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Patient-Safety-Learning

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News posted by Patient-Safety-Learning

  1. Patient-Safety-Learning
    There has been a "harrowing" rise in child deaths and serious cases of harm linked to to abuse or neglect of children since the first Covid lockdown, according to reports from the Local Government Association (LGA).
    Data has revealed there were 536 serious incident notifications in England between April 2020 and March 2021, with LGA saying it was a "huge cause for concern" and it is extremely concerned about children’s safety.
    Councillor Anntoinette Bramble, chair of the LGA’s children and young people board, has said, "The pandemic has put extra pressure on families, particularly those living in difficult circumstances, which can fuel harmful acts of abuse or neglect on children. Councils have been working hard with their partners to identify this and provide the help children need, but it is vital that children’s social care services are funded to meet this need.”
    Read full story.
    Source: The Independent, 21 August 2021
  2. Patient-Safety-Learning
    Almost 100 members of the army have been brought in to help four ambulance trusts amid staff shortages in the South Central, South West, North East and East areas of England, with Unison saying it was a sign "things were not right".
    Vicky Court, assistant chief operating officer at North East Ambulance Services has said "It will ensure everyone continues to get the care they need by freeing up paramedics to be more available to attend potentially life-threatening incidents."
    Read full story.
    Source: BBC News, 21 August 2021
  3. Patient-Safety-Learning
    Fifty senior consultants from a minority ethnic background at University Hospitals North Midlands have written to Tracy Bullock and trust chair David Wakefield asking for action to ‘protect’ staff from bullying behaviours following an internal survey in which 348 medics claimed to have experienced bullying and harassment.
    In a subsequent letter on 5 August, seen by HSJ, 50 doctors have now said: “We are forced to express our concerns over the prevailing poor culture within our organisation with most senior medical staff presently reporting they have suffered or witnessed first-hand discrimination, bullying, harassment, or victimisation. We… ask for urgent action by the executive and non-executive boards to immediately implement measures to protect senior medical staff from unacceptable ill-treatment.”
    A separate external review is now understood to have been commissioned amid concerns over bullying within ophthalmology services. 
    Read full story (paywalled).
    Source: HSJ, 19 August 2021
  4. Patient-Safety-Learning
    Ashford and St Peter’s Hospitals Foundation Trust, has apologised after nearly 1,000 patients faced delays due to a breakdown of referral systems. It was found 175 of these patients were considered urgent cases by their GPs and are now being reviewed for clinical harm. 
    When the error was discovered, the patients were added to the referral tacker by 9 July, however until that point, they had not been on any patient waiting list, nor were they visible to either operational management or clinical teams.
    Trust chief executive Suzanne Rankin said in a statement: “We are very sorry for any inconvenience these delays may have caused patients and we contacted all concerned and issued appointments where necessary.”
    Read full story (paywalled).
    Source: HSJ, 19 August 2021
  5. Patient-Safety-Learning
    Nottingham University Hospitals Trust has been served with a section 29a warning notice by the Care Quality Commission requiring it to ensure a ‘more positive culture’.
    A CQC spokeswoman confirmed: “The trust was issued with a warning notice requiring it to take action to improve corporate and clinical governance and oversight of risk, and to ensure a more positive, open and supportive culture across the organisation. We will report on the full findings from the inspection as soon as we are able to.”
    Although it is still not clear why the warning was issued, the trust is currently engaged in concerns over their accident and emergency department and maternity services. 
    “We accept the CQC’s comments and work is already underway to learn from the findings and make improvements so that the organisation is led as effectively as possible and we continue to provide world class care for our patients.” Nottingham University Hospitals Trust acting chief executive and chief finance officer Rupert Egginton has said. 
    Read full story (paywalled).
    Source: HSJ, 18 August 2021
  6. Patient-Safety-Learning
    According to new data, those who have been vaccinated against Covid-19, can still  harbour virus levels as high as unvaccinated people if infected with the Delta variant. This new data suggests that hitting the threshold for herd immunity remains unlikely. However, it evidence does show vaccination still offers protection against hospitals and infection. 
    “We don’t yet know how much transmission can happen from people who get Covid-19 after being vaccinated – for example, they may have high levels of virus for shorter periods of time, but the fact that they can have high levels of virus suggests that people who aren’t yet vaccinated may not be as protected from the Delta variant as we hoped.” said Sarah Walker, a professor of medical statistics and epidemiology at the University of Oxford.
