media stories about ketamine as a treatment for psychiatric disorders such as depression “go well beyond the evidence base” by exaggerating the efficacy, safety and longevity of the drug or by overstating the risks, an analysis has found.
    Researchers examined 119 articles about ketamine and mental illness published by major print media in Australia, the US and UK over a five-year period. They found articles peaked in 2019, when the US Food and Drug Administration approved a ketamine-derived nasal spray known as esketamine for treatment-resistant depression.
    Researchers found 37% of articles contained inaccurate information, largely related to efficacy, safety information and the longevity of the effect of the treatment. Ketamine treatment was portrayed in an “extremely positive light” in 69% of articles, the review found.
    “Overly optimistic statements from medical professionals regarding efficacy or safety may encourage patients to seek treatments that may not be clinically appropriate,” says the paper, published  in the journal BJPsych Open.
    “Disconcertingly, some articles included strong statements about treatment efficacy that went well beyond the evidence base. Conversely, exaggeration of the risks may discourage patients from pursuing a treatment that may be suitable for them.”
    Read full story
    Source: The Guardian, 8 June 2023
  12. Patient Safety Learning
    Doctors at an acute trust believe their clinical leaders have failed to tackle the ‘big personalities’ accused of being aggressive bullies, a review has found.
    The probe at University Hospitals of North Midlands Trust was prompted by a survey carried out last year by the British Associations of Physicians of Indian Origin, after concerns were raised by its members.
    The review was undertaken by Birmingham-based equalities charity Brap, and Roger Kline, a research fellow at Middlesex University Business School. It found the trust was not an outlier in statistical measures of bullying and harassment, but suggested the situation was still worse than leaders would wish.
    They said: “The most common reason people cited for bullying/harassment they experienced was the personality, attitude, and disposition of their managers and colleagues… it is felt senior clinical leaders have, in the past, failed to tackle these ‘big personalities’.
    “It is worth noting feedback from interviews suggesting many doctors feel they have endured poor behaviour – talking over people during meetings, criticising work in public, aggressive questioning – for years, and have simply become inured to it.
    The reviewers found that as a consequence, certain people within the organisation were perceived to be “bullet proof”, and added: “We would suggest the trust needs a big, long-term plan to ‘rehumanise’ the organisation.
    “The trust’s existing culture has permitted, and continues to permit infringements in behaviour… While this is not condoned by senior leaders in the trust, the lack of a plan to proactively tackle a legacy of overlooking poor behaviours has allowed them to persist.”
    Read full story (paywalled)
    Source: HSJ, 6 April 2022
  13. Patient Safety Learning
    More patients than ever before will be put at risk when consultants and junior doctors begin the “biggest walkout the NHS has ever seen”, the body that speaks for health trusts has warned.
    The latest round of industrial action in England, when consultants will strike in a dispute over pay on Tuesday and Wednesday and junior doctors on Wednesday, Thursday and Friday, would force hospitals to cancel a higher number of appointments and operations than ever before, the NHS Confederation revealed.
    Among the patients who were being placed in the greatest danger were the increasing number of people who have already had their operations cancelled due to strike action, and now face having their rescheduled appointments cancelled again, health officials have warned. That included growing numbers of cancer patients, who were expected to be more affected than in previous rounds of strikes.
    The government will launch a consultation on Tuesday over plans to impose new regulations on striking doctors and nurses to ensure hospitals provide a minimum level of cover.
    The regulations, which would cover urgent, emergency and “time-critical” hospital-based health services, would mean that employers could issue a “work notice” compelling doctors and nurses to work during industrial action, in order to maintain “necessary and safe levels of service”. Clinicians who still take industrial action could run the risk of losing their job.
    Read full story
    Source: The Guardian, 19 September 2023
  14. Patient Safety Learning
    Practitioners with no professional medical qualifications use social media to target women and girls, an investigation by undercover Times reporters has found.
    The medicines regulator has begun an investigation after undercover Times reporters found beauticians offering to inject women with “black market” Botox, putting them at risk of being disfigured for life.
    Practitioners with no professional medical qualifications used social media to target women and girls, suggesting the treatments were safe and would enhance their looks. Many used products that have not gone through safety checks in Britain. Reporters confirmed that at least three practitioners advertising facial injections on social media sites were using cheap versions of Botox that are not licensed in the UK.
