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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    A health system has stopped sending mental health patients to the country’s largest single provider of out-of-area placements.
    Southern Hill Hospital in Norfolk provided more than 18,000 bed days classed as OAPs for NHS patients last year, with Greater Manchester Integrated Care System (GM) being the main contributor to that total.
    However, HSJ has learned that GM’s integrated care board and mental health providers have decided not to send any more patients to the provider.
    The move comes after a recent visit to and review of the service at Southern Hill by GM commissioners. This, in turn, followed concerns about the “co-ordination” of patient care at Southern Hill received by GM. The exact nature of the concerns is unclear, and the ICB said in a statement “no significant safety or quality concerns were found and feedback from patients was positive,” when it carried out its review.
    The ICB said the decision to cease placements at Southern Hill shortly after the concerns were raised was a coincidence, and that the move was part of its strategy to reduce OAPs.
    Read full story (paywalled)
    Source: HSJ, 2 May 2024
  2. Patient-Safety-Learning
    A 15-year-old child was prescribed dangerous levels of hormones by an unregulated online clinic without speaking to a doctor, a court ruling has revealed.
    Now 16, the teenager, known as J, was born female but identifies as a boy and has an autism diagnosis.
    J got a prescription for testosterone and puberty blockers from Singapore-registered GenderGP in late 2022. He had previously been unable to get the treatment through the NHS.
    Judge Sir Andrew McFarlane said: "There must be very significant concern about the prospect of a young person such as J accessing cross-hormone treatment from any off-shore, online, unregulated private clinic."
    The judgement highlights the lack of NHS gender services for children and young people in England and Wales, after the closure of the Tavistock Gender Identity and Development Service (Gids) in April. Gids, rated as "inadequate" by inspectors in 2021, was the only specialist gender clinic for children and young people in the two countries. The judgement says that, as a result: "There is no relevant NHS service available for J."
    Although the prescription was from a private doctor, J was given injections of testosterone by his local NHS GP every six weeks between January and August 2023. 
    An expert witness in the case, Australia-based consultant paediatric endocrinologist Dr Jacqueline Hewitt, was critical of the lack of physical and psychological checks carried out by GenderGP on J. Dr Hewitt also raised concerns about the size of the doses of testosterone given to J, describing the level of the hormone in his blood during his treatment as "dangerously high".
    Read full story
    Source: BBC News, 2 May 2024
  3. Patient-Safety-Learning
    Hundreds of breast cancer patients have travelled more than 100 miles for diagnosis and treatment after waiting times soared at another health board because of staffing shortages.
    NHS Grampian, which previously received NHS Tayside patients because of staffing problems in Dundee, is now sending its own cases to Larbert, near Falkirk, because its breast cancer department can no longer cope.
    About 520 people from the Aberdeen area urgently referred to hospital with breast cancer symptoms have travelled to the Forth Valley Royal Hospital for diagnosis with some going on to receive their treatment miles away from home. It is anticipated that at least another 330 Grampian patients will be sent to Forth Valley while the waiting lists are brought under control in Aberdeen.
    Read full story (paywalled)
    Source: The Times, 2 May 2024
  4. Patient-Safety-Learning
    A study cited at the infected blood inquiry as evidence that the devastating consequences of blood products contaminated with hepatitis could not have been foreseen, misrepresented the results of a trial in making its case, according to the Guardian.
    Up to 6,520 people are believed to have been infected with hepatitis C through imported factor VIII blood products in the 1970s and 80s, while a further 26,800 are estimated to have been infected with the virus though blood transfusions. About 2,000 people are estimated to have died as a result.
    The inquiry, which publishes its final report on 20 May, heard that the medical profession considered non-A and non-B hepatitis (later known as hepatitis C) as “relatively benign” at the time, with Pier Mannuccio Mannucci’s 2003 paper, 'Aids, hepatitis and haemophilia in the 1980s: memoirs from an insider', quoted in support of this proposition. 
    Mannucci’s 2003 paper argued that the view held by “the great majority of haemophilia treaters was that the problem of hepatitis was a tolerable one, because the benefits of concentrates seemed to outweigh risks”.
    In making his argument, Mannucci cited his own work, writing: “A prospective biopsy study was undertaken by me … in 10 haemophiliacs with non-A, non-B chronic hepatitis followed up for more than six years. The study, published in 1982, demonstrated no case of progression towards cirrhosis or haepatocellular carcinoma.”
