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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Nearly five million patients each month in England wait more than a fortnight for a GP appointment, NHS figures show, which Labour is calling "unacceptable". The government says it expects all patients needing a GP appointment to be seen within two weeks. The Royal College of GPs says 85% of appointments happen within two weeks and nearly half on the same day. Those taking longer than two weeks may be routine ones for which the wait is therefore appropriate, it says. Prof Kamila Hawthorne, who chairs the Royal College of GPs, said: "GPs and our teams are working tirelessly to deliver safe, timely and appropriate care and to give patients the choice of appointment they want. "We share our patients' frustration when they struggle to access our care. However, this is not down to GPs and their hard-working teams, but due to decades of underfunding and poor resource planning." Read full story Source: BBC News, 21 April 2023
  2. Content Article
    Recording of a recent Care Quality Commission (CQC) webinar. Hear from Mandy Williams, Interim Director of integration, inequalities and improvement as she updates on CQC's approach to assessing integrated care systems. During the Q&A session, Mandy is also joined by Helen Rawlings, Deputy Director of Integration, Inequalities and Improvement, Matt Tait, Head of Acute Policy and Dominique Black, Strategy Manager who answers attendees questions from the live chat.
  3. Content Article
    Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. Morgan et al. evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs.  They found that SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change.
  4. Content Article
    Measures exist to improve early recognition of and response to deteriorating patients in hospital. However, management of critical illness remains a problem globally; in the United Kingdom, 7% of the deaths reported to National Reporting and Learning System from acute hospitals in 2015 related to failure to recognise or respond to deterioration. The current study from Albutt et al. explored whether routinely recording patient-reported wellness is associated with objective measures of physiology to support early recognition of hospitalised deteriorating patients. The preliminary findings suggest that patient-reported wellness may predict subsequent improvement or decline in their condition as indicated by objective measurements of physiology (NEWS). Routinely recording patient-reported wellness during observation shows promise for supporting the early recognition of clinical deterioration in practice, although confirmation in larger-scale studies is required.
  5. News Article
    Inadequate health visiting provision has led to gaps in care for children and heaped pressure on acute services, senior clinicians have told HSJ. Government data suggests that a fifth of infants are not receiving one or more of their five mandatory health visiting reviews across the first two years of life, with rates still substantially below pre-covid levels. Meanwhile, nationally about 1 in 10 children are still being seen virtually, contrary to the government’s delivery model and despite clinicians saying in-person contact is vital to spotting problems. Senior figures in children’s services told HSJ that in some areas a much higher rate was still being carried out with no in-person contact. Clinicians said the reasons were ongoing funding and staffing constraints, and that the problems were leading to parents turning to emergency departments and GPs instead. Read full story (paywalled) Source: HSJ, 20 April 2023
  6. News Article
    The US Supreme Court has extended until Friday a temporary block on limits to access of a popular abortion pill. A Texas judge suspended approval of abortion drug mifepristone on 7 April, questioning its safety. Parts of that decision were upheld on appeal, prompting the Biden administration to make an emergency request to the Supreme Court. It's the most significant such case since the Supreme Court last year ended the nationwide right to abortion. The pill - used in more than half of abortions in the US - was first approved by the Food and Drug Administration (FDA) more than two decades ago. Critics say that by overriding the FDA's approval, the court in Texas has usurped the federal health agency's remit to regulate food, medicine, and medical devices. Legal experts warn the ruling opens the door for challenges to other approved medicines in the US and could also stifle development of future drugs. Read full story Source: BBC News, 20 April 2023
  7. Content Article
    When resident physicians work shifts of extended duration, the risks of patient harm and occupational injury increase, even among experienced resident physicians, write Charles Czeisler and colleagues in this BMJ opinion piece.
  8. Content Article
    Joint safety alert from the British Menopause Society, Faculty of Sexual & Reproductive Healthcare, Royal College of General Practitioners, Royal College of Obstetricians & Gynaecologists, Society for Endocrinology and the Royal College of Nursing Women’s Health Forum.
