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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    A proposed pay settlement is making doctors consider leaving the health service, the British Medical Association (BMA) in Northern Ireland has said.
    In a BMA survey of more than 1,000 doctors, 85% of respondents said the proposed uplift of 4.5% was too low.
    The representative body said discontent was very high among junior doctors with 93% of them saying it was too low.
    "When asked about their intentions as to the likelihood of them continuing to work in Northern Ireland, junior doctors said they were now more likely to leave because of the low pay award," said the BMA.
    Read full story
    Source: BBC News (31 August 2022)
  2. Patient-Safety-Learning
    An “institutionalised” and “counterproductive” system of hiring and firing trust leaders was a contributory factor to care failings which caused the death of at least 45 babies an inquiry has concluded. 
    The inquiry into maternity care at East Kent Hospitals University Foundation Trust, chaired by Bill Kirkup, discovered what it described as the latest ”major service failure” in NHS maternity care. It concluded that successive chairs and chief executives were “wrong” to believe the trust had provided adequate care for more than a decade and urged they be held accountable. But he added the churn of senior management had been “wholly counterproductive” for the trust.
    His report said: “We have found at chief executive, chair and other levels a pattern of hiring and firing, initiated by NHS England. The practice may never have been an explicit policy, but it has become institutionalised. In response to difficult problems, pressure is placed on a trust’s chair to replace the chief executive, and/or to stand down themself."
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    Source: HSJ, 20 October 2022 (paywalled)
  3. Patient-Safety-Learning
    The deadline for the NHS to move to a new system for safety incident reporting has been delayed after widespread concerns the rollout could be a ‘disaster’.
    A memo from NHS England to local teams yesterday, seen by HSJ, says the deadline to transition to the new “learning from patient safety events” database has been pushed back by six months to September 2023.
    The creation of LFPSE is a key strand of NHSE’s safety strategy, along with the overhaul of how serious incidents are investigated. It aims to make it easier for staff across all healthcare settings to record safety events, as the service will be expanded to include primary care.
    It will replace the current national reporting and learning system, a central database created in 2003 to help identify trends and maximise learning from mistakes. The new system is part of a national strategy that pledges to save 1,000 extra lives and £100m in care costs each year from 2023-24.
    Multiple patient safety managers at local trusts had raised concerns to HSJ about the previous March deadline, with one patient safety lead saying it would have been a “disaster” if enforced.
    Helen Hughes, chief executive of charity Patient Safety Learning, said NHSE also needs to change its way of working, as well as the deadline extension. She said:
    “We believe that NHS England needs to seriously reconsider their approach to engaging with trust leaders and staff on this issue, so that improvements can be made to the new LFPSE service to ensure it has the best possible chance of success, and to enable patient safety improvement.”
    Read full story (paywalled)
    Source: HSJ, 20 October 2022
  4. Patient-Safety-Learning
    An expert panel convened by the US Food and Drug Administration voted 14-1 on Wednesday to recommend withdrawing a preterm pregnancy treatment from the market, saying it does not work.
    During the sometimes contentious three days of hearings, the drugmaker Covis Pharma, backed by some clinicians and patient groups, had argued there is evidence to suggest the drug, called Makena, might work in a narrower population that includes Black women at high risk of giving birth too soon.
    But FDA experts and others said the data does not support such a view. In closing arguments, Peter Stein, director of the Office of New Drugs at the FDA’s Center for Drug Evaluation and Research, agreed on the urgent need for a drug to reduce the incidence of preterm birth — a leading cause of infant mortality in the United States. But he said the data indicates that Makena is not that drug.
    Stein said, “Hope is a reason to keep looking for options that are effective,” he said. “Hope is not a reason to take a drug that is not shown to be effective, or keep it on the market.”
    Read full story
    Source: The Washington Post, 19 October 2022
  5. Patient-Safety-Learning
    Patients in England are being put at risk because of the unacceptably poor service they receive from GPs, MPs say.
    The House of Commons' Health Committee blamed the failure to tackle doctor shortages, which had led to a decline in the GP-patient relationship.
    Seeing a GP should not be like booking an Uber with a driver you are unlikely to see again, the MPs said. The warning comes just weeks after ministers launched a drive to improve access to GP services. But the cross-party group of MPs said more needed to be done.