    However, the original 1982 report says that there were actually 11–not 10–people included in the study and “one patient with active cirrhosis died of liver failure during the follow-up period”.
    Who knew what about the risks and when is a key plank of the inquiry.
    Read full story
    Source: Guardian, 2 May 2024
  5. Patient-Safety-Learning
    In the first half of 2023, Covid-19 killed 42,670 people in the United States, while the flu killed about half that amount. Yet half as many people received the updated covid booster as those who got the flu shot — even though covid is twice as deadly as influenza.
    In all, around 22% of people have received the new covid booster, while 47% of people have had a flu vaccine. Experts said much of that covid-shot resistance is due to the continued polarizing nature of the pandemic and of the covid vaccine, which has been shown to reduce the risk for Long Covid as well as serious acute viral infections and deaths.
    "Public health messaging is also to blame for the lower-than-normal covid vaccine rates," said Dr Al-Aly, a global expert on Long Covid and chief of research and development at the VA Saint Louis Health Care System. "Patients need to better understand that the role of the vaccine isn't to completely prevent covid but to reduce the likelihood of hospitalisation and death, similar to that of a flu shot. By reducing the risk for severe disease, the vaccine also reduces the risk for Long Covid, a debilitating condition that's still poorly understood, has no cure, and has already caused thousands of American deaths," he said.
    Botched public health messaging also allowed for misinformation to run rampant. Rare adverse events associated with the COVID vaccine have been severely overplayed and spread like wildfire on social media. "Patients need to know that like any vaccine, vaccine injury does occur, but these vaccines have a better safety profile than almost any others," Al-Aly said. "The rewards of getting the vaccine far outweigh the risks, and patients need to understand that."
    Read full story
    Source: Medscape, 2 May 2024
  6. Patient-Safety-Learning
    Leading pharmacists have blasted the government over “shameful” increases in the cost of NHS prescriptions. From 1 May they will increase from £9.65 per item to £9.90.
    Pharmacists across the country have hit out at the increase, warning it will disadvantage working patients on lower incomes. And the National Pharmacy Association (NPA) said the move will create an “arbitrary barrier” to people’s ability to receive healthcare.
    According to an NPA survey, patients have already reported not getting regular medication due to the costs. Antibiotics, pain killers, asthma inhalers, blood pressure medication and antidepressants are examples of the most commonly reported medicines which patients have not taken due to cost. Hundreds of pharmacies reported seeing patients decline medicines due to the cost of prescriptions, one to five times a week.
    Nick Kaye, chair of the NPA, said: “To allow the prescription charge to rise to this level is a shameful neglect of working people on low fixed incomes, who are not exempt. Many people already choose not to collect some or all their prescription medicines because of cost, with potentially dire health consequences. As pharmacists, we understand the healing power of medicines. So naturally we oppose arbitrary barriers to people getting the medicines they need. This is a tax on the working poor that deepens the cost of living crisis for them."
    Read full story
    Source: Independent, 1 May 2024
  7. Patient-Safety-Learning
    The safety of a teaching hospital’s out-of-hours supervision has been questioned, including reports trainees were told not to ask for help “unless your patient is dying”.
    The General Medical Council put University Hospital Southampton Foundation Trust’s general surgery training under enhanced monitoring at the end of 2023 following a referral and quality management visit by NHS England South East, Workforce Training and Education – Wessex.
    The NHSE team’s visit and subsequent report said doctors in training had claimed senior staff were “not contactable” out of hours and there was “difficulty” in securing senior clinical advice, particularly on Sundays. 
    The report added foundation year doctors were “discouraged” from contacting senior staff out of hours by “inappropriate” and “belittling” comments and behaviours, such as being told not to ask for help “unless your patient is dying”. Foundation doctors also reported starting rotation on call and conducting ward rounds without appropriate supervision.
    While the GMC open case is centred on patient safety concerns relating to supervising trainee doctors, the workforce and training directorate report also raised concerns about bullying, inappropriate sexual comments made by consultants, and a feeling that foundation doctors were unable to speak up.
    Read full story (paywalled)
    Source: HSJ, 1 May 2024
  8. Patient-Safety-Learning
    Increased reliance on imaging for diagnosis and efficient patient care mixed with higher volumes of patients has left US hospitals scrambling to meet demand with the few radiologists they have.
