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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Mehdian-Staffell, 37, is part of a new generation of female surgeons who are challenging the male-dominated culture in the profession. It is clear that she loves her job. “My aim is not just to be a surgeon – it is to be a damn good one. I didn’t go into it to be average,” she says. But she is also exhausted and demoralised. “The sexism comes from patients as well as other members of staff. People will assume you’re a nurse. I’ve previously worked in departments where the guys all went off to golf and men were prioritised for opportunities over women. Sometimes, as female surgeons, we feel as if we have to work twice as hard.” She says many of her more recent male colleagues have been supportive, but there is a systemic problem. Even the surgical instruments are made for male hands. Traditionally, surgeons are known as “Mr” rather than “Dr”, but women often get called by their first name. There have been darker moments. “I’ve been sexually harassed lots of times,” she says. In 2021 the Royal College commissioned the human rights lawyer Helena Kennedy to do a review of diversity and inclusion in surgery. “The evidence I had from women was that the culture was very male and the chat in and around the operating theatre for surgeons was often inappropriate. It’s really not a very conducive environment for women.” She made a raft of recommendations to improve the situation but says she is “disappointed” at how slowly they are being implemented. Read full story (paywalled) Source: The Times, 8 April 2023 Related reading on the hub: Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign
  2. News Article
    A former adviser for the Care Quality Commission (CQC) has called on the regulator to explain what action it has taken against the officials responsible for wrongly dismissing him after he raised whistleblowing concerns. Shyam Kumar, a surgeon who was part of inspection teams in the North West, told HSJ that he had to live with question marks over his reputation for several years. He is furious that a senior CQC official sought to question his honesty and integrity in evidence submitted to the employment tribunal examing his dismisal. The tribunal heard Mr Kumar had raised a number of whistleblowing disclosures to the CQC, including concerns about the lack of appropriate expertise on inspection teams. After a wide-ranging review around its handling of whistleblowing concerns, CQC chief executive Ian Trenholm last week apologised to Mr Kumar for “unacceptably poor treatment” by his organisation, and thanked him for contributing to the review. However, Mr Kumar told HSJ: “I’m glad the CQC has looked at this and finally acknowledged what they did to me was wrong. But I want to know what has happened to the individuals that were responsible.” Read full story (paywalled) Source: HSJ, 6 April 2023
  3. News Article
    A single children’s mental health hospital with just 59 beds reported more than 1,600 “sexual safety incidents” in four years, shocking NHS figures reveal. Huntercombe Hospital in Maidenhead was responsible for more than half of the sex investigations reported in the 209 children’s mental health units across the country. Despite warnings at a rate of more than one a day to the health service since 2019, no action was taken to stop vulnerable NHS patients being sent to the scandal-hit unit as a result of the 1,643 sexual incident reports. The private unit is now finally due to be closed after an investigation by The Independent revealed allegations of verbal and physical abuse, prompting the NHS to withdraw patients. The hospital since said it plans to reopen as an adult unit. Figures obtained from the NHS show Huntercombe’s Maidenhead unit, Taplow Manor, was behind 57% of the 2,875 reported sexual incidents and assaults reported at England’s child and adolescent mental health services (CAMHS) over the past four years. Reported incidents can range from sexually inappropriate language to serious sexual assault and rape. Read full story Source: The Independent, 11 April 2023
  4. News Article
    A woman who may only have months to live has told the BBC she is "angry and frustrated" at being in hospital five months after being cleared to go home. Charlotte Mills-Murray, 34, said attempts to organise care at her family home had been repeatedly delayed. Charlotte lives with intestinal failure caused by a severe form of Ehlers-Danlos syndrome, which weakens her body's connective tissue. She was admitted to St James's Hospital in Leeds in June 2022 following an infection, and a new Hickman line - a tube that allows feeding and the administering of pain relief - was inserted. By November, Charlotte was told she was well enough to be cared for at home, but she remains in hospital following delays in the hiring and training of staff able to support her. With limited access to a hoist which would enable her to use her wheelchair, Charlotte said she had spent 10 months "stuck in bed". Because of the complexity of her condition, Charlotte only has months to live. She believes her situation merits greater urgency because of the increased risk of infection in hospital. Charlotte qualifies for 24-hour home care support through the NHS Continuing Healthcare scheme, but she said decisions over how this would be put in place had been slow and unclear. The BBC has found a 16% rise over the past year in the number of patients in England who are in hospital despite being well enough to leave. The Department of Health and Social Care said it was "fully committed to speeding up the safe discharge of patients who no longer need to be in hospital" and was making £1.6bn available in England over the next two years to support this, on top of £700m of extra funding in 2022 to ease NHS pressures over the winter. Read full story Source: BBC News, 9 April 2023
