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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    Midwives at Suffolk Hospital have spoken out in a whistleblowing letter describing problems in their department as ‘demoralising and heartbreaking’.
    In the letter, written by midwives who declined to give their names "for fear of retribution", describe constant staff shortages, a culture of blame and fear, a high pressure environment and substandard care, saying " We entered midwifery to be able to give women centred, holistic care. Instead it feels like we are being overwhelmed by the unmanageable and relentless workload, and as a result are giving substandard care which is demoralising and heartbreaking. We are all feeling like we are now desperate for change. This change is beyond what we can achieve ourselves so we urge you to please help us to generate it. It should not be accepted or tolerated for us to be forced into giving unsafe care entirely due to unsafe staffing". 
    In response, Karen Newbury, head of midwifery at the trust, said: “We are working exceptionally hard to recruit additional midwives and we are very grateful for the flexibility and dedication of our staff in ensuring that we provide a safe and caring service – this was recognised by our Care Quality Commission inspection in April which found we managed safety well. We have recently completed recruitment so there will be at least two senior midwives on every shift to provide flexible and experienced support to our maternity teams, and we are working with colleagues regionally to recruit staff both locally and internationally as well as running a full student training programme.”
    Read full story.
    Source: Suffolk News, 20 August 2021
  2. Patient-Safety-Learning
    It has been recommended by UK researchers that patients, regardless of their metabolic rate, should be given weight management advice as people with obesity were still at risk of diabetes, cardiovascular and respiratory diseases. 
    A recent study found that regardless of your metabolic rate, it did not necessarily mean that the patient with obesity were healthy and that doctors should avoid using the term “metabolically healthy obesity” as it could be misleading. 
    Read full story. 
    Source: Nursing Times, 11 June 2021
     
  3. Patient-Safety-Learning
    A new survey by the BMA was conducted throughout the UK on moral distress from 18 March 2021 to 12 April 2021. 
    It was found that those doctors who worked with Covid-19 patients and doctors who were from ethnic backgrounds, were more likely to say moral distress was a feeling they had experienced. It was also found  doctors from ethnic backgrounds were also more likely to say moral injury resonated with their experiences.
     The results of the survey has raised concerns for staff wellbeing with the BMA asking that the government increase staffing to the NHS, and provide emotional and psychological support for healthcare workers. 
    Read full story
    Source: BMJ, 16 June 2021
  4. Patient-Safety-Learning
    Ambulance bosses have apologised to the family of a man who died after he had a heart attack but no ambulance came.
    Martin Clark, 68, started suffering with chest pains at his home in East Sussex on 18 November - before any strike action started in the NHS.
    His family rang three times for an ambulance and after waiting 45 minutes drove him in their car to hospital. When they arrived, the father of five went into cardiac arrest and, despite receiving medical attention, died.
    Dr Sonya Babu-Narayan of the British Heart Foundation (BHF), said cases such as the Clarks' were "incredibly distressing".
    "The difference between life and death can be a matter of minutes when someone is having a heart attack or stroke," she said. "Extreme delays to emergency heart and stroke care cannot become a new normal. Healthcare staff are doing all they can—but there aren't enough of them and many will be working in difficult conditions without fit-for-purpose facilities."
    Read full story
    Source: BBC News
  5. Patient-Safety-Learning
    In November last year, Unison and RCN raised concerns with NHS Forth Valley chief executive Cathie Cowan amid bullying claims made by emergency department staff at Forth Valley Royal Hospital. 
    In light of the reports of bullying, a review was commissioned and leaked details revealed junior doctors were left unsupervised on shifts, nurses and doctors had said they are 'battle-weary', and many senior staff members have resigned their posts. 
    Karren Morrison, Unison Forth Valley health branch secretary has said: ‘Last year, concerns were being raised by our members who worked in, or who had previously worked in the ED. Staff talked to us about feeling bullied and intimidated, being frightened to speak up, concerns about the delivery of safe patient care, high staff turnover and other issues.’
    Read full story (paywalled).