    Read full story.
    Source: The Guardian, 19 August 2021
  7. Patient-Safety-Learning
    In a positive step towards the future of pathology, NHS Digital has received approval from the Data Alliance Partnership Board (DAPB) for a new set of pathology information standards, and as part of NHS England CCIO7 workstreams, NHS Digital are delivering the ability to share pathology results across health and care.
    This move will enable clinicians to share and access critical information about pathology tests and results and receive the right information when they need it, which will help support improved clinical decision making and patient safety. 
    Read full story.
    Source: Wired Gov, 19 August 2021
  8. Patient-Safety-Learning
    New data has revealed doctors are experiencing “worrying levels of abuse” during the Codi-19 crisis. 
    In a survey, doctors (51% of respondents) have reported that they have witnessed violence and abuse against other staff, with 67% showing this was particularly high for those working in general practice. 
    We cannot let people take out their frustration at a system on individual doctors or their colleagues, who truly are doing their best in the most difficult of situations. Even before the pandemic we were vastly understaffed, and abusive behaviour will drive more and more talented and experienced doctors away from the NHS at a time when we need them most . . . We urge our patients to afford the same compassion to staff that they are shown in hospital, after what has been the most horrific year of our careers.” Said The chair of the BMA’s Consultants Committee, Vishal Sharma. 
    Overall results for the abuse questions are here, and broken down by healthcare setting here.
    Read full story.
    Source: BMJ, 10 August 2021
  9. Patient-Safety-Learning
    This interview with April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, a critical care nurse, discusses how Nurse Practitioners are changing healthcare, the likelihood of all states granting full practice authority to NPs, and what the American Association of Nurse Practitioner members can expect from her for the next two years.
    Read full story.
    Source: American Medical Association, 16 August 2021
  10. Patient-Safety-Learning
    According to recent reports, the number of patients on waiting lists for non-urgent hospital treatment in Wales has again hit record levels. Data has revealed there were 624,909 people waiting in June, and those waiting the longest, more than nine months, rose again to 233,210.
    A Welsh government spokesperson said: "Waiting times for treatment continue to grow. However, it is encouraging to see progress being made with the number of patients waiting over 52 weeks falling for the third month in a row. We also saw the largest number of specialist consultations completed and treatments started in any month since the start of the pandemic."
    A&E time performance has been at its worst on record, with 94,176 attendances to emergency units over the month. Health spokesman Russell George said: "To record the worst ever A&E waiting times and the longest NHS treatment waiting list in the same month shows a complete lack of leadership."
    Read full story.
    Source: BBC News, 19 August 2021
    Related Reading
    Patient Safety Learning blog: Tackling the care and treatment backlog safely (19 August 2021)
  11. Patient-Safety-Learning
    Selena Brash, a clinical team lead with the East Hampshire school nursing team, has spoken out about the controversial plans to cut back public health nursing services in Hampshire.
    Ms Brash, in response to the Hampshire County Council plans to save £6.8m from its public health budget, started a petition earlier in the summer calling for increased funding “to protect the provision of school nurses”, warning that cuts to to public health school nursing services would “result in a detrimental effect on children and young people’s health and wellbeing, with lifelong consequences”.
    “If the cuts go ahead, then this could set a precedent for other local authorities to follow suit, meaning there would be a massive impact on the health and wellbeing of our young people and future generations,” Ms Brash told Nursing Times. 
    Read full story.
    Source: Nursing Times
  12. 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
  13. Patient-Safety-Learning
    After three Covid-19 patients died at the make-shift Nightingale Hospital in London following a breathing tube mix-up, NHS trusts in England could be issued tougher ventilation guidance. In each of the cases, filters which prevent the build-up of fluid were not attached to the machines, resulting in dangerous blockages, but it has not yet been determined if these incidents contributed to their deaths. 
    Coroner Nadia Persaud has said the way the machines vary from model to model can be "confusing" and may lead to future deaths, also ruling that the classification and colour coding was "worthy of review, simplification, and standardisation". 
    The original coroners report, carrying advice from an independent expert said "In my opinion, the non-standardised colour coding used by manufacturers of these filters, the number of different types of filters with different names, the variable optimal position of the filters, and whether a wet or a dry breathing system is being used, results in an extremely confusing situation. One of the leading manufacturers of these filters produces HMEs that are blue, which is the same colour as the non-HME filters supplied by another company. In my experience, few doctors and nurses working in ICU are knowledgeable about all these different filters and which ones should be used for any given breathing system."