    There are over 1,400 vacant radiologist positions posted on the American College of Radiology's job board, according to a bulletin posted on its website. The total number of active radiology and diagnostic radiology physicians has dropped by 1% between 2007 and 2021, but the number of people in the U.S. per active physician in radiology grew nearly 10%, according to the Association of American Medical Colleges. An increase in the Medicare population and a declining number of people with health insurance adds to the problem.
    "Demand for imaging services is increasing across the country, creating longer worklists for radiology staff at the same time the healthcare system is experiencing a workforce shortage in radiology," Michigan Hospital Association CEO Brian Peters told The Detroit News in an April 28 report. "The combination of vacancies and increased demand can force imaging delays measured from days to upwards of two weeks."
    CMS also cut fees for both diagnostic (3%) and interventional radiology (4%) this year, according to an article published on healthcare technology company XiFin's website. This leaves many hospitals having to use external groups to stay on top of demand.
    Mr. Peters told Detroit News, "Hospitals and health systems are also competing with practices offering remote-only positions, which allows Michigan radiologists to work for out-of-state providers at higher rates."
    Read full story
    Source: Becker's Hospital Review, 29 April 2024
  9. Patient-Safety-Learning
    Medical devices should be judged more on the value they bring to a wider health economy than just the price of the items, according to draft Department of Health and Social Care procurement guidance seen by HSJ.
    The draft methodology, produced by Department of Health and Social Care’s MedTech directorate, outlines how “value” should be given a minimum weighting of 60 per cent while price should have a maximum weighting of 40 per cent when procurement teams are evaluating which products to buy. The “value” weighting will include a minimum of 10 per cent which must be applied to social value, which is already a requirement for all public procurements.
    This would reverse established practice across many procurements that sets the price of products or services as the most important factor, at times to the detriment of products that provide greater value to a health economy.
    It is intended to be used for all procurements of medical devices. It came from the 2023 MedTech strategy, which “identified that the value of medtech products should not be considered in isolation but across the whole patient pathway and that lowest price does not always translate to best value,” it said.
    The plan is for it to become one of a set of commercial ”playbooks” produced by NHS England as part of the implementation of its national commercial strategic framework, which it published in November 2023. The draft methodology should bring consistency to how the NHS judges value in a procurement and to the evidence suppliers produce to support their offering. This should mean effective products are adopted more widely and their system-wide benefits to patient pathways are realised at scale.
    Read full story (paywalled)
    Source: HSJ, 30 April 2024
  10. Patient-Safety-Learning
    A new trial to gather evidence on screening methods to detect prostate cancer is set to be led by researchers at Imperial College London, working alongside UCL, Queen Mary University of London and the Institute of Cancer Research.
    The £42million TRANSFORM screening trial, backed by charity Prostate Cancer UK, aims to find the best way to screen for prostate cancer and double the number of lives it could save.
    Previous trials using PSA blood tests and biopsies have shown that it is possible to prevent between 8% and 20% of prostate cancer deaths depending on how regularly patients are screened. But healthy people can potentially be harmed by this approach.
    Currently, there are more than 12,000 prostate cancer deaths in the UK alone, and this could mean thousands of lives saved each year in the UK.
    TRANSFORM will bring together leading prostate cancer researchers to test new approaches that have the potential to more than double the impact of screening, and ultimately reduce prostate cancer deaths by up to 40%.
    Read full story
    Source: Imperial College, 1 May 2024
  11. Patient-Safety-Learning
    Transgender women should not be put on single-sex female NHS wards, the government is proposing.
    The measure is part of a raft of changes to the NHS Constitution for England, the charter of rights for patients.
    The proposals stress the importance of biological sex for the first time when it comes to same-sex accommodation and intimate care. In both cases, the rights are available only where possible. For example, same-sex accommodation rights, which have existed for years, can and are breached where there is a clinically urgent need to admit and treat a patient and do not extend to areas such as critical care or accident and emergency.
    The guidance also means that trans men should not be housed on single-sex male wards.