    Source: Nursing Standard, 12 July 2021
  6. Patient-Safety-Learning
    New data from NHS Digital on the latest vacancy statistics shows as of June 2021 there were 38,952 registered nurse vacancies across the health service, with the Royal College of Nursing saying news of worsening nurse shortages should “stun” ministers into taking action. 
    RCN England director, Patricia Marquis, has said: “As health and care services head into what will be a very difficult winter, this should stun ministers to address the rising number of nursing vacancies and prevent further risk to patient care. After the pressures from the last 18 months we also know that many experienced nurses are considering leaving the profession. These are skills that cannot be replaced quickly. Unless there is an urgent investment in the nursing workforce, starting with an increase in pay that reflects their skill and professionalism, and there is accountability for workforce planning at ministerial level, we will be dealing with the fallout for years to come.”
    Read full story.
    Source: Nursing Times, 26 August 2021
  7. Patient-Safety-Learning
    A 45-year-old mother who almost died after injecting herself with a life-threatening amount of insulin she thought was Ozempic is calling on the Government and social media companies to crack down on the online counterfeit weight-loss jab trade.
    Michelle Sword, a receptionist from Carterton, Oxfordshire, first took Ozempic without any issues after she was prescribed it by a legitimate online pharmacy in early 2021. Ms Sword said she completed an online questionnaire and gave a false BMI that she knew would qualify her the drug. “I just told them what they wanted to hear,” she said.
    Ms Sword said she takes responsibility for her actions, but criticised rogue sellers for taking advantage of people with insecurities and selling a product that “can kill you”.
    She also wants the Government and social media companies to step in to tackle the trend. “I think the drug was in such infancy in what we knew about it that they weren’t able to “police” who got it, who took it, who sourced it. I think they [the Government] need to look at that.”
    Read full story (paywalled)
    Source: inews, 26 November 2023
  8. Patient-Safety-Learning
    Local NHS organisations are increasing their efforts to conserve ubiquitous blood collection products amid concerns current measures are not working and stocks may run even lower. There is also a concern in east London that the message to reduce routine tests is not being heeded, with GPs not cutting back enough. 
    However, this week the British Medical Association raised concerns over suspending routine tests, including “NHS Health Checks, monitoring of quality of care, and medication reviews”.
    The union said: “It would also be unreasonable to ask healthcare staff to simply delay these tests until a later date — not only for the sake of our patients, but also the entire system, which is already tackling an enormous backlog of care.”
    Read full story.
    Source: HSJ, 25 August 2021
  9. Patient-Safety-Learning
    Experts have warned misinformation around the Covid vaccine may be helping fuel the spread of the virus. Director of the Oxford Vaccine Group has warned "confused messaging" around the effectiveness to protect the population could threaten confidence in the jab. 
    Sir Andrew, together with Professor of vaccinology Shabir Madhi at the University of Witwatersrand in South Africa, have suggested lessons can be learned from South Africa. Writing for The Independent, they said “South Africa was one of the first African countries to procure the Oxford-AstraZeneca vaccine from Serum Institute of India. Unfortunately, these doses were never deployed because of misguided fears over efficacy, allowing the present third wave to occur in a largely unvaccinated population.” 
    Read full story.
    Source: The Independent, 26 July 2021
  10. Patient-Safety-Learning
    An independent group overseeing the reviews into a toxic culture at University Hospitals Birmingham have raised concerns over a possible ‘cover up’ of key reports.
    The cross-party reference group, which includes MPs, council and Healthwatch officials, has demanded transparency over key decisions, and says there are continuing concerns over the trust’s leadership. It has been scrutinising a review into patient safety concerns at UHB, which found the trust’s executive had become “overzealous and coercive”.
    On the day this review was released, it was revealed that UHB’s former CEO David Rosser had decided to retire.
    The group, chaired by MP Preet Gill, said in a statement: “The allegations made by whistleblowers were not isolated incidents, but the result of a deep-seated and toxic culture. While Dr Rosser has recently announced his retirement, one member of staff, albeit a chief executive, cannot be responsible for this alone. Feedback from staff has made it clear that there must be collective accountability by the senior leadership for the distressing culture afflicting the trust."
