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Content ArticleThis ethnographic study looked at five local Healthwatch organisations to determine the extent to which they have fulfilled their intended role of fostering co-creation in health and social care in England. The study results demonstrate clear activity and some tangible impacts that have been achieved towards the aim of cocreation. However, the authors also highlight that the positioning of these organisations as 'collaborative insiders' in local governance systems has limited the issues that have been prioritised in co-creative activities. This analysis suggests that the increasing promotion of ideas of co-production in English health and social care has resulted in fertile grounds for localised co-creation. However, the authors highlight that the areas Healthwatch focused on were ones where other agencies in the system recognised their limitations, and where they knew they needed help to avoid socially undesirable outcomes. As a result, the approaches taken to co-creation by Healthwatch were largely conservative and constrained. The authors state that, "Even though they were not explicitly ruled out-of-bounds, Healthwatch officers knew that to be considered legitimate and serious players in the governance of health and social care, they needed to be selective about which issues they brought to the table."
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Content ArticleWhen Emma Powell experienced psychosis this year, she was told to go to A&E by the mental health crisis team. But she was left waiting for a bed for three and a half days, in conditions that only made her distress worse. In this article, Emma describes several experiences of trying to access crisis care for her schizoaffective disorder. She explains the impact of long waits at A&E and how they make her condition worse, with the overcrowded and busy environment causing overstimulation, and changing staff carrying out repetitive consultations causing confusion and exhaustion.
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Content Article
This month marks two years of the hub's Patient Safety Spotlight interview series. Patient Safety Learning's Content and Engagement Manager Lotty Tizzard reflects on the value of sharing personal insights and identifies the key patient safety themes that interviewees have highlighted over the past two years. -
Content Article
Top picks: Ten resources on eating disorders
Patient-Safety-Learning posted an article in Eating disorders
Eating Disorders Awareness Week takes place 26 February - 3 March 2024 Eating disorders are complex mental health conditions that affect an estimated 1.25 million people in the UK. There are many unhelpful myths about who eating disorders affect, what the symptoms are and how to support people in recovery. Alongside a current lack of appropriately trained staff and capacity in mental health services, this can make it challenging for people with eating disorders to access the help and support they need. Patient Safety Learning has pulled together ten useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders. They include awareness-raising articles, practical tips for patients and their loved ones, and clinical guidance for primary, secondary and mental health providers. -
Content ArticleTo decrease surgical site infections after appendectomy for acute appendicitis, preoperative broad-spectrum antibiotics are often used in clinical practice. However, this treatment strategy has come under scrutiny because of increasing rates of antibiotic-resistant infections. This multisite quality improvement project aimed to decrease the treatment of uncomplicated acute appendicitis with piperacillin-tazobactam without increasing the rate of surgical site infections. The intervention had two distinct components: Updating electronic health record orders to encourage preoperative administration of narrow-spectrum antibiotics. Educating surgeons and emergency department clinicians about selecting appropriate antibiotic therapy for acute appendicitis. Patient demographics, clinical characteristics and outcomes were compared six months before and after implementation of the quality improvement intervention. The intervention successfully decreased piperacillin-tazobactam administration without increasing the rate of surgical site infections in patients with acute appendicitis.
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Content ArticleTo tackle the serious harms, up to and including death, associated with eating disorders it is crucial that more is done to identify them at the earliest stage possible so that the appropriate care and treatment can be provided. This new guidance by the Royal College of Psychiatrists is based on the advice and recommendations of an Expert Working Group. It provides a comprehensive overview of the latest evidence associated with eating disorders, including highlighting the importance and role of healthcare professionals from right across the spectrum recognising their responsibilities in this area.
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Content ArticleIn this article, investigative journalist Scilla Alecci reports on a court case brought against medical tech company Medtronic by a US whistleblower. Former Medtronic sales representative Leanne Houston alleges that between 2016 and 2018 she witnessed the company engaging in “unlawful conduct” by offering several US hospitals free equipment in exchange for the exclusive use of Medtronic products. She also claims that the company failed to acknowledge and deal with reports from surgeons that one of its surgical staple devices was causing harm to patients.