    Under the proposals:
    transgender people, whose gender identity differs from their biological sex, may be provided single rooms, where appropriate patients will have the right to request a person of the same biological sex delivers any intimate care Health Secretary Victoria Atkins said it was about making it clear that "sex matters." She said, "We want to make it abundantly clear that if a patient wants same-sex care, they should have access to it wherever reasonably possible. By putting this in the NHS Constitution, we're highlighting the importance of balancing the rights and needs of all patients, to make a healthcare system that is faster, simpler and fairer to all."
    Labour's shadow health secretary Wes Streeting said: "Rights on paper are worthless unless they are delivered in practice. "The NHS constitution already pledges that no patient will have to share an overnight ward with patients of the opposite sex, but that is not the case for too many patients."
    Read full story
    Source: BBC News, 30 April 2024
  12. Patient-Safety-Learning
    Healthcare providers are failing to protect the privacy of people living with HIV, the UK’s data watchdog has warned.
    The Information Commissioner’s Office said it has been forced to hand fines worth thousands to organisations which have released the details of those living with HIV.
    Speaking with The Independent, Information Commissioner John Edwards, said: “It is a huge problem [within healthcare] and it’s a disproportionate amount of our business. “That’s partly because of the seriousness and the sensitivity of health information, the huge scale of the health sector and very many moving parts, with many opportunities for information to slip out as it moves from one place to another, and frankly, they’re just not doing well enough.”
    In a warning on Tuesday the watchdog highlighted specific concerns over HIV patients’ data being breached through the use of bulk emails in which staff have not used the blind copy function.
    The Information Commissioner said: “People living with HIV are being failed across the board when it comes to their privacy and urgent improvements are needed across the UK. We have seen repeated basic failures to keep their personal information safe - mistakes that are clear and easy to avoid."
    Read full story
    Source: Independent, 30 April 2024
  13. Patient-Safety-Learning
    The number of young people receiving their MMR jab is up nearly a quarter from last year, official figures show.
    A national campaign to boost uptake was launched in January amid concern over measles rates in England, when the UK Health Security Agency (UKHSA) declared a national incident after a major outbreak in the West Midlands. The growth in infections shows no sign of abating, with a 40% increase in reported cases in England since March.
    The latest NHS England data shows more than 360,000 MMR jabs were administered in the 12 weeks to 24 March 2024, a 23% rise. 
    The new campaign encourages parents and carers of children aged from six to 11 to make an appointment with their child’s GP practice so they can receive missed MMR vaccinations, and just over a million people aged 11 to 25 in London and the West Midlands have also been encouraged to catch up on missed jabs. In order to keep measles at bay, more than 95% of children should be vaccinated, but NHS figures from December suggest England is only at about 85%.
    With an estimated 3.4 million under-16s at risk of getting the virus, the campaign sent more than a million parents letters and emails inviting them to get their child vaccinated. Pop-up MMR clinics have been held in wellbeing buses, libraries and schools, pharmacies and outside supermarkets.
    But measles cases continue to rise. According to UKHSA figures released last week, there were 103 new cases in the past week. The number of laboratory confirmed cases since 1 October 2023 rose to 1,212 , an increase of 40% on March’s figures . In October 2023, there were just 17.
    The biggest increases in vaccination numbers were in the north-west, London and the West Midlands.
    Read full story
    Source: Guardian, 28 April 2024
  14. Patient-Safety-Learning
    People with type 1 diabetes are being forced to endure the “stress and anxiety” of insulin shortages, patients, pharmacists and health campaigners have warned.
    The “distressing” drug scarcity, the latest to affect the UK, is sowing uncertainty for the 400,000 people with the condition, with some products not available again until next year amid global manufacturing shortages.
    Britain is already contending with record numbers of medicines becoming hard or impossible to obtain, including those for attention deficit hyperactivity disorder and epilepsy.
    The Juvenile Diabetes Research Foundation (JDRF) said “a regular and reliable supply of insulin is essential for life” for people with type 1 diabetes. That is because their disease – an autoimmune condition unrelated to type 2 diabetes – means they cannot make insulin naturally and must inject it every day or receive it through a pump.
    The Department of Health and Social Care (DHSC) confirmed there were “supply issues with a limited number of insulin products” that patients might find “distressing”.
    One patient, an NHS doctor who puts vials of the drug into her insulin pump, said: “I spent the last two days trying to get hold of insulin to treat my type 1 diabetes. I was terrified when my usual, very reliable pharmacist told me he couldn’t get hold of my insulin. I had no idea that insulin could go out of stock. Type 1 diabetics fall ill and will die within a few days without insulin. I’m worried for fellow diabetics, not only to access the supply, to stay alive, but the stress and anxiety this causes.”