    Read full story (paywalled)
    Source: HSJ, 5 April 2023
  11. Patient-Safety-Learning
    An open letter has been published calling for the end of Covid-related abuse against healthcare staff, with leading health organisations coming together to unite against the rising tide of violence against nurses and other NHS staff.
    The letter was signed by nine representatives including the Royal College of Nursing and Royal College of Midwives and warned of the “unacceptable behaviours”, a move that comes after he chief executive and general secretary of the RCM, Gill Walton, received online threats after she supported a national appeal for pregnant women to get the Covid-19 vaccine.
    “To those who issue death threats or incite violence against us, we say enough is enough”, Ms Walton has said. 
    Read full story.
    Source: The Nursing Times, 4 August 2021
  12. Patient-Safety-Learning
    Doctors recruited from some of the world's poorest countries to work in UK hospitals say they're being exploited - and believe they're so overworked they fear putting patients' health at risk.
    A BBC investigation has found evidence that doctors from Nigeria are being recruited by a British healthcare company and expected to work in private hospitals under conditions not allowed in the National Health Service.
    The British Medical Association (BMA) has described the situation as "shocking" and says the sector needs to be brought in line with NHS working practices.
    Dr Jenny Vaughan of the Doctors Association UK said, "This is a slave-type work with… excess hours, the like of which we thought had been gone 30 years ago. It is not acceptable for patients for patient-safety reasons. It is not acceptable for doctors. "
    Read full story
    Source: BBC News, 11 October 2022
  13. Patient-Safety-Learning
    Nurses and physiotherapists can now provide ill patients with “fit-notes” to stay off work in an attempt to ease pressure on GP services. A range of health staff including pharmacists and occupational therapists are certifying illness sign-offs under moves to free up doctors to tackle the treatment backlog.
    NHS Grampian has successfully completed a pilot scheme at a GP practice which staff described as “really positive” and a step in the right direction.
    David Cooper, a GP from Old Machar Medical Practice in Aberdeen, said: “It is a more efficient way for us to work as a practice. For the nurses, physiotherapists and others who are working closely with a patient, it makes sense for them to be able to work on fit-notes without having to refer back to a GP for sign off. “We have found it works particularly well for those with chronic, long-term conditions or illness and the process behind the scenes is also now electronic so it saves paper, time and energy.”
    Paul Gray, a physiotherapist at Old Machar, said: “It makes the patient’s journey easier and it is better for people to access them from those who are assessing your physical capabilities."
    Read full story (paywalled)
    Source: The Times, 6 April 2023
  14. Patient-Safety-Learning
    Delays in patient care and a lack of consultant support have left junior medics fearing for their mental health, an NHS England investigation has discovered.
    Junior doctors described haematology services delivered from University Hospitals Birmingham’s Heartlands Hospital as “chaotic”.
    Their concerns are raised in a report by NHS England Workforce, Training and Education (formerly Health Education England). UHB’s haematology service has been under scrutiny since 2021, when HSJ revealed whistleblower concerns over patient safety, including a series of blood transfusion’ never’ events.
    The WTE team visited UHB in April. As a result, the haematology service is now subject to the General Medical Council’s enhanced monitoring regime. This means intensive support is given to trainees and the trust to improve medical training. UHB’s obstetrics and gynaecology department is also under enhanced monitoring.
    The WTE report warns that consultants working across multiple sites left trainee medics at Heartlands without sufficient support and supervision. Most conversations with consultants were via telephone, leaving juniors feeling “unsupported and insecure”. 
    The report stated: “Trainees described the workload … as chaotic and some reported the stress … was affecting their mental health… Some reported they do not feel valued, and the panel heard examples of people crying every day. Most described their roles as 100 per cent service provision… [they] reported very limited learning opportunities overall.”
    Read full story (paywalled)
    Source: HSJ, 24 August 2023
  15. Patient-Safety-Learning
    A major review into a mental health unit abuse scandal has found a catalogue of failings, including repeated missed opportunities to act on concerns, and a board “disconnected” from the realities faced by patients and staff.