    Campaigners say they are receiving increasing reports of disfigurements such as permanent facial scarring and large sores caused by injections with unlicensed versions of Botox, often carried out in people’s homes and at beauty salons.
    The Medicines and Healthcare products Regulatory Agency (MHRA) said it was reviewing the findings and would “take appropriate regulatory action where any non-compliance is identified”.
    Sajid Javid, the health secretary, said the practices uncovered were “totally unacceptable” and officials were looking into whether legal changes were needed “to ensure no one is harmed”.
    Read full story (paywalled)
    Source: The Times, 2 February 2022
  15. Patient Safety Learning
    People experiencing Long Covid have measurable memory and cognitive deficits equivalent to a difference of about six IQ points, a study suggests.
    The study, which assessed more than 140,000 people in summer 2022, revealed that Covid-19 may have an impact on cognitive and memory abilities that lasts a year or more after infection. People with unresolved symptoms that had persisted for more than 12 weeks had more significant deficits in performance on tasks involving memory, reasoning and executive function. Scientist said this showed that “brain fog” had a quantifiable impact.
    Prof Adam Hampshire, a cognitive neuroscientist at Imperial College London and first author of the study, said: “It’s not been at all clear what brain fog actually is. As a symptom it’s been reported on quite extensively, but what our study shows is that brain fog can correlate with objectively measurable deficits. That is quite an important finding.”
    Read full story
    Source: The Guardian, 29 February 2024
  16. Patient Safety Learning
    An integrated care system which has some of England’s worst waiting times for emergency care lacks “delivery structure and processes” to make desperately needed improvements, according to an external report.
    Research by consultancy Prism into the Cornwall and Isles of Scilly integrated care system (ICS) concluded it had “unclear governance” for management and recovery of urgent and emergency care, with “multiple disconnected structures in place to manage tactical and strategic recovery of performance”.
    The report comes as the ICS grapples with record waits for emergency care, with stroke and heart attack victims waiting three hours for an ambulance  and patients stuck for two days in Royal Cornwall Hospital’s emergency department.
    The review was commissioned by the Cornwall Integrated Care Board to look at patient flow across the system and make recommendations about how this can be improved. 
    Prism interviewed leaders from the organisations within the Cornish ICS. One leader described the system as “so broken”, while another commented that the role of the ICB in supporting and delivering urgent and emergency care “is not clear”.
  17. Patient Safety Learning
    A quarter of a million children in the UK with mental health problems have been denied help by the NHS as it struggles to manage surging case loads against a backdrop of a crisis in child mental health.
    Some NHS trusts are failing to offer treatment to 60% of those referred by GPs, the research based on freedom of information request responses has found.
    The research carried out by the House magazine and shared with the Guardian also revealed a postcode lottery, with spending per child four times higher in some parts of the country than others, while average waits for a first appointment vary by trust from 10 days to three years.
    Olly Parker, head of external affairs at YoungMinds, said the freedom of information findings showed a “system is in total shutdown” with “no clear government plan to rescue it”, after the 10-year mental health plan was scrapped.
    “In the meantime, young people are self-harming and attempting suicide as they wait months and even years for help after being referred by doctors,” he said. “This is not children saying ‘I’m unhappy.’ They are ill, they are desperate and they need urgent help.”
    Read full story
    Source: The Guardian, 16 April 2023
  18. Patient Safety Learning
    A ‘culture of distrust’ between consultants and the use of incident reporting as a tool of ‘reprisal’ impacted patient care at a trust’s cardiology department, a review has concluded.
    An external review undertaken for Hull University Teaching Hospitals Trust has made a series of recommendations after looking into allegations of bullying and several examples of poor care within its cardiology services.
    In a report published in the trust’s board papers, the Royal College of Physicians reported a “perceived tendency to downplay clinical incidents, and, to undermine those who wanted to raise patient safety issues”.
    It added: “We met a group of individual consultants who did not work well as a team. There is a culture of distrust, a lack of departmental cohesion and allegations of bullying in the department. All of which reinforce a clear divide between the interventional and non-interventional consultant cardiologists."
    “There have been a number of allegations of belittling, intimidation and undermining…The review team heard accounts of a culture where datix has been used as a tool for possible personal reprisal along with ignoring/downplaying incidents that have been raised.”