    Louise Ansari, from the patient group Healthwatch England, said, "The impacts of poor access can be huge, with people feeling abandoned and suffering in silence and not getting referred to hospitals for more specialised treatment."
    Read full story
    Source: BBC News, 20 October 2022
  6. Patient-Safety-Learning
    The main corridor of an acute hospital has been closed to patients and staff and turned into a ‘makeshift ward’, in what sources describe as an ‘absolutely unprecedented’ situation.
    The move by Aintree Hospital comes after staff clashed with paramedics last week about whether ambulance patients could be brought into the crowded emergency department.
    One staff member, who wished to remain anonymous, said: “It’s exceptional for this to happen, but I can see it happening more over winter. It’s a rock and a hard place… either you wait in the ambulance if the queue is too long, or you wait in the main hospital corridor. Neither option is ideal.”
    Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: “Across the country, the urgent and emergency care system is in unprecedented crisis. Emergency medicine teams and our paramedic colleagues are doing their very best to deliver effective care in exceptionally difficult circumstances. Circumstances like these require ICB leaders to engage, take control of the situation and accept their responsibility. This will both help to de-escalate the situation and ensure the right decision is made for the patients, the ED teams and ambulance crews."
    Read full story
    Source: HSJ, 19 October 2022 (paywalled)
  7. 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
  8. Patient-Safety-Learning
    There are big differences in how well patients with hip fractures are cared for by hospitals in England and Wales, a Bristol University study says.
    In some hospitals one in 10 people died within a month of surgery - more than three times worse than in the best.
    Getting patients into theatre quickly and out of bed the next day for physio are key ways to improve care. People should receive the same, high-quality care wherever they live, the researchers said.
    "If you get it right for older people with hip fractures, you're probably getting it right for older people in general," says Professor Celia Gregson, who led the study of more than 170,700 patients in 172 hospitals between 2016 and 2019.
    An NHS spokesperson said hip fracture care in the UK had "seen dramatic improvements in recent years".
    Read full story
    Source: BBC News (31 August 2022)
  9. Patient-Safety-Learning
    The finalists for The Innovate Awards 2022 have been revealed following a rigorous round of judging over the summer, and Patient Safety Learning is a finalist in the 'Enabling Safer Systems of Care Through Innovation' category.
    In its inaugural year, The Innovate Awards saw a grand total of 194 entries from health and care teams across the country covering ten award categories. The ten eventual winners will also compete for ‘Innovation Champion of the Year’ to be announced on the evening of the award ceremony in September.
    Commenting on the awards, Matthew Taylor, Chief Executive, NHS Confederation from NHS Confederation said: “Judges across all the award categories have remarked on how impressive and inspiring the work contained in these submissions has been. It has been a delight to see the wonderful efforts taking place in terms of innovation in the health and care sector and it is hugely important to recognise and celebrate this.”
    Read full story
    Source: AHSN Network (30 August 2022)
  10. Patient-Safety-Learning
    Patients will be able to use the NHS app to shop around for hospitals with the shortest waiting lists in a renewed drive to cut backlogs for routine care.
    Health bosses agreed yesterday to give patients more choice over where they are treated by next April in an effort to use digital league tables to direct people towards hospitals with the shortest waits.
    Steve Barclay, the health secretary, wants to give patients “real-time data” on their phones to decide whether to travel further to get quicker treatment for hip replacements, cataract removals and other non-urgent procedures.
    A government source said: “We don’t need a big bureaucracy to funnel patients towards the hospital which NHS managers decide is best, when, armed with a right to choose and the right information on the app, patients will go where waiting times are lowest.”
    Read full story (paywalled)
    Source: The Times (31 August 2022)
     
  11. Patient-Safety-Learning
    Nearly 1.5 million patients have lost their GP in the last eight years after the closure of almost 500 practices, research has suggested.
    Issues around recruitment were a factor in the closure of about two-fifths of the surgeries, while workloads and inadequate premises were also cited as triggers.
    The investigation, by Pulse magazine, revealed for the first time the number of premises that have closed for good since 2013. Previously, research has identified the number of practices where GP partners have returned their contracts, or certain branches have closed or merged with others.
    Prof Martin Marshall, the chairman of the Royal College of GPs, said: “The impact of a practice closing on its patients and neighbouring practices can be considerable. As such, a decision to close a practice will be one of the most difficult a GP partner can make. When the reason for closing a practice is workload pressures, and not being able to fill vacancies, then this needs to be addressed as a matter of urgency.”