  9. News Article
    The UK is not ready for the next global pandemic because public services are being dismantled and key research is being defunded, experts have claimed. More than three years after the global outbreak of coronavirus, top scientists have warned that the UK is no better prepared for a pandemic than it was in 2020. They say another epidemic on the scale of Covid-19 is inevitable, but that disinvestment in infection-monitoring services, dismantling of key infrastructure, and the state of the NHS mean the country is “losing ground”. Sir John Bell, a leading immunologist and a member of the UK’s Covid vaccine taskforce during the pandemic, said it was too easy to dismiss Covid-19 as a “once in a generation crisis”. Writing in The Independent, he warned that it is “a question of when, not if, another pandemic strikes”, adding that the nation needs to adopt an “always on” approach that includes building a more resilient healthcare system, carrying out better surveillance, and identifying future threats. Read full story Source: The Independent, 18 April 2023
  10. News Article
    Medical leaders have called for third-party arbitration to break the impasse on a pay dispute between junior doctors and the government after hundreds of thousands of procedures and appointments were cancelled as a result of last week’s strike in England. The “colossal impact” of the four-day stoppage compounded by a health service already stretched by the coronavirus pandemic and facing workplace shortages has led the Academy of Medical Royal Colleges (AoMRC) to intervene and urge both parties to engage with an independent organisation. The AoMRC, the membership body for the UK and Ireland’s 24 medical royal colleges and faculties, said in a statement it was “concerned that a solution has not yet been reached and about the anticipated impact on NHS services and patients that will potentially follow any future action”. It added: “Both parties need to rapidly engage with an independent organisation to work out how the deadlock can be broken for the sake of patients and the wider NHS.” Read full story Source: The Guardian, 20 April 2023
  11. News Article
    NHS trusts have been given targets to increase elective activity that range from 103% of pre-pandemic levels to nearly 130%, internal data seen by HSJ reveals. The wide gap between the targets, which are based on past performance and reflect the value of activity carried out, indicate the slow pace of recovery at many trusts last year. Forty trusts have been set the least ambitious target, to deliver 103% of pre-covid activity levels in 2023-24, including Leeds Teaching Hospitals, Barts Health, and University Hospitals Birmingham. All providers were supposed to deliver at least 104% of pre-covid activity last year, but few managed to achieve this, with emergency pressures, the impact of covid and flu, and workforce problems hampering efforts to ramp up activity. Amanda Pritchard has previously admitted the health service would have to “re-profile” the trajectory to achieving 130% of pre-covid activity levels by 2025. Read full story (paywalled) Source: HSJ, 20 April 2023
  12. News Article
    Take-up and usage of the NHS App in England has begun to plateau, after covid drove huge growth, figures seen by HSJ suggest. This can be seen in the percentage of GP appointments booked or cancelled using the app; the number of records viewed; and the number of times it has been downloaded. Rapid uptake was driven during covid restrictions, when travel and other activities often required a covid vaccination pass. Government has said it wants the growth to continue. The number of GP appointments booked or cancelled using the app fell for a third consecutive month in March to 212,954, representing a decrease of 15% since January and 28% on October 2022, when usage peaked. The NHS app is central to government’s plan for digital health and care, published last year, billed as the “digital front door” to the NHS which would aid the recovery of services post-pandemic. Read full story (paywalled) Source: HSJ, 19 April 2023
  13. News Article
    The safety of a ward accused of failing children has been rated as inadequate by inspectors. The care regulator warned Kettering General Hospital (KGH) in Northamptonshire over its children's and young people's services. Inspectors' worries include sepsis treatment, staff numbers, dirt levels and not having an "open culture" where concerns can be raised without fear. Since the BBC's first report in February highlighting the concerns of parents with children who died or became seriously ill at KGH, dozens more families have come forward, bringing the number to 50 to date. Inspectors found that "staff did not always effectively identify and quickly act upon patients at risk of deterioration". They said there were sometimes "delays in medical reviews being undertaken outside of normal working hours", highlighting one case where a seemingly deteriorating patient was not seen until three hours after being escalated to the on-call team. Read full story Source: BBC News, 20 April 2023
  14. Content Article
    Exposure to ionising radiation during image guided procedures has been associated with a higher incidence of breast cancer in female healthcare workers. Lead or lead equivalent gowns are used to reduce radiation exposure during image guided procedures, but studies have shown that current gowns provide inadequate protection to breast tissue as they leave the upper outer quadrant and axilla exposed. Isobel Pilkington and colleagues discuss the risk and the steps that must be taken to ensure full protection of breast tissue in this BMJ Editorial.
  15. Content Article
    Patient safety in oncology should remain a standard indicator of quality of care and a critical objective on the EU health policy agenda as all European citizens deserve the same level of safeguarding and protection at all stages of their healthcare. Patient safety is also a critical indicator of life overall, as any irreversible or reversible patient safety issue potentially affects the quality of life. This report from the European Network for Safer Healthcare calls for 10 actions for European policy makers and national health authorities.
  16. Content Article
    At a recent Care Quality Commission (CQC) webinar, Kate Terroni, Deputy Chief Executive and Chris Day, Director of Engagement, gave an update on CQC's implementation timeline for their new regulatory approach and new provider portal.   The webinar lets providers know when to expect the new regulatory approach to start impacting them and the steps taken to get there.   Kate and Chris deliver a short presentation and are then joined by Amanda Hutchinson, our Head of Policy - Regulatory Change during the Q&A session.