    The review concludes: “This behaviour is impacting on patient care and therefore, all medical staff should be reminded of good medical practice as the [General Medical Council] code of conduct of how doctors must work collaboratively with colleagues.”
    Read full story (paywalled)
    Source: HSJ, 16 November 2021
  19. Patient Safety Learning
    Cancer services at large hospital trust have been at ‘catastrophic’ risk of being overwhelmed, after two of its hospital sites had to suspend life-saving cancer surgeries in the last month due to COVID-19.
    In its latest board papers Mid and South Essex Foundation Trust rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic”. It said the expected consequences at this risk level include “permanent disability or death, serious irreversible health effects” and an “unacceptable… quality of service”.
    The trust runs three general acute hospitals in the county. Its 2,000 plus beds make it the third largest trust in England after University Hospitals Birmingham FT and Leeds Teaching Hospitals.
    The same board papers, dated 28 January, said cancer surgery at Southend University Hospital, one of three hospital sites run by the trust, “ceased on 24 December”. At a second hospital site, Mid Essex Hospital covid “hit hard just before Christmas” and elective work was “dramatically impacted with short period of life and limb only carried out on site”. This meant all P2 cancer surgery — which requires treatment in less than four weeks — did not take place. 
    Both hospital sites said they hoped the independent sector could help them restart cancer surgeries this month with a focus on “long waiting and clinical urgent patients”. It is not clear how much capacity the sector has to work through waiting lists and the board papers said “some of this capacity may be reduced” because of recent changes to a new national contract for the independent sector.
    Read full story (paywalled)
    Source: HSJ, 29 January 2021
  20. Patient Safety Learning
    An acute trust in the Midlands is planning to move patients to chairs on wards to free up beds for people waiting in its emergency department, following one of its “most challenged” days.
    In an email sent to staff at Nottingham University Hospitals on Tuesday, interim chief operating officer Rachel Eddie and chief medical officer Keith Girling wrote: “We are asking wards to transfer [patients confirmed as ready for discharge] to the discharge lounge, or if that isn’t possible, move them to a chair on the ward so that a patient waiting for a bed in ED or in an emergency pathway assessment area can be brought up.”
    “This is referred to as going ‘one over’,” the email added. “We will ensure that on each ward that has been designated as being able to go ‘one over’, a chair has been added to their Nervecentre ward layout so patients are all visible.”
    The email describes how Monday was one of the “most challenged Mondays we have seen” and confirmed the trust remains in ‘Opel 4’, the most severe level of operational pressure.
    It also said nursing staff have “shared concerns” about the amount of time they are able to spend with their patients.
    “This does mean that at times you will be asked to work at a higher patient to nurse ratio than we would like,” the email said. “We know this isn’t where any of us want to be, but it is unfortunately the reality of balancing risk.”
    Read full story (paywalled)
    Source: HSJ, 1 December 2021
  21. Patient Safety Learning
    A trust given an “inadequate” rating for its “chaotic” maternity service last week had been criticised for many of the same failings only last year by another regulator, it has emerged.
    Bethan Harris died in a hospice 10 days after her birth at St George’s Hospital in South London in 2018. She had suffered hypoxic ischemic encephalopathy – a brain injury caused by lack of oxygen – during delivery, according to the coroner’s report.
    HSJ has now seen the conclusions of a Parliamentary and Health Service Ombudsman report into her death, completed and sent to the trust just last year.
    It found that if Ms Heatley had had better care Bethan might have been born in a better condition, as did a 2019 inquest into Bethan’s death, which led to the coroner issuing a “prevention of future deaths” report.
    It also shows St George’s University Hospitals Foundation Trust was warned about major problems in the maternity services in 2019 and in the 2022 ombudsman report, but had apparently not dealt with them when the Care Quality Commission inspected in March this year.
    Read full story (paywalled)
    Source: HSJ, 23 August 2023
  22. Patient Safety Learning
    Women and NHS staff have warned that mothers are being “forgotten” after giving birth, with a staff crisis only making matters worse.
    Kate, a 32-year-old from Leeds, says she has been left in “excruciating” pain for nine years after horrifying postnatal care.
    Other women have told The Independent stories of care ranging from “disjointed” to “disastrous”.
    It comes as midwives warn there are “horrendous” shortages in community services, which have prevented women from accessing adequate antenatal and postnatal care.