    The independent review into failings at Greater Manchester Mental Health Foundation Trust was published today, commissioned after BBC Panorama revealed a “toxic culture of humiliation, verbal abuse and bullying” at Edenfield Centre in Prestwich in September 2022.
    The trust’s then chair, Rupert Nichols, resigned in November 2022, and CEO Neil Thwaite stepped down in spring last year.
    Review chair Professor Oliver Shanley, a former mental health trust CEO and chief nurse, describes in his report how the trust’s culture and leaders’ “insufficient curiosity” contributed to the “invisibility” of the deterioration in care quality. He says its board was focused on “expansion, reputation and meeting operational targets”.
    Read full story (paywalled)
    Read the report of the Independent Review into Greater Manchester Mental Health NHS Foundation Trust
    Source: HSJ, 31 January 2024
  16. 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
  18. Patient-Safety-Learning
    An inspection of a hospital has found all wards were understaffed, while ‘tearful [and] exhausted’ clinicians raised patient safety concerns to the Care Quality Commission (CQC).
    The CQC’s visit to Colchester hospital, run by East Suffolk and North East Essex Foundation Trust, also found patients going unfed because of low staffing ratios and patient confidentiality concerns.
    The concerns were raised in a letter sent by the CQC to the trust, which also runs Ipswich hospital, ahead of publication of an inspection report for older people’s medical services, which is due later this month.
    The CQC’s letter, published in board papers for a meeting on Thursday, said: “All wards’ actual staffing levels and skill mix meant staff were often overstretched. All staff we spoke with expressed concern about the impact on patient care and personal wellbeing. Some staff we spoke with were tearful, reported feeling exhausted and concerned that they were unable to care for patients well enough to keep them safe.”
    The letter also said significant positives were found. Inspectors “found staff to be welcoming, hardworking and supportive of each other… We found staff at all levels working together with the aim of putting the patients first and providing a safe and effective service”.
    Read full story (paywalled)
    Source: HSJ, 11 January 2023
  19. Patient-Safety-Learning
    According to public health reports, there has been a sharp rise in drug overdoses, particularly heroin, over the past 10-14 days with the synthetic opioid isotonitazene implicated in some cases. In several areas of the country including five London boroughs, Hampshire, Essex, West Sussex, Dorset and Thames Valley, there has been 46 poisonings, resulting in 16 deaths, although currently, investigations are still ongoing. 
    In a National Patient Safety alert issued on 18 August 2021, Public Health England (PHE) have instructed all NHS organisations to ensure staff are made aware of the risk of severe toxicity resulting from the synthetic opioid, and that all organisations that treat emergency cases should ensure staff are able to treat suspected cases “using naloxone and appropriate supportive care”.
    Roz Gittins, director of pharmacy at the charity Humankind, said "People also need to know where they can get hold of naloxone, as well as being reminded to carry it with them and to let people know where they keep it. If advice and support is required then the local substance misuse service should be contacted for specialist support. We hope that the current consultation to widen naloxone provision will be successful and that improved funding will lead to naloxone being distributed more widely to help reduce the risk of accidental opioid overdoses."
    Read full story.
    Source: The Pharmaceutical Journal, 18 August 2021
  20. Patient-Safety-Learning
    According to reports, a hospital in the northeast of England is having to turn away non-emergency patients from A&E due to "unrelenting" pressures on the service. This new policy was announced on Tuesday by Hull Teaching Hospitals Trust, warning patients they may need to travel up to 30 miles in order to receive care. 
    Dr Makani Purva, chief medical officer said in a statement on the trust website on Tuesday: “Staff are working incredibly hard to provide care for patients in challenging circumstances but we need people to use the full range of services available. One in four patients who attend A&E in Hull could have been treated more appropriately elsewhere, that’s around 100 patients every day. So from today, after an initial screening process, those arriving at A&E who could safely be cared for elsewhere will be referred on to one of several alternative care centres and providers. Doing so will help us to reduce waiting times for more seriously ill patients and ensure they receive the priority care they need in hospital, while enabling those patients with non-urgent needs to receive care more quickly from a suitably skilled health professional elsewhere.”