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Content ArticleThis manifesto draws on the views of NHS Confederation members—health and care leaders across England, Wales and Northern Ireland. It suggests five changes that the next government will need to make in order to place the health and care system on a sustainable footing: Put the NHS on a more sustainable footing, with no top-down structural reform in England for the next parliament. Commit to a short-term stabilisation plan during the first 12 months of parliament to help get performance in the English NHS back on track. Increase NHS capital spending across the UK and reform how the capital regime operates. Specifically in England, capital funding needs to increase to at least £14.1 billion annually, a £6.4 billion increase from the current level of £7.7 billion. This is vital if we are to increase productivity and reduce waiting lists. Commit to fund and deliver the NHS Long Term Workforce Plan for England, alongside an equivalent plan for social care. Provide more care closer to home by enabling local health systems to proportionately increase investment upstream into primary care and community-based services, mental health and social care. Deliver a strategy for national health given that most policy that impacts people’s health is made outside the NHS. The Prime Minister should lead a cross-government national mission for health improvement to shift the focus from simply treating illness to promoting health and wellbeing, reducing inequalities and tackling the wider determinants of health, and supporting the public to be active partners in their own health.
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Content ArticleLeadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aimed to identify a framework, metrics and tools to improve surgical leadership and safety outcomes. It identified three areas of leadership needed to build a culture of safety in surgery: Control risk (risk management) Drive progress (opportunity management) Rally support for the mission (people management) A leadership assessment tool (SLAM) was developed to provide objective metrics of surgical leadership behaviours based on nine key performance indicators.
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Content ArticleOver the past decade, the implementation of simulation education in health care has increased exponentially. Simulation-based education allows learners to practice patient care in a controlled, psychologically safe environment without the risk of harming a patient. Facilitators may identify medical errors during instruction, aiding in developing targeted education programs leading to improved patient safety. However, medical errors that occur during simulated health care may not be reported broadly in the simulation literature. This study in the Journal of Patient Safety aimed to identify and categorise the type and frequency of reported medical errors in healthcare simulation.
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Content ArticleThis annual report published by the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) contains findings relating to people aged 10 and above who died by suicide between 2011 and 2021 across all of the UK. View an infographic outlining the report's key findings.
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Content ArticleIn this Guardian opinion piece, John Harris looks at reports of people with severe eating disorders being discharged from NHS services in the East of England. He shares the stories of several patients who are desperate to recover from their eating disorders, but have been discharged from specialist services because they are not showing progress in recovery. The article looks at the growth of a narrative that suggests some patients should not be treated if their eating disorder has reached a very severe state and highlights the way that this may be affecting practice and posing a significant risk to patient safety.
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Content ArticleEarly-onset colon cancer (EOCC) is increasing in the US and disproportionately affects African-Americans. This analysis in the American Journal of Surgery aimed to compare EOCC survival among Black and White patients after matching relevant socio-demographic factors and stage. The authors found that Black patients with stage 3 EOCC are less likely to receive chemotherapy and have worse survival than White patients. They call for further research to identify potential factors driving this inequality.
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Content ArticleThere is currently a lack of research addressing the impact of patient suicide on GPs. This qualitative study in BMJ Open aimed to examine the personal and professional impact of patient suicide, as well as the availability of support and why GPs did or did not use it. The authors found that GPs are impacted both personally and professionally when they lose a patient to suicide, but may not access formal help due to commonly held idealised notions of a ‘good’ GP who is regarded as being unshakable. Fear of professional repercussions also plays a major role in deterring help-seeking. A systemic culture shift which allows GPs to seek support when their physical or mental health requires it is needed, and this may help prevent stress, burnout and early retirement.
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Content ArticleFemale urologists report higher rates of work-related physical discomfort compared to male urologists. This study in the American Journal of Surgery compared ergonomics during simulated ureteroscopy—the most common surgery for kidney stones—between male and female urologists. The authors found that across all conditions, women required greater muscle activation in multiple muscle groups and had greater NASA Task Load Index (NASA-TLX) scores compared to men. These results suggest there may be gender differences in ergonomics during ureteroscopy based on muscle activation and subjective workload. There is therefore potential for personalising surgical workspaces and equipment.
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Content ArticleThis report by The King's Fund argues that the health and care system in England must shift its focus away from hospital care to primary and community services if it is to be effective and sustainable. It looks at a wholesale shift in the focus towards primary and community health and care across leadership, culture and implementation. Successive governments have repeated a vision of health and care services focused on communities rather than hospitals, but that vision is very far from being achieved. The report outlines research that explored the underlying factors that have prevented change, and what might need to be done to achieve the vision. The researchers analysed published evidence and national datasets, and interviewed stakeholders across the health and care system. The report concludes that to achieve community-based care, political and other national leaders will need to completely shift their focus away from hospitals towards primary and community health and care.