    Read full story (paywalled)
    Source: The Telegraph (29 August 2022)
     
  12. Patient-Safety-Learning
    Major concerns are being raised about the Irish State’s failure to set up an inquiry into a drug that caused serious birth defects and developmental delays in at least 1,200 Irish babies.
    Sodium valproate, a drug used to treat epilepsy and bipolar disorder, has been estimated to have caused major malformations in up to 341 Irish children between 1975 and 2015 after it was taken by their mothers during pregnancy.
    The drug, which is sold in Ireland as Epilim, is also believed to have caused neuro-developmental delays in 1,250 children.
    Many women were never warned of the risks that taking the drug during pregnancy would pose to their babies.
    Read full story
    Source: The Irish Independent
  13. Patient-Safety-Learning
    The average life expectancy of Americans fell precipitously in 2020 and 2021, the sharpest two-year decline in nearly 100 years and a stark reminder of the toll exacted on the nation by the continuing coronavirus pandemic.
    In 2021, the average American could expect to live until the age of 76, federal health researchers reported on Wednesday. The figure represents a loss of almost three years since 2019, when Americans could expect to live, on average, nearly 79 years.
    The reduction has been particularly steep among Native Americans and Alaska Natives, the National Center for Health Statistics (NCHS) reported. Average life expectancy in those groups was shortened by four years in 2020 alone.
    “Even small declines in life expectancy of a tenth or two-tenths of a year mean that on a population level, a lot more people are dying prematurely than they really should be,” said Robert Anderson, chief of mortality statistics at the NCHS.
    Read full story (paywalled)
    Source: The New York Times (31 August 2022)
  14. Patient-Safety-Learning
    More than ten million patients are on “hidden” waiting lists for NHS care.
    There are 6.7 million patients on the official NHS waiting list, which includes people who have been referred by GPs for hospital treatment such as cataract or hip and knee surgery.
    However, data released by health service trusts under freedom of information laws suggests there are 10.3 million further patients who need follow-up care, illustrating the scale of the task facing the NHS.
    Louise Ansari, national director at the patient group Healthwatch England, said: “Waiting a long time for treatment can put a huge strain on patients and their loved ones. But this can be so much worse when there is ‘radio silence’ from the NHS, leaving people uncertain if their referral has been accepted, unclear about how long they may have to wait and often feeling forgotten.”
    Read full story (paywalled)
    Source: The Times (30 August 2022)
  15. Patient-Safety-Learning
    Patients waiting for surgery are turning up at A&E because they “can't cope”, the head of the NHS Confederation has warned.
    Matthew Taylor, chief executive of the body which represents all areas of the health service, said the NHS was in a "terrible situation" where it was facing "more demand than we can deal with".
    Some 6.7 million people are waiting to start hospital treatment after being referred by their GP, latest official data show. Urgent and emergency care is also under significant pressure, with 12-hour A&E waits increasing by a third in July to reach 29,317 - the worst on record.
    "We also know that people, many people, who are sick in the community waiting for operations, for example, and that's one of the reasons people end up in the emergency department because they get to the stage where they can't cope,” Mr Taylor said. "So the problem is that pressures in one part of the system drive pressure in others.”
    Read full story (paywalled)
    Source: The Telegraph (30 August 2022)
  16. Patient-Safety-Learning
    A coroner has expressed concern at the difficulty of getting face-to-face appointments with GPs and other health professionals after a 17-year-old boy suffering from mental health problems was found dead.
    Sean Mark, who described himself as an “anxious paranoid mess”, was desperate for help but felt “palmed off” when he asked for assistance, an inquest heard. He was found dead in his bedroom four months after a phone consultation with a GP and before he had spoken to anyone in person about his concerns.
    The area coroner, Rosamund Rhodes-Kemp, recorded a verdict of death by misadventure, saying she could not be sure Sean had intended to kill himself.
    Dr Robin Harlow, clinical director of the Willow Group, where Sean Mark was a patient, said it had increased the number of face-to-face meetings. When told that Sean felt palmed off, he said: “I would want him to be seen face to face at the second time, if not the first time. We have seen a lot more face-to-face appointments since then.”