  5. News Article
    The four-day strike by junior doctors in England will have a “catastrophic impact” on NHS waiting lists, with up to 350,000 appointments and operations likely to be cancelled, the chief executive of the NHS Confederation has said. Matthew Taylor said the industrial action this week posed risks to patient safety and called on the public to avoid “risky behaviour”. “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover services,” he told Sky News. “The health service has to meet high levels of demand at the same time as making inroads into that huge backlog that built up before Covid, but then built up much more during Covid." He said he hoped everyone who needed urgent care would get it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.” He called on the public to use NHS services responsibly. Read full story Source; The Guardian, 10 April 2023
  6. Content Article
    NHS Resolution received 2,600 claims for needlestick injuries for incidents occurring between 2012 – 2022. Needlestick injuries can be costly to investigate and increase the risk blood-borne infections. Fortunately, the harm and cost of most needlestick injuries are largely avoidable. NHS Resolution has created two new resources to share the learning from these claims and help organisations identify how to prevent future injuries.
  7. Content Article
    Research paper by Toye et al. published in the Lancet on the experience of women reporting damage from vaginal mesh.
  8. Content Article
    As organisations navigate the ongoing impact and fallout of the COVID-19 pandemic, they must focus on strengthening the supply of our highly valued workforce and ensure that both new and existing staff are supported and encouraged to remain. In partnership with NHS England and NHS Improvement, NHS Employers has refreshed their retention guidelines. There are two main objectives for this guide: first, ensuring it continues to draw on the latest learning and innovation from the COVID-19 pandemic, which has forced employers to critically re-examine how to retain NHS staff. Second, ensuring it supports the ambitions set out within the NHS People Promise, so that employers can work to make this a lived reality for all NHS staff. To help achieve these objectives, this guide explores the experiences of organisations NHS Employers has worked with on retention. 
  9. Content Article
    New study from Farr et al. into the effect of implanting polypropylene (PP) surgical mesh into patients. More evidence is needed to show the harmful effect to patients by implanting a foreign body into them, especially into the pelvic floor.
  10. Event
    until
    The focus of GGI’s April health and care leaders webinar is systems partnerships and the Hewitt report, in conversation with Rt Hon Patricia Hewitt, a former Secretary of State for Health and now a Chair of an ICB. The Hewitt Report on systems partnerships and governance will really frame how boards will lead during this next crucial year for the NHS. With an election next year, all NHS board members will be navigating their way through financial and performance pressures of the likes never seen before. How the new ICBs behave will impact every single NHS board. In a ‘Chatham House Rule’ session this will be a valuable chance to understand the forces at play and what individual NHS directors need to understand in terms of context and direction. The webinar will be chaired by GGI Chief Executive Professor Andrew Corbett-Nolan. Register
  11. Event
    Join this webinar for presentations and a Q&A on The Positive Approaches to Safety. This webinar will describe some of the limitations of the traditional safety paradigm - to only explore and fix problems – and the idea that this misses vital opportunities to learn from what we do well or indeed to learn from everything. The faculty of this webinar has been instrumental in the development of the Learning from Excellence Quality Improvement methodology and the application of Appreciative Inquiry. Speakers: 1. Dr. Adrian Plunkett, consultant paediatric intensivist at Birmingham Children’s Hospital, founder of Learning from Excellence (LfE) (UK) 2. Dr. Chris Turner, consultant in emergency medicine at UHCW NHS Trust and co-founder of Civility Saves Lives (UK) 3. Prof. Suzette Woodward – highly respected healthcare safety expert, Board member at the National Patient Safety Agency and NHS Resolution (UK) Register
  12. Content Article
    MIT Sloan experts offer a systematic approach to organisational resilience that can help leaders manage risk and rebound rapidly when catastrophic events strike.