    Inquests into the deaths are scheduled for October. 
    Read full story.
    Source: The Daily Mail, 17 August 2021
  14. Patient-Safety-Learning
    According to reports, the number of children being treated by the NHS has soared, with waiting times tripling in a year, and experts warning the pandemic may have set back treatment for young people "by years".
    The Royal College of Psychiatrists have also said services are struggling to provide timely treatment due to an "overwhelming" demand. 
    Dr Agnes Ayton, the chair of the Royal College of Psychiatrists Faculty of Eating Disorders Psychiatry, said: “The pandemic has had a huge impact on children and young people with disruption to their schooling, social lives and home lives. Many young people have not received support early enough, causing their eating disorders to become much worse and harder to treat. Delays to treatment can put lives at risk. Services are struggling with soaring demand, fewer beds because of social distancing and an ongoing shortage of specialist doctors.”
    Read full story.
    Source: The Independent, 19 August 2021
  15. Patient-Safety-Learning
    Vaccinated nurses will now be expected to return to work instead of isolating as new rules are set to relax.
    In a letter on the latest rule change from NHS England chief nursing officer Ruth May, chief people officer Prerana Issar, and medical director for primary care Dr Nikita Kanani said “Fully vaccinated staff and students who are identified as a contact of a positive Covid-19 case will no longer be expected to isolate and will be expected to return to work.”
    Staff returning to work are required to have been double jabbed, have no Covid-19 symptoms and receive a negative PCR test. This latest change in rules go in line with changes for the wider population. 
    Read full story.
    Source: Nursing Times, 16 August 2021
  16. Patient-Safety-Learning
    With just hours left to go, a health watchdog has paused a final update to ME treatment guidance due to disagreement on some of it's contents. Charities have expressed their anger over this decision as NICE says it needs more discussions with patient groups and professionals so that the advice is supported.
    Although it is not yet clear when the guidance will be published, the advice on CBT (cognitive behavioural therapy) has been changed as it was only helping with anxiety around the condition rather than the illness itself, with NICE acknowledging the controversy over the best treatment has served only to alienate many people with the condition.
    "We were extremely concerned that the final guidelines proposed by NICE may not have taken into consideration the extensive comments we made to the draft version, particularly in relation to treatments we know to have significantly benefited many patients." Andrew Goddard, president of the Royal College of Physicians, has said. 
    Read full story.
    Source: BBC News, 17 August 2021
  17. Patient-Safety-Learning
    A new study has found night shifts are "significantly associated" with health issues related to the heart, particularly atrial fibrillation, finding that women may be at a greater risk. The research, published in the European Heart Journal also found working night shifts is linked to an increased risk of coronary heart disease (CHD). 
    “Night shift exposure also increased the risk of CHD (coronary heart disease) but not stroke or HF (heart failure). Whether decreasing night shift work frequency and duration might represent another avenue to improve heart health during working life and beyond warrants further study,” the paper said.
    Read full story.
    Source: The Independent, 16 August 2021
  18. Patient-Safety-Learning
    1,500 safety recommendations have been made to NHS trusts a year after hundreds of babies were left brain damaged and dozens of mothers and infants died.
    Safety watchdog Healthcare Safety Investigation Branch (HSIB) has outlined key themes from 760 investigations of maternity incidents, taking over investigations for NHS trusts in 2018 after concerns were raised over the poor quality of investigation by trusts and a lack of involvement in families. 
    Sandy Lewis, associate director of maternity said: “The publication of the HSIB maternity programme year review provides crucial details of the work that has been undertaken in the last year. We would like to thank all of those who have worked with us in the past year, sharing their experiences, insights and expertise. Many families have not only told us their stories but have also trusted our investigators to reflect their perspectives and share their experience. Trusts have responded promptly to this insight, this has contributed to improving safer care of mothers, babies and families across the country.”
    Read full story.
    Source: The Independent, 16 August 2021
  19. Patient-Safety-Learning
    Providers fear 'fragmentation' of specialised services as NHS England begins delegating specialised services budgets to integrated care systems under reform plans.
    One leader of a specialist trust told HSJ: “There is a real risk of fragmentation. You can already see some of the conversations around various services around how people want to keep patients within their own ICS. There is the potential there for systems to buck the trend of centralising specialist services. Rather than bringing expertise and quality together, systems looking after budgets will look to set up their own specialist services.” 