    Read full story
    Source: The Guardian (23 August 2022)
  17. Patient-Safety-Learning
    Nurses at 15 hospitals in the Twin Cities area (Minneapolis-St Paul) and Duluth, Minnesota, that are negotiating new union contracts with their respective hospitals have overwhelmingly voted to authorize a strike. A date for the work stoppage has not been set yet by the union, the Minnesota Nurses Association, which represents about 15,000 nurses who voted on the strike authorization, but a 10-day notice must be given ahead of any strike.
    If a strike is carried out, it would be one of the largest nurses’ strikes in US history.
    Jayme Wicklund, a registered nurse at the Children’s hospital in St Paul, Minnesota, and member of the negotiating committee, said, “We need more resources to take care of the patients. The hospitals are very focused on wages. We have to be comparable to other places. But that’s all that they focus on. Once you start talking about wages, they don’t want to talk about the other important issues around patient safety or actually, other ways to save money.”
    Read full story
    Source: The Guardian (23 August 2022)
  18. Patient-Safety-Learning
    Hospital bosses have warned that they face “impossible choices” under Liz Truss’s plan to divert £10 billion a year from the NHS to social care.
    They say that her pledge to remove cash earmarked for the health service will “slam the brakes” on efforts to tackle record waiting lists, with patients bearing the brunt.
    An extra £36 billion has been ring-fenced for health and care spending over the next three years, of which less than £2 billion a year is due to go towards social care. Truss, the frontrunner in the Conservative leadership contest, has announced that as prime minister she will divert the entire amount to local authorities to pay for older people’s care. This would create a £10 billion shortfall in annual NHS spending, the equivalent of imposing a 7 per cent budget cut on the service.
    NHS bosses say that they would have no choice but to cut services as they face the worst winter crisis in living memory, forcing patients to wait longer for treatment. There are already 6.7 million people on waiting lists, while patients are dying because of a sharp increase in ambulance response times and accident and emergency waiting times are the worst on record.
    Truss told a Times Radio hustings: “I still would spend the money. I would just take it out of general taxation rather than raising national insurance. But I would spend that money in social care. Quite a lot has gone to the NHS. I would give it to local authorities.”
    Read full story (paywalled)
    Source: The Times (25 August 2022)
  19. Patient-Safety-Learning
    At the beginning of this year, there was a thrum of excitement among global health experts: Eradication of polio, a centuries-old foe that has paralyzed legions of children around the globe, seemed tantalizingly close.
    But there were several ominous setbacks.
    Malawi in February announced its first case in 30 years, a 3-year-old girl who became paralyzed following infection with a virus that appeared to be from Pakistan. Pakistan itself went on to report 14 cases, eight of them in a single month this spring. In March, Israel reported its first case since 1988. Then, in June, British authorities declared an “incident of national concern” when they discovered the virus in sewage. By the time New York City detected the virus in wastewater last week, polio eradication seemed as elusive as ever.
    “It’s a poignant and stark reminder that polio-free countries are not really polio-risk free,” said Dr. Ananda Bandyopadhyay, deputy director for polio at the Bill & Melinda Gates Foundation, the largest supporter of polio eradication efforts. The virus is always “a plane ride away,” he added.
    Read full story (paywalled)
    Source: The New York Times (18 August 2022)
  20. Patient-Safety-Learning
    Senior leaders of an ambulance trust have been told their ‘extreme positivity’ has made them appear ‘out of touch’ as the Care Quality Commission downgraded the organisation’s rating to ‘inadequate’.
    The health watchdog has dropped the overall rating of South Central Ambulance Service Foundation Trust, as well as the provider’s ratings for safety, leadership and for its urgent and emergency care services, from “good” to “inadequate”.
    The CQC has served SCAS with a warning notice and has criticised the trust’s board for its “extreme positivity about its performance”, which “could feel dismissive of the reality to frontline staff.” The regulator also said it saw evidence “of executive leaders attempting to discredit people raising valid concerns” and was told that serious concerns including sexual harassment had been “brushed under the carpet”.
    The CQC, which published the report today, also said there was “no evidence” of action being considered by SCAS to manage risk for patients suffering long handover delays outside A&E departments, and that serious issues “had not been addressed internally”.
    Will Hancock, chief executive of SCAS, said the trust had an “extensive improvement plan” and is “committed to making things better”.