    Mary Ross-Davie, the Royal College of Midwives’ director for professional midwifery, said that with each Covid wave midwifery staffing has been hit worse than the last.
    To provide safe care during labour, antenatal and postnatal care, teams are sent into wards putting “huge pressure on care”.
    She said this could mean clinicians end up “missing things”, such as women struggling emotionally after birth.
    The warnings over poor antenatal and postnatal care come after experts at the University of Oxford said in November there were “stark” gaps in postnatal care, despite the highest number of deaths being recorded in the postnatal period.
    Dr Sunita Sharma, lead consultant for postnatal care at Chelsea and Westminster Trust, said that when NHS maternity inpatient staffing overall is in crisis “often the first place staff are moved from is the postnatal ward, which is clinically very appropriate, but it can come at a cost of putting more pressure on postnatal care for other mothers”.
    Dr Sharma said postnatal teams were doing their best to improve services but need national drivers and funding to sustain improvement.
    Read full story
    Source: The Independent, 16 March 2022
  23. Patient Safety Learning
    A major trust’s Freedom To Speak Up Guardian has warned that a failure to address staff concerns about alleged bullying and long-standing ‘dysfunctional behaviours’ is damaging confidence and resulting in the loss of high-quality staff.
    Professor Julian Bion, presenting a half-yearly report to University Hospitals Birmingham Foundation Trust’s board, revealed that the majority of the 41 reports to the FTSU service between April and October this year had expressed a “fear of detriment” when raising concerns.
    Just under half (44%) of 34 concerns raised by the contacts related to “problematic attitudes and behaviours”, ranging from reports of micro-aggressions to overt bullying.
    Professor Bion, UHB’s FTSU guardian since 2019, told HSJ such concerns are always “complex and sensitive issues” and recognised that the trust is handling them during “difficult circumstances” for the NHS. UHB has seen very large numbers of covid patients throughout much of the pandemic.
    But he warned the board that several “common themes” were emerging in UHB’s complaints process – including a fear of detriment, “problematic” delays to cases being resolved, and a lack of response from divisional departments.
    Suggesting there is a “disinclination” within the trust to address concerns, he said: “Very often, these dysfunctional behaviours are known about for a long time but they haven’t been addressed.”
    Read full story (paywalled)
    Source: HSJ, 2 November 2021
  24. Patient Safety Learning
    A trust has discovered 1,800 patients who were removed by mistake from its elective waiting list.
    Barking, Havering and Redbridge University Hospitals Trust chief executive Matthew Trainer wrote to colleagues in the east London health system today to “apologise for the stress this will have caused those experiencing a delay”.
    Of the 1,800 patients involved, 600 have been waiting more than a year and roughly 200 have been waiting for more than two years.
    Mr Trainer’s note explained: “The patients have been waiting to see our specialists in routine clinics in gynaecology, neurology, neurosurgery and ophthalmology.”
    It continued: “As we have been working through our waiting lists, we have discovered a problem with one of them that was used to deal with the backlog created by the pandemic.
    “It contained routine referrals that were submitted by GPs who wanted their patients to be seen by a specialist, but for whom there were no appointments available due to covid-19. Unfortunately, these patients were removed automatically from this list before they had been seen.”
    Read full story (paywalled)
    Source: HSJ, 26 April 2022
  25. Patient Safety Learning
    Modelling being used by NHS officials forecasts that hospital admissions could peak at five times the level seen in April without additional measures to control the virus, HSJ can reveal.
    In all scenarios presented, covid hospital admissions would remain high for an extended period of many months, even if new lockdown actions were taken. However, putting multiple measures in place could contain them to a peak of less than that seen in the spring, according to the work.
    They were included in a document marked “confidential” and included, apparently by accident, in public papers for Thursday’s meeting of Medway Foundation Trust board. Within hours of HSJ asking for more information, they were removed.
    They were badged with Kent and Medway Clinical Commissioning Group, the NHS body which oversees services for that area. The forecasts were marked as being “Kent and Medway level”, but were referred to as “regional scenarios”, indicating they may have been produced by regional teams of NHS England and Improvement. The trust’s board papers said its own planning for the coming months would make use of the three scenarios presented in the document.
    Read full story
    Source: HSJ, 7 September 2020
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