  13. Content Article
    Surgeons' News is a magazine for surgical, dental and allied healthcare professionals. Published quarterly by the Royal College of Surgeons of Edinburgh, it features comment and opinion from leading professionals, plus reviews and reports on subjects relevant to all career levels. Two articles in this month's issue we want to highlight are the Surgical safety update (p.10) on cases from the Confidential Reporting System for Surgery (CORESS) and Safe passage (p.18) discussing the National Patient Safety Syllabus.
  14. Event
    until
    Around 10% of people aged 65 and over live with frailty, with this figure rising to between 25%-50% for those over 85. It's estimated that 300,000 people living with frailty undergo surgery each year. Frailty is recognised as a significant risk factor for complications in both elective and emergency surgical patients and has a direct correlation to postoperative outcomes. This study day will review frailty in relation to surgery, the many aspects of risk to the frail patient, risk scoring and what we as perioperative practitioners can do to mitigate the risk of surgery. Topics will include: Recognising frailty and frailty scoring. Perioperative anaesthetic management. Hypothermia and venous thromboembolism. Skin integrity and managing continence. Intercurrent infections impacting on emergency surgery. Cognitive function and considerations for patients with dementia. Register
  15. Content Article
    On 1 July 2022, Integrated care systems (ICSs) were placed on a statutory footing. ICSs are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area. Following their introduction, on the 18 November 2022, the Government announced that it would commission an independent review into the oversight of ICSs, considering how to best enable them to succeed, balancing greater autonomy and robust accountability, to be led by former Secretary of State for Health, the Rt Hon Patricia Hewitt. This report sets out the findings of this review.
  16. News Article
    The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary. The study by Patricia Hewitt, commissioned by the government said that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective. It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times. The review sets out new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff. It adds that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”. Read full story Source: The Guardian, 3 April 2023
  17. News Article
    According to the South West Ambulance Service Foundation Trust, 104 patient deaths reviewed under National Quality Board guidelines in quarter three of 2022-23 related to delays “which are thought to be a result of pressures within the wider health system”. The trust has stressed the deaths were not necessarily directly caused by delays, but that delays were a “common factor” in the 104 cases. Since July 2019, all ambulance trusts have been required to implement Learning from Deaths reviews following a report by the Care Quality Commission three years earlier, which found that opportunities were being missed to learn from patient deaths. A total of 876 incidents were identified as being within the scope of a review at the end of last year by SWASFT, of which 210 were reviewed. Deaths included in the review occurred while the patient is under the care of the ambulance service, from the initial 999 call being made to their care being transferred to another part of the system or to the point where a decision is made not to convey them to hospital. Read full story (paywalled) Source: HSJ, 4 April 2023
  18. News Article
    The government is actively considering whether to give full legal powers to an independent inquiry investigating the deaths of mental health patients. Roughly 2,000 deaths at the Essex Partnership University NHS Foundation Trust (EPUT) are being examined. The BBC understands Conservative Health Secretary Stephen Barclay is minded to make the inquiry statutory, which would compel witnesses to come forward. Only 11 current and former trust staff have agreed to give live evidence. Melanie Leahy, whose son Matthew died aged 20 while an inpatient at the Linden Centre in Chelmsford, said families were "definitely" a step closer to what they had campaigned for. "We just need it converted [to a statutory inquiry] - it's just delay after delay after delay and we need those powers," she told BBC Essex. Read full story Source: BBC News, 3 April 2023
  19. News Article
    Funding promised to develop the social care workforce in England has been halved, the government has confirmed. In 2021 the government pledged "at least" £500 million for reforms, to be spent on training places and technology over three years. But that figure is now £250 million, according to the Department of Health. A coalition of charities said this cut is "just the latest in a long series of disappointments" over social care. The government said its reforms would give care "the status it deserves" but some organisations in the sector say they fall short of what is needed. Caroline Abrahams, co-chair of the Care and Support Alliance - which represents more than 70 charities - and charity director of Age UK, said the measures "aren't remotely enough to transform social care". Millions of older and disabled people and their carers "needed something far bigger, bolder and more genuinely strategic to give them hope for the future", she said. Read full story Source: BBC News, 4 April 2023
  20. News Article