    Read full story
    Source: Guardian, 28 April 2024
  15. Patient-Safety-Learning
    Inga Rublite died after being found unconscious under her coat in an A&E waiting room more than eight hours after arriving.
    Learning what happened to Rublite in the hours before her death has been gut-wrenching for her friends and family. She sat through the night at Queen’s Medical Centre (QMC) in Nottingham after arriving at 10.30pm on 19 January with severe headache, dizziness, high blood pressure and vomiting. When her name was called seven hours later, at about 5.30am, she did not respond and staff discharged her believing she had tired of waiting and gone home.
    But over an hour later she was discovered having a seizure after falling asleep, and then unconscious, under her coat. She was rushed to intensive care but had suffered a brain haemorrhage, and the bleeding was so severe it was inoperable. She was declared dead two days later on 22 January, when her life support was switched off.
    Inga's twin sister said, “In all those years, the one time she went to the hospital to ask for help, no one was looking at her. I can’t describe how that feels. That you can’t get help in the place where you’re supposed to go for help.”
    Read full story
    Source: Guardian, 26 April 2024
  16. Patient-Safety-Learning
    NHS England is floating proposals to cut the elective waiting list by nearly 50 per cent to under 4 million over the next five years.
    HSJ understands this scenario is being discussed among system leaders as they brace themselves for the next government, whoever wins the general election, demanding a radical reduction in the waiting list. The list stood at 7.5 million as of the last official figures.
    The figure of just under 4 million is in part being targeted because this is the level NHS bosses estimate the list would need to be reduced to if the service is to return to meeting the standard that 92 per cent of patients referred are treated within 18 weeks, which has not been met since February 2016.
    Waiting list expert Rob Findlay estimated the required level would need to be closer to 3.5 million if the 92 per cent target is to be met. He told HSJ the list “would need to shrink to around 3.6 million before the statutory 18-week target became achievable again”.
    HSJ understands NHSE’s leadership believes a target of under 4 million could be credible—albeit likely dependent on targeted extra capacity, technology, resolution of strikes and on which other targets are set, especially around emergency waiting times.
    Progress could be accelerated by, for example, major outpatient reform to remove many appointments deemed unnecessary and use of technology to overhaul some pathways, officials believe. These could have a similar impact to the likes of faecal immunochemical testing, known as FIT, which is said to be playing a big role in reducing the cancer backlog.
    Read full story (paywalled)
    Source: HSJ, 26 April 2024
  17. Patient-Safety-Learning
    On Tuesday, the UK Covid inquiry which is sitting in Belfast for three weeks will start hearing from the most senior politicians and health advisors in Northern Ireland about why decisions were taken and by whom.
    This is module 2c of the inquiry, which is focusing on decision-making and political governance.
    This module will investigate Northern Ireland specifically and will include the initial response, central government decision making, and political and civil service performance. It will also probe whether Northern Ireland's political nuances had any affect on the effectiveness of the response.
    There were tensions between the political parties when senior Sinn Féin figures attended the funeral of ex-IRA leader Bobby Storey and when the DUP's Edwin Poots, then minister for Agriculture, Environment and Rural Affairs, said coronavirus was more common in nationalist areas.
    The hearings begin with opening statements and evidence from Covid-19 Bereaved Families and Disability Action.
    Core participants who have been named in advance include the former first ministers, Dame Arlene Foster and Paul Givan, and Michelle O'Neill, who was deputy first minster during the pandemic. Senior representatives from the departments of health, finance, the Executive Office, and the civil service will also be questioned.
    Read full story
    Source: BBC, 29 April 2024
  18. Patient-Safety-Learning
    The use of mixed-sex wards has gone “through the roof” after the number of men and women being put in beds next to each other soared to nearly its highest level in a decade.
    Official figures from NHS England show the government’s strict rules against doing so were broken nearly 5,000 times in February alone.
    NHS leaders voiced concerns over the high number of breaches and warned that care that was “unthinkable a decade ago is at risk of becoming the new normal”.
    Shadow health secretary Wes Streeting said patients were left feeling humiliated and at risk, adding: “The use of mixed-sex wards has gone through the roof under the Tories.”