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Content ArticleBrain fog is one of the most common, persistent complaints in patients with Long Covid, affecting up to 46% of patients, many of whom also deal with other cognitive concerns like memory loss and difficulty concentrating. This Medscape article looks at new research suggesting these symptoms may be the result of a viral-borne brain injury that causes cognitive and mental health issues that persist for years. This may offer new options for treating brain fog and other cognitive symptoms associated with Long Covid.
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Content ArticleAiring Pain is a podcast from Pain Concern. Each edition brings together people in pain and top specialists to talk about resources that can help. This edition investigates the significant inequalities and disparities in treatment among primary care pain management services. It features the following participants: Professor Jonathan Hill, Director of Research for the School of Allied Health Professionals and Professor of Physiotherapy at the Keele School of Medicine; Dr Ama Kissie, post-doctoral fellow at the University of Ghent and a Clinical Psychologist; Dr Whitney Scott, clinical psychologist who lectures at Kings College London and is the research lead at the INPUT Pain Management Unit at Guy’s & St Thomas’ Hospital.
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Content ArticleThis descriptive and cross-sectional study in the Journal of Patient Safety aimed to examine the impact of nurses’ fear of Covid-19 on their nursing care behaviour during the pandemic. 450 nurses providing one-on-one care to Covid-19 patients between January and March 2021 took part in the study. The results showed that nurses providing care to patients during the pandemic feared Covid-19, that their care behaviours were generally at a good level, and that the care behaviours of nurses with a high degree of fear were negatively and significantly impacted.
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Content ArticleThis report by the Patients Association analyses the opinions and experiences of diagnostic testing services of more than 1,000 NHS patients. It highlights that patients view diagnostics as a fundamental part of the NHS—and one that should be prioritised. Most respondents (93%) want testing capacity to be invested in over the coming years so that patients can receive tests and diagnosis more quickly. Patients place such importance on diagnostics that 60% would consider paying for the tests they need if they faced a long wait on the NHS.
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Content Article
Can I be seen? Birthing while Black (17 February 2024)
Patient-Safety-Learning posted an article in Maternity
In this Lancet article, Lioba Hirsch shares her experience of labour and birth as a Black woman. She describes dismissive behaviours and blaming comments from several healthcare professionals that left her feeling unable to ask questions and advocate for herself and her baby. She suggests that the lack of compassion and dignity she was shown are a risk to patient safety: "I am so glad that my child was safe that day, but many children and their birthing parents are not and the slope from disrespect and disregard to dismissal and its consequences is a slippery one." -
Content ArticleThe Government plans to expand physician associate (PA) and anaesthesia associate (AA) roles and to establish the General Medical Council (GMC) as their statutory regulator. There has been concerted opposition to the plans by groups including the Doctors’ Association UK (DAUK) and the British Medical Association (BMA). Earlier this month, the House of Lords sent the draft legislation to the main chamber for proper scrutiny, stating that this was the procedure when an issue "is politically or legally important or gives rise to issues of public policy". In this Medscape article, Dr Sheena Meredith outlines the Government's proposals and why the issue has become so contentious.
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Content ArticlePrimary care appointments may provide an opportunity to identify patients at higher risk of suicide. This study in the British Journal of General Practice aimed to explore primary care consultation patterns in the five years before suicide to identify suicide high-risk groups and common reasons for seeing a healthcare professional. The authors found that frequent consultations (more than once per month in the final year) were associated with increased suicide risk. The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation, including females, patients experiencing less socioeconomic deprivation and those with psychiatric conditions. The commonest reasons that patients who went on to commit suicide requested consultations in the year before their death, were medication review, depression and pain.
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Content ArticleInfection Control Matters is a podcast in which infection control professionals discuss new research and issues on the topic of infection prevention and control. In this episode, Martin Kiernan and Phil Russo talk to Professor Michael Borg from the Faculty of Medicine & Surgery at the University of Malta They discuss a recent paper describing the stages that brought about a 90% reduction in MRSA bloodstream infections over a ten-year period.
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EventuntilThis webinar hosted by the Patients Association provides an opportunity to hear about the new Pharmacy First Service. Speakers include: David Webb, Chief Pharmaceutical Officer for England Pallavi Dawda, Head of Delivery, Clinical Strategy Community Pharmacy, NHS England Leighton Colegrave, member of Hertfordshire and West Essex ICB's Patient Engagement Forum Tunde Sokoya, community pharmacist, Essex Lindsey Fairbrother, community pharmacist, Derbyshire. The Patients Association Chief Executive Rachel Power will chair the webinar. Register for free.