    Read full story (paywalled)
    Source: HSJ (25 August 2022)
  21. Patient-Safety-Learning
    Most hospital patients and care home residents in England will no longer be tested for Covid unless they have symptoms, the government has said.
    From 31 August, NHS and social care staff will also not be offered lateral flow tests unless they fall sick. Free testing for the general public ended in April in England, but continued in some high-risk settings.
    Health Secretary Steve Barclay said: "This reflects the fact case rates have fallen and the risk of transmission has reduced, though we will continue to closely monitor the situation and work with sectors to resume testing should it be needed."
    Read full story
    Source: BBC News (25 August 2022)
  22. Patient-Safety-Learning
    Two new London hospitals will not open until 2027 at the earliest, the BBC has been told.
    In 2019, the government pledged to build a new hospital in Sutton and another at Whipps Cross in east London. The St Helier complex in Sutton in south London dates back to the 1930s and much of the Epsom site is about 40 years old.
    But Dr Ruth Charlton, chief medical officer at Epsom and St Helier Hospital, said: "Our working conditions... are not fit for 21st century healthcare. We really feel that our patients and or staff deserve facilities that would allow them to deliver the quality of healthcare that we all wish to receive."
    A Department of Health and Social Care spokesperson said: "We have committed to deliver 40 new hospitals by 2030, backed by an initial £3.7bn. We are working closely with all the schemes in the programme and providing funding to develop their plans - final funding allocations are only confirmed once business cases have been fully reviewed and agreed. By taking a more centralised approach, we will reduce the overall time taken to build the hospitals and provide better value for money for the taxpayer."
    Read full story
    Source: BBC News (25 August 2022)
  23. Patient-Safety-Learning
    A report into the care of three women at a former mental health unit has recommended greater monitoring and scrutiny of private provision.
    The Norfolk Safeguarding Adults Board (NSAB) review focused on care given to women known as L, M and N, who lived at Milestones Hospital near Norwich.
    The women, in their 20s, were found to have visited accident and emergency 53 times, mostly due to self-harm. The unit shut down last year and the company that run it has been dissolved.
    Heather Roach, chair of NSAB, said: "When vulnerable patients are placed in hospitals like Milestones, it's vital that our whole system works together to keep them safe. This review has shown that there are gaps in the monitoring of private provision, particularly when patients are placed in Norfolk from out of our county."
    Read full story
    Source: BBC News (25 August 2022)
  24. Patient-Safety-Learning
    People no longer believe the NHS will treat them quickly if they fall ill, according to new polling showing wide dissatisfaction about the state of the health service.
    With hundreds of ambulances stacked outside overstretched A&E departments and patients languishing on record waiting lists, voters are far more likely to say the service has worsened than improved in the last year.
    Fifty-eight per cent are not confident they would receive timely treatment from the NHS if they fell ill tomorrow, with 36 per cent not confident at all and 22 per cent just not confident. Meanwhile, 45 per cent believe the service they receive has worsened in the past 12 months. Just over half think it has become harder to get an appointment with their local doctor while 41 per cent think their local GP service has worsened.
    Robert Ede, head of health and social care at the Policy Exchange think tank, said: “It is concerning to see that a majority of the public don’t believe they would receive timely treatment from the NHS if they became ill tomorrow. There is a risk that the perception of a service in crisis beds in and actually leads to a complete erosion in public confidence."
    Read full story (paywalled)
    Source: The Times (27 August 2022)
  25. Patient-Safety-Learning
    Black and Asian people in England have to wait longer for a cancer diagnosis than white people, with some forced to wait an extra six weeks, according to a “disturbing” analysis of NHS waiting times.
    A damning review of the world’s largest primary care database by the University of Exeter and the Guardian discovered minority ethnic patients wait longer than white patients in six of seven cancers studied. Race and health leaders have called the results “deeply concerning” and “absolutely unacceptable”.
    The analysis of 126,000 cancer cases over a decade found the median time between a white person first presenting symptoms to a GP and getting diagnosed is 55 days. For Asian people, it is 60 days (9% longer). For black people, it is 61 days (11% longer).
    Michelle Mitchell, the chief executive of Cancer Research UK, which funded the research, said that while the differences are “unlikely to be the sole explanation for the inequalities in cancer survival”, at the very least “extended wait times may cause additional stress and anxiety for ethnic minority patients”.
    Read full story
    Source: The Guardian (28 August 2022)
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