    The government outlawed mixed wards in the NHS in 2010. Under the guidance, patients should not share wards overnight, share bathroom facilities or have to walk through areas occupied by patients of the opposite sex to get to the toilets.
    Despite promises more than a decade ago to eliminate mixed wards, The Independent found:
    4,811 reported breaches in February, up from 3,789 last November Nurses warning “sky-high breaches” are the tip of the iceberg Evidence that patients are suffering sexual assaults while on mixed mental health wards Under the guidance, no mental health units should have mixed wards. However, earlier this year, The Independent revealed the practice is widespread, with more than 500 sexual assaults reported across almost half of the NHS mental health hospitals in England.
    Read full story
    Source: Independent, 28 April 2024
  19. Patient-Safety-Learning
    Sexual harassment levels in the NHS are “shameful”, with incidents happening all the time, one of the country’s top health chiefs has admitted.
    Dr Navina Evans, chief workforce officer at NHS England, urged leaders to act on shocking levels of sexual harassment, following exposes by The Independent.
    Asked about the one in eight workers who have reported unwanted sexual behaviour, she said: “It is shameful... I could tell you stories from my own experience from when I was a trainee right up to last year.
    Last year, the NHS published its “sexual safety charter” which requires organisations to commit to eliminating sexual harassment and assault among staff and patients.  However, not all 240 NHS trusts have signed up to the charter yet, according to Dr Evans. She said: “It is really important that every organisation signs up.”
    The NHS staff survey this year found one in eight workers – around 58,000 – had reported experiencing unwanted sexual behaviour in the last 12 months, while one in 26 reported experiencing similar harassment from a work colleague.
    Read full story
    Source: Independent, 27 April 2024
  20. Patient-Safety-Learning
    Fears over patient safety have been raised after it was revealed that 600 jobs will be lost at hospitals in parts of Essex to save money.
    Mid and South Essex NHS Foundation Trust - which runs Southend, Basildon, Broomfield, St Peter's in Maldon and Braintree hospitals - is facing a £91m pound black hole in it's budget and said that "reducing headcount" would be necessary.
    The trust is one of the largest acute trusts in the country and employs 16,000 members of staff. It has a budget of around £1bn each year. Bosses said in a letter to staff that "all posts" must be reviewed, "including clinical roles". All current vacancies are being reviewed and no vacancies will be approved until that process is complete, they add.
    The news has been criticised by campaign groups and union bosses, who say that patients could be put at risk. UNISON Eastern regional organiser Sam Older said: "This vacancy freeze will ring alarm bells for already overworked staff. These 600 posts weren't created for the hell of it - they are there to provide healthcare to 1.2 million people in Essex. The trust was already struggling with rising demand. Slashing staff numbers, cancelling bank shifts and long waits to fill vacancies is only going to make this worse. And there's a clear risk that cutbacks will pose a threat to patient safety if staffing levels fall too low."
    Read full story
    Source: ITV, 27 April 2024
  21. Patient-Safety-Learning
    An inquest jury has found there were “gross failings in care amounting to neglect” before a woman had a heart attack at a private mental health hospital due to complications from drinking excessive amounts of water.
    Lillian Lucas, 28, known as Lily to her family and friends, died in September 2022 after being found unresponsive in her room on Milton ward at the Cygnet hospital in Kewstoke, near Weston-super-Mare, where she had been an inpatient since June.
    An inquest jury at Avon coroner’s court found on Wednesday that opportunities were missed by staff to render care that would have prevented Lucas’s death, including a failure to monitor her worsening condition and inadequate response to her deterioration.
    On 8 September 2022 she was found unresponsive in her room after drinking excessive amounts of water and transferred to Bristol Royal Infirmary (BRI), the jury heard. She died the following day. Postmortem examinations found she died of a heart attack and the impact of psychogenic polydipsia, when due to a mental disorder a person experiences an uncontrollable urge to drink water.
    The jury concluded on Wednesday that there were “gross failings in her care amounting to neglect”. In the record of the inquest, the jury said the Milton ward was “understaffed at a level deemed to be unsafe”.
    Read full story
    Source: Guardian, 24 April 2024
  22. Patient-Safety-Learning
    An NIHR and UK Research and Innovation (UKRI) funded study has revealed that Long Covid leads to ongoing inflammation which can be detected in blood. 