    Read full story (paywalled).
    Source: HSJ, 17 August 2021
  20. Patient-Safety-Learning
    Plasma from blood donations in England will be used to make a life-saving drug whilst also helping to secure NHS plasma stocks to make the antibody-based medicines, called immunoglobulins. The service will begin roll-out in the coming months, with other parts of the UK potentially following suit. 
    Gerry Gogarty, from NHS Blood and Transplant, welcomed the decision, calling it a huge step forward. "By recovering plasma from blood donations, we can improve long-term supplies of immunoglobulin medicine, and each generous blood donation will go even further in helping to save the lives."
    Read full story.
    Source: BBC News, 17 August 2021
  21. Patient-Safety-Learning
    According to reports, Barts Health Trust and most other providers in the north east London health system may run out of blood tube collection products by the end of August. Though, according to notes seen by HSJ, a “mitigation plan with demand management in place this may extend into September”.
    After warning colleagues in north east London that the shortage of blood collection tubes made by Becton Dickinson affects “all NEL areas” except acute trust Barking, Havering and Redbridge University Hospitals Trust, Diane Jones, chief nurse of the NEL integrated care system has said “NHSE are looking at mitigations, but nothing confirmed as yet, and [they] may take a few weeks to come on stream. The mitigation may get us up to 50 per cent of usual supply in the short term.” 
    Read full story (paywalled).
    Source: HSJ, 13 August 2021
  22. Patient-Safety-Learning
    Coroners have raised multiple concerns that visiting restrictions are having a damaging effect on patient care and wellbeing, also raising the issue that families of vulnerable patients may be unable to pass on information to clinicians which would be relevant to their care.
    NHS Providers chief executive Chris Hopson said: “No trust makes the decision to suspend or restrict visiting lightly. Trust leaders understand the importance of allowing visitors, in a safe and manageable way, or finding alternative ways to enable particularly vulnerable patients to stay in touch with their families and carers. They are also aware of the important information that families and carers can provide about patients.”
    Read full story (paywalled).
    Source: HSJ, 16 August 2021
  23. Patient-Safety-Learning
    A hospital in Yorkshire has suspended all routine inpatient surgeries amid overcrowding in A&E caused by a lack of beds. Staff at the Mid Yorkshire Hospitals NHS Trust were told in an email that this had been a "critical issue for too long."
    “It is with regret that this decision has had to be made given that it will result in less patients receiving surgical treatment, slowing down our progress on reducing waiting times. However, the extreme pressure on beds has to be reduced and quickly. The trust consistently has between 25 and 50 patients waiting for a bed at any one time at Pinderfields emergency department, causing serious overcrowding and long delays [and] contributing to an unacceptable patient and staff experience.” Martin Barkley, chief executive of the trust, told staff.
    Read full story.
    Source: The Independent, 14 August 2021
  24. Patient-Safety-Learning
    The new head of NHS England has urged people not to ignore the signs of cancer and encourages people to get checked out if symptoms emerge, such a cough or stomach pain that won't go away.
    Experts believe certain cancers such as abdominal cancers - throat, stomach, bowel, pancreatic, ovarian - and urological cancers - prostate, kidney and bladder - are the most likely to go unrecognised and suggest anyone with symptoms to tell their GP. 
    "People should not feel like they cannot trouble the NHS, which is open and ready to treat people." NHS England chief executive Amanda Pritchard has said.
    Read full story.
    Source: BBC News, 15 August 2021
  25. Patient-Safety-Learning
    Performance data published by NHS England has revealed a big surge in the number of immediately life-threatening incidents ambulance services have responded to.
    The data also showed average response times have increased and a large number of patients are attending emergency departments. So far, the reason for the increase remains unclear, however, a potential factor could be the return of respiratory illnesses, particularly in children, as the lockdown has eased. 
    In a statement Association of Ambulance Chief Executives said, ”The reasons for the demand increases are complex and will include some patients who have not accessed care as early as they might have done normally and therefore present to the ambulance service as a high acuity patient and many patients who are contacting us for lower acuity issues which in some cases could have been managed by accessing other parts of the UEC system. We continue to work closely with NHS England to mitigate the demand as much as possible and encourage sign-posting of patients to other parts of the UEC system when that is a safe and more appropriate solution to their problem.”
    Read full story (paywalled).
    Source: HSJ, 12 August 2021
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