    Read full story.
    Source: The Independent, 24 August 2021
  21. Patient-Safety-Learning
    Britain faces a low uptake of the Covid booster jab this autumn amid “vaccine fatigue” and complacency about the virus, the new Pfizer boss has warned.
    The booster campaign starts next week, with care home residents and the housebound the first to be invited. Over-75s and the clinically vulnerable will be able to book appointments from September 12, with a wider rollout for over-50s taking place in phases. Roughly 26 million in England will be eligible.
    Susan Rienow, who was appointed UK managing director at Pfizer in February, said: “We have to remain vigilant. I recognise there may be some vaccine fatigue in the population. But making sure that people are boosting their immunity, so that we can prevent people from being hospitalised, is going to be really important.”
    Read full story (paywalled)
    Source: The Times (28 August 2022)

  22. Patient-Safety-Learning
    £140m that was spent on developing ventilators has been written off by ministers. According to the Observer, the ventilators were never put to use in the NHS in the months after the pandemic began. 
    The 'ventilator challenge' was launched to help provide more machines where needed, however problems began early last year when companies complained their expertise was not being used, while others who had no relevant experience of building ventilators, were asked to do so. 
    A government spokesperson has said: “Throughout the pandemic, we have done whatever it takes to protect the NHS and save lives. This included launching the ventilator challenge, which saw more than 15,000 new machines delivered to the NHS, meaning every patient who needs a ventilator has been able to access one". 
    Read full story.
    Source: The Guardian, 18 July 2021
  23. Patient-Safety-Learning
    NHS England could have gone further to insist that errors and failures by senior NHS leaders are disclosed to future employers, according to the leading barrister who reviewed the NHS’s fit and proper person test (FPPT).
    Tom Kark KC’s review of the FPPT was delivered to government five years ago and made public the following year, and changes were finally proposed by NHSE earlier this month. 
    In an interview with HSJ, Mr Kark said he broadly welcomed the plans, and that the revised framework should provide greater consistency across NHS boards “if applied correctly”; and could “strengthen the hand” of chairs and chief executives.
    Part of the purpose of the regime is to prevent senior managers and other board members who make big errors in one role, from keeping this secret from a future employer.
    Mr Kark told HSJ he had heard evidence that when “someone leaves under a cloud, they pop up somewhere else, and the information is lost.”
    Read full story (paywalled)
    Source: HSJ, 16 August 2023
  24. Patient-Safety-Learning
    In April of last year, many people in America came out and cheered for the healthcare workers fighting to save lives during the height of the coronavirus pandemic, but now, nurses across the US are holding strikes due to staff shortages and inadequate equipment amid the pandemic.
    “Most of us felt like we went from heroes to zeroes quickly,” says Dominique Muldoon, a nurse for more than 20 years at Saint Vincent’s hospital in Worcester, Massachusetts. Muldoon, co-chair of the local bargaining unit has also said nurses are going home crying in their cars, working through breaks and staying up late just to get the work done as demand for patient care has increased. 
    “You’ll end up staying late or working through your break trying to fit the workload all in, but ultimately become so frustrated, because eventually you keep trying to overcompensate and cannot keep up with it." Muldoon has said. 
    Read full story.
    Source: The Guardian, 30 July 2021
  25. Patient-Safety-Learning
    Some cancer patients have been left in limbo with their surgeries after the unlocking of the nation on the 19th July. Ms DePastino, who was scheduled to have surgery on Monday to remove cancer from her womb was told it had to be rearranged due to the number of Covid patients being admitted into the Princess Alexandra Hospital in Harlow. So far, Ms DePastino has not been given a new date or allowed to speak to her consultant. 
    “People have got this idea they want to get back to normal but what about people like me whose normal has been ripped away from them? Our only chance at normal is now being delayed or taken away so that people that are completely healthy can go about their business. If we’re going to get back to normal that means people who need care should be able to get care; it can’t be one or the other, that’s not right.” Said Ms DePastino, who also says her pleas to be referred to somewhere else have been ignored. 
    Read full story.
    Source: The Independent, 1 August 2021
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