    This suggests that existing drugs which help treat conditions that affect the body’s immune system could be helpful in treating Long Covid, and should be investigated in future clinical trials. The study, which has been published in Nature Immunology, is from two collaborative UK-wide consortia, PHOSP-COVID and ISARIC-4C. These involve scientists and clinicians from universities across the UK, including Imperial College London and the Universities of Leicester, Edinburgh and Liverpool, among others.
    The research compared 426 people who were experiencing symptoms consistent with Long Covid with 233 people who were also hospitalised for Covid-19 but had fully recovered. The researchers took samples of blood plasma and measured a total of 368 proteins known to be involved in inflammation and immune system modulation.
    They found that, relative to patients who had fully recovered, those with Long Covid showed a pattern of immune system activation indicating inflammation of myeloid cells and activation of a family of immune system proteins called the complement system.
    Read full story
    Source: NIHR, 11 April 2024
  23. Patient-Safety-Learning
    The Royal Pharmaceutical Society (RPS) has published updated professional standards to support pharmacists, pharmacy technicians and pharmacy teams in responding to patient safety incidents.
    Created in collaboration with the Association of Pharmacy Technicians UK (APTUK) and the Pharmacy Forum Northern Ireland (PFNI), the Patient safety professional standards: responding to patient safety incidents are designed to support pharmacy professionals to meet regulatory standards.
    The standards, published on 24 April 2024, reflect new legislation and updated guidance from the General Pharmaceutical Council and NHS England, replacing the previous standards published in 2016.
    They also provide a framework for reflecting, reporting and recording incidents, and sharing learning, taking action and reviewing and evaluating incidents as part of a patient safety culture.
    Read full story
    Source: The Pharmaceutical Journal, 24 April 2024
  24. Patient-Safety-Learning
    Use of antipsychotic medications in patients with dementia is linked with a much wider range of serious harms than previously thought, say UK researchers.
    Although there have been safety warnings on use of the antipsychotics from regulators about increased risk of stroke and death, a large study has now found increased risks for pneumonia, venous thromboembolism, heart attack, heart failure, fracture, and acute kidney injury.
    Reporting the findings in the BMJ, researchers from the University of Manchester said it underscores the need for increased caution when prescribing. The analysis showed that antipsychotic use was associated with increased risks for all outcomes looked at with the exception of ventricular arrhythmia. Over the first six months of treatment, it was estimated that antipsychotic use was linked with one additional case of pneumonia for every nine patients treated, and one additional heart attack for every 167 patients treated.
    Professor Charles Marshall, professor of clinical neurology at Queen Mary University of London, said the study findings should prompt renewed efforts to reduce the prescribing of antipsychotics to people living with dementia. "There are rare circumstances where antipsychotics are genuinely required, and the benefits outweigh these risks, but for the majority of patients with behavioural symptoms that might lead to them being prescribed anti-psychotics, we should be focussing on much safer behavioural management approaches."
    Read full story
    Source: Pulse, 24 April 2024
  25. Patient-Safety-Learning
    The Biden administration set a first-ever minimum staffing rule for nursing homes Monday, making good on the president’s promise more than two years ago to seek improvements in care for the nation’s 1.2 million nursing home residents. 
    The final rule, proposed in September, requires a registered nurse to be on-site in every skilled nursing facility for 24 hours a day, seven days a week. It mandates enough staff to provide every resident with at least 3.48 hours of care each day. And it beefs up rules for assessing the care needs of every resident, which will boost staff numbers above the minimum to care for sicker residents.
    For a facility with 100 residents, it translates to a minimum of two or three registered nurses and at least 10 or 11 nurse aides per shift, as well as two additional staffers who could be nurses or aides per shift, according to the administration’s interpretation of its new formula. Set to phase in over the next few years, the mandate will replace the current vague standard that gives operators wide latitude on how to staff their facilities.
    While the administration has said the rule will improve care, industry lobbyists have said it’s unworkable, with staffing goals that will be impossible to achieve because of a shortage of workers.
    The administration received 47,000 public comments on the rule since it was proposed last September. They included observations of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, Secretary of Health and Human Services Xavier Becerra said in an interview Monday.
    Read full story
    Source: Washington Post, 22 April 2024
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