  17. Content Article
    All countries of the WHO European Region currently face severe challenges related to the health and care workforce (‎HCWF)‎.  This report focuses on identifying effective policy and planning responses to these HCWF challenges across the Region. The report presents an overview of the HCWF situation in the Region (‎focusing on medical doctors, nurses, midwives, dentists, pharmacists and physiotherapists, for whom data are available) ‎and identifies relevant policy options, their expected benefits and potential facilitators or barriers to successful implementation. Examples of sound evidence-informed practices in countries are also provided. The aim of the report is to describe the data, rather than to analyse. Data supplied by countries have been used, but in many cases these have been incomplete. It is expected that data will grow progressively in future. No data on informal health workers are included.
  18. Event
    until
    Public Policy Project's second phase of its integrated care policy programme will centre around the ICS Delivery Forum. The Delivery Forum will build on the foundations of the ICS Roadshow, continuing to connect key health and care stakeholders at a localised debate and networking. However, the Delivery Forum will focus on developing impact-driven, results-orientated insights. Working in close collaboration with ICSs and crucial providers, PPP is creating a programme that highlights exactly how ICSs are making place based, personalised care a reality and the impact this is having on individual citizens and communities. Rather than discuss issues such as health inequalities in broad framing and terminology, the Delivery Forum will ask local systems leaders and stakeholders to demonstrate exactly how integrated care systems can affect change in key health and care challenges. The Delivery Forum will also provide a helping hand to ICBs grappling with workforce challenges and service pressures by connecting system leaders with on the ground innovators and industry experts. Audiences will consist of local ICS leaders and representatives from the NHS, social care, primary care and local government, as well as community workers and social prescribing specialists. Further, the ICS Delivery Forum will engage with patients and end-users to gather first-hand experience of receiving care within a system in dire need of reform. This event is free for the Public Sector– including, NHS Organisations, Local Authorities, academics, researchers, non-for-profit and third sector providers and charitable sectors. Register
  19. Event
    until
    Public Policy Project's second phase of its integrated care policy programme will centre around the ICS Delivery Forum. The Delivery Forum will build on the foundations of the ICS Roadshow, continuing to connect key health and care stakeholders at a localised debate and networking. However, the Delivery Forum will focus on developing impact-driven, results-orientated insights. Working in close collaboration with ICSs and crucial providers, PPP is creating a programme that highlights exactly how ICSs are making place based, personalised care a reality and the impact this is having on individual citizens and communities. Rather than discuss issues such as health inequalities in broad framing and terminology, the Delivery Forum will ask local systems leaders and stakeholders to demonstrate exactly how integrated care systems can affect change in key health and care challenges. The Delivery Forum will also provide a helping hand to ICBs grappling with workforce challenges and service pressures by connecting system leaders with on the ground innovators and industry experts. Audiences will consist of local ICS leaders and representatives from the NHS, social care, primary care and local government, as well as community workers and social prescribing specialists. Further, the ICS Delivery Forum will engage with patients and end-users to gather first-hand experience of receiving care within a system in dire need of reform. This event is free for the Public Sector– including, NHS Organisations, Local Authorities, academics, researchers, non-for-profit and third sector providers and charitable sectors. Register
  20. Event
    until
    Public Policy Project's second phase of its integrated care policy programme will centre around the ICS Delivery Forum. The Delivery Forum will build on the foundations of the ICS Roadshow, continuing to connect key health and care stakeholders at a localised debate and networking. However, the Delivery Forum will focus on developing impact-driven, results-orientated insights. Working in close collaboration with ICSs and crucial providers, PPP is creating a programme that highlights exactly how ICSs are making place based, personalised care a reality and the impact this is having on individual citizens and communities. Rather than discuss issues such as health inequalities in broad framing and terminology, the Delivery Forum will ask local systems leaders and stakeholders to demonstrate exactly how integrated care systems can affect change in key health and care challenges. The Delivery Forum will also provide a helping hand to ICBs grappling with workforce challenges and service pressures by connecting system leaders with on the ground innovators and industry experts. Audiences will consist of local ICS leaders and representatives from the NHS, social care, primary care and local government, as well as community workers and social prescribing specialists. Further, the ICS Delivery Forum will engage with patients and end-users to gather first-hand experience of receiving care within a system in dire need of reform. This event is free for the Public Sector– including, NHS Organisations, Local Authorities, academics, researchers, non-for-profit and third sector providers and charitable sectors. Register
  21. News Article