    The independent sector should be commissioned to provide more NHS outpatient appointments, rather than just be focused on cutting cataract waiting lists, the president of the Royal College of Ophthalmologists has said. A “workforce census” survey carried out by the college and shared with HSJ found almost 60% of respondents believed independent providers were having a “negative impact” on care and ophthalmology services in their area. Speaking about its findings to HSJ, RCOphth president Bernie Chang said Covid had exacerbated problems caused by use of independent sector providers. These problems included cases being passed back to the NHS when IS care failed, and the NHS being left with a greater concentration of more serious, and costly, cases as the IS focussed on routine cataract operations. Read full story (paywalled) Source: HSJ, 3 April 2023
  21. News Article
    NHS England has told trust, system and regional leaders to avoid “block rescheduling” of elective cases during the four-day junior doctors’ strike next month. In a letter sent by national medical director Sir Steve Powis and NHSE’s chief operating officer Sir David Sloman, NHS leaders are asked instead to use “rolling day-to-day cancellations” and reschedule cases “based on clinical risk”. The letter also urges leaders to maintain “as much day case and outpatient capacity as possible” and to use digital or virtual consultations to support outpatient delivery. However, it acknowledges that because of the “unprecedented scale and timing of these strikes we accept that rescheduling activity is going to be essential to minimise risks to patients”. Read full story (paywalled) Source: HSJ, 31 March 2023
  22. News Article
    NHS England has launched a “very aggressive campaign” to ensure all acute trusts give patients the ability to make appointments and receive messages online. Details of the new “national requirement” which must be met by the end of 2023-24 were sent by NHS England to acute trust chief information officers on Friday. NHSE wants all trust portals to integrate with the NHS App to enable patients to manage outpatient appointments and respond to messages through a single channel. Under NHSE’s requirements, the portals must: Enable patients to view their outpatient appointments; Enable the trust to send a waiting list validation questionnaire to patients; Provide patients with a single point of access to contact the provider, for example to cancel appointments; and Enable patients to access their correspondence from the trust. Read full story (paywalled) Source: HSJ, 31 March 2023
  23. News Article
    Doctors are warning that embarrassment about naming parts of the female anatomy is putting women's health in jeopardy. Dr Aziza Sesay said the hyper-sexualisation of women's bodies and anatomy "perpetuates the taboo, stigma and embarrassment". She said it could lead to women not getting the medical help they need. She said a lot of women's health conditions are often considered benign - meaning they're not life-threatening - but that she disliked the term as it minimised "how much it will affect someone's life". Dr Sesay is one of a number of women's health specialists who are due to appear at Cardiff's Everywoman Festival on 24 June, where topics will range from periods to menopause. The festival is the brainchild of colorectal surgeon, Julie Cornish, who works for Cardiff and Vale health board. She said "embarrassing" symptoms are all too often never discussed. "It's not uncommon to see patients who waited 10, 15 years with symptoms," she said. "It's got to the point where they've had to stop working, or their relationship has broken down. "People retire early, they stop working or stop socialising. And that delay often means it's more severe. They might need surgery rather than simple physiotherapy, dietary tricks or modifications that could've worked so easily early on." Read full story Source: BBC News, 3 April 2023
  24. Content Article
    Aqua recently convened a selection of expert panellists to a round table discussion, considering ‘What does safety look like at a system level?’. The round table was chaired by Professor Ted Baker, who led the discussion around the key issues facing Integrated Care Systems and how we can help support their development.
  25. News Article
    The director of a leading pharmacy chain invited to advise the prime minister on healthcare reform has claimed the NHS makes people too “lazy” to take responsibility for their health. Day Lewis director Sam Patel also said the fact the NHS was “free” meant there was little “jeopardy” discouraging people from becoming ill, and encouraged people to accept a lower level of care. Mr Patel’s fellow Day Lewis director Jay Patel was one of the private healthcare leaders invited to Rishi Sunak’s Downing Street health summit this January. The company has more than 250 branches concentrated in London and the south of England. Speaking at an event organised by strategy advisory firm Global Counsel last week, Mr Patel said: “Having an NHS fundamentally makes too many people lazy about taking care of their own health. “Anything that’s free we just accept a lower level of care…. [We should be] making sure we’re taking good care of ourselves with vitamins, minerals, supplements, staying fit." ”... the jeopardy of feeling ill is not that bad because you get taken care of. In other countries, even in emerging markets like India where my parents originally come from, people spend vast amounts to make sure they don’t get ill because there is jeopardy in doing so. We need to change the population’s mindset to take care of themselves.” Read full story (paywalled) Source: HSJ, 3 April 2023
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