    A team from NHS Ayrshire & Arran has successfully created a system to ensure that people with Parkinson’s get their medication on time while they are in hospital. Parkinson’s nurse specialist Nick Bryden, who led the team, explains: “The timely administration of medication is hugely important in helping to control symptoms in people with Parkinson’s. "Guidance states that Parkinson’s medication should be administered within 30 minutes, either side, of the prescribed time which can be challenging within a busy hospital ward environment." Nick, who works out of Biggart Hospital in Prestwick, added: “When we initially worked with our digital pharmacist, Richard Cottrell, it was to develop a system that would alert us to when a Parkinson’s patient was admitted to hospital. "It then became clear that we could take the system a step further and use it to monitor if people are on the right medication and whether or not it is being administered at the right time.” The team worked to develop a further system of clear visual prompts with NHS Digital services, which appear alongside relevant patient details on wards’ electronic whiteboards. Every patient prescribed Parkinson’s medication has a tulip symbol beside their name which changes colour and flashes when it’s close to the time to administer the medication. The system was initially piloted in a couple of wards and, due to its success, has now been rolled out to almost every ward in Ayrshire and Arran. Read full story Source: The Herald, 19 April 2023 Related reading on the hub: Top picks: Seven resources about Parkinson’s Professionals with Parkinson’s tackle time critical patient safety issue: a blog by Sam Freeman Carney
  22. News Article
    Up to one in 20 new diabetes cases could be related to Covid infection, data suggests. The research adds to mounting evidence the pandemic may be contributing to a rapidly escalating diabetes crisis, with individuals who have experienced more severe Covid at greatest risk. However, lifestyle factors such as being overweight or obese continue to be the main driver for the increase, with 4.3 million officially diagnosed cases in the UK alone. Although previous research has hinted that Sars-CoV-2 infection may increase the risk of developing diabetes – possibly by damaging insulin-producing cells in the pancreas – these studies were either relatively small or limited to specific groups of individuals, such as US military veterans, who may not represent the general population. To delve deeper, Prof Naveed Janjua at the University of British Columbia in Vancouver, Canada, and his colleagues turned to the British Columbia Covid-19 Cohort, a surveillance platform that links data on Covid infections and vaccinations with sociodemographic and administrative health data. They examined records from 629,935 people who took a PCR test for Covid and found those who tested positive were significantly more likely to experience a new diagnosis of type 1 or type 2 diabetes in the following weeks and months – with 3-5% of new diabetes cases attributable to Covid overall. Read full story Source: The Guardian, 18 April 2023
  23. News Article
    The backlog for ophthalmology appointments in England is the second-largest in the NHS, with UK eye doctors concerned about the number of patients losing sight unnecessarily. Their shock is palpable. How this could be happening in a rich country such as Britain? There are treatments for common blindness-causing conditions such as macular degeneration, but to get them patients must be able to access the service. And right now the NHS doesn’t have the capacity to deliver them in a timely way. As junior doctors’ unions – and possibly those of consultants and nurses – proceed with strike action, it’s easy to attack medical professionals with the question: “How many people are dying because of your actions?” The truth is that the entire system has been struggling, and people have been dying anyway because of system failures. Now add to this people living with disabilities that were preventable, such as going blind. When Labour was in power, it made a real effort, including with financial allocation, to reduce waiting-list times for non-emergency care. But since the Tories were elected in 2010, years of austerity and public-sector neglect – and the shifting of resources and wealthy patients into a lucrative and growing private sector – has meant that the NHS has been transformed from a robust, preventive healthcare service into an acute one. Its basic offering is now: “If you’re dying, we will save you.” Read full story Source: The Guardian, 19 April 2023
  24. Content Article
    Covid-19 infection may lead to acute and chronic sequelae. Emerging evidence suggests a higher risk of diabetes after infection, but population-based evidence is still sparse. In this study, Naveed et al. evaluated the association between COVID-19 infection, including severity of infection, and risk of diabetes. They concluded that Covid-19  was associated with a higher risk of diabetes and may have contributed to a 3% to 5% excess burden of diabetes at a population level.
  25. Content Article
    The occupational therapy (OT) workforce is under huge pressure. Increased demand coupled with workforce shortages is challenging OTs’ capacity to provide essential support to people whose lives are impacted by long term health conditions and disability. In November 2022, the Royal College of Occupational Therapists surveyed OT practitioners across the UK about the workplace issues they’re facing now, and how these affect the services they deliver to the public. They also asked how practitioners are impacted personally, including whether they intend to continue working as OTs. The challenges shared by over 2,600 respondents have significant implications for the resilience of the current and future OT workforce, and the people who use OT services.
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